SlideShare une entreprise Scribd logo
1  sur  25
Télécharger pour lire hors ligne
MAST: a model for HTA-based
assessment of telemedicine
applications


ANNA KOTZEVA, on behalf of the MAST Working group
Catalan Agency for Health Information, Assessment and Quality, Spain

HTAi Annual meeting, June 2012, Bilbao
Contents


1. MAST as a multidisciplinary assessment model
    Background
    Development process
    Aim and structure of the model

2. Empirical test of MAST in the RENEWING HEALTH project
     Project overview
     Experiences and results so far

3. Conclusions
Background


 Telemedicine is considered as a possible solution to the
  challenges of healthcare systems

 Critique of existing evidence for telemedicine
   Hailey et al. 2002:    Lack of clinical outcomes
   Whitten et al. 2002:   Economic studies do not meet standards
   Hersh et al. 2006:     Few studies are well designed



    Lack of high quality evidence on the effectiveness of
telemedicine as a main barrier for its wider implementation
Background


Promotion of assessment of telemedicine-based services




                  MethoTelemed project (2009)
    Aiming to provide a structured framework for assessing the
 effectiveness and contribution to quality of care of telemedicine
                            applications
             Based on users’ and stakeholders’ needs
Development of MAST


Comprehensive process




                         MAST
                    (Manual & Toolkit)
Aim

MAST can be used when the assessment aims to describe
effectiveness and contribution of telemedicine to quality
of care and to produce basis for decision making



Assessment defined as:

A multidisciplinary process that summarizes and evaluates
information about the clinical, economic, organizational and
socio-ethical issues related to the use of telemedicine, in a
systematic, unbiased and robust manner.

                                       *based on EUnetHTA Core Model
How does MAST ensure a
multidisciplinary assessment?
Structure and elements of MAST


The framework suggests 3 stages of assessment:

   I. Preceding considerations


   II. Multidisciplinary Assessment


   III. Transferability of results
I. Preceding considerations



 This stage is about “setting the context”

 Various aspects have to be taken into consideration:
    Maturity of the technology
    Selection of appropriate comparator/s
    Level on which the assessment should be carried out – single
     hospital, region, state
    Number of patients included in the assessment
    Existing legislation and reimbursement policy for telemedicine-
     based services
II. Multidisciplinary assessment



     WHAT should be assessed?
             1. Health problem and characteristics of the application   Descriptive

             2.   Clinical effectiveness
DOMAINS




             3.   Safety                                                Evaluation by outcome
             4.   Patient perspectives                                  (systematic review OR
             5.   Economic aspects                                      empirical study)
             6.   Organisational aspects

             7. Socio-cultural, ethical and legal aspects               Descriptive
II. Multidisciplinary assessment



HOW it should be assessed?

 Study design - Aim for highest possible level of evidence


 Outcome measures should be:
  • patient-important outcomes
  • based on scientific literature to enable comparison
  • validated instruments
III. Transferability assessment


 Answers the question:                                       ?
Can results be generalized to other settings?

This consideration has to be made within each of the domains!


 Examples of limitations for direct transferability of results:
    Country-specific reimbursement conditions
    Healthcare price/hour
    Values and culture influence user preferences and hence, satisfaction
     with the new service
Empirical test of MAST in the
RENEWING HEALTH project
 Project overview

 Experiences and results so far
   Tools to support study design, reporting & analysis
   Training
   Close collaboration and feedback from users
Empirical test of MAST in the
RENEWING HEALTH project
 Project overview

 Experiences and results so far
   Tools to support study design, reporting & analysis
   Training
   Close collaboration and feedback from users
 Funded by the European Community
   ICT Policy Support Program, Competitiveness and Innovation Framework Program


 So far, the largest pragmatic RCT in the area of telemedicine



  DM             7158 patients
 COPD              3 diseases
 CVD
                   84 centers
                    21 pilots
                                            9 RCTs           9 European regions
                   10 clusters
                                           1 observ.
General objective:

 To produce evidence and decision support for the EU health
 policies and the regional authorities regarding the future
 deployment of telemedicine services in those fields where
 these can lead to improved care and reduced cost.


