eHealth Research Group, Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, UK.
BMJ Open. 2013 Dec 16;3(12):e003737. doi: 10.1136/bmjopen-2013-003737.
There is a need to develop new, more cost-effective models of healthcare and in this vein there is a considerable international interest in exploiting the potential offered by major developments in health information technologies (HITs). Very substantial investments are, as a result, now being made globally, but these still probably only represent a fraction of the investments needed if healthcare is to make the transition from the paper to the digital era. Investing greater resources is, however, inherently challenging and unpopular at a time of financial austerity and this is furthermore complicated by the thus far variable evidence of health benefits and demonstrable short-term to medium-term returns associated with investments in HITs.
Building on our related systematic overviews investigating the impact of HITs, we now seek to estimate the cost-effectiveness of HITs and as a secondary aim to identify potentially transferable lessons in relation to how to realise returns on investments in these technologies.
We will conduct a systematic review to identify the empirical evidence base surrounding the return on investments from implementing HITs. Two reviewers will independently search major international databases for published, unpublished and on-going experimental and quasi-experimental studies of interest published during the period 1990-2013. These searches of bibliographic databases will be supplemented by contacting an international panel of experts. There will be no restriction on the language of publication of studies. Studies will be critically appraised using the Critical Appraisal Skills Programme (CASP) Economic Evaluations checklist. In view of the anticipated heterogeneity in intervention investigated, study design and health system contexts, we will undertake a descriptive, narrative and interpretative synthesis of data.
Ethical approval is not required.
These will be presented in one manuscript. The protocol is registered with the International Prospective Register for Systematic Reviews (PROSPERO) CRD42013005294.
需要开发新的、更具成本效益的医疗保健模式,因此,国际上非常关注利用健康信息技术(HIT)的重大发展带来的潜力。因此,现在全球范围内正在进行大量投资,但如果医疗保健要从纸质时代过渡到数字时代,这些投资可能还只是所需投资的一小部分。然而,在财政紧缩时期,增加资源投入具有内在的挑战性,而且不受欢迎,而且由于迄今为止与 HIT 投资相关的健康效益证据和可证明的短期到中期回报存在差异,情况变得更加复杂。
在我们相关的系统综述调查 HIT 影响的基础上,我们现在旨在估计 HIT 的成本效益,并作为次要目标,确定与如何实现这些技术投资回报相关的潜在可转移经验。
我们将进行系统综述,以确定围绕实施 HIT 投资回报的实证证据基础。两名审查员将独立搜索主要的国际数据库,以寻找 1990 年至 2013 年期间发表的、未发表的和正在进行的有关 HIT 投资回报的实验和准实验研究。对文献数据库的搜索将通过联系国际专家小组进行补充。研究将不受研究发表语言的限制。研究将使用批判性评估技能计划(CASP)经济评估检查表进行批判性评估。鉴于预期干预措施、研究设计和卫生系统背景的异质性,我们将对数据进行描述性、叙述性和解释性综合。
不需要伦理批准。
这些结果将在一篇文章中呈现。该方案在国际前瞻性系统评价注册处(PROSPERO)CRD42013005294 中进行了注册。