European study uncovers the economic impact of e-health technologies
Despite the availability of new e-health technologies, their adoption in real-life medical or health situations remains limited across the UK and Europe. A major reason for this is the lack of reliable evidence on the positive (economic and other) impacts of such innovations. For this reason, in 2004, the European Commission initiated a major study: eHealth IMPACT.
The principal objective of eHealth IMPACT has been to develop a generic assessment and evaluation framework (including measurement tools for quantitative indicators) to understand the economic benefits of e-health products and services. It has identified over 100 good practice examples of e-health applications and the project website has a searchable directory of these studies, some of which showcase the important issue of telecare and/or telehealth technologies in the support of people with long-term conditions.
Of particular interest amongst this collection of evidence is the Boario Home Care Project - a system established in Italy for remote cardiology consultations for emergency cases, later extended to cardiovascular disease management in general.
Originally based in Vallecamonica, a remote mountain territory in the pre-Alps with a hard-to-reach population, the project established 24-hour monitoring of patients with cardiovascular disease. The approach used mobile electro-cardiographers who sent ECGs to a service centre manned by a cardiologist.
When a patient is referred to a cardiologist - who is connected to the centre’s database remotely via the internet - they are given an electronic update on the patient’s health records as well as the ECG trace. Following a teleconsultation (with patient, health or social care professional) the new data is stored and available for future consultations.
The success of the scheme has seen its coverage extend nationally with over 1,200 GPs and 52,000 patients registered on the database. The service has also expanded to provide telediagnosis for arrhythmia and home telenursing for chronic vascular disease management. It has been estimated that the scheme has reduced referrals to Italy’s emergency departments by 47 per cent while hospital-based cardiological consultations have reduced by 95 per cent. It is also claimed that patients’ quality of life has improved.
The eHealth IMPACT database contains many other interesting examples of successful telehealth applications. These include an assisted self-monitoring scheme for hypertension in primary care in Tampere, Finland; a home-monitoring and web-based support system for managing thrombosis for 3,500 patients in the Netherlands; online diabetes management programmes in France and Switzerland; and examples of generic remote health monitoring and management services for people with long-term care needs in Spain, Italy, Belgium and France.
Another exciting element to the website is that you can submit any well established e-health application that may qualify for inclusion in its case study collection using a simple but detailed online template. To qualify for inclusion the study should be well-established and be able to demonstrate quantifiable impacts on patients and the wider health system, and provide details of the technology, key operational milestones and success factors.
Nick Goodwin is Senior Fellow at the King’s Fund and co-project lead for WSDAN.
Access the European Commission’s eHealth IMPACT study website