As healthcare institutions expand and vertically integrate, healthcare delivery is less constrained by geography, nationality, or even by institutional boundaries. As part of this trend, some aspects of the healthcare process are shifted from medical centers back into the home and communities. Telehealth applications intended for health promotion, social services, and other activities—for the healthy as well as for the ill—provide services outside clinical settings in homes, schools, libraries, and other governmental and community sites. Such developments include health information web sites, on-line support groups, automated telephone counseling, interactive health promotion programs, and electronic mail exchanges. Concomitant with these developments is the growth of consumer health informatics, in which individuals seeking medical care or information are able to find various health information resources that take advantage of new information technologies.
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Bonnie Kaplan gratefully thanks the participants in discussions following her presentations of some of this material at the Kay-Claremont Graduate University Symposium on Pacific Edge E-Health Innovations, December 2006; University of Miami and VA Health care System Dialogues in Research Ethics, January 2007; and at the Conference on Education and Health Professionals in the New Millenium: Technological Advances, Multicultural Competence, Documented Outcomes and Evidence-Based Practice, in Celebration of the Tenth Anniversary of the College of Education and Health Professions, Sacred Heart University, March 2007.
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