Introduction of New Health Technology in Surgery: An Alberta Environment Scan CADTH Symposium April 16, 2019 Edmonton, AB Poulin P, Robert J, Rudmik L, Schuler T Presented by: Paule Poulin
Disclosure I have no actual or potential conflict of interest in relation to this topic or presentation.
4+M Albertans Rural hamlets to urban centres 100,000 AHS employees 15,000 volunteers 7,900 medical staff 106 acute care hospitals 650 facilities 5 psychiatric facilities 8,471 acute care beds 23,742 continuing care beds 208 community palliative & hospice beds 2,439 addiction and mental health beds
Environment Scan Edmonton Zone Calgary Zone Misericordia Stollery Foothills Medical Community Peter Lougheed Grey Nuns Children’s Hospital Centre Centre Hospital Hospital Alberta Rockyview University Children’s Sturgeon General of Alberta Hospitals Community Hospital Hospital Royal South Health Hospital Campus Alexandra Hospital North Zone Central Zone South Zone Northern Queen Medicine Hat Chinook Red Deer Regional Lights Elizabeth II Hospital Regional Regional Hospital Hospital Hospital Hospital
What Did We Do? • Key ES survey elements: 1. Definition of new Health Technologies 2. Review process 3. Committee structure / Relevant decision-making bodies/individuals 4. Literature appraisal /Types and sources of information considered 5. Decision/adoption Process/ factors/ philanthropy 6. Budget authority 7. Outcomes measure
What Did we Find? • Key Challenges Encountered • Unwarranted variations in technology adoption • Silos decision making processes • Duplication of efforts • Significant budget impact • No outcomes reporting
What Did we Find? • Key Opportunity for Improvements • Coordination, Communication and Education • Guidance for topic identification and prioritization • Provincial Advisory Committee on Surgical Innovation (PACOSI)
PACOSI • Purpose • Enhance Communication, Coordination & Education • Provide Recommendations • Value & Impact • Implementation strategy • Outcomes reporting • Advise on Key Emerging Technologies
PACOSI • Roles • Topic identification and prioritization • Evaluate selected technology request • Recommend where the technology should be implemented • Evaluate budget impact across zones • Provide support for implementation strategy development • Facilitate post-implementation monitoring • Strengthen engagement with stakeholders • Review appeals
Committee Procedure PROVINCIAL REFERRAL EVIDENCE SYNTHESIS APPEALS RECOMMENDATION INTAKE DUE DILIGENCE & ASSESSMENT 4 1 2 3 6 5 • PACOSI review the • Due diligence team • Handle appeals • Stakeholders • Refer selected • PACOSI make R&R carry out evidence engagement requests for provincial scope assessment • Evaluate impacts review • Check priority and and scale across the Zones • Impact Assessments • Due diligence recommendations unmet needs • Suggest strategic to SSCN Core team identified • Budget/Risk/Benefit • Review requests & implementation • SSCN Core make analysis recommend how • Support business recommendations requests should • Report & to AHS leadership plan creation be handled at a Recommendation to for decision provincial level PACOSI • Performance monitoring
PACOSI Accountability and Reporting: Implementation, Monitoring Evaluation SSCN Core Make Recommendations Technology Requests Approval Pending: Evaluation, to AHS Leadership To PACOSI Clinical Trial, Funding Due diligence team Appeal Process Not Approved Assessment & Recommendation to Decision by AHS Leadership PACOSI Zone Operation Approved Purchase / Site Leaders Implement PACOSI Make Recommendations to SSCN Core
Acknowledgements • Trevor Schuler • Paule Poulin • David Williams • Sean Grondin • Jill Robert • Luke Rudmik • Jonathan White • Stacey Litvinchuk • And all members who participated in the Environment Scan
April 23, 2019
Surgery SCN PACOSI Membership Zone Clinical Department Head, Calgary Zone (or delegate). Zone Clinical Department Head, Edmonton Zone (or delegate). Clinical surgical leaders from each additional Zone/Site (Red Deer, Lethbridge, Medicine Hat, Grand Prairie, Fort McMurray Operational surgical leaders from each Zone (e.g., SOOs, ED Surgical Services, others) A representative from the AHS Innovation Evidence & Impact group A representative from Alberta Health, Alberta Advisory Committee for Health Technology (AACHT) Representatives from SSCN Core Committee leadership
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