  RENEWING HEALTH Project is not envisioned to produce scientific
          evidence on clinical outcomes of telehealth, BUT
a broader knowledge on benefits of telemedicine services through a
               number of multidisciplinary outcomes
Empirical test of MAST in the
RENEWING HEALTH project
 Project overview

 Experiences and results so far
   Tools to support study design, reporting & analysis
   Training
   Close collaboration and feedback from users
Application of MAST in practice stimulates its
  further development and improvement




A number of tools were developed to support
  study design, data management, analysis
          and reporting of results
• Clinical study protocols
   1

        • Minimum dataset of common outcomes
   2
        • Clinical database and guidance on coding
   3      and monitoring

        • Guide for analysis and reporting of results
   4

Ensures quality and comparability of data
Training


 Open seminars
     Berlin, May 2010
      Introduction to the framework, 80 participants
      www.mast-model.info
     Treviso, Feb 2012
      Guidance on data analysis and reporting of results, 60 participants


 Dissemination
     Kidholm et al. A model for assessment of telemedicine applications -
      MAST. Int J Tech Ass Health Care, 28:1, Jan 2012
     Communications
     Website forthcoming!!!
Collaboration and users feedback


 European projects
  RENEWING HEALTH http://www.renewinghealth.eu/ (21 trials)

              http://www.incasa-project.eu/news.php (5 trials)

  INTEGRATED HOME CARE http://www.integratedhomecare.eu/


 Recommended by:
  British Thoracic Society (statement on respiratory care)
  National Danish Strategy for Telemedicine
Collaboration and users feedback


 European regions adopting MAST as a general framework
  for telemedicine assessment
    Norbotten (Sweden)
    Veneto (Italy)
    Basque country (Spain)


 Development of a French version
  MEETIC:
  Modèle pour l'Evaluation (Economique) de la Télémédecine
  Recherche Clinique Santé Publique, Paris
In conclusion…

 Advantages of MAST
    Multidisciplinary and very comprehensive
    Based on scientific evidence, on criteria for quality and on
     stakeholders’ needs
    Establishes a common standard for all stages of study development
     (design, data collection, analysis and reporting)

 Limitations of MAST
      Time consuming
      Only relevant in assessment of mature telemedicine applications
      Doesn’t give indications for prioritization when resources are limited
      More operational criteria are needed
                                    ON THE WAY TO             MAST 2
In conclusion…


 Empirical test of MAST is ongoing (>25 trials use it currently)

 Based on the results a revision will be made

 So far MAST has been a useful and comprehensive framework
  for study design, data collection and assessment, and ensures
  comparability of results for telemedicine studies in different
  cultural contexts

 Based on the validation we hope MAST will be established as
  the first widely accepted methodology for the evaluation of
  complex telemedicine interventions
Thank you!

Anna Kotzeva
akotzeva@aatrm.catsalut.cat

Kristian Kidholm
Kristian.Kidholm@ouh.regionsyddanmark.dk




     www.renewinghealth.eu

Contenu connexe

Similaire à MAST: a model for HTA-based assessment of telemedicine applications

MAST and its application in RENEWING HEALTH
MAST and its application in RENEWING HEALTHMAST and its application in RENEWING HEALTH
MAST and its application in RENEWING HEALTHAnna Kotzeva
 
Implementing eHealth: from pilot to practice
Implementing eHealth: from pilot to practiceImplementing eHealth: from pilot to practice
Implementing eHealth: from pilot to practiceAnna Kotzeva
 
Evaluating the impact of HTA and ‘better decision-making’ on health outcomes
Evaluating the impact of HTA and ‘better decision-making’ on health outcomesEvaluating the impact of HTA and ‘better decision-making’ on health outcomes
Evaluating the impact of HTA and ‘better decision-making’ on health outcomescheweb1
 
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...Criteria for assessment of new technologies at the hospital level (mini-HTA) ...
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...HTAi Bilbao 2012
 
eHealth and patient outcomes
eHealth and patient outcomeseHealth and patient outcomes
eHealth and patient outcomesAnna Kotzeva
 
Four strategies to upgrade clinical trial quality in this computerized world ...
Four strategies to upgrade clinical trial quality in this computerized world ...Four strategies to upgrade clinical trial quality in this computerized world ...
Four strategies to upgrade clinical trial quality in this computerized world ...Pubrica
 
