HTA-reports in digital and multilayered formats. Supporting policy-makers in well-informed decisions for new health technologies

Article type
Authors
1University Hospitals Geneva
2MAGIC Evidence Ecosystem Foundation
3Norwegian Institute of Public Health
Abstract
Background: policy makers face major challenges in making timely and well-informed decisions about reimbursement or disinvestment of costly drugs, medical devices and other health technologies. Such technologies now enter the market and health care at unprecedented speed. Health Technology Assessment (HTA) reports represent key tools for decision support for policy makers but current formats are typically inaccessible, lengthy and difficult to understand. Optimised presentation formats are therefore needed and can make use of advances in knowledge translation, enhanced by technology.

Objectives: to develop a prototype for a digital and multilayered presentation format for HTA-reports, customized to and applied by policy makers in Norwegian specialist care.

Methods: with the MAGIC Evidence Ecosystem Foundation as initiator of the project and main partner we set out to create a digital and multilayered format of HTA reports. In doing so we built on previous research and innovations (e.g. DECIDE project, MAGICapp and BMJ Rapid Recommendations). In the digital and multilayered format conclusions appear in a top layer with the ability for end-users to drill down and find all details about the evidence and other pertinent information in deeper layers. We also aimed to create a generic and flexible format that could suit the needs of various countries and healthcare systems, through internationally accepted definitions and frameworks for HTA (e.g. EUnetHTA). We developed the prototype through a stepwise process with brainstorming, sketching and design co-creation through stakeholder feedback and usability testing. To demonstrate real-life feasibility we co-ordinated the prototype development with an ongoing national HTA on 'PFO-closure for patients with cryptogenic stroke' performed by the Norwegian Institute for Publich Health (NIPH).

Results: the figure shows a screenshot of the prototype and it can be accessed online here: fhistyleguide.azurewebsites.net/pilot-hta/ We presented the final version to 13 policy makers in a face-to-face meeting, noting that they were able to make a real-life decision after 10 minutes of exploring and discussing the content online. The initial feedback was positive and more formal evaluation will be presented at the conference.

Conclusions: the potential use of the innovative HTA report formats is substantial for all HTA organisations interested in improving their dissemination strategies. Further testing and improvement of the formats is warranted, across a diversity of settings. A digital authoring and publication platform for HTA reports in such formats should facilitate co-production, dissemination and updating of systematic reviews, HTA and guidelines, sharing evidence and work.

Patient involvement: patients were directly involved in the systematic review that informed the HTA report, through the BMJ Rapid Recommendations.This resulted in policy makers having access to full evidence summaries with all patient-important outcomes.