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      Applicability of the five case model to African eHealth investment decisions

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          Abstract

          Background

          eHealth programmes in African countries face fierce competition for scarce resources. Such initiatives should not proceed without adequate appraisal of their probable impacts, thereby acknowledging their opportunity costs and the need for appraisals to promote optimal use of available resources. However, since there is no broadly accepted eHealth impact appraisal framework available to provide guidance, and local expertise is limited, African health ministries have difficulty completing such appraisals. The Five Case Model, used in several countries outside Africa, has the potential to function as a decision-making tool in African eHealth environments and serve as a key component of an eHealth impact model for Africa.

          Methods

          This study identifies internationally recognised metrics and readily accessible data sources to assess the applicability of the model’s five cases to African countries.

          Results

          Ten metrics are identified that align with the Five Case Model’s five cases, including nine component metrics and one summary metric that aggregates the nine. The metrics cover the eHealth environment, human capital and governance, technology development, and finance and economics. Fifty-four African countries are scored for each metric. Visualisation of the metric scores using spider charts reveals profiles of the countries’ relative performance and provides an eHealth Investment Readiness Assessment Tool.

          Conclusion

          The utility of these comparisons to strengthen eHealth investment planning suggests that the five cases are applicable to African countries’ eHealth investment decisions. The potential for the Five Case Model to have a role in an eHealth impact appraisal framework for Africa should be validated through field testing.

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          Most cited references11

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          Health economic evaluation: important principles and methodology.

          To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.
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            What Is eHealth (6): Perspectives on the Evolution of eHealth Research

            Background The field of eHealth holds promise for supporting and enabling health behavior change and the prevention and management of chronic disease. Objective In order to establish areas of congruence and controversy among contributors to the early development, evaluation, and dissemination of eHealth applications, as well as the desire to inform an evaluation research funding agenda, 38 semistructured, qualitative interviews were conducted among stakeholders in eHealth between May 2002 and September 2003. Methods Participants were asked about their perspectives on the credibility, value, and future potential of information technology for health behavior change and chronic disease management. Interviews were coded and analyzed for emergent themes using qualitative methods. Results Consistent themes were identified across stakeholder groups, with slight differences in emphasis. These topics included the following: (1) consensus and standardization—most stakeholders expressed a strong desire for a more coordinated, rigorous effort to define and integrate the field; (2) evaluation methods and challenges—demonstrating outcomes is required to establish eHealth quality and efficacy, but stakeholders were not satisfied with the sensitivity, validity, and reliability of existing outcome measures; (3) quality, value, and future potential—the intersection between eHealth’s potential cost-effectiveness, efficiency, and improved clinical status among users generated a high degree of interest; and (4) health disparities—many stakeholders contended that traditionally underserved populations will particularly benefit from eHealth applications, although others argued that the underserved are also disadvantaged in terms of access to technology. Conclusions Recommendations included the need for improvement and formalization of development and evaluation standards across private and public sectors, additional research on the technology needs and preferences of traditionally underserved populations, and long-term epidemiologic studies of the impact of eHealth on outcomes and cost-effectiveness.
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              DOES ICT GENERATE ECONOMIC GROWTH? A META-REGRESSION ANALYSIS: DOES ICT GENERATE ECONOMIC GROWTH?

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                Author and article information

                Contributors
                sean.broomhead@gmail.com
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                20 July 2020
                20 July 2020
                2020
                : 20
                : 666
                Affiliations
                [1 ]GRID grid.16463.36, ISNI 0000 0001 0723 4123, Department of TeleHealth, Nelson R. Mandela School of Medicine, , University of KwaZulu–Natal, ; Durban, South Africa
                [2 ]African Centre for eHealth Excellence, Cape Town, South Africa
                [3 ]Health Information Systems Program, Waterkloof Ridge, Pretoria, South Africa
                [4 ]NT Consulting – Global e-Health Inc., Calgary, Alberta Canada
                [5 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, University of Calgary, ; Calgary, Alberta Canada
                Author information
                https://orcid.org/0000-0002-1904-4383
                Article
                5526
                10.1186/s12913-020-05526-6
                7370424
                f4a17889-a2a3-4f33-be82-8651d06a8909
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 December 2019
                : 9 July 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000061, Fogarty International Center;
                Award ID: D43TW007004-13
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                ehealth,digital health,investment,impact,economics,developing countries,africa
                Health & Social care
                ehealth, digital health, investment, impact, economics, developing countries, africa

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