Inspection of property: a need for health technology reassessment

2014 ◽  
pp. 50-52
Author(s):  
Oleg Lischuk ◽  
Keyword(s):  
Health Technology ◽  
Property A ◽  
Health Technology Reassessment

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 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

scholarly journals Characteristics of knowledge translation theories, models and frameworks for health technology reassessment: expert perspectives through a qualitative exploration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rosmin Esmail ◽  
Fiona M. Clement ◽  
Jayna Holroyd-Leduc ◽  
Daniel J. Niven ◽  
Heather M. Hanson
Keyword(s):  
Knowledge Translation ◽  
Technology Implementation ◽  
Health Technology ◽  
Theory Model ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Centered ◽  
Research Knowledge ◽  
Knowledge To Action ◽  
Health Technology Reassessment

Abstract Background Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables to transfer/translate knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks could be useful, specifically for decreased use or de-adoption of a technology. Methods A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT theories, models, and frameworks for decreased use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT theories, models, and frameworks. Results Thirteen experts from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select interventions, and assess impact. Of the KT theories, models, and frameworks that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels. Conclusions Characteristics that need to be considered within a KT theory, model, and framework for implementing HTR outputs have been identified. Consideration of these characteristics may guide users to select relevant KT theories, models, and frameworks to apply to HTR projects.

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

HEALTH TECHNOLOGY REASSESSMENT OF NON-DRUG TECHNOLOGIES: CURRENT PRACTICES

2012 ◽  
Vol 28 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Laura Leggett ◽  
Tom W. Noseworthy ◽  
Mahmood Zarrabi ◽  
Diane Lorenzetti ◽  
Lloyd R. Sutherland ◽  
...  
Keyword(s):  
Health Technology ◽  
Economic Effects ◽  
Text Documents ◽  
Health Technologies ◽  
Work Related ◽  
Program Budgeting ◽  
Obsolete Technology ◽  
Future Work ◽  
Health Technology Reassessment ◽  
Current Practices

Objectives: Obsolescence is a natural phase of the lifecycle of health technologies. Given increasing cost of health expenditures worldwide, health organizations have little choice but to engage in health technology reassessment (HTR); a structured, evidence-based assessment of the medical, social, ethical, and economic effects of a technology, currently used within the healthcare system, to inform optimal use of that technology in comparison to its alternatives. This research was completed to identify and summarize international HTR initiatives for non-drug technologies.Methods: A systematic review was performed using the terms disinvestment, obsolescence, obsolete technology, ineffective, reassessment, reinvestment, reallocation, program budgeting, and marginal analysis to search PubMED, MEDLINE, EMBASE, and CINAHL until November 2011. Websites of organizations listed as members of INAHTA and HTAi were hand-searched for gray literature. Documents were excluded if they were unavailable in English, if the title/abstract was irrelevant to HTR, and/or if the document made no mention of current practices. All citations were screened in duplicate with disagreements resolved by consensus.Results: Sixty full-text documents were reviewed and forty were included. One model for reassessment was identified; however, it has never been put into practice. Eight countries have some evidence of past or current work related to reassessment; seven have shown evidence of continued work in HTR. There is negligible focus on monitoring and implementation.Conclusions: HTR is in its infancy. Although health technology reassessments are being conducted, there is no standardized approach. Future work should focus on developing and piloting a comprehensive methodology for completing HTR.

PP100 Characteristics To Consider In A Knowledge Translation Theory, Model Or Framework For Health Technology Reassessment

2021 ◽  
Vol 37 (S1) ◽  
pp. 18-19
Author(s):  
Rosmin Esmail ◽  
Heather M. Hanson ◽  
Jayna Holroyd-Leduc ◽  
Daniel J. Niven ◽  
Fiona M. Clement
Keyword(s):  
Knowledge Translation ◽  
Health Technology ◽  
Theory Model ◽  
Evidence Based ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Centered ◽  
Research Knowledge ◽  
Knowledge To Action ◽  
Health Technology Reassessment

