Hospital Based Health Technology Assessment

A timely work describing how localized hospital-based health technology assessment (HB-HTA) complements general, ‘arms-length’ HTA agency efforts, and what has been the collective global impact of HB-HTA across the globe. While HB-HTA has gained significant momentum over the past few years, expertise in the field, and information on the operation and organization of HB-HTA, has been scattered. This book serves to bring this information together to inform those who are currently working in the field of HTA at the hospital, regional, national or global level. In addition, this book is intended for decision-makers and policy-makers with a stake in determining the uptake and decommissioning of new and established technologies in the hospital setting. HTA has traditionally been performed at the National/Regional level by HTA Agencies, typically linked to governments. Yet hospitals are the main entry door for most health technologies (HTs). Hospital decision-makers must undertake multiple high stakes investment and disinvestment decisions annually for innovative HTs, usually without adequate information. Despite the existence of arms-length HTA Agencies, inadequate information is available to hospital decision-makers either because relevant HTA reports are not yet released at the time of entry of new technologies to the field, or because even when the report exists, the information contained is insufficient to clarify the contextualized informational needs of hospital decision makers. Therefore, there has recently been a rising trend toward hospital-based HTA units and programs. These units/programs complement the work of National/Regional HTA Agencies by providing the key and relevant evidence needed by hospital decision makers in their specific hospital context, and within required decision-making timelines. The emergence of HB-HTA is creating a comprehensive HTA ecosystem across health care levels, which creates better bridges for knowledge translation through relevance and timeliness.

This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA’s features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Examines the management of health care technology in 8 countries: Australia, Canada, France, Germany, the Netherlands, Sweden, the U.K & the U.S. Six technologies (or sets of technologies) -- including evaluation & management efforts & how the technologies diffused -- are presented & compared: treatments for coronary artery disease, imaging technologies (CT & MRI scanning), laparoscopic surgery, treatments for end-stage renal disease, neonatal intensive care, & breast cancer screening. Extensive bibliography for each country. Charts & tables.

New technologies with the potential to improve the health of populations are continuously being introduced. But not every technological development results in clear health gains. Health technology assessment provides evidence-based information on the coverage and usage of health technologies, enabling them to be evaluated properly and applied to health care efficaciously, promoting the most effective ones while also taking into account organizational, societal and ethical issues. This book reviews the relationship between health technology assessment and policy-making, and examines how to increase the contribution such research makes to policy- and decision-making processes. By communicating the value and potential of health technology assessment to a wider audience, both within and beyond decision-making and health care management, it aims ultimately to contribute to improve the health status of the population through the delivery of optimum health services.

This is the first book to offer a comprehensive guide to involving patients in health technology assessment (HTA). Defining patient involvement as patient participation in the HTA process and research into patient aspects, this book includes detailed explanations of approaches to participation and research, as well as case studies. Patient Involvement in HTA enables researchers, postgraduate students, HTA professionals and experts in the HTA community to study these complementary ways of taking account of patients’ knowledge, experiences, needs and preferences. Part I includes chapters discussing the ethical rationale, terminology, patient-based evidence, participation and patient input. Part II sets out methodology including: Qualitative Evidence Synthesis, Discrete Choice Experiments, Analytical Hierarchy Processes, Ethnographic Fieldwork, Deliberative Methods, Social Media Analysis, Patient-Reported Outcome Measures, patients as collaborative research partners and evaluation. Part III contains 15 case studies setting out current activities by HTA bodies on five continents, health technology developers and patient organisations. Each part includes discussion chapters from leading experts in patient involvement. A final chapter reflects on the need to clearly define the goals for patient involvement within the context of the HTA to identify the optimal approach. With cohesive contributions from more than 80 authors from a variety of disciplines around the globe, it is hoped this book will serve as a catalyst for collaboration to further develop patient involvement to improve HTA. "If you’re not involving patients, you're not doing HTA!" - Dr. Brian O’Rourke, President and CEO of CADTH, Chair of INAHTA

This book examines the nature of service design and service thinking in healthcare and hospital management. By adopting both a service-based provider perspective and a consumer-oriented perspective, the book highlights various healthcare services, methods and tools that are desirable for customers and effective for healthcare providers. In addition, readers will learn about new research directions, as well as strategies and innovations to develop service solutions that are affordable, sustainable, and consumer-oriented. Lastly, the book discusses policy options to improve the service delivery process and customer satisfaction in the healthcare and hospital sector. The contributors cover various aspects and fields of application of service design and service thinking, including service design processes, tools and methods; service blueprints and service delivery; creation and implementation of services; interaction design and user experience; design of service touchpoints and service interfaces; service excellence and service innovation. The book will appeal to all scholars and practitioners in the hospital and healthcare sector who are interested in organizational development, service business model innovation, customer involvement and perceptions, and service experience.

Healthcare Technology Management Systems provides a model for implementing an effective healthcare technology management (HTM) system in hospitals and healthcare provider settings, as well as promoting a new analysis of hospital organization for decision-making regarding technology. Despite healthcare complexity and challenges, current models of management and organization of technology in hospitals still has evolved over those established 40-50 years ago, according to totally different circumstances and technologies available now. The current health context based on new technologies demands working with an updated model of management and organization, which requires a re-engineering perspective to achieve appropriate levels of clinical effectiveness, efficiency, safety and quality. Healthcare Technology Management Systems presents best practices for implementing procedures for effective technology management focused on human resources, as well as aspects related to liability, and the appropriate procedures for implementation. Presents a new model for hospital organization for Clinical Engineers and administrators to implement Healthcare Technology Management (HTM) Understand how to implement Healthcare Technology Management (HTM) and Health Technology Assessment (HTA) within all types of organizations, including Human Resource impact, Technology Policy and Regulations, Health Technology Planning (HTP) and Acquisition, as well as Asset and Risk Management Transfer of knowledge from applied research in CE, HTM, HTP and HTA, from award-winning authors who are active in international health organizations such as the World Health Organization (WHO), Pan American Health Organization (PAHO), American College of Clinical Engineering (ACCE) and International Federation for Medical and Biological Engineering (IFMBE)