The Service of Health Technology Assessment, Basque Country (Osteba) has identified five domains “non-core” (key variables in the nomenclature and English) on which to develop the decision making that measure the “value” of technologies in the field of health.
This is reflected in the document ‘synthesis of relevant information in support of MCDA (multicriteria Decision Analysis) for decision-making’ which identifies ‘ethical, legal, social, organisational and environmental’ values as the triggers for making ‘necessary’ and ‘correct’ decisions when assessing health technology.
Based on the aforementioned MCDA, a group of experts from Osteba have analyzed these fields under the Coordination of the project developed by the Spanish network of Health Technology Evaluation agencies. In their final assessments, although all agree on the importance of making decisions by evaluating all fields, some see ethics as more important, among which it emphasizes (among other issues) that technological value does not take precedence over the dehumanization of care.
This domain (ethics) highlights the aforementioned ethical conflicts related to the use of technology; as well as the proper transmission of information to the patient; equity, impartiality, justice and inclusion of the gender perspective; the reduction of poverty and inequality; and the empowerment of the citizenry or the patient.
Legal and organizational
From the legislative side, the document states that it is necessary to develop standards, directives, accreditations and transpositions for the proper implementation of the technology. In addition, these standards (they argue) should be complemented by verification of their compliance with particular value to data protection and respect for patient autonomy.
At the organizational level, patient-centred care and long-term alignment are two of the main objectives of the project. For the correct disposition, in addition, the availability of infrastructure, organization (possibility of integrating technology into the existing Health Organization or creating a new one), human resources (quantitative, qualitative and training), skills for introduction (acceptability) and the proper use of Health Technology (adequacy) should be studied.
Social and environmental
Finally, social domains have a special impact on the impact on health prevention and on the environmental domain of the need to manage waste, the use of technology and the study of planned obsolescence.
Outside of these domains, the document identifies “other” values include the opportunity and usefulness, consistency with the plan Profarma and the contribution to the national Gross domestic Product, the innovation of the intervention, the tecnovigilancia and the cyber security of the technology being evaluated.