Unpacking early experiences with health technology reassessment in a complex healthcare system

2017 ◽  
Vol 13 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Kristen Sevick ◽  
Lesley J. J. Soril ◽  
Gail MacKean ◽  
Tom W. Noseworthy ◽  
Fiona M. Clement
Keyword(s):  
Healthcare System ◽  
Health Technology ◽  
Early Experiences ◽  
Health Technology Reassessment

UNTANGLING, UNBUNDLING, AND MOVING FORWARD: FRAMING HEALTH TECHNOLOGY REASSESSMENT IN THE CHANGING CONCEPTUAL LANDSCAPE

2018 ◽  
Vol 34 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Lesley J.J. Soril ◽  
Daniel J. Niven ◽  
Rosmin Esmail ◽  
Tom W. Noseworthy ◽  
Fiona M. Clement
Keyword(s):  
Healthcare System ◽  
Policy Process ◽  
Health Technology ◽  
Health Technologies ◽  
Inductive Synthesis ◽  
The Common ◽  
Current Utilization ◽  
Common Understanding ◽  
Synthesis Approach ◽  
Health Technology Reassessment

Objectives:Health technology reassessment (HTR) is a policy process to manage health technologies throughout their lifecycle and ensure their ongoing optimal use. However, within an ever-evolving field, HTR is only one of many concepts associated with the optimization of health technologies. There is limited understanding of how other concepts and processes might differ and/or be interrelated. This study aims to describe the concepts underlying the various technology optimization processes and to reconcile their relationships within the HTR process.Methods:A synthesis of the literature on approaches to HTR was completed. An inductive synthesis approach was completed to catalogue common concepts and themes. Expert stakeholders were consulted to develop a schematic to diagrammatically depict the relationships among concepts and frame them within the HTR process.Results:A practical schematic was developed. Common concepts and themes were organized under six major domains that address the following discussion questions: (i) what is the value of the existing technology?; (ii) what is the current utilization gap?; (iii) what are the available tools and resources?; (iv) what are the levers for change?; (v) what is the desired outcome?; and (vi) who are the foundational actors?Conclusions:Using these six questions to frame the issues faced by HTR will advance the common understanding of HTR, as well as improve implementation of HTR initiatives. These questions will clearly identify the process required to move forward within a complex healthcare system.

scholarly journals HEALTH TECHNOLOGY REASSESSMENT: THE ART OF THE POSSIBLE

2013 ◽  
Vol 29 (4) ◽  
pp. 418-423 ◽  
Author(s):  
Gail MacKean ◽  
Tom Noseworthy ◽  
Adam G. Elshaug ◽  
Laura Leggett ◽  
Peter Littlejohns ◽  
...  
Keyword(s):  
Monitoring And Evaluation ◽  
Health Technology ◽  
Economic Effects ◽  
Policy And Practice ◽  
Political Will ◽  
Multiple Levels ◽  
Methodological Approaches ◽  
Context Specific ◽  
Constant Comparative Analysis ◽  
Health Technology Reassessment

Background:Health technology reassessment (HTR) is “a structured, evidence-based assessment of the clinical, social, ethical, and economic effects of a technology currently used in the healthcare system, to inform optimal use of that technology in comparison to its alternatives.” The purpose of this study is to describe the key themes in the context of current HTR activities and propose a way forward for this newly emerging field.Methods:Data were gathered from a workshop held as part of the 2012 Canadian Agency for Drugs and Technology in Health (CADTH) symposium. The workshop consisted of two panel presentations followed by discussion; data gathered, including presentations and rich audience discussion transcripts, were analyzed for key themes emerging in the field of HTR using constant comparative analysis.Results:The language chosen to describe HTR will set the tone for engagement. The identification of champions at multiple levels and political will are essential. Key lessons from international experience are: disinvestment is difficult, focus on clinical areas not specific technologies, identify clear goals of the HTR agenda. Six key themes were identified to move the HTR agenda forward: emphasize integration over segregation, focus on development of HTR methods and processes, processes are context-specific but lessons must be shared, build capacity in synergistic interdisciplinary fields, develop meaningful stakeholder engagement, strengthen postimplementation monitoring and evaluation.Conclusions:To move this field forward, we must continue to build on international experiences with a focus on developing novel methodological approaches to generating, incorporating, and implementing evidence into policy and practice.

scholarly journals Health technology assessment in Brazil: what do healthcare system players think about it?

2011 ◽  
Vol 129 (4) ◽  
pp. 198-205 ◽  
Author(s):  
Marcos Bosi Ferraz ◽  
Patricia Coelho de Soárez ◽  
Paola Zucchi
Keyword(s):  
Health Economics ◽  
Health Technology Assessment ◽  
Healthcare System ◽  
Technology Assessment ◽  
International Health ◽  
Health Technology ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
The Government

CONTEXT AND OBJECTIVES: The health technology assessment (HTA) process has been developed locally. The aim of this study was to describe, analyze and compare the opinions of participants in international health economics symposia about the HTA process used in Brazil. DESIGN AND SETTING: Observational cross-sectional study at the 2006 and 2008 International Health Economics Symposia, in São Paulo. METHODS: A structured questionnaire was applied. For the statistical analysis, the percentage distribution for each category was calculated, and variables were compared using tests for two-sample proportion hypotheses. RESULTS: Totals of 153 and 74 participants answered the 2006 and 2008 surveys, respectively. The response rate was better for the 2006 survey (67.1%) than for the 2008 survey (31.8%). Most interviewees were between the ages of 30 and 49 years and were managers in the healthcare system. Most of them considered that the current HTA process was incomplete and unable to meet the needs of the healthcare system. They mentioned the government, academia and experts as the three main groups of people who should be involved in the process, and selected efficiency/effectiveness, safety and disease relevance as the three main criteria to be considered in the HTA process. There is a trend towards developing decentralized regionalized HTA processes, with separate assessment and decision-making for the public and private systems. CONCLUSIONS: The HTA concept is well known. Healthcare system players feel that the process has methodological limitations. Additional surveys are needed to track the HTA process and its application in Brazil.

