Health technology assessment frameworks for eHealth: A systematic review

Area of Science:

• Health Services Research
• Informatics
• Health Policy

Background:

• Traditional health technology assessment (HTA) primarily evaluates pharmaceutical interventions.
• eHealth innovations are increasingly integrated into healthcare, necessitating clear assessment methods.
• The current landscape of eHealth assessment frameworks prior to implementation remains unclear.

Purpose of the Study:

• To identify existing frameworks and methods for assessing the impact of eHealth services.
• To support evidence-informed policy-making for eHealth implementation.
• To understand the scope and characteristics of current eHealth assessment approaches.

Main Methods:

• Systematic literature review across five bibliographical databases.
• Inclusion criteria: clinical setting, HTA framework use, and eHealth service assessment.
• Analysis and reporting using a systematic qualitative narrative approach.

Main Results:

• Twenty-one HTA frameworks were identified, assessing technical, cost, clinical, organizational, and system-level aspects.
• Frameworks were primarily dimensional (13), followed by staged (3), hybrid (3), and business modeling (2).
• Six frameworks detailed specific assessment outcomes and methods; practical applicability was limited.

Conclusions:

• Available HTA frameworks can assess eHealth services a priori, but vary in outcomes, methods, and specificity.
• Limited demonstrated applicability in practice highlights a need for improvement.
• Standardization of eHealth reporting and a stepped-approach for assessment methods are recommended to enhance quality and comparability.