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Strategic plan 1994 British Columbia Office of Health Technology Assessment Oct 7, 2014

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ooooooooooDoooooB.C. OFFICE OFHEALTH TECHNOLOGYASSESSMENTSTRATEGIC PLAN1994This document was prepared by the Steering Committee of the BCOHTAwith the assistance of the Health Management Resource GroupoooooooooooooooooTABLE OF CONTENTS1.0 INTRODUCTION 12.0 MISSION, PURPOSE AND OBJECTIVES 12.1 Mission 12.2 Purpose 12.3 Objectives 23.0 INTERNAL ASSESSMENT 23.1 BCOHTA Faculty and Staff 23.2 Market Analysis - Who do we Serve? 33.3 Client Feedback 43.4 Active Liaisons :...................................................................................... 54.0 EXTERNAL ENVIRONMENT 64.1 Reforming Health Care Delivery in British Columbia.......................................... 64.2 Anticipating Our Clients' Needs :.................. 65.0 STRATEGIC DIRECTIONS 7LIST OF APPENDICES 8A. CONTRACT WITH THE MINISTRY OF HEALTH (SCHEDULES A & B)B. EVALUATION OF BCOHTA (EXECUTIVE SUMMARy)C. LIST OF DISCUSSION PAPERS AND REPRINTSD. SUMMARY OF REQUESTS FOR INFORMATIONE. LIST OF TECHNOLOGY RESEARCH REQUESTSF. RECOMMENDATIONS RE: COMMUNICATIONSThe British Columbia Office of Health Technology Assessment (BCOHTA) was established inthe fall of 1990 with the specific goal to "promote and encourage the use of assessment researchin policy and planning activities at the government level and in policy, acquisition andutilization at the clinical and operational levels." The office is funded by the Ministry of Healththrough a grant to the Centre for Health Services and Policy Research, based at the Universityof British Columbia. This strategic plan has been developed to help chart the future direction ofBCOHTA.oooooDoB.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLAN1.0 INTRODUCTION1ooooooooooIn this plan the Mission and Objectives of BCOHTA are reviewed together with an assessmentof the internal and external environments and an evaluation of the results to date. Strategicdirections for ensuring the ongoing success of BCOHTA are proposed.2.0 MISSION, PURPOSE AND OBJECTIVES2.1 MissionTo promote the use of health technology assessment in clinical and public policydecision-making through the evaluation and dissemination of information and researchregarding the safety, efficacy, effectiveness and efficiency of emerging and existingtechnologies as well as an examination of social, ethical and political implications.2.2 PurposeTo review, evaluate and disseminate health technology research and information inaccordance with the priorities of the Steering Committee of the B.e. Office of HealthTechnology Assessment. Health technology includes the drugs, devices and medical orsurgical procedures used in health care and the organizational/administrative/financial and support systems through which health care services areprovided.2. To identify technologies for review using established criteria.3. To develop communication strategies for the dissemination of research resultsand technology assessment information.4. To promote the application of the results of critically-appraised healthtechnology assessments in decision making among health care providers andpolicy makers.1. To review systematically the literature on selected health technologies usingappropriate methodology, and to provide consultation and expert assistance toindividuals and organizations undertaking technology assessment.22.3 ObjectivesB.C. OFFICE OFHEALm TECHNOLOGY ASSESSMENTSTRATEGIC PLANoooooooooThe above objectives refer to our major activities in the areas of research,communication, education and consultation.3.0 INTERNAL ASSESSMENToooooooo3.1 BCOHTA Faculty and StaffBcomA was established by Dr. Arminee Kazanjian, chair of the Steering Committee,Associate Director of the Centre for Health Services and Policy Research and AssociateProfessor in the Department of Health Care and Epidemiology and Kathryn Friesen,MSc, Program Manager, in conjunction with the Division of Policy, Planning &Economics of the B.C.Ministry of Health.There are two other Centre faculty involved extensively with the activities of theBcomA: Dr. Samuel B. Sheps, Head of the Department of Health Care andEpidemiology who serves on the BCOmA Steering Committee, and Dr. KennethBassett, a medical consultant to the Office who is also a practicing physician part time.Seven other core staff, both full and part-time, support the office research activities: onemedical consultant, two researchers, one research assistant, one librarian, one libraryassistant and a secretary.We have been fortunate to attract and keep faculty, staff and consultants with theinterests, skills and aptitude in developing the expertise to work in this complexenvironment. This is critical if we are to continue to achieve our goals.Despite cramped quarters and an extremely taxing workload, we have developed anenvironment which supports teamwork, innovation and excellent technologyassessment research.University affiliation affords the academic freedom to examine the evidence criticallyand impartially, and to produce and disseminate objective results. Other benefits of thelocation and affiliation include direct access to Centre expertise for data analysis,Woodward Library for biomedical literature and the cost savings on operating expenses.The disadvantages of the University affiliation are the limitations imposed by theadministrative structure of the University such as salary levels. As well, we mustcompete with other academic units for scarce university resources such as physicalspace or academic appointments to support the work of the Office.oooooooB.