Assessing the early impact of a hospital-based health technology assessment program, smart innovation

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Erik J. Landaas ◽  
Ryan N. Hansen ◽  
Geoffrey S. Baird ◽  
Sean D. Sullivan
Keyword(s):  
Aortic Valve ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Medical Center ◽  
New Technology ◽  
Statistical Significance ◽  
Health Technology ◽  
Percent Reduction ◽  
The Difference ◽  
Post Period

Abstract Objective We evaluated the early impact of a new hospital-based health technology assessment (HB-HTA) program, called Smart Innovation, at the University of Washington Medical Center (UWMC). Methods We compared the UWMC's utilization trends for two surgical procedures to control hospitals by evaluating the difference before and after adoption decisions: (i) a new filter for transcatheter aortic valve replacement (TAVR) procedures that treat aortic valve stenosis and (ii) microwave ablation (MWA) for treating hepatocellular carcinoma. We used descriptive statistics to assess the difference between the UWMC and controls for TAVR and MWA procedures and multivariate difference-in-differences (DID) analyses to test for statistical significance. Results The UWMC experienced a 10 percent reduction in TAVR procedures compared with controls following the implementation of the TAVR Sentinel filter. The DID regression model indicated a 1.5 reduction in the number of TAVR procedures per quarter at the UWMC between the pre- and post period, which was not statistically significant (p-value: .87). The UWMC experienced a 51 percent reduction in utilization when compared with controls for MWA procedures in the pre- and post periods. The DID model for MWA indicated an 18.8 decrease in utilization per quarter during the study period for the UWMC, which was statistically significant (p-value: .0007). For MWA procedures, the UWMC experienced a $647,658 dollar reduction in total costs in the post period compared with controls. Conclusions When the UWMC used HB-HTA methods for technology adoption, there was a reduction in utilization and total costs when compared with controls; however, when the UWMC adopted a new technology without using HB-HTA methods, there was no difference in utilization.

scholarly journals Assessment of Computerized Medical Equipment Management and Maintenance System From Health Technology Assessment (HTA) Perspective: Need and Approach

2021 ◽  
Author(s):  
Joshi Nitin Kumar ◽  
Bhardwaj Pankaj ◽  
Singh Kuldeep ◽  
Joshi Vibha ◽  
Suthar Praveen
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Medical Equipment ◽  
New Technology ◽  
Health Technology ◽  
Flexible Tool ◽  
Quality Healthcare ◽  
Biomedical Equipment ◽  
Computerized Maintenance Management System ◽  
Assessment Approach

Appropriate management of medical equipment is of crucial importance for providing quality healthcare. A computerized maintenance management system (CMMS) is a computerized program used by healthcare technology management (HTM) systems as an instrument for maintaining, organizing, storing, and reporting the data related to medical technologies in health facilities. Though CMMS is introduced as a beneficial and flexible tool for transforming the management of biomedical equipment, but no evidence of the same has been documented yet to highlight the efficacy of CMMS in the Indian context. CMMS, an e-Health system used by HTM programs, is a relatively new technology being adopted by various states of India. Such systems are vital to judging whether the system is operating and delivering the effects as desired. Assessment not only can inform policy-makers about what is known about the technology, but it also provides a better knowledge of the strengths and weaknesses of the intended technology. Health Technology assessment (HTA) is a systematic process designed to synthesize and evaluate the prevailing evidence for treatment or health delivery innovation. So considering the HTA perspective, an assessment approach to CMMS could be planned. Systematic reviews and empirical frameworks that have been used for understanding and assessing e-health programs can be used for evaluating technologies. Assessment of CMMS from a HTA perspective should be vital to the implementation of HTM systems by healthcare agencies.

