Performance and cost evaluation of health information systems using micro-costing and discrete-event simulation

Abstract

Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach. The methodology is applied to the consultation for cancer treatment process. Simulation scenarios are established to conclude about the impact of HIS on patient pathway. We demonstrated that although high level HIS lengthen the consultation, occupation rate of oncologists are lower and quality of service is higher (through the number of available information accessed during the consultation to formulate the diagnostic). The provided method allows also to determine the most cost-effective ICT elements to improve the care process quality while minimizing costs. The methodology is flexible enough to be applied to other health-care systems.

An economic assessment of contemporary kidney transplant practice

“…DES was used to model patients’ progression . In DES modeling, occurrence of clinical events is defined as time to event, as drawn from distributions based on population data.…”

Clinical pathway modelling: a literature review

“…Obtained Data Driven [5, 7-9, 11, 13, 32, 33, 37, 47-49, 54, 58, 62, 66, 70-72, 74-76, 80, 81, 83, 85-99, 104, 107, 108, 112, 120, 121, 124, 126, 127, 131, 133, 134, 138-140, 143, 144, 147-150, 153, 157, 160, 162, 167, 170, 172, 177-179, 183-185, 191, 192, 195, 197-206, 209-211] Collaboration [3,10,14,17,27,42,51,73,100,114,142,152,163] Both [12,20,35,40,56,101,103,129,136,146,154,166,171,186] Other [19,21,22,24,41,60,79,82,116,128,169] Table A6. Care level considered.…”

“…Investigating Type Mapping (Ma) [1, 4, 5, 7, 22, 29, 33, 37, 42, 47, 48, 54, 56, 57, 70, 71, 81, 83, 87, 88, 90, 91, 94-99, 104, 112, 121, 126, 127, 131, 136, 138, 139, 144, 149, 154, 157, 161, 162, 164, 170, 172, 177-179, 183-185, 192, 195, 197-203, 206, 209-211] Modelling (Mo) [15, 19-21, 23, 24, 30, 31, 36, 39, 43, 50, 55, 58, 64, 67, 76, 79, 82, 86, 89, 102, 103, 115, 117-119, 122, 129, 145-147, 150, 151, 160, 169, 171, 187, 188, 190, 191, 196, 212] Improving (I) [13,46] Ma & Mo [3, 9, 11, 17, 18, 40, 60, 62, 66, 72-74, 80, 85, 90, 93, 101, 107, 108, 114, 120, 124, 125, 128, 133, 134, 140, 143, 158, 205] Mo & I [8,16,25,32,34,41,45,52,53,68,75,110,111,113,116,141,148,165,182] All Types [10,12,14,27,35,49,51,100,142,152,153,163,166,167,186,204] Table A12. Outcome focus of the pathway.…”

“…Outcome Pathway Mapping [1, 4, 5, 13, 20, 33, 37, 42, 47, 54-56, 58, 62, 70, 71, 81-83, 86-99, 107, 112, 114, 115, 121, 126-128, 136, 138-140, 149, 154, 157, 162, 164, 171, 172, 177-179, 183, 184, 187, 188, 192, 195, 197-202, 206, 210, 211] Time [3, 8, 10, 12, 15, 16, 18, 23, 29-32, 34-36, 41, 46, 50, 52, 57, 62, 64, 67, 68, 72, 74, 75, 80, 85, 94, 100, 108, 110, 118, 129, 133, 138, 141-143, 145-147, 151, 160, 161, 163, 165-167, 169, 182, 185, 190, 204, 205, 212] Resource [3, 7, 10, 14, 15, 17, 25, 27, 29, 31, 32, 35, 36, 46, 52, 64, 75, 76, 100, 113, 118-120, 142, 145, 148, 151-153, 160, 161, 163, 170, 182, 191, 204] Cost [9,11,14,15,19,21,22,40,43,45,53,60,73,79,101,111,117,118,125,133,134,138,145,158,166,167,209] Patient Progression [24, 29, 39, 40, 45, 48, 49, 51, 60, 79, 86, 101-104, 107, 116, 122, 124, 131, 139, 144, 145, 150, 186, 196] Legal [66,203] Table A14. Planning decision level taxonomy.…”

Adoção da tecnologia da informação em saúde sob a perspectiva do custo efetividade

“…Elliott (2014) tem um estudo convergente, mencionando que existem poucas pesquisas que relacionem tecnologia da informação unida ao custo efetividade em setores individuais hospitalares (UTI por exemplo), ou procedimentos médicos, Rejeb, et al (2017) argumentam que muitas organizações de saúde, consideram a aplicação da Tecnologia da Informação como uma chave fundamental para melhorar a gestão de saúde, porém poucos trabalhos analisam o impacto de sistemas de informação em termos econômicos e de qualidade dos cuidados aos pacientes, além disso também existem poucos estudos que considerem as características da tecnologia informação em saúde e as relações que vinculam a informação ao seu ambiente para tomada de decisão (Sedig, Naimi, Haggerty, 2017).…”