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLAN 3ooooDoQooo3.2 Market Analysis - Whom do we serve?The BCOHTA has a number of audiences for the work it produces. These have beenseparated into the following categories according to sources of past requests:• Academic/Research• Health Care Facilities• Government• Professional Associations• Business/Manufacturers/Suppliers/Labs/Pharmaceutical• Libraries• Media• Individuals who request specific reports.Because of the limited budget there is general agreement that the priority clients forBCOHTA work should be decision makers: clinical, healthcare facilities management,and public policy. Appendix A contains the contract negotiated on an annual basis withthe Ministry of Health. A major ongoing policy question for both the BCOHTA and thefunding body, is how and to what extent the academic and general public audiences canand should be served.Appendix D presents a summary of our requests for information for 1993 and 1994.This shows that approximately 75%of all requests do in fact come from the three groupsmentioned above.External EvaluationIn the summer of 1993 P.A. Research Consultants Ltd. (see Appendix B) wascommissioned by the Ministry of Health to conduct an evaluation of the BCOHI'A witha mandate to:What do our clients need and value? How do we measure up? In this section wereview the results of an external evaluation and other comments we have received onour work.oooooooB.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLAN3.3 Client Feedback4o·ooooooooo- examine the mission and objectives of the BCOHI'A from the perspectives ofthe Ministry and the BCOHI'A- evaluate the efficiency of the BCOHI'A, given available funding- evaluate audiences and level of awareness of BCOHI'A outputsdesign indicators of BCOmA effectiveness and make an assessment of whenand how these should be implemented.The report concluded: ''The BCOmA is a first-class organization which, given thelimited funds available, is efficient, productive and has the potential to become a verycost-effective mechanism in improving health outcomes and the management andcontrol of health care cost. Its activities could effect changes in policy and clinicaldecision making in the British Columbia health care system." However it noted thatbudget limitations were causing a decline in the production of major technologyassessment reports and suggested that, unless funding levels were increased, theBCOmA would have to limit its activities to the preparation of short reports, seminarsand liaison activities. The key problem is stable funding amid rapidly increasingdemands which means that it is more and more difficult to deal adequately withpriority requests.Feedback from clients and potential audienceThe work produced by the BCOmA seems to be very well received. As the externalevaluation noted, "Even critics of the BCOmA praise the quality of the actual workdone... The work produced is viewed by most to be outstanding." One criticism of theresearch process is the use of non-physician researchers in addition to those physicianswho are used. While this may be of concern to some in the medical community, thequality of systematic review of clinical research is dependent on the skill of theresearchers in evaluating research design and not on expert medical opinion.Medical Services Commission Reviews3.4Active LiaisonsFurthermore, the Office is able to employ its own M.D. staff and to consult widely asnecessary, to ensure adequate medical input. A different area of concern generallyexpressed by others is priority setting for research projects, although the criterianegotiated with the Ministry of Health were met in all cases examined.For the 1994/5 year the BCOmA has been contracted by the Ministry of Health toconduct reviews related to the development of clinical practice guidelines for the newlyreorganized Medical Services Commission. This represents a further vote of confidencein the organization and comes as a result of some work previously carried out for theCommission. A first request from the Commission under this new contract has nowbeen completed.5A workshop was held in conjunction with BOT in February 1993 called "HealthTechnology Assessment - Charting the Course." At this workshop many constructivesuggestions were made by stakeholders in the areas of producing the right informationat the right time; disseminating assessment information to the professionals and thepublic; and understanding decision-making and policy development processes. Many ofthese comments have been incorporated into the activities of the BCOmA in the lastyear and they have assisted in the development of the Office's Mission and Objectives. Itwas also agreed that communications would be kept open and all opportunities forcollaboration would be considered.The BcomA exchanges information on technologies and technology assessment withrepresentatives from key organizations. Much effort has been dedicated to fosteringthese contacts so that information used and disseminated by BCOmA will be accurate,timely and comprehensive. While not an exhaustive compilation, the list in Appenidix Frepresents many of the active liaisons which include local, national and internationalgroups, professional associations, technology assessment organizations, health facilities,academic and governmental organizations.B.