Glossary of Terms - Products / Services

Our services are extensive and include all aspects of telehealth, e-health, telemedicine and the application of Information Communication Technology (ICT) in health care. The following terms will better describe the scope of our services and aid in the understanding of the terminologies we use:

Buy-in refers to the acceptance by health care professionals, management and other Stakeholders of what the Client is attempting to accomplish. In the context of ICT integration, it is a vital element which will, in most cases, determine the success or failure of any system. If Stakeholders do not have an understanding of what is intended, Buy-in is not achieved.

Digital works with the Client to develop 'champions' (knowledgeable Stakeholders who believe in what is to be accomplished). We have found that involving key Stakeholders in the development process at an early stage is tremendously beneficial to the Client and aids us in the integration of the ICT system. Because a health care system has several components, we take a multi-disciplinary approach to the services we provide. Our team of experienced physicians, lawyers, business and financial advisors, health care administrators, project managers, change management experts, educators, computer programmers and networking consultants are prepared to address all aspects of the Client’s organization to maximize buy-in and enhance the success of the program.

Change Management is the process of controlling changes to the health care infrastructure as a result of technology integration, thereby enabling these approved changes with a minimum of disruption to the health care delivery process. We work with the Client to develop the necessary processes to accommodate internal and external change that integrating ICT will necessitate. The procedure we utilize often involves the use of questionnaires, interviewing health care professionals & management, as well as working with the Client to develop Committees to oversee this process.

Cost Benefit Analysis is an appraisal technique that attempts to place values on all benefits arising from a project and then compares the total value with the project's total cost. Ascertaining benefits may not be solely restricted to financial benefits. Integration of ICT can often increase access to care (telemedicine and telehealth) and can generate a time benefit to the health care system (e-Health). This in-turn can contribute to an increase in the quality of care as well.

E-Health (Electronic Health) refers to health services and information delivered or enhanced through computerization and/or the Internet and related technologies. Although there are many interpretations to what e-Health is, it can also be seen as the computer programs (software) that are used to maintain EHR/EMR/EPR, financial and management systems and to facilitate the processing and security of this information.

Digital works with the Client to select the appropriate systems that will provide the correct solution for the Client. This must ensure interoperability with current and future systems and address the Client’s training requirements (face-to-face, video conference or on-line). We have also been retained to assist in the development of RFPs and the selection process of the proposals received to select the right Vendor. E-Health systems are also integrated into current or future telemedicine or telehealth processes to ensure a seamless and secure transfer of information. Our development of e-Health portals can harness the power of the Internet and are especially useful for patient and health care professional education.

E-Learning (Electronic Learning) is education delivered via the Internet, a network or a stand alone computer. Video conferencing is also used for Continuing Medical Education (CME) and Continuing Nursing Education. The term 'Continuing Practical Education' is also used. Digital can develop secure educational Websites and Video conferencing networks for this purpose.

E-Procurement (Electronic Procurement) involves the use of electronic records that track inventory, facilitate ordering, project requirements and assist operational staff. Digital has gained experience in this area and has assisted our Clients with all aspects of this development.

EHR is an acronym for Electronic Health Record.

EPR is an acronym for Electronic Patient Record. The EHR or EPR are designed as a secure ‘cradle to grave’ record of the patient’s medical history. It addresses all aspects of what was previously recorded on paper and/or film, microfiche, etc. As these records are stored electronically they can be easily distributed to those health care professionals who have a ‘need to know’ this information. Digital has assisted our Clients with not only integrating these records but doing so in a manner which will conform to provincial/state and federal legislation. We are often requested to make recommendations or provide solutions to the areas of liability, security, interoperability and training.

Financial Analysis in the context of the planning process, attempts to ascertain whether the project will be financially viable in the sense of satisfying the return expectations of the senior management. Various aspects are considered including: investment/cost of the project, projected cost savings, break-even point, project cash flow, projected financial position and level of risk. The Financial Analysis can often form an important segment in the Cost-Benefit Analysis where non-financial benefits of the project may be evaluated. In some circles this may be referred to as an economic analysis. Digital can provide experienced financial professionals to address the often complex financial areas of planning and evaluation.

HIS is an acronym for Health Information System. The HIS is often considered to be a record of all information applicable to a health care facility (or group of facilities). This information includes all electronic records applicable to business management and operation of the facility.

HL7 is a standard for health information.

ICT is an acronym for Information and Communication Technology. Previously referred to as IT (Information Technology) the term ICT refers to the expansion of information systems to include wireless, Internet, Intranet, network and other technologies such as video conferencing.

Information Technology Management involves an organized approach to the acquisition, storage, manipulation, management, control, display, exchange, transmission and reception of data or information.

Installation is the act of installing physical systems, such as computers, video conferencing equipment, telecommunication routers, wireless networks and computer software programs for use within a telehealth, telemedicine or e-Health system. It may also include the design of rooms (paint, lighting, security) for use with these systems.

