Post-Implementation Evidence-Based Decision Making: The Telehealth Assessment Tool For Health (TeATH)

Abstract

Few telehealth implementations survive the initial pilot phase, and any anticipated Return on Investment seldom materialises. Within South Africa a reason is the lack of post-implementation monitoring and assessment. To address this practice gap we developed a simple and practical tool to allow decision- and policy-makers to assess the post-implementation state of current telehealth applications. Recognised management approaches were reviewed, and elements adopted or adapted to develop the new decision support tool. A systems-based approach, applying a revised People, Process, and Technology methodology (incorporating Infrastructure), and Balanced Score Card and e-Readiness principles, was applied. This allowed development of the Telehealth Assessment Tool for Health (TeATH), whose utility was demonstrated by assessing the current performance of existing teleradiology implementations in three Provincial hospitals in Mpumalanga Province. Expected results were achieved, with TeATH revealing fair performance in the Technology dimension, but poor performance across People, Process, and Infrastructure for all three hospitals. TeATH is a simple and generic tool that provides decision support and guidance to health planners, differentiating weak or lagging implementations for which remedial action can be introduced. The tool has been adopted by the Provincial Department of Health, and has already influenced recent policy decisions. Broad application of TeATH would reduce wasteful expenditure, and facilitate implementation and uptake of telehealth in South Africa and elsewhere.