PP140 Barriers And Prospects For The Development Of Hospital-Based Health Technology Assessment In Kazakhstan

2021 ◽  
Vol 37 (S1) ◽  
pp. 21-21
Author(s):  
Andrey Avdeyev ◽  
Valeriy Benberin ◽  
Nasrulla Shanazarov ◽  
Larissa Makalkina ◽  
Aigul Kaptagayeva ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Medical Center ◽  
Hospital Staff ◽  
Health Technology ◽  
System Level ◽  
Managerial Decisions ◽  
Organizational Barriers ◽  
Center Hospital ◽  
Promising Area

IntroductionThe experience of implementing a hospital-based health technology assessment (HB-HTA) system in Kazakhstan is currently represented by only one organization, an independent HB-HTA unit established in 2015 in the Medical Center Hospital of the President's Affairs Administration (the Hospital). Despite the demonstrated positive experience of the Hospital, the widespread implementation of the HB-HTA system in Kazakhstan has experienced some barriers that must be considered before further development can occur.MethodsTo determine the barriers to developing and implementing HB-HTA in Kazakhstani hospitals, data from the Hospital's experience were obtained through a survey of Kazakhstan hospitals, conducted on behalf of the Ministry of Health Care. An official response was received from 29 hospitals. During the survey and discussions with hospital staff using the “brainstorming” method, several barriers to the development of HB-HTA in Kazakhstan were identified.ResultsBarriers at the system level included the lack of monitoring of the HB-HTA system at the national and regional levels and a lack of methodological support. Organizational barriers included a critically small number of HTA experts and the need for additional logistical support and funding from hospitals. The subjective factors we attributed to the rejection of the HB-HTA system by hospital management were the underestimation of lost profits and that HTA is a tool for promoting a transparent and open system for making managerial decisions.ConclusionsDespite some barriers, the development of HB-HTA in Kazakhstan is a promising area. The heads of key hospitals in Kazakhstan demonstrated a readiness and understanding of the need to use the principles of health technology assessment and clinical and economic analysis to promote the active transfer and implementation of innovative medical technologies.

LOCAL HEALTH TECHNOLOGY ASSESSMENT IN CANADA: CURRENT STATE AND NEXT STEPS

2016 ◽  
Vol 32 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Janet Martin ◽  
Julie Polisena ◽  
Nandini Dendukuri ◽  
Marc Rhainds ◽  
Laura Sampietro-Colom
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technology ◽  
Health Technology ◽  
Health Service Delivery ◽  
Decision Makers ◽  
Evidence Based ◽  
Local Health ◽  
Local Evidence ◽  
Assessment Of Evidence

Objectives: Canada has witnessed expansion of the health technology assessment (HTA) infrastructure in the last 25 years. Local HTA entities at the hospital or regional level are emerging to assist decision makers in the acquisition, implementation, maintenance, and disinvestment of healthcare technologies. There is a need to facilitate collaboration and exchange of expertise and knowledge between these entities regarding the role of local HTA in Canada.Methods: In November 2013, the pan-Canadian Collaborative hosted a symposium, Hospital/Regional HTA: Local Evidence-based Decisions for Health Care Sustainability, bringing together over 60 HTA producers, researchers, stakeholders, and manufacturers involved in local HTA across Canada. The objective was to showcase the diversity of local HTA in Canada, while highlighting common gaps to be addressed.Results: The Symposium focused on current practices in local HTA in Canada to support informed decision making, and opportunities for information sharing and provide equal access to timely evidence-based information to decision makers. The main themes included assessment of evidence for local HTA, contextualization, stakeholder engagement in local HTA, knowledge translation and impact of recommendations, and challenges and opportunities for local HTA.Conclusions: Local HTA in Canada complements HTAs conducted at the provincial and federal levels to improve the efficient and effective health service delivery in institutions or regions faced with limited resources. Some challenges faced by local HTA producers to influence hospital policies and clinical practice involve the engagement of healthcare professionals and potential lack of training and support necessary for the introduction of a new technology.

HEALTH TECHNOLOGY ASSESSMENT IN IRELAND

2000 ◽  
Vol 16 (2) ◽  
pp. 449-458 ◽  
Author(s):  
Frank Ahern ◽  
Nessa O'Doherty
Keyword(s):  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
New Technology ◽  
Health Technology ◽  
Maximum Efficiency ◽  
Hospital System ◽  
Health Technologies ◽  
New Public Health

