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Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

Mathias t svendsen.

1 Department of Clinical Research, University of Southern Denmark, Odense M, Denmark

Sylvia N Tiedemann

2 Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

Klaus Ejner Andersen

Associated data.

Supplemental material, sj-pdf-1-smo-10.1177_20503121211016179 for Pros and cons of eHealth: A systematic review of the literature and observations in Denmark by Mathias T Svendsen, Sylvia N Tiedemann and Klaus Ejner Andersen in SAGE Open Medicine

Objectives:

The main objectives of this article are to systematically review the recent literature on patient safety in relation to the use of eHealth and to investigate how the Danish authorities supervise private eHealth clinics with regard to patient safety.

Original studies reporting the association between patient safety and the use of eHealth as a means of communication between patients and healthcare providers were included. Four literature databases were searched for English-language articles reporting results from cohort studies and clinical trials, published from 2015 until March 2021. Moreover, registered private eHealth clinics in Denmark were evaluated with reference to a recent national audit of patient safety issues in eHealth.

The literature search retrieved four intervention studies. The studies did not identify any particular patient safety risks associated with the use of eHealth. Many different authorized healthcare providers (preferably, doctors) apply eHealth in various contexts. eHealth is being used as the only form of contact between the healthcare provider and the patient, as a supplement to patient visitations in an outpatient clinic, or as a tool for communicating between two or more healthcare providers. The regulation of eHealth involves patient safety issues but also has interfaces to marketing, IT systems, and infrastructure. Supervision of eHealth includes the organization of clinics, handling patient charts, prescription medicine, patient legal rights, and patient transition. However, there are many interfaces in the division of responsibilities among the various governmental players.

Conclusion:

eHealth is being used increasingly and in many settings, although recently published intervention studies investigating patient safety issues by the use of eHealth are limited. A structured and continuous governmental control and regulation of patient safety in relation to the use of eHealth is warranted.

Introduction

In recent decades, there has been a rapid growth in the use of electronic health (eHealth), and recently, the growth has been accelerated by restrictions on in-person practice associated with the Coronavirus Disease 2019 (COVID-19) pandemic. 1 , 2 The increased use of eHealth has raised legal implications connected with the implementation of the technology and poses a challenge to patient safety. 3 According to the World Health Organization (WHO), patient safety includes the absence of preventable harm to a patient during the process of health care and the reduction of the risk of unnecessary harm associated with health care to an acceptable minimum. 4 Among the safety issues associated with the use of eHealth are a lack of proof of efficacy and reliability in clinical decision-making, 5 the protection of patient data with respect to privacy, 6 and its influence on the patient–healthcare provider relationship. 7 – 9 This may be due, in part, to the limited knowledge and supervision of eHealth providers.

eHealth is a broad concept that covers many types of information communication technology (ICT) tools used in the healthcare sector. 7 The WHO places eHealth into various categories including electronic health records (EHRs), health information systems, remote monitoring and consultation services, tools for self-management, and health data analytics. Mobile health (mHealth) is a subset of eHealth that is linked to cell phones and apps. 10 eHealth has the potential to transform health care and the practice of medicine by improving the quality of patient safety and care. 7

Healthcare providers use eHealth for many purposes including administration, health records maintenance and access, communication and consulting, information gathering, and medical education. 7 Patient care management and treatment compliance are among the challenges faced by healthcare providers. Recently, an app in combination with an electronic monitoring system (EMS) has been shown to improve the treatment compliance of psoriasis patients and short-term outcomes. 11 Yet, systematic studies investigating the potential long-term improvement of treatment efficacy 12 and cost-effectiveness 1 of eHealth are limited. As more patients own electronic devices, new opportunities for direct digital communication with healthcare providers and improved self-monitoring and disease prevention have been introduced. 13 Furthermore, patient safety issues in regard to the increased use of eHealth need to be addressed.

In Denmark, the use of eHealth as a digital communication form (e.g. apps, websites, or mobile phone consultations) is expanding in the tax-financed public health sector at hospitals (where most hospitals have introduced eHealth services through which patients may get access to information about their treatment plans and video consultations with doctors or nurses) and with general practitioners (who are obliged to offer email appointments) as well as smaller private healthcare providers who offer their services to patients thorough digital communication. Since smaller private healthcare clinics operated by one or a few healthcare professionals may pose a greater potential risk to patient safety than eHealth used in a well-established public sector, the first Danish governmental supervision of patient safety in the use of eHealth was conducted among private eHealth clinics. 14

This article has two objectives: to provide an overview of recently published literature reporting eHealth effects on patient safety and to discuss the findings in a context of the use of private eHealth clinics in Denmark and governmental supervision thereof. The assessment of the clinical value of eHealth and its economic effects is outside the scope of this study.

Materials and methods

Literature review.

A systematic literature review was performed for English-language, peer-reviewed articles in four major databases. The search included studies from 2015 until March 2021.

A three-block search strategy was designed using a combination of search terms for eHealth, patient safety, and limitations in use ( Supplementary Material 1.1 ). The search blocks may be found in Supplementary Material 1.2 specified for the respective databases PubMed, Embase, Web of Science, and the Cochrane Library. The design for the review was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. 15

Published English-language articles reporting results from cohort or intervention studies in which eHealth was used as a communication tool between the patient and healthcare provider were considered for inclusion. The primary outcomes extracted were any associations between the use of eHealth and patient safety.

Duplicate independent study selection was done by M.T.S. and S.N.T. The sorting process was performed with Covidence software (Melbourne, Australia). 16 The first sorting was done by reading the title and abstract. The remaining studies were selected after reading the full text by focusing on study data that specifically reported any verified or presumed association between the use of eHealth and patient safety. Inconsistencies were resolved by consensus. The authors independently extracted data from identified studies using a standardized data extraction form.

