RIVM National Institute for Public Health and the Environment and Nictiz have made an overview of the risks that eHealth applications may entail and how these risks can be controlled. Online therapy, remote care, telemedicine: many healthcare institutions are integrating eHealth. More awareness is needed about the risks of e-Health technology.
While information regarding its potential is abundant,
the risks associated with the use of information (including mobile)
and communication technology in health care have scarcely been
addressed. In order to implement e-Health technology successfully
and safely, the evaluation of their benefits should be integrated
into and complemented with systematic risk assessment. This is the
main recommendation resulting from an exploratory literature study
that was performed at the request of the Dutch Health Care
A review of scientific literature identified no
systematic studies (randomized controlled trials) that directly
investigated the risks of e-Health technology. However, many
unintended, 'secondary', outcomes have been reported that
indicate risks for patient safety or quality of care at the level
of the technology, the end-user (patient, professional) or the
organization. They vary from high time consumption, adverse
effects, usability problems, limited server access and
malfunctioning devices due to improper use or financial issues.
Similar outcomes were found through searching 'grey'
sources accessed through the internet. From the combined scientific
and grey sources, we found anecdotal evidence for a wide variety of
risks in e-Health, of which the magnitude is largely unknown.
Confirmation of these findings was obtained from several other
recent, authoritative reports.
E-Health interventions are being increasingly used in Dutch health care. It is important that tools currently used for risk management are applied to e-Health as well. A reliable system to report, identify, document and monitor risks would help to increase transparency in this field.