Developing a Business Case for Digital Investments in health and social care

Abstract

Introduction: One of the main reasons digital transformation projects fail is because organisations tend to start by picking solutions they like the look of, rather than fully evaluating the business case. This is demonstrated in recent NHS history[i]. A business case can be a useful tool to support smart investment by defining the 'why' (strategy) and 'what' (roadmap). This in turn supports the 'how' by acting as the logic model and the framework for evaluation of impact and return on investment. Optimity Advisors has a substantial track record of designing and supporting digital transformation in the UK and US healthcare sectors, and has specific experience in codesigning business cases using the Treasury Five Case Model[ii]. Business case for Digital Investments in healthcare The Strategic Case: The problemAre there alternatives to going digital? What happens if we don't? Who are the stakeholders? The Economic Case: Options appraisalWho will accrue the benefits - patients, providers or commissioners (or a combination?) What are the benefits and how will you measure them? The Commercial Case: Commercial opportunities and risksWho are the vendors? What products are available? What does the supply chain look like? How will you manage it? The Financial Case: Financial implicationsWhat is the initial investment and ongoing maintenance costs? Is sufficient funding available over the lifetime of the proposal? The Management Case: Implementation and delivery risksHow can we avoid the mistakes from previous projects? Are the appropriate governance and management structures in place? Application in the UK context Recently, Optimity worked with an STP[iii] footprint to create a business case for digital investment[iv]: Strategic case: we assessed the gap between the current and 'to-be'; Economic case: we defined the expected output, outcomes and impact over a five-year period; Commercial case: based on analysis of current systems, an open house session will be held to assess options; Financial case: costs were defined for procuring systems, and for project management of the programme; and Management case: the business case is being used as a narrative to get buy-in and define the governance structure. Lessons learned and conclusion: Optimity's experience shows that a business case for digitisation serves multiple purposes in the face of complexity: it defines a strategy, not just solutions to status quo; it's a narrative to bring the right champions on board; it is used as a logic model to define causal relationships; it's also a framework against which impact and RoI can be assessed. Thus, a business case in this context can be a powerful tool to not only define, but also implement and measure change.