Domain 3: Responding to complexity in the value proposition
This project is only going to work if all stakeholders gain something of value from it.
Consider how to increase the technology’s appeal to investors. If the technology is at an early stage of development, what is its likely upstream value as viewed by investors (especially the business case for generating profits, further spin-offs, and highly qualified jobs), drug and device regulators (preliminary evidence of efficacy and safety), and financial regulators (auditable business processes and governance)? Can the technology be ‘de-risked’ by removing costly but inessential features? See the Guidance and Impact tracking System (GAITS) resource linked above.
Consider how to increase the technology’s value to patients or citizens. If a technology is meant to be used by patients or lay people, its potential benefits must be weighed against its costs (and the person’s willingness and ability to contribute to these), the work needed to use it (and whether the person or their carer is able and willing to do that work), and the desirability of medicalisation and surveillance. Can the design be improved to make the technology more appealing? Can the data be visualised in a way patients or carers can engage with?
See links above under ‘Responding to complexity in the illness’
Getting the most out of PROMS – A guide to using patient-reported outcome measures to assess whether an intervention or technology is actually improving outcomes that are valued by patients
A guide to PROMs methodology from NHS Digital (using hip and knee replacement as an example)
Identify evidence of effectiveness and cost-effectiveness. If the technology is at a more advanced stage of development, there may be research evidence comparing its effectiveness (does it work?) and cost-effectiveness (is it good value for money?) with ‘usual care’ and measuring an outcome that is important to patients. Try these resources:
NICE Evidence Standards for digital health technologies – These cover both effectiveness and economic impact.
Consider real-world value issues. Is there a realistic assessment of the challenges of implementing this innovation at scale in a particular public-sector health or care environment? Even when something has been shown to be cost-effective, it may not be locally affordable or a funding priority.
The NICE Evidence Standards website linked above offers a budget impact guide and budget impact template for local cost planning.