Evaluation of IT modernisation in the NHS - NETSCC

Report to SDO for NCRS ProjectReview of Economic Implications3. Systematic review of the economic implications of large scale ITimplementation in health care3.1. IntroductionThe scarcity of available health care resources means that they need to beallocated so that they generate the maximum possible health benefit. The goal ofeconomic evaluation is to provide a comprehensive assessment of potential costsand benefits to provide the necessary support in this decision making process.Drummond et al. define economic evaluation as “the comparative analysis ofalternative courses of action in terms of both costs and consequences”. 46 Acomprehensive economic evaluation should contain a number of key elements.These include the identification, measurement, valuation and comparison of allrelevant costs and consequences relating to the alternative technologies underconsideration. A competent economic evaluation will also assess the level ofuncertainty surrounding these results so that the decision-maker can assess therobustness of the results with respect to alternative assumptions. 47In theory, all health care technologies should be subject to economic analysis.However, the need for robust and comprehensive economic evaluations becomeseven greater when the implementation of particularly costly technologies is beingdebated. The current National Programme for IT (NPfIT) for the NHS, with anestimated investment outlay of £6.2 billion over ten years, certainly satisfies thiscriterion. 483.2. Background information on IT implementationThe economic implications of the integration of information technology (IT) intohealth care and its consequences have been studied widely. Although theamount of literature on this subject is vast, it is difficult to find a consensus amongresearchers on the methods of evaluation and the effects of the implementedtechnology.The majority of the studies in this review compared the impact of an ITintervention, by studying various outcome measures (e.g. costs, time saved,change in productivity) before and after introduction of the intervention. A small24