copy of marzban -a model for national health technology selection and use[1]

A Model for National Medical Technology

Selection and Use

Dr. Sima MarzbanIRAHTA

Dr.

Sim

a M

arzb

an

Health Technology Assessment

Knowledge Production

Synthesis ofInformation

Data Bases

HTASocial and

Ethical Factors

Health Policy (MACRO)

Practice Guidelines (MICRO)

Quality Assessment of Services

PROCESS

RN Battista et al., 1999

Institutional Management (MESO)

Knowledge Production

Synthesis ofInformation

Data Bases

HTASocial and

Ethical Factors

Health Policy (MACRO)

Practice Guidelines (MICRO)

Quality Assessment of Services

PROCESS

RN Battista et al., 1999

Institutional Management (MESO)

Dr.

Sim

a M

arzb

an

Role of HTA units in Health strategic planning

Proposals

Investment Budget

HTA-U

Mission(Effectiveness)

(Balance)(Appropriateness)

Goal setting(Selection of strategic options)

Strategic Plan

Implementation of plans

Strategic Monitoring

Feedback

Guidelines for technology needs

assessment

Clinical Departments

Dr.

Sim

a M

arzb

an

Research conceptual frameworkTo reply questions like : What are the sources of appropriate medical technology

selection and use in other countries?

What are the Health technology assessment and Management as used tools for selection and use of appropriate medical equipment in health systems?

What methods are being used for selection and use of health technology/medical equipment in Iran?

What model of management system is suitable for adoption of HTA & M approach to the context of health system in Iran ?

Dr.

Sim

a M

arzb

an

Components of HCT selection and use system

Policy and plans of HCT

Financial resource allocation pattern to HCT

Methods of assessment and selection of HCT

Methods of maintaining HCT use maintenance

Selection and use of appropriate Technology/

Medical Equipment

Scope of study

Dr.

Sim

a M

arzb

an

To review and analyze current system for the selection and use of medical equipments

To design an improved model of medical

equipment appropriate selection and use in Iran’s health system

Dr.

Sim

a M

arzb

an

SSADM Structured system analysis and design

methodology Tool Structured questionnaire, exploring, confirmatory

and complementary interviews, Showing system byDFDs

Ration Systemic relations ,Integrative policies and

information ,Technology assessment Approach, Stratified decision making D

r. S

ima

Mar

zban

Medical Equipment Current National Situation Data Flow Diagram Zero level

Dr.

Sim

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arzb

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Medical Equipment central Office Current situation Data flow diagram (first level)

Dr.

Sim

a M

arzb

an

Medical Equipment central Office Current situation DFD: first levelDr.

Sim

a M

arzb

an

Lack of systemic integration Health policy Health technology policy Strategic health plan Strategic technology plan Prioritized health pack Prioritized health tech Macro health tech/Equipment policy Micro health Information flow (ex. inventory ) Down Top

Dr.

Sim

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arzb

an

Structural insufficiency Focusing on non value added duties Units based on kinds of administrative inputs Preference of informal relationships Non clarified process and relationships Centralized administrative decision making? Lack of systemic and informational integrity

Dr.

Sim

a M

arzb

an

Rational financial planning Separate budget lines? life time costs? Annual expenditure plans? Clarified process of work? Donation priorities? Selection of technology? Assessment of technology ? Personnel training? Procurement process? Maintenance and repair ?

Dr.

Sim

a M

arzb

an

Involved divisions Management and planning Allocation of financial resources Technology Assessment Selection of technology and suppliers Pre use activities Continued operation ,maintenance and

use

Dr.

Sim

a M

arzb

an

Integration of health policies and plans with health technologies

Defined prioritized health package Prioritized health technology package Standardization of technologies Decentralization of local decisions Enabling local experts for decisions

Dr.

Sim

a M

arzb

an

Dr.

Sim

a M

arzb

an

Process –based structure Focus on Value –added process Resignation & decentralization Integrative decision making and flow of

information Stratified decision making model by

provider’s level of authority Less complexity and minimum waste of Time and expertise

Dr.

Sim

a M

arzb

an

Designed Medical Equipment Central Office Data Flow Diagram

Dr.

Sim

a M

arzb

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Des

igne

d M

edic

al E

quip

men

t ce

ntra

l Offi

ce

MO

H D

ata

Flow

Dia

gram

Dr.

Sim

a M

arzb

an

Medical Universities Data Flow Diagram: Equipment selection and Use Area

Dr.

Sim

a M

arzb

an

Des

igne

d M

edic

al U

nive

rsiti

es D

ata

Flow

Dia

gram

:

Equ

ipm

ent

sele

ctio

n an

d U

se A

rea

Dr.

Sim

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Designed Hospitals Data Flow Diagram: Equipment Selection and Use Area

Dr.

Sim

a M

arzb

an

Future researches:

To develop inventory data bank clarifying existent equipment , performance level of medical equipments and invested resources to this field .

To define human resources and required educational programs needed including workshops, degrees and training packages.

Developing guide draft of HCTM for policy makers and managers and experts

To study effectiveness or efficiency of broad use of costly medical equipments in Iran .

Setting prioritized medical equipment for all health care levels.

Dr.

Sim

a M

arzb

an