2014 11-19 rb progressive fieldevaluationmerck
2014 11-19 rb progressive fieldevaluationmerck2014 11-19 rb progressive fieldevaluationmerck
2014 11-19 rb progressive fieldevaluationmerckReiner Banken
 
Structured decision making approaches to the inclusion of multiple criteria i...
Structured decision making approaches to the inclusion of multiple criteria i...Structured decision making approaches to the inclusion of multiple criteria i...
Structured decision making approaches to the inclusion of multiple criteria i...Office of Health Economics
 
Seeking value: Experience from the UK's National Institute for Health and Car...
Seeking value: Experience from the UK's National Institute for Health and Car...Seeking value: Experience from the UK's National Institute for Health and Car...
Seeking value: Experience from the UK's National Institute for Health and Car...OECD Governance
 
The bottom line in telemedicine slide show
The bottom line in telemedicine slide showThe bottom line in telemedicine slide show
The bottom line in telemedicine slide showHeather Zumpano
 
International Journal of Technology Assessment in Health Care,
International Journal of Technology Assessment in Health Care,International Journal of Technology Assessment in Health Care,
International Journal of Technology Assessment in Health Care,TatianaMajor22
 
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.IMSTA
 
Co-ordinated malaria research for better policy and practice: the role of res...
Co-ordinated malaria research for better policy and practice: the role of res...Co-ordinated malaria research for better policy and practice: the role of res...
Co-ordinated malaria research for better policy and practice: the role of res...ACT Consortium
 
Technologies Working Group ERS 2017
Technologies Working Group ERS 2017Technologies Working Group ERS 2017
Technologies Working Group ERS 2017Kathryn Brown
 
Nchcmm presentation 10 variables_the reason_g_cole_8-2011
Nchcmm presentation 10 variables_the reason_g_cole_8-2011Nchcmm presentation 10 variables_the reason_g_cole_8-2011
Nchcmm presentation 10 variables_the reason_g_cole_8-2011eileenhaag
 
National frontier and rural attc workforce
National frontier and rural attc workforceNational frontier and rural attc workforce
National frontier and rural attc workforcemikewilhelm
 
hsns09:The Scottish telecare development programme:the evaluation - Sophie Beale
hsns09:The Scottish telecare development programme:the evaluation - Sophie Bealehsns09:The Scottish telecare development programme:the evaluation - Sophie Beale
hsns09:The Scottish telecare development programme:the evaluation - Sophie BealeIriss
 

Similaire à MAST: a model for HTA-based assessment of telemedicine applications (20)

MAST and its application in RENEWING HEALTH
MAST and its application in RENEWING HEALTHMAST and its application in RENEWING HEALTH
MAST and its application in RENEWING HEALTH
 
Implementing eHealth: from pilot to practice
Implementing eHealth: from pilot to practiceImplementing eHealth: from pilot to practice
Implementing eHealth: from pilot to practice
 
Evaluating the impact of HTA and ‘better decision-making’ on health outcomes
Evaluating the impact of HTA and ‘better decision-making’ on health outcomesEvaluating the impact of HTA and ‘better decision-making’ on health outcomes
Evaluating the impact of HTA and ‘better decision-making’ on health outcomes
 
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...Criteria for assessment of new technologies at the hospital level (mini-HTA) ...
Criteria for assessment of new technologies at the hospital level (mini-HTA) ...
 
eHealth and patient outcomes
eHealth and patient outcomeseHealth and patient outcomes
eHealth and patient outcomes
 
Four strategies to upgrade clinical trial quality in this computerized world ...
Four strategies to upgrade clinical trial quality in this computerized world ...Four strategies to upgrade clinical trial quality in this computerized world ...
Four strategies to upgrade clinical trial quality in this computerized world ...
 
2014 11-19 rb progressive fieldevaluationmerck
2014 11-19 rb progressive fieldevaluationmerck2014 11-19 rb progressive fieldevaluationmerck
2014 11-19 rb progressive fieldevaluationmerck
 
Structured decision making approaches to the inclusion of multiple criteria i...
Structured decision making approaches to the inclusion of multiple criteria i...Structured decision making approaches to the inclusion of multiple criteria i...
Structured decision making approaches to the inclusion of multiple criteria i...
 
