Hospital staff perspectives towards health technology assessment: data from a multidisciplinary survey

Abstract

Background Technology adoption in hospitals is usually based on cost-effectiveness analysis, feasibility and potential success. Different countries have embraced a range of principles to accomplish an effective comprehensive process of health technology assessment (HTA). The aim of the study was to analyse the viewpoints and relative weight of technology-oriented hospital staff members toward the clinical, social, technological and economic aspects of HTA. Methods Using a structured questionnaire, a survey was conducted among different professionals in an 850-bed hospital. Results We revealed a range of viewpoints among hospital staff members according to their personal characteristics and professional standpoints. The clinical aspects of HTA were considered ‘highly important’ (HI) by most participants, especially the ‘lifesaving’ parameter. Similarly, the ‘lack of effective alternative technology’ was ranked HI by a high percentage of participants, independent of their profession. Economic aspects were ranked HI only by half of the participants, while social and technological aspects were ranked HI only by a relatively low percentage. Nurses added ‘improving quality of life’, ‘increasing teamwork efficiency’ and ‘improving medical standards’. Allied health professionals focused on ‘lack of effective alternative technologies’ as a main argument for adoption of HTA, alongside increasing efficiency, budget savings and contribution to hospital reputation. Engineers emphasised the requirement of significant investment in infrastructure and increasing efficiency. Administrators ranked patient experience as HI. Interestingly, the high ranking of social aspects correlated with older responders, while junior staff ranked safety significantly higher. Conclusions A multi-perspective multidisciplinary approach would be beneficial for policy-makers at hospitals and even on a national scale in Israel.

Overview of information retrieval in a hospital-based health technology assessment center in a Swedish region

“…However, only one of them (8) mentioned information retrieval. In all, eight articles, four book chapters, and one report were included in the review (1;5;8–18).…”

“…The exact role of the library (expertise in information retrieval, access to resources, or something else) was not specified. Finally, Tal et al (18) mentioned an HB-HTA unit at the Shamir Medical Center in Israel that had the support of an information specialist, but they did not describe how this support was designed.…”

Multiple Criteria Decision Analysis (MCDA) for evaluating cancer treatments in hospital-based health technology assessment: The Paraconsistent Value Framework

“…However, as decision-making in hospitals is influenced by a set of factors, including clinical benefits, overall costs, business plans, and acceptability [ 16 ], the use of economic evaluation methods, particularly cost-effectiveness analysis (CEA), to assess the incremental benefit of new medical technologies provides little guidance, since it does not capture a number of important dimensions of value [ 17 ].…”

“…Such discussion has led to two taskforce reports from the International Society for Pharmacoeconomics and Health Outcomes (ISPOR) [ 18 , 19 ] and to extensive literature review [ 20 – 24 ]. Defined as both an approach and a set of methods that permit the simultaneous consideration and prioritization of different factors that may conflict during the decision-making process [ 16 , 25 ], MCDA has increasingly been used to support health-care decision-making in the hospital level [ 18 , 20 ]. These sets of methods offer a way to extend CEA to account for a wider variety of non-health benefits while allowing flexibility in the way that society collectively would like to make trade-offs between competing goals such as efficiency and equity [ 26 ].…”

“…The urge to do so in a limited timeframe may limit an appropriate benefit-risk balance. So, HB HTA might foster decision-making by involving skilled experts that inspire clinical excellence to support priority setting in the short term [ 15 , 16 , 25 ].…”