Independent quality assessments were done by M.T.S. and S.N.T. A study-specific quality assessment table was designed for the specific requirements for this review. The quality table was inspired by the Scottish Intercollegiate Guidelines Network (SIGN) methodology checklist. 17 To address the internal validity, an overall quality assessment was given for each study. Each study was graded by assigning yes, no, or not applicable (NA) to every question. Questions assigned NA were excluded from the overall quality assessment grading. If yes answers comprised 67%–100%, the study was considered of high quality. If yes answers comprised 34%–66%, the study was considered of medium quality. If yes answers comprised 0%–33%, the study was considered of low quality. Inconsistencies were resolved by consensus.

Use and supervision of eHealth clinics in Denmark

In Denmark, there is no register providing an overview of eHealth clinics, whether they are public or private. However, private eHealth clinics advertise on the Internet and operating systems (OSs) and, therefore, can be identified. A search was conducted of private providers of eHealth advertising in Denmark on the Internet and OS. The findings were sorted according to the type of services offered and the form of contact between provider and patients.

Institutions with supervisory responsibility were identified in Danish patient safety legislation 14 and the institutions were grouped according to their respective supervisory area. Moreover, all recent indicators for the supervision of Danish eHealth providers were identified and summarized. 14

Scientific literature reporting how eHealth affects patient safety

Four studies addressing how the use of eHealth as communication between the patient and healthcare provider influences patient safety were identified ( Figure 1 ). A summary of the evidence in the included studies is presented in Table 1 . A list of excluded studies is available in Supplementary Material 1.3 while a list of included studies is available in Supplementary Material 1.4 .

Trial flow depicting the selection of process of studies included in the literature review.

Summary of evidence from included studies.

Quality assessment is presented in Supplementary Material 1.5 . Two of the included studies 20 , 21 were deemed well-conducted and had a low risk of bias. However, two other included studies 18 , 19 had a medium risk of bias due to limited information regarding sampling 18 and lack of sufficient information regarding the outcome measures. 19

Prochaska et al. 18 investigated the experience of an eHealth-based coagulation service and found the eHealth service to reduce adverse events (i.e. thromboembolic events and bleeding) in patients receiving anticoagulation therapy compared to standard care. Liao et al. 19 explored the use of a telephone-based text-messaging system to support smoking cessation and reported no adverse events from use of the intervention. Schwalm et al. 20 reported an intervention in which non-physician healthcare providers with the support of an algorithm-based app significantly reduced blood pressure and reported no adverse events from the use of the intervention. Finally, Toro-Ramos et al. 21 found that a coach-guided mobile-delivery system reduced weight in pre-diabetic patients while reporting no adverse events from using the intervention.

Types of eHealth clinics and their supervision

A total of 26 Danish clinics offering eHealth were found. The total number of patients seen by these clinics was not publicly available. In 21 clinics, contact was restricted to digital communications between the healthcare provider and patient; two clinics provided a combination of digital contact and physical attendance, while three clinics operated through digital contact between two or more healthcare providers. A broad spectrum of authorized healthcare providers offered their healthcare services through the eHealth clinics. The clinics hired healthcare providers within the following professions: 15 clinics were run by doctors, three by dieticians, two by physiotherapists, one by a nurse, and another by a midwife. Moreover, four clinics had mixed types of healthcare providers, that is, doctors, nurses, midwives, dentists, and physiotherapists (see Supplementary Materials 1.6–1.8 for a detailed description of the healthcare clinics and providers operating from the clinics).

Three main types of eHealth clinics were observed (see Figure 2 ):

Constellations of digital healthcare contacts. Type (a): only digital contact. Type (b): mixed—digital and physical contact. Type (c): digital contact between providers. Type (a) (provided with a red circle) was the type of patient–healthcare provider contact supervised by the Danish Patient Safety Authority in the first supervision of private eHealth clinics in 2019.

• All communication takes place via digitally based communication (e.g. app or Internet-based communication) between the patient and an authorized healthcare provider or staff member responsible for treatment.
• Part of the healthcare treatment takes place by means of digital communication between the patient and the authorized healthcare provider or staff member responsible for treatment. In addition, the patient physically visits the clinic.
• Exchange of patient data by digital communication between authorized healthcare providers or persons acting under their authority. The eHealth clinic may have no physical address. This means there is no direct patient–healthcare provider contact.

The Danish Patient Safety Authority is responsible for supervision with focus on areas such as the organization of the clinics, handling patient charts, medication prescriptions, patients’ legal rights, and the individual patient’s transition between clinics (for a detailed description, see Table 2 ). However, several national authorities are involved in different aspects of the regulation of eHealth, and many areas with interfaces to patient safety issues (see Figure 3 ). The supervision of healthcare activities that directly handle patient treatment is the responsibility of the Danish Patient Safety Authority. In addition, certain aspects of the supervision of marketing healthcare services are the shared responsibility of the Danish Patient Safety Authority, the Danish Consumer Ombudsman, and the Danish Medicines Agency. The supervision of the IT systems in eHealth clinics has interfaces to the Danish Patient Safety Authority (how the systems are used in the treatment of patients), the Danish Data Protection Agency (whether the system is safe in sharing and storing personal identifiable data) as well as the Danish Medicines Agency (in cases in which a medical device is being used). Finally, the supervision of the infrastructure is a responsibility for both the Danish Health Data Authority and the Danish Data Protection Agency. In order to ensure the safe handling of people’s personal data, the European Union (EU) has introduced the General Data Protection Regulation (GDPR). All member states have standardized their treatment of citizens’ personal data throughout the EU. 6

Essential indicators.

Governmental offices regulating safe use of eHealth.

There are many interfaces in the supervisory responsibilities of eHealth clinics. Nevertheless, with respect to the delivery of a healthcare service, the legislation on eHealth clinics does not differ from the legislation that all healthcare clinics are obliged to follow.

Principal findings

Even though the use of eHealth is rapidly expanding, the literature search on eHealth safety in cohort and clinical trials investigating eHealth interventions in the last 5 years resulted in only four studies with low-to-medium risk of bias. In general, the literature findings did not raise any particular patient safety concerns regarding the use of eHealth.

