Evaluating eHealth Interventions: The Need for Continuous Systemic Evaluation
نویسندگان
چکیده
There is now considerable interest internationally in exploiting the potential of information communication technology (ICT) systems to improve the quality, safety, and efficiency of health care. Given that the adoption of ICT systems by health care providers is some 25 to 30 years behind many other private and public sectors [1], there is an understandable sense of urgency with which these eHealth initiatives are now being commissioned, developed, and deployed, typically at considerable expense [2–5]. The American Recovery and Reinvestment Act of 2009 [6], which includes $34 billion to incentivise health care professionals to ‘‘use a certified EHR (electronic health record) technology in a ‘meaningful manner’,’’ is a recent highprofile example of the sums of money that are being invested in eHealth [7]. Whilst eHealth interventions undoubtedly have the potential to play a substantial role in shaping and helping to create health care systems that are fit for the 21st century [8], experience has repeatedly shown that if attempts are made to implement poorly designed systems, there is a real danger that not only will the anticipated benefits fail to be realised [4,5,8–10], but also that vast sums of money will have been squandered in the process. Worse still, patients’ safety may also be compromised [11–13]. The argument about the need rigorously to evaluate medical technologies themselves as well as their social and economic impact is not new [14–16]. However, those responsible for ICT developments must appreciate that health information systems should be evaluated with the same rigour as a new drug or treatment programme, otherwise decisions about future deployments of ICT in the health sector may be determined by social, economic, and/or political circumstances, rather than by robust scientific evidence. Health care is in what Heathfield has described as ‘‘a catch 22 situation’’ [17]: until we develop eHealth interventions that are ‘‘fit for purpose’’ [18]—and early evaluations suggest they are frequently not [19]—health care professionals are, justifiably, reluctant to adopt these new technologies. The paradox is that unless we have the means to demonstrate the true benefits of these systems, which requires integrating these technologies throughout the health care industry, we will never have the necessary evidence to support the case for ICT in health care [17]. So, while financial incentives to adopt certain eHealth interventions may be understandable [6,7], they should never be the main reason for their adoption. Instead, society must be able to judge the true value of eHealth interventions in its own right. Therefore a means simultaneously to evaluate eHealth interventions while they are being developed and deployed is required [20]. In this article, we argue for continuous systematic multifaceted evaluations— throughout the lifecycle of eHealth interventions—on the grounds that such an evaluative approach is likely to provide timely and relevant insights that can help to assess the short-, medium-, and long-term safety, effectiveness, and cost-effectiveness of eHealth interventions. The suggested lifecycle–based approach to evaluation should [20], we believe, become the norm rather than the exception, as is currently the case.
منابع مشابه
CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions
BACKGROUND Web-based and mobile health interventions (also called "Internet interventions" or "ehealth/mhealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The "Consol...
متن کاملCONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions
The CONSORT-EHEALTH checklist is intended for authors of randomized trials evaluating webbased and Internet-based applications/interventions, including mobile interventions, electronic games (incl multiplayer games), social media, certain telehealth applications, and other interactive and/or networked electronic applications. Some of the items (e.g. all subitems under item 5 description of the ...
متن کاملCONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions
The CONSORT-EHEALTH checklist is intended for authors of randomized trials evaluating webbased and Internet-based applications/interventions, including mobile interventions, electronic games (incl multiplayer games), social media, certain telehealth applications, and other interactive and/or networked electronic applications. Some of the items (e.g. all subitems under item 5 description of the ...
متن کاملCONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions
The CONSORT-EHEALTH checklist is intended for authors of randomized trials evaluating webbased and Internet-based applications/interventions, including mobile interventions, electronic games (incl multiplayer games), social media, certain telehealth applications, and other interactive and/or networked electronic applications. Some of the items (e.g. all subitems under item 5 description of the ...
متن کاملCONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions
The CONSORT-EHEALTH checklist is intended for authors of randomized trials evaluating webbased and Internet-based applications/interventions, including mobile interventions, electronic games (incl multiplayer games), social media, certain telehealth applications, and other interactive and/or networked electronic applications. Some of the items (e.g. all subitems under item 5 description of the ...
متن کامل