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医疗保健领域的颠覆性技术不再令人着迷:概念和实例的系统回顾。

Disruptive technologies in health care disenchanted: a systematic review of concepts and examples.

机构信息

Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss (G-BA), Berlin, Germany.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Directorate for Technology and Innovation, Health Technology Assessment Unit, Rome, Italy.

出版信息

Int J Technol Assess Health Care. 2022 May 16;38(1):e70. doi: 10.1017/S0266462322000307.

Abstract

OBJECTIVES

To clarify the concept of disruptive technologies in health care, provide examples and consider implications of potentially disruptive technologies for health technology assessment (HTA).

METHODS

We conducted a systematic review of conceptual and empirical papers on healthcare technologies that are described as "" We searched MEDLINE and Embase from 2013 to April 2019 (updated in December 2021). Data extraction was done in duplicate by pairs of reviewers utilizing a data extraction form. A qualitative data analysis was undertaken based on an analytic framework for analysis of the concept and examples. Key arguments and a number of potential predictors of disruptive technologies were derived and implications for HTA organizations were discussed.

RESULTS

Of 4,107 records, 28 were included in the review. Most of the papers included conceptual discussions and business models for disruptive technologies; only few papers presented empirical evidence. The majority of the evidence is related to the US healthcare system. Key arguments for describing a technology as disruptive include improvement of outcomes for patients, improved access to health care, reduction of costs and better affordability, shift in responsibilities between providers, and change in the organization of health care. A number of possible predictors for disruption were identified to distinguish these from "" innovations.

CONCLUSIONS

Since truly disruptive technologies could radically change technology uptake and may modify provision of care patterns or treatment paths, they require a thorough evaluation of the consequences of using these technologies, including economic and organizational impact assessment and careful monitoring.

摘要

目的

阐明医疗保健领域颠覆性技术的概念,提供示例,并考虑潜在颠覆性技术对卫生技术评估(HTA)的影响。

方法

我们对 2013 年至 2019 年 4 月(2021 年 12 月更新)期间被描述为“颠覆性”的医疗保健技术的概念和实证论文进行了系统回顾。我们在 MEDLINE 和 Embase 上进行了搜索。数据提取由两组评审员使用数据提取表进行重复。根据用于分析概念和示例的分析框架,进行了定性数据分析。得出了颠覆性技术的关键论点和一些潜在预测因素,并讨论了对 HTA 组织的影响。

结果

在 4107 条记录中,有 28 篇被纳入综述。大多数论文包括对颠覆性技术的概念讨论和商业模式;只有少数论文提供了经验证据。大多数证据与美国医疗保健系统有关。将技术描述为颠覆性的关键论点包括改善患者的治疗效果、改善获得医疗保健的机会、降低成本和提高可负担性、提供者之间责任的转变,以及医疗保健组织的变革。确定了一些可能的破坏预测因素,以将其与“创新”区分开来。

结论

由于真正的颠覆性技术可能会彻底改变技术的采用方式,并可能改变医疗服务模式或治疗路径,因此需要对使用这些技术的后果进行彻底评估,包括经济和组织影响评估以及仔细监测。

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