Maritime provinces symposium on health technology assessment

Abstract

Canada's Maritime Provinces have no provincial health technology organizations; therefore, the awareness and utilization of health technology assessment in health care decision making is limited. Dalhousie University Continuing Medical Education and the College of Pharmacy have experience in developing evidence-based interprofessional educational interventions and aimed to address this deficiency. Why We Undertook This InitiativeThe rapid innovation and diffusion of health technologies is straining health care budgets. The term health technology includes drugs, medical devices, equipment, and procedures. Systematic reviews synthesize evidence for the efficacy of these technologies. However, adoption of many health technologies has societal implications that extend beyond efficacy. Health technology assessment evaluates other factors including safety, cost-effectiveness, effects on the health care system, and ethical issues. It requires people with diverse skills such as clinicians, epidemiologists, ethicists, administrators, economists, pharmacists, and biomedical engineers.For example, suppose scientific evidence shows benefit from a new surgical procedure and there is pressure on the hospital administration to provide it. Adopting a health technology assessment approach allows decision makers to systematically look at the consequences of adopting the procedure by asking questions such as: How safe is the procedure? How many patients might be candidates? How much operating time is required? How many other operations or interventions will not be done if it is adopted? How much training will surgeons and support staff need? How much will it cost to buy and maintain required equipment? Current trends in CME emphasize the role of organizational and interprofessional factors, the same factors that are evident in health technology assessment. What We DidWe developed a 2-day symposium for clinicians and decision makers in the Maritime Provinces. The overall goal was to increase the awareness of health technology assessment and promote evidence-based decision making. To maximize interaction, we limited attendance to 60 participants (participants included administrators of health care organizations, decision makers from provincial governments, physicians, pharmacists, biomedical engineers, academics, and graduate students) and developed 2 cases: assessment of a drug and a medical device. Before the symposium, participants selected 1 case and received 2 documents for presymposium reading: a technology report and a workbook that guided them through the issues involved in deciding whether to recommend adoption of the technology.Ninety-minute workshops were devoted to critical appraisal of the reports, and discussion periods occurred through the symposium. Program content included economic assessment, quality-of-life measures, ethical issues, national and international examples of health technology assessment, and other topics. The final session was a panel with a health economist, a hospital executive, and two CEOs of healt...