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Bhatia R. Emerging Health Technologies and How They Can Transform Healthcare Delivery. JOURNAL OF HEALTH MANAGEMENT 2021. [DOI: 10.1177/0972063421995025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health technologies have been and shall always be an integral part of the health system. Appropriate technologies provide solutions to improve healthcare services at an affordable cost. New biomedical, bioengineering and digital technologies continue to swamp the health system and consume a major part of the health budget. National authorities should develop a policy framework that articulates needs, standards and projections of safe and cost-effective technologies in the context of local epidemiological data and the felt needs of communities. Efficient implementation of health technologies requires availability of an adequate number of skilled human resources for health and infrastructure, for maintenance and replacement or for upgradation of these technologies.
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Affiliation(s)
- Rajesh Bhatia
- Former Director, Communicable Diseases, WHO Regional Office for South-East Asia, New Delhi, India
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Doos L, Packer C, Ward D, Simpson S, Stevens A. Past speculations of future health technologies: a description of technologies predicted in 15 forecasting studies published between 1986 and 2010. BMJ Open 2017; 7:e016206. [PMID: 28760796 PMCID: PMC5642756 DOI: 10.1136/bmjopen-2017-016206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/24/2017] [Accepted: 06/01/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To describe and classify health technologies predicted in forecasting studies. DESIGN AND METHODS A portrait describing health technologies predicted in 15 forecasting studies published between 1986 and 2010 that were identified in a previous systematic review. Health technologies are classified according to their type, purpose and clinical use; relating these to the original purpose and timing of the forecasting studies. DATA SOURCES All health-related technologies predicted in 15 forecasting studies identified in a previously published systematic review. MAIN OUTCOME MEASURE Outcomes related to (1) each forecasting study including country, year, intention and forecasting methods used and (2) the predicted technologies including technology type, purpose, targeted clinical area and forecast timeframe. RESULTS Of the 896 identified health-related technologies, 685 (76.5%) were health technologies with an explicit or implied health application and included in our study. Of these, 19.1% were diagnostic or imaging tests, 14.3% devices or biomaterials, 12.6% information technology systems, eHealth or mHealth and 12% drugs. The majority of the technologies were intended to treat or manage disease (38.1%) or diagnose or monitor disease (26.1%). The most frequent targeted clinical areas were infectious diseases followed by cancer, circulatory and nervous system disorders. The most frequent technology types were for: infectious diseases-prophylactic vaccines (45.8%), cancer-drugs (40%), circulatory disease-devices and biomaterials (26.3%), and diseases of the nervous system-equally devices and biomaterials (25%) and regenerative medicine (25%). The mean timeframe for forecasting was 11.6 years (range 0-33 years, median=10, SD=6.6). The forecasting timeframe significantly differed by technology type (p=0.002), the intent of the forecasting group (p<0.001) and the methods used (p<001). CONCLUSION While description and classification of predicted health-related technologies is crucial in preparing healthcare systems for adopting new innovations, further work is needed to test the accuracy of predictions made.
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Affiliation(s)
- Lucy Doos
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Claire Packer
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Derek Ward
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sue Simpson
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Andrew Stevens
- Institute of Applied Health Research,University of Birmingham, Birmingham, UK
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Doos L, Packer C, Ward D, Simpson S, Stevens A. Past speculations of the future: a review of the methods used for forecasting emerging health technologies. BMJ Open 2016; 6:e010479. [PMID: 26966060 PMCID: PMC4800127 DOI: 10.1136/bmjopen-2015-010479] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Forecasting can support rational decision-making around the introduction and use of emerging health technologies and prevent investment in technologies that have limited long-term potential. However, forecasting methods need to be credible. We performed a systematic search to identify the methods used in forecasting studies to predict future health technologies within a 3-20-year timeframe. Identification and retrospective assessment of such methods potentially offer a route to more reliable prediction. DESIGN Systematic search of the literature to identify studies reported on methods of forecasting in healthcare. PARTICIPANTS People are not needed in this study. DATA SOURCES The authors searched MEDLINE, EMBASE, PsychINFO and grey literature sources, and included articles published in English that reported their methods and a list of identified technologies. MAIN OUTCOME MEASURE Studies reporting methods used to predict future health technologies within a 3-20-year timeframe with an identified list of individual healthcare technologies. Commercially sponsored reviews, long-term futurology studies (with over 20-year timeframes) and speculative editorials were excluded. RESULTS 15 studies met our inclusion criteria. Our results showed that the majority of studies (13/15) consulted experts either alone or in combination with other methods such as literature searching. Only 2 studies used more complex forecasting tools such as scenario building. CONCLUSIONS The methodological fundamentals of formal 3-20-year prediction are consistent but vary in details. Further research needs to be conducted to ascertain if the predictions made were accurate and whether accuracy varies by the methods used or by the types of technologies identified.
