AHRQ Health Care Horizon Scanning System A Systematic Review of Methods for Health Care Technology Horizon Scanning Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 Contract No. 290-2010-00006-C Prepared by: Fang Sun, M.D., Ph.D. Karen Schoelles, M.D., S.M., F.A.C.P ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 AHRQ Publication No. 13-EHC104-EF August 2013 This report incorporates data collected during implementation of the U.S. Agency for Healthcare Research and Quality (AHRQ) Health Care Horizon Scanning System by ECRI Institute under contract to AHRQ, Rockville, MD (Contract No. 290-2010-00006-C). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to identify resources and methods for improving the AHRQ Health Care Horizon Scanning System in the future. The purpose of the AHRQ Health Care Horizon Scanning System is to assist funders of research in making well-informed decisions in designing and funding comparative-effectiveness research. This report may periodically be assessed for the urgency to update. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program website at: www.effectivehealthcare.ahrq.gov. Search on the title of the report. This document is in the public domain and may be used and reprinted without permission. Citation of the source is appreciated. Persons using assistive technology may not be able to fully access information in this report. For assistance, contact [email protected]. None of the individuals compiling this information has any affiliations or financial involvement that conflicts with the material presented in this report. Suggested citation: Sun F, Schoelles K. A systematic review of methods for health care technology horizon scanning. (Prepared by ECRI Institute under Contract No. 290-2010-00006- C.) AHRQ Publication No. 13-EHC104-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2013. www.effectivehealthcare.ahrq.gov. ii Preface In September 2010, the U.S. Agency for Healthcare Research and Quality (AHRQ) established the Healthcare Horizon Scanning System. Its purpose is to conduct horizon scanning of emerging health care technologies and innovations, in order to better inform patient-centered outcomes research investments at AHRQ through the Effective Health Care Program. A literature review and an expert panel meeting were conducted to identify existing best practices and effective methods for health technology horizon scanning and to provide input to AHRQ to optimize its horizon scanning program. The Health Care Horizon Scanning System gives AHRQ a systematic process to identify and monitor target technologies and innovations in health care and to create an inventory of target technologies that have the highest potential for impact on clinical care, the health care system, patient outcomes, and costs. It is also a tool for the public to identify and find information on new health care technologies and interventions. Any investigator or funder of research can use the AHRQ Health Care Horizon Scanning System to select potential topics for research. The health care technologies and innovations of interest for horizon scanning are those that have yet to diffuse into or become part of established health care practice. These health care interventions are still in the early stages of development or adoption except in the case of new applications of already-diffused technologies. Consistent with the definitions of health care interventions provided by the Institute of Medicine and the Federal Coordinating Council for Comparative Effectiveness Research, AHRQ is interested in innovations in drugs and biologics, medical devices, screening and diagnostic tests, procedures, services and programs, and care delivery. Horizon scanning involves two processes. The first is the identification and monitoring of new and evolving health care interventions that are purported to or may hold potential to diagnose, treat, or otherwise manage a particular condition or to improve care delivery for a variety of conditions. The second is the analysis of the relevant health care context in which these new and evolving interventions exist in order to understand their potential impact on clinical care, the health care system, patient outcomes, and costs. It is NOT the goal of the AHRQ Health Care Horizon Scanning System to make predictions about the future utilization and costs of any health care technology. Rather, the reports will help to inform and guide the planning and prioritization of research resources. We