"Given what has happened in the last few years in the technology sector, one would think eHealth developers would be discouraged", observed Tom Eng, president of the eHealth Institute and chair for the Summit. "But innovators are increasingly resilient and continue to challenge existing paradigms in health and health care."
At the Summit, there was renewed optimism about the role of eHealth despite the economic downturn. Seventy-seven percent of Summit participants were somewhat or very optimistic about the adoption of eHealth applications by health care organisations in the next five years. Over the past year, health care organisations have increased their emphasis on the Internet as a way to cut costs and provide more convenient services, such as enabling beneficiaries to complete administrative tasks.
"A few years ago, eHealth was a nice adjunct to our core services for our beneficiaries", stated Anna-Lisa Silvestre of Kaiser Permanente in Oakland, California. "Now our Web presence is an integral part of how we deliver care."
In the current economic climate, however, eHealth developers need a well thought-out commercialisation strategy in order to succeed. The optimal model for eHealth developers is to find a sponsor or strategic ally with business experience to partner in product development and distribution. They will also need to think more deliberately about their product's value proposition by focusing on the needs of customers and end-users, and by incorporating an evidence-based approach to product development.
In the post-dot-com period, the perceived influence of venture capitalists and other private investors as drivers of new eHealth development has declined dramatically. Consumers and health care organisations are now perceived to be the major eHealth players in the short-term and government influence on eHealth is increasing.
The proportion of Summit participants who considered the government as the "most influential eHealth driver/player in the next five years" increased from 9 percent in 2001 to 24 percent in 2002. And the perceived influence of the pharmaceutical and biotech including medical device industry dropped considerably from 20 percent in 2001 to 6 percent in 2002.
"Investments in health care technology must demonstrate value in meeting business objectives, whether they are to improve quality, service, or operational or clinical efficiency. The challenge health care organisations have, not unlike other industries, is to be able to quantify the tangible benefits", stated Sam Karp, chief information officer of the California HealthCare Foundation.
Although major eHealth research gaps remain, there is increasing evidence that eHealth interventions can improve quality and outcomes, reduce costs, and improve access. Summit participants emphasised that eHealth applications should not be thought of as stand-alone interventions, but, rather, they should be developed and implemented with an understanding of the user's total environment.
Although cutting research and evaluation activities may be tempting in hard economic times, developers were reminded that customers may be reluctant to invest in or purchase applications that have not been rigorously tested and evaluated. "Ongoing systematic evaluation of eHealth products will enable health care organisations to make more informed decisions about eHealth investment", according to David Ahern, national programme director of the Health e-Technologies Initiative and chief science officer for Abacus Technologies.
The future of eHealth lies in the development of creative approaches to longstanding health problems. Collaboration and strategic alliances are essential business strategies. "Successful eHealth ventures", noted Tom Eng, "require the kind of creativity and experience found in multi-disciplinary teams. Effective and sustainable products are those that draw upon experts from disparate backgrounds, but who have a common focus on the needs of customers and end-users."
The annual eHealth Developers' Summit is the only meeting in the United States that is solely focused on eHealth application development issues. It is an intensive, highly interactive, invitation-only meeting of executive-level eHealth developers and funders. The Summit promotes the sustainable development and dissemination of effective eHealth applications by enhancing communication and collaboration among developers and funders from commercial entities, academia, government, and non-profit organisations. Details about the report "Sustaining eHealth in Challenging Times", which can be downloaded free of charge, are available at the eHealth Institute Web site.