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Healthcare Development & Architecture

E-Health and Telemedicine ~ A Matter of Buying Solutions

Healthcare Development & Architecture

From computers to RFID chips, technology is part of our daily lives. In the healthcare arena also, e-health and telemedicine practices are raising offering to patients and hospitals a new relationship and state-of-the-art medical services. Dr. Dennis J. Streveler, HMIS Consultant from The World Bank provided a virtual presentation to a select group of healthcare cluster participants in presenting his views on technology in healthcare.

Connecting in from Algeria, Dr. Streveler shared that e-health along with telemedicine are truly large domains. According to him, through his experiences working with developing countries, the application of e-health and telemedicine can be diverse according to the environment they are use in.

E-health is an extension to the internet of existing core business processes in healthcare. E-health simplifies the exchange of information and services for health consumers such as citizenry, patients or even participating providers. However, e-heath can only work if providers, insurance or buyers are taking the time to upload and update their information on internet.

“A good example of this type of structure is eligibility checking for insurance,” Streveler said. “We can check by Internet if we are, or not, eligible for insurance. However, if the database containing the eligibility information is not accurate, then not much will be accomplished.

Also, e-health is enabling and allowing secure email between patients and their providers. This has proven to have an enormous impact in improving quality especially for chronic disease situations. A Kaiser Permanente study discovered that email alone had as much impact as the billions of dollars spent to date on Electronic Medical Records.

Another e-health capability typically explored into by many hospital providers is telemedicine. In terms of telemedicine capabilities the answer and solutions are not so simple. Depending on coordinating time zones, real-time applications can take place, but, have an expensive cost. Indeed, the providers’ schedules tend to require large telecommunications networks which translates into significant expenses. Nonetheless, there currently exist some simple off-line methods. For teleradiology it’s all about improving the coverage area of scarce well-trained radiologists, telecardiology easily enables the suitability for surgery process for patients, and teledermatology permits to take a quick look at nasty lesions.

In the medical tourism arena, e-health applications are an advantage in terms of pre and post surgery, patients will feel more confident about their medical travel and host hospital. Dr. Streveler qualified e-health as crucial for the medical tourism industry. “It serves as a glue for the patient referral process, and later, as part of the follow up process,” he said.

However, according to Streveler, the modalities chosen will depend on the nature of the referral network, the nature of the procedures performed at the medical tourism site and the means used to market its services.


Nowadays, patients have come to expect technology to be everywhere. From a hospital provider perspective, competitors are using state-of-the art and advanced technology to their market advantages. “Those avoiding jumping on the bandwagon will surely be pushed aside in the globally competitive market” Streveler said. However, one must keep in mind it is not an inexpensive investment to make. Therefore, done properly would require strategic input in terms of what an institution is trying to accomplish; ways to measure its success based on objectives determined in advance; and a keen eye on finding the right modalities that are bought or built-in house to meet the hospital provider and/or organization’s needs.

Finally, Dr. Streveler stressed that integration is the key and makes the difference between effective technological capabilities and ‘toys’. E-Health applications must be considered as part of the biggest health informatics initiatives of any particular institution. Rather than considered and applied within a microcosm, they are best served if the platforms wrap around all of the other systems initiatives. Undoubtedly, this giant puzzle is a challenge; even for the most tech-savvy of world-class institutions.
“In effect, keeping one’s eye clearly on the objective and not being swayed by gadgetry of the day, fads and other distractions should serve a hospital, clinic or country in good stead,” Streveler said. “The key is that one is buying solutions, not buying technology.”

Some of the distinguished delegates from countries that are all engaged in various stages of healthcare cluster development included: Dr. Awni Al-Bashir ~ Chairman ~ Jordan Private Hospitals Association, Dr. Abdalla Al Bashir ~ Chairman Board of Directors ~ Jordan Hospital, Caroline Haddad ~ Medical Services Sector Lead ~ USAID Jordan, Laila Al Jassmi and Tony El Zoghbi of Dubai Health Authority UAE, Dr. Mukitani and members of Japan’s Ministry of Health, Labour and Welfare; Ministry of Global Health; Massimo Manzi ~ Executive Director at Council for International Promotion of Costa Rica Medicine – PROMED ~ Costa Rica, Nixia Lasso ~ Marketing Executive and Product Development~ Authority of Tourism Panama, Julia Lima ~ Director of Public Relations ~ Porto Alegre Healthcare Cluster Brazil, David Morgan of OCED, James Bae and Dr. Do Hyun Cho of KHIDI, Seoul – Korea.

This group also heard from David Morgan of OECD, who commented that there is a growing importance of medical tourism in terms of overall trade and services between countries. Understanding the extent of this bilateral, multilateral trade is of importance to many agencies. Currently, OECD is championing the lead in evaluating ministerial guidelines as one project in medical tourism. Dr. Jeanette Takamura, also provided a short summary overview of the keynote speech during WMT&GHC. Drs. Streveler, Takamura and Morgan provided an opportunity for Q&As; while delegates discussed their respective clusters amongst each other.

About the Author

Vivian Ho is President of AGHP, a 501c3 that works on global health philanthropy ventures. She also serves as Managing Director, Asia Pacific for MTA, and Co-Editor of MTA’s health tourism e-magazine. Prior to this, Vivian was President & CEO of Queens International in Honolulu, Hawaii building Hawaii’s medical travel & health tourism initiative. She currently advises on country, sector and organization initiatives in Medical & Health Tourism. She may be reached at

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