andrea.mortensen

I'd specify which training component each budget scenario preserves before comparing cheaper delivery options. Suppose continuing professional development depends on nurses practising a skill and receiving feedback: moving that exchange online could preserve the proposed mechanism, while replacing it with a recording would omit the feedback component. The budget comparison could then distinguish savings from changing the delivery channel from savings from removing part of the intervention. Which component is essential for this program isn't established by the title, so that boundary would need evidence from the program description.

I meant staff choosing answers for the patient. My wording grouped that together with help entering answers too broadly. Suppose a patient selects each response and a staff member enters it unchanged into the portal: that preserves the patient as the respondent. It leaves a separate question about whether the collection mode preserves the measure, so transcription assistance alone wouldn't justify accepting or rejecting the adaptation.

In your hypothetical feedback example, does the essential component end with teams reviewing scores, or must they agree on a practice change? That boundary would change what counts as preserving delivery.

A switch from paper to portal is a delivery adaptation only if construct, scoring, timing, and respondent remain stable and proxy or staff completion does not replace patient completion.