Wednesday, June 15, 2011

The Importance of Looking into the Future: Horizon Scanning at AHRQ

I was in DC last week and spent some time with AHRQ's Healthcare Horizon Scanning System folks.  Their job is to identify, monitor, and track new and emerging health care technologies and interventions that could signal important changes to patient care, health outcomes, and the United States health care system - ranging from drugs and medical devices to new services and innovative care processes. The HHSS is a resource for the Effective Health Care (EHC) Program as it makes decisions about allocating resources for patient-centered outcomes research. It will also be a tool for the public to identify and find information on new health care technologies and interventions. Any investigator or funder of research will be able to use the HHSS to select potential topics for research.

While this is a relatively new group at AHRQ, it turns out this type of formal "Horizon Scanning" process is common in Europe, although more centered on meds, devices and procedures.  For example, there is the UK's National Horizon Scanning Centre as well as the larger International Information Network on New and Emerging Health Technologies (EuroScan), a collaborative network of member agencies for the exchange of information on important emerging new drugs, devices, procedures, programmes, and settings in health care.

One thing that struck me was the clear distinction between Products and Technologies (e.g. pharmaceuticals, medical devices, procedures) vs. Information Technology (e.g. EMRs and "health apps") vs. Care Innovations. For products, it appears that the methodology is relatively consistent (e.g. you can easily find early items via phase 2 trials, prioritize based on significance and effectiveness, and do comparative evaluations against similar products -- and then market forces help with diffusion since some companies can make so much money on successes).

But the same process cannot be applied to Care Innovations or HIT. So what is the best way to "find, filter, evaluate and diffuse" these items?  Here are some ideas:

• Scanning: The AHRQ Innovations Exchange is an amazing collection of healthcare service and IT innovations and is a great starting point for those who are looking for new ideas to stimulate them!  Other obvious resources are a wide a variety of conferences and newsletters.  Some conferences I like for cutting edge ideas are Health 2.0, HIMSS (yes, it's big and corporate - but there are always things bubbling there) and World Congress Innovation Summit.  I also have stumbled onto a few non-healthcare conferences dealing with User Interface/Human Centered design which are amazing.  For blogs, some favorites are  HISTalk, Ted Eytan, Jay Parkinson, and Halamka's.  For newsletters, I follow CHCF, ModernHealthcare, HIT Strategist, iHealthbeat, H&HN, HDM, CMIO and FierceEMR. 

• Filtering/Evaluation: This will involve watching how pilot project fare, creating models to help extrapolate to different environments (e.g. based on size, payment methods…), and ideally help support funding to try additional pilots in different environments to understand if reproducible and scalable.

• Diffusing: Major education, funding for early beacon programs, possible policy change around reimbursement and other (e.g. allowing more tele-care).   A recent CHCF paper on Spreading Innovations is particularly relevant.

So thank you AHRQ for being on the lookout for Care and HIT Innovations and trying to figure out how to spread those that are doing well!


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