title: Health technology assessment in its local contexts: studies of telehealthcare.
abstract: Health technology assessment (HTA) is one of the major research enterprises of late modernity, reaching into fields of previously autonomous professional practice, and critically interrogating the organisation and delivery of health care. The 'evaluation' of new health technologies within the field of HTA is increasingly a normative political expectation, as discourses of 'evidence-based' practice run through health policy in the UK and elsewhere. Despite its importance in governing the direction of innovation in health care delivery, there are hardly any empirical studies of HTA in practice. In this paper, we draw on two ethnographic studies of telehealthcare implementation and evaluation in the UK to explore the practical conduct of HTA, and we focus specifically on the social organisation and conduct of randomised controlled trials of these new technologies. The paper examines how evaluation forms a mediating set of practices that make the embedding or normalisation of a new technology possible; and present a simple model of the social and technical contingencies within the evaluation process.
authors.affiliation: Centre for Health Care Services Research, University of Newcastle upon Tyne, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA, UK. c.r.may@ncl.ac.uk
authors.forename: Carl
authors.initials: C
authors.lastname: May
authors.forename: Maggie
authors.initials: M
authors.lastname: Mort
authors.forename: Tracy
authors.initials: T
authors.lastname: Williams
authors.forename: Frances
authors.initials: F
authors.lastname: Mair
authors.forename: Linda
authors.initials: L
authors.lastname: Gask
mesh_terms: D000884:Anthropology, Cultural; D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D005069:Evaluation Studies as Topic; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D011050:Policy Making; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D013222:State Medicine / Q000458:organization & administration*; D013673:Technology Assessment, Biomedical / Q000379:methods* / Q000458:organization & administration; D017216:Telemedicine; D006113:United Kingdom