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USING THE HEALTH TECHNOLOGY ASSESSMENT TOOLBOX TO FACILITATE PROCUREMENT: THE CASE OF SMART PUMPS IN A CANADIAN HOSPITAL

Published online by Cambridge University Press:  05 June 2017

Thomas G. Poder*
Affiliation:
Centre de Recherche du CHUS and UETMIS, CIUSSS de l'Estrie - CHUS Département d'Économique, École de Gestion, Université de Sherbrooketpoder.chus@ssss.gouv.qc.ca

Abstract

Objectives: The aim of this study was to present the experience of a Canadian hospital-based health technology assessment (HTA) unit that performed the traditional functions of the HTA process along with many other activities to facilitate the choice of smart pumps.

Methods: A rapid literature review was initiated, but little evidence was found. Moreover, the evidence provided was too far from our hospital context. To help our decision makers, we offered them a list of various services based on the skills of our HTA unit staff.

Results: To involve our HTA unit in the choice of the new smart pumps led to a strong collaboration between hospital services. After a rapid review on smart pumps, we proceeded to establish the clinical needs, followed by an evaluation of technical features. To ascertain clinical needs, we participated in the establishment of a conformity list for the tender, a failure and mode-effect analysis, an audit on the use of actual smart pumps, and simulation exercises with nurses and doctors to evaluate the ease of use and ergonomics. With regard to technical tests, these were mainly conducted to identify potential dysfunction and to assess the efficiency of the pump. This experience with smart pumps was useful for evidence-based procurement and led to the formulation of a nine-step process to guide future work.

