1. The document discusses the evolution of health technology assessment (HTA) from its origins in responding to decision-maker needs to its current role in knowledge mobilization and supporting universal health coverage.
2. Key aspects of mature HTA systems include assessing a wide range of health technologies, strong stakeholder involvement, and knowledge translation activities.
3. For HTA to be effective, it requires both scientific expertise to conduct assessments and links to decision-making through governance and stakeholder participation.
Placing the Evolution of HTA In Emerging Markets in Context of Health System ...Office of Health Economics
These slides were presented by Professor Adrian Towse at the 9th World Congress of the International Health Economics Association in July 2013. The presentation examined how the development of health care systems affect the evolution of the use of health technology assessment. Three countries provide case studies: Brazil, China and Taiwan.
The document outlines challenges facing the New Zealand health system and a long term framework (LTSF) to address them. Pressures include workforce shortages, rising costs and quality/safety issues. The LTSF focuses on system performance, clinical networks, and shifting care models. It also discusses the role of health information and communication technology in enabling new models of person-centered, integrated care and improving productivity. Key priorities include a national health information architecture and infrastructure to support information sharing and clinical collaboration.
Evaluating the impact of HTA and ‘better decision-making’ on health outcomescheweb1
This document outlines a conceptual framework for assessing the impact of health technology assessments (HTA). It begins by discussing what is already known about evaluating HTA, including the limited literature on long-term effects and barriers to implementation. The document then presents two case studies and proposes a theory-driven, realist approach to impact assessment using configurations of context, mechanism, and outcomes. Interviews and primary data collection are suggested to test an initial program theory regarding how and why HTA influences policy and practice. The goal is to produce guidance on effective implementation by understanding what works, for whom, and in what contexts.
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an ...cheweb1
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an Urban Regeneration context using economic evaluation techniques. Economic evaluation seminar presented by Camilla Baba, PhD candidate, University of Glasgow 12 May 2016
Health Technology Assessment (HTA) Report: Interventions to increase particip...HTAi Bilbao 2012
The document summarizes a Health Technology Assessment report on interventions to increase participation in organized cancer screening programs. It found that mail and phone recalls, as well as having a general practitioner's signature on the invitation letter, consistently increased participation. Fixed appointments also increased participation compared to open invitations. Self-sampling for HPV testing increased participation in non-responders relative to standard recall letters. The report evaluated interventions' efficacy, cost-effectiveness, organizational impact, and social/ethical issues.
This document discusses the relationship between research evidence and decision making in the context of health system reform. It makes three key points:
1) While decisions are influenced by many factors besides evidence, good research can guide decision makers towards better policies by highlighting issues and limiting discretion. However, evidence must also be seen as an empowering tool.
2) Health system reform is currently widespread as countries address both old and new health challenges. Reform processes need research to illuminate unknowns, and a research agenda should be integral to every reform initiative.
3) Essential National Health Research (ENHR) has an important role by ensuring research priorities are participatory and address national problems. ENHR can contribute to reform at
Accountability, Health Governance, and Health Systems: Uncovering the LinkagesHFG Project
This document summarizes evidence from literature and key informant interviews on different types of accountability mechanisms and their links to health governance and systems. It finds that accountability interventions can impact health governance, but their effects depend greatly on how they are designed and implemented based on context. Specifically, it discusses evidence around vertical and horizontal democratic, performance, and financial accountability mechanisms. Across studies, context and how interventions interact with context are consistently found to influence outcomes. The evidence points to effectively integrating contextual considerations into accountability efforts through multiple coordinated approaches, understanding change as systemic, expecting to iterate based on learning, and leveraging local meanings of accountability.
1. The document discusses the evolution of health technology assessment (HTA) from its origins in responding to decision-maker needs to its current role in knowledge mobilization and supporting universal health coverage.
2. Key aspects of mature HTA systems include assessing a wide range of health technologies, strong stakeholder involvement, and knowledge translation activities.
3. For HTA to be effective, it requires both scientific expertise to conduct assessments and links to decision-making through governance and stakeholder participation.
Placing the Evolution of HTA In Emerging Markets in Context of Health System ...Office of Health Economics
These slides were presented by Professor Adrian Towse at the 9th World Congress of the International Health Economics Association in July 2013. The presentation examined how the development of health care systems affect the evolution of the use of health technology assessment. Three countries provide case studies: Brazil, China and Taiwan.
The document outlines challenges facing the New Zealand health system and a long term framework (LTSF) to address them. Pressures include workforce shortages, rising costs and quality/safety issues. The LTSF focuses on system performance, clinical networks, and shifting care models. It also discusses the role of health information and communication technology in enabling new models of person-centered, integrated care and improving productivity. Key priorities include a national health information architecture and infrastructure to support information sharing and clinical collaboration.
Evaluating the impact of HTA and ‘better decision-making’ on health outcomescheweb1
This document outlines a conceptual framework for assessing the impact of health technology assessments (HTA). It begins by discussing what is already known about evaluating HTA, including the limited literature on long-term effects and barriers to implementation. The document then presents two case studies and proposes a theory-driven, realist approach to impact assessment using configurations of context, mechanism, and outcomes. Interviews and primary data collection are suggested to test an initial program theory regarding how and why HTA influences policy and practice. The goal is to produce guidance on effective implementation by understanding what works, for whom, and in what contexts.
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an ...cheweb1
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an Urban Regeneration context using economic evaluation techniques. Economic evaluation seminar presented by Camilla Baba, PhD candidate, University of Glasgow 12 May 2016
Health Technology Assessment (HTA) Report: Interventions to increase particip...HTAi Bilbao 2012
The document summarizes a Health Technology Assessment report on interventions to increase participation in organized cancer screening programs. It found that mail and phone recalls, as well as having a general practitioner's signature on the invitation letter, consistently increased participation. Fixed appointments also increased participation compared to open invitations. Self-sampling for HPV testing increased participation in non-responders relative to standard recall letters. The report evaluated interventions' efficacy, cost-effectiveness, organizational impact, and social/ethical issues.
This document discusses the relationship between research evidence and decision making in the context of health system reform. It makes three key points:
1) While decisions are influenced by many factors besides evidence, good research can guide decision makers towards better policies by highlighting issues and limiting discretion. However, evidence must also be seen as an empowering tool.
