Healthcare IT Assessment Model Evaluating Technology-Supported Healthcare Programs in Developing Nations White Paper Healthcare IT Assessment Model A practical framework from Intel helps governments and nongovernmental organizations (NGOs) assess near-term program effectiveness, improve service delivery, and advance toward long-term health goals. Around the world, poor health produces widespread suffering, exacerbates poverty, and limits social opportunity. Leaders at every level are committed to improving global health, but they face challenges that include limited resources, inefficient and overburdened healthcare systems, and severe supply-and-demand inequities between urban and rural areas. Digital technologies play an important role in addressing these challenges. Investments in PCs, broadband infrastructure, network connectivity, and effective content can help improve medical education, expand healthcare access in underserved areas, and enhance the quality and consistency of rural health services. These changes, in turn, can accelerate progress toward national and international health goals. For example: Digital care templates can remind workers of best practices for diagnosing and treating tuberculosis. Backed by appropriate medications, such an approach can potentially reduce mortality and improve health. Laptop-based videos on disease prevention can help rural health workers educate citizens and reduce communicable disease transmission. Using mobile communications technologies, field health workers can report data more rapidly, potentially allowing faster identification of unusual outbreaks and helping to reduce fatalities. With streamlined workflows and higher productivity, mobile health workers can visit a greater number of expectant mothers and monitor them more closely, to potentially reduce maternal and neonatal deaths.
Digital Technologies Deliver Value From village health workers to urban medical centers, digital technologies enable more efficient, equitable access to higher quality healthcare services. In a pilot conducted by World Vision* Foundation of Thailand, mobile PCs helped field workers reduce travel back to the community to report their data. With round trips costing USD 200 or more per week for each worker, full-scale deployment will save hundreds of thousands of dollars annually. At King Fahad Medical City (KFMC) in Saudi Arabia, wireless networks and mobile computers allow nurses and doctors to access electronic patient records and document care at the bedside. Based on achieved results, KFMC expects to decrease consultation times by 30 percent, enabling providers to treat up to nine more patients each day. KFMC ultimately expects to cut cost-per-bed by up to 40 percent. A Practical Approach to Assessing Benefits While technology-based healthcare programs can deliver significant value, this value may be difficult to measure. Changes in disease rates and mortality can take years to identify, and causes are often difficult to isolate. In the meantime, health leaders are hampered in their ability to identify and scale programs that are delivering compelling value, and modify those that are not working. To fill this need, Intel has developed the Healthcare IT (HIT) Assessment Model for Developing Nations, and collaborates with governments and NGOs to apply it. Targeted to conditions and concerns of developing nations, the model provides a practical framework to identify and measure value produced by technologyenabled healthcare programs within a 3 18 month timeframe. The HIT Assessment Model bridges the gap between service delivery on the ground and long-term health goals. It helps Ministries of Health, NGOs, financial institutions, funding agencies, and technology providers to replicate successful approaches, align technology investments with healthcare objectives, and advance toward their health improvement goals. The model also aids program planning by providing a common language for stakeholders to discuss and agree on intended outcomes. HIT Assessment Model Overview: Measuring Change at the Point of Service Delivery The HIT Assessment Model builds on earlier value models that Intel developed for measuring the benefits of investments in hospitalbased healthcare IT and mobile point-of-care solutions. In adapting the model for developing nations, Intel focused it on service delivery, with healthcare objectives such as the accessibility and quality of rural healthcare, resource planning and delivery, and secondary care capacity. The new assessment model also reflects environmental and policy frameworks. To assess progress toward healthcare objectives, the model provides a set of key performance indicators (KPIs) intuitive, quantifiable metrics designed for measuring changes that can be achieved in 18 months or less. Regional ministries of health, policymakers, and program planners can select relevant KPIs, and healthcare providers and administrators at the point of service delivery can measure changes to the indicators. KPIs reflect practical realities of service delivery at the local level. Intel has extracted an initial set of KPIs from a review of over 50 reference sources, and the set can be expanded and modified to align with local, regional, and national needs. Many KPIs are based on data that agencies, ministries, and NGOs already collect. Note that many indicators are relevant to multiple objectives, but for calculating financial value, each KPI is counted only once. Intel World Ahead Program The World Ahead Program is Intel s global initiative to connect people to a world of opportunity. Intel collaborates with governments and NGOs on comprehensive programs to improve lives, economies, and societies through: Access to highly capable PCs High-speed connectivity Effective teaching and learning Locally relevant content and services Healthcare advances