Interoperability is the ability of different types of computers, networks, operating systems, and applications to work together effectively, in order to exchange information in a useful and meaningful manner. There are four aspects of interoperability: clinical, technical, operational and language. Considering that hardware and software may be purchased at different times (versions), or from different manufacturers, Interoperability is a major component in the ability of any ICT system to function as designed. Digital's resources include computer scientists, networking specialists, engineers and project planners that will work with you to insure that ICT systems are interoperable with your infrastructure and Stakeholders.

E-Lab Systems (Electronic Laboratory Systems) make use of software to facilitate laboratory workflow, enabling users to provide higher levels of service.

Needs Assessment is a business process that involves researching how health care is practiced and making an assessment of gaps and priorities in the processes used. The needs assessment investigates how the implementation of ICT may provide and/or supplement the current delivery model in a cost-effective and sustainable way. Digital works with the Client to understand the limitations of technology, as well as which technologies should be integrated and when. It has been our experience that health care facilities want to employ a specific technology without a bona fide requirement to do so. We assist the Client to understand when and why a technology should be employed and the potential return on investment.

E-Pharmacy Systems (Electronic Pharmacy Systems) make use of ICT to track the use of prescribed medications, inventory, facilitate the ordering process and assist operational staff. Digital has gained experience in this area and has assisted our Clients with all aspects of this development.

Policy & Procedures have a very important role in the development of an ICT program. It is important to consider policies and procedures that are currently in-place and ascertain how they may be needed to be revised to accommodate business in an ‘electronic environment.’ New policies may be required for operational purposes, to mitigate liability and conform to legal statute. One area of particular importance is that of confidentiality of patient information, for example. Digital can provide legal advisors and policy experts to assist the Client in the development and revision of policies and procedures. Moreover, we can develop databases, CDs or a Web portal to facilitate stakeholder education.

Program Planning entails planning for the implementation of an ICT system in the context of the current enterprise and in-light of social responsibilities. The context includes business strategy, financial management, legal responsibility, liability, conformance to policies and procedures and other human and cultural factors. Digital can supplement current staff expertise in this area with experienced consultants.

Project Evaluation is the process of realistically measuring the work completed against known project management concepts and standards. Particular emphasis is put upon the project's alignment to business direction and priorities, accountability, joint work with other departments, sharing resources, working according to project management and corporate disciplines and risk management. Depending upon the scope of the project evaluation being conducted, it may address financial and other issues such as the training given and the satisfaction of all stakeholders in the service being offered. Ideally any project should be monitored periodically. Results can be compared on an annual basis and a Cost-Benefit Analysis created. Changes may be made to improve the results throughout the System Life Cycle. An ICT system should be managed by an appropriate Committee, such as the Medical Advisory Technology Committee (MTAC). Digital has undertaken Project Evaluations of various ICT projects on behalf of our Clients.

Project Management is the application of knowledge, skills, tools and techniques to a broad range of activities to meet the requirements of the particular project. Project management knowledge and practices are best described in terms of their component processes. These processes can be placed into five process groups (initiating, planning, executing, controlling and closing) and nine knowledge areas (project integration management, project scope management, project time management, project cost management, project quality management, project human resource management, project communications management, project risk management and project procurement management). Digital can provide experienced project managers to oversee any ICT project and ensure timely reporting and communication with the Client.

SmarTeam ™ - We at the Digital Group of Telehealth Companies acknowledge that any health care system is a complex network that encompasses a variety of skill sets. For it to be successful, it requires physicians, medical specialists, nurses, allied health professionals, administrators, financial specialists, educators, equipment specialists, legal advisors and ICT professionals. For us to do our job properly we believe that we have to relate to all of these areas. That’s why we use what we call a SmarTeam ™ Approach. In other words we incorporate a wide range of professionals into developing the solution that include physicians, medical specialists, nurses, allied health professionals, administrators, financial specialists, educators, equipment specialists, legal advisors and ICT professionals that have particular expertise in the areas of e-Health/Telehealth, as well as experience in the development of ICT programs for health care providers such as yours.

Stakeholders refer to those individuals with a vested interest in the ICT project under development. These may include: patients, affiliated health care organizations, vendors, funding bodies, health care professionals, managers, executives, administrators, customers, governance board, regulatory bodies, insurance providers, licensing bodies, shareholders and government. For a project to be successful the needs and concerns of all stakeholders must be taken into consideration and a workable solution developed. Digital’s ICT integration process recognizes the importance of Stakeholders in the development plan.

Strategic Planning is the process of understanding the business plan and projecting (usually over a 5 year period) what is to be accomplished over this period. It provides a roadmap for management, as it identifies priorities and helps identify various financial requirements that may assist in the budgetary process. There is usually more than one Strategic Plan within a health care organization. In the context of ICT, there may be an e-Health plan, as well as a Telehealth plan, for example. As the purpose of developing these technologies are to assist the organizational overall Strategic Plan and Business Plan, they may not be undertaken without a clear understanding of these ‘higher’ planning processes.

