Health Technology Assessment at the University of California-San Francisco

Gutowski, Christina J.; Maa, John; Hoo, Kent Soo; Bozic, Kevin J.

doi:10.1097/00115514-201101000-00004

Cited by 10 publications

(18 citation statements)

References 13 publications

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“…21 Several other studies described decisions for which organizations requested evidence syntheses, including choices between alternatives when standardizing products across a system, and choosing between vendors or manufacturers of similar products. [18][19][20][21][22][23][24] A health system in Australia sought evidence to inform decisions about disinvesting in technologies and practices. 25 …”

Section: Adoption Of Medical Technologymentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

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PrefaceThe Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public-and private-sector organizations in their efforts to improve the quality of health care in the United States.The reports and assessments provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments.To improve the scientific rigor of these evidence reports, AHRQ supports empiric research by the EPCs to help understand or improve complex methodologic issues in systematic reviews. These methods research projects are intended to contribute to the research base in and be used to improve the science of systematic reviews. They are not intended to be guidance to the EPC program, although may be considered by EPCs along with other scientific research when determining EPC program methods guidance.AHRQ expects that the EPC evidence reports and technology assessments will inform individual health plans, providers, and purchasers as well as the health care system as a whole by providing important information to help improve health care quality. The reports undergo peer review prior to their release as a final report.If AcknowledgmentsThe authors gratefully acknowledge the input of the late Robert Lewis Kane, M.D., who was a member of our workgroup until his unexpected death on March 6, 2017. Dr. Kane stimulated the conversation of our workgroup with his ideas and challenges, and inspired creation of the initial framework for our efforts (See Appendix B).The authors also acknowledge two health system representatives, Lucy Savitz, Ph.D., and Charles P. Friedman, Ph.D. for their feedback on our initial framework and draft report. A Framework for Conceptualizing Evidence Needs of Health Systems Structured AbstractObjectives. To develop a framework for understanding the evidence needs of health systems to inform the AHRQ EPC Program future efforts.Data sources. Three data sources were used: (a) peer-reviewed literature from a systematic search of English-language publications in MEDLINE from January 2007-April 2017, (b) original data from four programs serving health system requests for evidence syntheses, and (c) input during a face-to-face meeting at AHRQ in June 2017 from health system stakeholders and EPC investigators.Methods. Data were synthesized narratively and thematically. We developed an initial framework to guide discussion and qualitative analysis. We built consensus around themes and refinement of the framework through weekly phone conferences, electronic communications, and a face-to-face meeting of workgroup members and health systems experts. Results.From the literature review, we found that health systems seek evidence to ...

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Section: Adoption Of Medical Technologymentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

View full text Add to dashboard Cite

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“…In 2006, the UCSF Medical Center introduced a Healthcare Technology Assessment Program (HTAP) [15]. The structure and impact of the UCSF HTAP program has been outlined by Gutowski et al [15].…”

Section: Discussionmentioning

confidence: 99%

“…The structure and impact of the UCSF HTAP program has been outlined by Gutowski et al [15]. The experiences of the UCSF HTAP led to interest at two other academic medical centers (AMCs).…”

Section: Discussionmentioning

confidence: 99%

“…The expenditures for health care are estimated to equal 17% of the GDP in the United States [17]. The increasing cost of health care is recognized to be a multifaceted problem, and many potential strategies to control costs have been suggested [15,17,18].…”

Section: Introductionmentioning

confidence: 99%

“…In 2006 the University of California, San Francisco (UCSF) introduced a Healthcare Technology Assessment Program [15]. The program was unique in that it was a physician-led process.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Technology: Physician Collaboration in Reducing the Surgical Cost

Olson

Obremskey

Bozic

2013

Clinical Orthopaedics &Amp; Related Research

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Background The increasing cost of providing health care is a national concern. Healthcare spending related to providing hospital care is one of the primary drivers of healthcare spending in the United States. Adoption of advanced medical technologies accounts for the largest percentage of growth in healthcare spending in the United States when compared with other developed countries. Within the specialty of orthopaedic surgery, a variety of implants can result in similar outcomes for patients in several areas of clinical care. However, surgeons often do not know the cost of implants used in a specific procedure or how the use of an implant or technology affects the overall cost of the episode of care. Questions/purposes The purposes of this study were (1) to describe physician-led processes for introduction of new surgical products and technologies; and (2) to inform physicians of potential cost savings of physician-led product contract negotiations and approval of new technology. Methods We performed a detailed review of the steps taken by two centers that have implemented surgeon-led programs to demonstrate responsibility in technology acquisition and product procurement decision-making. Results Each program has developed a physician peer review process in technology and new product acquisition that has resulted in a substantial reduction in spending for the respective hospitals in regard to surgical implants. Implant costs have decreased between 3% and 38% using different negotiating strategies. At the same time, new product requests by physicians have been approved in greater than 90% of instances. Conclusions Hospitals need physicians to be engaged and informed in discussions concerning current and new technology and products. Surgeons can provide leadership for these efforts to reduce the cost of high-quality care.

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Evidence synthesis activities of a hospital evidence‐based practice center and impact on hospital decision making

Jayakumar

Lavenberg

Mitchell

et al. 2015

Journal of Hospital Medicine

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BACKGROUND Hospital evidence‐based practice centers (EPCs) synthesize and disseminate evidence locally, but their impact on institutional decision making is unclear. OBJECTIVE To assess the evidence synthesis activities and impact of a hospital EPC serving a large academic healthcare system. DESIGN, SETTING, AND PARTICIPANTS Descriptive analysis of the EPC's database of rapid systematic reviews since EPC inception (July 2006–June 2014), and survey of report requestors from the EPC's last 4 fiscal years. MEASUREMENTS Descriptive analyses examined requestor and report characteristics; questionnaire examined report usability, impact, and requestor satisfaction (higher scores on 5‐point Likert scales reflected greater agreement). RESULTS The EPC completed 249 evidence reviews since inception. The most common requestors were clinical departments (29%, n = 72), chief medical officers (19%, n = 47), and purchasing committees (14%, n = 35). The most common technologies reviewed were drugs (24%, n = 60), devices (19%, n = 48), and care processes (12%, n = 31). Mean report completion time was 70 days. Thirty reports (12%) informed computerized decision support interventions. More than half of reports (56%, n = 139) were completed in the last 4 fiscal years for 65 requestors. Of the 64 eligible participants, 46 responded (72%). Requestors were satisfied with the report (mean = 4.4), and agreed it was delivered promptly (mean = 4.4), answered the questions posed (mean = 4.3), and informed their final decision (mean = 4.1). CONCLUSIONS This is the first examination of evidence synthesis activities by a hospital EPC in the United States. Our findings suggest hospital EPCs can efficiently synthesize and disseminate evidence addressing a range of clinical topics for diverse stakeholders, and can influence local decision making. Journal of Hospital Medicine 2016;11:185–192. © 2015 Society of Hospital Medicine

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Health Technology Assessment at the University of California-San Francisco

Cited by 10 publications

References 13 publications

A Framework for Conceptualizing Evidence Needs of Health Systems

A Framework for Conceptualizing Evidence Needs of Health Systems

Healthcare Technology: Physician Collaboration in Reducing the Surgical Cost

Evidence synthesis activities of a hospital evidence‐based practice center and impact on hospital decision making

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