Technology and Service Assessment Tools in Healthcare

The role of clinical engineers is rapidly changing and the economic constraints have pulled them towards new responsibilities to manage. Particularly, the assessment of health technologies has covered one of the most important areas among clinical engineers’ duties. Different techniques and methodologies for technology assessment and improvement are available in the literature and they are currently in use within hospitals and healthcare facilities. However, scientific research and practical needs seem to be misaligned, causing misuse of scientific results due to the lack of tools easy-to-use from practical perspective. This thesis aims at integrating methodologies, even derived from different sectors, for providing standardized and versatile tools that overcome the current issues, providing healthcare facility with a path to follow for choosing the best methodology to be used in diverse situations. Different case studies are presented, in order to cover the wide range of possibilities within health technology assessment (HTA). Particularly, technology assessment was performed on medical devices using both Hospital-Based HTA for an existing technology and horizon scanning for designing an innovative solution. Then the assessment was extended to hospital services, with particular attention to clinical engineering services, using Multi-Criteria Decision Analysis. Process improvement methodologies were also considered and applied to sterilization service that was also studied and assessed integrating the classical HTA approach with Multi-Criteria Decision Analysis. These studies allowed to identify a path useful from practical perspective and based on scientific approach aimed at helping healthcare professionals and clinical engineers to choose the best methodology in accordance to specific constraints and needs of particular situations.