title: Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings.
abstract: OBJECTIVE
  Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA) reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting.
  
  
  METHODS
  We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada), for use by other departments. The framework consists of six steps: 1) development of a program review and adaptation manual, 2) education and readiness assessment of interested departments, 3) evaluation of the program by individual departments, 4) joint evaluation via retreats, 5) synthesis of feedback and program revision, and 6) evaluation of the adaptation process.
  
  
  RESULTS
  Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified.
  
  
  CONCLUSIONS
  Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence-informed recommendations for introducing new health technologies. We encourage others to use this framework for program adaptation and to report their experiences.
authors.affiliation: Department of Surgery, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Paule
authors.initials: P
authors.lastname: Poulin
authors.forename: Lea
authors.initials: L
authors.lastname: Austen
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Scott
authors.forename: Michelle
authors.initials: M
authors.lastname: Poulin
authors.forename: Nadine
authors.initials: N
authors.lastname: Gall
authors.forename: Judy
authors.initials: J
authors.lastname: Seidel
authors.forename: René
authors.initials: R
authors.lastname: Lafrenière
keywords: evidence-based medicine; health technology assessment; program adaptation; program development