Cambridge Journals Online

POLICIES

Health technology assessment to optimize health technology utilization: Using implementation initiatives and monitoring processes

Katrine B. Frønsdala1, Karen Faceya2, Marianne Klempa3, Inger Natvig Norderhauga3, Berit Mørlanda3 and John-Arne Røttingena3 on behalf of the HTAi Policy Forum a1 Norwegian Knowledge Centre for the Health Services a2 University of Glasgow a3 Norwegian Knowledge Centre for the Health Services

Article author query frønsdal kb   facey k   klemp m   norderhaug in   mørland b   røttingen ja

Abstract

Background: The way in which a health technology is used in any particular health system depends on the decisions and actions of a variety of stakeholders, the local culture, and context. In 2009, the HTAi Policy Forum considered how health technology assessment (HTA) could be improved to optimize the use of technologies (in terms of uptake, change in use, or disinvestment) in such complex systems.

Methods: In scoping, it was agreed to focus on initiatives to implement evidence-based guidance and monitoring activities. A review identified systematic reviews of implementation initiatives and monitoring activities. A two-day deliberative workshop was held to discuss key papers, members’ experiences, and collectively address key questions. This consensus paper was developed by email and finalized at a postworkshop meeting.

Results: Evidence suggests that the impact and use of HTA could be increased by ensuring timely delivery of relevant reports to clearly determined policy receptor (decision-making) points. To achieve this, the breadth of assessment, implementation initiatives such as incentives and targeted, intelligent dissemination of HTA result, needs to be considered. HTA stakeholders undertake a variety of monitoring activities, which could inform optimal use of a technology. However, the quality of these data varies and is often not submitted to an HTA.

Conclusions: Monitoring data should be sufficiently robust so that they can be used in HTA to inform optimal use of technology. Evidence-based implementation initiatives should be developed for HTA, to better inform decision makers at all levels in a health system about the optimal use of technology.

Keywords:Technology assessment; Utilization; Optimization; Implementation; Monitoring

Footnotes

We thank Gro Jamtvedt for sharing information on the Cochrane Effective Practice and Organization of Care (EPOC) work and HTAi for funding this work.