A mapping of Danish private eHealth clinics showed that 26 private clinics offered health care restricted to eHealth, and the majority of the providers were doctors. The eHealth clinics were divided into three groups: those with digital contact only between healthcare providers and the patient, those with an eHealth supplement to outpatient clinic visitation, or those that acted as a tool for communication between two healthcare providers.

The Danish Patient Safety Authority is responsible for the supervision of patient safety matters in private eHealth clinics. Yet, other governmental offices may be consulted with regard to aspects of marketing, the use of IT systems, and the organization of infrastructure. The indicators for the national supervision of eHealth are equivalent to the indicators used for the supervision of private health clinics, encompassing supervision of the organization, patient charts, handling medication, patients’ legal rights, and the transition between clinics.

eHealth has potential but also pitfalls

The technologies are considered beneficial in the hospital sector for both patients and healthcare providers, who use it in diagnostics and follow-ups, in monitoring chronic diseases, in rehabilitation, and in residential management of patient medication. Nevertheless, broader experience with the use of eHealth is still needed, since it could be associated with potential risks that might put patient safety in jeopardy if not carefully monitored.

The use of private eHealth in Denmark is still limited—perhaps, because Danish patients predominately consult tax-financed public clinics and hospitals, where they are not charged for the healthcare services. 22 The studies included in the literature review found the use of eHealth efficacious compared to standard care with respect to anticoagulant therapy, 18 smoking cessation, 19 blood pressure reduction 20 and weight-loss. 20 However, eHealth has been widely introduced in spite of limited evidence of its efficacy. 12 In addition, physical contact between patients and doctors may be reduced without considering the value and understanding of this physical contact. 23 All studies had a medium-low risk of bias.

The included studies 18 – 21 did not investigate whether improved efficacy also had economic benefits compared to standard care. Modai et al. 24 studied hospital costs and treatment safety in telepsychiatry compared to physical consultations and concluded that patients and physicians are satisfied with the safety and effectiveness of video conference telepsychiatry (VCTP), although the operational costs of VCTP may be higher than face-to-face consultations. Using eHealth in daily clinical practice is assumed to save time and money, although published health economy analyses show mixed results. The findings from Modai et al. 24 are in agreement with Pak et al., 25 who found that eHealth used in an asynchronous setting in dermatology was even more expensive than conventional dermatology when only direct costs were considered. In contrast, Zakaria et al. 26 reported that the implementation of a teledermatology triage system within the dermatology department was associated with cost savings compared to a conventional dermatology care model. Nonetheless, the study was limited by not including the revenue generated from billing and the exclusion of costs associated with rent, utilities, and non-personnel overhead. Armstrong et al. 1 concluded that the literature has shown mixed results on how the use of eHealth influences the health economy and advised conducting cost analyses of the use of eHealth from a societal perspective in which the total cost of eHealth is analyzed but also taking in account patients’ reduced transportation costs and regained work productivity. While the benefit of the use of eHealth to the health economy is unknown, eHealth is still being used more frequently. 27

The studies included in the literature search 18 – 21 did not find any patient safety concerns with the use of eHealth for communication between the patient and healthcare provider. However, van Poelgeest et al. 28 investigated the experience of healthcare providers with eHealth and found no improvement in the safety of hospital care through the use of advanced electronic medical records. Coletti et al. 29 explored the association between advanced electronic medical records and patient safety and concluded that tele-intensive care unit (tele-ICU) implementation is associated with perceived improvements in patient safety. Finally, Demiris et al. 30 investigated residents’ perception of the influence tele-ICU implementation has on patient safety and concluded that eHealth providers need to be educated about security features related to the technology and recommended continuous quality improvement in order to increase quality and minimize errors. The residents reported that the use of eHealth was not associated with high risk for patient safety. Moreover, in order for eHealth to be safe, the residents recommended that they continuously update their education in the use of the technologies.

The literature included in the review raised 18 – 21 no particular concerns regarding the use of eHealth, which accords with a recent conclusion from governmental inspections of Swedish private eHealth clinics finding no serious patient safety issues in the use of eHealth. 31 However, the retrieved literature review had no hard data endpoints (e.g. severe unexpected adverse reactions such as mortality rates or hospitalization) as a measure of patient safety. The lack of similar outcome measures for patient safety among the studies limits a clear conclusion.

Even though the search did not find any warning signs in regard to the use of eHealth, it points out the importance of continuous education for healthcare providers in the use of eHealth and addressing situations in which it is not the best option to use. Rasmussen et al. 32 conducted a randomized controlled trial (RCT) and found that eHealth used in the monitoring of diabetic foot ulcers was associated with an increased mortality in the group that received eHealth. The increased mortality rate might be explained by a reduced ability to detect serious complications through digital contact compared to seeing the patient in the outpatient clinic. Severe unexpected adverse events associated with the use of eHealth may only be detected in an RCT, which is why it is problematic if new and promising eHealth practices are introduced into clinics without being tested in a high-quality RCT. When new eHealth is introduced, there is no general agreement requiring that the technology to be introduced is superior to previous contact forms.

The supervision of eHealth clinics is equivalent to the supervision of healthcare clinics based on patients’ physical presence and is subject to the same legislation. The potential risks are numerous and include unsafe patient identification and patient record-keeping, limitations in digital diagnosis and treatment without physical attendance, losing personal contact and continuity in patient care, lack of sufficient treatment plans and follow-ups, prescribing addictive medication, antibiotics misuse, and false or misleading online advertising. Furthermore, the quality of the technical equipment and use thereof is also of importance, for example, quality of sound, photo, or video.

eHealth supervision is focused on situations in which there is a potential risk in its use. For example, eHealth may be advantageous for giving patients the results of selected tests or scheduling outpatient visits and of doubtful value for diagnosing diseases and prescribing medications with potentially severe side-effects. The use of eHealth is expanding, and the development of eHealth may be a sound supplement to outpatient visits. Still, this expansion is often being implemented without an analysis of the potential benefits for patients, the health economy, patient safety, or the need for the education of healthcare providers and patients in the use.

