Understanding Canadian Health Technology Assessment through a systems lens

Abstract

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Systems thinking in health technology assessment: a scoping review

“…The difference between the number of studies included that considered single health interventions versus multiple health interventions might suggest that there is a general acceptance of a ), perioperative care (n = 1), perinatology (n = 2), oncology (n = 2), neurological (n = 2), multiple areas (n = 9), mental health (n = 1), infectious disease (n = 1), gastroenterology (n = 1), chronic diseases (n = 1), cardiovascular disease (n = 1). 4 Marina Richardson et al…”

“…Recently, Lopes and colleagues (4) conceptualized HTA from a system lens to capture the diversity and complexity of HTA as a system with multiple actors. The authors recognized that there are complex interactions among agents in a system and that a small change in one part of the system is likely to impact another part (4). A similar type of systems thinking could be used to consider to what extent the conduct of HTA takes a systems perspective and what the impacts of doing so are.…”

The most important facilitators and barriers to the use of Health Technology Assessment in Canada: a best–worst scaling approach

“…This is consistent with the strong emphasis that Canadian processes place on stakeholder engagement 38,39 , which has long been recognized as the key step to improved HTA uptake 40 . Stakeholder interactions have been described as central to the exchange and interpretation of information in the Canadian HTA process, which Lopes et al specifically characterize as "a social enterprise involving diverse people with differing world-views" 9 . Consistent with our results, they find that stakeholders value initiatives that bring them together to formulate recommendations 9 .…”

“…This network has been characterized as " … a complicated labyrinth … " 6 facing a multitude of challenges [5][6][7][8] . These arise because the system is complex, adaptive and composed of individuals with diverse perspectives 8,9 . Current shortcomings in the Canadian HTA system have been linked to inequity, delays in the equitable access to health technologies arising from differences in the management of P/T healthcare systems 9 .…”

“…Internationally, the processes and actual uses of HTA vary 10,11 , yet the influence of HTA has been judged as limited 9 . Factors that facilitate or hinder the use of HTA in policy making at the macro-and micro-levels have been studied for more than two decades [12][13][14][15] .…”