Digital has assisted several of our Clients in this most important of processes. In the past, ICT systems have been integrated at high cost, only later to find that the way they have been integrated does not contribute to the objective of the health care organization or maximize the return on the investment.

Sustainability - There are many reasons for the introduction of new technologies into a health care organization. Some of these are not required to be financially sustainable in themselves; while other ICT systems like telemedicine are often expected to 'prove their worth.' In other words, an ICT application such as telemedicine may not be undertaken unless it can be projected to be cost-effective. For this to occur, it is important to develop a plan that will manage the expectations of all Stakeholders. ICT systems are only tools to be applied judiciously to support the organization's strategic and operational plans.

To this end, Digital has experience interacting with various Stakeholders and can define the parameters of expectations. Through a Needs Assessment and a Cost-Benefit Analysis, we can assist you in defining what type of system should be implemented and what applications are sustainable. We believe that this is a critical factor to an ICT project's success.

System Life Cycle (SLC) encompasses the entire life of a technology system. Stages include: program planning, project planning, deployment, operations and retirement. The SLC of any technology should be monitored by a responsible body such as the Medical Technology Advisory Committee or MTAC. Digital has experience in working with our Clients to ensure that appropriate processes are in-place to insure the required management of the SLC.

Systems Development (also called Systems Integration) is the overall process of assessing need, qualifying appropriate Technology, Strategic Planning, Program Planning, Project Management, Change Management, Installation, Training, Maintenance, Policy & Procedures Development, Systems Life Cycle, Cost Benefit Analysis and Project Evaluation. Having undertaken several ICT projects in the Health care sector, Digital can provide the needed expertise to undertake, or to supplement our Client’s expertise in such a development.

Systems Engineering is structured analytical problem solving. In healthcare the problems to be solved embrace management, administrative, clinical, legal, financial, social and technical concerns. The expertise and experience of all these disciplines must be involved if the complex system is to be successful.

Technical Analysis is the analysis of the technical and engineering aspects of a project. Technical analysis seeks to determine whether the prerequisites for the successful commissioning of the project have been considered and reasonably good choices have been made with respect to location, size, process, etc. Several areas are evaluated including an evaluation on the scale of operation, the suitability of processes, equipment, work schedules, suitability of technology employed, etc. This type of analysis should be conducted prior to commencement of the integration process.

Telecardiology is the use of communications and information technology to capture data for the purpose of diagnosing and monitoring cardiac patients at a distance.

Teledermatology is the use of communications and information technology to capture data for the purpose of diagnosing and monitoring dermatology patients at a distance.

Telehealth is the use of ICT to deliver health services and exchange health information when distance separates the participants. The term ‘telehealth’ is much broader in scope than telemedicine as it’s not restricted to the electronic ‘practice of medicine.’ Telehealth includes telenursing, home health care / monitoring, e-Health, telemedicine, CME, CNE and patient education.

Telehomecare - see Telenursing

Telemedicine is the use of medical information exchanged from one site to another via electronic communication to facilitate physician-to-patient and physician-to-physician encounters such as diagnostic consultations. Telemedicine often incorporates real time video links and store-and-forward technologies.

Teleophthalmology enables ophthalmologists to make use of digital ophthalmic diagnostic equipment and by utilizing ICT, reach patients who may not otherwise have access to this type of care.

Telenursing is also known as ‘demand management,’ ‘medical call centre,’ ‘telephone triage,’ and ‘nurse phone care.’ Through the use of a telephone or video-based systems, a patient is connected to a health care practitioner, who then gives information or makes an assessment of the caller’s condition. This process can evaluate the possible need for a physical visit to a physician and facilitates patient education. When used in conjunction with a public Web portal, such a system may be enhanced and efficiency increased.

Telepsychiatry allows a psychiatrist to consult with a patient in real-time using videoconferencing equipment or other appropriate ICT technology.

Teleradiology involves the use of ICT to transmit radiographs from one location to another.

Training may involve either training in-house technical people to address the inspection and maintenance aspects of various hardware and software, or facilitating the training of health care professionals in the use of a given technology. Digital can provide initial training and enhance it through the development of CD training material or e-Learning.

Video conferencing facilitates a face-to-face meeting environment with the use of special equipment (or a personal computer) to others within the same city, nation or those located elsewhere. More than one location at a time may be connected through a telecommunications bridge or through special features within the video conference unit. Video conferencing facilitates telemedicine and telehealth activities including consultation, e-Learning activities such as CME and CNE, as well as management meetings.

Web Portal - In the context of health care, a Web portal is a Website that offers a wide array of resources and services. These may include: e-mail, forums, search engines and on-line educational modules. A Web portal is often divided into insecure and secure areas. Insecure areas are often used for access by the general public and may include patient education information. Secured areas are usually reserved for Stakeholder access or electronic commerce activities. Digital can provide a full range of Web services, custom designed to meet your needs.