Norton Healthcare (Louisville, KY) was selected as a finalist for the inaugural Health Devices Achievement Award, announced in June 2006, for its submission outlining how a technology assessment committee can help bring a disciplined approach to the adoption of new technologies.
The Health Devices Achievement Award recognizes outstanding initiatives undertaken by member healthcare institutions to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology. Learn about the other submissions that achieved recognition.
ECRI congratulates the applicant, George Hersch.
The emergence and rapid adoption of new medical technologies had significantly added to double-digit inflation in the supply budget at Norton Healthcare. Even more troubling, new technology was often adopted without evidence that it would contribute to better patient outcomes. In this environment, it became evident that competition within the organization for new technology dollars needed more rigorous oversight, both from a clinical efficacy and a cost-effectiveness perspective.
To address this issue, the organization's administration and Board of Directors agreed that a Technology Assessment Committee (TAC) should become part of the health system's critical infrastructure. The TAC would meet regularly to review new technologies under consideration. Based on a physician peer-review decision-making model—with evidence-based medical reviews at the heart of the decision criteria—the TAC would be expected to do the following:
Develop a process to ensure that all medical technologies used would be safe for patients.
Use third-party medical-evidence-based information like ECRI's HTAIS product to ensure that patients would experience better outcomes with the new technologies. (ECRI's Health Technology Assessment Information Service [HTAIS] provides members with broad access to health technology assessment information and research results so that decisions about medical devices, drugs, procedures, systems of care, and behavioral health interventions can be based on the best analysis of available evidence. HTAIS functions as a member-funded cooperative for the development and dissemination of evidence-based health technology assessment information, with the work performed by ECRI's Evidence-Based Practice Center staff. Many healthcare facilities use HTAIS analyses in conjunction with information from ECRI's Health Devices service to address technology management challenges.)
Allocate scarce financial resources to the most deserving service lines.
Understand the financial implications from a cost and reimbursement perspective.
As evidenced by the committee's composition, the Norton Healthcare TAC emphasizes medical staff involvement: The Chief Medical Officer and Associate Vice President of Medical Affairs play key roles on the committee, and nearly a dozen physicians from diverse medical backgrounds serve on the TAC, along with representatives from operations and financial departments. In addition, the organization recruited a clinician (a registered nurse with a strong surgical services background) to staff the committee and to provide members with research summaries on any technologies to be discussed.
The TAC also emphasizes the analysis of unbiased, evidence-based information. The committee relies on third-party services and its own internal research. And while information from device suppliers is used to better understand the products under consideration, supplier-sponsored studies are not used as part of the decision-making criteria. Furthermore, physicians who are championing a particular technology are required to disclose whether they have an economic interest in the company providing the technology.
Implementing the TAC has allowed Norton Healthcare to protect patients by rejecting suspect technologies (including one that the U.S. Food and Drug Administration subsequently removed from the market) and to adopt technologies using a more balanced approach, considering patient outcome improvements and related costs to the organization.