Healthcare Objectives: Where Technology Delivers Value Technology investments accompanied by careful program planning, training, ongoing support, and political will can improve the delivery of healthcare services and enable far-reaching social and economic value. Effective approaches include: Equipping visiting health workers with mobile PCs, electronic forms, up-to-date treatment templates, educational materials, and decision-support tools Providing medical students with mobile computers, videoconferencing, and educational content Modernizing rural clinics through network connectivity, affordable PCs, wired or wireless broadband to rural clinics, electronic medical records, interactive videoconferencing, and treatment templates The HIT Assessment Model correlates the value delivered by such programs with six healthcare objectives: Rural access to healthcare services Secondary care capacity Resource planning Resource delivery Quality of rural care Containment of exceptional outbreaks Rural Access to Healthcare Services Providing equitable access to healthcare services is a critical challenge for developing nations, particularly in rural areas and underserved communities. Technology investments can increase citizen access to services by improving health worker productivity. Using electronic forms and charting their work electronically at the point of services, rural health workers replace cumbersome paperbased processes with streamlined workflows, and are able to see more patients and families and deliver more services. With digital technologies, rural care providers can access up-to-date treatment information and consult electronically with experts. This can allow local treatment of conditions that previously required referral to secondary care. Effective digital content may help mobile workers bring reluctant population segments women, in many areas into the formal healthcare system. Sample Indicators Increase in number of patients seen per week Increase in number of services delivered through primary community care Increase in new patients Increased rates of female participation in the healthcare system
Secondary Care Capacity Technology-enabled improvements in rural care can reduce unnecessary referrals to hospitals and larger community centers. In addition, rural clinics and mobile workers can use locally relevant educational content to expand awareness and encourage individuals to visit the clinic before a condition requires more complex, expensive treatment. By reducing demands on secondary care, improvements in rural care can shorten wait times for hospital services and allow more effective resource usage throughout the healthcare system. These changes also enable rural citizens to avoid long trips and lost productivity to obtain medical care. Resource Delivery Technology-supported medical education can enlarge the supply of skilled clinicians and scale the expertise of medical educators. With PC-based videoconferencing, a single lecture can be delivered to thousands of students, and standardized content can be accessed by students working from home at their own pace. Such changes can expand the capacity of the education system and accelerate production of physicians, nurses, pharmacists, and other health professionals. For professionals working in rural and remote areas, digital technologies help relieve isolation and increase job satisfaction, slowing the flow of skilled workers to developed nations. Sample Indicators Reduction in unnecessary referrals to secondary care Reduction in hospital admissions for complications of chronic diseases Reduction in wait times for scheduled admissions and procedures Sample Indicators Increase in number of students receiving training Increase in qualified medical workers overall Increase in qualified medical workers in specific regions Increase in virtual healthcare services accessed Increase in job satisfaction on worker surveys Reduction in staff turnover Resource Planning When resources are precious, resource management is critical. With computer-based record-keeping and decision-support systems, clinics and mobile workers can provide more accurate data and file reports sooner, and resources such as vaccines and equipment can be tracked more effectively. As a result, planners are better able to identify areas of greater and lesser need. They can allocate and manage scarce resources more efficiently, shifting medical staff, medications, vaccines, and equipment accordingly. This reduces costs while allowing more responsive care. Sample Indicators Number of local service improvements that scale to regional or national levels Cost savings based on better management of assets, medications, and other resources Quality of Rural Care Technology programs can improve care by empowering rural health workers with up-to-date clinical information and comprehensive patient health records. Providers can use convenient templates and decision-support tools at the point of service delivery. These tools help standardize care around evidence-based practices, improve disease management, increase the accuracy and timeliness of health data, and reduce many common errors. When referral to secondary care is necessary, rural workers can electronically transmit the patient s treatment history so the hospital can provide more knowledgeable care. Medical education programs can deliver standardized, evidencebased educational content, to raise education standards and improve quality of care. Sample KPIs Increase in citizens reporting they are satisfied with primary or rural care Increased compliance with standards of care Increase in vaccinations Reduction in misdiagnoses and errors
Containment of Exceptional Outbreaks With electronic communications, health authorities have faster access to more accurate data from the field. They can more rapidly identify and respond to significant disease outbreaks, shifting resources as needed. Sample KPIs Speed of receiving local data Reduction in time to notify neighboring regions or countries Increase in health workers trained on disease prevention, food safety, etc. Recognizing External Factors The HIT Assessment Model takes account of external or environmental influences that cut across healthcare objectives and offer a broader perspective. These factors can enhance, impede, or be affected by the success of healthcare initiatives. The model encompasses six external factors. Communities and Collaboration Healthcare delivery occurs in a community context, often with informal providers delivering a majority of care. Collaboration both within the healthcare environment and with informal providers is essential to build trust, share knowledge, and support change. Technology can enable rural health workers to build knowledge communities and collaborate with peers and experts. Accessibility This area includes technology access within the healthcare community and the population at large, as well as access to affordable healthcare. Investments to expand technology access can improve access to health information, education, and services. High healthcare costs affect the government s ability to provide services as well as the citizens ability to pay for services not covered by government programs. Technology solutions that improve efficiency and reduce demands on secondary care can help control rising costs.
