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.

106 acute care hospitals 650 facilities 5 psychiatric facilities

4+M Albertans Rural hamlets to urban centres 100,000 AHS employees 15,000 volunteers 7,900 medical staff

8,471 acute care beds 23,742 continuing care beds 208 community palliative & hospice beds 2,439 addiction and mental health beds

Calgary Zone

North Zone Central Zone

Red Deer Regional Hospital

Stollery Children’s Hospital

Edmonton Zone

University of Alberta Hospital

Misericordia Community

Hospital

Sturgeon Community

Hospital

South Zone

Medicine Hat Hospital

Foothills Medical Centre

Alberta Children’s Hospitals

South Health Campus

Peter Lougheed Centre

Chinook Regional Hospital

Grey Nuns Hospital

Royal Alexandra Hospital

Rockyview General Hospital

Queen Elizabeth II

Hospital

Northern Lights

Regional Hospital

Environment Scan

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

INTAKE

REFERRAL

DUE DILIGENCE RECOMMENDATION

APPEALS

2 3 4 5 6 1

• Stakeholders engagement

• Check priority and unmet needs

• Review requests & recommend how requests should be handled at a provincial level

• Refer selected requests for review

• Due diligence team identified

• Due diligence team carry out evidence assessment

• Impact Assessments

• Budget/Risk/Benefit analysis

• Report & Recommendation to PACOSI

• Handle appeals

EVIDENCE SYNTHESIS

& ASSESSMENT

• PACOSI review the R&R

• Evaluate impacts across the Zones

• Suggest strategic implementation

• Support business plan creation

• Performance monitoring

• PACOSI make provincial scope and scale recommendations to SSCN Core

• SSCN Core make recommendations to AHS leadership for decision

Due diligence team Assessment & Recommendation to

PACOSI

Technology Requests To PACOSI

PACOSI

Accountability and Reporting:

PACOSI Make Recommendations

to SSCN Core

Approved

Not Approved

Implementation, Monitoring Evaluation

Appeal Process

Approval Pending: Evaluation, Clinical Trial, Funding

Decision by AHS Leadership Zone Operation

Site Leaders Purchase / Implement

SSCN Core Make Recommendations

to AHS Leadership

Acknowledgements

• Paule Poulin

• Sean Grondin

• Jill Robert

• Jonathan White

• And all members who participated in the Environment Scan

• Trevor Schuler

• David Williams

• Luke Rudmik

• Stacey Litvinchuk

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