Economic Evaluation of an Investment in Medical Websites and Medical Web-Based Services
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AbstractHealthcare is a unique and complex economic sector much different from any other. It is a sector highly institutionalized, under great government influence, and facing crucial resource allocation issues that threaten the stability of healthcare systems and the survivability of healthcare units worldwide. Evaluation of the processes, interventions and Information Technology (IT) use in healthcare systems is a pressing since the emerging e-Health applications carry a strong potential for solving efficiency and resource allocation problems. Especially nowadays, the increasingly popular medical websites, with the plethora of web medical applications that they offer, are forming a promising emerging market which enables better efficiency and the further evolution of the healthcare systems. Through understanding the factors that lead people to use medical websites and by evaluating the new technological initiatives in healthcare, the road towards better efficiency and cost effectiveness may become shorter. The main thrust of this research is to examine ways of evaluating an investment in the medical websites and apply methods that are well-established and successfully used in other economic sectors To achieve the aims of this research a comprehensive investigation of the extant literature performed and showed that until now evaluation methods like Cost-Benefit Analysis and Return on Investment were used in healthcare with main purpose to evaluate medical treatments, treatment processes and enhance medical education rather than focusing on evaluating processes and technological changes and interventions in healthcare and apply in healthcare sector what was successfully used in other economic sectors such as business and manufacturing. Moreover this research investigated the factors that contribute to the success and the survivability of the medical websites and provided some forecasting and key performance indicators for medical websites. In order to fulfil the aims of this research, a sample of medical web sites was used to form a rich dataset that was analysed using regression modelling. The medical websites were evaluated from the perspective of a medical virtual enterprise that provides medical advices/content and medical applications using a unique feature selection based methodology employing the use of novel tools. Furthermore a novel crowd-sourcing methodology was implemented, tested first in a Willingness to Pay online survey setting, utilising innovative tools and the power of the social networks for the identification of the perceived value of the medical web-based services The results of this research show that the factors that can have great impact on the business excellence and survivability of the medical websites seem to be the current status of the medical website, the category in which it is classified according to its content, the nature of the organization that supports the website, the source of its funding, as well as its presence in search engines and social networks. Finally These results showed that an investment on a successful medical website can be proved to be quite beneficial and profitable, not just for the public/private organization or the individual investor(s) who develops or owns it, but also sufficiently satisfactory for a great number of the Internet users/ patients. Chapter 1: IntroductionHealthcare is a unique and complex economic sector much different from any other. It is a sector highly institutionalized, under significant government influence and facing crucial resource allocation issues that threaten the stability of healthcare systems and the survivability of healthcare units worldwide. The factors that make healthcare a unique economic sector are (Kuljis et al., 2007):
Especially in this period of the worldwide economic downturn, rapid changes are applied and many resources are invested aiming to sustain the survivability of the healthcare and improve its overall efficiency. In healthcare, decision makers make decisions in three different levels, a macro level that affects policy processes and interventions, a meso level that affect administrative processes and interventions and a micro level that affects clinical practices (Lesard et al, 2009). Various researchers emphasised the fact that although rapid changes are crucial to be applied in a sector like health which presents great complexity and unique characteristics, especially when decision making is forced to allocate more efficiently the even scarcer resources, only in very rare cases these allocation decisions are accompanied with a comprehensive evaluation plan. The lack of evaluation plans and processes is identified also as the main reason of inefficiencies in healthcare, and problematic resource allocation (Michael Drummond et al, 1982). The Aforementioned points make the adoption of evaluation methods a crucial issue for the future of healthcare systems. Evaluation of the healthcare processes, interventions and information systems is urgently required since the newly born and constantly developing Telemedicine and e-Health web-based services can be a deus ex machina solution to the efficiency and resource allocation problems. Especially medical websites and the web-based services that they offer are a promising emerging market that can help to achieve better efficiency and further evolution of the healthcare systems. Medical websites are becoming more and more usable and popular among the Internet users (for example NHS Direct website, WebMD.com, BootsWebMD.co.uk, Patient.co.uk, NetDoctor.co.uk, Mayo Clinic) (Silence et al., 2007a). As it is suggested, from 2002 until 2007 the Internet use increased by 169% (Silence et al., 2007a) and more than 80% of the adult Internet users in USA and 67% of the European users (Taylor and Leitman, 2002) have used the Internet in order to seek medical advice. Moreover, 4.5% of all searches on the Internet around the world is considered to be related to seeking of medical information (Morahan-Martin, 2004), while in 2000 about 30 million people turned to the Internet for medical advice visiting one of the 7000 to 10000 medical websites (Yan et al., 2004). Furthermore, the average daily visits to medical websites in USA were estimated to be 6 million more than the daily ambulatory visits to hospitals (Yan et al., 2004). In addition to the aforementioned facts of the popularity of the medical websites, it is stated that until 2002 in the UK 1-2% of the people were using Internet for medical advice, compared to 32% of the people in the USA (Yan et al., 2004). Medical websites provide services including viewing online the medical health record, symptom checkers and advice over various healthcare conditions, onset of conversations in forums about healthcare conditions and support from various specialist in healthcare issues (Silence et al., 2007a). These services attract the users/patients since they offer better results than the traditional, limited telephone communication between the physician and the potential patient, and there is a continuously increasing interest in seeking medical advice, medical information and other medical services through the Internet (Silence E. et al., 2007a, 2007b; Moreno et al., 2009). The users/patients want to have more control over their health and use the ease of Internet to book medical appointments, access their medical records, or even ask their personal physician direct inquiries about their medication or their general health status (Silence E. et al., 2007a, 2007b; Moreno et al., 2009). Finally the number of medical websites that offer medical advice and in general medical web-based services has dramatically increased and studies has shown that the Internet can affect the healthcare decisions of the individuals and is a very popular method to assess healthcare conditions among adolescents (Silence E. et al., 2007a, 2007b; Moreno et al., 2009). Web-based service Nowadays many healthcare systems and individual healthcare organizations provide medical websites and medical web-based services to the patients and the Institute of Medicine suggests that the use of IT in healthcare and the creation of safe and good quality medical online medical services can be a critical issue towards the healthcare reform (Moreno et al., 2009). Although there are many studies covering the clinical evaluation, economic evaluation of investment in medical web-based interventions is almost non-existent. In addition to this, the specific need for economic evaluation to support and enable decision makers is recognised and considered crucial (Hoffmann C. et al., 2002). Moreover it is suggested that the quality of current evaluation studies is variable and current results are showing that although decision makers consider evaluation useful, only a few studies address decision-makers’ concerns and emphasize the need for more studies concerning the economic/financial evaluations in the healthcare sector (Hoffmann C. et al., 2002). Furthermore, the need for economic evaluation of healthcare IT and more specific web interventions is also identified and considered vital (Hoffmann C. et al., 2002). Download 1.95 Mb. Share with your friends:
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