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLANoooooo8ooo@oooooooo4.1Reforming Health Care Delivery in British ColumbiaWhat is happening in the "real world"? Are we meeting the needs of clients and potentialaudiences?Cost containment and continued shift of resources from the acute care sector to thecommunity is expected to continue.The New Directions for a Healthy British Columbia paper issued by the Minister ofHealth in February, 1993 has formalized many of the recommendations raised by theRoyal Commission and presented ''Five New Priorities for Health Care." These are:• A major new emphasis onhealth promotion in government policy;• Equitable access for all B.C. residents to Medicare;• Increased public involvement in health care decisions;• Decentralization of health care decisions from Victoria to local communities andregions, and delivery of health services "closerto home," whenever appropriate; and• Improved management of the health care system by reorganization of health carepriorities, re-allocation of existing resources; and improved efficiency and costmanagement.64.0 EXTERNAL ENVIRONMENTB.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLANooooooooooooooooThese are the "reform concepts" shaping the health care environment today which willaffect our clients over the next few years. Certainly the last three priorities and the costcontainment issue are of direct interest to BCOmA and are areas where the Office canprovide most assistance. The BCOmA could provide information on technologies toRegional Boards, which could become an extensive new set of important decision­making clients.4.2Anticipating our clients' needsOne of the recommendations from the evaluation of BCOmA was to develop acommunications strategy which targets intended audiences agreed to by the MOH andthe BCOmA (Appendix G). A proposal was solicited and received in 1993to carry outa communications audit and a communications plan but action on this has beendeferred for the time-being. Communications is probably the weakest link in theBCOmA chain as it is largely dependent on staff and faculty time to produce thenewsletter and disseminate the research results to various audiences, and to promotesystematic review techniques and evidence-based medicine to targeted groups such asphysicians. A formal communication plan is an essential tool to raise the level of ouraudience awareness, and to fulfill the BCOmA mission over the next few years.Our analysis of the environment suggests that, in close working relationship with alliedorganizations, we need to:This section deals with how BCOHTA should position itself as it moves forward to meet thechallenges and opportunities arising out of the new directions in health care delivery.• Maintain or, if possible, increase financial support in order to be able to carry out ourmandate, especially in light of the additional information needs of the Medical ServicesCommission Tri-Partite Committee.ooooooos.c OFFICE OF HEALTH TECHNOLOGY ASSESSMENTSTRATEGIC PLAN5.0 STRATEGIC DIRECTIONS7• Respond to organizations' requests in a timely fashion.o·o••Continue to provide an essential service that demonstrates the utility of technologyassessment to a number of important decision-making processes.Proceed with a review of communication strategies for the Office.oooooooo• Maintain an environment that attracts and retains the highest calibre of researchers,stimulates "leading edge" thinking, and fosters excellent academic work.• Concentrate our scope of services in the following areas:-preparing and distributing technology assessment reports.-offering seminars to target audiences-maintaining liaison with B.C.health care agencies, physicians, the CanadianCoordinating Office of Health Technology Assessment and other internationaltechnology assessment organizations.• Develop an acceptable solution to the space problems, through exploring additional oralternate space at UBC,as well as exploring other sites off-eampus.Over the next few months serious consideration will be given to the above in the continuingdevelopment of the B.C.Office of Health Technology Assessment.00 B.C. OFFICE OF HEALTHTECHNOLOGY ASSESSMENTSTRATEGIC PLAN 800 LIST OF APPENDICES0 A. CONTRACTWITH THE MIN1STRY OF HEALTH(SCHEDULES A & B)0 B. EVALUATION OF BCOHTA(EXECUTIVE SUMMARY)0 C. PUBLICATIONS0 D. Sm.1MARY OF REQUESTS FORINFORMATION0 E. BCOHTAWORKIN PROGRESS & LIST OF TECHNOLOGY RESEARCH REQUESTS0 F. RESEARCH LIAISONS AND AFFILIATIONSooooooooooo·oooooooooooooAPPENDIX ACONTRACT WITH THE MINISTRY OF HEALTH(SCHEDULES A & B)oooooooooooooooooo·7-SCHEDULE A1994/95British Columbia Office of Health Technology Assessment (BCOHTA)A. SERVICES PROVIDED BY THE AGENCYIt is agreed that:A.1 The BCOHTA, in consultation with the Ministry of Health, will selecttechnologies for review, using the following criteria:a) broad potential impact (number of users and potential change in qualityof life);b) high cost of the technology to the health care system (acqulsltlon costand operating cost);c) potential to influence service as a result of a review; andd) ability of researchers/reviewers to produce definitive results.A.2 The BCOHTA will identify technologies meeting the criteria in A.1 andhaving insufficient scientific study.A .3 The BCOHTA will review and analyze scientific literature and preparesummary papers on each technology selected as indicated in A.1.A.4 The BCOHTA will write and circulate a BCOHTA quarterly newslettercontaining technology assessment summaries. _. .A.5 The BCOHTA will provide guidance to researchers developing researchproposals addressing these gaps, to be submitted to the traditional sourcesof research funding.A.6 The BCOHTA will organize a program of at least four workshops or seminarsin 1994/95 directed at particular target audiences to examine issues intechnology assessment using the criteria in A.1 for selecting topics.A.7 The BCOHTA will respond to information requests from the Ministry orhospitals meeting the criteria in A.1 related to technology funding requests,to the extent possible with available staff and funding.A.a The BCOHTA will provide financial support in the form of bursaries toqualified students pursuing closely