PP150 Bevan Health Technology Exemplars: Early Dialogue To Systematize HTA

2019 ◽  
Vol 35 (S1) ◽  
pp. 66-66
Author(s):  
Susan Myles ◽  
Sion Charles ◽  
Claire Davies ◽  
Lauren Elston ◽  
Helen Howson ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
National Health ◽  
Expert Panel ◽  
Health Technology ◽  
Incremental Innovation ◽  
Key Stakeholders ◽  
Value Propositions ◽  
Technology Lifecycle ◽  
Clear Goal ◽  
Critical Consideration

IntroductionWales has ambitious health, wealth, and innovation policies and a clear goal to use the economic muscle of the Welsh National Health Service (NHS) to support its strong life sciences sector. Health Technology Wales (HTW) has a clear remit to appraise technologies over the span of their lifecycle from innovation to obsolescence. HTW is collaborating with the Bevan Commission through their national Health Technology Exemplars (HTEs), which partners NHS and industry stakeholders to strengthen innovation within the Welsh health system.MethodsHealth technology assessment (HTA) methods were used to produce topic exploration reports for assessing the evidence underpinning applicant innovations. A “Dragons’ Den” expert panel was convened to select the successful HTEs.ResultsFourteen Bevan HTEs were awarded funds, which were matched by industry partners. Application of HTA methods resulted in more critical consideration of technology value propositions, including: developing pull models of innovation focused on delivering health technology solutions for current problems facing NHS Wales; supporting early dialogue between the NHS and industry partners around demonstrating evidence of improved patient outcomes; and focusing on transformative rather than incremental innovation. The most promising innovations will progress to rapid HTA, where the evidence generated will be used to develop guidance for NHS Wales.ConclusionsHTA methods were productively deployed at the innovation phase of the technology lifecycle to support evidence-informed allocation of scarce innovation resources. In this way, HTW is working with key stakeholders to identify and offer early support to the most promising innovations, with the aim of expediting their adoption and realizing health benefits for patients as quickly as possible. The Bevan Commission has partnered with HTW to routinely build in HTA and evidence considerations in its future innovation calls and competitions. Thus, HTW has established a “feeder” pipeline for assessing bottom-up service-led innovations and encouraging evidence consideration throughout the lifecycle of innovative technologies.

scholarly journals Predictors and Consequences of Veterans Affairs Mental Health Provider Burnout: Protocol for a Mixed Methods Study

10.2196/18345 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e18345
Author(s):  
Kara Zivin ◽  
Jennifer Kononowech ◽  
Matthew Boden ◽  
Kristen Abraham ◽  
Molly Harrod ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Patient Outcomes ◽  
Primary Care Physicians ◽  
Quantitative Methods ◽  
Expert Panel ◽  
Veterans Affairs ◽  
Mixed Methods Study ◽  
Mental Health Provider ◽  
Health Administration

Background In the Veterans Health Administration (VHA), mental health providers (MHPs) report the second highest level of burnout after primary care physicians. Burnout is defined as increased emotional exhaustion and depersonalization and decreased sense of personal accomplishment at work. Objective This study aims to characterize variation in MHP burnout by VHA facility over time, identifying workplace characteristics and practices of high-performing facilities. Methods Using both qualitative and quantitative methods, we will evaluate factors that influence MHP burnout and their effects on patient outcomes. We will compile annual survey data on workplace conditions and annual staffing as well as productivity data to assess same and subsequent year provider and patient outcomes reflecting provider and patient experiences. We will conduct interviews with mental health leadership at the facility level and with frontline MHPs sampled based on our quantitative findings. We will present our findings to an expert panel of operational partners, Veterans Affairs clinicians, administrators, policy leaders, and experts in burnout. We will reengage with facilities that participated in the earlier qualitative interviews and will hold focus groups that share results based on our quantitative and qualitative work combined with input from our expert panel. We will broadly disseminate these findings to support the development of actionable policies and approaches to addressing MHP burnout. Results This study will assist in developing and testing interventions to improve MHP burnout and employee engagement. Our work will contribute to improvements within VHA and will generate insights for health care delivery, informing efforts to address burnout. Conclusions This is the first comprehensive, longitudinal, national, mixed methods study that incorporates different types of MHPs. It will engage MHP leadership and frontline providers in understanding facilitators and barriers to effectively address burnout. International Registered Report Identifier (IRRID) PRR1-10.2196/18345

scholarly journals Implementing health technology assessment in Kuwait: a qualitative study of perceived barriers and facilitators