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Affiliation(s)
- Lucy Doos
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Claire Packer
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Derek Ward
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sue Simpson
- NIHR Horizon Scanning Research and Intelligence Centre, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Andrew Stevens
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Price R, Le Masurier S. Longitudinal changes in extended roles in radiography: A new perspective. Radiography (Lond) 2007; 13:18-29. [DOI: 10.1016/j.radi.2005.11.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2005] [Accepted: 11/04/2005] [Indexed: 11/29/2022]
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Douw K, Vondeling H, Sørensen J, Jørgensen T, Sigmund H. "The future should not take us by surprise": preparation of an early warning system in Denmark. Int J Technol Assess Health Care 2004; 20:342-50. [PMID: 15446764 DOI: 10.1017/s0266462304001163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To explore and test methods for the operation of a national Early Warning System (EWS) in Denmark and to support decision making by the Danish Centre for Evaluation and Health Technology Assessment on this issue. METHODS On the basis of literature reviews, information from members of EuroScan, and supported by clinical experts and stakeholders, existing methods were adapted and new methods were developed as part of a feasibility study. RESULTS Approximately 200 technologies in 30 specialties were identified on the basis of information by EuroScan. A new instrument was developed to distinguish between important and unimportant technologies (filtering). Clinical experts in six specialties applied the instrument to sixty-two technologies in their respective fields, of which nine (15%) were judged potentially important for the Danish health care system. For priority setting, adapting a Dutch instrument to the Danish context was discussed. In principle, the instrument was acceptable, but several changes were proposed, for example, relating to the decentralized structure of the Danish health care system. For early assessment, the format and methods applied by SBU and Canadian Coordinating Office for Health Technology Assessment (CCOHTA) were compared and applied to pharmaceuticals (glitazones in treatment of type 2 diabetes mellitus) and a procedure (embolization of uterine fibromas). Given the main target group of the Danish EWS, local decision makers, the CCOHTA format was preferred. CONCLUSIONS The findings of the study have laid the foundation for an EWS using appropriate methods adapted to local circumstances. On the basis of the findings, a decision was made to start an EWS.
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Affiliation(s)
- Karla Douw
- Department of Health Economics, University of Southern Denmark, Odense
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Price R, Miller L, Mellor F. Longitudinal changes in extended roles in radiography. Radiography (Lond) 2002. [DOI: 10.1053/radi.2002.0383] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pron G, Common A, Simons M, Ho CS. Interventional radiology and the use of metal stents in nonvascular clinical practice: a systematic overview. J Vasc Interv Radiol 1999; 10:613-28. [PMID: 10357489 DOI: 10.1016/s1051-0443(99)70092-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The intent of this systematic overview was to describe the clinical role of metal stents in nonvascular health care interventions and the level of evidence supporting their use. MATERIALS AND METHODS Structured searches of Medline were conducted and limited to original peer-reviewed articles published in English. RESULTS Clinical practice involving metal stents was reported in more than 109 clinical series involving 4,753 patients. Stents were placed mainly for palliation of malignant biliary, esophageal, and airway obstruction in patients who were untreatable or had surgically unresectable lesions. Assessment of these interventions has so far centered on safety and technical success. Efficacy, quality of life, and costing factors were not routinely reported. Randomized trial evidence was available but limited; six randomized trials involving metal stents have been reported. Three trials involved biliary malignant obstruction, and all three reported metal stent (132 patients) palliation to be superior to plastic stent palliation (136 patients) based on longer patency and lower reintervention costs. Safety and complication differences between stents, however, were inconsistent across trials. In three trials involving esophageal malignant obstruction, metal stent (82 patients) palliation was reported to be superior to plastic stent (41 patients), based on lower complication and reintervention rates, and superior to laser therapy (18 patients), based on better dysphagia relief. CONCLUSION Use of metal stents has been reported for obstructed ducts and passageways of most body systems. There is, however, limited controlled trial evidence confirming the advantages of their use over plastic stents or other forms of treatment.
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Affiliation(s)
- G Pron
- Department of Medical Imaging, University of Toronto, Ontario
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Jørgensen T, Larsen LG. Basis for decisions on emerging health technology. A Danish feasibility study. Int J Technol Assess Health Care 1999; 14:624-35. [PMID: 9885452 DOI: 10.1017/s0266462300011934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The objectives of the feasibility study were to evaluate sources of information for an eventual Danish system for early identification and assessment of emerging health technology, to identify potential users of the system, and to clarify their specific need for information concerning emerging health technology. The methods used were questionnaires to informants within and outside the health services and to decision makers on different levels in the health services, and follow-up telephone interviews. Our study reveals a strong, and to some extent unsatisfied, need among policy makers, planners, and managers in the Danish health services for information concerning emerging health technology. The requested information should in particular concern indication for use, number of patients affected, clinical effectiveness and side effects, running cost, and investments. The time horizon most relevant to the decision makers seems to be only zero to 2 years. Furthermore, we found that numerous sources are available that frequently display information on emerging technology important to the health services. The challenges seem to be to select information of sufficient importance and quality, and to combine information, since very few, if any, single primary sources cover all the requested information. In conclusion, we recommend the establishment of a Danish national system for early identification and assessment of emerging health technology, consisting of a small secretariat that collaborates nationally and internationally, the latter in particular on identification of technology and on development of methods for early assessment.
