Article type
Abstract
"Background: The fast pace and increasing number of technologies available in healthcare create a challenge for hospital managers, committees and clinicians who must decide which health technologies to incorporate into their institutions.
Objectives: To develop and implement a hospital base Health Technology Assessment Unit (HB-HTA) that standardizes the procedure and methods that will guide decision making for investing in health technologies in a high level of specialty care hospital setting.
Methods: By decision of hospital directives a team of epidemiologist experienced in HTA was structured. A literature review was set to identify conceptual frameworks, experiences, and recommendations of HTA bodies at national and hospital level. Interviews and reviews of documented procedures of the areas involved in the actual process, aided to map current actors and workflows. Finally, as a pilot, the team took part assessing two health technologies proposed for adoption, further enhancing the process understanding.
Results: Two methodology guidelines were produced, one for clinical safety and effectiveness assessments and one for economic evaluations and budget impact analysis. A third document describes the new process, with the tailored route to evaluate proposed technologies (Figure 1). Prioritization for evaluation, when needed, is done with a multi-criteria decision analysis (MCDA) tool. For the assessment, dimensions include clinical effectiveness and safety, patients’ preferences; organizational and strategic changes; technical, economic, and financial aspects. A brief report that includes items for each dimension and a recommendation on adoption, is submitted to the deciding committee for final discussion. Methodology manuals, documented process and reports are to be published internally for staff.
Conclusions: Implementation of a HB-HTA unit, that allows a more transparent and objective process for decision-making regarding the adoption health technologies, requires a firm decision and support from hospital management and directives, multidisciplinary teamwork, knowledge of HTA and the understanding of the established process. Identifying the specific areas of uncertainty for each decisions optimizes and heightens the value and impact of HB-HTA for the organization.
HTA units impact patients directly as it defines the technologies which they will have access to and how the healthcare organization optimices its resources.
No public or consumers were involved."
Objectives: To develop and implement a hospital base Health Technology Assessment Unit (HB-HTA) that standardizes the procedure and methods that will guide decision making for investing in health technologies in a high level of specialty care hospital setting.
Methods: By decision of hospital directives a team of epidemiologist experienced in HTA was structured. A literature review was set to identify conceptual frameworks, experiences, and recommendations of HTA bodies at national and hospital level. Interviews and reviews of documented procedures of the areas involved in the actual process, aided to map current actors and workflows. Finally, as a pilot, the team took part assessing two health technologies proposed for adoption, further enhancing the process understanding.
Results: Two methodology guidelines were produced, one for clinical safety and effectiveness assessments and one for economic evaluations and budget impact analysis. A third document describes the new process, with the tailored route to evaluate proposed technologies (Figure 1). Prioritization for evaluation, when needed, is done with a multi-criteria decision analysis (MCDA) tool. For the assessment, dimensions include clinical effectiveness and safety, patients’ preferences; organizational and strategic changes; technical, economic, and financial aspects. A brief report that includes items for each dimension and a recommendation on adoption, is submitted to the deciding committee for final discussion. Methodology manuals, documented process and reports are to be published internally for staff.
Conclusions: Implementation of a HB-HTA unit, that allows a more transparent and objective process for decision-making regarding the adoption health technologies, requires a firm decision and support from hospital management and directives, multidisciplinary teamwork, knowledge of HTA and the understanding of the established process. Identifying the specific areas of uncertainty for each decisions optimizes and heightens the value and impact of HB-HTA for the organization.
HTA units impact patients directly as it defines the technologies which they will have access to and how the healthcare organization optimices its resources.
No public or consumers were involved."