Ireland's health system is primarily funded from general taxation and is publicly provided, although private health care retains a considerable role. It is a unique structure, a mixture of universal health service free at the point of consumption and a fee-based private system where individuals subscribe to private health insurance that covers some of their medical expenses. The recent history of the Irish health services saw consolidation of existing services and an expansion into new areas to adapt to changing practices and needs. There has also been a drive to extract maximum efficiency so as to maintain the volume and quality of patient services at a time of very tight financial constraints. Introduction of new health technologies continued to accelerate. New technologies tended to spread rapidly before systematic appraisal of their costs and benefits. When the state is involved in funding the public hospital system, acceptance of new technology is a matter for discussion between agencies and the Department of Health and Children. Decisions about spending annual “development funding” have generally not been based on careful assessment of proposals for new technology. In 1995, a healthcare reform put new Public Health Departments in Health Boards in a prime position in Ireland's health services organization. These departments now emphasize evidence-based medicine. While Ireland does not have a national health technology assessment (HTA) program, there are plans to form an advisory group on HTA in 1998. HTA is seen as a significant element of future health policy in Ireland.

OP21 Involving Clinical Experts In Prioritizing Topics For Health Technology Assessment: A Randomized Controlled Trial

2017 ◽  
Vol 33 (S1) ◽  
pp. 9-10
Author(s):  
Andrew Cook ◽  
Elke Streit ◽  
Gill Davage
Keyword(s):  
Randomized Controlled Trial ◽  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Controlled Trial ◽  
Health Technology ◽  
Free Text ◽  
Usual Practice ◽  
Randomized Controlled ◽  
The Difference

INTRODUCTION:The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme commissions research to inform health services in the United Kingdom. The program prioritises research ideas from literature, guidelines, patients, and clinicians, to decide which research should be funded. We get clinical input on these ideas through (i) committees of clinicians and patients and (ii) seeking written advice from multiple clinicians — a refereeing process. Chairs of our committees suggested that the material we sent to clinicians was too extensive and the method of response too burdensome. We set out to determine whether reducing the information provided or burden of response would improve the engagement of clinicians with our processes, and hence improve the quality of advice provided, and the research available to health services.METHODS:We undertook a factorial randomized controlled trial (University of Southampton Faculty of Medicine Ethics Committee #8192, Trial registration: ACTRN12614000167662). Each participant was randomized to receive one of two types of material to comment on, and one of two means to respond. In the first allocation participants were randomised in a 1:1 ratio between receiving a ‘vignette’ (a briefing paper of up to ten pages discussing possible research = usual practice), or a ‘commissioning brief’ (a single page summarising the proposed research). In the second allocation, the method of response was randomized, between a structured form and free text email.RESULTS:We randomized 460 clinical experts, and 356 (77.4 percent) responded. The responses were graded for quality on a scale of 0 to 4 (higher scores better). Non-response was scored as 0. Analysis using ANOVA gave results of a structured response scoring .34 points (Standard Deviation, SD .36) over a freeform response (p = .02); and the commissioning brief as .04 points over a vignette (p = .81).CONCLUSIONS:This was the first randomized trial to take place inside the secretariat of the HTA program. The difference in quality score between the brief and the vignette allocations was neither statistically nor practically important. The difference between the structured and freeform response was statistically significant, and sufficiently large to be important in practice. While the choice of material to share with clinicians seems unimportant we have shown that it is worth sending a structured response form to experts.

scholarly journals Metodevurderinger: Kunnskapsbasert beslutningsstøtte på overordnet nivå i helsetjenesten

2013 ◽  
Vol 23 (2) ◽  
Author(s):  
Brynjar Fure ◽  
Vigdis Lauvrak ◽  
Helene Arentz-Hansen ◽  
Åse Skår ◽  
Sari Susanna Ormstad ◽  
...  
Keyword(s):  
Decision Support ◽  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technology ◽  
Health Economic Evaluation ◽  
Health Technology ◽  
English Summary ◽  
Health Technologies ◽  
Men I