2) Health system reform is currently widespread as countries address both old and new health challenges. Reform processes need research to illuminate unknowns, and a research agenda should be integral to every reform initiative.
3) Essential National Health Research (ENHR) has an important role by ensuring research priorities are participatory and address national problems. ENHR can contribute to reform at
Accountability, Health Governance, and Health Systems: Uncovering the LinkagesHFG Project
This document summarizes evidence from literature and key informant interviews on different types of accountability mechanisms and their links to health governance and systems. It finds that accountability interventions can impact health governance, but their effects depend greatly on how they are designed and implemented based on context. Specifically, it discusses evidence around vertical and horizontal democratic, performance, and financial accountability mechanisms. Across studies, context and how interventions interact with context are consistently found to influence outcomes. The evidence points to effectively integrating contextual considerations into accountability efforts through multiple coordinated approaches, understanding change as systemic, expecting to iterate based on learning, and leveraging local meanings of accountability.
1) The document discusses a project called HTAIm (Health Technology Assessment and Implementation) which aims to support better decisions in healthcare through evaluating health technologies.
2) HTAIm was designed through literature reviews, stakeholder consultations, and iterative model building. It provides a blueprint for conducting health technology assessments that consider local context.
3) Case studies show HTAIm can identify low-value care and reduce costs, such as through an aged care emergency program that avoided ambulance transfers and ED presentations, saving $920,000 annually.
This document provides an overview of a seminar on international perspectives in eHealth. It discusses definitions of eHealth and various eHealth applications. It also discusses the importance of evidence-based medicine and evaluating eHealth interventions using rigorous scientific evidence. Challenges of eHealth evaluation include the complexity of eHealth interventions and involvement of multiple stakeholders. Guiding principles for effective eHealth evaluation emphasize the importance of considering contextual factors, stakeholder perspectives, and using emergent and narrative approaches.
This document discusses the Independent Hospital Pricing Authority's (IHPA) work on pricing reforms beyond 2020. Key points include:
1) IHPA sets national efficient prices, develops classification systems, and handles cross-border disputes to promote transparency, value, and efficiency in the public hospital system.
2) IHPA is moving public hospital funding toward an activity-based funding model, with blocks of funding still used in some areas. This has led to a significant slowdown in cost growth.
3) IHPA is developing pricing approaches to incentivize safety, quality and efficiency. This includes not funding episodes involving sentinel events, paying less for episodes complicated by hospital-acquired conditions,
Health Accounts Peer-Learning Workshop: Summary of Key Themes and DiscussionsHFG Project
In November 2016, over 60 government technicians, policymakers and technical advisors from 47 countries across the Americas, Africa, Asia and Europe participated in the first global Health Accounts Peer-Learning Workshop. During this workshop, participants shared their experiences and ideas on how to improve Health Accounts production and increase the uptake of Health Accounts results for policy.
This document discusses consumer demand for health information and how technology can help meet those needs. It explores health literacy and eHealth initiatives to promote access to information. Approaches by health organizations to provide education include patient portals, social media, websites and mobile apps. Challenges include the digital divide and ensuring information is understandable. Future directions may include more audio/video and personalized behavior change tools to improve disease management.
This document provides an overview of health technology assessment (HTA) through a presentation given at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean. It defines HTA and its goals of providing evidence-informed input to decision makers and ensuring value for money. The presentation outlines how HTA is a multidisciplinary activity that examines the effects of health technologies on resources, costs, technical aspects, and other issues. It provides examples of HTA implementation from Thailand, Iran, and other countries. The presentation calls for all countries to establish national HTA programs and capacities and emphasizes that HTA is especially important for resource-limited settings. It outlines future commitments and steps from member states and WHO to strengthen HTA in the
Value in healthcare aims to improve patient outcomes while lowering costs. It rewards providers for quality rather than quantity of care. While some progress has been made through examples like integrated systems in India and Germany that lower costs through better processes, value-based care has not been widely adopted due to barriers like entrenched financial incentives that prioritize volume over value. Fully realizing value-based care requires health informatics to track outcomes, benchmarking to share best practices, alternative payment models, and delivery innovations to better coordinate care.
Generating Quality Data through Collaborative Research with an ACOTodd Berner MD
This document summarizes a presentation about generating quality data through collaborative research with an ACO. The number of public and private ACOs is growing rapidly, with over 250 CMS MSSP ACOs covering 4 million Medicare beneficiaries. The goal of the collaborative research is to disseminate valued information on effectiveness and costs of care to payers and policymakers. Real-world evidence studies can provide insights beyond randomized controlled trials by observing patient outcomes across delivery system models. Measuring quality requires considering multiple stakeholder perspectives to identify metrics that drive improvement and have utility.
This document discusses strategies for electronic health records (EHRs) and compares centralized, top-down approaches to more incremental, bottom-up methods. It summarizes experiences with large national EHR programs in the UK, Canada, Australia and New Zealand that struggled due to a lack of local involvement and clinical benefits. Alternative approaches seen in Holland, Denmark and New Zealand that focus on clear objectives, flexibility and incentives are highlighted. The document advocates experimentation and collaboration over rigid centralized systems based on structural paradigms.
Psychiatrist - Saviour of the Cash Trapped NHS - Akmal Makhdum and Hashim RezaJP Rajendran
This document discusses the changing landscape of the NHS from 1997-2010 and the increasing financial pressures it faces. It outlines several key changes and initiatives over this period that aimed to improve outcomes, standards of care, and increase transparency and accountability. However, it questions whether an "information revolution" and increased monitoring can be sustained indefinitely given the NHS budget has more than tripled without corresponding increases in quality and outcomes. It suggests psychiatrists may need to take on more leadership roles to develop new care models and business opportunities to help ensure the future sustainability of mental health services.
