This seminar will discuss how reimbursement and technology approval organisations are expanding the remit of health technology appraisal from narrow questions of health technology appraisals (HTA) to wider questions of health technology optimisation (HTO). Typically decisions about whether or not some technology, intervention or programme should be funded are expressed as either a simple ‘Yes’ or ‘No’. This approach works well in cases where an intervention and its effects are both clearly defined and limited in scope.
Health technology appraisal bodies such as NICE or CADTH frequently evaluate technologies in this fashion. In the Canadian province or Alberta, the HTA body responsible for such decisions is increasingly exploring decision making processes that go beyond individual appraisals to focus on wider questions of technology optimisation. Jeff Round will draw on recent experience in Alberta of an appraisal and optimisation programme around services for the treatment and rehabilitation of people who have suffered an ischemic stroke. He will illustrate the impact that focusing on optimisation can have for a health system, and the challenges for analysts in moving to more complex decision making processes.