Friday, July 03, 2015

Some More Thinking Regarding Just Where The Value Lies In Health IT. We Need To Keep Value In Mind.

This appeared a little while ago

Industry professionals create framework for measuring HIT value

January 29, 2015 | By Katie Dvorak
Healthcare professionals have created a framework for measuring health information technology with a goal of making "HIT evaluations more relevant to the current needs of the healthcare system," according to a paper published at the American Journal of Managed Care.
In the paper, sponsored by the Office of the National Coordinator for Health IT, the researchers--from RAND Health, Harvard Medical School and Brigham and Women's Hospital--say that HIT should take into account three principles.
Those principles are:
  • Value includes costs and benefits: Value cannot be found through cost analysis alone, the report's authors say. While costs are important, they do not reveal what the health benefit to patients may be nor do they assess the potential benefits of the technology or system. Studies must be sure to measure both, they say.
  • Value accrues over time: New tools have short-term costs and long-term costs, and the same holds true for the benefits they provide. While capturing the impact of technology over the long term is not "feasible for any study," the authors say, a study must allow for enough time to show the upside of having the new tool compared to not having it.
  • Value depends on stakeholder's perspective: Perception varies from person to person and practice to practice, the authors say. This must be a consideration because differing opinions could impact conclusions about the value of the study. "Ideally, all evaluations of HIT would take the perspective of all relevant stakeholders," according to the paper.
Lots more (with links) here:
Here is a link to the full paper with a .pdf also available :
Here is the introduction to the paper:

The Value of Health Information Technology: Filling the Knowledge Gap | Page 1

Published Online: January 26, 2015
Robert S. Rudin, PhD; Spencer S. Jones, PhD; Paul Shekelle, MD, PhD; Richard J. Hillestad, PhD; and Emmett B. Keeler, PhD
In 2010, the United States Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act, thereby dedicating roughly $27 billion to eligible healthcare providers who demonstrate “meaningful use” of health information technology (HIT). This action motivated the purchase and installation of tens of thousands of HIT products across the US healthcare system and placed a national spotlight on HIT. The HITECH Act was justified, in part, by early studies that documented positive effects on healthcare quality, safety, and efficiency at a subset  of institutions that were early to implement HIT, and by policy analyses that extrapolated the implications of these potential benefits throughout the US healthcare system.1,2 These studies suggested that HIT had the potential to create enormous value by facilitating improvements in the quality of healthcare and reductions in costs.

However, systematic reviews of HIT have found that the evidence for value is inconclusive and that existing studies suffer from major limitations.3-6 This finding is true even of the most recent literature reviews, despite a greatly increasing number of studies evaluating HIT.6 In this paper, we suggest a way to overcome these deficiencies and make HIT evaluations more relevant to the current needs of the healthcare system, by presenting a conceptual framework for measuring the value of HIT, examining how a sample of published HIT articles report the information needed to make meaningful assessments of value, and proposing a set of criteria for future evaluations that would make them more useful for policy makers.

This paper was sponsored by the Office of the National Coordinator for Health Information Technology, which otherwise had no role in the conduct or writing of the paper or the decision to publish it.
----- End extract.
This is really useful as it attempts to show how we might assess how well we are going with our e-Health efforts. We must do better in this area otherwise funding will gradually evaporate!
You can’t keep just spending without being able to prove you are making a positive difference - especially in these restrained times!
David.

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