This document discusses telehealth and telenursing. It begins by defining telehealth and describing its history. Telehealth utilizes technology to provide health services from a distance. While early uses date back centuries, major advances occurred in the last 50 years as technology improved. The document then discusses driving forces for telehealth like aging populations and provider shortages. It explores clinical applications of telehealth including transmitting images, data, and providing education. Telenursing involves using telecommunications for remote nursing care. Key roles of telenurses discussed are home telehealth, tele-intensive care, and chronic disease management. The tools, software, practice protocols and legal/ethical considerations of home telehealth are outlined. The future of more
Evidence-Informed Public Health Decisions Made Easier: Take it one Step at a ...Health Evidence™
The document outlines the steps involved in evidence-informed public health decision making. It discusses defining a focused question, efficiently searching for relevant research evidence such as from systematic reviews, critically appraising the research methods, interpreting the results and adapting the information to the local context, deciding whether and how to implement changes, and evaluating the effectiveness of changes made. The goal is to integrate the best available research evidence with local factors to inform public health policies and practices.
This document discusses strategies for achieving whole system change towards universal health coverage through primary healthcare renewal. It outlines that removing user fees, improving drug supply, maintaining health worker motivation, strengthening supervision and the gatekeeping role of primary care facilities requires considering the interlinkages of a system-level intervention. Whole system change to achieve good health at low cost requires effective primary care, fair financing, new health worker roles and payment mechanisms, and essential drug supply. Primary healthcare increases access, manages common health issues, prevents diseases, focuses on the individual and avoids unnecessary care. Universal health coverage aims to ensure all people obtain needed health services without financial hardship and requires raising funds, reducing financial barriers, allocating funds efficiently, meeting priority needs through integrated care
Strengthening the Health Workforce to Improve Quality and Achieve Universal H...HFG Project
Universal health coverage (UHC) means anyone can access necessary, good quality health care without suffering financial hardship. A strong health workforce is crucial to achieving UHC, but poor quality pre-service training and governance often weaken the health workforce. In many countries, governments and families alike spend their limited funds on pre-service training institutions that graduate health workers with inadequate skills, which can result in poor patient care and poor health outcomes. Further, some governments do not provide strong stewardship of the health workforce, and miss critical opportunities to improve morale, retention, and skills.
This presentation focuses on three countries that are taking a systems approach to solving these two problems, with help from HFG: Haiti, Côte d’Ivoire, and Swaziland.
In Haiti, HFG is working with the Ministry of Health to bolster its process for accrediting nursing education institutions, known as reconnaissance. More than 40 schools have already received the new accreditation. The government of Côte D’Ivoire identified task-sharing between nurses/midwives and doctors for HIV care as a key strategy to improve HIV outcomes. HFG is supporting the Ministry of Health in developing policies and training programs on task-sharing to integrate into health worker training curricula. In Swaziland, HFG is working with the government to establish standardized hiring and compensation policies for health workers, and to strengthen human resource information systems. HFG also worked with the Swaziland Nursing Council to strengthen their capacity to regulate the nursing profession and expand nursing competencies to incorporate international best practices.
Local leaders report that integrated care can provide benefits like reduced hospital delays and admissions as well as improved patient experiences. Factors helping integration include leadership commitment, joint planning, and collaborative working between organizations. Hindrances include different data/IT systems, organizational complexity, and cultural differences. To accelerate integration, leaders emphasize sharing good practices, addressing financial barriers, and providing practical IT solutions rather than more central guidance. While reform disrupted some joint working, leaders remain optimistic about continuing integration under the new structures. Population-focused initiatives, multidisciplinary teams, and shared values are seen as most effective for patients. Efforts prioritize older adults, those with learning disabilities, and mental health patients. Aspirations for 2015 include further developing pooled budgets
Better Health? Composite Evidence from Four Literature ReviewsHFG Project
The Marshaling the Evidence secretariat agreed that a cross-cutting synthesis paper was necessary to frame the work in the wider context of governance in health systems, drawing distinctions and consensus across all four TWG papers. Members of the secretariat, some of whom also were members of the TWGs, conducted the analysis across each TWG report and wrote the synthesis report. The report compiles results from the TWGs into a searchable database, contained in Annex 1. The report also lays the foundation for future action—from dissemination to further research agendas and policy plans.
9054 Cardiff Student Poster final .6.08bNicola Allen
This study aimed to systematically characterize and compare the processes for new medicine approval and reimbursement across different countries. The researchers created process maps for 11 countries that identified the key agencies involved, milestones, and activities. They found considerable variability between countries in terms of which agencies conducted evaluations, how they were connected, and where health technology assessment was included in the process. By developing this standardized framework for comparison, future studies can more easily analyze differences in factors like reimbursement timelines between nations.
% GDP spending in UK, G5 countries and OECD upper middle income countries. W...Office of Health Economics
The document discusses healthcare spending in Malaysia relative to other countries. It notes that while Malaysia spends around 4% of GDP on healthcare, this is split almost evenly between public and private spending. There are pressures to increase healthcare spending due to an aging population and shift to chronic diseases. While additional investment may pay off through economic and health gains, funding needs to be increased through measures like taxes on tobacco or reducing fossil fuel subsidies. The large public-private divide and high out-of-pocket spending also need to be addressed through more strategic purchasing of healthcare services.
Priority setting in uhc sep 9 short versionAlaa Hamed
A presentation delivered for the MNA Health Policy Forum to argue that HTA could be used to prioritize the selection of health services for the health benefit package taking in consideration equity, political economy, and country values.
Complimenting others can encourage good performance and improvement. Compliments express appreciation for someone's efforts, appearance, possessions, or achievements. Appropriate times to compliment others include special occasions, when someone has tried their best, or upon noticing something new. Common compliments acknowledge a performance, appearance, or job well done. The recipient should respond thanking the compliment giver for their kind words.
1) The document discusses a project called HTAIm (Health Technology Assessment and Implementation) which aims to support better decisions in healthcare through evaluating health technologies.
2) HTAIm was designed through literature reviews, stakeholder consultations, and iterative model building. It provides a blueprint for conducting health technology assessments that consider local context.
3) Case studies show HTAIm can identify low-value care and reduce costs, such as through an aged care emergency program that avoided ambulance transfers and ED presentations, saving $920,000 annually.
This document provides an overview of a seminar on international perspectives in eHealth. It discusses definitions of eHealth and various eHealth applications. It also discusses the importance of evidence-based medicine and evaluating eHealth interventions using rigorous scientific evidence. Challenges of eHealth evaluation include the complexity of eHealth interventions and involvement of multiple stakeholders. Guiding principles for effective eHealth evaluation emphasize the importance of considering contextual factors, stakeholder perspectives, and using emergent and narrative approaches.