Strengths and limitations of this study

This article is limited in that it does not analyze the efficacy and cost-effectiveness of the use of eHealth.

The literature review only included results from intervention studies published in the last 5 years and, thus, provided limited results. A further constraint on the search strategy might be that patient safety issues are rarely the main focus in reporting results from the use of new advanced technologies, and new technologies are rarely tested in systematic trials. A possible explanation is that the technology may often be outdated before a clinical trial is finished and results reported.

The systematic mapping of private eHealth clinics was limited by the lack of an updated central register of clinics offering eHealth, and no consensus was available on how to search for eHealth service. 33 Therefore, some private eHealth clinics may have been missed. Since there is no central register of eHealth clinics in Denmark, we do not know what percentage of private eHealth clinics was covered by our search. Health apps without direct patient–healthcare provider contact or without the use of medical devices are not supervised by the health authority, and many apps were outside the scope of this article. Furthermore, all general practitioners in Denmark are obliged to offer digital consultations, and many hospitals have different digital platforms for communicating with patients.

The division of different situations in which eHealth can be applied is a simplification. Future models may include other constellations for the use of eHealth.

The review of governmental offices involved with the supervision of Danish eHealth may not be illustrative for other countries, which may have different structures because responsibilities and governmental organizations differ between countries. The indicators mentioned for supervising eHealth were taken from the most recent Danish audit of eHealth, conducted in 2019 by the Danish Patient Safety Authority. Indicators are frequently revised, and the focus of supervisions differs, so the indicators are presented primarily as a guidance and inspiration for how the supervision of eHealth may be planned.

In order to ensure the safe use of eHealth, a number of safety measures must be thought through and put into the right context by clinicians, such as the management and organization of the eHealth clinic, written instructions, safe identification, informed consent, treatment follow-ups, and the retention of patient records by healthcare providers. Many new technologies may escape a thorough analyses in the context for which they are designed before they are implemented. A lack of evidence of the efficacy and safety of eHealth may be a barrier for policymakers’ visions for a broader implementation of eHealth. A structured, effective, reliable and continuous governmental supervision is warranted to monitor the expanding use of eHealth.

Recommendations for future research

This study was limited by a lack of definition of outcomes for patient safety, which restricted the opportunity for comparative studies. Scientific associations and governmental offices regulating eHealth could collaborate and come up with simplified, comparable measures for patient safety, which could be applied in supervision as well as in research. In addition, a central registry of eHealth clinics would aid in the mapping of the field. This would help to identify eHealth clinics and allow a comparison of the efficacy and safety of eHealth across medical specialties and nations.

Supplemental Material

Acknowledgments.

The Danish National Library in Copenhagen assisted in the literature search strategy.

Data availability: In Supplementary Materials 1.1–1.8, readers may access the relevant data underlying the findings of the study.

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.T.S. and K.E.A. have received grants from LEO Pharma to conduct clinical trials testing interventions using eHealth patient-support solutions (ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT04220554","term_id":"NCT04220554"}} NCT04220554 and {"type":"clinical-trial","attrs":{"text":"NCT02858713","term_id":"NCT02858713"}} NCT02858713 ). In addition, M.T.S. was responsible for designing indicators and safety benchmark measures for eHealth for the Danish Patient Safety Authority and conducted the first national regulatory supervision of private eHealth providers. All of the data reported are publicly available. S.N.T. declares no conflicts of interest. No private companies or governmental regulatory institutions have been involved in the ideas behind or the writing of this article. All authors take full responsibility for the content of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

Supplemental material: Supplemental material for this article is available online.

Health and Wellness Articles from Cooper University Health Care

Tour inside cooper’s brand new specialty care center at cherry hill.

The doors are now open at Cooper Specialty Care at Cherry Hill, the newest addition to Cooper’s expanding health system. The new state-of-the-art center consolidates high-demand, adult care specialties into one easy-to-access location at 2339 West Route 70, in the heart of Cherry Hill, overlooking the Cooper River.

Here you will find cardiology, endocrinology, nephrology, neurology, neurosurgery, orthopaedics, physical therapy, physical medicine and rehabilitation, podiatry, pulmonary medicine, rheumatology, and outpatient laboratory services to meet your health needs. The Specialty Care center offers advanced technology with more than 100 exam and procedural rooms for patient visits and a range of outpatient services. The ground floor features a welcome concierge and a full-service café offering Starbucks beverages and snacks.

Early morning and evening appointments are available to fit into everyone’s busy schedules.

Cooper’s team of physicians, advanced practice providers, technicians, and support staff representing the many specialties and diagnostic services in the new Cooper Specialty Care at Cherry Hill are committed to making your experience the best it can be.

Click here to take a virtual tour inside our beautiful new Specialty Care center, located at 2339 West Route 70 in Cherry Hill, New Jersey.

Don’t put your health on hold. As with all of Cooper’s offices during the pandemic, practices in the facility offer both in-person and telemedicine appointments.

If your doctor determines that you need an in-person visit, you can be confident that you safety is our top priority. Cooper has taken a number of actions to limit your exposure to other patients, including providing masks, making waiting areas less crowded, additional hand sanitizer stations, and a multi-level screening process for everyone who enters its buildings, including employees. Additionally, Cooper is strictly following all public health and CDC safety guidelines, and, as always, ensuring our waiting areas and patient rooms are thoroughly disinfected and cleaned.

For more information or to make an appointment with a Cooper specialist, visit Cooper Specialty Care at Cherry Hill.

Visite el Nuevo Centro de Atención Especializada de Cooper en Cherry Hill

Las puertas ahora están abiertas en Cooper Specialty Care en Cherry Hill, la última incorporación al sistema de salud en expansión de Cooper. El nuevo centro de vanguardia consolida las especialidades de alta demanda para el cuidado de adultos en un lugar de fácil acceso en el corazón de Cherry Hill con vista al río Cooper.

