Public Sector Health Information Systems

In the Evaluation section:


Benefits and Costs of Public Sector Health Information Systems Projects

"Why proceed with my e-health project?"

In rational terms, your public sector e-health project should go ahead if its expected benefits are greater than its costs. If, on the other hand, the expected costs are greater than the benefits, you should not proceed or should only proceed if your project is redesigned.

Two problems, though, with this simple analysis. First, it is hard to identify all project costs and even harder to quantify project benefits. Therefore, it is almost impossible to say which is bigger: costs or benefits. Second, e-health project "go/no go" decisions are determined largely by political factors which may or may not be linked to objective benefits and costs.

Despite these problems, it normally makes sense to at least roughly sketch out likely costs and benefits of your e-health project. The details below give you a checklist for this.

Checklist of Potential Benefits of eHealth Projects

Below are listed the potential benefits of your e-health project. The word 'potential' is important: in practice, few e-health projects have managed to deliver these benefits; most e-health projects have so far failed to deliver these benefits (follow this link for case evidence). Some of the example links below thus give potential, expected or hoped-for rather than actual benefits. However, you can still use all the items as a checklist to identify potential benefits on your project.

There are many ways in which benefits for e-health projects can be classified. An alternative to the one shown below, is to divide into:

Task-level benefits, e.g. improvements to the cost or speed of data-handling tasks.

Health process-level benefits, e.g. improvements to the speed or quality of health management or health policy decision-making, or of health care delivery.

i. Cheaper

ICTs can cut the costs of health tasks and processes. For example, telemedicine can reduce the need for travel and the need for referral to a secondary or tertiary health institution; this cuts costs for both patients and the health system. eHealth systems used in immunisation can save wastage of vaccines.

ii. Quicker

ICTs can reduce the time required to perform health tasks and processes. For example, new technology can reduce the time that health workers spend on data-handling tasks. This can have the additional benefit of then releasing health worker time for more valuable health interventions. Quicker data-handling can also lead to faster health decisions and action, potentially saving lives. By making health data accessible on the desktop, ICTs can also enable faster health decisions and actions.

iii. More

ICTs can enable health processes to handle more cases without raising staff numbers or associated costs. For example, computerised systems can help patient registration and medical records staff to cope with increases in patient numbers.

iv. Better

ICTs can improve the quality of health tasks and processes. For example, they can improve the quality of data held in health systems. This, in turn, can make for better-quality health decisions and actions at the operational level and at the managerial and policy levels.

ICTs can also make things better in deeper, less tangible ways. They can improve the skills of health workers. They can improve the knowledge of health workers; for example their understanding of the importance and role of information in their working lives. Thus, more generally, they can empower health workers in different ways.

v. First Time

ICTs can help new health tasks and processes to be undertaken for the first time: things that were simply not possible before. No explicit examples were provided in the case studies given here, but a number of health management and health policy decisions can only be made once ICT-enabled health information systems deliver reliable data for the first time.

Informal, Personal Benefits of eHealth Projects

Self-interest and politics play an important role in e-health projects; as in all projects. Therefore, you should recognise the informal, personal benefits that an e-health project can bring. In some cases, these will support the formal benefits; but in other cases there may be a conflict:

Checklist of Potential Costs of eHealth Projects

Benefits of an e-health project are often potential rather than real. Costs, though, are very real and typically fall into the following categories that can be used as a cost checklist for your e-health project:

Costs estimates provided in the e-health cases reported on this Web site vary enormously: from systems costing just a few thousands of US dollars, to a hospital system costing more than US$200,000 in direct costs alone. None of these estimates covers anything other than the ICTs category listed above.

Downsides of eHealth

In addition to financial costs, there are also "dis-benefits": downsides that can emerge when you use ICTs to support public health systems:



Page Author: Richard Heeks. Last updated on 19 October, 2008.
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