Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

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Difficulties in achieving health targets, such as the Millennium Development Goals, and growing consumer demand have forced health planners to look for innovative ways to improve the outcomes of health-care and public-health initiatives while controlling service costs.


Health systems must address diverse population needs, provide high-quality services even in remote and resource-poor environments, and improve training and support for health-care workers.


Services that can be scaled up and are reliable (despite any infrastructural deficits) and cost-effective are in high demand worldwide, especially in low- and middle-income countries. E-health systems have the potential to support these objectives in ways that are both economically viable and sustainable.


E-health tools are designed to improve health surveillance, health-system management, health education and clinical decision-making, and to support behavioural changes related to public-health priorities and disease management.


 Some systematic evidence of the benefits of e-health in general, and of specific areas of e-health, such as decision-support systems for clinicians or patient-targeted text messaging, already exists. The objectives of the current review were to highlight gaps in our knowledge of the benefits of e-health and identify areas of potentially useful future research on e-health.


There were three main topics of interest: outcomes among patients with chronic health conditions, the cost-effectiveness of various e-health approaches, and the impact of e-health in low- and middle-income countries.

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