Attending an international conference presents an opportunity to learn first-hand how other countries manage technology acquisition. European hospitals seem to rely more and more on health technology assessment (HTA) when investing in new health technologies. I attended a panel meeting on "HTA in Hospitals – Role of the Manager and Clinician," where clinicians and managers from the Agostino Gemelli University Hospital in Rome explained that "each investment creates trajectories." At their institution, they regard HTA as an invaluable tool for strategic planning to help them make important investment decisions. Their hospital-based HTA process includes HTA experts as well as top-level hospital managers, clinicians, and other stakeholders. Some hospitals create an organizational firewall to make sure the HTAs are of good quality.
A member of the audience asked what would happen if only very few data were available. The answer: "We design a research protocol and help the clinician to obtain funding to use the new technology within a clinical trial."
During a lunch meeting of the Hospital-based HTA Interest Group, Laura Sampietro-Colom, who is the head of the health technology assessment unit at the Hospital Clinic Barcelona, announced that a European collaboration of nine hospitals received funding from the European Comission to establish a hospital-based HTA network. The paperwork was signed just yesterday! Part of this effort will be an HTA database as a platform for international collaboration and exchanging experiences.
After lunch, I switched from HTA for investment to HTA for "disinvestment.” HTA agencies are now being called upon to help design an evidence-based approach to reduce or eliminate the use of a technology when it has become obsolete, or is harmful or ineffective. Several sessions focused on methodologies for this emerging new field of health technology REassessment or HTR.
In both areas, clinicians and hospital managers increasingly rely on HTA to help them make these tough decisions.