2019 ◽  
Vol 35 (6) ◽  
pp. 422-426 ◽  
Author(s):  
Basshar Darawsheh ◽  
Evi Germeni
Keyword(s):  
Developing Countries ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Health Technology ◽  
Barriers And Facilitators ◽  
Policy Makers ◽  
Face To Face ◽  
Key Stakeholders

AbstractObjectivesThis study sought to explore main barriers and facilitators to implementing health technology assessment (HTA) in Kuwait from the perspective of key stakeholders.MethodsSemi-structured qualitative interviews were conducted with ten key stakeholders: seven healthcare providers working at various departments of the Kuwaiti Ministry of Health (MOH), and three academics with substantial experience in teaching HTA or related fields. Interviews were conducted face-to-face, audio-recorded, and transcribed verbatim. Data were analyzed using an inductive thematic approach.ResultsParticipating stakeholders reported several factors that might act as a barrier to building HTA in Kuwait: minimal awareness of HTA, lack of institutional and human capacity, a fragmented healthcare system, poor communication between researchers and policy makers, the country's wealth, politics, as well as data quality, availability, and sharing. Institutionalizing HTA as a politically empowered body, enforcing its recommendation by law, and benefiting from neighboring countries' experiences were suggested as possible ways to move forward.ConclusionStudies exploring the unique challenges that high-income developing countries may face in implementing HTA are still scarce. The results of this study are consistent with evidence coming from other developing countries, while also suggesting that the abundance of financial resources in the country is a double-edged sword; it has the potential to facilitate the development of HTA capacity, but also hinders recognizing the need for it.

OP51 Thrombectomy In France: A National Use Of European Network for Health Technology Assessment (EUnetHTA) Joint Assessment

2017 ◽  
Vol 33 (S1) ◽  
pp. 24-24
Author(s):  
Huguette Lhuillier-Nkandjeu ◽  
Michèle Morin-Surroca
Keyword(s):  
Health Insurance ◽  
Ischaemic Stroke ◽  
Health Technology Assessment ◽  
National Health Insurance ◽  
National Health ◽  
Technology Assessment ◽  
Acute Ischaemic Stroke ◽  
Health Technology ◽  
List Type ◽  
European Network

INTRODUCTION:Mechanical thrombectomy (MT) is used in patients with acute ischaemic stroke due to occlusion of a proximal cerebral artery. Over the years endovascular techniques have been used to re-canalise blocked vessels, but are not currently reimbursed by National Health Insurance in France.The aim was to assess the efficacy and safety of MT in combination with intravenous tissue plasminogen activator (IV t-PA), or as an alternative to it, in adults with an acute ischaemic stroke who are not eligible for thrombolysis or in whom thrombolysis has failed; to support the reimbursement decision by National Health Insurance.METHODS:Within the scope of The European Network for Health Technology Assessment (EUnetHTA), a rapid assessment of “Endovascular therapy using devices for acute ischaemic stroke” was jointly produced with Haute Autorité de santé (HAS) as a reviewer.RESULTS:The EUnetHTA report provided a systematic review based on eight randomized controlled trials (RCT) for effectiveness and all available published data for safety.To produce its assessment, HAS has adapted the EUnetHTA report by: 1.Updating the systematic literature review including the latest published trials2.Retaining the subgroup analysis of the five most recent trials considered more relevant in the EUnetHTA report for the assessment of effectiveness3.Analysing specifically the different endovascular interventions studied in the five RCTs4.Taking into account contributions from stakeholders.CONCLUSIONS:This horizontal collaboration among European HTA doers has facilitated and shortened the assessment of the clinical benefit of this technology, confirming the relevance of EUnetHTA cooperation.This clinical assessment of thrombectomy is to be completed by the evaluation of its organizational impact in the management of acute ischemic stroke.

PP186 Telemonitoring With Pacemakers For Patients With Heart Failure

2019 ◽  
Vol 35 (S1) ◽  
pp. 72-72
Author(s):  
Susan Myles ◽  
Ruth Louise Poole ◽  
Karen Facey
Keyword(s):  
Heart Failure ◽  
Patient Outcomes ◽  
Best Practice ◽  
Core Outcome Set ◽  
Outcome Set ◽  
Patients With Heart Failure ◽  
Technical Issues ◽  
Technology Lifecycle ◽  
Multi Stakeholder ◽  
Improve Patient

