Health Technology Assessment Overview

Definition of HTA

• HTA is a multidisciplinary process involving explicit methods to determine the value of a health technology at different stages of its lifecycle.
• The purpose of HTA is to inform decision-making for a more equitable, efficient, and high-quality health system.
• HTA aims to reduce duplication of effort.

What to Consider?

• HTA process is formal, systematic, transparent, and utilizes cutting-edge methodologies to consider the best available evidence.
• It necessitates collaboration amongst various disciplines and agencies.
• Health technology is defined as an intervention for disease prevention, diagnosis, treatment, health promotion, rehabilitation, or healthcare organization.
• Examples include devices, medicines, vaccines, procedures, programs, or systems.

Examples of Health Technology

• Medical Devices:
  • Assistive Technology: Devices aid individuals with disabilities to perform tasks (e.g., hearing aids, wheelchairs).
  • Imaging Devices: Technologies used for diagnostic and monitoring purposes (e.g., MRI machines, X-rays, ultrasound).
  • Surgical Devices: Instruments used during surgical procedures (e.g., scalpels, laparoscopes, robotic surgery systems).
• Health Information Systems:
  • Electronic Health Records (EHRs): Digital versions of patient records.
  • Decision Support Tools: Software assisting healthcare professionals in clinical decision-making.
  • Scheduling Systems: Tools for managing patient appointments and provider schedules.

Value of Health Technology

• The value of health technology is subjective and depends on the perspective of stakeholders (patients, caregivers, healthcare professionals, insurers, regulators).
• Factors like clinical effectiveness, economic implications, and ethical considerations determine the value.

HTA Lifecycle

• HTA can be applied at various stages: pre-market, during market approval, post-market, and disinvestment.
• Examples include finding less invasive heart surgery methods as an alternative to invasive open heart surgery.

Who Uses HTA Reports?

• Private health insurers: Use HTA to determine coverage for treatments and technologies.
• Government payers: Rely on HTA for funding decisions and ensuring cost-effective utilization of public resources.
• Researchers: Utilize HTA findings to identify knowledge gaps and prioritize research efforts.
• Patients: Benefit from HTA by receiving effective and safe treatments.
• Caregivers: Use HTA information to understand available care options.
• Healthcare providers: Refer to HTA to guide clinical practice and ensure the use of effective treatments.
• Manufacturers: Depend on HTA to demonstrate product value and effectiveness for market approval and reimbursement.
• Hospitals: Implement HTA recommendations for improved patient care and resource allocation.

Basic HTA Orientations

• Technology-Oriented: Focus on technology characteristics and impacts.
  • Example: Assessing cochlear implants or PET scanners.
• Problem-Oriented: Focuses on solutions or strategies managing specific diseases or conditions.
  • Example: Developing clinical practice guidelines for diagnosing dementia.
• Project-Oriented: Evaluates the implementation of technology within a specific institution or project.
  • Example: Deciding to purchase a PET scanner considering resources, financial status, and market potential.

HTA Products

• Full HTA Reports: Comprehensive assessments of technologies (agency/governmental level).
• Systematic Reviews: Reports based on existing literature (academic).
• Joint Papers: Reports published collaboratively.
• Short Documents: Technical briefs, rapid assessments, and updates.

Information Produced by HTA

• Effectiveness: Does the technology improve health outcomes compared to alternatives?
• Patient Benefit: Which patients benefit the most, and is their health status meaningfully improved?
• Safety: What are the potential risks and adverse effects of the technology?
• Cost-Effectiveness: Is the technology good value for the money spent?
• Ethical and Social Impact: What are the ethical, social, and cultural implications?
• Legal Considerations: Are there legal issues related to the technology's use?
• Organizational Impact: How will the technology affect healthcare delivery and organization?
• Patient and Caregiver Experience: How will the technology impact patients, relatives, and caregivers?
• Environmental Impact: What are the environmental consequences?
• Additional Considerations: What other factors make this technology important?

Basic HTA Steps

• Identify Assessment Topics: Specifying cost-effectiveness, effectiveness, or ethical implications of health technologies.
• Specify Assessment Problem or Questions: Defining the scope of the report including population, intervention, alternatives, outcome, and timeframe.
• Scoping (PICOT): Defining the population, intervention, comparison, outcome, and timeframe.
• Retrieve Available Relevant Evidence: Identifying existing evidence and potential knowledge gaps.
• Generate or Collect New Evidence: Gathering additional evidence if required.
• Appraise/Interpret Quality of Evidence: Assessing the methodology and reliability of the evidence.
• Integrate/Synthesize Evidence: Combining and interpreting the evidence.
• Formulate Findings and Recommendations: Generating findings and recommendations in various formats.
• Disseminate Findings and Recommendations: Communicating findings and recommendations for decision-making.
• Monitor Impact: Tracking the impact of the technology's implementation.

HTA Frameworks and Guidelines

• CADTH Model: One of the most popular models.
• HTA Core Model: Developed by the European network for Health Technology Assessment.
• ICER HTA Process: Implemented by the Institute for Clinical and Economic Review.
• ISPOR Good Practices in HTA: Recommended practices by the International Society for Pharmacoeconomics and Outcomes Research.

Explore the fundamentals of Health Technology Assessment (HTA), a critical process for evaluating health technologies. Learn about the systematized methods and collaboration required to inform decision-making in healthcare. This quiz covers the stages, examples, and significance of HTA in creating a functional health system.