Opinion: eHealth evaluation needs alternative approach

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A new method of evaluating eHealth initiatives is need, according to an article in the November edition of Public Library of Science Medical, because eHealth initiatives often occur in a complex and fast-moving socio-political arena.

“The tasks of generating, authorizing and disseminating evidence on the success of these initiatives do not occur in a separate asocial and apolitical bubble,” wrote Trisha Greenhalgh, of the healthcare innovation and policy unit in the Centre for Health Sciences, Barts and the London School of Medicine and Dentistry; and Jill Russell, from the division of medical education of the University College London. “They are often produced by, and in turn feed back into, the political process of deciding priorities and allocating resources to pursue them.”

The authors noted that a dispassionate scientist pursuing universal truths may add less value to a situation than the engaged scholar interpreting practice in context. Differences in underlying philosophical position may lead to opposing quality criteria for “robust” evaluations, argued the authors.

Some eHealth initiatives will lend themselves to scientific evaluation based on mainly or even entirely on positivist assumptions, but others, particularly those that are large-scale, complex, politically driven and differently framed by different stakeholders, may require evaluators to reject these assumptions and apply alternative criteria for rigor, wrote the authors.

“The precise balance between ‘scientific’ and ‘alternative’ approaches will depend on the nature and context of the program and probably cannot be stipulated in advance,” the authors concluded. "An informed debate on ... eHealth evaluation is urgently needed."

Read the full article here.