1. Health Technology Assessment

2. What is ECRI Institute?
A ‘not for profit’ health services research agency chartered in 1955
International – Offices in Europe, Middle East, Far East, USA
11,500 m2 Head Office
One of the world’s most comprehensive source of information on healthcare practices and technology employing over 300 staff
A Collaborating Centre for WHO.

3. Our mission……..
To improve the safety, efficacy, delivery and cost-effectiveness of healthcare through an informed consumer.

4. Why we are different…...
‘Not for profit’ (similar to a charitable trust) and not a corporation or a company
We are totally independent, which maintains our objectivity and integrity
We accept no royalties, gifts or commissions
Neither ECRI Institute nor its staff are permitted to own shares in or consult for the medical device or pharmaceutical companies
…….strict conflict of interest rules.

5. Our services…... Applied research Publications Software Databases
Information services (web access)
Risk Management including Accident and Forensic services
Consultancy.

6. Health Technology Assessment

7. What is Health Technology include?
Drugs
Devices
Procedures
Biotechnology
Information technology
Systems technology.

8. Definition: Technology Assessment
Technology Assessment-- a practical process of determining the value of a new or emerging technology in and of itself or against existing or competing technologies using efficacy, effectiveness, outcome, risk management, strategic, financial and competitive criteria.

9. Purpose of Technology Assessment
Determining the safety, efficacy and cost-effectiveness of medical technology
Discriminate between the appropriate and inappropriate indications of use of medical technologies
To advise upon the formulation of safe, effective, health policies that are patient focused and seek to achieve best value.

10. The Current Environment
Enormous duplication of services
Technology changing faster than clinical practice
Pressure for information on the value of new approaches
Pressure on providers to deliver care in a capitated environment
Integration and consolidation
Pressure from payers for less costly services

11. The Challenge of Technology Assessment
Encourage the development of new technology
Avoid inappropriate diffusion
Align payers, providers, and manufacturers in the assessment of technology
Propagate complex issues in an intelligible form..

13. Issues in the Health Care Debate
Wide variations in practices among clinicians locally, regionally, nationally and internationally
No match between resources used and needs
Information ABOUT technology diffuses faster than information about the VALUE of technology
How do we empower the clinician for the rational use of technology?

14. How Do Hospitals Assess and Acquire Technology?
By careful review of value and other criteria?
By comparison against competing and existing technology?
By buying what clinicians want?
By buying what the manufacturers tell them?
By listening to the BBC?
Google?

15. The Technology Chasm
Don’t just look for the big “splash” in the pond—follow the ripples; few reach shore
Pushing the technology edge is critical—but real-world use and real-world benefits must be demanded
Whether a technology becomes successful depends on much more than whether it works well
Never underestimate psychology and emotion.

16. Technology Assessment Spectrum
Macro
Micro
Holistic
Regional/
National
Local
Pre-purchase
Evaluation
Procurement
Efficacy
Safety
Cost-effectiveness
Legal issues
Ethical issues
Epidemiology
Patient demographics
Health priorities
Resource allocation
Competition
Business feasibility
Financial benefits
Assimilation capability
User expertise
Effectiveness
Performance
Features
Ease of use
Life-cycle cost
User support
Training
Service
Specification
Bid analysis
Selection
Financing

17. Gartner Hype Cycle
Source: Gartner,

18. How a technology is used determines whether it will be cost-effective

19. The First Rule of Technology Assessment
In God we trust,
all others bring data.
-Anonymous

20. The Second Rule of Technology Assessment
Data is not the plural of anecdote.
- Donald Berwick

21. Putt’s Law
Technology is dominated by two types of people: those who understand what they do not manage, and those who manage what they do not understand.

22. Thank you for your attention