Call for discussion about the framework for categorizing economic evaluations of health information systems and assessing their quality

In the recent JAMIA article ‘Measuring value for money: a scoping review on economic evaluation of health information systems (HIS),’ Bassi and Lau1 identified 42 studies conducted from different perspectives within public, private and mixed healthcare systems and assessed 33 of them as good quality. The importance of establishing value for money of large HIS investments is indisputable. Numerous assessments of economic aspects of different HIS implementations have been conducted; however, there is a paucity of reviews classifying and summarizing their results. Bassi and Lau's review makes a useful contribution by introducing a new methodological framework, which classifies HIS studies with an ‘economic component’ and assesses their quality. In our view, the framework has some limitations that may confuse readers and result in misguided conclusions. Here we briefly discuss these limitations and we hope this will stimulate further discussion. One of the central challenges is that many HIS studies, including those identified by Bassi and Lau, contain some information on benefits and/or costs, but such studies were often not designed to conduct an economic evaluation or assess economic efficiency as defined by the economics discipline. The stated objectives and the correspondent methods (eg, econometric modelling) may be sufficient to quantify ‘cost savings' associated with investing in HIS, but cannot show …