PhD top-up scholarship for Thomasina Donovan: Methods for costing implementation strategies for digital health innovations

Opportunity

Digital health innovations have the potential to promote better value care and help address health system challenges. Adoption of digital health innovations can be challenging in complex health systems due to many factors, including implementation-related difficulties. Relationships between the technology design factors, workflows, health professional interactions, and other organisation factors have meant that concerted implementation efforts are required to ensure successful scaled adoption.

Implementation science has been applied to promote successful healthcare innovations adoption in many clinical areas and is now being increasingly applied to support digital health intervention adoption. Implementation theories, models, and frameworks can be used to identify contextual barriers and enablers to implementation and guide the deployment of strategies to overcome or enhance them.

However, the additional resourcing required for implementation strategies is not often considered when planning digital health implementations. Under-resourcing of the implementation phase of digital health initiatives can lead to failed deployment, or over-spending on reactive responses to undesirable downstream consequences.

Economic evaluation provides an important framework for allocating resources to the programs that will be of greatest benefit to consumers, health services, and society. Economic evaluations are also increasingly being applied to digital health initiatives; however, appropriate costings for implementation strategies are often lacking from economic evaluations, which can impact cost-effectiveness estimates.

From prior research, we know that implementation costs have often not been reported in academic literature and there is a lack of methodological guidance for their assessment. This final phase in a PhD program seeks to overcome this through application of a newly developed framework template for costing the implementation phase of digital health initiatives.

Project Objectives

1. Apply a recently developed complete implementation costing framework/prompting template to two intervention deployment use cases.
2. Describe the key costs components that were captured using the complete framework/prompting template approach in comparison to initial costings that were completed by evaluators who did not use a digital health implementation costing template.
3. Describe how the inclusion or exclusion of key implementation strategy costing features could influence the interpretation of cost-effectiveness.

The overarching longer term objective is to validate a digital health implementation costing framework/template that can assist healthcare delivery organisations, and the digital health community more broadly, with future implementation planning, policy and evaluation. Thus far, an implementation costing tool has already been developed, but the proposed work seeks to validate its potential use through applying it to two use cases, at least one of these use cases will be digital health enabled clinical decision support.