Challenges facing healthcare systems
In 2018, world’s healthcare systems are facing unique and mounting challenges.

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In 2018, world’s healthcare systems are facing unique and mounting challenges. Until now, growing demand has been met with ongoing increases to resources, expanding budgets and recruitment to meet demand. However, according to research, by 2030 this will not be a sustainable strategy. This means that more coordinated, coherent and innovative healthcare services will be needed to meet expectations of healthcare quality and accessibility. Establishing and adapting services in this way can be a lengthy process, meaning now is the time to look for alternative solutions. E-health could be the solution to the challenges presented by the future of healthcare in an ever-changing world.

Growing elderly populations
In Norway alone, by the year 2030 there will be around 300,000 more elderly people (over 70 years old) than there are today, an increase of 50%. The consumption of health services among those over 70 is twice as high as for 40-year-olds, creating an increased need for health services. Furthermore, as life expectancy increases, this elderly population is set to continue to grow in future years, meaning significantly more patients needing healthcare. Our population isn’t just aging, it’s growing too. Immigration is causing populations to swell in size which places greater demand on healthcare services, in particular in the case of refugees and asylum seekers who may need urgent mental and physical healthcare. 

Settlement patterns
It’s crucial to also look at changing settlement patterns: more people than ever are moving to cities, meaning populations become concentrated there. However, this is mostly the case among younger people who have greater mobility, with older people left in suburbs, outskirts and rural areas. This presents a challenge because occasionally areas outside of cities have less healthcare personnel, slower access to new technologies and resources - leading to a disparity in the healthcare services inside and outside urban centers. 

Changes in diseases 
Though developments in medicine mean that treatment for existing diseases will improve, we must be aware of changes in the map of diseases that continue to affect populations, in order to prepare for anticipated spikes or rises in particular illnesses. For instance, the prevalence of diabetes (type 2 diabetes and type 1 diabetes) is predicted to increase by 54% to more than 54.9 million Americans between 2015 and 2030. Similarly, it’s anticipated that the number of cancer cases in Norway will increase by 42% for men and 27% for women by 2030. A rise in these life-threatening diseases poses a further challenge to the healthcare systems of modern societies, which will need to offer the flexibility to integrate cutting-edge treatments for diseases such as cancer and others that may arise among the aging populations of years to come.  

Changing expectations
Since we access so many services such as transport, banking and taxis from our phones, laptops or tablets, a new kind of patient is emerging with a modern set of expectations for their healthcare services. Self service portals are increasingly common and users can connect with services via social media, meaning more patients expect to communicate digitally with a specialist health service. They expect a greater level of flexibility from their health services, and a willingness to change and adapt with the times and to their personal preferences. Everywhere the modern customer travels, their data travels with them, they also expect an intuitive service which can manage and store their data safely and easily. Furthermore, with many treatments and care able to be performed closer to the patient in local care centers or smaller hospitals, the idea of traveling for healthcare is becoming a thing of the past. Plans for the future health services will need to take these challenges into account and adapt in order to be able to provide for an ever-evolving and increasing demand. E-health may be the solution to this issue. 

By opening the possibilities for new alternative and more efficient ways for patients and clinicians to communicate, e-health also therefore opens the possibility for more streamlined healthcare services. In providing patients and medical professionals with more direct, simple and effective pathways of communication, feedback from patients can be more easily gathered, meaning services can be improved and research accelerated too. This will better enable professionals to monitor the progress of rehabilitation or the effects of treatment or medication, and bring them closer to patients in the long term through follow-ups, supervision and the ability to answer ongoing patient queries. 

What is e-health? 
E-health refers broadly the use of technology to offer care to patients. It’s a buzzword often used to describe anything related to computers and medicine. However, Gunther Eysenbach has defined it as the “emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies.” It can be seen as more than just technical development too: e-health is also a way of thinking, a state-of-mind and an approach to solving the challenges of healthcare in a way that leverages information and communications technology to improve healthcare for all. 

How could e-health be applied? 
By offering digitized healthcare services where possible to those that are interested in or willing to receive their treatment this way, we can free up time and resources to be allocated elsewhere, such as to the growing population of elderly people. These alternative approaches might be beneficial to those who would like to live at home as long as possible with e-health monitoring via IoT devices such as weight scales or blood pressure measurement tools. They will provide clients with more flexible services they can organize with ease, without wasting time. 

E-health and obesity
In dealing with the growing problem of obesity, e-health solutions could be employed to offer workout or nutritional programs, to follow-up on face-to-face treatment, to provide motivation to persevere with diets and strict programmes. Crucially it can also be used to report numbers back to doctors and healthcare professionals. For instance, by connecting a scale to IoT to report weight data or by utilizing smartwatches to track activity levels over time. 

E-health and rehabilitation
E-health could also open possibilities to improve rehabilitation treatment for patients following injuries or recovering from addiction. It can allow for better reporting of progress towards defined targets, help to motivate patients to maintain independent activities like physiotherapy programs and to enable digitized follow-ups.  

E-health and mental health treatment 
Given that a key barrier to patients seeking mental health treatment is the potential embarrassment of going to see a therapist or psychiatrist, e-health could be particularly transformative for mental health treatments. It facilitates an open channel of conversation with a healthcare professional, the opportunity for follow-ups and tracking progress over time. It reduces travel-time for patients which can lead to higher levels of engagement. 

E-health and pregnancy
Pregnant women present a key target for e-health solutions, in particular in guiding customers through a 9-month ‘project-based’ solution. E-health could be used to support midwifery and check-ups, to promote healthier lifestyle during pregnancy, and to build communities. 

Conclusion
Therefore, it’s clear that the healthcare of tomorrow must be adapted to deal with these growing and ever-evolving challenges, whilst also allowing for the rapid application of new research and treatment methods in key areas of application. This will be facilitated by closer cooperation between different hospitals, as well as between hospitals and local governments, research and education centers. By putting economic sustainability and adaptability at its heart, e-health could provide the solution to the world’s future healthcare issues. 

An example of the application of e-health to confront healthcare challenges is Health Village, an online service which relays information and support both to patients, in the form of care, and professionals, in the form of healthcare tools. As a virtual hospital which can be accessed at any time, from anywhere, it has ‘buildings’ for specific needs like pain management, rehabilitation, mental health, and weight management. This is an example of a customer-centric service which has improved care standards, response times and remote appointment quality, meaning human resources can be allocated where they are most needed. 

Health Village is evidence of e-health in action, and the initiative won a 2018 Microsoft Health Innovation Award. This successful project demonstrates how e-health could present a sustainable and effective solution to the serious challenges facing healthcare systems around the world in coming years.

Thorstein Rinde
Senior Account Manager 
Innofactor