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Introduction Hospitals, healthcare system, Physicians practices don’t know the actual costs of their service, their responsibilities, their part to state the persons healthcare and secure the health information secrete. They are always trying to improve the way of therapy effectively and control the cost of service by providing a satisfactory care to the customers/patient. There is another question of cost effective health delivering services.

Need to develop a new technology that will easy to access patient and care providers, and also physicians learn from the previous experiences to avoid mistakes and improving health service with the ease of data entry, reliability, easy to learn, vendor training program, customer support, interactive with other providers, satisfaction of both care provider and patient. There is one newly developed service called as E-clinic works satisfied the all requirement.The e-clinic concept concerned with the re-engineering, comprehensive current framework in order to keep up with the ever changing complex health care delivery system. It will provide the Shared-care or Managed Care program in order to delivering of the chronic diseases.

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It will provide a more robust platform to integrate clinical guidelines and local care flow process in the delivery system.E clinic media releases E clinic is the newly invented health informatics techniques to deliver test results to medical practitioners and streamline administration tasks more securely and reducing the time of service. * Using a macromedia-based Web site from online medical services aggregator e-clinic, doctors are able to deliver tests results and patient history faster as well streamline previously time consuming administrative tasks. * E-clinic enables to receive patient’s radiological and pathological information’s over the internet more securely and conveniently.* E-clinic site also providing on line facilities to practitioners regard to assess the latest medical and top braking news stories of the day and online ordering of a samples from pharmaceutical companies. * E-clinic also enables to purchase of medical consumables such as surgical gloves and swabs on line. Here is the benefits of one the health care service providing health care firms called as NetMed Care Center, and also a video demonstration how easily you can get the health service, and getting your prescription from the pharmacy.

Benefits: – 1. No hassle to getting the quality care of health service 2. Physical and mental care 3. Economically affordable and competitive to regular check up 4. Works for both insured as well as uninsured 5. Just need appointment no waiting room to spending a long time to consult with physician 6. Keeps electronic records 7.

Keeps secure of personal health records 8. Efficient to patient time 9. Quick response and quick outcomes 10.Treat, educate, monitor, prevent Link for video demonstration of how e-clinic works: – http://www. netmedcare. com/video-corp. htm E-clinic web application software works in internet or intranet, it’s work for different users like patient, clinic assistants, general practitioners (GP) and clinic manager are able to get the information about the book appointment, Queue status, check their medical records online, billing information, drug issued to patient record, patient medical information and diagnosis information during a consulting session.Here is a scratch diagram show the E-clinic software application to get the information is stated below: – Various fields of application works of e-clinic:- Patient portal Through the e-clinic works web based patient portal.

Patient and physicians communicate easily, safely and securely over the internet, patients have their own secure passwords. So, patients can looks at its medical records, history, and set of clinical documents. On other hand doctors can easily remind patient and his history to look at the patient portal.

Benefits: – more secure to communicate patients, keeps record of patient history, accurate and effective treatment due to less misguiding, patient keep aware to his treatment due to assessment of portal records, promote to easier performance of preventive care, patient able to request prescription refills, send and receive message from patient and nurse to get complete health assessment, examine their statements. Also is able to look at their balance and much more.There is one article published by MEDINFO 2004 by Yusof Rahman, based on Diabetes Mellitus a group of metabolic disorders and its complications are associated with morbidity and early mortality. The newly advantage of concepts of e-clinic as an electronic triage system with integrated health care records, related to decision support system to analyze patients data and provide a continuous monitoring system according to agreed clinic guidelines.

The e-clinic works as the filtering system to identify unstable patients. A newly diagnosed diabetic patient was having on controllable diabetes than physician put on e-clinic work.Patient and physician can assess his regular schedule of treatment online.

Patient who has been referred to e-clinic will receive an appointment date for routine blood test such as HbA1c, patient get the three month of regular glucose monitoring reading. Patient can able to analyzing the home glucose reading and post to the portal so physician can assess that reading from their glucose meter and figure out analyze the result of diabetic patient. Based on the reading physician post the feedback as stable or unstable diabetic, if he found that it’s an unstable diabetes than he fix the further more schedule of treatment.For the stable patient will discharge from the e-clinic registration. All the transaction will be recorded appropriately in medical record and can be assess any time in future. Electronic Medical Records/Electronic Health Records E-clinic works as Electronic Medical Record manage the customers/patient flow, immediately access the patient records, electronically assess to communicate the available physicians and securely send the related patient’s medical history and records with his clinical data at the relevant persons.E-clinic works EMR allows to assess the patient and physicians also to the relevant medical representative for easily review patients medical record as patient histories, past visits to the physicians, past and current medications with its significant actions, allergies, major complication with their treatment, clinical and diagnostic test reporting, clinical decisions etc.

keeping the patient review, clinical decisions and reporting has an advantage to development of next generation of EMR.Passively collected data will helps to actively working care givers for the best medical care as possible as physician and all health care service providers can do. Benefits: – * Customers receive different layouts to communicating information about the patient visits. * Primary care physicians make a SOAP format to focus on the sections they want the recipient to read.

