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UNTANGLING, UNBUNDLING, AND MOVING FORWARD: FRAMING HEALTH TECHNOLOGY REASSESSMENT IN THE CHANGING CONCEPTUAL LANDSCAPE

Published online by Cambridge University Press:  04 April 2018

Lesley J.J. Soril ,
Daniel J. Niven ,
Rosmin Esmail ,
Tom W. Noseworthy  and
Fiona M. Clement
Lesley J.J. Soril
Affiliation:
Department Community Health Sciences, O'Brien Institute for Public Health
Daniel J. Niven
Affiliation:
Department Community Health Sciences, O'Brien Institute for Public Health, Department of Critical Care Medicine
Rosmin Esmail
Affiliation:
Department Community Health Sciences, O'Brien Institute for Public Health, Health Technology Assessment and Adoption
Tom W. Noseworthy
Affiliation:
Department Community Health Sciences, O'Brien Institute for Public Health
Fiona M. Clement
Affiliation:
Department Community Health Sciences, O'Brien Institute for Public Healthfclement@ucalgary.ca
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Abstract

Objectives: Health technology reassessment (HTR) is a policy process to manage health technologies throughout their lifecycle and ensure their ongoing optimal use. However, within an ever-evolving field, HTR is only one of many concepts associated with the optimization of health technologies. There is limited understanding of how other concepts and processes might differ and/or be interrelated. This study aims to describe the concepts underlying the various technology optimization processes and to reconcile their relationships within the HTR process.

Methods: A synthesis of the literature on approaches to HTR was completed. An inductive synthesis approach was completed to catalogue common concepts and themes. Expert stakeholders were consulted to develop a schematic to diagrammatically depict the relationships among concepts and frame them within the HTR process.

Results: A practical schematic was developed. Common concepts and themes were organized under six major domains that address the following discussion questions: (i) what is the value of the existing technology?; (ii) what is the current utilization gap?; (iii) what are the available tools and resources?; (iv) what are the levers for change?; (v) what is the desired outcome?; and (vi) who are the foundational actors?

Conclusions: Using these six questions to frame the issues faced by HTR will advance the common understanding of HTR, as well as improve implementation of HTR initiatives. These questions will clearly identify the process required to move forward within a complex healthcare system.

Keywords

Health technology reassessmentDisinvestmentTechnology managementLow-value careDe-adoption
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 2 , 2018 , pp. 212 - 217
Copyright
Copyright © Cambridge University Press 2018 

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