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Affiliation(s)
- T Jørgensen
- Danish Institute for Health Services Research and Development (DSI)
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Robert G, Gabbay J, Stevens A. Which are the best information sources for identifying emerging health care technologies? An international Delphi survey. Int J Technol Assess Health Care 1999; 14:636-43. [PMID: 9885453 DOI: 10.1017/s0266462300011946] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this survey was to assess potential information sources for identifying new health care technologies. A three-round Delphi study was conducted, involving 38 selected experts who suggested and assessed potential sources by applying agreed criteria. Twenty-six potential information sources were considered. Timeliness, time efficiency, and sensitivity were important criteria in determining which were the most important sources. The eight recommended sources were: pharmaceutical journals, pharmaceutical and biotechnology companies, specialist medical journals, key medical journals, medical engineering companies, private health care providers, newsletters and bulletins from other health technology assessment agencies, and groups of expert health professionals. There is a need to use a combination of sources because the most useful sources will vary according to the type of technology under consideration.
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Carlsson P, Hultin H, Törnwall J. The early experiences of a national system for the identification and assessment of emerging health care technologies in Sweden. Int J Technol Assess Health Care 1999; 14:687-94. [PMID: 9885459 DOI: 10.1017/s0266462300012009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article presents the experiences from a pilot study and the establishment of a permanent system called SBU Alert. The question of establishing a system for the identification and assessment of emerging technologies in health care in Sweden has been on the agenda since the late 1980s. The demand came primarily from policy makers. The pilot study showed that the awareness of the project in the target group (politicians, leading managers, hospital directors, and senior medical advisors) was high. Almost all of those who replied to an assessment questionnaire were in favor of a continuation of the work. In 1997, the Swedish Council on Technology Assessment in Health Care (SBU) was selected to establish a permanent organization. This work has resulted in the identification of a number of methodological problems and tentative solutions concerning all components in the SBU Alert system. We have found that a system for systematic identification and early assessment of emerging technologies is a new and promising tool in the health technology assessment arsenal. Still, experiences are limited. Methodology and the impact of early judgments on decision making need further evaluation.
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Affiliation(s)
- P Carlsson
- Swedish Council on Technology Assessment in Health Care (SBU)
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Stevens A, Packer C, Robert G. Early warning of new health care technologies in the United Kingdom. Int J Technol Assess Health Care 1999; 14:680-6. [PMID: 9885458 DOI: 10.1017/s0266462300011995] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this paper we describe the present range of organizations that have a role in the early warning of new and emerging health care technologies in the United Kingdom. We discuss in more detail the processes and prioritization criteria used by the U.K. horizon-scanning project for the NHS Health Technology Assessment Programme, and the principal methods of technology identification for the horizon-scanning project are outlined. The United Kingdom plans to develop an integrated system for the identification of technologies for commercial planning, health service research prioritization, financial planning, and provision of information to policy makers, purchasers, and providers of health care.
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Abstract
AbstractCurrent interest in early warning can be understood as a natural response to the regularity with which health service planners have been overwhelmed by new technology. Planning the rational introduction of a new technology should be facilitated by advance warning of its imminent arrival on the market. Current approaches to early warning tend to rely on the insights and expectations of scientific and clinical experts in the field in question. In this paper it is argued that such an approach fails to recognize important changes that have occurred both in the innovation process itself, and in theoretical understanding of it. With the more complex roles that governments now play, and with the increasingly articulate demands of consumers, the innovation process has become more complex. At the same time, it is now clear that the innovation process embodies a multitude of choices. Approaches to early warning must be compatible with these new perspectives.
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ten Velden GH. The identification of new health care technologies by the Health Council of The Netherlands. Int J Technol Assess Health Care 1999; 14:671-9. [PMID: 9885457 DOI: 10.1017/s0266462300011983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The article gives a global overview of the 14 years of signposting experience of the Health Council of the Netherlands. The Council signals new health care technologies and emerging health care problems in briefs, comprehensive reports, and bulletins. Its main purpose is to provide the government with timely information to support rational policy decision making.
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Rosen R, Mays N. Controlling the introduction of new and emerging medical technologies: can we meet the challenge? J R Soc Med 1998; 91:3-6. [PMID: 9536131 PMCID: PMC1296414 DOI: 10.1177/014107689809100102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- R Rosen
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
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