Demonstration. In this Effectiveness. Assess Health services delivery Middle stage, the intervention whether the digital at moderate-scale is no longer taking health intervention can implementation in a place in controlled achieve the intended non- research setting is conditions, but is still results in a determined to be limited in terms of (uncontrolled) feasible, high quality population/geography setting. and cost-effective, (usually restricted to a improving the region or subregion). effectiveness of This stage seeks to bringing about positive understand the costs change in health and implementation outcomes. requirements needed to both deliver the intervention at high fidelity and replicate the uptake in new contexts. In this stage, Implementation Technology is functional Advanced approaches are ready science. Assess the and being effectively to be optimised and uptake, integration and implemented at scale. scaled up across sustainability of Support systems are in multiple subnational, digital operation to ensure national or population health interventions for continuous service levels. a given context, provision. including policies and Integrated and Health services delivery practices. sustained program. at large-scale Efforts at this stage implementation through are focused on integrated service determining the delivery is determined necessary to be feasible, high components of an quality and enabling environment improving the that will support effectiveness of impact of the bringing about positive intervention at a large change in health scale (e.g. policies, outcomes. finance, human resources, interoperability). The intervention has been integrated into a broader health system. 6.4.3 National Quality Forum Health Information Technology Measurement Framework The last example is the National Quality Forum Health Information Technology Measurement Framework.90 This model suggests nine key measurement areas for digital health (Table 4). Each area includes several process measures that could reflect performance in that area, and possible data sources or data collection strategies for each area. This model is an adaption of the Health IT Safety Framework126, is based on the sociotechnical environment of digital
Middle Demonstration. In this stage, the intervention is no longer taking place in controlled conditions, but is still limited in terms of population/geography (usually restricted to a region or subregion). This stage seeks to understand the costs and implementation requirements needed to both deliver the intervention at high fidelity and replicate the uptake in new contexts. Effectiveness. Assess whether the digital health intervention can achieve the intended results in a (uncontrolled) setting. Health services delivery at moderate-scale implementation in a non- research setting is determined to be feasible, high quality and cost-effective, improving the effectiveness of bringing about positive change in health outcomes. Advanced In this stage, approaches are ready to be optimised and scaled up across multiple subnational, national or population levels. Integrated and sustained program. Efforts at this stage are focused on determining the necessary components of an enabling environment that will support impact of the intervention at a large scale (e.g. policies, finance, human resources, interoperability). The intervention has been integrated into a broader health system. Implementation science. Assess the uptake, integration and sustainability of digital health interventions for a given context, including policies and practices. Technology is functional and being effectively implemented at scale. Support systems are in operation to ensure continuous service provision. Health services delivery at large-scale implementation through integrated service delivery is determined to be feasible, high quality and improving the effectiveness of bringing about positive change in health outcomes. 6.4.3 National Quality Forum Health Information Technology Measurement Framework The last example is the National Quality Forum Health Information Technology Measurement Framework.90 This model suggests nine key measurement areas for digital health (Table 4). Each area includes several process measures that could reflect performance in that area, and possible data sources or data collection strategies for each area. This model is an adaption of the Health IT Safety Framework126, is based on the sociotechnical environment of digital