This document discusses the Independent Hospital Pricing Authority's (IHPA) work on pricing reforms beyond 2020. Key points include:
1) IHPA sets national efficient prices, develops classification systems, and handles cross-border disputes to promote transparency, value, and efficiency in the public hospital system.
2) IHPA is moving public hospital funding toward an activity-based funding model, with blocks of funding still used in some areas. This has led to a significant slowdown in cost growth.
3) IHPA is developing pricing approaches to incentivize safety, quality and efficiency. This includes not funding episodes involving sentinel events, paying less for episodes complicated by hospital-acquired conditions,
Health Accounts Peer-Learning Workshop: Summary of Key Themes and DiscussionsHFG Project
In November 2016, over 60 government technicians, policymakers and technical advisors from 47 countries across the Americas, Africa, Asia and Europe participated in the first global Health Accounts Peer-Learning Workshop. During this workshop, participants shared their experiences and ideas on how to improve Health Accounts production and increase the uptake of Health Accounts results for policy.
This document discusses consumer demand for health information and how technology can help meet those needs. It explores health literacy and eHealth initiatives to promote access to information. Approaches by health organizations to provide education include patient portals, social media, websites and mobile apps. Challenges include the digital divide and ensuring information is understandable. Future directions may include more audio/video and personalized behavior change tools to improve disease management.
This document provides an overview of health technology assessment (HTA) through a presentation given at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean. It defines HTA and its goals of providing evidence-informed input to decision makers and ensuring value for money. The presentation outlines how HTA is a multidisciplinary activity that examines the effects of health technologies on resources, costs, technical aspects, and other issues. It provides examples of HTA implementation from Thailand, Iran, and other countries. The presentation calls for all countries to establish national HTA programs and capacities and emphasizes that HTA is especially important for resource-limited settings. It outlines future commitments and steps from member states and WHO to strengthen HTA in the
Value in healthcare aims to improve patient outcomes while lowering costs. It rewards providers for quality rather than quantity of care. While some progress has been made through examples like integrated systems in India and Germany that lower costs through better processes, value-based care has not been widely adopted due to barriers like entrenched financial incentives that prioritize volume over value. Fully realizing value-based care requires health informatics to track outcomes, benchmarking to share best practices, alternative payment models, and delivery innovations to better coordinate care.
Generating Quality Data through Collaborative Research with an ACOTodd Berner MD
This document summarizes a presentation about generating quality data through collaborative research with an ACO. The number of public and private ACOs is growing rapidly, with over 250 CMS MSSP ACOs covering 4 million Medicare beneficiaries. The goal of the collaborative research is to disseminate valued information on effectiveness and costs of care to payers and policymakers. Real-world evidence studies can provide insights beyond randomized controlled trials by observing patient outcomes across delivery system models. Measuring quality requires considering multiple stakeholder perspectives to identify metrics that drive improvement and have utility.
This document discusses strategies for electronic health records (EHRs) and compares centralized, top-down approaches to more incremental, bottom-up methods. It summarizes experiences with large national EHR programs in the UK, Canada, Australia and New Zealand that struggled due to a lack of local involvement and clinical benefits. Alternative approaches seen in Holland, Denmark and New Zealand that focus on clear objectives, flexibility and incentives are highlighted. The document advocates experimentation and collaboration over rigid centralized systems based on structural paradigms.
Psychiatrist - Saviour of the Cash Trapped NHS - Akmal Makhdum and Hashim RezaJP Rajendran
This document discusses the changing landscape of the NHS from 1997-2010 and the increasing financial pressures it faces. It outlines several key changes and initiatives over this period that aimed to improve outcomes, standards of care, and increase transparency and accountability. However, it questions whether an "information revolution" and increased monitoring can be sustained indefinitely given the NHS budget has more than tripled without corresponding increases in quality and outcomes. It suggests psychiatrists may need to take on more leadership roles to develop new care models and business opportunities to help ensure the future sustainability of mental health services.
This document discusses telehealth and telenursing. It begins by defining telehealth and describing its history. Telehealth utilizes technology to provide health services from a distance. While early uses date back centuries, major advances occurred in the last 50 years as technology improved. The document then discusses driving forces for telehealth like aging populations and provider shortages. It explores clinical applications of telehealth including transmitting images, data, and providing education. Telenursing involves using telecommunications for remote nursing care. Key roles of telenurses discussed are home telehealth, tele-intensive care, and chronic disease management. The tools, software, practice protocols and legal/ethical considerations of home telehealth are outlined. The future of more
Evidence-Informed Public Health Decisions Made Easier: Take it one Step at a ...Health Evidence™
The document outlines the steps involved in evidence-informed public health decision making. It discusses defining a focused question, efficiently searching for relevant research evidence such as from systematic reviews, critically appraising the research methods, interpreting the results and adapting the information to the local context, deciding whether and how to implement changes, and evaluating the effectiveness of changes made. The goal is to integrate the best available research evidence with local factors to inform public health policies and practices.
This document discusses strategies for achieving whole system change towards universal health coverage through primary healthcare renewal. It outlines that removing user fees, improving drug supply, maintaining health worker motivation, strengthening supervision and the gatekeeping role of primary care facilities requires considering the interlinkages of a system-level intervention. Whole system change to achieve good health at low cost requires effective primary care, fair financing, new health worker roles and payment mechanisms, and essential drug supply. Primary healthcare increases access, manages common health issues, prevents diseases, focuses on the individual and avoids unnecessary care. Universal health coverage aims to ensure all people obtain needed health services without financial hardship and requires raising funds, reducing financial barriers, allocating funds efficiently, meeting priority needs through integrated care
Strengthening the Health Workforce to Improve Quality and Achieve Universal H...HFG Project
Universal health coverage (UHC) means anyone can access necessary, good quality health care without suffering financial hardship. A strong health workforce is crucial to achieving UHC, but poor quality pre-service training and governance often weaken the health workforce. In many countries, governments and families alike spend their limited funds on pre-service training institutions that graduate health workers with inadequate skills, which can result in poor patient care and poor health outcomes. Further, some governments do not provide strong stewardship of the health workforce, and miss critical opportunities to improve morale, retention, and skills.
This presentation focuses on three countries that are taking a systems approach to solving these two problems, with help from HFG: Haiti, Côte d’Ivoire, and Swaziland.
