Health technology assessment to optimize health technology utilization: using implementation initiatives and monitoring processes.
BACKGROUND
The way in which a health technology is used in any particular health system depends on the decisions and actions of a variety of stakeholders, the local culture, and context. In 2009, the HTAi Policy Forum considered how health technology assessment (HTA) could be improved to optimize the use of technologies (in terms of uptake, change in use, or disinvestment) in such complex systems.


METHODS
In scoping, it was agreed to focus on initiatives to implement evidence-based guidance and monitoring activities. A review identified systematic reviews of implementation initiatives and monitoring activities. A two-day deliberative workshop was held to discuss key papers, members' experiences, and collectively address key questions. This consensus paper was developed by email and finalized at a postworkshop meeting.


RESULTS
Evidence suggests that the impact and use of HTA could be increased by ensuring timely delivery of relevant reports to clearly determined policy receptor (decision-making) points. To achieve this, the breadth of assessment, implementation initiatives such as incentives and targeted, intelligent dissemination of HTA result, needs to be considered. HTA stakeholders undertake a variety of monitoring activities, which could inform optimal use of a technology. However, the quality of these data varies and is often not submitted to an HTA.


CONCLUSIONS
Monitoring data should be sufficiently robust so that they can be used in HTA to inform optimal use of technology. Evidence-based implementation initiatives should be developed for HTA, to better inform decision makers at all levels in a health system about the optimal use of technology.
Frønsdal
Katrine B
KB
Norwegian Knowledge Centre for the Health Services, Oslo, Norway. kbf@nokc.no
Facey
Karen
K
Klemp
Marianne
M
Norderhaug
Inger Natvig
IN
Mørland
Berit
B
Røttingen
John-Arne
JA
D020811:Biomedical Technology; D032921:Consensus; D004059:Diffusion of Innovation; D004493:Education; D013673:Technology Assessment, Biomedical