* Regard to special practice of treatment they send copies of notes in order to assessment, plan, subjective and then objective treatment of patient particularly for chronic disorders, it will based on the patient’s diagnostic treatment.* Helps in measurement of management of patient disease using the built-in registry reporting. Advantage of e-clinic works EMR Providers are able better manage care of patient by monitoring and promoting patient safety.

It will reduce the costs and improving the patient health due to better and frequent community and coordination in patient care with the health care providers.There is one article from Sri Lanka bio medical Informatics by ‘Manthan’ awarded of 2010 prestigious Vidusuwa, project is based on the concept of a patient centric approach in utilizing ICT and providing a working model developed solely by Sri Lankan professionals in the IT and Health sectors to empower the rural population of Sri Lanka http://www. sljol. info/index. php/SLJBMI/article/view/1618 . Based on this project the health records and information of patient from the rural area can be transferred through E-clinic works.

It states that these service is delivering by health care experts at a minimal costs, even patient from rural area can receive the health care service through E-clinic works, people don’t need to unnecessary traveling to meet medical consultants thus it will saving cost, time and inconvenience. Also it states that patient can get the health care knowledge from the E-clinic works online through web based EMR. Also it will explain about the usage of E-clinic works web based of EMR, through which we can transfer the medical records and history of patient to the qualified doctors.Vidusuwa explains that the usage of these service easily by acquirable and relatively inexpensive technology, also it will be under practiced with little extension to existing technology. E-clinic works- Practice Management E-clinic works Practice Management system is particularly concern with the medical billing management it’s reliable for small to large sizes transactions. It will help to reduce the customer account receivable and improve their collections. It will unify with the information collected from the patient EMR records.Patient can manage their appointment schedule through this web browser, h=just log in to their portal and go to appointment and cancel it.

Through these work patient health care service provider’s schedule can copied and send to the other providers. Through practice management patient should able to claim electronically, type of claims, and online communicate with the prayers to confirm their eligibility and determine what kind of service he was taken from the service area. Also what amount of claim he want to claim for.

E-clinic work supports with different kind of electronic forms for billing like NPI numbers, CMS 1500, UB and ADA. Getting the health service through e-clinic has special advantage that it will confirm the patient for insurance, check codes, electronically receive and post payments, automatically council patient records; it will ensure error-free claim submission. E-clinic works PM software can able to generate the financial documents for daily records, monthly records, yearly records.

Few financial reports are posted online so patient can easily monitor their service costs. E-clinic works PM can provide features to look up and manage patient accounts with multiple providers, accurately and availability quickly. Once, the patient visit will be over able get summary easily. This article is based on those are highly qualified mental health professionals from middle or low income countries; those are looking for good position migraine to developed countries.

In under developing countries, patients having chronic disorders like mental disorders, in that cases e-clinic works play a major role to provide service. For mental illness patient can treated by telepsychiatry, use of communication technology to provide service from the long distances. These services are usually for diagnostic, management, or educational purposes should be provided in form of electronic medium or through internet or telephony.

Also for the treatment of mentally ill patient are treated through video conferencing or telephony for real time clinical interactions.Such kind of technology and services are provided in rural parts of USA and Australia. Based on the few records of child care through computer based video conferencing system compare with the results coming out of face to face assessment by a psychiatric and found that there is no significant difference between their assessment , diagnostic results, their way of recommendations, user satisfaction.

That indicates people are more likely happy with this kind of e-clinic works or e-health services.E-clinic works through mobile service/ E-clinic works through mobile communication E-clinical Mobile uses a mobile browser, through which providers can easily access the online system through their is smart phone and enrolled in communication with health care system. Using this software easily check out the schedules, reviewing telephone and web messages. E-prescription, check out patient medical records, look up a laboratory test and results, current treatment information.According to the project held on base of hospital in Sri Lanka at an outpatient having accessibility of mobile phones.

Results show that 51% of patient having their own personal cell phones out of this 50% of patient using SMS for frequent communication. Around 80% of patient use their family members cell phones. All to gather says that most of patients using mobile phones effectively to communicate with the patients. Based on analysis says that mobile phones is the best ways to send the important information frequently to the patient.Such information are vaccination date, precautions, re admission date, operation date, medical tests, postponement or cancellation of appointment etc. E-clinic Applications- a Global Perspective Now a days due to development and invention of new therapeutic health care service technologies, health care system is moving from a traditional hospital based system to more patient centered approach. Because of usage of ICT in developed countries health sector 50% of reduction in mortality and/or 25% to 50% increase on productivity.

