Digitalization as an Engine for Change? Building a Vision Pathway towards a Sustainable Health Care System by Using the MLP and Health Economic Decision Modelling

Grand social challenges, such as type 2 diabetes (T2D), are increasing, which creates sustainability problems for health care service systems. To reduce socio-economic burdens, changes are required in the socio-technical system. However, there is an uncertainty of the most cost-effective policy action that can create sustainability while providing health benefits. To find potential solutions to these challenges, the multi-level perspective (MLP) and health economic decision modelling was used to study socio-technical change and project potential health economic consequences of different scenarios. The study focuses on creating a vision pathway for reducing T2D in Finland. In total, 23 interviews were carried out and the results were analyzed utilizing the MLP model. As a result, five themes towards prevention of T2D were identified. Digitalization was found to be a cross-cutting theme for preventing T2D and was thus taken as the object of study and the main focus of this paper. As a result, this paper reports on the opportunities and barriers for using digital tools in a transition towards T2D prevention. A health economic decision modelling revealed that the highest expected savings could be obtained by prioritizing prevention programs based on T2D risk. Finally, the model was converted into a web-based online tool by combining vision pathway, transition-focused storylines and forward-looking health economic scenario analysis to give the policy makers an overall picture of the needed societal changes and support the impact assessment of alternative policies in a case of T2D prevention in Finland.