This popped up a few days ago.
Digital health not just a cost to be recouped
Spending in healthcare is a tricky line to straddle. When lives and health are at stake, justifying funnelling money into one area over another can be a minefield.
And when it comes to digital health, decision makers have traditionally viewed it as a cost that needs to be recouped, according to a perspective paper published in the MJA this week.
But, the authors argue, this is a short-sighted and incomplete way to understand the value of digital health.
“Recouping the costs from an information technology investment in the short to medium term is unlikely due to the large upfront expense and the limited efficiencies that can be delivered in the short term,” the authors wrote.
The paper calls for a shift away from the business case model of evaluating the value of digital health, as the benefits of digital health far exceed financial recoupment.
“The traditional business case approach, which many existing digital health evaluation models adopt, fails to consider the value of the downstream effects of a connected digital health ecosystem, which enables sophisticated technological advances such as artificial intelligence, machine learning and precision medicine,” they wrote.
Instead, the authors advocate using the “quadruple aim” framework to measure health system performance:
- Enhance patient experience
- Improve population health
- Reduce cost per patient
- Improve work-life balance for staff
Not all of these aims are easily measurable like profit and loss evaluations. However, the authors argue that they offer a more comprehensive and sophisticated view of the value of healthcare initiatives.
Lots more here:
https://wildhealth.net.au/digital-health-not-just-a-cost-to-be-recouped/
This article is referring to a paper in the Medical Journal Of Australia, which was not linked as far as I could tell, not sure why.
Here is the title and link – it is freely accessible.
Show me the money: how do we justify spending health care dollars on digital health?
Leanna Woods, Rebekah Eden, Oliver J Canfell, Kim‐Huong Nguyen, Tracy Comans and Clair Sullivan
Med J Aust || doi: 10.5694/mja2.51799
Published online: 12 December 2022
The first paragraph nicely frames the supposed issue:
“Focusing solely on financial measures is unlikely to deliver a comprehensive view of the value of digital health.”
I would go further and say won’t – not unlikely!
The real
issue is that just measuring financial outcomes just ignores all the benefits
and costs that are not financial – and every system has them. We need to look more holistically!
It just so happens that some IT systems (think banking etc.) can show a financial benefit so easy to justify in those terms but other benefits are still present – but simply not measured!
ALL useful IT Systems can be assessed on a financial dimension but will have a lot of other dimensions and measured that can also be assessed! The question is ultimately do the total spectrum of benefits outweigh the implementation costs (financial, human etc.)
Of course understanding the full spectrum of benefits is valuable as it makes deciding whether to proceed with a system or not – which should never be a purely financial assessment!
Enough said. Did we really need a long article to understand this truth? I doubt it!
David.
"The question is ultimately do the total spectrum of benefits outweigh the implementation costs (financial, human etc.)" plus operating costs.
ReplyDeleteAnd benefits are not enough, they need to have a value as seen by the user. You can have as many benefits (usually predicted by a biased technologist) as you like, but if nobody values them, it's worse than useless.
In summary - the value and return should be measured by the services delivered, not through individual capabilities, technology, process, data or people investments. Those business scales still need to demonstrate the financial case, economic case and management case at a minimum. They should then map the tangible and intangible benefits of the target service(s) as a justification for consideration.
ReplyDeleteIn summary - axe the fax - case closed
ReplyDeleteIronically health should reach back to early business cases for the introduction of facsimile- you might find a raft of similarities. The cost to fax against the cost of a postal stamp never measured up - so why and how did it get past the bean counters?
ReplyDelete"The cost to fax against the cost of a postal stamp never measured up - so why and how did it get past the bean counters?"
ReplyDeleteSpeed and simplicity. Feed a document into the machine, press go and hey presto in a few minutes it ends up at the other end. If necessary, a simple phone call can confirm it has arrived. And the system works independently of the content.
The ambition of eHealth was atomic data useful for decision support, which is where the advantage is. The ADHA have devolved to a digital Fax network of pdf documents with no atomic data, which is the case with pathology in My Health Record. We would actually be better off with actual digital Fax machines, which can easily produce pdf documents and would probably be cheaper and more reliable, if that's all you want. The standards which are capable of atomic data have been restricted to a low bar of pdf content with even that not working reliably because of a lack of decent PKI infrastructure and poor handling of messages by many endpoints. Its a case of dumb it down to the point where it no longer makes any sense...
ReplyDelete