Application of E-clinic works in Developed Countries There are many instances using the ICT for better health care around in the world here are few listed below: * In Spain doctors/nurses use the PDAs to transfer the electronic medical records * In Sweden and Denmark nearly 90% of doctors use electronic medical records for the treatment. * In Spanish hospitals around 16 of them doctors using satellite videoconferencing system and online consultations for specialized diagnosis in radiology, cardiology, surgery, and for dermatology.* Using the online/electronic participation of patient with doctors of chronically ill, which reduce their visits around 20% * Wireless ambulatory, mobile and remote patient monitoring by using the wireless devices for 24 hour services. * Usage of online web-based health information system for e-learning. * Using the existing technology in developed countries may possible to usage of e-clinic works for more accurate assessment and centered health care monitoring of patient.Applications of E-clinic works in developing countries In developing countries have a poor telecommunications infrastructure, limited number of internet services, lack of access to international bandwidth and high internet access, to develop the scenario of E-clinic works?But even though they are few applications available of e-clinic works in developing countries are listed below:- * India has developing technologies in telemedicine, tele-education, tele-consultation and tele-follow up initiatives that helped their rural population increasingly.

* In South Africa usage of mobile phones based technology to send them medial information through SMS.* Uganda, using Email palm hand to deliver medical/journal content to health workers. * In India, before eConsultations regard to treatment will done, need to fill up a form with using PDA between the specialist and health care workers. * The Ruwanden treatment and Research center uses a network for monitoring the delivery of anti-retroviral agents to patient and clinics. List of various hospitals and health care service centers allowed to e-clinic works New York city regional Extension center, New York State Regional Extension Center, St.

Luke’s of Minnesota Select e-clinic works comprehensive Her solution, Maryland’s Adventist Healthcare, IntelliDose and e-clinic works partner for End-to-End Oncology Practice Management, California Forensic medical Group Selects e-clinic Works’ EMR System, Maryland’s Peninsula Regional Medical Center, Customers Achieve Success with Patient Centered Medical Homes, E-clinic works Named One of the fastest growing companies in Boston area, North Carolina’s Sandhills physicians IPA selects e-clinic works Unifies EMR?PM System, Indiana’s Johnson memorial Hospital Selects e-clinic works for electronic health records, Michigan’s portage Health selects e-clinic works for Ambulatory Electronic Health records, Buffalo’s catholic IPA selects e-clinic works Unified EMR/PM. Conclusion Technology is only a tool but if we used this technology in proper ways to improve the flow of information and efficiency of physician’s services. Physician’s service is more likely clinical software based. Physician’s service providing outsourcing for the other research and provides more choices for clinical solutions due to holding the all clinical records through EMR or PM.

In future there will be a greater choice of healthcare serving as E-clinic works. Hospitals and integrated delivery networks have expressed interest in doing same network with E-clinic works with vendors, data centers, resellers, consulting firms and independent physician associations. E-clinic works are through internet through so its works faster to connect service provider to patient anywhere in the world. Through E-clinic works can send the all patient records to one place to another without any incompatibility reasons.There are more widely spread of usage in developed countries due to facility of internet services, in reasons of under developing countries spread is limited but its works in rural areas having a problem to get treatment with lower cost for chronic diseases.

More convenient technology to access a portal for patient, easily get connected through mobile services. E-clinic works is cost effective faster to connect with healthcare provider and works in concern of safety of patient and patient records.Reference E-clinic Media Releases, written by Kinetics Pty Ltd on 30th October, 2001, what the doctor ordered for e-clinic online. Online posted on http://www.

eclinic. com. au/eclinic/macromedia.

cfm http://www. netmedcare. com/video-corp. htm, online video presentation by NetMed Health Care. To demonstrate how E-clinic works? Article published by Yusof Rahman on 2004IMIA, MEDINFO on heading of E-clinic an electronic triage system in the management of Type 2 Diabetes Mellitus. Online available at http://cmbi.bjmu.

edu. cn/news/report/2004/medinfo2004/pdffiles/papers/4531Rahman. pdf ChapmanKPR and Arunthilake MKD. Vidusuwa- Electronic Distance Healing; a patient centric Telemedicine Solution in Sri Lanka. (2010) Sri Lanka Journal of Bio-Medical Informatics 2010; 1:63-75. DOI: DOI: 10.

4038/sljbmi. V1i1. 1487 http://www. sljol.

info/index. php/SLJBMI/article/view/1618 A. Tareen, I. Mirza and A. Rahman: E-Mental health in Pakistan: a pilot study of training and supervision in child psychiatry using the internet.; May 1, 2006 30: 149-152 Psychiatric Bulletin(2006), online available at http://pb. rcpsych.

org/cgi/content/full/30/4/149#BDY Vidusuwa- Electronic Distant Healing: A Patient Centric Telemedicine Solutions in Sri Lanka; Sri Lanka Journal of Bio-Medical Informatics 2010;1(1):63-75 DOI: 10. 4038/sljbmi. v1i1.

1487. Online available at http://www. sljol. info/index.

php/SLJBMI/article/viewFile/1487/1321 Online access of E-clinic works available at http://www. eclinicalworks. com/index. php

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