STUDY OF THE ECONOMIC EFFICIENCY OF PROJECTS FOR DIGITAL TRANSFORMATION OF THE BP MONITORING MODEL

Abstract

Objective: To investigate the economic efficiency of business models for a project for BP monitoring in patients with hypertension in the context of digital transformation of medical services. Design and method: Applied functional, structural and business modeling of design options, methods for assessing market capacity, competition analysis, financial modeling, project sensitivity analysis, analysis of regulatory constraints. Results: We studied two business models - implemented in commercial medicine and in a budgetary healthcare institution. Common in the models is the patient service scheme (supplying it with a certified tonometer with a built-in GSM or Bluetooth module - measuring BP - transmitting encrypted data to the remote monitoring center - storing it in a cloud database and the patient's electronic medical record - monitoring BP indicators - doctor's response to critical deviations in measurement results — patient feedback through the messenger). The difference in models is related to the sources and form of payment. In a private clinic, it is possible to use the patient's personal funds, voluntary medical insurance schemes, compulsory medical insurance (CMI), in a budgetary healthcare institution - payment at the CMI rate. The considered options turned out to be cost-effective (NPV > 0) with a discounted payback period from 2.8 (option 1) to 3.35 years (option 2). In case of state insurance system, the time for launching a project is lengthened due to the agreeing period on the telemonitoring tariff; the methods of stimulating the medical personnel participating in the RMBP are different. The sensitivity analysis showed that the most critical factor is the tariff level for the service (the acceptable range is 4.84 -8.81 euros for the telemedicine component), investments vary in the range from 225988.7 to 293785.3 euros. IRR of the project - 38% -45%, PI - 1.6 -1.75. Conclusions: The use of telemedicine technologies is economically feasible in both commercial and budgetary institutions. An increase in the project's efficiency indicators is possible due to the coverage of large regions. The accumulation and analysis of big data as a result of monitoring will create conditions for the chronopharmacology of antihypertensive drugs.