There are huge changes taking place in healthcare education and delivery. Drivers for change include controlling expenditure, workforce development and improving patient care and patient safety.

The traditional approach to improving healthcare has been to spend more on treatment. This is unsustainable and prevention of ill health should have much greater emphasis.

"The doctor of the future will give no medicine, but will his patient in the care of the human frame, in diet, and in the cause and prevention of disease."  Thomas A. Edison 1902

Governments everywhere are investigating electronic personal health records in one form or another. Ownership of health data by patients offers many individuals opportunities to improve their health and access to healthcare (see). Unfortunately it may also increase health differentials in the community. 

Education of health professionals has been impacted by changes in the way healthcare is being delivered and, in many countries, increased numbers of students. The apprenticeship system of healthcare education in hospitals has been replaced by peripatetic students in new settings. Assessment of learning and competence has become a major issue and ePortfolios are increasingly being used for this.

Advances in healthcare can take a long time to be introduced into clinical practice. Graduation or accreditation as a health professional once signified the completion of education. That event is now recognised as just the beginning of continuing professional development (CPD). The challenge for professional bodies has been to track what CPD has been undertaken and most have now adopted some form of ePortfolio. Some CPD programs are simply based on exposure to CPD but using ePortfolios it is possible to research the quality and effectiveness of CPD activities.