Aquí encontrará cardiología, endocrinología, nefrología, neurología, neurocirugía, ortopedia, fisioterapia, medicina física y rehabilitación, podología, medicina pulmonar, reumatología y servicios ambulatorios de laboratorio para satisfacer sus necesidades de salud. El Centro de atención especializada ofrece tecnología avanzada con más de 100 salas de exámenes y procedimientos para visitas de pacientes y una gama de servicios ambulatorios. La planta baja cuenta con un conserje de bienvenida y una cafetería de servicio completo que ofrece bebidas y aperitivos de Starbucks.

Las citas temprano por la mañana y por la noche están disponibles para adaptarse a los horarios ocupados de todos.

El equipo de médicos, proveedores de práctica avanzada, técnicos y personal de apoyo de Cooper que representan las diversas especialidades y servicios de diagnóstico en la nueva Atención especializada en Cherry Hill están comprometidos a hacer que su experiencia sea lo mejor posible.

Haga clic aquí para realizar un recorrido virtual por nuestro hermoso y nuevo Centro de atención especializada ubicado en 2339 West Route 70 en Cherry Hill, Nueva Jersey.

No ponga su salud en espera. Al igual que con todas las oficinas de Cooper durante la pandemia, las prácticas en las instalaciones ofrecen citas tanto en persona como por telemedicina.

Si su médico determina que necesita una visita en persona, puede estar seguro de que su seguridad es nuestra principal prioridad. Cooper ha tomado una serie de medidas para limitar su exposición a otros pacientes, que incluyen proporcionar máscaras, hacer que las áreas de espera estén menos concurridas, estaciones de desinfectante de manos adicionales y un proceso de detección multinivel para todos los que ingresan a sus edificios, incluidos los empleados. Además, Cooper sigue estrictamente todas las pautas de salud pública y seguridad de los CDC y, como siempre, se asegura de que nuestras áreas de espera y habitaciones de pacientes estén completamente desinfectadas y limpiadas.

Para obtener más información o hacer una cita con un especialista de Cooper, visite Cooper Specialty Care at Cherry Hill .

11 Comments

May 6, 2020 at 11:36 pm

i would like to know how u all taking procaution if we want to get service as an out patient.

May 7, 2020 at 12:42 am

Hello, Mr. Bur. Cooper has taken a number of actions to limit your exposure to other patients, including providing masks, making waiting areas less crowded, additional hand sanitizer stations, and a multi-level screening process for everyone who enters its buildings, including employees. Additionally, Cooper is strictly following all public health and CDC safety guidelines, and, as always, ensuring our waiting areas and patient rooms are thoroughly disinfected and cleaned.

Where is the facility located in a Cherry Hill?

May 7, 2020 at 12:43 am

Hello Ms. Boyce, the center is at 2337 West Route 70, right next to the Crowne Plaza.

May 7, 2020 at 1:21 am

Muy bueno gracias saludos para todos

May 7, 2020 at 1:28 am

What drs are out here?? How do I know if my dr moved

May 7, 2020 at 1:33 am

Hello Marie, letters were mailed to patients whose doctors are moving. If you want to double check, please go to our Find a Doctor page, search for your physician, and check the addresses listed on his/her profile. https://www.cooperhealth.org/doctors

May 7, 2020 at 12:59 pm

Do you take united healthcare community plan / Medicaid? Insurance

May 13, 2020 at 2:20 am

Dear Ms. Win, The health plans that we accept are here: https://www.cooperhealth.org/patients-visitors/accepted-health-plans , for the health plans that we accept. However, as the plans do sometimes change, it is always best to check with your insurance carrier before you make an appointment. Thank you.

May 7, 2020 at 6:55 pm

Mi esposa y yo hemos sido clientes de Cooper Health por muchos años. Nuestra casa está muy cerca de su nuevo Specialty Care Center at Cherry Hill. Podríamos utilizar su nuevo centro para recibir servicios de Medicina de Familia (Primary Care)? Gracias, por su atencion.

May 13, 2020 at 2:16 am

Estimado Señor Grafals:

Gracias por su pregunta. Lo sentimos mucho, pero Cooper no tiene oficinas de atención primaria en nuestro nuevo centro. Tiene solo oficinas especializadas.

Nosotros tenemos tres oficinas de atención primaria en Cherry Hill: 1210 Brace Road, 1050 North Kings Highway y 1103 North Kings Highway. También tenemos uno cerca en Haddon Heights, en 504 White Horse Pike.

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• Your eHealth Initiative – Three Strategic Steps

The eHealth initiative

eHealth initiative general outcomes expected include benefits to providers and to patients, rapidly expanding technological tools, and even more use of internet based activities.

Working with The Fox Group’s eHealth experts through our three strategic eHealth Thought Lab meetings allows you to get customized knowledge on the processes and strategic changes that must be made in order to maximize the eHealth initiative potential within your organization. Each eHealth Thought Lab meeting will be tailored to your situation, and can jump-start your organization’s eHealth initiatives.  By the end of this series of three strategic meetings, you will have an appreciation of the potential for your organization to embark on a meaningful eHealth initiative.

The specific outcomes expected of the eHealth Thought Lab

I.  The Current eHealt h Initiative: a short, to the point workshop introducing the main elements of the eHealth initiative, a working definition, the effectiveness and implications of eHealth in the future.  You select the proper internal stakeholder audience of your organization.

• This workshop is a quick tour around basic issues, examples of effective applications, and rationales for undertaking an eHealth initiative .
• B e nefits include (1) development of a common frame of reference within your internal stakeholder audience; (2) correction of mis-perceptions and biases; (3) clarify expectations as to the impact of an eHealth initiative; (4)  follow up; and (5) motivation to get things going.

