OBJECTIVES: Virtual hospital 2.0 (VH2.0) platform, joint project between Finnish university hospitals produces and implements client-oriented digitalized secondary care services. Predictive modelling of cost and capacity effects associated with VH2.0 digital care path for insulin-dependent diabetes patients (IDDP) was done.

METHODS: PICOSTEPS reporting framework was applied. Patients: IDDPs (newly diagnosed, transitioning from paediatric to adult care or poor treatment balance) using secondary care services in 1) Kuopio University Hospital Catchment Area (KUH ERVA) or 2) Finland generally. Intervention: VH2.0 digital care path operational change. Comparator: Conventional practice. Outcome: Potential capacity freed (PCF, cost difference; 2017 real value). Setting: Dynamic predictive modelling. Time: Five years (2018 to 2022) in annual cycles; assuming implementation completed gradually in three years at the KUH ERVA level and in four years at the national level. No discounting. Effects: Predicted over-time changes in population structure and morbidity, resource use (e.g., clinician and nurse visits, letters and calls, inpatient days, e-appointments, e-messages, travelling, patient fees) and unit costs based on the real-world data and expert information. Perspective: Payer including only direct secondary care and travelling costs. Sensitivity analyses: The gradual implementation in two or five years.

RESULTS: At the KUH ERVA level, average annual PCF was estimated at €0.125 million for the first five years, summing up to total estimated five-year PCF of €0.626 million (27.5 % of the total included conventional practice costs). At the national Finnish level, average annual PCF was estimated at €0.577 million for the first five years, summing up to total estimated five-year PCF of €2.89 million (23.2 %). Five most important PCF drivers were physician visits, nurse visits, patient fees, travelling and nurse calls.

CONCLUSIONS: VH2.0 digital care path for IDDPs is potentially capacity-freeing and cost-saving, possibly increasing availability and achievability of the secondary care services for IDDPs.