Decision making processes for introducing new health technology at institutional level: decision makers' perspective

Abstract

New health technologies have significantly improved health and quality of life. Nevertheless, they also create challenges in ensuring value for money and concerns over safety and efficacy. Health technology assessment (HTA) has been recognised as an essential tool in addressing these issues. However, concern about HTA dissemination and use by decision makers at institutional level has been expressed. This study explores health care decision makers' experiences concerning decision-making processes for the introduction and adoption of new health technologies at one group of not-for-profit private hospitals in South East Queensland. The aim of the study was to gain knowledge about HTA adoption at institutional level and suggest ways to encourage diffusion of HTA into practice. Thirteen in-depth, semi-structured interviews were conducted with key decision makers. Interviewees described decision-making processes as "informal". Safety and effectiveness were considered important, but cost and doctor demand were the standard drivers for decisions about the uptake of new technologies. The decision makers were generally unclear about HTA and its potential. Most information for decisions was based on information from suppliers, other hospitals within the group, and the people or departments who requested the product. The main areas identified for improvement were a desire to have a more formal process for evaluating new health technology, the need for unbiased and timely information, and the usefulness of hospital based, or local HTA. Findings from this study show that the evidence provided by HTA is not being fully utilised by decision makers in this group of hospitals to make informed decisions.