Multidimensional Assessment of E- Health Projects Sustainability
Résumé
Today e-health (information and communication technology - ICT - for health services) is considered as a promising solution to overcome financial and human deficits of health systems and to improve quality and accessibility of care. However ICT introduce new cost structures, organizational and medical practice changes. They are also known to have significant environmental impacts, not only in terms of energy use but also due to required raw materials. Hence these impacts need to be evaluated in a multidimensional way in order to confirm the sustainable value of such solutions. Myriam le Goff and Robert Picard have recently developed a socioeconomic multidimensional ICT model to evaluate technology projects: GEMSA, Grille d'Evaluation Multidisciplinaire Santé Autonomie [Multidimensional Evaluation Grid for Health and Autonomy] (Le Goff-Pronost and Picard, 2011). The proposed evaluation framework is based on five specific categories: strategy, technology, quality and usage, organization and economics. We propose to add environmental criterion to get a complete sustainability assessment, even if it is not yet considered as a priority in the health sector. Indeed, due to environmental international pressure and to the development of the Green IT, we think these criteria should be implemented in e-health projects from their beginning. Notably, raw material extraction is one of the most important polluting phases in the lifecycle of electronic and electric equipment of ICT, which also include nu-merous hazardous materials and heavy metals. To define these criteria we perform a transverse analysis of: i/ techno-functional analysis of existing ongoing e-health projects, ii/ general environmental ICT impacts (notably due to raw materials ex-traction), iii/ existing eco-labels applying to ICT, and iv/ e-health regulation. As a result, we propose a first list of environmental criteria which take into account technology mate-rials and lifecycle. Project leaders can test and use them to auto-evaluate and try to minimize envi-ronmental impacts of their project - in addition to social, organizational and economic criteria. The resulting global evaluation model for e-health would be the first to include the three main di-mensions of sustainable development.