How can we future-proof HTA in an era of innovations in digital health? Reflections from participants

We had an invaluable opportunity to attend the Priorities 2024 conference, held at the Millennium Hilton Bangkok from May 8th to 10th, 2024. We attended the session, “Pushing the Edge of the Envelope: Future-Proofing Health Technology Assessment in the Era of Innovation,” which was hosted by the Health Intervention and Technology Assessment Program (HITAP).

The session addressed the futureproofing of Health Technology Assessment (HTA) in the era of rapid digital innovation. It was very insightful for us since it is a combination of healthcare, technology, management, and economics. The session included speakers from various regions of the world including India, the UK, Korea, Singapore, and Tanzania. Throughout the discussion, we observed many topics such as criteria of evaluation, the impact of AI on HTA, and adaptation strategies among countries.

Evaluation of digital health technologies hinges on a few important criteria:

• Clinical effectiveness: Assessing the real-world impact of technologies on patient health outcomes.
• Cost-efficiency: Evaluating the economic benefits versus the costs involved.
• Accessibility: Ensuring technologies are accessible to all segments of the population.
• User Satisfaction: Gauging the satisfaction of both healthcare providers and patients.
• Interoperability: Ensuring seamless integration with existing systems.
• Regulatory Compliance: Adhering to local and international health regulations.
• Scalability: Evaluating the potential for technologies to be scaled up efficiently.

For instance, during the COVID-19 pandemic, telemedicine was evaluated for its capacity to maintain healthcare access amidst lockdowns, focusing on patient outcomes, satisfaction, and cost savings. The evaluations would ensure that the technologies not only enhance healthcare delivery but also integrate seamlessly into existing systems and address ethical and regulatory standards.

Overall, we learned the key takeaways for effective digital health innovations were resource alignment, the importance of early HTA, professional collaboration, optimal approaches for different situations, and real-world data utilization.

Firstly, the lack of alignment of resources and the absence of interoperable systems hinders the efficient assessment and integration of digital health technologies. When resources such as funding and personnel are not strategically aligned, efforts become fragmented, leading to inefficiencies and gaps in evaluation processes. Similarly, without interoperable systems, data sharing and integration are disrupted, resulting in incomplete assessments. A cohesive approach, with strategically aligned resources and interoperable systems, is essential to support thorough evaluations and seamless integration of digital health technologies into healthcare frameworks.

Secondly, emphasizing early HTA is crucial. By evaluating technologies at an earlier stage, healthcare systems can better anticipate and address potential challenges, ensuring smoother implementation and more effective use of innovations. Early HTA could align with the Gartner Hype Cycle1, a model that describes the adoption, maturity, and social application of new technologies. Early HTA is crucial during the cycle’s initial phases when inflated expectations of technologies are followed by a period of disillusionment. By providing evidence-based evaluations, early HTA helps temper unrealistic expectations and guide stakeholders through these phases. This ensures informed decision-making, smoother transitions, and sustainable integration of technologies into healthcare systems, leading to more effective use and proven benefits as the technologies mature.

Thirdly, each country has a different approach to its health system due to different conditions. As a result, there is no exact answer to how countries should implement digital health technologies. However, we can exchange experiences and learn from one another. The idea of establishing a central data repository to aggregate data from multiple countries was discussed, which could facilitate data sharing and enhance evaluation processes. Such an initiative holds promise for facilitating cross-border data sharing and enhancing the utilisation of health data for research and policy-making purposes. For instance, countries with robust public healthcare systems might prioritise population-level health outcomes, while those with predominantly private healthcare systems might focus more on individual patient care and cost-effectiveness. A central repository could help bridge these differences by providing a shared platform where data can be harmonised and analysed, offering insights that transcend national boundaries.

In conclusion, attending the conference gave us insights into the dynamic nature of digital health technologies and the critical role of early and comprehensive HTA. By learning from diverse international experiences and applying key strategies such as resource alignment, early HTA, and professional collaboration, we can effectively leverage digital health innovations to improve population health and enhance the resilience of healthcare systems.

I am grateful to the conference organisers for selecting me as a recipient of the 2024 grant and providing this enriching experience. The knowledge gained and connections made at this event will undoubtedly inform and inspire my future work.