When Was Your Last
Healthcare Technology
Assessment

Health technology is an integral toolkit for hospitals and health systems. It streamlines many administrative tasks, improves the safety and efficiency of the system, and helps address existing gaps in healthcare.

However, every technology, whether new or existing, needs regular evaluation. This ensures it is free of any medical, social, economic, or ethical issues and stays compatible with currently available technologies. This is where Healthcare Technology Assessment (HTA) comes in.

What Is a Technology Needs Assessment in Healthcare?

HTA is a relatively new tool introduced to support evidence-informed policy decisions about health technology. As new innovations make headlines each year, health technologies consequently undergo a constant cycle of development and refinement. However, it is unclear what impact these innovations have on healthcare systems. To address this problem, a technology needs assessment, or HTA, is needed ⁽¹⁾⁽²⁾.

HTA is a multidisciplinary process of systematically evaluating the necessity, relevance, and value of new or existing medical technologies or interventions (systems, devices, pharmaceuticals, procedures, and techniques) at different points in their life cycles. It serves as a form of policy research that helps decision-makers determine whether to introduce or withdraw these technologies ⁽¹⁾⁽³⁾.

What Do Health Technology Assessments Do?

HTA reports help healthcare institutions adopt only efficient, safe, current, and cost-effective health technologies that add value to their growth. The final assessment provides evidence-based conclusions so that stakeholders at national, regional or hospital level can make informed decisions regarding the assessed technology ⁽⁴⁾.

An HTA report typically answers the following critical questions:

• Does the technology improve patient outcomes?
• Is it cost-effective?
• Does it meet the market demand?
• What are the potential risks?
• Are there any social, ethical, and regulatory concerns with it?
• Is it clinically and technically safe?
• What are the potential organizational implications?

While there’s no single, standardized protocol, HTA typically involves the following steps:

• Technology identification: Selecting the technology to be assessed.
• Review of Evidence: Gathering existing evidence on the technology’s safety, efficacy, and cost-effectiveness.
• Data collection: Conducting studies or analyses to fill knowledge gaps.
• Economic evaluation: Assessing the technology’s financial impact.
• Ethical considerations: Examining potential ethical concerns.
• Dissemination of findings: Sharing results with decision-makers and stakeholders.

Decision-Making: Determining whether the technology should be adopted, modified, or withdrawn.

Why Are Regular Health Technology Assessments Important?

HTAs enable healthcare providers to stay updated with the latest advancements. However, since new technologies are often costlier than older ones, conducting regular HTAs ensures they adopt only the most effective technologies. This practice helps avoid the use of low-value, outdated, or ineffective health technologies, potentially saving unnecessary costs and preventing resource wastage ⁽²⁾⁽³⁾.

Informed decision-making through HTAs helps address the following issues:

• Determining coverage and reimbursement
• Making informed pricing decisions
• Ensuring adherence to clinical guidelines and protocols
• Complying with medical device regulation
• Maintaining high standards of care

First in the US and Europe, HTA is now being adopted worldwide. This widespread adoption is primarily driven by the emergence of new health technologies and limited health budgets. However, to become a robust policy analysis tool, HTA still has a long way to go. While patients’ perspectives should ideally be considered, health institutions currently tend to focus more on using HTAs for cost-effectiveness analysis ⁽¹⁾⁽²⁾.

How Is a Health Technology Assessment Conducted in the U.S.?

In the U.S., HTAs are mostly conducted in a decentralized and fragmented manner. The primary reason for it is limited public sector funding. In fact, most HTAs in the U.S. are funded by various private sector entities such as insurance companies, hospitals, and consulting firms ⁽⁵⁾.

The U.S. HTA system, however, contrasts with those in other countries, particularly within the European Union. While the U.S. lacks a national HTA program, EU countries have more centralized systems, where national bodies collaborate with the European Medicines Agency (EMA) to conduct HTAs ⁽⁵⁾⁽⁶⁾.

Conducting HTAs in the U.S. typically involves multiple stakeholders from both the public and private sectors ⁽⁶⁾. These include:

• Government agencies like the National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ)
• Independent, non-profit organizations such as the Institute for Clinical and Economic Review (ICER)
• Private organizations such as hospitals, and health maintenance organizations (HMOs)
• Academic institutions like universities

Case Study: Smart Innovation in Hospital-Based Health Technology Assessment (HB-HTA)

Implementing HB-HTA programs like Smart Innovation can streamline decision-making processes, leading to cost savings and avoidance of low-value technologies. Landaas et al. ⁽⁷⁾ evaluated the early impact of this program at the University of Washington Medical Center (UWMC). Utilizing Smart Innovation, the institute saw a 51% reduction in utilization and $647,658 cost savings for a procedure compared to controls. However, when another new technology was adopted without the HB-HTA program, the UWMC experienced no significant difference in utilization.

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References

1. Wang, Y., Rattanavipapong, W., & Teerawattananon, Y. (2021). Using health technology assessment to set priority, inform target product profiles, and design clinical study for health innovation. Technological Forecasting and Social Change, 172, 121000. doi:10.1016/j.techfore.2021.121000

2. Babidge, W. J. (2021). Global HTA: past, present, and future. Medical Writing, 30, 16-21.

3. O’Rourke, B., Oortwijn, W., & Schuller, T. (2020). The new definition of health technology assessment: A milestone in international collaboration. International journal of technology assessment in health care, 36(3), 187-190. doi:10.1017/S0266462320000215

4. van der Wilt, G. J., & Oortwijn, W. (2022). Health technology assessment: A matter of facts and values. International Journal of Technology Assessment in Health Care, 38(1), e53. doi:10.1017/S0266462322000101

5. Mulligan, K., Lakdawalla, D., Neumann, P. J., Wilensky, G. R., Goldman, D. P., Katz, R. J., … & Ryan, M. (2020). Health Technology Assessment for the US Healthcare System. USC Schaeffer Center.

6. Lakdawalla, D., Neumann, P. J., & Wilensky, G. R. (2021). Health Technology Assessment in the US–A Vision for the Future. USC Schaeffer Center.

7. Landaas, E. J., Hansen, R. N., Baird, G. S., & Sullivan, S. D. (2021). Assessing the early impact of a hospital-based health technology assessment program, smart innovation. International Journal of Technology Assessment in Health Care, 37(1), e76. doi:10.1017/S0266462321000477