related research.ooooooo~oooooooo- 8 -A.9 The BCOHTA will maintain a regular working relationship with the CanadianCoordinating Office of Health Technology Assessment and internationaloffices for technology assessment.A. 10 The BCOHTA will complete a draft strategic plan by May 30, 1994A.11 The BCOHTA will conduct up to five visits to hospitals for seminars ordiscussion groups reviewing technology issues.A.12 The BCOHTA will establish research/review capacity with funds identified inSchedule B as originating with the Medical Services Plan (MSP), MSP cannegqtiate up to 12 reviews with varying degrees of detail through out theyear. This capacity, once established, will be available as priority for suchresearch and reviews. When not being utilized for such requests, thecapacity will be used by the BCOHTA to meet items A.1 to A.11 above.Reviews requested by MSP will be provided to the Ministry of Health (MSPcontact and the contract administrator) in draft form as promptly as possibleand may be followed up with a published, peer-reviewed publication at thediscretion of the BCOHTA.A.13 The BCOHTA will provide consultation to the clinical guidelines program forMSP.Costs associated with items A. 12 and A. 13 will be tracked separately from therest of the contract. The Ministry of Health may request a statement of thesecosts during the term of the contract.SCHEDULE 8- 9 -The Agency will receive operating contributions from the Ministry in theperiod April1p994 to March 31, 1995 of $500,000.Payments by the Ministry to the Agency will be made as follows:Month Year$ 125,000.00125,000.00125,000.00125.000.001994199419941995 . :.AprilJulyOctoberJanuary1 .2.oo·ooooooo3.$500,000.00Funding of $150,000 originated with the Medical Services Plan.Note: Items A.5, A .6, A.a, and A.1 1 will only be completed if additional resourcesare available. All other items must be completed.ooooooo tg/C:BCOHTA.AGR/June 14, 1994oooo·ooooooooooooooAPPENDIXBEVALUATION OF BCOHTA(EXECUTIVE SUMMARY)ooooooo0'ooooooooExecutive SummaryP.A. Research Consultants Ltd. was commissioned by the Ministry of Health(MOH) in the summer of 1993 to conduct a limited evaluation of the BritishColumbia Office of Health Technology Assessment (BCOHTA) located at theUniversity of British Columbia (UBC). The mandate of the assignment wasto:o compare and' contrast the mission and objectives of BCOHTA from theperspective elfthe BCOHTA, on the one hand, and the MOH on theother;o evaluate the efficiency of the BCOHTA within available funding;u note audiences and level of awareness of BCOHTA outputs;o design indicators of BCOHTA effectiveness and make an assessment ofwhen and huw these shuuld be implemented.The BCOH1'A was created in the fall of 1990. The role of the BCOHTA .from its inception has not been to do primary research but rather to reviewresearch of various kinds, make critical assessments to determine goodresearch from poor, present the findings in a clear concise understandablefashion.and disseminate this information to British Columbia health policyand clinical decision makers in a timely fashion. Funded by a $O.:J5mannual contribution from the MOH the BCOHTA Steering Committee setspolicy and priorities for technology assessment review. Technologiesassessments for review must meet the following criteria:o broad potential impact (number of users and potential change inquality of life);o cost of technology tu the health care system (acquisition costs andoperating costs);o potential to influence services as a result of the review; ando ability of researchers/reviews to produce definitive results.Till; BCOIITA has ~~igh~. rull tdiU pnrt-tirue employees who:o produce technology assessment summaries and reports;o produce Newsletters:- 11 -p.A. RESEARCH CONSULTAN1S LTD.oooooooooooooooooo(J develop and give a series of workshop/seminars annually;u attend, host and participate in conferences on technology assessment;(J muiutaiu an ongoing relationship with other technology assessmentorganizations;o provide guidance to and assist researcher in the field of technologyassessment;The audiences for BCOHTA outputs include the MOH. governments,hospitals, protessinnal associations, lihruries, academic institutions,individual practitioners, and individuals. .ConclusionsThe BCOHTA is a first-class organization which, given the limited fundsavailable, is efficient, productive and has the potential to become a very costeffective mechanism in improving health outcomes and the managementand control of health care cost. Its activities could effect changes in policyand clinical decision making in the British Colombia health care system,The problem facing the BCOHTA is maintaining a focus on those activitieswhich, given a very limited budget, will provide the greatest return for thepeople of British Columbia. The BCOH'T'A is at a crossroads in itsdevelopment; it is experiencing declining outputs of major technologyassessment reports over time as existing resources are being consumed tomeet a variety of different-outputs to a variety of audiences that havedifferent demands. The Office should limit its activities to the preparationand distribution of technology assessment reports, seminars and liaisonactivities as these activities appear tu have the most chance to effect achange in behaviour in British Columbia health care policy and clinicaldecision makers.Simply put, the BCOHTA dues excellent work in areas that have -thepotential to improve the quality of care as well as save the health systemmilliuns of dollars. Even critics of the BCOHTA praise the quality of theactual work dune. 