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Fulltext Landscape analysis of health technology assessment (HTA): systems and practices in Asia

Teerawattananon Y, Rattanavipapong W, Lin LW, Dabak SV, Gibbons B, Isaranuwatchai W, et al.

Int J Technol Assess Health Care, 2019;35(6):416-421.
PMID: 31594553 DOI: 10.1017/S0266462319000667

This paper explores the characteristics of health technology assessment (HTA) systems and practices in Asia. Representatives from nine countries were surveyed to understand each step of the HTA pathway. The analysis finds that although there are similarities in the processes of HTA and its application to inform decision making, there is variation in the number of topics assessed and the stakeholders involved in each step of the process. There is limited availability of resources and technical capacity and countries adopt different means to overcome these challenges by accepting industry submissions or adapting findings from other regions. Inclusion of stakeholders in the process of selecting topics, generating evidence, and making funding recommendations is critical to ensure relevance of HTA to country priorities. Lessons from this analysis may be instructive to other countries implementing HTA processes and inform future research on the feasibility of implementing a harmonized HTA system in the region.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
PERSPECTIVE: SOME CONCLUSIONS FROM MY LIFE IN HEALTH TECHNOLOGY ASSESSMENT

Banta HD

Int J Technol Assess Health Care, 2018 Jan;34(2):131-133.
PMID: 29609663 DOI: 10.1017/S0266462318000107

I have worked in health technology assessment (HTA) since 1975, beginning in the United States Congress Office of Technology Assessment (OTA), where we were charged with defining "medical technology assessment". My main concern in HTA has always been efficacy of healthcare interventions. After years in OTA, I was invited to the Netherlands in 1985, where the Dutch government invited me to head a special commission concerning future healthcare technology and HTA. From there, I became involved in over forty countries, beginning in Europe and then throughout the world. My most intense involvements, outside the United States and Europe, have been in Brazil, China, and Malaysia. During these 40-plus years, I have seen HTA grow from its earliest beginnings to a worldwide force for better health care for everyone. I have also had some growing concerns, outlined in this Perspective article. Within HTA, I am most disappointed by a narrow perspective of cost-effective analysis, which tends to ignore considerations of culture, society, ethics, and organizational and legal issues. In the general environment affecting HTA and health care, I am most concerned about the need to protect the independence of HTA activities from influences of the healthcare industries.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
Health Technology Assessment in Malaysia: Past, Present, and Future

Roza S, Junainah S, Izzuna MMG, Ku Nurhasni KAR, Yusof MAM, Noormah MD, et al.

Int J Technol Assess Health Care, 2019;35(6):446-451.
PMID: 30864531 DOI: 10.1017/S0266462319000023

OBJECTIVES: The aim of this study was to provide a comprehensive overview of the evolution of health technology assessment (HTA) in Malaysia over the past decade.
METHODS: We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation.
RESULTS: Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated.
CONCLUSIONS: HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
Investigating evaluation frameworks for health information systems

Yusof MM, Papazafeiropoulou A, Paul RJ, Stergioulas LK

Int J Med Inform, 2008 Jun;77(6):377-85.
PMID: 17904898 DOI: 10.1016/j.ijmedinf.2007.08.004

BACKGROUND AND PURPOSE: Evaluation of health information systems (HIS) enables the assessment of the extent to which HIS are fulfilling their objectives in supporting the services of healthcare delivery. This paper presents an overview of evaluation in health informatics and information systems.
METHODS: Literature review on discourses, dimensions and methods of HIS and IS evaluation. A critical appraisal of selected HIS and IS evaluation frameworks is undertaken in order to identify HIS evaluation dimensions and measures. The frameworks are compared based on their inclusion of human, organizational and technological factors.
RESULTS: We found that an increasing number of evaluation studies deal with two distinct trends of HIS: one considers human and organizational issues and the other is concerned with the employment of a subjectivist approach. Our review indicates that current evaluation methods complement each other in that they evaluate different aspects of HIS and they can be improved upon.
CONCLUSIONS: Evaluation is complex; it is easy to measure many things but not necessarily the right ones. Nevertheless, it is possible to consider, a HIS evaluation framework with more comprehensive and specific measures that would incorporate technological, human and organizational issues to facilitate HIS evaluation.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
Fulltext Interview: Health technology assessment in Asia: an emerging trend

Yang BM

J Comp Eff Res, 2012 May;1(3):221-4.
PMID: 24237405 DOI: 10.2217/cer.12.20

Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit)

Yusof MM, Kuljis J, Papazafeiropoulou A, Stergioulas LK

Int J Med Inform, 2008 Jun;77(6):386-98.
PMID: 17964851

The realization of Health Information Systems (HIS) requires rigorous evaluation that addresses technology, human and organization issues. Our review indicates that current evaluation methods evaluate different aspects of HIS and they can be improved upon. A new evaluation framework, human, organization and technology-fit (HOT-fit) was developed after having conducted a critical appraisal of the findings of existing HIS evaluation studies. HOT-fit builds on previous models of IS evaluation--in particular, the IS Success Model and the IT-Organization Fit Model. This paper introduces the new framework for HIS evaluation that incorporates comprehensive dimensions and measures of HIS and provides a technological, human and organizational fit.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*
Fulltext HISTORICAL DEVELOPMENT OF THE HTAsiaLINK NETWORK AND ITS KEY DETERMINANTS OF SUCCESS

Teerawattananon Y, Luz K, Yothasmutra C, Pwu RF, Ahn J, Shafie AA, et al.

Int J Technol Assess Health Care, 2018 Jan;34(3):260-266.
PMID: 29911515 DOI: 10.1017/S0266462318000223

OBJECTIVES: The aim of this study was to describe the historical development of the HTAsiaLink network, draw lessons for other similar initiatives globally, and to analyze key determinants of its success and challenges for its future development.
METHODS: This study is based on the collective and direct experiences of the founding members of the HTAsiaLink Network. Data were collected from presentations they made at various international forums and additional information was reviewed. Data analysis was done using the framework developed by San Martin-Rodriguez et al.Results and Conclusions:HTAsiaLink is a network of health technology assessment (HTA) agencies in Asia established in 2011 with the aim of strengthening individual and institutional HTA capacity, reducing duplication and optimizing resources, transfer and sharing of HTA-related lessons among members, and beyond. During its 6 years, the network has expanded, initiating several capacity building activities and joint-research projects, raising awareness of the importance of HTA within the region and beyond, and gaining global recognition while establishing relationships with other global networks. The study identifies the determinants of success of the collaboration. The systemic factors include the favorable outlook toward HTA as an approach for healthcare priority setting in countries with UHC mandates. On organizational factors, the number of newly established HTA agencies in the region with similar needs for capacity building and peer-to-peer support was catalytic for the network development. The interactional aspects include ownership, trust, and team spirit among network members. The network, however, faces challenges notably, financial sustainability and management of the expanded network.

Matched MeSH terms: Technology Assessment, Biomedical/organization & administration*