The case for updating health economic evaluation of digital technologies: in response to the demographic challenges

Abstract

Abstract Shortage of healthcare professionals is a major challenge for healthcare systems in many countries. The problem is expected to further increase due to demographic changes, with a rising percentage of elderly patients with multiple chronic conditions. Digital health technologies (DHTs) are proposed as a strategy to tackle this challenge by saving clinician time. However, guidelines for health economic evaluation of DHTs remain generally unchanged in most countries, with the main focus on the clinical impact and estimation of the incremental cost-effectiveness ratio (ICER), with limited interest in the impact of digital technologies on clinical staff. Objectives The objective of this article is to present arguments and examples of practical tools for adjusting economic evaluations and Health Technology Assessment (HTA) to ensure that assessments of DHTs reflect current demographic challenges. Methods The arguments are based on a narrative review of studies of the effects of DHTs on health care professionals’ workload and use of time. Results Based on the review, three recurring themes were identified: (1) the different definitions of effects on clinician time, (2) the need for quantitative assessment of effects on clinician time, and (3) the different kinds of effects on clinician time. Conclusion On this basis, two suggestions for adjustment of economic evaluations and HTA are presented: by the collection of data and presentation of results on the effects of DHTs on Time Needed to Treat (TNT), and by the use of shadow prices to ensure that the costs of healthcare professionals are correctly reflected in the alternative costs.