Avoiding Bedlam: Optimal

Health Technology Diffusion

at the Bedside and Boardroom

Don Juzwishin PhD

Director, Health Technology

Assessment and Innovation

March 17, 2010

Research and Development Experimental Technology Innovative

TechnologyGeneral Use Obsolescence/

Replacement

Use

Time

HTA and Diffusion of Health Technologies

HTA

HTA

HTAMedical Device

Licensing

Innovation

Disinvestment

Obsolescence

Cert

ain

ty o

f E

vid

en

ce

Effectiveness

Evidence certain

Effective

Uncertain evidence

Not effective

Evidence certain

Not effective

Uncertain evidence

Effective

Promising

technology

Ineffective

technology

Technology

to be

adopted

2. Disinvestment 1. Assessment

4. Innovation

3. Access with

Evidence Development

Alberta Health Services

Health Technology Assessment, Appraisal and InnovationUNIT

FUNCTION

AHS

PROGRAM

OR

SERVICE

disease

prevention

health

promotionscreening diagnosis intervention continuing

care

palliativepublic

healthrehabilitation

AHS HTAI Ecosystem

• Commercially-

valuable IP

• Better

healthcare

products

&treatments

• Increased

demand for

HQP

• Economic

diversification

• Employment

growth

• Increased

system

efficiency

Industry: SME, MNE

Health Technology Assessment and Innovation

Alberta Health and Wellness

Product Testing &

Validation

Wa

rd o

f th

e 2

1st

Cen

tury

Gle

nro

se

Reh

ab

ilita

tion

Ho

sp

ita

l

iRS

M

Oth

ers

Te

stin

g &

De

ve

lop

me

nt S

ite

s

BO

SE

Bio

ma

teri

als

an

d T

issu

e

En

gin

ee

ring

Inte

gra

Nerv

e R

ep

air

an

d R

eg

en

era

tio

n

Bio

se

nso

rs/

Bio

Ima

gin

g

Oth

er

Te

ch

no

log

y

Deve

lop

me

nt

Cen

tre

s

Technology

Commercialization

Ma

rke

t D

eve

lop

me

nt

Pro

gra

ms

Bu

sin

ess G

row

th

Me

nto

rin

g

Inte

rna

tio

na

l Tra

de

Pro

gra

ms

Acce

ss to

Ca

pita

l

Fa

cilita

tion

Fe

de

ral, p

rovin

cia

l an

d

ind

ustr

y fu

nd

ing

Alberta Health Services

HTA ProducersGovernment

Funders

Knowledge and

Technology

Creators

HTA Users

Funder of health

services

Alberta Health

and Wellness

AHTDP

Provider of

health

services

Alberta Health

Services

IHE

U of A

U of C

ECRI

CADTH

Research &

Development

molecules to

bedside to

population

Knowledge Management and Exchange

Knowledge Management

And

Exchange

Monitor

Knowledge

Use

Sustain

Knowledge

Use

Evaluate

Outcomes

Adapt

Knowledge

to Local Context

Assess

Barriers to

Knowledge Use

Select, Tailor,

Implement

Interventions

Identify Problem

Identify, Review,

Select Knowledge

Products/

Tools

Synthesis

Knowledge

Inquiry

KNOWLEDGE CREATION

Graham et al., 2006

Knowledge-to-Action Cycle

•Discussion

•Questions