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TECHNOLOGY ASSESSMENT IN HOSPITALS: LESSONS LEARNED FROM AN EMPIRICAL EXPERIMENT

Published online by Cambridge University Press:  05 June 2017

Emanuela Foglia ,
Emanuele Lettieri ,
Lucrezia Ferrario ,
Emanuele Porazzi ,
Elisabetta Garagiola ,
Roberta Pagani ,
Marzia Bonfanti ,
Valentina Lazzarotti ,
Raffaella Manzini  and
Cristina Masella
...Show all authors
Emanuela Foglia
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC
Emanuele Lettieri
Affiliation:
Department of Management, Economics and Industrial Engineering, Politecnico of Milano Centre for Healthcare Improvement, Chalmers University (Sweden)
Lucrezia Ferrario
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUClferrario@liuc.it
Emanuele Porazzi
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC
Elisabetta Garagiola
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC
Roberta Pagani
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC
Marzia Bonfanti
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC
Valentina Lazzarotti
Affiliation:
School of Industrial Engineering and Management, IIEM, University Carlo Cattaneo – LIUC
Raffaella Manzini
Affiliation:
School of Industrial Engineering and Management, IIEM, University Carlo Cattaneo – LIUC
Cristina Masella
Affiliation:
Department of Management, Economics and Industrial Engineering, Politecnico of Milano
Davide Croce
Affiliation:
Centre for Research in Health Economics, Social and Health Care Management, University Carlo Cattaneo – LIUC School of Industrial Engineering and Management, IIEM, University Carlo Cattaneo – LIUC
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Abstract

Objectives: Hospital Based Health Technology Assessment (HBHTA) practices, to inform decision making at the hospital level, emerged as urgent priority for policy makers, hospital managers, and professionals. The present study crystallized the results achieved by the testing of an original framework for HBHTA, developed within Lombardy Region: the IMPlementation of A Quick hospital-based HTA (IMPAQHTA). The study tested: (i) the HBHTA framework efficiency, (ii) feasibility, (iii) the tool utility and completeness, considering dimensions and sub-dimensions.

Methods: The IMPAQHTA framework deployed the Regional HTA program, activated in 2008 in Lombardy, at the hospital level. The relevance and feasibility of the framework were tested over a 3-year period through a large-scale empirical experiment, involving seventy-four healthcare professionals organized in different HBHTA teams for assessing thirty-two different technologies within twenty-two different hospitals. Semi-structured interviews and self-reported questionnaires were used to collect data regarding the relevance and feasibility of the IMPAQHTA framework.

Results: The proposed HBHTA framework proved to be suitable for application at the hospital level, in the Italian context, permitting a quick assessment (11 working days) and providing hospital decision makers with relevant and quantitative information. Performances in terms of feasibility, utility, completeness, and easiness proved to be satisfactory.

Conclusions: The IMPAQHTA was considered to be a complete and feasible HBHTA framework, as well as being replicable to different technologies within any hospital settings, thus demonstrating the capability of a hospital to develop a complete HTA, if supported by adequate and well defined tools and quantitative metrics.