Conclusions: HTA units and agencies are faced with rapid development of new technologies that may not be supported by sufficient amount of pertinent published evidence. Under these circumstances, approaches other than evidence-based selection might provide useful information. Because these activities may be different from those related to classic HTA, this widens the scope of what can be done in HTA to support decision making.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. Bodenheimer, T. High and rising health care costs. Part 2: Technologic innovation. Ann Intern Med. 2005;142:932957.Google Scholar
2. Henshall, C, Oortwijn, W, Stevens, A, Granados, A, Banta, D. Priority setting for health technology assessment. Theoretical considerations and practical approaches. Priority setting Subgroup of the EUR-ASSESS Project. Int J Technol Assess Health Care. 1997;13:144185.Google Scholar
3. INAHTA. What is Health Technology Assessment (HTA)? International Network of Agencies for Health Technology Assessment. 2016. http://www.inahta.org (accessed January 29, 2016).Google Scholar
4. Lampe, K, Makela, M, Garrido, MV, et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. Int J Technol Assess Health Care. 2009;25:920.Google Scholar
5. Sampietro-Colom, L, Lach, K, Pasternack, I, et al. Guiding principles for good practices in hospital-based HTA units. Int J Technol Assess Health Care. 2015;31:457465.Google Scholar
6. 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/sites/files/adhophta/media/adhophta_handbook_website.pdf (accessed December 25, 2016).Google Scholar
7. Merlin, T, Tamblyn, D, Ellery, B. What's in a name? Developing definitions for common health technology assessment product types of the International Network of Agencies for Health Technology Assessment (inahta). Int J Technol Assess Health Care. 2014;30:430437.Google Scholar
8. 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;22:295301.Google Scholar
9. 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;119:14241432.Google Scholar
10. Lehoux, P, Tailliez, S, Denis, JL, Hivon, M. Redefining health technology assessment in Canada: Diversification of products and contextualization of findings. Int J Technol Assess Health Care. 2004;20:325336.Google Scholar
11. Demirdjian, G. A 10-year hospital-based health technology assessment program in a public hospital in Argentina. Int J Technol Assess Health Care. 2015;31:18.Google Scholar
12. Poder, TG, Fisette, J-F. Are drug-coated balloons cost-effective for femoropopliteal occlusive disease? A comparison of bare metal stents and uncoated balloons. J Comp Eff Res. 2016;5:335344.CrossRefGoogle ScholarPubMed
13. Stephens, J, Doshi, J. International survey of methods used in health technology assessment (HTA): Does practice meet the principles proposed for good research? Comp Eff Res. 2012;2:29.Google Scholar
14. INESSS. Réflexion sur l’évaluation terrain en évaluation des technologies et des modes d'intervention en santé. Montréal, QC. 2012. https://www.inesss.qc.ca/publications/publications/publication/reflexion-sur-levaluation-terrain-en-evaluation-des-technologies-et-des-modes-dintervention-en.html (accessed January 29, 2016).Google Scholar
15. Poder, TG, Bellemare, C.K. Bédard, S, He, J, Lemieux, R. New design of care: Assessment of an interdisciplinary orthopedic clinic with a pivot nurse in the province of Quebec. Orthop Nurs. 2010;29:381389.Google Scholar
16. Chilcott, J, Tappenden, P, Rawdin, A, et al. Avoiding and identifying errors in health technology assessment models: Qualitative study and methodological review. Health Technol Assess. 2010;14:1107.Google Scholar
17. Bedard, SK, Poder, TG, Larivière, C. Validation d'un outil de mesure de l'interdisciplinarité en pratique clinique: le questionnaire IPC65. Sante Publique. 2013;25:763773.Google Scholar
18. Martelli, N, Billaux, M, Borget, I, Pineau, J, Prognon, P, van den Brink, H. Introduction of innovative medical devices at French university hospitals: An overview of hospital-based health technology assessment initiatives. Int J Technol Assess Health Care. 2015;31: 1218.Google Scholar
19. Poder, TG, Pruneau, D, Dorval, J, et al. Effect of warming and flow rate conditions of blood warmers on red blood cell integrity. Vox Sang. 2016;111:341349.Google Scholar
20. Arshoff, L, Henshall, C, Juzwishin, D, Racette, R. Procurement change in Canada: An opportunity for improving system performance. Healthc Manage Forum. 2012;25:6669.Google Scholar
21. Prada, G. Value-based procurement: The new imperative for Canada. Online presentation, May 10, 2016. http://hscn.org/Data/Sites/8/media/1050-gabriela-prada.pdf (accessed December 25, 2016).Google Scholar
22. Morgan, L, Siv-Lee, L. Intelligent infusion. Nurs Manage. 2009;40: 2024.Google Scholar
23. Phelps, P, Kleinke, P. Choosing a pump: The request for proposal and value analysis. In: Phelps, P, ed. Smart Infusion pumps implementation, management, and drug libraries. Bethesda, MD: American Society of Health-System Pharmacists; 2011:926.Google Scholar
24. Rossi, PG, Camilloni, L, Todini, AR, et al. Health technology assessment of the negative pressure wound therapy for the treatment of acute and chronic wounds: Efficacy, safety, cost effectiveness, organizational and ethical impact. Ital J Public Health. 2012;9:4666.Google Scholar
25. ECRI Institute. Best and worst infusion pump. Ratings for six products. Health Devices. 2012;41:378391.Google Scholar
26. ISMP-Canada. Modèle canadien d'analyse des modes de défaillances et de leurs effets (AMDE). Identification proactive des risques dans le milieu de la santé. Montréal, QC: ISMP-Canada; 2007.Google Scholar
27. Wetterneck, TB, Skibinski, KA, Roberts, TL, et al. Using failure mode and effects analysis to plan implementation of smart i.v. pump technology. Am J Health Syst Pharm. 2006;63:15281538.Google Scholar
28. Namshirin, P, Ibey, A, Lamsdale, A. Applying a multidisciplinary approach to the selection, evaluation, and acquisition of smart infusion pumps. J Med Biol Eng. 2011;31:9398.Google Scholar
29. Elias, BL, Moss, JA. Smart pump technology. What we have learned. Comput Inform Nurs. 2011;29:TC61TC67.Google Scholar
30. ECRI Institute. Infusion pump integration. Health Devices. 2013;42:210221.Google Scholar
31. Fan, M, Pinkney, S, Easty, A. Smart medication delivery systems: Infusion pumps. Supplementary report: Evaluation of effective smart pump design and education strategies. Toronto, Ontario: University Health Network; 2010.Google Scholar
32. Rothschild, JM, Keohane, CA, Cook, EF, et al. A controlled trial of smart infusion pumps to improve medication safety in critically ill patients. Crit Care Med. 2005;33:533540.Google Scholar
33. Murdoch, LJ, Cameron, VL. Smart infusion technology: A minimum safety standard for intensive care? Br J Nurs. 2008;17:630636.CrossRefGoogle ScholarPubMed
34. Trbovich, P, Jeon, J, Easty, A. Smart medication delivery systems: Infusion pumps. Toronto, Ontario: University Health Network; 2009.Google Scholar
35. Trbovich, PL, Pinkney, S, Cafazzo, JA, Easty, AC. The impact of traditional and smart pump infusion technology on nurse medication administration performance in a simulated inpatient unit. Qual Saf Health Care. 2010;19:430434.Google Scholar
36. Pinkney, S, Trbovich, P, Fan, M, Rothwell, S, Cafazzo, JA, Easty, A. Do smart pumps actually reduce medication errors? Biomed Instrum Technol. 2010;44:6469.Google Scholar
37. Ohashi, K, Dalleur, O, Dykes, PC, Bates, DW. Benefits and risks of using smart pumps to reduce medication error rates: A systematic review. Drug Saf. 2014;37:10111020.Google Scholar
38. Husch, M, Sullivan, C, Rooney, D, et al. Insights from the sharp end of intravenous medication errors: Implications for infusion pump technology. Qual Saf Health Care. 2005;14:8086.CrossRefGoogle ScholarPubMed
39. ECRI Institute. Evaluation: General-purpose infusion pumps. Health Devices. 2007;36:309336.Google Scholar
40. ECRI Institute. Top 10 health technology hazards for 2013. Health Devices. 2012;41:123.Google Scholar
41. UETMIS-Ste-Justine. Constats et enjeux relies à l'acquisition et à l'implantation d'un nouveau parc de pompes volumétriques et de pousse-seringues au CHUS Sainte-Justine. Montréal, QC: UETMIS-Ste-Justine; 2009.Google Scholar
42. Poder, TG, Boileau, J-C, Lafrenière, R, et al. Quantitative assessment of haemolysis secondary to modern infusion pumps. Vox Sang. 2017;112:201209 Google Scholar
43. Dupouy, C, Gagnon, M-P. The influence of hospital-based HTA on technology acquisition decision. Int J Hospital-Based Health Technol Assess. 2016;1:1928.Google Scholar
44. Hailey, D. Commentary on “The influence of hospital-based HTA on technology acquisition decision”. Int J Hospital-Based Health Technol Assess. 2016;1:2930.Google Scholar