Seeking value: Experience from the UK's National Institute for Health and Car...
Seeking value: Experience from the UK's National Institute for Health and Car...Seeking value: Experience from the UK's National Institute for Health and Car...
Seeking value: Experience from the UK's National Institute for Health and Car...
 
The bottom line in telemedicine slide show
The bottom line in telemedicine slide showThe bottom line in telemedicine slide show
The bottom line in telemedicine slide show
 
International Journal of Technology Assessment in Health Care,
International Journal of Technology Assessment in Health Care,International Journal of Technology Assessment in Health Care,
International Journal of Technology Assessment in Health Care,
 
Health technology
Health technologyHealth technology
Health technology
 
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.
Dr Brenda Dooley, Managing Director, AXIS Healthcare Consulting Ltd.
 
2.tic sante atelierh2020- pcn santé-10sept15
2.tic sante atelierh2020- pcn santé-10sept152.tic sante atelierh2020- pcn santé-10sept15
2.tic sante atelierh2020- pcn santé-10sept15
 
Co-ordinated malaria research for better policy and practice: the role of res...
Co-ordinated malaria research for better policy and practice: the role of res...Co-ordinated malaria research for better policy and practice: the role of res...
Co-ordinated malaria research for better policy and practice: the role of res...
 
Technologies Working Group ERS 2017
Technologies Working Group ERS 2017Technologies Working Group ERS 2017
Technologies Working Group ERS 2017
 
Nchcmm presentation 10 variables_the reason_g_cole_8-2011
Nchcmm presentation 10 variables_the reason_g_cole_8-2011Nchcmm presentation 10 variables_the reason_g_cole_8-2011
Nchcmm presentation 10 variables_the reason_g_cole_8-2011
 
National frontier and rural attc workforce
National frontier and rural attc workforceNational frontier and rural attc workforce
National frontier and rural attc workforce
 
Aligning Health Service And ICT Trends
Aligning Health Service And ICT TrendsAligning Health Service And ICT Trends
Aligning Health Service And ICT Trends
 
hsns09:The Scottish telecare development programme:the evaluation - Sophie Beale
hsns09:The Scottish telecare development programme:the evaluation - Sophie Bealehsns09:The Scottish telecare development programme:the evaluation - Sophie Beale
hsns09:The Scottish telecare development programme:the evaluation - Sophie Beale
 

Plus de HTAi Bilbao 2012

How Glaucoma Patients Assess Different Aspects of Their Treatment? An Elicit...
How Glaucoma Patients Assess Different Aspects of Their Treatment?  An Elicit...How Glaucoma Patients Assess Different Aspects of Their Treatment?  An Elicit...
How Glaucoma Patients Assess Different Aspects of Their Treatment? An Elicit...HTAi Bilbao 2012
 
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...HTAi Bilbao 2012
 
Health Technology Assessment (HTA) Report: Interventions to increase particip...
Health Technology Assessment (HTA) Report: Interventions to increase particip...Health Technology Assessment (HTA) Report: Interventions to increase particip...
Health Technology Assessment (HTA) Report: Interventions to increase particip...HTAi Bilbao 2012
 
The use of ‘colloquial evidence’ in HTA: the experience of NICE
The use of ‘colloquial evidence’ in HTA:  the experience of NICE The use of ‘colloquial evidence’ in HTA:  the experience of NICE
The use of ‘colloquial evidence’ in HTA: the experience of NICE HTAi Bilbao 2012
 
Social values international programme: integrating research and policy to ens...
Social values international programme: integrating research and policy to ens...Social values international programme: integrating research and policy to ens...
Social values international programme: integrating research and policy to ens...HTAi Bilbao 2012
 
Challenges in commissioning research on what works in integrated care
Challenges in commissioning research on what works in integrated careChallenges in commissioning research on what works in integrated care
Challenges in commissioning research on what works in integrated careHTAi Bilbao 2012
 
Building a portfolio of research findings for use by healthcare managers and ...
Building a portfolio of research findings for use by healthcare managers and ...Building a portfolio of research findings for use by healthcare managers and ...
Building a portfolio of research findings for use by healthcare managers and ...HTAi Bilbao 2012
 