II.  eHealth Discussion and Analysis: a workshop reviewing your current eHealth applications, including electronic health record systems, mobile health , internet-based, social media interaction tools , telemedicine, and similar components.  It will also address your organizational enthusiasm and/or challenges to creating a strategic planning process addressing the future in eHealth technologies as they unfold.  Discussion between your representatives and experts from The Fox Group will run deep into several aspects of the eHealth initiative phenomenon.

• Using tailored examples fitting your organization, moderators of The Fox Group will demonstrate how eHealth technologies pertinent to providers, patients and your organization can result in a successful eHealth initiative for your organization.
• Implications for your organization to be addressed include (1) consequences of the use of eHealth technologies to operations, organization, and Information Technology resources; (2) costs of care and administration;  and (3) satisfaction of patients and other stakeholders.

III. eHealth Strategic Planning: a strategic workshop, where you discuss currently existing concepts, modules, and devices available to you and your patients.   The final step is to identify the strategic  actionable steps to implement your eHealth initiative, bridging the gap between what is available and what needs to be developed.

• Within the workshop, you and your selected stakeholders will reflect on the organization’s actual situation, both from a medical, organizational (structures, processes, staff, IT), and financial and patient perspective.  Wishes, challenges, and criteria for a successful eHealth initiative development path are explored. Initial ideas about a specific eHealth initiative can be discussed and placed in a framework of pros and cons.
• Financial considerations will be addressed as well.  This strategic plan outline will be tailored to capture the ROI, patient and provider benefits and ultimate outcome expectations of your eHealth initiative. Government, payor, and regulatory issues are addressed as well.
• Expectations and outcome : The output is a structured roadmap defining the path to development and implementation of your eHealth initiative, fully tailored to your specific situation.

The eHealth Thought Lab actionable and practical implementations

Finally, a summary proposal for your organization will be drafted to guide you into an actionable eHealth initiative and practical implementations.

eHealth Initiative: what are the next steps?

The Fox Group will assist you in concept, development, and implementation resulting in a fully operational plan to start your proper eHealth initiative with motivated stakeholders.  Information about process and follow though, financial estimates and expected impact on organizational functions will be identified. Planned outcomes and specifications of expected patient and provider responses to the strategic process are delineated.  In other words: “Welcome to the current and future of eHealth!”

"I would highly recommend you and The Fox Group …our business is much more organized, thanks to you…"

…evaluations have consistently been excellent …knowledgeable, enthusiastic, very qualified and stimulating…(his) experience and expertise…an asset to our faculty.”

“…it is apparent that you have a wide experience in the very things we need to know.”

“I would be pleased to recommend the consulting services of The Fox Group … your staff completed a comprehensive diagnostic process, substantial cost reductions, and a downsized, reorganized staff.”

“We have worked with The Fox Group since the inception of our company. They have been instrumental in our expansion from service in one location to our current size, offering service in 20 different locations.”

“…through your leadership, our company grew to achieve over $500,000 in net revenue after the first twelve months of operation.”

Through your assistance we have been able to reach far beyond what we ever dreamed of. Your expert advice has helped us prevent long-lasting mistakes with lasting consequences.

Information Technology

• Electronic Health Records
• EHR Meaningful Use Criteria
• Meaningful Use Stage 1 Criteria
• Meaningful Use Stage 2 Criteria
• Meaningful Use Matrix Stage 1
• Meaningful Use Matrix Stage 2
• EHR Certification Consulting
• What is eHealth and the eHealth Thought Lab?
• eHealth Solutions, eHealth Thought Lab and Strategic Tool
• eHealth Technologies and the eHealth Thought Lab

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Culture and Tourism in a Smart, Globalized, and Sustainable World pp 609–623 Cite as

The E-Tour Facilitator Platform Supporting an Innovative Health Tourism Marketing Strategy

• Constantinos Halkiopoulos 3 ,
• Eleni Dimou 3 ,
• Aristotelis Kompothrekas 3 ,
• Giorgos Telonis 3 &
• Basilis Boutsinas 3  
• Conference paper
• First Online: 22 June 2021

1488 Accesses

12 Citations

Part of the book series: Springer Proceedings in Business and Economics ((SPBE))

Health tourism is a special form of tourism that refers to international patients who wish to combine diagnosis, prevention, or treatment with a holiday. In health tourism marketing, services are designed, produced, and promoted in the market to meet specific both health and tourism need or desires of the people who want and can accept them. In general, the rapid development of information and communication technologies (ICTs) in tourism sector has led to new touristic and thematic tourism products tailored to the preferences and characteristics of the tourists. The hotel industry could benefit from its cooperation with thematic tourism platforms to address the seasonality, expand its target audience, and enhance the effectiveness of its marketing strategy. Nevertheless, most tourism providers in Greece, being small family businesses, lack the necessary information and communication technologies (and inherent technologies) to become globally competitive. Given the growing trend in the interest in health tourism, this paper aims to present the case of “e-Tour Facilitator Platform,” an intelligent information system aiming at supporting an Innovative Health Tourism Strategy. The platform focuses on the end-users, namely the patients/tourists, matching their profile to characteristics of both medical and tourism services. It exploits state-of-the-art machine learning techniques in order both to help end-users to view/select the proper health tourism product (recommender system) with respect to their profile as well as to automatically handle their comments (text mining) for evaluating purposes.

• Tourism marketing
• Health tourism
• Thematic tourism
• Digital marketing

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Constantinos Halkiopoulos, Eleni Dimou, Aristotelis Kompothrekas, Giorgos Telonis & Basilis Boutsinas

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Halkiopoulos, C., Dimou, E., Kompothrekas, A., Telonis, G., Boutsinas, B. (2021). The E-Tour Facilitator Platform Supporting an Innovative Health Tourism Marketing Strategy. In: Katsoni, V., van Zyl, C. (eds) Culture and Tourism in a Smart, Globalized, and Sustainable World. Springer Proceedings in Business and Economics. Springer, Cham. https://doi.org/10.1007/978-3-030-72469-6_39

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HEALTH Announce New Album and 2024 North American Tour, Share New Songs “Children of Sorrow” and “Sicko”: Stream

The post HEALTH Announce New Album and 2024 North American Tour, Share New Songs “Children of Sorrow” and “Sicko”: Stream appeared first on Consequence .