I Norge har vi siden slutten av 1990-tallet utført metodevurderinger om effekt av tiltak i helsetjenesten som støtte til beslutningstakere. Metodevurderingene ble frem til 2004 utført ved Senter for medisinsk metodevurdering, og deretter ved Nasjonalt kunnskapssenter for helsetjenesten, som i dag er landets nasjonale metodevurderingsorganisasjon. Metodevurderinger kan i prinsippet brukes som beslutningsstøtte på alle nivåer i helsetjenesten, men i praksis benyttes metodevurderinger først og fremst som en del av et kunnskapsbasert beslutningsgrunnlag på overordnet politisk eller administrativt nivå. Hovedhensikten med metodevurderinger er å bidra til at gode og nyttige metoder kommer raskt ut til pasientene. Med metoder menes alle tiltak som er aktuelle i helsetjenesten, både legemidler, medisinsk utstyr, prosedyrerelatert diagnostikk og behandling, screening og organisatoriske tiltak. Metodevurderingene sammenfatter først og fremst kunnskapsgrunnlaget om klinisk effekt og sikkerhet, men ofte inngår også en helseøkonomisk evaluering. Her benyttes en strikt og etterprøvbar metodikk utarbeidet av anerkjente og veletablerte internasjonale metodevurderingsmiljøer. Avhengig av hva slags metode det er snakk om, vurderes også andre aspekter, som for eksempel etiske, sosiale, organisatoriske eller juridiske konsekvenser av å innføre metoden. For å sikre metodevurderingenes relevans i de kliniske miljøene, inviteres vanligvis kliniske spesialister til å delta i arbeidet. Metodevurderingsorganisasjoner samarbeider i økende grad med søsterorganisasjoner i andre land, ikke bare rundt forskning og utvikling av metodikken som benyttes i metodevurderinger, men også ved å dele resultater fra metodevurderinger, og dermed unngå dobbeltarbeid. En metodevurdering oppsummerer utelukkende forskningsresultatene om en metode, og inneholder ingen anbefaling om hvorvidt metoden bør innføres i helsetjenesten. Fure B, Lauvrak V, Arentz-Hansen H, Skår Å, Ormstad SS, Vang VS, Frønsdal KB. Health Technology Assessment: Knowledge-based decision support at the superior level in the health services. Nor J Epidemiol 2013; 23 (2): 165-169. ENGLISH SUMMARY In Norway, Health Technology Assessment (HTA) has existed since the late 1990s as support for decision makers in the health services. Until 2004, HTA was performed at the Norwegian Centre for Health Technology Assessment and later at the Norwegian Knowledge Centre for the Health Services which is, today, the national HTA-organization in Norway. HTA may be used as decision support at all levels in the health services. However, in practice, HTA is mainly used as part of evidence-based decisions by politicians or health leaders. The main purpose of HTA is to contribute to rapid introduction of useful health technologies, for the benefit of the patients. HTA may be used for all types of health technologies, including pharmaceuticals, medical devices, diagnostic and therapeutic procedures, screening and organizational measures. In HTA-reports, the evidence regarding effect and safety of a technology is summarized, and, in most cases, also include a health economic evaluation. A strict and transparent methodology, developed by well-established international HTA-agencies, is used. Other aspects such as ethical, social, organizational or legal consequences of the technology may be evaluated, depending on the technology. In order to make HTA clinically relevant, clinical experts are usually invited to participate in the work. HTA-organizations, increasingly, collaborate with HTA-organizations in other countries, not only in order to develop the methodology of HTA, but also to share the results of HTA-reports, and, thus, avoid double work. An HTA-report summarizes the research results on a technology, and gives no advice regarding the decision that should be made about the introduction of the new technology.

Case study of the comparison of data from conference abstracts and full-text articles in health technology assessment of rapidly evolving technologies: Does it make a difference?

2006 ◽  
Vol 22 (3) ◽  
pp. 288-294 ◽  
Author(s):  
Yenal Dundar ◽  
Susanna Dodd ◽  
Paula Williamson ◽  
Rumona Dickson ◽  
Tom Walley
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Full Text ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Health Technology ◽  
Sensitivity Analyses