Poland’s Health Reform: Politics, Markets and Informal Payments

2002 ◽  
Vol 31 (1) ◽  
pp. 103-118 ◽  
Author(s):  
IAIN McMENAMIN ◽  
VIRPI TIMONEN
Keyword(s):  
Healthcare System ◽  
Health Reform ◽  
Public Spending ◽  
Informal Payments ◽  
Future Developments ◽  
Use Of Resources ◽  
Early Experiences ◽  
Economic Climate ◽  
Recent Reform ◽  
National Governments

This article analyses the pre-reform Polish healthcare system, the theory of the recent reform, the early experiences, and the likely future developments. The reform aims to preserve a state-guaranteed egalitarian healthcare system while ensuring optimal use of resources by the introduction of market-type mechanisms. These mechanisms cannot function as intended while sub-national governments, which have little incentive to support restructuring, remain a vital part of the system. An even greater impediment to the proper functioning of the system is the practice of informal payments. Therefore, smaller than expected gains in efficiency and equity, together with demographic and technological pressures on health costs and a political and economic climate which is unlikely to deliver large increases in public spending, are likely to result in a more privatised and unequal health system than is intended.

scholarly journals SOME ADDITIONAL THOUGHTS ON FORTHCOMING AMENDMENTS TO HTA IN POLAND

2017 ◽  
Vol 33 (3) ◽  
pp. 358-359
Author(s):  
Anna Zawada
Keyword(s):  
Health Technology Assessment ◽  
Healthcare System ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
Additional Information

In reference to the article A Decade of Health Technology Assessment in Poland by I. Lipska et al. (1), I would like to provide you with some comments and additional information on the changes in reimbursement policies in the Polish healthcare system currently taking place, which is likely to lead to increased number of health technology assessments (HTAs) of medical devices (MDs).

scholarly journals Achieving optimal technology use: A proposed model for health technology reassessment

2017 ◽  
Vol 5 ◽  
pp. 205031211770486 ◽  
Author(s):  
Lesley JJ Soril ◽  
Gail MacKean ◽  
Tom W Noseworthy ◽  
Laura E Leggett ◽  
Fiona M Clement
Keyword(s):  
Technology Use ◽  
Health Technology ◽  
Proposed Model ◽  
Optimal Technology ◽  
Health Technology Reassessment

Austria: History of health technology assessment during the past 20 years

2009 ◽  
Vol 25 (S1) ◽  
pp. 74-81 ◽  
Author(s):  
Claudia Wild
Keyword(s):  
Decision Support ◽  
Health Technology Assessment ◽  
Healthcare System ◽  
Technology Assessment ◽  
System Analysis ◽  
High Volume ◽  
Health Technology ◽  
Public Understanding ◽  
Added Value ◽  
Research Activities

Objectives: The aim of this article is to describe and analyze the stages toward recognition and implementation of health technology assessment (HTA).Methods: System analysis of structures and institutions and their use of HTA.Results: Austria is a latecomer in implementing evaluations/HTA as decision support. It can to a certain degree absorb the increasing international knowledge. Austria had a long time to observe the successes and failures of HTA in other countries and to learn from other countries. The implementation of HTA within the Austrian healthcare system ran through stages of uptake: starting 1989 with a systematic review on international activities, first international networking and collaboration since 1991, proposed assessments until the late 1990s, followed by reactive assessments on demand mostly on high volume and costly technologies since then. Since 2000, HTA is used on a regular basis for investment and reimbursement decisions by several players, namely the Ministry of Health, the Social Insurance and hospital cooperations. In 2006, the Austrian HTA-institute was founded.Conclusions: It took approximately 15 years from first research activities in HTA to an institutionalization. HTA in Austria is not only product- but also process-oriented: The actual production of assessments for decision support is as important as the structuring and accompanying of the process of decisions making. In addition, shaping the public understanding of science (characterized by the intrinsic belief that all new medical interventions provide added value to the healthcare system) is part of Austrian HTA.

Supporting tough decisions in Norway: A healthcare system approach

2010 ◽  
Vol 26 (4) ◽  
pp. 398-404 ◽  
Author(s):  
Berit Mørland ◽  
Ånen Ringard ◽  
John-Arne Røttingen
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Organizational Structure ◽  
Healthcare System ◽  
Priority Setting ◽  
System Approach ◽  
Health Technology ◽  
Complex Task ◽  
Key Stakeholders ◽  
Priorities In Health Care

Objectives: We describe, in general, the principles used in priority setting and, in particular, policy processes and decision making in Norway.Methods: A newly established council for setting priorities in health care is presented to illustrate how health technology assessments (HTAs) can support national advisors in complex priority-setting processes.Results and Conclusions: Setting priorities in health care is a complex task. Careful thinking is, therefore, required in determining the components of a system for priority-setting. Based on recent Norwegian experiences, we believe that the following generic parts may provide some of the solution: a common set of values; an organizational structure made up of key stakeholders; supporting mechanisms in the form of HTA organizations and documented best evidence; and loyalty to decisions by stakeholders responsible for implementing national policies.

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