There seems to be a consensus emerging in the literature about how one would categorize the benefits of eHealth. As we move further with the evaluation of eHealth initiatives, it is important to agree on definitions and categories, and to establish measures for each of these benefits. This will help us to compare projects and help health care managers to develop solid business cases for their eHealth projects.
The categories are:
Improved Productivity: increased efficiency, reduced duplication of tests and procedures, cost reduction/avoidance/containment, support to program reform and health system change management.
Improved Access: easier access to health services in remote or under serviced areas, reduction in wait-times for medical and surgical procedures, improved access to data for research.
Improved Quality: improved patient health outcomes, improved population health outcomes, reduction in preventable adverse events, patient empowerment, improved patient satisfaction, improved privacy and security, enhanced accountability.
We continue to have a challenge coming up with quantifiable measures for eHealth benefits that are comparable across a range of eHealth initiatives. This is a particular problem with the assertion that eHealth can help to improve patient and population health outcomes and improve patient safety. The literature is very sketchy on these subjects and even conflicted on the issue of patient safety. Defining benefits and their measures is an essential task to complete if we are to justify the investments being made in eHealth infrastructure and applications.
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What I can't figure out is why there is even a question as to whether having patient information easily accessible in a digital format offers tangible benefits. I shudder to think about the number of times I have had a healthcare professional ask me about my medical history. When I walk into my neighborhood bank to deal with a financial matter they seem to have all the information they need about my financial transactions, credit history, etc. Why can't my doctor have ready access to similar information about my prescriptions, past encounters with other healthcare providers, etc? Certainly it would seem to make sense that having access to this information will reduce the time spent re-collecting this information and will result in overall better care.
Another question that arises is what is a life worth? If one person is saved because a medication error was averted, for example, what is that worth? If a elderly person feels better because medications aren't interacted, what is that worth?
Yet another challenge is that eHealth enables fundamental transformation of healthcare processes and is really a means to an end. From this perspective, does eHealth itself make a difference or does changing the way that a service is delivered, enabled by eHealth, actually make the difference?
I suggest that we should focus on transforming healthcare delivery processes to acheive tangible benefits. If eHealth is needed to support the change, then lets make the investment. However, lets not try to justify the eHealth investment. Rather, let's try to measure the benefits of the healthcare transformation and take into consideration all costs associated with the transformation.
Michael Martineau
eHealth Practice Lead
Branham Group Inc.
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