Stimulus and Sustainable Value Many developing nations are identifying compelling economic and social benefits from their investments in digital technology, and are undertaking healthcare IT projects as part of their economic stimulus efforts. For example: Some countries say local health workers spend up to 50 percent of their time on administrative paperwork. Automating their administrative workloads can significantly reduce healthcare budget costs while keeping health workers more satisfied and enabling them to visit more families. Connectivity Reliable connectivity is a core requirement for digital healthcare in rural and remote areas. Broadband networks that support healthcare improvements also provide economic and social benefit by enabling citizens to access e-government, agricultural, and other services. Education Content provided for healthcare workers or citizens must reflect local literacy levels, languages, and cultures. Education programs can advance health workers skills, and literacy efforts can enable more people to access health information. Organization Organizational factors reflect issues such as how smoothly decisions are made and how cumbersome or streamlined an organization s processes are. Technology initiatives can accelerate information flow and provide better data for decision making. One large Latin American nation found it was spending 10 percent of its public healthcare budget to transport patients across long distances between major cities for specialized care. With telemedicine and broadbandenabled videoconferencing, it expects to dramatically reduce unnecessary patient transport. Not only does the government cut costs, but patients and families avoid lost wages. They also appreciate being able to stay close to home. An Asian leader is considering creating universal, lifetime electronic health records for its citizens as part of its plans for economic recovery. The nation s leaders calculate that universal electronic health records will create approximately 7,000 sustainable IT jobs, improve the delivery of healthcare services, and drive cost savings by reducing the need for duplicate diagnostic procedures. Sustainability For long-term success, healthcare solutions require sustainable financing models. Investments in healthcare technologies foster sustainability by enabling productivity and efficiency gains and other improvements that can more than justify investment costs (see sidebar). In addition, rural clinic initiatives can promote sustainability by enabling faster billing and payments.
Applying the Model The Intel World Ahead Program works with governments and NGOs to design effective healthcare initiatives and apply the HIT Assessment Model. Intel collaborates to help organizations: Explore a pilot s or project s intended outcomes and define relevant KPIs Collect baseline KPI data to establish a before picture Develop infrastructure and deployment strategies Measure post-deployment changes in KPIs and determine project value As part of this work, Intel shares an interactive tool that summarizes and indexes reference materials by external factors and healthcare objectives and lists relevant KPIs. (See image below.) Using the model, planners and decision makers can build program success, replicate successful programs and practices, and create a business case for funding requests. By helping governments and NGOs architect and assess programs designed to improve healthcare services, Intel demonstrates its commitment to create the world ahead.
Achieve Your Vision to Improve Healthcare How can the Healthcare IT Assessment Model enhance progress toward your health goals? Contact your Intel representative to learn more about the model, see a demonstration, and plan your healthcare initiative. For more about Intel in healthcare, talk to your Intel Health representative, or visit us at intel.com/healthcare. Learn more about Intel s programs to encourage opportunity worldwide at intel.com/worldahead. 2009 Intel Corporation. All rights reserved. Intel and the Intel logo are trademarks or registered trademarks of Intel Corporation and its subsidiaries in the United States and other countries. This document is for informational purposes only. INTEL MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS DOCUMENT. *Other names and brands may be the property of their respective owners. 0409/60/CMD/XX/PDF