Concept of Operations: Relating to the introduction of a Personally Controlled Electronic Health Record System
9 Outcomes evaluationThe learning from organisations that have implemented large-scale eHealth technologies is that outcomes and benefits are not automatically delivered through the deployment of new eHealth systems, but rather the value has to be actively managed [FISH2004]. This reinforces the importance of measuring outcomes and benefits for the purpose of informing course correcting activities and driving change. In order to sustain the case for investment in a PCEHR System, it is critical to show how the outcomes and benefits will be demonstrated as the system is developed and deployed.
The outcomes and benefits are likely to start modestly due to the need to implement the foundational capabilities of the PCEHR System before progressing to more advanced functionality, the need to educate stakeholders on the benefits delivered by the PCEHR System, and finally the need to allow the supporting vendor landscape to mature. However, it will be critical to show meaningful progress towards the desired PCEHR System outcomes and benefits through a focus on whether adoption and meaningful use is occurring, and as a result whether leading indicators of benefits are being achieved.
In order to realise the value of the PCEHR System, a benefits realisation and evaluation framework is being established. This framework will:
- Specifically address how stakeholders will be impacted by the PCEHR System. This will cover those directly impacted such as a consumers and providers (including the differences between different groups of each), but also consider the impacts upon parties such as regulators, IT vendors and other participants in the health system.
- Specify the capabilities required for outcomes realisation and clarify the ownership and commitments by different parties to establish these capabilities and realise the outcomes.
- Illustrate the real world enablement of the benefits and outcomes through a cohesive set of clinical scenarios, which will use specific capabilities and drive corresponding outcomes and benefits.
- Identify candidate outcomes and benefits, source evidence for their achievability and build consensus around the final set of outcomes to be sought. Critically, the framework will also identify where particular outcomes may be disbenefits, particularly for specific stakeholders.
- Define the metrics, level of specificity, measurement techniques, frequency of outcomes reviews and how double counting will be avoided.
The framework logic is illustrated in Figure 15
Figure 15: Realisation of outcomes
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