Researchers from Harvard Medical School (HMS) have developed 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” 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 preventive measures all the time, but no one has ever really captured the important contribution of the many nontraditional 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.”
The report is published online today in the open access journal BMC Medicine.
The Family Van, a program of HMS, is a mobile clinic providing preventive health care and education to disadvantaged areas throughout Boston. The van provides screening, testing, and education for nutrition, weight management, diabetes, heart disease, pregnancy, and STDs, and other health concerns. The goal is to train and educate people to take 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 hundreds of such 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 information technology expert.
Using published data from the National Commission on Prevention Priorities (NCPP), which assigns values to a broad array of preventive 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 are a proof-of-principle demonstrating the feasibility of this online calculation tool, which they intend to have publicly available in less than a year.
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 Co.