mHealth? eHealth? Digital health? Telehealth? Telemedicine? What’s the difference?

You’re right – it’s confusing. If you’re new to conversations at the intersection of digital data and healthcare, it can be hard to make sense of the different terms that get thrown around.

An easy place to start is with definitions, but we will also review when different terms appeared relative to technology developments. This should help put things in context and sort out the slurry of digital health concepts in circulation.

Defining digital health

Let’s start with some simple definitions of common terms that describe healthcare developments in the digital era. As with many relatively new terms, most of these definitions are slippery and debatable.

Digital health – Best understood as an umbrella term that includes categories like mobile health, electronic health, health information technology, wearable devices, telehealth, telemedicine and personalized medicine.

mHealth or mobile health – A general term for the use of mobile phones and other wireless technology in medical care. mHealth is increasingly associated with smartphone apps and wearable devices designed to promote health and fitness.

eHealth – The use of information and communication technologies to promote health. eHealth is often used as a synonym for Health IT, but it emphasizes the delivery of clinical information, care and services rather than the functions of technologies themselves.

Telemedicine – The clinical application of technology, specifically to deliver remote healthcare services using telecommunications infrastructure. Telemedicine is an older term than telehealth, referring to providers’ ability to evaluate, diagnose and treat patients without an in-person visit.

Telehealth – The use of electronic information and telecommunications technology to enhance healthcare, public health, health education and health administration. Notice that telehealth is a more universal and consumer-facing term than telemedicine because it refers to technology applications beyond just clinical care.

Personalized medicine – Any medical procedure that separates patients into different groups and tailors medical decisions, interventions, or products to individual patients based on their predicted response or risk of disease. Personalized medicine is often used synonymously with precision medicine. The most common example of personalized medicine is genomic medicine (e.g. to determine the optimal therapies for cancer treatment).

Connected health – The use of technology to connect various pieces of the healthcare system (people, tools, facilities, etc.) in a way that enables virtual or remote care.

Putting digital health concepts in context

Another way to make sense of different terms that describe digital health is to think chronologically. We borrowed an idea from social scientists at IHD and used Google’s Ngram Viewer to graph the frequency of different terms that appear in Google Books from 1990-2008.

As you can see, terms like telemedicine, telehealth and eHealth emerged much earlier than mHealth and digital health. Telehealth and telemedicine became major topics in the 1990s, with the rise of mobile phone technology and the ability to deliver healthcare to remote locations.

Literature discussing eHealth coincides with the rapid development of the web in the late 1990s and early 2000s. Many businesses and initiatives branded themselves with the prefix ‘e’ for electronic.

It becomes easier to compare terms like mHealth and digital health if we eliminate the terms telemedicine, telehealth and eHealth from the Ngram Viewer. In the graph below, you can see how mHealth and digital health emerged as popular concepts around the year 2000.

Two major limitations of Google’s Ngram Viewer is that it only works up until 2008 and it only catalogues books. Social scientists at IHD offer a nice alternative focused on the Twitterverse. Last year they took a week long sample of activity on Twitter that focused around terms related to digital health. The result is an image they produced showing common hashtags related to digital health and wearable devices (health, connected health, digital health, precision medicine, quantified self, tele-health and wearable tech).

The visualization below is a co-hashtag network based on a method called co-word. In normal language this just means that you’re looking at common hashtags connected by lines to other hashtags that appear in the same tweets. More connected terms are bigger and bigger lines connected hashtags that appear together more often.

Image: Twitter co-hashtag created by researchers at Insuring Healthcare for a Digital World

As IHD explains:

“The following graph is called a co-hashtag network, based on a method called co-word. Simply put it shows which hashtags appear in tweets together – if they appear together in a tweet, they are connected by a line or ‘edge’ and the line becomes thicker the more times they appear. The graph has then been arranged so that more associated hashtags are drawn together for ease of reading. The graph has also been reduced so that only the most connected hashtags appear – again for ease of reading.”

This is a useful discovery because it helps identify digital health and mHealth as connecting concepts.

As the IHD researchers point out, #digitalhealth and #mhealth are some of the most connected terms, meaning they are often used along with other hashtags. This is a useful discovery because it helps identify digital health and mHealth as connecting concepts. While there are many terms in the digital health alphabet soup – and while each refers to a distinct intersection of technology and health – some draw our attention to the connections between related concepts.