Chiumente Marco, Kamal Khalid M, Dauben Hans-Peter, Riedel Rainer, Gutierrez-Ibarluzea Inaki
Scientific Direction, Italian Society for Clinical Pharmacy and Therapeutics, Milan, Italy.
Division of Pharmaceutical, Administrative and Social Sciences, School of Pharmacy, Duquesne University, Pittsburgh, United States.
GMS Health Innov Technol. 2019 Sep 24;15:Doc02. doi: 10.3205/hta000132. eCollection 2019.
Health Technology Assessment (HTA) is a systematic evaluation of a health technology, designed to appraise the direct or intended effects and indirect or unintended consequences of the technology with an overall goal of supporting informed decision making regarding the use of these health technologies in the healthcare system. In this paper, we present fundamental HTA concepts and provide a conceptual framework that embraces the processes and outcomes required for integrated healthcare decision-making. The "HTA Metro Map" was designed to guide the user through the different areas on: where to use, what and whom to involve within the decision process. The map reflects the complexity and inter-connectedness of the different kind of healthcare services that need to work together to be able to efficiently deliver coordinated decisions at local, regional, national, and international levels. This tool may also serve as base for facilitating developments and improvements of the HTA structure worldwide. The paper discusses the main features of the "HTA Metro Map" while reinforcing the key concepts underlying HTA's integrated approach. The first view of the map provides the several layers of complexity seen in HTA and the various lines within the map represent the main actors involved in the assessment processes. The map connections and crossings symbolize the interprofessional and interpersonal collaborations while the stations denote the knowledge, skills, experiences, and attitudes of each professionals as they interact within this framework. Every line represents a HTA stakeholder and the circular line in the centre represents the patient at the centre of the system. The zones, from social to community and hospital level, represent the need for integration from the perspective of health systems. The HTA Metro Map also has different dimensions depicted by the level of profoundness. Finally, the concepts of different healthcare stakeholder perspectives are introduced both in visual and temporal terms. The "HTA Metro Map" is designed as a flexible model for easy adaptability and in accurately capturing the complexity inherent in any healthcare system. It is hoped that the map will assist different stakeholders to build network capacity, pool existing resources, and develop a more holistic vision that will result in a sustainable, efficient and collaborative decision-making process.
卫生技术评估（HTA）是对一项卫生技术进行的系统评估，旨在评估该技术的直接或预期效果以及间接或非预期后果，其总体目标是支持就这些卫生技术在医疗保健系统中的使用做出明智决策。在本文中，我们介绍了卫生技术评估的基本概念，并提供了一个概念框架，该框架涵盖了综合医疗保健决策所需的过程和结果。“HTA地铁图”旨在引导用户了解不同领域：在决策过程中何处使用、涉及什么以及涉及何人。该图反映了不同类型医疗保健服务的复杂性和相互关联性，这些服务需要协同工作，以便能够在地方、区域、国家和国际层面高效地做出协调一致的决策。这个工具也可以作为促进全球卫生技术评估结构发展和改进的基础。本文讨论了“HTA地铁图”的主要特征，同时强化了卫生技术评估综合方法的关键概念。该图的第一视角展示了卫生技术评估中可见的多层复杂性，图中的各种线条代表了评估过程中涉及的主要行为者。图中的连线和交叉点象征着跨专业和人际间的合作，而站点则表示每个专业人员在这个框架内互动时的知识、技能、经验和态度。每条线代表一个卫生技术评估利益相关者，中心的环线代表处于系统中心的患者。从社会到社区再到医院层面的区域，从卫生系统的角度代表了整合的必要性。“HTA地铁图”还通过深度级别描绘了不同维度。最后，从视觉和时间角度介绍了不同医疗保健利益相关者视角的概念。“HTA地铁图”被设计为一个灵活的模型，便于适应并准确捕捉任何医疗保健系统中固有的复杂性。希望该图将帮助不同利益相关者建立网络能力、汇聚现有资源，并形成更全面的愿景，从而实现可持续、高效和协作的决策过程。
