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
a M
arzb
an
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
a M
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
an
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
a M
arzb
an
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