'I'he primary reasons it has yet to improve care and/orsave these millions til dute are not a lack ofeffort but rather a combinationuf limited resources, decline in tht: production of the primary outputs(published reports with critical assessments of technologies) and themarketing/communications strategy to reach policy and clinical decisionmakers.- III -P.A. RESEARCII CONSULTANTS L'I1).oooooooo~ooooooooWhat. the BCOHTA Does WellThe BCOHTA have the right people doing first class work in a veryinteresting areaof public policy. The BCOHTA is developing a goodreputation. The work produced is viewed by most to be outstanding. Thecusts of' the BCOHTA are certainly less than the projected costs of similarurganizations in other jurisdictions and most of the money spent to date hasheeu spent 011 people doing critical reviews of technology assessment, nottalking about it. Given the financial scale of the Office and the amount ofwork produced to date there is value for money spent.BCOHTA Areas for ImprovementAreas for improvement include getting more technology assessment reportsand summaries completed and distributed to policy and clinical decisionsmakers in British Columbia if only to allow the Newsletter to becomeq uarterly as specified in the contract, A communications and marketingstrategy should be developed to ensure that the target audience agreed to bythe Office and MOH of BCOHTA outputs are being served. Finally theBCOHTA needs to focus more of its attention on conducting its own seminarworkshops and liaison activities with BritishColumbia hospitals, and onbetter coordination with other Canadian and international technologyassessment agencies.RecommendationsThe MOH is at a crossroads with respect to funding the BCOHTA. Initialindicators note that the BCOHTA is at the limit of what it can do givenexisting MOH funding levels of $O.:35m per year. To meet the requirementsof the contribution agreement either more money must be made available orthe MOH must note which items in the current contract should beeliminated so as to increase productivity. Clearly, if more money is madeavailable then the contract should specifically note the expectation for moreproduct, With an expectation of more money the BCOHTA should:1. hire more researchers to produce more reports;2. contract more medical consultant time so that BCOHTA medicaldoctors can conduct workshop/seminars to British Colombia policyand clinical decision makers;:;. expand Iiaison at~ivities with British Columbia hospitals;4. expand liaison and work more couperatively with other technologyassessment orgunizutiuns.- IV -P.A. RESEARCH CONSULTANTS LTD.ooo·ooooooooooooooAPPENDIXCPUBLICATIONSoooooooooo. ',HPRU90:9DBCOHTA 91:1DBCOHTA 91:20BCOHTA 92: ID'Technology Diffusion: The Troll Under the Bridge-A Pilot Study of Low andHigh Health Technology in British Columbia." (A. Kazanjian. K. Friesen)"Collagen Implant Therapy for the Treatment of Stress Incontinence."Originally released in December, 1991. (M.M. Johnson)'j<! Review of Research on the Use of Desk-Top Analyzers for CholesterolScreening." Originally released in December, 1991. (C. Archibald)Review of the Literature on Health Technology Assessment (1992). Originallyreleased in January, 1992.ooo·oooooBCOHTA 92:2D "Home Uterine Activity Monitoring: A Review of the Scientific Evidence."Originally released in October, 1992. (C.J. Green, S.B. Sheps, K.D. Friesen, R.Parker, A. Kazanjian, N. LeMire)BCOHTA 92:3D "Hyperbaric Oxygen for Osteomyelitis and Osteoradionecrosis." Originallyreleased in October, 1992. (S.B. Sheps)BCOHTA 92:4D 'The Erythrocyte Sedimentation Rate: An Examination of the Evidence."Released January, 1993. (CJ. Green, S.M. Wait G.M. Anderson, K.D. Friesen.A. Kazanjian)BCOHTA 92:5R "Defusing Technology: Technology Diffusion in British Columbia."International Journal of Technology Assessment in Health Care, 9:1 (1993),46­61. (A Kazanjian, K.D. Friesen)BCOHTA 93:3 "Directory ofHealth Technology Research Projects in B.C. 1988-1992.BCOHTA 93:4D "Percutaneous Transluminal Coronary Angioplasty." Released in June, 1993.(1. Gait, S.B. Sheps)BCOHTA 93:5D "BCOHTA Review- 1991 & 1992." Released in August, 1993.D =Discussion Paper R =Reprint T =Technology ReviewsD =Discussion Paper R =Reprint T - Technology ReviewsBCOHTA 94:9R The Erythrocyte Sedimentation Rate -- An Examination of the Evidence." B.C.Medical Journal, 36:2 (1994), 108-112. (C.J. Green, K.D. Friesen, K. Bassett.SM. Wai,A. Kazanjian)O'oooooooooooooooBCOHTA 93:6DBCOHTA 94:1TBCOHTA94:2BCOHTA 94:3DBCOHTA 94:4RBCOHTA 94:5RBCOHTA 94:6RBCOHTA 94:7RBCOHTA 94:8R-2-"Prostate Specific Antigen in the Early Detection ofProstate Cancer." Releasedin September, 1993. (C. Green. D. Hadorn, K. Bassett. A. Kazanjian)"The Efficacy andEffectiveness ofSustained Release Oral Nitroglycerine inComparison to Regular Delivery Isosorbide Dinitrate for the ProphylacticTreatment ofStable Angina Pectoris. ". (K.. Bassett.M. Rhone)"Directory ofHealth Technology Research Projects in B.C. -1993.""Frameworkfor Technology Decisions: Literature Review." To be released inNovember, 1994. (A. Kazanjian. K. Cardiff. K. Friesen. N. Pagliccia)Guest Editorial: Health Technology Assessment and Clinical Medical Care:Different Methods, Common Goals." B.C. Medical Journal 36:1 (1994), 20-21.(S.B.Sheps, CJ. Wright)"Collagen Implant Therapy for the Treatment of Stress Incontinence." B.C.Medical Joumal Btul (1994), 22-25. (M.M. Johnson, K.D. Friesen)"Home Uterine Activity Monitoring." B.C. Medical Journal; 36:1 (1994), 26-31.