In Haiti, HFG is working with the Ministry of Health to bolster its process for accrediting nursing education institutions, known as reconnaissance. More than 40 schools have already received the new accreditation. The government of Côte D’Ivoire identified task-sharing between nurses/midwives and doctors for HIV care as a key strategy to improve HIV outcomes. HFG is supporting the Ministry of Health in developing policies and training programs on task-sharing to integrate into health worker training curricula. In Swaziland, HFG is working with the government to establish standardized hiring and compensation policies for health workers, and to strengthen human resource information systems. HFG also worked with the Swaziland Nursing Council to strengthen their capacity to regulate the nursing profession and expand nursing competencies to incorporate international best practices.
Local leaders report that integrated care can provide benefits like reduced hospital delays and admissions as well as improved patient experiences. Factors helping integration include leadership commitment, joint planning, and collaborative working between organizations. Hindrances include different data/IT systems, organizational complexity, and cultural differences. To accelerate integration, leaders emphasize sharing good practices, addressing financial barriers, and providing practical IT solutions rather than more central guidance. While reform disrupted some joint working, leaders remain optimistic about continuing integration under the new structures. Population-focused initiatives, multidisciplinary teams, and shared values are seen as most effective for patients. Efforts prioritize older adults, those with learning disabilities, and mental health patients. Aspirations for 2015 include further developing pooled budgets
Better Health? Composite Evidence from Four Literature ReviewsHFG Project
The Marshaling the Evidence secretariat agreed that a cross-cutting synthesis paper was necessary to frame the work in the wider context of governance in health systems, drawing distinctions and consensus across all four TWG papers. Members of the secretariat, some of whom also were members of the TWGs, conducted the analysis across each TWG report and wrote the synthesis report. The report compiles results from the TWGs into a searchable database, contained in Annex 1. The report also lays the foundation for future action—from dissemination to further research agendas and policy plans.
9054 Cardiff Student Poster final .6.08bNicola Allen
This study aimed to systematically characterize and compare the processes for new medicine approval and reimbursement across different countries. The researchers created process maps for 11 countries that identified the key agencies involved, milestones, and activities. They found considerable variability between countries in terms of which agencies conducted evaluations, how they were connected, and where health technology assessment was included in the process. By developing this standardized framework for comparison, future studies can more easily analyze differences in factors like reimbursement timelines between nations.
% GDP spending in UK, G5 countries and OECD upper middle income countries. W...Office of Health Economics
The document discusses healthcare spending in Malaysia relative to other countries. It notes that while Malaysia spends around 4% of GDP on healthcare, this is split almost evenly between public and private spending. There are pressures to increase healthcare spending due to an aging population and shift to chronic diseases. While additional investment may pay off through economic and health gains, funding needs to be increased through measures like taxes on tobacco or reducing fossil fuel subsidies. The large public-private divide and high out-of-pocket spending also need to be addressed through more strategic purchasing of healthcare services.
Priority setting in uhc sep 9 short versionAlaa Hamed
A presentation delivered for the MNA Health Policy Forum to argue that HTA could be used to prioritize the selection of health services for the health benefit package taking in consideration equity, political economy, and country values.
Complimenting others can encourage good performance and improvement. Compliments express appreciation for someone's efforts, appearance, possessions, or achievements. Appropriate times to compliment others include special occasions, when someone has tried their best, or upon noticing something new. Common compliments acknowledge a performance, appearance, or job well done. The recipient should respond thanking the compliment giver for their kind words.
2015-12-11 UdM l’ETS en appui à la couverture sanitaire universelleReiner Banken
Présentation lors de la journée internationale de la couverture sanitaire universelle organisée par la Communauté étudiante de santé mondiale de l'Université de Montréal
Perkembangan ilmu pengetahuan di dunia islam222Kodogg Kritingg
1. Pada masa Daulah Abbasiyah, Baghdad menjadi pusat kemajuan ilmu pengetahuan dan intelektual Islam.
2. Banyak buku diterjemahkan dan ilmuwan berkembang dalam bidang filsafat, matematika, kedokteran, dan lainnya.
3. Periode ini menandai puncak kemajuan pendidikan dan ilmu pengetahuan dalam sejarah peradaban Islam.
The document discusses properties of right triangles and trigonometry including:
1) Identifying right triangles and their hypotenuse and legs.
2) Relationships between side lengths and angles, including using the Pythagorean theorem.
3) Defining trigonometric ratios of sine, cosine, and tangent and evaluating them given angle measures and side lengths.
4) Using trigonometry to solve real world problems involving right triangles.
This document provides rules for making nouns plural in English. It presents 6 main rules for adding suffixes like -s, -es, -ies to make words plural based on their spelling. It also lists irregular plurals that are formed by changing spellings or staying the same in plural form. Examples are provided to illustrate each rule. The document concludes with a practice activity to test understanding of regular and irregular plural forms.
Oral Cholera Vaccination in 2015 - Post Earthquake Nepal experienceAnuj Bhattachan
In Nepal, the earthquake affected 14 districts comprising a population of about 5.3 million in the early year of 2015. According to government of Nepal (GoN) figures, 488,579 houses were destroyed and 260,026 damaged. The water resources of about 660,000 to 1.3 million people were affected and between 850,000 to 1.7 million need sanitation support. Out of 5.3 million people in these 14 affected districts, 2.7 million were displaced and are likely to be at an increased risk for infectious diseases including cholera. These displaced communities are the most vulnerable population and should have the highest priority for implementation of preventive strategies, including possible mass vaccinations.
The Department of Health Services (DoHS), Government of Nepal (GON) implemented preventive strategy against enteric diseases including WASH in conjunction oral cholera vaccination in selected high risk villages of the affected districts.
همایش رازهای برنامه ریزی و کسب موفقیت در کنکور 93 چهارشنبه هفدهم مهرماه با ارائه ی مهندس احسان فارسی مقدم مشاور مجتمع رستگاران و مشاور ویژه ی گزینه دو در مجتمع غیردولتی رستگاران برگزار گردید
This document provides an overview of the business support services offered by Midnight Oil, including bookkeeping, tax preparation, payroll, network administration, and other customized services. Their goal is to provide clients with any business tools needed by taking on tasks like billing, payments, sales inputting, banking, vendor payments, accounts receivable, cash management, inventory management, report generation, and more. Services are customizable based on each client's specific needs and budgets.
