Varying stakeholder value assessments impact health IT adoption

Innovations might be slow to spread in healthcare because of various stakeholders' differing views of their value, according to a study published this week in BMC Medical Informatics and Decision Making.

Decision makers assess an innovation's costs and benefits--including improvement in efficiency, health gains, satisfaction with the care process, and investments required--the researchers from The Netherlands noted. Different groups perceive those differently.

The study looked at those differing views among patients, nurses, physicians, managers, healthcare insurers and policy-makers for nine IT innovations, including:

  • A regional electronic medical file
  • Computer-assisted telesurgery using a robot
  • Barcode medication administration technology
  • Telepathology
  • Self-testing and online automated management
  • A digital hospital portal
  • Planning software to support operating room planning
  • A PDA with decision support
  • Virtual consultations

Insurers and managers, for instance, expecting greater efficiency and health gains via self-testing, rated it highly. But patients gave it a low score, as did nurses and physicians, doubting its use in making health gains.

Patients ranked the electronic record and medication barcodes highest; nurses concurred, but added in planning software for operations. Physicians preferred the electronic record, followed by the PDA.

In fact, the electronic record was the top-ranked innovation among four of the six groups, but the policy makers appeared to have little faith in it.

Virtual consultations, telepathology and telesurgery did not appear in any of the top three preferences for any of the stakeholders, leading the authors to say they don't expect adoption of those innovations to grow rapidly.

However, telehealth services are growing in the U.S. in some cases due to healthcare staffing shortages. Research methods for studies touting the benefits of telemonitoring were called into question, though, in a recent study published in the Journal of Medical Internet Research.

Robotic surgery has had its critics lately, including the American Congress of Obstetricians and Gynecologists, which earlier this year warned that it's not the best choice for routine procedures.

To learn more:
- read the research (.pdf)

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