HEALTH have announced a new album, RAT WARS , along with a 2024 North American tour. In advance of the album’s December 7th release date, the band has unveiled the tracks “Children of Sorrow” and “Sicko.”

The 2024 trek kicks off March 2nd in Ventura, California, and runs through April 4th in Los Angeles. Pixel Grip and King Yosef are set to support.

Tickets to select shows are available via  Ticketmaster beginning Friday (October 6th) at 10 a.m. ET. Fans can also look for deals or get tickets to sold-out dates via StubHub , where your purchase is 100% guaranteed through StubHub’s Fan Protect program.

The two singles showcase the multi-faceted sound that’s allowed HEALTH to expand their fanbase and crossover conventional genre barriers. “Children of Sorrow” features Lamb of God guitarist Willie Adler and has a tangible metal edge; meanwhile, “Sicko” samples Godflesh’s signature song “Like Rats” — appropriate given the title of the new album — and is an unabashed homage to industrial’s past, present, and future.

RAT WARS was produced by Stint (Oliver Tree, Demi Lovato) and mixed by Lars Stalfors (SALEM, The Neighbourhood). The 12-track LP follows up HEALTH’s two-part DISCO 4 saga, and was written during “the most emotionally trying period of the band’s life,” as stated in a press release.

You can pre-order RAT WARS on vinyl and cassette via Loma Vista Recordings . Below you can stream both new singles and watch a trailer for the album, as well as see the album art, tracklist, and HEALTH’s upcoming tour dates. Get tickets here .

RAT WARS Artwork:

RAT WARS Tracklist: 01. Demigods 02. Future of Hell 03. Hateful 04. (Of All Else) 05. Crack Metal 06. Unloved 07. Children Of Sorrow 08. Sicko 09. Ashamed 10. (Of Being Born) 11. Dsm-V 12. Don’t Try

HEALTH’s 2024 Tour Dates with Pixel Grip and King Yosef: 03/02 – Ventura, CA @ Ventura Music Hall 03/04 – Mesa, AZ @ Nile Theatre 03/05 – Albuquerque, NM @ Sunshine 03/07 – Austin, TX @ Empire Garage 03/08 – Dallas, TX @ Studio at the Factory 03/09 – Houston, TX @ Warehouse Live Midtown 03/11 – Atlanta, GA @ The Masquerade @ Heaven Stage 03/12 – Charlotte, NC @ The Underground 03/13 – Richmond, VA @ The National 03/15 – Brooklyn, NY @ Brooklyn Steel 03/16 – Philadelphia, PA @ Union Transfer 03/17 – Boston, MA @ Royale 03/19 – Toronto, ON @ The Opera House 03/20 – Detroit, MI @ The Majestic 03/22 – Chicago, IL @ Concord Music Hall 03/23 – Saint Louis, MO @ Red Flag 03/25 – Englewood, CO @ Gothic Theatre 03/26 – Salt Lake City, UT @ Metro Music Hall 03/28 – Seattle, WA @ The Showbox 03/29 – Vancouver, BC @ The Commodore 03/30 – Portland, OR @ Revolution Hall 04/01 – Roseville, CA @ Goldfield Trading Post 04/02 – San Francisco, CA @ August Hall 04/04 – Los Angeles, CA @ Belasco Theater

HEALTH Announce New Album and 2024 North American Tour, Share New Songs “Children of Sorrow” and “Sicko”: Stream Jon Hadusek

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He was goin’ down.

That’s what iconic rocker Bruce Springsteen felt about his powerhouse voice during his battle with peptic ulcer disease that forced him to take a six-month break from his world tour with the E Street Band.

Indeed, at one point, the man who was born to roar was scared that he might never perform live again.

“When I had the stomach problem, one of the big problems was I couldn’t sing,” said Springsteen, 74, in an interview on SiriusXM’s “E Street Radio With Jim Rotolo” program .

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Springsteen feared the worst-case scenario.

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17 Best Moscow Tours

Are you planning a visit to the capital of Russia and looking for the best Moscow tours? From Red Square to the Kremlin and from world-class art to fairytale buildings, Moscow is an enchanting city that offers plenty of excitement and elegance. Its history dates back more than 800 years, and there is culture in abundance for visitors to immerse themselves in.

Make the most of your visit with 17 of the best Moscow tours that let you see everything the city and its surroundings have to offer.

1 – Guided Tour of the Moscow Metro

Moscow’s metro is world-famous, thanks to the architectural delights on offer underground stations around the capital. This guided tour of the Moscow stations, otherwise known as “the palace of the people” lasts for 1.5 hours and includes an English-speaking guide who will tell you how the Russian metro became one of the most beautiful in the world. Highlights include Mayakovskaya station with its aviation-themed mosaics.

• Moscow metro tours

2 – Cosmonautics Museum Space Tour

Discover Cosmonautics Museum with this space tour. Dive into one of the greatest battles between the Soviet Union and the United States – the space race. Hear about the space programs of the USSR and learn about how the USSR shaped space travel and technology.

• Cosmonautics Museum tours

3 – Guided Tour of the Kremlin

A Kremlin is actually a citadel in Russian towns, and Moscow’s version is, without doubt, the most famous. The Kremlin is the heartbeat of the city, and this guided tour takes you to the most important points of interest. See Cathedral Square with its orthodox temples; Tzar Cannon with its 890mm calibre, which is the largest in the world; and the exterior of the all-important government buildings that are located within the Kremlin’s walls.

Click here to learn how to book Kremlin tickets .