This document provides information about an English learning website for kids called Learn English Kids. It is a basic level course where kids can learn shapes and colors in activities. The website is created and run by the British Council, the UK's international organization for cultural relations and education opportunities. It recommends grammar, speaking, and game activities to help kids learn English and have fun.
Ultrabooks are a new category of laptop promoted by Intel that are lightweight, thin, and use solid-state drives for better performance. They are designed to compete with tablets but provide the full functionality of a notebook. While more expensive initially, Ultrabooks offer longer battery life, faster responsiveness and are becoming more widely available from manufacturers like Samsung, Dell, Asus, and Apple.
This document discusses hopes and dreams and how to express them. It defines hopes and dreams as something we want to happen but are unsure will occur. It provides examples of expressing hope using present continuous verbs ("I am hoping"), verbs with "to" and "that" ("I hope to become"), and verb tenses ("I hoped to win"). Additionally, it notes hopes can be expressed using the verb "want" followed by an infinitive ("I want to sing"). The document also briefly discusses congratulating others and provides sample congratulatory responses.
Strengthening health systems in Sub-Saharan Africa requires health policy and systems research and analysis (HPSR+A). HPSR+A takes a multidisciplinary approach to understand how health systems function and how to improve them. It also examines how to influence health policies and implement policies effectively to strengthen systems. Some priorities for HPSR+A include conducting mixed-method longitudinal studies, using theory, and thinking outside disease-specific approaches to consider the broader health system issues. Several HPSR+A studies provided examples of how health systems can be strengthened by taking a systems perspective rather than just focusing on individual programs or diseases.
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Paper Assignment # 2 Using your exploration from paper 1, .docxbunyansaturnina
Paper Assignment # 2
Using your exploration from paper 1, choose one (1) way to use health information
technology to address your identified community health related issue and describe
the process of implementation in a chosen context. Paper should be approximately
5-6 pages, (not including title or reference pages). It is to be written in APA format.
The following information needs to be included in the paper:
1. Introduce your idea and identify the context of how your HIT idea will be used
2. Discuss theoretical support for your idea
3. Identify a goal for your idea and three (3) objectives
4. Detail strategies you will take to implement your idea
5. Discuss anticipated barriers to implementation
Limited Developing Mastery
Introduction and
identification of
context
No introduction or
elementary
introduction with no
context or
supporting evidence
provided
Basic introduction
with limited
details and
minimal context or
supporting
evidence
Detailed introduction
of topic with context
and supporting
evidence provided.
Theoretical support,
goal statement and
objectives (Total 3
objectives must be
provided)
No theoretical
support, goal
statement or less
than 3 objectives
for proposed idea
Basic discussion of
theory, basic goal
statement and non-
specific objectives
Detailed, in-depth
discussion of how
theory applies to idea,
detailed goal
statement and (3)
specific measurable
objectives.
Process for
implementation and
anticipated barriers
No process of
implementation
presented or no
barriers identified
Limited process of
implementation
discussed with few
examples and
minimal discussion
of barriers
Detailed Process
of implementation
discussed,
multiple
examples, and
substantial
discussion of
barriers
Conclusion No conclusion
paragraph included
Basic conclusion Detailed conclusion of
topic
References 0-2 references 3-4 references 5 or more references
Paper Assignment #1
Some of the health related issues from the community commons report include being
overweight and obesity. These conditions increase a person's chances of dying from type 2
diabetes, hypertension, coronary heart disease, stroke, osteoarthritis, respiratory issues, and sleep
apnea, and breast, colon, and prostate cancers. Research shows that maintaining physical fitness
can help stop or decrease some to the chances in getting some of these illnesses.
Using the EHR System to Improve Outcomes for Older Adults
Studies conducted by nurses show that the effective use of Electronic Health Record
System (EHR) can progress results of significance to older adults suffering from pressure ulcers
and falls. Bowles and colleagues assessed the effect of an assimilated EHR in various hospitals
on the course and outcome indicators for patient falls and pressure ulcers acquired from the
hospitals. They discovered that the EHR system was linked with improved fall and pressure u.
Health technology assessment- Dr. Saraswathy MD, PGIMERYogesh Arora
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2. HTA involves systematically evaluating medical, economic, social, and ethical aspects of health technologies to inform policy decisions. It aims to maximize health benefits within limited budgets.
3. India has established the Health Technology Assessment Board to conduct HTAs and provide recommendations to guide public health programs and policies. However, developing local evidence and building capacity remains an ongoing challenge.
This document summarizes presentations from a MEASURE Evaluation event on making health information available to improve health. It discusses MEASURE Evaluation's work strengthening health information systems and monitoring and evaluation systems in various countries. A key presentation summarized MEASURE Evaluation's guide for monitoring and evaluating health systems strengthening initiatives. Another presentation discussed MEASURE Evaluation's initiative to strengthen health information systems in Latin America and the Caribbean through regional coordination, country-led processes, and knowledge sharing between countries.
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Findings: Health technology assessment (HTA) creates a common language among health care providers to improve engagement and patient centred care. Optimization of health technology assessment involves the development of relationships, education, and simple technological tools to create a culture of HTA acceptance.
The document provides an overview of comparative healthcare systems and their development. It discusses definitions of healthcare systems and how they are shaped by their operational environments. Key components of healthcare systems include service delivery, health workforce, health information, medical products/technologies, financing, and leadership/governance. The document outlines variables to consider when comparing systems, such as cost, outcomes/quality, and access to services. It provides frameworks for measuring system performance and lists factors that influence the expected outcomes of well-functioning systems.
Personal Connected Health Alliance StrategyPCHA2016
Discover the new 5 year strategy of the Personal Connected Health Alliance (PCHA) to achieve personal health and wellness for everyone. Visit pchalliance.org for more information about PCHA.
Join us at the Connected Health Conference in Washington D.C. on December 11-14, 2016. For more information, visit www.pchaconference.org.
Personal connected health is currently characterized by limited thought leadership, insufficient coordination and collaboration, and a lack of awareness and understanding of the full potential by all stakeholders: public, providers, policymakers, industry and patients. The Personal Connected Health Alliance is defining the the field of personal connected health to inspire market and policy innovation, research and collective action for sustained adoption of personal connected health technology. The vision is better health and well being for all through increased personal responsibilities and connectivity as well as improved care delivery enabled by technology.
