How do Swiss hospitals rate digital health solutions?
Knowledge database Organisation Strategy & control D.4: Method kit for quantifying the process potential of digital health toolsDigital health solutions - such as the heyPatient platform - promise major gains in effectiveness and efficiency. On the one hand, these are due to digitalisation itself and, on the other, to optimised work processes. Patient logistics, from registration and appointment dispatch to preparation and navigation, can be automated, while patients interact digitally and intuitively with the hospital. This raises the question: How do Swiss hospitals assess the benefits of digital healthcare solutions?
Problem description, research question and relevance
The development of the methodological toolkit is based on findings from literature research. These are discussed in D.4 Knowledge contribution no. 1: What findings do we have from the literature for assessing the benefits of digital health solutions?
Secondly, findings from interviews with experts are included in order to find out which criteria and methods various stakeholders in Swiss hospitals currently use to quantify the benefits of digital health solutions. The benefits of expert interviews in qualitative research include obtaining detailed and contextually relevant data to supplement research findings in terms of quality and depth (Eppich et al., 2019; Family Health International (FHI), 2005).
Methods and procedures in the project
In November and December 2022, qualitative interviews were conducted with experts involved in decision-making in hospitals. The interviews were conducted in two stages.
In a first step, the experts were asked how they evaluate digital health solutions in their institution. Two main questions formed the starting point:
- Who evaluates the value of digital health solutions in the respective hospital context? Which stakeholders are involved?
- How is an evaluation carried out? What criteria are used and how are they quantified?
In a second step, the experts were asked to assess and evaluate the dimensions of the so-called HTA Core Model, e.g. with regard to whether they already use them implicitly or explicitly and/or would like to use them.
The following question formed the starting point:
- Please prioritise the listed decision criteria according to the HTA Core Model of EUnetHTA according to their importance for the assessment of benefit.
The HTA Core Model of EUnetHTA (European Network for Health Technology Assessment) is a standardised framework for the assessment of health technologies (Health Technology Assessment, HTA). This model is used to systematically and comprehensively analyse and assess various aspects of health technologies. The aim of the model is to provide a structured and consistent methodology to support decision-making in the healthcare sector (EUnetHTA, n.d.).
The 9 domains of the model cover the following aspects:
HTA Core Model Domain | Description |
Health problem and current use of technology | z. e.g. whether the technology was developed for a specific disease |
Description and technical characteristics | z. e.g. whether an interface with other existing technologies is possible |
Safety | z. e.g. whether the technology does not jeopardise patient safety |
Clinical effectiveness | z. e.g. whether the clinical effectiveness of the technology has been scientifically proven |
Costs and economic evaluation | z. e.g. whether the investment in the technology relieves the budget in the short or medium term |
Ethical aspects | z. e.g. whether the technology protects the integrity of patients |
Organisational aspects | z. e.g. whether the human resources are available to introduce the technology |
Patient and social aspects | z. e.g. whether the technology increases patient satisfaction |
Legal aspects | z. e.g. whether the technology has already been authorised in another country |
Results and findings
The experts represented various areas and functions from the hospitals. They included members of management, staff, executives, process management and research.
The data analysis revealed the following findings: Three-quarters of the experts stated that they follow a formal decision-making approach. They also stated that their hospitals use different approaches to evaluate digital health solutions within the scope of their capabilities. Some hospitals follow a rigorous and systematic approach, while others take a more unstructured approach. The approaches used to evaluate and make decisions on digital health solutions include obtaining internal and external feedback, applying the design thinking approach, conducting comparative analyses and using crowd intelligence. In most cases, management, ICT, steering committees or an innovation hub are in charge of the evaluation. The following basic decision criteria were mentioned most frequently in the interviews: Patient aspects, process optimisation, strategy and economic aspects.
At first glance, the experts' assessment or prioritisation of the 9 areas of the HTA Core Model does not provide a clear picture.
Figure 1: Prioritisation ranking of 9 areas of the HTA Core Model by the experts. The lower the number, the higher the priority. Source: Own illustration ZHAW.
The experts' assessment of the 9 areas of the HTA Core Model showed that some of the criteria correspond to those that are already used or would like to be used in their institutions but are not yet in use. Nevertheless, it is clear that some areas or criteria of the HTA Core Model are given higher priority than others. This result is also reflected in the findings from the interviews to date. These include patient and social aspects, costs and economic evaluation, safety and clinical effectiveness. These findings in turn have also been incorporated into the development of the methodological toolkit.
Recommendations for practice
- Reflect on the evaluation process in your organisation. Think about how the benefits of digital health tools are evaluated in your organisation. Is this done according to formal or more informal steps?
- Reflect on the decision-making structures. Who is involved in the decision? Which approaches are used?
- Use the HTA Core Model as a guide. How does your organisation prioritise the different dimensions?
The knowledge contribution provides an aggregated insight into the different ways and approaches that Swiss hospitals are currently using to evaluate digital health solutions. With the development of the method kit for quantifying the process potential of digital health tools, a further approach is to be developed that can be provided to hospitals in the future.
Literature and other sources
Eppich, W. J., Gormley, G. J., & Teunissen, P. W. (2019). In-depth interviews. In D. Nestel, J. Hui, K. Kunkler, M. Scerbo, & A. Calhoun (Eds.), Healthcare simulation research (pp. 189-200). Springer. https://doi.org/10.1007/978-3-030-26837-4_12
European Network for Health Technology Assessment. (n.d.). HTA core model. EUNetHTA. https://www.eunethta.eu/hta-core-model/
Family Health International (FHI). (2005). Qualitative research methods: A data collector's field guide. Retrieved from https://www.fhi360.org/wp-content/uploads/drupal/documents/Qualitative%20Research%20Methods%20-%20A%20Data%20Collector's%20Field%20Guide.pdf