[PHNUTR-L] Calculating preventative medicine's return on investment

[Kathrynne Holden]

Public release date: 2-Jun-2009
http://www.eurekalert.org/pub_releases/2009-06/hms-cpm052909.php

Contact: David Cameron
david_cameron at hms.harvard.edu
617-432-0441
Harvard Medical School

Calculating preventative medicine's return on investment

BOSTON, Mass. (June 2, 2009) —There are many reasons why health care 
costs in the US are spiraling out of control: ineffective use of 
resources, unmanaged chronic conditions and infrequent implementations 
of proven prevention strategies all contribute. While it stands to 
reason that preventative actions are one solution, no one has yet 
quantified the value of investing in non-traditional prevention programs.

Researchers from Harvard Medical School have led the development of a 
prototype "return on investment calculator" that can measure the value 
of prevention services. Using a Boston-based mobile health program 
called the "Family Van" 
http://www.news.harvard.edu/multimedia/flash/vid_familyvan.swf to test 
the tool, the team found that for the services provided in 2008, this 
program, in the long run, will return $36 for every dollar invested.

"People talk about the value of preventative measures all the time, but 
no one has ever really captured the important contribution of the many 
non-traditional prevention-based programs like the Family Van," says 
study first-author Nancy Oriol, HMS dean of students and an obstetric 
anesthesiologist at Beth Israel Deaconess Medical Center. "This value is 
underscored by the unique role that mobile health plays in reducing 
disparities in health outcomes, increasing access to care, and its 
ability to reach out to particularly vulnerable, at-risk communities."

Findings were published online June 2 in the open access journal BMC 
Medicine.

The Family Van, a program of HMS, is a mobile clinic providing 
preventative health care and education to disadvantaged areas throughout 
Boston. The Van provides screening, testing, and education in areas such 
as nutrition, weight management, diabetes, heart disease, pregnancy, and 
STDs, to name a few. Their goal is to train and educate people in taking 
the steps necessary to prevent or better manage chronic disease.

When Oriol, co-founder of the Family Van, decided that there needed to 
be some way to quantify the benefits of this and similar programs, she 
and executive director Jennifer Bennet teamed up with the Mobile Health 
Clinics Network, a membership-based organization of mobile health 
clinics and liaison to hundreds of mobile health clinics across the 
country; Paul Cote, former Massachusetts Commissioner of Public Health; 
and Isaac Kohane, director of the Countway Library of Medicine at HMS, 
and a health IT expert.

Using published data from the National Commission on Prevention 
Priorities (NCPP), which assigns values to a broad array of preventative 
practices, as well as published data on the cost-savings of preventing 
avoidable emergency room visits, the team developed an algorithm that 
"calculates" a return on investment ratio, thereby quantifying the value 
of mobile health care to the overall health care system.

"These data provide evidence for what we have long suspected, that is, 
preventative health services are perhaps the most cost-effective way to 
address both our ailing health care system and the needs of 
disadvantaged communities," says Cote.

The researchers emphasize that the Family Van data presented here is 
simply a proof-of-principle demonstrating the feasibility of this online 
calculation tool, which they intend to have publicly available in less 
than a year. In fact, Oriol's team is in the process of developing a 
web-based version of the calculator in order to measure the impact of 
the more than 2,000 mobile health programs across the nation.

###

Ronald McDonald House Charities funded the initial phase of the project. 
Work is now continuing with support from the Harvard Provost Fund for 
Interfaculty Collaboration and the Boeing Company.

Written by David Cameron

Full citation:

BMC Medicine, online publication, June 2, 2009

"Calculating the return on investment of mobile healthcare"

Nancy E Oriol(1), Paul J Cote(2), Anthony P Vavasis(3), Jennifer Bennet(4),
Darien DeLorenzo(5), Philip Blanc(6) and Isaac Kohane(7)

1-Department of Anesthesia and Critical Care, Beth Israel Deaconess 
Medical Center, Harvard Medical School, Boston, MA

2-Independent Health Care Consultant, Boston, MA

3-Health Outreach to Teens, Callen-Lorde Community Health Center, New 
York, NY

4-The Family Van, Harvard Medical School, Boston, MA

5- Mobile Health Clinics Network, San Francisco, CA

6-Robert Wood Johnson Medical School, Camden, NJ

7-Countway Library of Medicine, Harvard Medical School, Boston, MA