In January 2005 the European Commission established a project to conduct a Study on Economic Impact of e-Health. The following summarises the approach adopted:
“Study on Economic Impact of e-Health
Presently, despite the availability of e-Health systems and services, they are not yet widely used in real-life medical or health situations. A major reason why European and national policy goals have so far not been achieved with respect to e-health is that very little reliable evidence is available on the positive (economic and other) impacts of these innovations. The objectives of this project are:
• to develop a generic assessment and evaluation framework and method, including measurement tools for quantitative indicators, for e-health products and services, focusing on optimising economic resource allocation;
• identification of good practice examples of e-health applications across Member States which have relevance in the domain of this study (hospitals, regional networks)
• integrating the experience and lessons learned from these examples into the method;
• applying the method and measurement tools developed to 10 application sites reflecting the regional and health system diversity of the Union in the fields of hospitals and regional networks;
• making the assessment method and tools generally available online.”
The results are strongly positive and make fascinating reading.
In summary a press article states:
“With Europe's population ageing rapidly and the demand for healthcare growing, healthcare services need to become more efficient. However, little hard evidence is available on the contribution of eHealth solutions. Now one EU project, eHealth Impact, has demonstrated that eHealth can provide enormous benefits – if the technology is properly implemented.
Electronically enhanced healthcare promises to reduce costs, improve quality and efficiency and treat more patients with the same resources. However, to date, no reliable data has been available to support this claim.
Now that data exists. The eHealth Impact project, which finished in May 2006, conclusively demonstrated that there is over a 2:1 ratio between economic benefits and costs. In other words, the benefits gained from implementing eHealth systems are more than two times greater than the additional cost of implementing them. "An eHealth system might cost more, but the benefits far outweigh the costs," says Alexander Dobrev of the project team.
"But that ratio needs to be treated with caution," he warns. "This is the cumulative average from ten of the best eHealth implementations we could find in Europe."
The full set of reports can be accessed under the download section at the following site:
http://www.ehealth-impact.org/index.htm
The documentation provides very useful analysis and some recommendations for policy makers.
“Policy recommendations
The eHI findings point to a few important recommendations to policy makers at all levels: local, national, and EU. In strategic terms, the overarching conclusion from the ten detailedsite analyses is that effective eHealth in support to meeting citizens’ healthcare demands can have substantial economic impacts and benefits, and is therefore worth encouraging. Key success factors to achieve such outcomes where identified above.
However, to pursue and accelerate the realisation of these benefits, health system policies as well as healthcare providers and third party payers must implement polices which foster such results. Policy makers, healthcare providers and other actors must ensure the right mix of eHealth applications in order to achieve the goal of increasing benefits at stable costs. The following specific recommendations towards this goal are made:
1. Support investment in eHealth because of the significant and sustained positive economic impact possible:
- Provide incentives, such as tax breaks, regulatory and other advantages
- Invest directly, with co-funding, or even full funding, by governments or third party payers for national and other eHealth applications benefiting society, but not sufficiently benefiting an individual private investor
- Integrate eHealth strategies into overall healthcare strategies
- Promote proven eHealth applications and effectively disseminate lessons learnt.
2. Ensure the investment is appropriate:
- Monitor the mix of existing applications and adjust efforts in order to achieve the virtual eHealth economy result. Otherwise, there is a risk of overall costs rising at a rate similar to the rate of increase of benefits, which might not be affordable or desirable in the medium to long term
- Analyse and treat eHealth alongside other investments in healthcare systems and provision, both as complementary and substitutive
- Base eHealth investment decisions on clear business cases that focus on the benefits to be gained and the needs that will be addressed
- Reflect eHI findings in eHealth strategies and investment decisions, especially realism in time periods allocated for achieving net benefits, setting realistic goals to be realised in progressive stages, and committing the resources needed for essential enablers
- Invest in training and education to create stable multi-disciplinary teams with several multi-disciplinary individuals, and extend this to structured training to expand the personnel available.
3. Ensure meaningful investment is allowed to work by providing the appropriate frameworkand environment:
- Invest in relevant RTD and innovation research, education and curriculum development, Continuing Professional Development, and a better understanding of the organisational change processes
- Support the professional development and retention of eHealth ICT expertise in health systems and provider organisations
- Disseminate case studies and develop application models of successful eHealth dynamics for healthcare providers and cooperative health systems at the local and regional level
- Ensure solutions are thought through, yet pragmatic, so implementation can start within a reasonable time period of no longer than 5 years, depending on the application
- Encourage, and actively organise working partnerships between suppliers of the ICT component, HPO and third party payers’ managers, and most importantly users: healthcare professionals and non-professionals, citizens and administrative staff.
- Use the eHealth Impact methodology to monitor performance of investments and identify corrective actions
- Continue to analyse more applications and services in diverse settings to validate and improve the method developed, and to compile more evidence about economic performance from other healthcare settings across the Union, and include financing implications, possibly with users and suppliers working in partnership.”
It is truly refreshing to see work of this type being undertaken. There are a number of ideas found here that NEHTA should carefully review in its Benefits Realisation Studies.
Download and reading of the published material is highly recommended to those with an interest in the Benefits area.
David.
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