(CJ. Green, S. B. Sheps,K.D. Friesen, R. Parker, G.M.Anderson)"Current Controversies in Screening for Hypercholesteremia using Desk-TopAnalyzers." B.C. Medical Journal 36:1 (1994), 32-38. (K.D. Friesen, C.J.Wright, A. Kazanjian)"Percutaneous Transluminal Coronary Angioplasty." B.C. Medical Journal36:2 (1994),104-107. (JM. Gait, S.B. Sheps)-o "o0' .ooooooooooooooAPPENDIXDSUMMARY OF REQUESTS FOR INFORMATIONSUMMARYOFREQUESTS FORINFORMATIONRequests for BCOHTA deliverables come from a wide variety of health industry groups. Asummary of the 1993 and 1994 requests for technology assessment information and publishedreports is listed below. These figures were collated from BCOHTA's general request list andthe technology research request list.oooooooooooooooooREQUEST GROUPSIndividual medical professionals (medical, nursing, etc.)Administrators (professional associations, societies, etc.)HospitalsGovernment (provincial, federal, international)Academic/researchTechnology assessment organizationsClinical laboratoriesPharmaceutical companiesBusinesslmanufacturers/suppliers/research & designMediaInterested publicStudentsas of October 1994h:requeslS94\summary19934146613317204214243199443142550149o10411101ooooooooo .ooooooooAPPENDIXEBCOHTA WORK IN PROGRESS&LIST OF TECHNOLOGY RESEARCH REQUESTSSeptember/94 Bone Densitometry PendingAugust/94 Health Canada grant proposal for $140,000 October/94 forover one year accept/rejectAugust/94 National Centres of Excellence IIUTECH Canada- November/94 forUsingTechnology to Enable Community Health" accept/rejectLetterof intent for $8 million over five yearsAugust/94 ISTAHC Fellowship - "Oritioal Health Technology November/94 forAssessment: Examining the Facts, Values and accept/rejectPolitical Economy of the Electronic Fetal HeartMonitor" Proposal for $140,000 (US) over oneyearJune 16/94 Liver Resection for Secondary Carcinoma January/95June 16/94 CurrentStatusof Fetal Cell Trensptantatlon in October/94Parkinson's DiseaseMarch 17/94 Lasers in Urology: Treatment of Benign In processProstatic HypertrophyNovember 18/93 Vision Screening for Strabismus and Amblyopia: November/94A CriticalAppraisal of the EvidenceJune 23/93 CT Scanners: Technology Acquisition in Rural January/95British ColumbiaApril 17/93 Medicine and the Law - 'Health Technology January/95Assessment and the Legal Literature Problem:The Caseof Cesarean Section Operations'July 27/92 Anti-coagulation for Stroke Prevention in Chronic November/94Non-valvular Atrial FibrillationooooooooooooooooooDATEREQUESTEDBCOHTA WORK I~ PROGRESSPROJECTANTICIPATEDCOMPLETION~~~~~~ ~ ~ I- l ~ ~ ~ ~ ~ ~ ~ ~ ~ ~. TECHNOLOGY RESEARCH REQUESTS..ORGANIZATION/NAMEDr. Charles WrightVancouver General HospitalDATE OFREQUEST REQUESTJune 16/94 Liver Resection for Secondary CarcinomaDATE REQUESTFILLEDIn processDr. O. SchneiderMinistry of HealthLinda BirdsalVDonJuzwishinGreater Victoria Hospital SocietyLoree MarcantonioMinistry of HealthVancouver BCDeborah Little. ResearcherCargo Surveyors -InchcapeTesting Service - PKB ScanningDr. Ed DomovitchMedical ConsultantMinistry of HealthDr. Manfredo PaceMedical DirectorLiza Kallstrom, ManagerHealth Policy DevelopmentB.C. Health AssociationDr. Rob ParkerMinistry of HealthJeff Coleman. V.P. MedicineUniversity Hospital-UBC SiteJune 16/94 Current Status of Fetal Cell Transplantation in Parkinson's In procesDiseaseMarch 17/94 Lasers in Urology: Treatment of Benign Prostatic Hypertropy In processJuly 22/93 Sustained Release Oral Nitroglycerine Sept. 30/94Nov 24/93 Info. on a chemical compound related to industrial Nov 25/93toxicology application. (Methyltertiarybutylether-MTBE)Sept 27/93 TRUS for screening for prostate cancer Oct 13/93Sept 27/93 Chorionic Villus Sampling Sept 27/93Sept 15/93 Tissue Plasma Activator & Streptokinase drugs Sept 17/93Used clinically In emergency treatment situationsJune 23/93 CT Scanners: Technology Acquisition In Rural British In processColumbiaMay 3/93 Transjugular Intrahepatic Portosystemic Shunting (TIPS) July/93Treatment of hemorrhage due to portal hypertensionEarly detection & screening for hemochromatosis1c:=:Jc::JCJCJc:Jc:J CJ c::J c=Jc:Jc::Jc:Jc::JCJc=:lc::Jt=:JCJTECHNOLOGY RESEARCH REQUESTS, IORGANIZATIONINAMEDATE OFREQUEST REQUESTDATE REQUESTFILLEDDr. David Stringer Apr 18/93 Critique on Economic Evaluation Proposal on June/93B.C. Children 's Hospital UltrasoundTom Vincent April 17/93 Health Technology Assesment and the Legal Literature In processDirector, Health Economics Problem: The Case of Cesarean Section Operationsand Planning. MOHMs. Sharon Stevens -. Dec 8/92 Minimal Access Surgery Dec 9/92PT Services DirectorVancouver General HospitalWCB Sep 30/92 MRI vs Arthroscopy in back. shoulder and knee injuries Nov/92Dr. G.B. John Mancini Ju127/92 Cost effectiveness of chronic anticoagulation or In processProfessor & Head chronic aspirin therapy of patients with nonvalvularDept. of Medicine atrial fibrillationUniversity HospitalUBC SiteDeborah Marshall Jul17/92 Prostate Specific Antigen·Screening for Prostate Cancer May/93Director. Special ProjectsUniversity HospitalUBC SiteDr. David Stringer Jun 29/92 Economic evaluation of computerized digital radiology Feb 1/93Children's HospitalFreida Home. Capital Planner Jun 22/92 Efficacy/effectiveness of laparoscopic surgery Oct 8/92GVRHD and anticipated effect on hospital uselbulldingStella Tsang Jun 5/92 Right Ventricle Ejection Fraction Catheter . Jun 8/92St. Paul's Hospital2CJc:JCJCJCJc:::l CJ r.