The Benefit Trajectory – a framework to support innovative and beneficial technology based solutions in integrated care

Abstract

Introduction: The implementation of technology in telehealth and integrated care poses several challenges as users often expect technologies to be similar to what they know from their everyday lives, such as smartphones, tablets and social media. These expectations are difficult to meet by the healthcare sector, as development and implementation of new technologies can be challenging, especially for smaller healthcare providers such as municipalities and counties. The purpose of this study was to clarify whether there exists a robust health technology assessment model for development, implementation and assessment of maturing telehealth solutions. Methods: We have conducted a narrative literature overview [1] to identify published use of health assessment technology models in order to identify how they can be used in relation to telehealth and telemedicine projects. We searched for the words “telehealth”, “telemedicine” and “health technology assessment” in PubMed and Google Scholar. Results: Seven models were identified: Constructive Technology Assessment [2], Continuous Systematic Evaluation model [3], mini-HTA [4], Model for Assessment of Telemedicine [5], an Assessment for Decision Makers [6], the West Midland Toolkit [7] and Plan-Do-Check-Act [8], an instrument to iterate processes. None of these models seemed to be suitable for application in the setting of development, implementation and evaluation of maturing technologies. Discussion: The identified models all have various benefits in relation to assuring agile development, involving users and stakeholders, aligning processes or ensuring evidence-based practice. However, a model which covers all these areas as one framework is missing. We therefore propose a “Benefit Trajectory” which is a framework based on the business development concept from the Continuous Systematic Evaluation Model [3] with the addition of key elements from the other models. The Benefit Trajectory consists of four stages; I Inception, II Materialization, III Implementation and IV Assessment. The core of the framework is a need-based process that ensures alignment of needs, goals and expected outcome by a smooth project trajectory.