IntroductionEvidence supporting the use of pacemakers is well established. However, evidence about the optimal use of pacemaker telemonitoring for disease management in heart failure is not. Health Technology Wales (HTW) held a national adoption event to encourage implementation and best practice in use of pacemaker telemonitoring in the National Health Service (NHS) Wales to improve patient outcomes in heart failure.MethodsMulti-stakeholder national adoption workshop using a mixture of expert presentations, case studies and interdisciplinary group and panel discussions to agree key actions to understand the value and promote optimal use of pacemakers for remote disease monitoring in patients with heart failure in Wales.ResultsThe workshop was attended by forty-five senior professionals with an interest in improving care of patients with heart failure. Actions to progress included: providing a centralized Welsh system to support technical issues that arise with telemonitoring; considering interoperability with other NHS Wales systems; encouraging value-based procurement with collection of a core outcome set; agreeing implementation issues with both professionals and patients; audit to understand experience, resource use and outcomes; and sharing manufacturer evidence on the accuracy of telemanagement algorithms. It was suggested that these actions be progressed via an All-Wales multi-stakeholder approach, led by the Welsh Cardiac Network.ConclusionsDeveloping a more agile, lifecycle approach to technology appraisal is currently advocated; recalibrating the focus from technology assessment to technology management across the complete technology lifecycle. HTW will endeavour through regular adoption events to facilitate such a paradigm shift that aims to understand value and optimise use of evidence-based technologies.

scholarly journals Which multi-attribute utility instruments are recommended for use in cost-utility analysis? A review of national health technology assessment (HTA) guidelines

2020 ◽  
Vol 21 (8) ◽  
pp. 1245-1257 ◽  
Author(s):  
Matthew Kennedy-Martin ◽  
Bernhard Slaap ◽  
Michael Herdman ◽  
Mandy van Reenen ◽  
Tessa Kennedy-Martin ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
National Health ◽  
Technology Assessment ◽  
Market Access ◽  
Health Technology ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Disability Weights ◽  
Value Sets

Abstract Background Several multi-attribute utility instruments (MAUIs) are available from which utilities can be derived for use in cost-utility analysis (CUA). This study provides a review of recommendations from national health technology assessment (HTA) agencies regarding the choice of MAUIs. Methods A list was compiled of HTA agencies that provide or refer to published official pharmacoeconomic (PE) guidelines for pricing, reimbursement or market access. The guidelines were reviewed for recommendations on the indirect calculation of utilities and categorized as: a preference for a specific MAUI; providing no MAUI preference, but providing examples of suitable MAUIs and/or recommending the use of national value sets; and recommending CUA, but not providing examples of MAUIs. Results Thirty-four PE guidelines were included for review. MAUIs named for use in CUA: EQ-5D (n = 29 guidelines), the SF-6D (n = 11), HUI (n = 10), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). EQ-5D was a preferred MAUI in 15 guidelines. Alongside the EQ-5D, the HUI was a preferred MAUI in one guideline, with DALY disability weights mentioned in another. Fourteen guidelines expressed no preference for a specific MAUI, but provided examples: EQ-5D (n = 14), SF-6D (n = 11), HUI (n = 9), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). Of those that did not specify a particular MAUI, 12 preferred calculating utilities using national preference weights. Conclusions The EQ-5D, HUI, and SF-6D were the three MAUIs most frequently mentioned in guidelines. The most commonly cited MAUI (in 85% of PE guidelines) was EQ-5D, either as a preferred MAUI or as an example of a suitable MAUI for use in CUA in HTA.

Using information graphics in health technology assessment: Toward a structured approach

2009 ◽  
Vol 25 (4) ◽  
pp. 555-563 ◽  
Author(s):  
Martin Pitt ◽  
Will Stahl-Timmins ◽  
Rob Anderson ◽  
Ken Stein
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Current Practice ◽  
Health Technology ◽  
Information Graphics ◽  
The United Kingdom ◽  
Classification Framework ◽  
Key Stakeholders ◽  
The Uk ◽  
Structured Approach

Objectives: This study investigates the use of information graphics to display the outputs of health technology assessment (HTA) in the United Kingdom and proposes a more structured approach founded in an analysis of the decision-making requirements of the key stakeholders.Methods: A scoping review of HTA reports was conducted to investigate current practice in the use of information graphics in HTA literature. A classification framework using dimensions of report section, graphical type, and originating research center was devised and used for a full content analysis of the graphical figures in the fifty most recent reports produced for the UK National Health Service's HTA process.Results: Our survey shows that graphical tools are used extensively in HTA reports although less frequently than tables. Use of information graphics varies widely between different report sections and tends to follow conventional lines with little evidence of variance from established practice. The largest variance was found between the quantities of graphics used by different research centers responsible for authoring the reports.Conclusions: HTA makes extensive use of graphics; however, there is little evidence of a systematic or standardized approach, or of much innovation. Significant potential exists to explore the application of information graphics in this field, but there are many research challenges. A contextually based, structured approach to the design of effective information graphics in HTA is proposed as a basis both to investigate the application of existing graphical tools in HTA, and to explore the considerable scope for innovation.

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