Exploration of benefits realisation management for teledermatology scale-up framework development and sustainable scaling

• Main Authors: Laticha Elizabeth Marolana Walters, Richard Ernest Scott, Maurice Mars
• Format: Article
• Language: English
• Published: Elsevier 2019-01-01
• Series: Informatics in Medicine Unlocked
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352914818302296

Introduction: Realisation of proven telemedicine scale-up benefits is a key consideration for South Africa, a developing country with a quadruple disease burden, inequitable access to healthcare, and ineffective and inefficient specialist referral pathways. Proven benefits of teledermatology include virtually enhancing access of rural communities to scarce urban specialist dermatologists, reducing time to triage of skin lesions, frequently an initial sign of underlying disease, and timely treatment initiation. Benefits realisation management (BRM) is a recognised means of managing how resources are invested into making effective and desirable changes, and enhancing project and programme success. The need for this study was identified in a recent review and critique of teledermatology and related scale-up frameworks. This study explores the use of BRM as a whole life-cycle approach applied to ehealth or teledermatology related scale-up framework development, and to sustain benefits of scaling ehealth or healthcare service delivery interventions. Material and methods: A structured search of academic literature was performed using Scopus, Science Direct, PubMed, IEEE Explore, Web of Science, and Google Scholar. The key terms Benefits Realisation Management or BRM were linked with: a) ehealth or telehealth or telemedicine or teledermatology related scale-up framework development, and b) sustainability of interventions such as scale-up. Subsequent Google searching explored grey literature evidence for BRM in ehealth. Results: The academic literature searches could not identify peer-reviewed literature to support the use or consideration of BRM as a whole life-cycle approach within ehealth or teledermatology related scale-up framework development. Discussion: However, the results showed that BRM has been used in related domains to promote sustainability of non-healthcare interventions. In contrast the grey literature provided evidence of limited use of BRM within healthcare and within ehealth. Conclusions: There is renewed support for the use of BRM as a whole life-cycle approach for management disciplines that focus on change, project, programme, and portfolio management. Although limited, the academic and grey literature provides support for consideration of BRM in ehealth, and for the use of BRM to ensure sustainability. Future research should explore the use of BRM as a whole life-cycle approach for ehealth implementation, and teledermatology scale-up framework development in particular, including its possible contribution to sustaining scaled-up teledermatology. Keywords: ehealth, Benefits realisation management, BRM, Teledermatology, Scale-up, Sustainability