Evaluation of IT modernisation in the NHS - NETSCC

Report to SDO for NCRS ProjectReview of Economic Implications3.4.3. Economic findings and methods of evaluationApart from the studies that used a financial approach, other studies werepartial economic evaluations because they only evaluated differences in costs,and not health benefits. Table 8 further summarises the results of theincluded studies by intervention type. The perspective was identified in fourstudies and implied in the text for four other studies. One adopted a societalperspective 53 and the remaining seven adopted a hospital 52,56,57,63,65,67 ordepartmental perspective. 66 Only five studies applied discounting. 51,53,56,57,65The majority of studies compared pre and post implementation effects. All buttwo evaluations of the effects of PACS used a pre and post comparison withthe pre-PACS comparator identified as film-based imaging. One studyreported changes in the outcome measure during the implementation of PACSand once PACS was fully implemented, further comparing those findings withpre-PACS data. 65 Another study compared the effects of PACS versus PACSwith the addition of CR (computer radiography). 50 Maass et al. evaluated theeffects of implementing PACS in addition to a film-based system and usedtheir findings to estimate the costs of a full-scale PACS implementation. 67Similarly, studies evaluating the effects of EMR and CPOE implementationscompared outcomes and costs before and after introduction.3.4.4. CostsAll but one of the 7 studies of the effects of PACS reported the costs ofmaintaining and operating the new system. In addition, two studies 49,67reported the initial capital cost of implementing PACS and staffing costsassociated with using the system. Wagner et al. did not report any costs.Only two of the five studies of the effects of CPOE implementation reporteddata on costs. Both Wang et al. and Kaushal et al. included the costs ofmaintaining/operating and staffing associated with the new system; the formeralso reported the initial cost of implementing CPOE. Most studies of theeffects of EMR included the initial costs of implementation; three also includedthe costs associated with EMR operation and maintenance. 53,61,6230