Keywords

Hospital based health technology assessmentHBHTAHealth care technologyHospitalDecision making
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 2 , 2017 , pp. 288 - 296
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. Hood, C. A Public Management for All Seasons? Public Adm. 1991;69:3-19.CrossRefGoogle Scholar
2. Greenberg, D, Peterburg, Y, Vekstein, D, Pliskin, JS, Decisions to adopt new technologies at the hospital level: Insights from Israeli medical centers. Int J Technol Assess Health Care. 2005;21:219-227.Google Scholar
3. Drummond, MF, Schwartz, JS, Jönsson, B, et al. Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care. 2008;24:244-258.Google Scholar
4. Zanaboni, P, Lettieri, E. Institutionalizing telemedicine applications: The challenge of legitimizing decision-making. J Med Internet Res. 2011;13:e72.Google Scholar
5. Battista, RN. Expanding the scientific basis of health technology assessment: A research agenda for the next decade. Int J Technol Assess Health Care. 2006;22:275-280.Google Scholar
6. Frønsdala, KB, Faceya, K, Klempa, M, et al. Health technology assessment to optimize health technology utilization: Using implementation initiatives and monitoring processes. Int J Technol Assess Health Care. 2010;26:309-316.Google Scholar
7. Lettieri, E. Uncertainty inclusion in budgeting technology adoption at a hospital level: Evidence from a multiple case study. Health Policy. 2009;93:128-136.Google Scholar
8. Gagnon, MP, Desmartis, M, Poder, T, Witteman, W. Effects and repercussions of local/hospital-based health technology assessment (HTA): A systematic review. Syst Rev. 2014;3:129.Google Scholar
9. EUnetHTA, The HTA Core Model, Version 2.1, April 2015. http://meka.thl.fi/htacore/model/HTACoreModel2.1.pdf (accessed July 8, 2015).Google Scholar
10. Goetghebeur, M, Wagner, M, Khoury, H, Levitt, RJ, Erickson, LJ, Rindress, D. Evidence and Value: Impact on DEcisionMaking – the EVIDEM framework and potential applications. BMC Health Serv Res. 2008:8;270.Google Scholar
11. Thokala, P, Duenas, A. Multicriteria decision analysis for health technology assessment. Value Health. 2012;15:1172-8112.Google Scholar
12. Thokala, P, Devlin, N, Marsh, K, et al. Multiple criteria decision analysis for health care decision making — An introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 2016;19:1-13.CrossRefGoogle ScholarPubMed
13. Lettieri, M, Masella, C, Nocco, U. Budgeting and health technology assessment: First evidence obtained from proposal forms used to submit the adoption of new technology. Int J Technol Assess Health Care. 2008;24:502-510.CrossRefGoogle ScholarPubMed
14. Ehlers, L, Vestergaard, M, Kidholm, K, et al. Doing mini-health technology assessments in hospitals: A new concept of decision support in health care? Int J Technol Assess Health Care. 2006;22:295-301.CrossRefGoogle ScholarPubMed
15. Uphoff, ME, Krane, D. Hospital-based technology assessment: Essential questions and an operational model. Public Prod Manage Rev. 1998;22:60-70.Google Scholar
16. Mitton, C, Dionne, F, Damji, R, Campbell, D, Bryan, S. Difficult decisions in times of constraint: Criteria based resource allocation in the Vancouver Coastal Health Authority. BMC Health Serv Res. 2011;11:169.Google Scholar
17. Sampietro-Colom, L, Lach, K, Cicchetti, A, et al. The AdHopHTA handbook: A handbook of hospital-based Health Technology Assessment (HB-HTA); Public deliverable; The AdHopHTA Project (FP7/2007-13 grant agreement nr 305018); 2015. http://www.adhophta.eu/handbook (accessed July 8, 2015).Google Scholar
18. Radaelli, G, Lettieri, E, Masella, C, Merlino, L, Strada, A, Tringali, M. Implementation of Eunethta core model® in Lombardia: The VTS framework. Int J Technol Assess Health Care. 2014;30: 105-112.Google Scholar
19. Cicchetti, A, Manca, A, Ruggieri, M. L'utilizzo dei modelli decisionali per le valutazioni economiche dei farmaci in Italia: stato dell'arte e prospettive future. PharmacoEconomics – Italian Research Articles. 2007;1: 19-46.Google Scholar
20. Kidholm, K, Ehlers, L, Korsbek, L, Kjaerby, R, Beck, M. Assessment of the quality of mini-HTA. Int J Technol Assess Health Care. 2009;25: 42-48.Google Scholar
21. Demirdjian, G. A 10 year hospital-based health technology assessment program in a public hospital in Argentina. Int J Technol Assess Health Care. 2015;31:1-8.Google Scholar
22. McGregor, M. Impact of TAU reports, Technology Assessment Unit (TAU) of the McGill University Health Centre (MUHC): McGill University Health Centre; 2008.Google Scholar
23. Ølholm, AM, Kidholm, K, Birk-Olsen, M, Christensen, JB. Hospital Managers’ need for information on health technology investments. Int J Technol Assess Health Care. 2015;31:414-425.Google Scholar
24. Kidholm, K, Ølholm, AM, Birk-Olsen, M, et al., Hospital managers’ need for information in decision-making–An interview study in nine European countries. Health Policy. 2015;119:1424-1432.Google Scholar
25. Lettieri, E, Masella, C. Adopting ICTs in healthcare organisations: A framework to measure value and sustainability. Int J Healthc Technol Manage. 2006;7:319-332.Google Scholar