=:J c:Jc:Jc:Jc:Jc::Jc::Jc:J(::Jc::JCJTECHNOLOGY RESEARCH REQUESTSI IORGANIZATION/NAMEAlex Berland, DirectorPatient ServicesVGHIsabelle Savoie, StudentArthritis SocietyDATE OFREQUEST REQUESTJun 3/92 Patient Lifting DevicesMay 26/92 Joint arthroplasty: accessibilityDATE REQUESTFILLEDCancelledJun 3/92Kit Henderson/Debra SheraMOH - Director of ProgramMonitoring & EducationGlenn McAndrewPrivate CitizenTricia Braidwood-LooneyMOH - PP&LMrs. DyrlandMOH - Operational ReviewDr. HarriganCollege of Physicians & SurgeonsDr. Charles WrightVGHDr. SullivanVGHMay 24/92Apr 23/92Apr 23/92Apr 7/92Apr 6/92Apr /92Mar 2192Effective methods of influencing physicianconsumer adherence to practice guidelinesInformation on xero-mammogram used formammography that does not put pressureon breast which is important when thereare breast implantsInformation"on breast implants.Provided Info. sent from CCOHTA; she will callto determine further action after viewingliteratureLaser lysis of adhesions by carbon dioxide laserProstatronVag LaserDiasonic Sonablate TechnologyVag LaserProstatronMay 19/92Apr 23192May 11/92Apr 16/92MayS/92Mar 2192Mar 21923C::JCJCJc:Jc=Jc:Jc:Jc=J c:JCJCJCJCJCJc::::JC:JC:Jc:JTECHNOLOGY RESEARCH REQUESTS, ,DATE OF DATE REQUESTORGANIZATIONINAME REQUEST REQUEST FILLEDStella Tsang Mar 2/92 Desk-Top Analysers for Cholesterol Screening Mar 26/92St. Paul's Hospital Collagen Implant TherapyReview of LiteratureJanet Comis Mar/92 Articles for study on Osteoporosis Mar/92CCOHTA (Journal of Health Economics)Loree Marcantonio Feb 26/92 Erythropoietin (EPO) in the treatment of Apr 13/92MOH Hereditary Hemorrahagic Telangiectasia (H.H.T.)Dr. Kit Henderson Feb 12/92 Erythrocyte Sedimentation Rate (4 weeks) ESR Draft - May 13/92Chairman-Medical Liver Function Tests (3 months)Services Commission Request for technology assessment of these common testsFrieda Home, Capital Planner PTCA & Angioplasty Literature Review Feb 11/92GVRHDStella Tsang DUP - Duplex Ultrasound in Vascular Surgery Feb 11/92St. Paul's HospitalFrieda Home, Capital Planner Cardiac Catheterization Jan 30/92GVRHDDeborah Shera Periodic Health Exam Consensus Jan 27/92MOH - Program Monitoring & DevelopmentEducation Branch, MSPCharles Wright Jan 15/92 Vag Laser Feb 13/92VGH Prostatron Feb 24/92Frieda Home, Capital Planner Dec 17/91 Distribution of cardiac catheterization Dec 18/91GVRHD labs in provinces4c:::JCJc:JCJc:Jc::Jc::Jc::J fii:Jc:JC:Jc::::JCJc::JL:JCJCJt:::JCJTECHNOLOGY RESEARCH REQUESTSr IDATE OF DATE REQUESTORGANIZATIONINAME REQUEST REQUEST FILLEDDianne Coulas Dec 2/91 Discussions with D. Coulas on T.A. at Dec 3/91University Hospital: New Medical Devices.Procedures and Evaluation CriteriaSam Sheps for: Nov /91 Hyperbaric Oxygen for the treatment ofDr. C. Wright - VGH deep-bone infectionMichael Johnson Oct 1/91 Would like to replace the CT scanner in University Oct 15/91Asst. V.P. - Operations Hospital - UBC Site. Request for information onUniversity Hospital utilization/application from an administrativeShaughnessy Site, B2-West perspective. Will provide literature review andabstracts.Alan D. Thomson Sep 18/91 Home Uterine Activity Monitoring. Tocodynamometer In ProcessMedical Consultant to measure the contractions of the womb of aHospital Care pregnant woman. Would like the BCOHTA to estimateMOH cost and benefits, since institutional transfer ofreallocation of resources is likely to be requiredDr. Reni Chong Kit Aug/91 Requested Information on: 1) Use of candela laser Oct /91 (Updatedfor treatment of pigmented and vascular dermatologic version sent Dec 19/91)lesions, 2) use of echocardiography, 3) use ofmethotrexate in rheumatoid arthritis and auto immunediseases, 4) laparoscoplc cholecystectomy, 5) patientcontrolled analgesia, 6) intrathecal baclofen fortreatment of spasticity, 7) implanted electrodes inspine for ambulationGordon Chan Ju123/91 Wants Information about a 'muscle toner' machine mid-September(private request) that claims to facilitate the healing process in (Message left275-3884 inflammatory conditions (ie: arthritis) & cancer on answering-- Myomatlc 20~O is name of the machine (KC told machine)him that if we found anything we would call withreference)5CJc:::JCJc:JCJCJ CJ CJ CJc:JC:JCJCJr=JCJc::Jc:JCJTECHNOLOGY RESEARCH REQUESTS, ,ORGANIZATION/NAMEDATE OFREQUEST REQUESTDATE REQUESTFILLEDDr. Litherland Ju110/91 Assessment of Vascular Surgery Technology (would Aug /91Department of Surgery like the Information by mid-August '91)3rd Floor, 910 West 10th AveVancouver, B.C. V5Z 4E3Anne Kelly Jun /91 CAT Scan - indications for utilization Jun /91GVRHDDr. David Matheson Jun /91 Management Information Systems ie: Operating Room Jun /91Vice-President, Medicine Scheduling Systems (pediatric settings) • requestChildren's Hospital literature - submitting proposal to BCHRFDr. Lionel McLeod Jun /91 Intra-urethral collagen injections (treatment for Jan 15/92Vice-President, Medicine urinary stress incontinence)University Hospitalh:lrequesls.93lrequesla.lst (Updated: Jan.31/94)6-o ~o0"ooooooooooooo•APPENDIXFRESEARCH LIAISONS AND AFFILIATIONSooooooooooooooooooProvincial AffiliationsArthritis SocietyB.C. Cancer AgencyB.C. HealthAssociationB.C. Health Management ReviewB.C. Health Research FoundationB.C. Heart Health CoalitionB.C. MedicalAssociation (BCMA)BC Medical JournalB.C. Medical SelVices CommissionB.C. Ministryof Health (MOH)Health Economics and Planning, Policy Planning and LegislationProgram Monitoring and Education, Medical servlces PlanB.C. Ministryof Advanced Education, Technology and TrainingB.C. Rehabilitation SocietyClinical Management Resource AdvisoryCommitteeCollege of Physicians and Surgeons of B.C.Council of University Teaching HospitalsCranbrookand District HospitalGreaterVancouverRegional Hospital DistrictGreaterVictoria Hospital SocietyMedical Device Development CorporationP.A. Woodward's FoundationRegistered NursesAssociation of B.C.Science Council of B.C.Vancouver FoundationNational AffiliationsAlberta HealthConseil d'evaluation des technologies de la Santedu QuebecCentre for Health Economics and PolicyAnalysis (CHEPA)Canadian Coordinating Officeof HealthTechnology AssessmentMcMasterUniversity Medical CenterNational Health Research and Development ProgramNational Scienceand Engineering Research CouncilSaskatchewan HealthServices Utilization and Research Commission (HSURC)International AffiliationsAgencyfor Health Care and PolicyResearch, U.S. Dept. of Health and Human ServicesAmerican