• Kremlin tours

4 – Moscow City Walking Tour

One of the best Moscow tours for seeing everything the city has to offer, this small-group walking tour lasts for 2 hours and includes an expert guide. Make the most of the capital and see the cobbled spaces of Red Square, take pictures of St Basil’s Cathedral, visit the elegant Bolshoi Theatre, and enjoy the ornamental Alexandrovsky Garden.

• Moscow walking tours

5 – Night Tour of Moscow

When the sun sets, the fun begins – and it all starts with a night tour of Russia’s most famous city. The beauty of Moscow comes into full effect after hours, as iconic buildings like St Basil’s Cathedral illuminate against the night sky. Other locations on this tour include the Moscow River and the Ukraine Hotel, which is a landmark skyscraper that was constructed during the era of Stalin.

6 – Sergiev Posad Day Trip

One of the best Moscow tours that take you outside of the city, the Sergiev Posad day trip provides the opportunity to see The Trinity Lavra of St. Sergius, a UNESCO World Heritage Site that is the spiritual centre of the Russian Orthodox Church. It’s made up of a number of different buildings that include the blue domes of the Cathedral of the Assumption, Church of St. Sergius and the Bell Tower.

• Sergiev Posad day trips from Moscow

7 – City Sightseeing Moscow Hop-On Hop-Off Bus Tour with Optional Cruise

If your time in Moscow is limited, this hop-on, hop-off bus tour is ideal – and it even features an optional cruise on the river. Choose between a 2 and 3-day ticket and see famous landmarks like Red Square, the Kremlin and the Bolshoi Theatre from an open-top panoramic bus with informative audio commentary. Take your experience to the next level by upgrading to a boat tour.

• Moscow hop on hop off bus tours

8 – Guided Tour of the Tretyakov Gallery

As one of the world’s most important galleries, the Tretyakov Gallery is a must-see for any art lovers and is one of the best Moscow tours for culture vultures. Learn about the masterworks of Pablo Tretyakov with a guided tour and discover the secrets behind the paintings. Other noticeable artists on view include Fedotov, Vasnetsov, Rokotov and Kiprenski, who is the author of the famous “Portrait of Alexander Pushkin”.

• Tretyakov Gallery tours

9 – Alternative Moscow: 2-Hour Walking Tour

See a different side of Moscow with this 2-hour alternative tour. An expert guide will take you around quirky streets, suburbs and squares while as your veer away from the traditional tourist hotspots. Highlights include a ride on the famous “Annushka” tram and a visit to the neighbourhood of Khitrovka, which was once known as the criminal district of the city.

10 – St.Basil’s Cathedral and Red Square: Private Tour and Ticket

Combine two of Moscow’s biggest attractions with a visit to Red Square and St.Basil’s Cathedral. Admire the beautiful architecture of St.Basil’s Cathedral from inside and out, before wandering Red Square and learn about the soldiers, farmers and revolutionaries that all called this famous square their home. Round things off with the changing of the guard at Alexander Garden.

• Red Square tours

11 – Bunker-42 Cold War Museum Guided Tour

Moscow is notorious for the Cold War, which lasted for about 45 years between 1945 and 1990. Head to the world-famous Bunker-42, located 65 meters below ground level, and learn about the storied past. Visit rooms and passages that were set up to shelter 3,000 people in case of nuclear attack and discover other sections, such as the equipment room and the war-proof telecommunications system.

• Bunker-42 Cold War Museum tours

12 – Architecture Tour of Moscow’s Metro and Kolomenskoye Estate

Combine the beauty of the metro stations with the Kolomenskoye Estate and see some of Moscow’s grandest sights. After visiting the elegant metro stations, it’s time to go to the Kolomenskoye Estate, which is filled with UNESCO-listed sites that are dedicated to Tsar Peter the Great.

• Kolomenskoye tours

13 – Tour of Soviet Moscow

Unpick the history of the USSR with one of the best Moscow tours for discovering Soviet Moscow. Starting at Monument to the Conquerors of Space, a tribute to the success of the Soviet space programme, the tour includes historical landmarks and interesting tidbits about Soviet Russia. There is also a visit to the All-Russia Exhibition Centre (VDNKh), a site that was constructed under the aegis of the USSR in tribute to state achievements.

14 – Moscow: 2.5-Hour Luxury River Cruise with Dining Option

Sail down the Moscow River on this 2.5 hour tour that provides a different perspective of the city and includes landmark sights. The boat features two decks and has panoramic views as well as free Wi-Fi access. Attractions along the route include Ukraine hotel, Sparrow Hills, Christ the Saviour Cathedral, Crimean Bridge, St. Basil’s Cathedral, Zaryadye Park and more.

• Moscow boat tours

15 – Izmailovo Market and Vodka Museum Tour

Visit the museum of Vodka and gain insight into one of Russia’s most famous exports and head to the Izmailovo antique and handicraft market to find a gem or two. The tour starts with Izmailovo market, which features the iconic matryoshka dolls, fur hats and amber jewellery. Next up is a trip to the Museum of Vodka, where you will discover a distillery that dates back to the 15th century.

• Izmailovo market tours

16 – Súzdal and Vladímir Day Tour

Discover Russia’s famous “Golden Ring” on this tour of two medieval cities outside of Moscow. The historic city of Vladimir is first up with its Golden Gate, which is an ancient city-fortress that dates back to the 13th century. Next up is the neighbouring town of Suzdal, which features historic architecture and the Kremlin, where you can see its striking white walls topped with blue domes.

• Suzdal & Vladimir tours from Moscow

17- Moscow Food Tasting & Walking Tour

Sample the unique flavours of Moscow with this food tour that lasts for 3 hours and features more than 15 different food and drink tastings. Weave in and out of small alleys in the city centre while enjoying the best food spots in town. See Moscow like a local while trying classic dishes from local breakfast haunts, bustling markets, the oldest monastery in Moscow, and dumpling cafes where you can taste authentic dumplings and enjoy local coffee.

• Moscow food tours