A Strategy Framework for eHealth: Flow-through to ROI

We’ve now covered three stages of Geonetric’s strategy framework for eHealth: The eHealth Maturity Model. Today, we move forward to Level 4: Flow-through to ROI (return on investment). This level focuses on the financial impact that eHealth initiatives can bring to the table, translating the Level 3 outcomes into financial form.

Before we begin, let’s quickly review the first three levels of the model.

The eHealth Maturity Model Levels 1-3

The eHealth Maturity model includes five steps:


At Level 1: Critical Mass In Adoption, organizations value usage of the site and are focused heavily on usability, making sure visitors to the site successfully complete tasks.  Level 2 organizations, however, look past usability and concentrate on the overall experience users have on the site.  At Level 2: Measurable User Satisfaction, organizations seek to create an experience that users will prefer over the traditional approach for accomplishing the same end result.

Once organizations have reached the first two levels, they have a platform that is highly valuable to users.  It is at that stage that they can successfully begin looking inwardly at increasing the value delivered to their organization.  At Level 3: Demonstrable Change in Outcomes that Matter to Our Core Business, organizations capture the various non-financial measures of value delivery.

Level 4: Flow-through to ROI

According to the results from our Annual Survey on Initiatives in eHealth, few organizations are at this stage of maturity.  Few healthcare organizations successfully measure ROI for focused eHealth initiatives, and even fewer organizations have a comprehensive and systematic program for measuring ROI.  Despite this, however, interest in measuring ROI continues to grow, and we believe this trend will continue given the current economic climate.

There are many financially-oriented metrics that can be used to measure eHealth ROI, such as the total value delivered by some aspect of eHealth, the relative value of a patient who works with the organization online as compared to patients overall, or days receivables outstanding.  While these are worthwhile metrics, our goal is to provide a metric that compares the impact of eHealth in a way that can be compared to other investments.  The goal is to normalize the return in a way that is simple and easy to understand.

Unfortunately, it can be challenging to define the ROI metrics for many eHealth initiatives. Long timeframes between an online encounter and reimbursement make it a trailing indicator-one that is informative but doesn’t offer the real-time feedback needed to make adjustments quickly mid-stream.  Likewise, since many organizations require consumers to convert through offline processes, it can be difficult-to-impossible to connect an online interaction to a patient encounter at the hospital.  Even when such a connection is made, the value of the transaction is often challenged by those who think the patient would have sought your services some other way if an online channel was not available.

As a result, the question of ROI boils down to two fundamental levels of tracking:

  • Real-time estimated ROI. You can approximate the financial return on an interaction by using real-time (or near real-time) tracking data and your assumptions about the value of the interaction. For example, let’s say your data confirms that a consumer who signs up for a heart screening yields, on average, $150 in service revenue (reimbursements) over a six-month period. By using tracking tools during a promotional campaign for heart screenings, along with this estimated return, you can estimate that return value in near real-time.
  • Periodic ROI calculation. ROI assessments should be performed periodically to measure the effectiveness of your site capabilities as well as your promotional campaigns. When compared to your estimates, these ROI calculations can identify potential problems with your measurements or campaign performance. For example, using our heart screening evaluation, let’s say the actual ROI calculated for the campaign falls far short of the estimated value. After further assessment, you may determine there was little availability for follow-up services by your cardiovascular unit, which lead many of the cases to seek care at a competing facility. By calculating the ROI, you are able to address the situation promptly.

Questions to assess your Level 4 success

In order to reach Flow-through to ROI in the eHealth Maturity Model, you should be able to answer yes to the following questions:

1. Do we capture project and campaign costs (including staff costs) in a way that will allow us to perform ROI calculation?

___ Yes, we have a comprehensive expense capture process that allows me this visibility.

___ No, but we capture costs associated with projects other than staff time.

___ No, we have no visibility to this information.

2. Do we perform periodic ROI evaluations on our major initiatives?

___ Yes, we perform this analysis on every initiative.

___ No, we’ve tried, but the systems that we have in place make this process cumbersome or impossible to track.

___ No, we lack the expertise to perform this analysis.

3. Do we have a real-time or near real-time expected ROI dashboard?

___ Yes, we watch our progress on this closely.

___ No, but we track non-financial input metrics in near real-time.

___ No, we can’t get this information in a timely fashion.

4. Do we meet regularly with finance to ensure that the numbers we generate for ROI will be accepted by the organization?

___ Yes, we have a documented standard for developing ROI.

___ No, we’ve met with them, but have no clear guidance on what they will accept.

___ Wow, that’s a really good idea…

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This entry was posted in Best Practices, eHealth by Ben Dillon. Bookmark the permalink.
Ben Dillon

About Ben Dillon

Ben’s a big picture type of guy. He loves sharing new ideas in digital marketing, keeping a watchful eye on healthcare industry trends and seeing how it all intersects. A sought-after speaker, writer, blogger and current SHSMD board member, Ben’s an influential voice in healthcare marketing, helping organizations across the country embrace online strategies to engage health consumers. Combine his industry savvy with his background in software development and you can see why he’s also an important member of Geonetric’s software team, ensuring our content management system stays a step ahead of market needs. Ben holds a master’s degree in eBusiness and strategic management from the University of Iowa and a bachelor’s degree in computer engineering from the University of Michigan. When he’s not traveling and evangelizing, Ben enjoys cooking with his family and playing the Big House with the University of Michigan Alumni marching band.

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