IntroductionHealth technology reassessment (HTR) is a structured evidence-based assessment of an existing technology in comparison to its alternatives. The process results in the following four outputs: (i) increased use; (ii) decreased use; (iii) no change; or (iv) de-adoption. However, implementing these outputs remains a challenge. Knowledge translation (KT) can be applied to implement findings from the HTR process. This study sought to identify which characteristics of KT theories, models, and frameworks (TMFs) could be useful, specifically for decreasing the use of or de-adopting a technology.MethodsA qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT TMFs for decreasing the use of or de-adopting a technology. One-to-one semi-structured interviews were conducted. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using the following five distinctive steps: familiarization; identifying an analytic framework; indexing; charting; and mapping and interpretation. Themes and sub-themes were also mapped to existing KT TMFs.ResultsThirteen experts participated. The following three themes emerged as ideal characteristics of a KT TMF: (i) principles foundational for HTR: evidence-based, high usability, patient-centered, and ability to apply to micro, meso, and macro levels; (ii) levers of change: characterized as positive, neutral, or negative influences for changing behavior; and (iii) steps for knowledge to action: build the case for HTR, adapt research knowledge, assess context, select, tailor, and implement interventions, and assess impact. The Consolidated Framework for Implementation Research had the greatest number of ideal characteristics.ConclusionsApplication of KT TMFs to the HTR process has not been clearly established. This is the first study to provide an understanding of characteristics within KT TMFs that could be considered by users undertaking projects to decrease or de-adopt technologies. Characteristics to be considered within a KT TMF for implementing HTR outputs were identified. Consideration of these characteristics may guide users in choosing which KT TMF(s) to use when undertaking HTR projects.

Optimizing red blood cell transfusion practices in the intensive care unit: a multi-phased health technology reassessment

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Lesley J.J. Soril ◽  
Tom W. Noseworthy ◽  
Derek R. Townsend ◽  
Sean M. Bagshaw ◽  
Henry T. Stelfox ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Cell ◽  
Behavior Change ◽  
Red Blood Cell ◽  
Technology Use ◽  
Health Technology ◽  
Audit And Feedback ◽  
Small Scale ◽  
Health Technology Reassessment

Abstract Background Health technology reassessment (HTR) is a process to manage existing health technologies to ensure ongoing optimal use. A model to guide HTR was developed; however, there is limited practical experience. This paper addresses this knowledge gap through the completion of a multi-phase HTR of red blood cell (RBC) transfusion practices in the intensive care unit (ICU). Objective The HTR consisted of three phases and here we report on the final phase: the development, implementation, and evaluation of behavior change interventions aimed at addressing inappropriate RBC transfusions in an ICU. Methods The interventions, comprised of group education and audit and feedback, were co-designed and implemented with clinical leaders. The intervention was evaluated through a controlled before-and-after pilot feasibility study. The primary outcome was the proportion of potentially inappropriate RBC transfusions (i.e., with a pre-transfusion hemoglobin of 70 g/L or more). Results There was marked variability in the monthly proportion of potentially inappropriate RBC transfusions. Relative to the pre-intervention phase, there was no significant difference in the proportion of potentially inappropriate RBC transfusions post-intervention. Lessons from this work include the importance of early and meaningful engagement of clinical leaders; tailoring the intervention modalities; and, efficient access to data through an electronic clinical information system. Conclusions It was feasible to design, implement, and evaluate a tailored, multi-modal behavior change intervention in this small-scale pilot study. However, early evaluation of the intervention revealed no change in technology use leading to reflection on the important question of how the HTR model needs to be improved.

scholarly journals HEALTH TECHNOLOGY REASSESSMENT: SCOPE, METHODOLOGY, & LANGUAGE

2012 ◽  
Vol 28 (3) ◽  
pp. 201-202 ◽  
Author(s):  
Tom Noseworthy ◽  
Fiona Clement
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
Health Technology ◽  
Universal Health Care ◽  
Informed Decision Making ◽  
Universal Health ◽  
Health Technology Reassessment

Health systems are challenged continuously to provide the highest quality universal health care within their means. While for 30 years, health technology assessment (HTA) has contributed to the process of evidence-informed decision making and the managed entry of new technologies, its remit has not expanded to include assessment of technologies currently in use, as a means of managing their use and potentially their exit. We propose that health technology reassessment (HTR) become standard practice, an integral part of all health technology assessment agencies, and that we develop standardized models and methodologies for reassessment drawing from what we have learned from HTA.

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