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PrefaceThis eHealth Handbook for Managers of Health Systems and Services is intended to facilitate decisionmaking processes concerning the incorporation of information technology (IT) into public strategies in the area of health and healthcare. It discusses almost all the fields in which IT can be applied, clarifying concepts, pointing out benefits and explaining requirements.Information technology tools can enhance the quality, safety and continuity of healthcare.They also enable patients and families to play a more active role in the care of their health Furthermore, they allow the rising healthcare costs derived from the population's ageing and the increase of chronic conditions to be more efficiently controlled.In order for these tools to be effectively incorporated into public sector healthcare, an active commitment on the part of the government is essential. The leadership of health authorities is of key importance in developing regulatory frameworks that support the redesign of traditional work processes. The role of such authorities is also crucial in articulating the interests and needs of the many different stakeholders involved.The European experience, particularly that of Spain, can serve as a valuable lesson for the countries of Latin America and the Caribbean, both in the formulation of policies and strategies and in the actual implementation of eHealth projects. For this reason, the Economic Commission for Latin America and the Caribbean (ECLAC) and the Spanish Society of Health Informatics (SEIS) have been working together, over the last three years, to spread knowledge and exchange experiences. It was in this context that European and Latin American experts were asked to create a guide that would facilitate the task of decision makers and contribute to the knowledge of the professionals taking part in these innovation processes.This book is the result of almost a full year of work by an interdisciplinary team of 38 specialists, comprising both the authors of the contents and also reviewers and editors of the same. To each of them we express our sincere gratitude for their efforts. Alicia Bárcena Executive Secretary Luciano Sáez PresidentEconomic Commission for Latin American and the Caribbean ECLAC -United Nations Spanish Health Informatics Society SEIS eHealth handbook for managers of healthcare services and systems 7 Executive summary David Rojas Javier CarniceroThe application of IT to healthcare systems, a trend known as eHealth, is the fruit of a public policy decision to improve the effectiveness and efficiency of the health sector. Its specific objectives vary from region to region and country to country, but they generally respond to two facts.First of all, today's social reality is marked by the growing needs of citizens, whose expectations are also growing because they have access to vast amounts of information. In Europe, the greatest challenge is probably the increasing demand for ongoing care for chronic patients, due to the aging of the population. In Latin America and the Caribbea...