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Introduction the training clients  for  treatment , and obtaing consent are functions that many clinicians might perform without much thoght. with each step , however, a little forthought can spare aggravation and possible litigation  when the  professional relationship is  mediated or supplemented with technology . ocpm step 2;Referrals In psychotherapy  and counseling practice, accepting referrlas  has been primarily  by telephone . referrals  are increasingly being  controlled by  insurance companies , in line with the overall shift in power created by the  market forces described  in chapter 1.many insurance companies in the united states  ask client to dial the 800 numbers  listed on their  insurance cards and request a list  of potential practioneres. soe  companies refer client to web page  that list  provider panels  searchable by zip code and specialty . As economic pressues force insurance companies  to copete  for market  share , they  will folow the treand  toward

 Notwithstanding the venerable history of telemental  health  whenver  the topic of electronically mediated mental helath service  arises in casul conversation , people tend  to regard it as a novel idea . in fact, it might even be a social gaffe  to suggest that the humble telephone has  long been an independent , established , widely used , versatile, and important , if under appreciated , tool  for scheduling and delivering  mental health care . when more  recently  given specific  consideration, some writers have convinicingly argued against its inclusion  in the  telehealth toolkit . however, the  telephone of yesteryers os not  the telephone  of  today  or of  tomorrow . many newere telephones have already been merged with other  technologies   and  are  fast becoming  a versatile  tool for  mental  health  professionals . a  good example  is the videophone , a small  device  that  plugs  into  almost  any telephone  and  television .  the videophone  is likely  to be the nex

Introduction                                                                                                                                                                                In 2001/42% of physicians were working in practices with web sites, Today/ nearly every large mental health organization maintains a Web site. Consumer use of hospital and health plan Web sites is burgeoning. A worldwide online presence will soon become an ordinary part of the clinical toolbox for mental health practitioners as well.         The public strongly favors integrating Web sites into health care  practices. the jupoter research  center repored in february 2001 that 63% of  consumers  would  switch  to a physician whose web site  offerd ' solid  content , appointment  schedulong , or secure communication channels' . more than half want to make appointement request ,48% would ask for prescription refills , and 38% favor seeing  their  laboratory test result  online .one third 

Store and forward E-health           In store and forward E-health, digital images, video, audio and clinical data are captured and 'stored' on the client computer; than at a convenient time transmitted securely to a specialist hospital at another location where they are studied by the relevant specialist. the opinion of the specialist is then transmitted back. based on the requirements of specialist  is then healthcare entites , thise round trip could take between 2 to 48 hours . in many store and forward specialties , such as telerdilogy, an immediate response is not critical . dermatology , radiology , and pathology are common specialites that are conducive to store and  forward technologies . Real Time E - Health                  in real time E - Health  a telecommunications link between  the involved parties allows a real time interaction to tale place . videos- coferencing equipment is one of the most common forms of  techonologies used in synchronous  telemedi

A first step towards achieving this goal is to adumbrate the notion of information and decision space a little more closely. and here ,it may be begin with the logic of representation itself . let us postulate an object a material system which  responds to external causal stimulation by an internal modification of its states. form a purely formal perapective,the modification which the system undergoes as a result of being acted upon by external causal stimulation are functionally determined by the nature of the system and by those features of the causal stimuli that were causally active in producing the modifications. To give an analogy ,the modification produced in a piece of wax by a signet ring is functionally determind by those features of the ring that are causally activ on the wax and the natureand condition of the wax at time of its modification .similarly , the mosofication of a piece of photographic film by the light that strikes it is funcationally setermind by the nature

Nevertheless,electronic patientrecords are fundamentally distinct from paper -based records -a difference that ,as we shall see ,has tremendous ethical implication .howevr, this fundamental  sifference dose not lie in their physical difference from paper -based records,or in the greater technical sophistication that is necessary to generate and use them .instead, it lies in their logical natures as records and the funcation manipu;ation to which they can be subjected .for instance ,electronic patient records can be combined and manipulated in a holostic  fashion to yield an integrated picture of the patient which can directly involved in ,patient as health  care consumers in a way that is not possible for paper -based records .          Thise difference reflects a fundamental difference in the relationship in which the element of electronic patient records as  well as the records as a whole stand  to the patient .to adopt terminology suggested  by wittgenstein  in the tractatus in a

Introduction in the beginning, contact between health care providers and health care consumers was limited in scope . it ecompassed the physician and the patient in a direct and immediate personal intercation . in sociological terms ,therefore, the scale of intercation was small. of course there were exceptions to this .for instance,physicians sometimes inquired about their patients' symptoms from othre persons who stood in direct contact with the patients and who knew them .further ,in china and medieval europe physicians were often not in direct contact with socially exalted patient but communicated with them only through intermediaries.however, these were noteworty precisely because they were exceptions. in princiole,direct examination was the rule . consequently,from an information-and decision -theoretical point of view,the touchstone of traditional medical diagnosis and treatment decision-mqking was the direct interction between the physician and  the patient, where patien

E-Health is a benefit in countries where the traditionl delivery of health service are impacted on by distance and lack of local specialist clinicians to deliver services could benefit. the rate of adoption of E-Health service in any country or jurisdiction is frequently influenced by factirs such as the adequacy and cost of existing conventional health services in meeting patient need; the policies of government and/or insurers with respect to coverage and payment for E-health service ; and medical licensing  requirements that may prohibit or deter the provision of E -health second opinions or primery or primary consulation by physicians  not licensed in  the jurisdiction where the patient resides. The terms E-health and telemedicine are at times interchanged with telehealth. like the terms 'medicine ' and ;healthcare', telemedicine often refers only to the provision of clinical services while the terms E-Health can refer to both cloinical and non-clinical service such

overview e- health  refers to the use of modern information and communiction technologies to meet need of citizens , patients healthcare professionals ,healthcars providers ,as well as policy markers . E-Health is the delivery of medicine at a distance .E-health may be as simple as two health professionals discussing a case over the telephone ,or as complex as using satellite technology and video-conferencing equipment to conducta real-time consulationbetween medical specialists in two different countries .it can also involve the use of an unmanned robot . E-health is the delivery of health related service and information via telecomunications technologies. it may be as simple as two health professionals discussing a case over  the telephone ,or as sophisticated as using satellite  technology to brodcast a consultation between providers  at facilities in two countries,using videoconfererencing equipment or robotic technology .E-Health generally refers to the use of communications