Personal Connected Health Alliance StrategyMary Sheridan
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Join us at the Connected Health Conference in Washington D.C. on December 11-14, 2016. For more information, visit www.pchaconference.org.
Health technology assessment (HTA) is a tool that examines the medical, economic, social and ethical implications of new technologies. HTA helps policymakers evaluate the clinical and cost effectiveness of technologies compared to existing standards of care given finite healthcare budgets. HTA analysis considers factors like health outcomes, costs, and implementation challenges to help prioritize funding and expand coverage. While not a perfect solution, HTA can increase transparency and legitimacy around difficult healthcare spending decisions.
This document presents a framework for strengthening public and patient engagement in Health Quality Ontario's evidence review process. Key elements of the framework include articulating goals and principles, establishing a common language, describing a menu of engagement approaches matched to process stages, and identifying measures. The framework was developed through a review of literature and practices, expert consultation, and stakeholder dialogue. It recommends increasing transparency, incorporating diverse perspectives throughout stages, and evaluating engagement impacts. The framework provides guidance to enhance public and patient contributions to health technology decision-making in Ontario.
HIA in Decision Making: What We Know and What We Need to Know Francesca Viliani
HIA in Decision Making: What We Know and What We Need to Know presentation made at the 2015 Global Health Forum on “Public Health Governance” in Taiwan
This document outlines strategies for building a person-centered health system in New Zealand, including:
1) Shifting from a provider-centric to person-centric model organized around individual needs.
2) Developing interoperable health IT systems to improve information sharing across settings and support personalized care.
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1. Incorporating
HTA into
Health
Systems
Reiner Banken M.D. M. SC.
Advisor to the CEO, Alliances and Networks
reiner.banken@inesss.qc.ca
Cape Town, Oct 4, 2014
HTA in Sub-Saharan
Africa meeting: Use of
HTA in Health Systems
strengthening
2. 2
Objectives of the presentation
• Understanding
– the objectives for introducing HTA
– the evolution of HTA in Health Systems
– the human resources and instutional arrangements
necessary for effective HTA
3. 3
Outline
• Why should Health Systems use HTA ?
• Messages from high income countries
• From HTA to action: Context, policy tools and
governance
• Resources needed
• Conclusion
4. 4
Why should Health Systems
use HTA ?
Improve the quest for clinical excellence
Support the efficient use of health technologies
Inform the formulation of safe, effective, sustainable
decision-making in health systems that is patient-focused and
seeks to achieve best value
Favor consensus between clinicians and managers
Define benefit packages for health care
Provide evidence for the development of clinical practice
guidelines
Increase the transparency of decision-making
All of the above and more
6. 6
Why should you support the
development of HTA?
Decision-makers in all Health Systems are being
held accountable for not meeting the rising
expectations of patients, clinicians and the public.
HTA can partially solve this
unsolvable problem.
HTA makes your life easier
7. 7
The price to be paid….
HTA as a service for the health system
cannot work without rigor, independence
and transparency.
8. 8
The “natural history” of health
technology assessment: emergence,
consolidation, and expansion.
• Emergence: need expressed by decision-makers in a context
of depoliticizing allocation decisions in times of increasing
resource constraints, importance of leaders, development of
the scientific know-how, high cost medical device focused,
little stakeholder involvement,
• Consolidation: more structured organizational HTA systems,
priority setting, enlargement of scope of technologies,
increased stakeholder involvement
• Expansion: multiple disciplines, multiple products, political
recognition, HTA system, strong stakeholder involvement,
investment into Knowledge translation
Battista RN, Hodge MJ . Int J Technol Assess Health Care.
2009 Jul;25 Suppl 1:281-4.
9. 9
INESSS – 40 years of science
advice for decision-making
1972 1991
1996
Conseil d’évaluation des
technologies de la santé
(1988)
Réseau de revue
d’utilisation des
médicaments
January, 19,
Agences d’évaluation
des technologies et
des modes d’intervention
en santé
Comité de revue
de l’utilisation des
médicaments
2000
Conseil consultatif
de pharmacologie
Conseil du
médicament
2003
2003
Institut national
d’excellence
en santé et en
services sociaux
Social Services
Clinical Practice
Guidelines
2009
2011
1988
2011
Medical Biology
Lab tests
10. 10
HTA in the 21 century – A
perspective from Political Science
• HTA has developed in a relatively depoliticized environment … buffered
from the capricious impacts of electoral politics.
• HTA in all the countries began with relatively politically innocuous studies
of technologies recognized to be of major import to national health
systems or researcher-initiated studies.
• However, with increased focus in health systems on explicit determination
of health benefits baskets, the role of HTA has become more high profile.
This means that political accountability for the entire HTA process will
increase.
• The implication is that future management of HTA programs will require
self-conscious attention to the building of institutions capable of handling
the delicate process of integrating science and politics in health policy.
Citation from the abstract of Chinitz. Health technology
assessment in four countries: response from political science.
IJTAHC 20:1 (2004), 55–60
11. 11
Messages from the evolution of
HTA
1. The use of HTA in Health Systems is evolving over time.
2. Institutions (rules, organisations, legal frameworks) are
important and should enable HTA to evolve.
3. Mature HTA systems include a wide range of health
technologies and interventions to be assessed, strong
stakeholder involvement and knowledge mobilisation
activities.
4. The development of HTA takes place in a political arena; the
objectives and processes have to clear from the start.
12. 12
Reasoning in HTA
Implementation
Appropriateness
Effectiveness
and safeness
How should we do
it here?
Should we
do it here?
Can it
work
here?
(here=context
of decision-making)
Theoretical
safety and
Can it work? efficacy
Research
Translational research
Adapted from Health technology assessment of medical devices. WHO Medical device technical series,
2011. Available at: http://whqlibdoc.who.int/publications/2011/9789241501361_eng.pdf
13. 13
Context is essential for evidence-informed
decision making
There are decisions that…
take good
evidence …
… and use it
well
in context
w i t h o u t c o n t e x t
i n c o n t e x t
poor evidence … and use it poorly
…
without context
Adapted from Shaxson, L 2004: Evidence-based policy making: if it exists
what makes it robust? Available at http://bit.ly/hIsNC
14. 14
On Context
1. Stakeholder involvement is an important element
of scoping and contextualizing HTA.
