The concept of e-health introduces new channels of communication and transactions in healthcare and challenges the traditional definitions of patients' and providers' roles. E-health is often viewed as the digital transformation of care delivery and redesign of the business models that prevail in the health care industry. For the purposes of this book, we define e-health as the use of advanced telecommunications such as the Internet, portable and other sophisticated devices, advanced networks and new design approaches aiming to support healthcare delivery and education. Thus, e-health refers to a fundamental redesign of healthcare processes based on the use and integration of electronic communication at all levels. It aims to lead to patient empowerment which describes the transition from a passive role where the patient is the recipient of care services to an active role where the patient is informed, has choices and is involved in the decision making process.

Within the context of e-health, the term “consumer health informatics” is often used to describe the study of behaviors and information seeking patterns of patients in their role as consumers of health related information and managers of their health decisions. Obviously, the Internet has played a great role in enabling consumers to access a wealth of information and exchange knowledge with peers and support groups. However, other advanced technologies have also introduced innovative ways of empowering patients and improving the patient-provider communication. Technological advances such as wearable devices and sensors that capture and automatically transmit vital signs, mobile applications that enhance care delivery and enable disease prevention or early detection and new applications of electronic medical records are emerging. In addition to the evaluation of the impact of such applications on the health status of citizens, we need to address issues related to policy and reimbursement and furthermore, create an ethical framework for the design and implementation of such systems. The ethical issues are also an integral part of research in the era of post-genomic medicine.

E-health has the potential to improve efficiency on a global level when patients cross national boundaries to seek treatment in other countries and to enable medical facilities and services across countries to be linked and accessible to citizens. This book is the result of a two-day conference that took place in February of 2004 in Columbia, Missouri. The conference was sponsored by the European Union Center of the University of Missouri-Columbia and the Department of Health Management and Informatics and examined issues of e-health applications in the United States and Europe. Guest speakers from Europe and the US covered a broad range of e-health issues and carried out a dialogue between researchers, practitioners, vendors and consumers. Discussion topics focused on the use of mobile technologies in health care, “smart home” technologies, telemedicine applications that cross national borders, transatlantic collaborations in bioinformatics and the use of the Internet in health care. Furthermore, legislative efforts and ethical concerns associated with the diffusion of e-health were discussed and policies in the EU and the US were reviewed and compared.

This book reflects the discussion that was fostered by the conference and covers a wide range of topics related to e-health research. The contributors are academic researchers from the European Union and the United States and are presenting current work, future trends and a discussion of challenges that will arise in the coming years.

The concept of telemedicine is obviously an essential component of the e-health era. Hicks and Boles present a model that provides a systematic framework to be used in evaluating the effectiveness, efficiency, and feasibility of telemedicine. Demiris describes telehomecare and smart home applications and provides an overview of an evaluation framework for home-based e-health applications and the associated implementation challenges.

E-health will have a great effect on medical education. Headrick describes the qualities required for future physicians to deliver the care that their patients need and deserve, in the context of e-health. There are professions that might have been traditionally not included in the digital transformation of medicine that can benefit from the use of new technologies. Oliver and Demiris discuss the potential application of e-health tools for social workers. The use of such tools impacts the way health care professionals and researchers conduct their work. Patrick et al address the issue of standards for information retrieval to support decision making in e-health.

Contributors of this book also discuss innovative technologies and new concepts that are being introduced by e-health. Schopp discusses the concept of telework for people with disabilities and provides a comparison of the current status in the United States and Europe. Mitchell explores ways that the Human Genome Project will change health care and she also investigates the ways that e-health systems will be influenced by the genomic data. De Moor and Claerhout highlight the relevance of privacy enhancing techniques in the context of e-health. Chan defines and discusses health captology, the application of persuasive technology to health care, and its potential to leverage proven persuasive techniques to improve clinical outcomes.

Finally, specific projects that are currently being carried out and demonstrate future trends, are being described. Van Halteren et al. describe the MobiHealth system which is based on the concept of a Body Area Network (BAN) allowing high personalization of the monitored signals and thus adaptation to different classes of patients. The system and service have been tested in four European countries. Pinciroli et al provide a description of an audible web-based medical record for emergency patients and in a different chapter discuss service level web monitoring in the field management of emergencies. Pedersen provides an overview of e-health in the Nordic countries and the way the national health care system of a country impacts the diffusion rate of e-health.

I would like to thank all of the contributors of this book. I wish to acknowledge and give special thanks to Dr. James Scott and Dr. Kelly Shaw of the European Union Center at the University of Missouri-Columbia for assisting and supporting me in the organization of the e-health conference and the invitation of guest speakers from different parts of the world. Furthermore, I would like to thank Dr. Gordon Brown, Chair of the Health Management and Informatics Department and Dr. Joyce Mitchell, Director of Informatics and Director of the National Library of Medicine Biomedical and Health Informatics Training Program at the University of Missouri-Columbia for their advice and support, and David Moxley, Associate Director of the Executive Informatics Program, for his valuable assistance in the editorial process.