Objectives: The aim of this study was to examine (i) the consistency of reporting research findings presented in conference abstracts and presentations and subsequent full publications, (ii) the ability to judge methodological quality of trials from conference abstracts and presentations, and (iii) the effect of inclusion or exclusion of data from these sources on the pooled effect estimates in a meta-analysis.Methods: This report is a case study of a selected health technology assessment review (TAR) of a rapidly evolving technology that had identified and included a meta-analysis of trial data from conference abstracts and presentations.Results: The overall quality of reporting in abstracts and presentations was poor, especially in abstracts. There was incomplete or inconsistent reporting of data in the abstract/presentations. Most often inconsistencies were between conference slide presentations and data reported in published full-text articles. Sensitivity analyses indicated that using data only from published papers would not have altered the direction of any of the results when compared with those using published and abstract data. However, the statistical significance of three of ten results would have changed. If conference abstracts and presentations were excluded from the early analysis, the direction of effect and statistical significance would have changed in one result. The overall conclusions of the original analysis would not have been altered.Conclusions: There are inconsistencies in data presented as conference abstracts/presentations and those reported in subsequent published reports. These inconsistencies could impact the final assessment results. Data discrepancies identified across sources included in TARs should be highlighted and their impact assessed and discussed. Sensitivity analyses should be carried out with and without abstract/presentation data included in the analysis. Incomplete reporting in conference abstracts and presentations limits the ability of reviewers to assess confidently the methodological quality of trials.

Budgeting and health technology assessment: First evidence obtained from proposal forms used to submit the adoption of new technology

2008 ◽  
Vol 24 (04) ◽  
pp. 502-510 ◽  
Author(s):  
Emanuele Lettieri ◽  
Cristina Masella ◽  
Umberto Nocco
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technology ◽  
Health Technology ◽  
Budget Process ◽  
Hospital Level ◽  
Level Of Evidence ◽  
Adoption Of New Technology ◽  
The Relationship ◽  
Support Decision Making

Objectives:The aim of this study was to benchmark the proposal forms used by a sample of Italian hospitals to inform the budget process for the adoption of new technology to understand the relationship with the guidelines provided by the Health Technology Assessment (HTA) literature.Methods:A literature review was first undertaken to identify the frameworks developed to support decision making regarding new technology at a hospital level. A checklist of criteria drawn up according to five main perspectives (technology, patient, organization, economics, and level of evidence) has been formalized to review and compare the collected proposal forms.Results:The “technology” perspective appears to have been broadly covered. The “patient” perspective has focused to clinical issues and partially neglects other dimensions such as patient satisfaction and potential adverse events. The “organization” dimension has paid little attention to change management. The “economics” dimension has been broadly covered, even though a sensitivity analysis has not been considered. The “level of evidence” that is required for submitting the proposal form is little.Conclusions:The proposal forms used to inform the budget process regarding the adoption of new technology are accountable for a limited set of dimensions from among those proposed in literature. Further research is required to understand how to render technology assessment multidimensional, multidisciplinary, evidence-based, and accountable at a hospital level.

OP14 The 2017 Health Technology Assessment International Asia Policy Forum: The Perspective Of Industry Members

2018 ◽  
Vol 34 (S1) ◽  
pp. 6-7
Author(s):  
Parashar Patel ◽  
Rebecca Trowman
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real World ◽  
New Technology ◽  
Health Technology ◽  
Real World Data ◽  
Apparent Lack ◽  
World Data ◽  
Keynote Presentation ◽  
Policy Forum

Introduction:The fifth Health Technology Assessment International (HTAi) Asia Policy Forum (APF) was held in Beijing, November 2017. The topic of the meeting was ‘Universal Health Care in the Asia Region: Overcoming the Barriers using HTA and Real World Data’. This presentation will focus on the use of real world data (RWD) as a mechanism of informing HTA in the Asia region – from the perspective of industry that were represented at the APF.Methods:The 2017 HTAi APF had senior representatives from 11 pharmaceutical and medical device companies active in the region. A keynote presentation was delivered that explored the findings of the background paper and survey, and there were guided breakout group discussions.Results:RWD is needed in all stages of the life cycle of a product; however, of greatest importance to industry is RWD to develop value propositions, inform HTA assessments, gauge market need and demonstrate where a new technology sits within an established clinical pathway. Although the HTA agencies present at the APF stated that RWD is available in the Asia region, this was not reflected by industry members who had limited awareness and access. Key concerns raised included whether this RWD is available for public use (and what caveats will be placed around its release), the quality of the data, whether it is longitudinal, and if it includes costs.Conclusions:There is a clear difference in the perspective of RWD between industry and HTA agencies in the Asia region. It is possible that this difference is driven by the apparent lack of publicly available data in the region and industry members comparing the use of RWD in Asia with the use in higher-income countries. This can be improved with clearer definitions, increased dialogue and multi-stakeholder collaboration in the region.

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