TY - JOUR
T1 - Defining a staged-based process for economic and financial evaluations of mHealth programs
AU - LeFevre, Amnesty E.
AU - Shillcutt, Samuel D.
AU - Broomhead, Sean
AU - Labrique, Alain B.
AU - Jones, Tom
N1 - Funding Information:
Funding for this manuscript was provided by the Johns Hopkins University Global mHealth Initiative, Health.Enabled (http://www.healthenabled.org) and the World Health Organization as part of technical assistance to the United Nations Innovation Working Group (IWG) Catalytic mHealth Grants program. Costs to support the publication of this manuscript were provided by the Johns Hopkins University Global mHealth Initiative.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/4/17
Y1 - 2017/4/17
N2 - Mobile and wireless technology for health (mHealth) has the potential to improve health outcomes by addressing criticalhealthsystems constraints that impede coverage, utilization, and effectivenessof health services. To date, few mHealth programs have beenimplemented at scaleand there remains a paucity of evidence on their effectiveness and value formoney. This paper aims toimproveunderstanding among mHealth program managers and key stakeholders of how to select methods for economicevaluation (comparativeanalysis for determining value for money) and financial evaluation (determination of the cost ofimplementing anintervention, estimation of costs for sustaining or expanding anintervention, and assessment of its affordability). We outline a 6 stage-basedprocess for selecting and integrating economic and financial evaluation methods into the monitoringand evaluation of mHealth solutions including (1)defining the program strategy and linkages with key outcomes, (2) assessmentof effectiveness, (3) full economic evaluation or partial evaluation, (4)sub-group analyses, (5) estimatingresource requirements for expansion, (6)affordability assessment and identification of models for financialsustainability. Whileapplication of these stages optimally occurs linearly,finite resources, limited technical expertise, and the timing of evaluationinitiationmay impede this. We recommend that analysts prioritize economic andfinancial evaluation methods based on programmatic linkageswith healthoutcomes; alignment with an mHealth solution's broader stage of maturity andstage of evaluation; overarching monitoringand evaluation activities;stakeholder evidence needs; time point of initiation; and available resourcesfor evaluations.
AB - Mobile and wireless technology for health (mHealth) has the potential to improve health outcomes by addressing criticalhealthsystems constraints that impede coverage, utilization, and effectivenessof health services. To date, few mHealth programs have beenimplemented at scaleand there remains a paucity of evidence on their effectiveness and value formoney. This paper aims toimproveunderstanding among mHealth program managers and key stakeholders of how to select methods for economicevaluation (comparativeanalysis for determining value for money) and financial evaluation (determination of the cost ofimplementing anintervention, estimation of costs for sustaining or expanding anintervention, and assessment of its affordability). We outline a 6 stage-basedprocess for selecting and integrating economic and financial evaluation methods into the monitoringand evaluation of mHealth solutions including (1)defining the program strategy and linkages with key outcomes, (2) assessmentof effectiveness, (3) full economic evaluation or partial evaluation, (4)sub-group analyses, (5) estimatingresource requirements for expansion, (6)affordability assessment and identification of models for financialsustainability. Whileapplication of these stages optimally occurs linearly,finite resources, limited technical expertise, and the timing of evaluationinitiationmay impede this. We recommend that analysts prioritize economic andfinancial evaluation methods based on programmatic linkageswith healthoutcomes; alignment with an mHealth solution's broader stage of maturity andstage of evaluation; overarching monitoringand evaluation activities;stakeholder evidence needs; time point of initiation; and available resourcesfor evaluations.
KW - Costs
KW - Digital health
KW - Economic evaluation
KW - Financial evaluation
KW - MHealth
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U2 - 10.1186/s12962-017-0067-6
DO - 10.1186/s12962-017-0067-6
M3 - Article
C2 - 28428734
AN - SCOPUS:85018421375
SN - 1478-7547
VL - 15
JO - Cost Effectiveness and Resource Allocation
JF - Cost Effectiveness and Resource Allocation
IS - 1
M1 - 5
ER -