welcome comments on this literature review and meeting summary. Send comments by mail to the Task Order Officer named in this report to: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, or by email to [email protected]. Carolyn M. Clancy, M.D. Jean Slutsky, P.A., M.S.P.H. Director Director, Center for Outcomes and Evidence Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality Elise Berliner, Ph.D. Task Order Officer Center for Outcomes and Evidence Agency for Healthcare Research and Quality iii Acknowledgments The authors gratefully acknowledge the efforts of Eileen Erinoff, M.S.L.I.S., and Helen Dunn for providing literature retrieval and documentation management support; and Janice Kaczmarek, M.S., Gina Giradi, M.S., Eloise DeHaan, and Lydia Dharia for program management, editorial support, and administrative support. We would also like to thank the expert panel members and the peer reviewers for providing us with their insights on horizon scanning methods. Horizon Scanning Expert Panel Lyle Berkowitz, M.D. David Hailey, Ph.D. Medical Director of Clinical Information Senior Advisor Systems Institute of Health and Economics Northwestern Memorial Physicians Group Edmonton, Alberta, Canada Chicago, IL Rosemarie Hakim, Ph.D. George Bockosh, M.S. Senior Technical Advisor Consultant Centers for Medicare and Medicaid Services Centers for Disease Control and Prevention Baltimore, MD Atlanta, GA William Halal, Ph.D. Tammy Clifford, Ph.D. Professor of Management Science Chief Scientist The George Washington University Canadian Agency for Drugs and Washington, DC Technologies in Health Ottawa, Ontario, Canada William A. Herman Consultant Joe Cummings, Ph.D. The U.S. Food and Drug Administration Manager, UHC Technology Assessment Silver Spring, MD Program University Healthsystems Consortium Juliet Jegasothy M.D. Chicago, IL Medical Advisor, Department of Medical Management Margaret Dennis, M.S., M.B.A. UPMC Health Plan Program Manager, Washington Health Pittsburgh, PA Technology Assessment Program Washington State Healthcare Authority Peter Kolchinsky, Ph.D. Olympia, WA Managing Director RA Capital Management, LLC Iñaki Gutiérrez Ibarluzea, Ph.D. Boston, MA Knowledge Manager Basque Office for Health Technology Assessment Vitoria-Gasteiz, Basque Country, Spain iv Amy Kottler, M.A., R.N. Eduardo Ortiz, M.D., M.P.H. Director, Horizon Scanning Services Senior Medical Officer, Division for the Hayes, Inc. Application of Research Discoveries Lansdale, PA National Heart, Lung, and Blood Institute Bethesda, MD Jerod Loeb, Ph.D. Executive Vice President for Healthcare Claire Packer, M.D. Quality Evaluation Director The Joint Commission National Horizon Scanning Centre Oakbrook Terrace, IL Birmingham, UK Linda Mundy, M.P.H. Ted E. Palen, Ph.D., M.D., M.S.P.H. Research Officer Clinician Researcher, Institute of Health The University of Adelaide Research Adelaide, Australia Kaiser Permanente Denver, CO Anna Nachtnebel, Dr.med., M.Sc.P.H. Senior Scientist Lawrence Schott, M.D., M.S. Ludwig Boltzmann Institute for Health Lead Medical Officer Technology Assessment Centers for Medicare and Medicaid Services Vienna, Austria Baltimore, MD Hussein Noorani, M.S. Mitchell Sugarman, M.B.A. Senior Scientist Sr. Director, Health Economics, Policy and Blue Cross and Blue Shield Association Payment Technology Evaluation Center Medtronic, Inc. Chicago, IL Minneapolis, MN Peer Reviewers Tammy Clifford, Ph.D. Claire Packer, M.D. Chief Scientist Director Canadian Agency for Drugs and National Horizon Scanning Centre Technologies in Health Birmingham, UK Ottawa, Ontario, Canada Eugene Rich, M.D. David Meltzer, M.D., Ph.D. Senior Fellow and Director, Center on Associate Professor of Medicine Health Care Effectiveness University of Chicago Mathematica Policy Research Chicago, IL Princeton, NJ v Structured Abstract Objectives. Since September 2010, under contract with the U.S. Agency for Healthcare Research and Quality (AHRQ), ECRI Institute has been establishing a national program to conduct horizon scanning of emerging health technology. The program’s main purpose is to better inform investments in patient-centered outcomes research at AHRQ by systematically identifying and monitoring target technologies to create an inventory of technologies that have the highest potential for impact on clinical care, the health care system, patient outcomes, and cost. We conducted this study to identify existing best practices and effective methods for health technology horizon scanning