Govert Veldhuijzen

22 Chapter 1 Many valuable lessons can be drawn from the literature as summarized in this introduction. The main take home messages were 1. how the content of education should be designed, 2. what the most optimal strategy is to present this to the patient and 3. how this will affect the patient in several clinically relevant outcomes. The following section describe briefly the definition, history and use of eHealth interventions. DEFINITION AND BACKGROUND OF eHEALTH The history of eHealth started with ‘Telemedicine’; remote care for patients with no physical contact between patient and caregiver. In 1929 the first telemedicine publication was on Flying Doctors in Australia, that provided a telegraph service using Morse code for emergency medicine. 115 This is a good example of the fact that the first prerequisite is adequate communication technology before eHealth implementation can follow. A further relevant historical overview is depicted here. (Figure 2.) Figure 2. Timeline of eHealth development (blue) and virtual reality (gold) The advent of the Internet came with new challenges. Efforts to use this technology from 1999 onwards are referred to as eHealth. But the wide span of these efforts has resulted to a myriad of different definitions. 116 The most widely adopted definition of eHealth is: “eHealth is an emerging field of medical informatics, referring to the organization and delivery of health services and information using the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a new way of working, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”. 117