Assessing the International Use
Assessing the International Use Assessing the International Use
Assessing the International Use HTAi Bilbao 2012
 
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...HTAi Bilbao 2012
 
On the outside looking in.
On the outside looking in. On the outside looking in.
On the outside looking in. HTAi Bilbao 2012
 
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...HTAi Bilbao 2012
 
How to promote the prescription of evidence-based non-pharmacological treatme...
How to promote the prescription of evidence-based non-pharmacological treatme...How to promote the prescription of evidence-based non-pharmacological treatme...
How to promote the prescription of evidence-based non-pharmacological treatme...HTAi Bilbao 2012
 
The eunethta planned and ongoing projects database
The eunethta planned and ongoing projects databaseThe eunethta planned and ongoing projects database
The eunethta planned and ongoing projects databaseHTAi Bilbao 2012
 
Evaluation of an e health intervention for cancer patients' support
Evaluation of an e health intervention for cancer patients' supportEvaluation of an e health intervention for cancer patients' support
Evaluation of an e health intervention for cancer patients' supportHTAi Bilbao 2012
 
Classification of oecd countries reimbursement systems at the individual tech...
Classification of oecd countries reimbursement systems at the individual tech...Classification of oecd countries reimbursement systems at the individual tech...
Classification of oecd countries reimbursement systems at the individual tech...HTAi Bilbao 2012
 
Bevacizumab for neovascular age related macular degeneration
Bevacizumab for neovascular age related macular degenerationBevacizumab for neovascular age related macular degeneration
Bevacizumab for neovascular age related macular degenerationHTAi Bilbao 2012
 
Azienda ospedaliero Universitaria of Udine
Azienda ospedaliero Universitaria of UdineAzienda ospedaliero Universitaria of Udine
Azienda ospedaliero Universitaria of UdineHTAi Bilbao 2012
 
The application of Health Technology Assessment in the field of biologics: an...
The application of Health Technology Assessment in the field of biologics: an...The application of Health Technology Assessment in the field of biologics: an...
The application of Health Technology Assessment in the field of biologics: an...HTAi Bilbao 2012
 
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...HTAi Bilbao 2012
 

Plus de HTAi Bilbao 2012 (20)

How Glaucoma Patients Assess Different Aspects of Their Treatment? An Elicit...
How Glaucoma Patients Assess Different Aspects of Their Treatment?  An Elicit...How Glaucoma Patients Assess Different Aspects of Their Treatment?  An Elicit...
How Glaucoma Patients Assess Different Aspects of Their Treatment? An Elicit...
 
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...
 
Health Technology Assessment (HTA) Report: Interventions to increase particip...
Health Technology Assessment (HTA) Report: Interventions to increase particip...Health Technology Assessment (HTA) Report: Interventions to increase particip...
Health Technology Assessment (HTA) Report: Interventions to increase particip...
 
The use of ‘colloquial evidence’ in HTA: the experience of NICE
The use of ‘colloquial evidence’ in HTA:  the experience of NICE The use of ‘colloquial evidence’ in HTA:  the experience of NICE
The use of ‘colloquial evidence’ in HTA: the experience of NICE
 
Social values international programme: integrating research and policy to ens...
Social values international programme: integrating research and policy to ens...Social values international programme: integrating research and policy to ens...
Social values international programme: integrating research and policy to ens...
 
Challenges in commissioning research on what works in integrated care
Challenges in commissioning research on what works in integrated careChallenges in commissioning research on what works in integrated care
Challenges in commissioning research on what works in integrated care
 
Building a portfolio of research findings for use by healthcare managers and ...
Building a portfolio of research findings for use by healthcare managers and ...Building a portfolio of research findings for use by healthcare managers and ...
Building a portfolio of research findings for use by healthcare managers and ...
 
Assessing the International Use
Assessing the International Use Assessing the International Use
Assessing the International Use
 
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...
 
On the outside looking in.
On the outside looking in. On the outside looking in.
On the outside looking in.
 
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...
 
How to promote the prescription of evidence-based non-pharmacological treatme...
How to promote the prescription of evidence-based non-pharmacological treatme...How to promote the prescription of evidence-based non-pharmacological treatme...
How to promote the prescription of evidence-based non-pharmacological treatme...
 