Hospital AssociationAustralian Instituteof HealthCOMETT- ASSESS, finlandCongress of the US Officeof Technology AssessmentDepartment of Health, Basque GovernmentDepartamento de Sanidad, Vitoria-Gasteiz, SpainDepartament de Sanitat i Seguretat, Barcelona, SpainooooooooooooooooEmergency Care Research Institute, PA, U.S.A.Erasmus Universlteit, The NetherlandsFaculty of Medicine, University of Newcastle, AustraliaGeorgetown University School of Medicine, U.S.A.Health Economic Research Group, Brunei University, EnglandHealth and Environment, Royal Netherlands Embassy, Washington DCHvidovre Hospital, DenmarkIntemational Society of Technology Assessment in Health CareInstitute of Medicine, Washington, D.C., U.S.A.Jerusalem Ministry of HealthKing1s Fund Centre, United KingdomNational Library of Medicine, Washington, D.C.Officeof Health Technology Assessment, Agency for Health Care Policy and ResearchOffice of Technology Assessment Congressional Office, Washington, D.C.The Rand CorporationSBU,Swedish Council on Technology Assessment in Health CareSubdireccion General de Prestaciones y Evaluacion de Technologias Sanitarias, Madrid, SpainTe Tari Ora, Department of Health, NewZealandUniversity of Colorado Health Science CenterUniversity of Limburg, NetherlandsWorld Health OrganizationYale University School of Medicineh:\annrepl93\ResUaisooo·ooD·oo~ooooooooAPPENDIXGRECOMMENDATIONS RE: COMMUNICATIONSoooooooooooooooooo2 OUR RECOMMENDATIONSThe BCOHTA needs to develop an effective communications program which willposition the association clearly and consistently in the minds of your audiences. Thisprogram must identify who BCOHTA is, what you represent and what services you provide.Each part ot the program must support this positioning in order to reinforce it in theminds of recipients. The result is recognition and understanding; as audiences areexposed to the same basic messages and design elements reflected in a variety ofcommunications materials. Your audience will soon come to easily recognize who you areand understand your mandate.Based on our research and analysis, Parallel will develop an effectivecommunications plan to meet your specific needs. The program will assist BCOHTA inmeeting its mandate/objectives in 1993/94 and beyond.Our expertise helps you convey your message accurately and effectively and tothe right audience. Behind the scenes, we work to implement communications programswhich meet pre-determined objectives, achieve exacting standards of quality and fitwithin our clients' budget.Phase 1Communications AuditOur first step is a communications audit. The information gained from a preciseand careful assessment of BCOHTA's image and presence today with external audiences,will influence all of our recommendations. By thoroughly understanding the perceptionsof the association, we can successfully move forward with a program that will trulysupport the association's goals and objectives, boosting your presence in the community,and dearly establishing who the association is, what it stands for and where it is going.The kinds of questions that need to be answered are:• V'ho are the key audiences?• what is the awareness level of BCOHTA?• how does the audience use BCOHTA7• what is objective of better communication?• do you want to raise/lower profile?• is your mandate still representative of your goals and objectives?These are only a sampling of questions that will need to be answered to give us aclear understanding of the environment we are operating in.Phase 2Communications PlanBased on our research and analysis, Parallel will develop a communications plan tomeet your specific needs. The program will assist BCOHTA in meeting its objectives in1993/94 and beyond. The plan will indude a strategic and a tactical component. Thestrategic plan will suggest long-term recommendations on communicatic?"s strategies. Thetactical plan will outline specific recommendations about what Parallel, as well as theprogram management team, will do to accomplish the strategic plans.Estimate: $1,000.00oooooo....Estimate: $1,500.00• r IDevelop a fact sheet about BCOHTA which would alleviate having to re-introduceyourselves every time you write a newsletter. The format would be faxable and easilyadapted as changes take place within the office.Develop a media relations program so that key messages can be communicated toimportant stakeholders through the media. The media relations program would involveidentifying and prioritizing stakeholders; developing appropriate media lists to reachPhase 3The following outlines some recommendations which could be implemented aspart of a tactical plan. A complete tactical plan will be developed after research isconducted.Develop a logolworclmark to be printed on the newsletter masthead, stationery,reports and other printed material produced so that it will become a integral part ofBCOHTA's identity and a recognizable symbol, regionally, nationally and internationally.Production of camera ready artwork for each application not included.$750.00$750.00Estimate:Estimate:oo~oooooooothese stakeholders; identifying spokespersons and providing media training; formulatingkey messages; identifying potential news or feature story opportunities; preparing mediamaterials; distributing material to appropriate media; and monitoring the media forcoverage.Phase 4Parallel will prepare a final report and evaluation of the communications programand results achieved over a given period of time. The communications program will bedesigned so that an evaluation of the program is achievable. The report will induderecommendations on future communications activities.ooooooD­Ooooooooo-.Estimate:Estimate:.:$1,500.00$1,000.00

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