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Health Informatics New Zealand 2010 If you can’t stand the heat…  The role of scientists in evaluating  government policy Professor Trisha Greenhalgh Acknowledging critical insights from Jill Russell  Slide 1
Slide 2
Slide 3
[object Object],[object Object],[object Object],THREE CRITICAL QUESTIONS Slide 4
[object Object],[object Object],Slide 5
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],SUMMARY CARE RECORD: FINDINGS Slide 6
Slide 7
THE POLITICAL WORLD:   SCR is a tool for achieving manifesto promises e.g. fewer unnecessary admissions, more efficient public spending THE CLINICAL WORLD:   SCR will improve quality in out-of-hours care BUT threatens confidentiality / privacy THE TECHNICAL WORLD:   SCR must be innovative, elegant, fit for purpose & close to specification THE COMMERCIAL WORLD: SCR must bring return on investment for shareholders THE PERSONAL WORLD: SCR will help my doctor provide personal care for me (but are there risks to my privacy?) Slide 8 POLITICAL CLINICAL TECHNICAL COMMERCIAL PERSONAL
The theoretical basis for this analysis was complex and challenging Slide 9
Slide 10
Slide 11
Slide 12
“ Health information systems should be evaluated with the same rigour as a new drug or treatment programme, otherwise decisions about future deployments of ICT in the health sector may be determined by social, economic, and/or political circumstances, rather than by robust scientific evidence.”  Slide 13
“… systematically address each part of a chain of reasoning, at the centre of which are a programme’s goals.”  Slide 14
Slide 15
“ The step-wedge design appears to have particular promise in the evaluation of eHealth systems.  The largest project commissioned under the NPfIT follows the step-wedge design.”  Slide 16
“… the authors of the empirical study flagged as an exemplary illustration of the step-wedge design abandoned it in favour of a largely qualitative case study because they found it impossible to establish anything approaching a controlled experiment in the complex, fast-moving and politicised context in which their study was conducted”.  Slide 17
[object Object],[object Object],Slide 18
“ The [positivist evaluation] model is elegant in its simplicity, appealing for its rationality, reasonable in asking little more than that people do what they say they will do, and it is efficient in its economical definition of what data count….” BUT….. Professor Saville Kushner Slide 19
Professor Saville Kushner ,[object Object],[object Object],[object Object],[object Object],Slide 20
[object Object],[object Object],Slide 21
“ RIGOROUS” EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Slide 22
[object Object],[object Object],[object Object],[object Object],THREE TYPES OF EVALUATION OF GOVERNMENT PROGRAMMES Slide 23
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BUREAUCRATIC EVALUATION XYZ Slide 24
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],AUTOCRATIC EVALUATION Slide 25
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],DEMOCRATIC /DELIBERATIVE EVALUATION Slide 26
[object Object],[object Object],[object Object],[object Object],[object Object],AN ALTERNATIVE SET OF GUIDING PRINCIPLES FOR eHEALTH EVALUATION Slide 27
[object Object],[object Object],[object Object],[object Object],[object Object],AN ALTERNATIVE SET OF GUIDING PRINCIPLES FOR eHEALTH EVALUATION Slide 28
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],THREE CRITICAL QUESTIONS Slide 29
Thank you for your attention Trisha  Greenhalgh Acknowledging  critical insights from  Jill Russell Slide 30

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If you can’t stand the heat: The role of scientists in evaluating government policy

  • 1. Health Informatics New Zealand 2010 If you can’t stand the heat… The role of scientists in evaluating government policy Professor Trisha Greenhalgh Acknowledging critical insights from Jill Russell Slide 1
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  • 8. THE POLITICAL WORLD: SCR is a tool for achieving manifesto promises e.g. fewer unnecessary admissions, more efficient public spending THE CLINICAL WORLD: SCR will improve quality in out-of-hours care BUT threatens confidentiality / privacy THE TECHNICAL WORLD: SCR must be innovative, elegant, fit for purpose & close to specification THE COMMERCIAL WORLD: SCR must bring return on investment for shareholders THE PERSONAL WORLD: SCR will help my doctor provide personal care for me (but are there risks to my privacy?) Slide 8 POLITICAL CLINICAL TECHNICAL COMMERCIAL PERSONAL
  • 9. The theoretical basis for this analysis was complex and challenging Slide 9
  • 13. “ Health information systems should be evaluated with the same rigour as a new drug or treatment programme, otherwise decisions about future deployments of ICT in the health sector may be determined by social, economic, and/or political circumstances, rather than by robust scientific evidence.” Slide 13
  • 14. “… systematically address each part of a chain of reasoning, at the centre of which are a programme’s goals.” Slide 14
  • 16. “ The step-wedge design appears to have particular promise in the evaluation of eHealth systems. The largest project commissioned under the NPfIT follows the step-wedge design.” Slide 16
  • 17. “… the authors of the empirical study flagged as an exemplary illustration of the step-wedge design abandoned it in favour of a largely qualitative case study because they found it impossible to establish anything approaching a controlled experiment in the complex, fast-moving and politicised context in which their study was conducted”. Slide 17
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  • 19. “ The [positivist evaluation] model is elegant in its simplicity, appealing for its rationality, reasonable in asking little more than that people do what they say they will do, and it is efficient in its economical definition of what data count….” BUT….. Professor Saville Kushner Slide 19
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  • 30. Thank you for your attention Trisha Greenhalgh Acknowledging critical insights from Jill Russell Slide 30