2. Health Service Research and Implementation
Science are important for providing a perspective of
health systems context.
3. The capacity of health information systems to
provide contextual data is very useful for
supporting the context aspect of the HTA
knowledge synthesis
15. 15
Health Technology Assessment for
Improving Health Systems and
Health
Governance
Health Technology
Efficient Health Systems
Improving population
health
Appropriate
Use
Decisions
Policy Tools
HTA
16. 16
Science, decisions and policy
tools for pharmaceuticals
Governance Current tools in Québec
Knowledge
Uncertainties
Drug
Reimbursement
Decision
Policy
Tool
•Regular list
•« Médicament d’exception »
•Refusal
Other possible tools,
currently not available
•CED
•Risk sharing
•Limited to specific
settings
•…
17. 17
Impact of HTA depends on links to
policy instruments
In some countries there are specific mechanisms that lead to the
incorporation into policy instruments of research such as Health
Technology Assessments (HTAs) ….no direct link between the
amount of money spent on HTA and its impact on the decision-making
process. Indeed, they suggest that small programmes
can be involved in the core of the policy-making structure whilst
larger HTA programmes have difficulty in demonstrating
impact….It seems clear that HTAs have had most impact in
those situations where there are specific mechanisms in place
that require research evidence to support well-defined policy
decisions on provision, coverage or reimbursement.
Citation from Hanney et al. The utilisation of health research in policy-making:
concepts, examples and methods of assessment. Health
Research Policy and Systems 2003, 1:2
18. 18
How to start the process and
make it last?
“Start small, have a clear
audience and scope, and address
important questions”
(Lavis et al 2008, Synthesis of findings from a
multi-method study of organizations that
support the use of research evidence)
19. 19
Dedicated resources for HTA
1-2 persons
HTA Knowledge
Mobilizer
Putting HTA
into Context
HTA Unit/
Agency
4-5 persons
>9 persons
Dedicated
Resources
HTA
Committee
HTA
System
20. 20
Human resources and objectives
1-2 persons
4-5 persons
>9 persons
Team with health
economist, librarian and
social scientist.
Translation of HTA
knowledge produced
elsewhere into the local
decision-making context.
Clinician champion with
scientific background in
knowledge synthesis. Receptor
for HTA knowledge produced
elsewhere. Second person could
act as an HTA Knowledge
mobilizer and support an HTA
Committee.
Multidisciplinary team
for HTA Knowledge
Synthesis and Knowledge
Mobilisation
21. 21
Guiding principles
• If you do not have the human resources to do scientific
knowledge synthesis, you cannot do HTA.
• If you do not have good links to decision-making, you
can do HTA, but it will not be effective.
• If you do not have strong stakeholder participation and
health systems governance, HTA will not be effective
for Universal Health Coverage.
22. 22
Spectrum of HTA implementations
• Level of governance: HTA for hospital based decision-making,
for health system level decision-making, for decision-making
by health insurances Multi-jurisdictional HTA, HTA for
international decision-making ??? (WHO, World Bank,
international development, …)
• Objects and objectives: selected non pharmaceutical
technologies, wide range of technologies including care
processes, health care delivery models, health benefit
baskets, Universal Health Coverage.
• Dedicated resources: HTA receptor, small unit, full blown
HTA agency, networked HTA (crowdsourcing ?)
23. Agenda setting- the policy context in Colombia
Problem
stream
Policy
stream
Politics
stream
Policy
window of
opportunity
2
2004 inflationary costs
and raising exceptions,
government starts
considering HTA
processes
2008 Constitutional
court´s mandate to
amend structural
factors
2008 National
methods
guidelines
Early 2009 crisis
within the health
system threatening
sustainability
Policy
window of
opportunity
Mid 2009
increased
interest in NICE
methods and
processes,
government´s
official request
for technical
advice
Late 2009
controversial
law of social
emergency by
former
president
1
2007 Decision
making body
created not an
HTA agency
2011 HTA
agency
(IETS)
enacted by
law
2012 HTA
agency
(IETS) starts
operations
Late 2010
New
government
Early 2010 law of
social emergency
declared
unenforceable
04 05 06 07 2008 2009 2010 11
Source: Based on Kingdon model- 1984 by Castro HE, 2013 work in progress
12
2012 Decision
making body
abolished lack of
legitimacy
2013 POS
content
updated
using HTA by
IETS
13
Hector Castro, IETS, Columbia. From presentation at EMRO First Intercountry HTA Meeting,
November 2013, used with permission.
24. 24
HTA as a service for the health system
cannot work without rigor,
independence and transparency
The strategies of influence entail a number of risks that may undermine the
scientific evaluation of drugs. Some outcomes of drug evaluation may favour
the interests of multinational drug companies over those of the public payer.
We suggest that the risks involved in drug evaluation might be mitigated
through (1) professionalization of health technology assessment; (2)
restriction of job seeking and post public-payer employment; (3) disclosure
and management of experts’ conflicts of interest; (4) institutionalisation
of patient and public involvement; and (5) increased institutional
separation of the AHTAPol from political elites.
Citation from the abstract of Ozieranski et al. The politics of health
technology assessment in Poland. Health Policy 108 (2012) 178–193
25. 25
Strategies for Africa
• Developping scientific capacity for knowledge synthesis in
collaboration with universities, the Cochrane Collaboration,
EVIPNet Africa, and other Health Systems Research initiatives.
• Capacity building with existing HTA networks, such as
INAHTA.
• Using country or region specific Policy Windows.
• Regional communities of practice in HTA.
• Promoting the need for HTA with policy makers and funding
agencies , but also the necessary conditions of rigor,
independence and transparency
• Linking HTA to collaborations in regulation for
pharmaceuticals and devices (NEPAD ?, ECOWAS ?,…)
26. 26
Conclusion
• HTA as a service for the health system cannot work
without rigor, independence and transparency.
• HTA should be implemented gradually, starting with
scientific human resources.
• HTA Systems need institutions (organisations, legal
frameworks, dedicated resources)
• HTA relies on strong stakeholder participation and
health systems governance in order to contribute
significantly to Universal Health Coverage.