Economic impact of a nationwide interoperable e-Health system using the PENG evaluation tool.

Objective: The aim of this paper is to evaluate the costs and benefits of the Estonian interoperable health information exchange system. In addition, a framework will be built for follow-up monitoring and analysis of a nationwide HIE system. Methods: PENG evaluation tool was used to map and quantify the costs and benefits arising from type II diabetic patient management for patients, providers and the society. The analysis concludes with a quantification based on real costs and potential benefits identified by a panel of experts. Results: Setting up a countrywide interoperable eHealth system incurs a large initial investment. However, if the system is working seamlessly, benefits will surpass costs within three years. The results show that while the society stands to benefit the most, the costs will be mainly borne by the healthcare providers. Therefore, new government policies should be devised to encourage providers to invest to ensure society wide benefits.