How the decision making process is made in Radiology: a TA C lapproach
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1 III PhD Conference on Technology Assessment How the decision making process is made in Radiology: a TA C lapproach i c k to e d i t c o m p a n y s l o g a n. Maria João Maia FCT / UNL Superviosor: Prof. António Brandão Moniz (ITAS / KIT) Co-Supervisor: Prof. Michael Decker (ITAS / KIT)
2 Contents 1 Introduction 2 Methods 3 Preliminary Results 4 Remarks 2
3 Introduction HTA importance Portugal does not have HTA tradition (except for pharmaceutical products) Medical Devices - There are currently no effective methods for regulating the distribution (private sector) Lack of research in the field Thesis importance 3
4 Introduction Medical Device - Magnetic Resonance Recent medical device WHY? Promising future Large benefits for diagnose /Therapeutic Relevancy due to the current situation (NHS) Lack of TA studies 4
5 Introduction Properties Impacts Effects Direct, intended consequences Indirect, unintended consequences 5
6 Introduction 6
7 Methods WHO??? HOW???? WHEN??? How many??? WHERE??? stakeholders Decision Making Process Acquisition Medical Device - MRI 7
8 Analysis Methods 1. Characterization Form Baseline Information on MRI installed capacity Data collection (Maia, 2011) Contact with companies Document research - Web pages from Hospitals, Clinics... - International agencies reports (HTA), WHO, OECD, EUnetHTA... - National agencies reports DGS, ACSS, ERS... 8
9 Preliminary Results 9 1. Technological Park - MRI A. Number and Characterization of MRI Units B. Geographic Distribution 9
10 Preliminary Results 10 Sector Firm Public Private Total nº % nº % nº % GE???? Hitachi Phillips Siemens Toshiba Esaote TOTAL
11 Preliminary Results 11 Geographic Distribution Public Sector Private Sector 11
12 Methods 2. Questionnaire Competences (Maia, 2011) 12
13 Preliminary Results 3. Questionnaire Decision Making Process Total of 137 MRI equipment Total of 126 Entities 64 on private sector 78 entities contacted 14 on Public Sector
14 Methods 3. Questionnaire Decision Making Process Radiology Department Respondents Radiographer Radiologist (Physician) Technical Assistant (Office) Operational Assistant 14
15 Preliminary Results 2. Questionnaire Competences 116 responses
16 Preliminary Results 116 responses Q28 Q29 5 Q1 Q2 Q3 Q27 4 Q4 Q25 Q26 3 Q5 Q6 Radiographer 2 Q24 1 Q7 Radiologist Q23 Q22 0 Q8 Q9 Technical Assistant Q21 Q10 Operacional Assistant Q20 Q19 Q12 Q11 Average Q18 Q13 Q17 Q16 Q15 Q14
17 Methods 3. Questionnaire Decision Making Process Q1 What was the strongest reason for the technology acquisicion Public Private Expansion capability 3 4 Competitive action. Contract expiration Leadership change Technology development
18 Methods 3. Questionnaire Decision Making Process Q14 Regarding the decision made for the acquisition of the MRI equipment, what is your satisfaction perception, under the perspective of the following? Pu Pri Pu Pri Pu Pri Pu Pri Pu Pri Pu Pri Pu Pri Adminstration unsatisfactory Very Satis. Clinical Leadership Technical Leadreship unsatisfactory Very Satis. unsatisfactory Very Satis. Clinical Staff unsatisfactory Very Satis. Technical Staff unsatisfactory Very Satis. 18
19 Methods 3. Questionnaire Decision Making Process Q15 - Were you the last decision maker throughout the process? Public Private Yes - Department Director No - Administration Board No - Radiology Department No - Administration Board No - Administration Board No - Administration Board No - Department Director No - Administration Board No - Adminstration Board No - Administration Board 19
20 Remarks So far... Finished = 16 Refused = 3 Incomplete = 20 Waiting Auth. = 52 Not contacted = 49 20
21 Remarks Chronogram Selecção das Unidades / Serviços Imagiologia Entrega da tese Contactos com Unidades / Serviços Pré-Teste Apresentação de dados preliminares (1) Publicação (5) Apresentação de dados preliminares (2) Aplicação dos Questionários Realização de Entrevistas Recolha dos questionários Análise dos dados Apresentação de dados preliminares (4) Publicação (6) Apresentação de dados preliminares (3) Publicação (7) Apresentação de dados preliminares Publicação 21
22 Remarks Limitations... Inexistence of MRI technological park Companies list of MRI localization not updated Time to respond to invitation to participate Time to schedule the interview Time to have all questionnaires answered Working Student - contacting hours - lack of time 22
23 Bibliography (1) 2011 Maia, Maria J. F. Competences for decision making in Radiology: a technology assessment approach. (with António B. Moniz) APSIOT, UAL, Lisbon, Portugal. (2) 2011 Maia, Maria J. F. Technology Governance in Radiology: the example of Magnetic Resonance Imaging, PhD Conference on Technology Assessment, FCT UNL, Monte de Caparica, Portugal. (3) 2012 Maia, Maria J.F. O processo de Tomada de Decisão na Radiologia: o exemplo da Ressonância Magnética no contexto da Avaliação de Tecnologia em Saúde, Encontro Pós II Conferência Doutoral em Avaliação de Tecnologia (FCT/UNL). CESNova, Lisbon, Portugal. (4) 2013 Maia, Maria J.F. Equity in access to MRI equipment in an ageing society: a TA approach based on the Portuguese case. (with António B. Moniz) European TA Conference Policy Areas of Great Transitions PACITA Project, National Technical Library, Prague. (5) 2011 Maia, Maria J. F. Decision making process in Radiology: the magnetic resonance example in the TA context, Enterprise and Work Innovation Studies, vol. 7, IET, pp (6) 2011 Maia, Maria J. F. "Competências para a Tomada de Decisão na Radiologia: Uma abordagem de Avaliação de Tecnologia [Competences for decision taking in Radiology: A Technology Assessment approach] (with António B. Moniz) IET Working Papers Series 02/2011, Universidade Nova de Lisboa, IET Research Center on Enterprise and Work Innovation, Faculty of Science and Technology (7) 2012 Maia, Maria J. F. "Technology governance in radiology: the example of magnetic resonance imaging," IET Working Papers Series02/2012, Universidade Nova de Lisboa, IET Research Center on Enterprise and Work Innovation, Faculty of Science and Technology. 23
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