The eunethta planned and ongoing projects database
The eunethta planned and ongoing projects databaseThe eunethta planned and ongoing projects database
The eunethta planned and ongoing projects database
 
Evaluation of an e health intervention for cancer patients' support
Evaluation of an e health intervention for cancer patients' supportEvaluation of an e health intervention for cancer patients' support
Evaluation of an e health intervention for cancer patients' support
 
Classification of oecd countries reimbursement systems at the individual tech...
Classification of oecd countries reimbursement systems at the individual tech...Classification of oecd countries reimbursement systems at the individual tech...
Classification of oecd countries reimbursement systems at the individual tech...
 
Bevacizumab for neovascular age related macular degeneration
Bevacizumab for neovascular age related macular degenerationBevacizumab for neovascular age related macular degeneration
Bevacizumab for neovascular age related macular degeneration
 
Azienda ospedaliero Universitaria of Udine
Azienda ospedaliero Universitaria of UdineAzienda ospedaliero Universitaria of Udine
Azienda ospedaliero Universitaria of Udine
 
HTAi in hospitals
HTAi in hospitalsHTAi in hospitals
HTAi in hospitals
 
The application of Health Technology Assessment in the field of biologics: an...
The application of Health Technology Assessment in the field of biologics: an...The application of Health Technology Assessment in the field of biologics: an...
The application of Health Technology Assessment in the field of biologics: an...
 
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
 

Dernier

High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...bkling
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
General_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingGeneral_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingAnonymous
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 

Dernier (20)

High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...
Moving Forward After Uterine Cancer Treatment: Surveillance Strategies, Testi...
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
General_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingGeneral_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_Wellbeing
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 

MAST: a model for HTA-based assessment of telemedicine applications

  • 1. MAST: a model for HTA-based assessment of telemedicine applications ANNA KOTZEVA, on behalf of the MAST Working group Catalan Agency for Health Information, Assessment and Quality, Spain HTAi Annual meeting, June 2012, Bilbao
  • 2. Contents 1. MAST as a multidisciplinary assessment model  Background  Development process  Aim and structure of the model 2. Empirical test of MAST in the RENEWING HEALTH project  Project overview  Experiences and results so far 3. Conclusions
  • 3. Background  Telemedicine is considered as a possible solution to the challenges of healthcare systems  Critique of existing evidence for telemedicine Hailey et al. 2002: Lack of clinical outcomes Whitten et al. 2002: Economic studies do not meet standards Hersh et al. 2006: Few studies are well designed Lack of high quality evidence on the effectiveness of telemedicine as a main barrier for its wider implementation
  • 4. Background Promotion of assessment of telemedicine-based services MethoTelemed project (2009) Aiming to provide a structured framework for assessing the effectiveness and contribution to quality of care of telemedicine applications Based on users’ and stakeholders’ needs
  • 5. Development of MAST Comprehensive process MAST (Manual & Toolkit)
  • 6. Aim MAST can be used when the assessment aims to describe effectiveness and contribution of telemedicine to quality of care and to produce basis for decision making Assessment defined as: A multidisciplinary process that summarizes and evaluates information about the clinical, economic, organizational and socio-ethical issues related to the use of telemedicine, in a systematic, unbiased and robust manner. *based on EUnetHTA Core Model
  • 7. How does MAST ensure a multidisciplinary assessment?
  • 8. Structure and elements of MAST The framework suggests 3 stages of assessment: I. Preceding considerations II. Multidisciplinary Assessment III. Transferability of results
  • 9. I. Preceding considerations  This stage is about “setting the context”  Various aspects have to be taken into consideration:  Maturity of the technology  Selection of appropriate comparator/s  Level on which the assessment should be carried out – single hospital, region, state  Number of patients included in the assessment  Existing legislation and reimbursement policy for telemedicine- based services
  • 10. II. Multidisciplinary assessment WHAT should be assessed? 1. Health problem and characteristics of the application Descriptive 2. Clinical effectiveness DOMAINS 3. Safety Evaluation by outcome 4. Patient perspectives (systematic review OR 5. Economic aspects empirical study) 6. Organisational aspects 7. Socio-cultural, ethical and legal aspects Descriptive
  • 11. II. Multidisciplinary assessment HOW it should be assessed?  Study design - Aim for highest possible level of evidence  Outcome measures should be: • patient-important outcomes • based on scientific literature to enable comparison • validated instruments
  • 12. III. Transferability assessment  Answers the question: ? Can results be generalized to other settings? This consideration has to be made within each of the domains!  Examples of limitations for direct transferability of results:  Country-specific reimbursement conditions  Healthcare price/hour  Values and culture influence user preferences and hence, satisfaction with the new service
  • 13. Empirical test of MAST in the RENEWING HEALTH project  Project overview  Experiences and results so far  Tools to support study design, reporting & analysis  Training  Close collaboration and feedback from users
  • 14. Empirical test of MAST in the RENEWING HEALTH project  Project overview  Experiences and results so far  Tools to support study design, reporting & analysis  Training  Close collaboration and feedback from users
  • 15.  Funded by the European Community ICT Policy Support Program, Competitiveness and Innovation Framework Program  So far, the largest pragmatic RCT in the area of telemedicine DM 7158 patients COPD 3 diseases CVD 84 centers 21 pilots 9 RCTs 9 European regions 10 clusters 1 observ.
  • 16. General objective: To produce evidence and decision support for the EU health policies and the regional authorities regarding the future deployment of telemedicine services in those fields where these can lead to improved care and reduced cost. RENEWING HEALTH Project is not envisioned to produce scientific evidence on clinical outcomes of telehealth, BUT a broader knowledge on benefits of telemedicine services through a number of multidisciplinary outcomes
  • 17. Empirical test of MAST in the RENEWING HEALTH project  Project overview  Experiences and results so far  Tools to support study design, reporting & analysis  Training  Close collaboration and feedback from users
  • 18. Application of MAST in practice stimulates its further development and improvement A number of tools were developed to support study design, data management, analysis and reporting of results
  • 19. • Clinical study protocols 1 • Minimum dataset of common outcomes 2 • Clinical database and guidance on coding 3 and monitoring • Guide for analysis and reporting of results 4 Ensures quality and comparability of data
  • 20. Training  Open seminars  Berlin, May 2010 Introduction to the framework, 80 participants www.mast-model.info  Treviso, Feb 2012 Guidance on data analysis and reporting of results, 60 participants  Dissemination  Kidholm et al. A model for assessment of telemedicine applications - MAST. Int J Tech Ass Health Care, 28:1, Jan 2012  Communications  Website forthcoming!!!
  • 21. Collaboration and users feedback  European projects RENEWING HEALTH http://www.renewinghealth.eu/ (21 trials) http://www.incasa-project.eu/news.php (5 trials) INTEGRATED HOME CARE http://www.integratedhomecare.eu/  Recommended by: British Thoracic Society (statement on respiratory care) National Danish Strategy for Telemedicine
  • 22. Collaboration and users feedback  European regions adopting MAST as a general framework for telemedicine assessment  Norbotten (Sweden)  Veneto (Italy)  Basque country (Spain)  Development of a French version MEETIC: Modèle pour l'Evaluation (Economique) de la Télémédecine Recherche Clinique Santé Publique, Paris
  • 23. In conclusion…  Advantages of MAST  Multidisciplinary and very comprehensive  Based on scientific evidence, on criteria for quality and on stakeholders’ needs  Establishes a common standard for all stages of study development (design, data collection, analysis and reporting)  Limitations of MAST  Time consuming  Only relevant in assessment of mature telemedicine applications  Doesn’t give indications for prioritization when resources are limited  More operational criteria are needed ON THE WAY TO MAST 2
  • 24. In conclusion…  Empirical test of MAST is ongoing (>25 trials use it currently)  Based on the results a revision will be made  So far MAST has been a useful and comprehensive framework for study design, data collection and assessment, and ensures comparability of results for telemedicine studies in different cultural contexts  Based on the validation we hope MAST will be established as the first widely accepted methodology for the evaluation of complex telemedicine interventions
  • 25. Thank you! Anna Kotzeva akotzeva@aatrm.catsalut.cat Kristian Kidholm Kristian.Kidholm@ouh.regionsyddanmark.dk www.renewinghealth.eu