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Technology assessment in dentistry.

Technology, in the context of dental health care, is a term that can encompass systems such as water fluoridation, clinical procedures such as sealants, or clinical protocols such as antibiotic coverage of patients with a history of heart surgery. Similarly, the term technology assessment (TA) describes a multidisciplinary, scientific process established to guide policy on the adoption and distribution of health technologies. While this process is already well established in medicine, it is just beginning in dentistry. As such, TA is still evolving in dental care in terms of methods and process. TA is required to guide the content of curriculum and standards of practice in a rapidly changing dental environment. It should precede the adoption or deletion of both technologies and of writing practice guidelines. TA makes it possible to shed inappropriate technologies or the inappropriate application of existing technologies, which may free resources to pay for improvements in the dental care we offer.

Canada↗

Medical and dental technology assessment.

Spiraling costs dictate that healthcare expenditures be limited to medical products and services of demonstrated safety and effectiveness, if quality care is to be provided at affordable cost. Scientifically conducted, randomized controlled trials are essential elements of this process. Applicable governmental regulatory procedures are reviewed. These serve as the foundation of the technology assessment process and should not be restricted or curtailed. Healthcare provider groups may make significant contributions in this area, when scientific investigation and objective research are emphasized. Technology manufacturers must promote and support objective analysis of their products. Healthcare insurers are assuming greater responsibility and involvement in outcomes research and technology assessment. The process by which this is accomplished by a major insurer is described. Private insurers and governmental agencies should share data in a consolidated research effort. This will require data base adjustments for compatibility and comparability in inter-agency analysis. Insurance company data bases are significant public health assets that have yet to be utilized to the fullest extent.

American Dental Association↗

Obstetrical data management systems.

Obstetrical data management systems (OBDMSs) are computer systems designed to interface with fetal and maternal monitors. This allows monitoring and charting records to be created and maintained electronically and to be viewed from centralized workstations. In theory, these systems could eliminate paper record keeping from the obstetrics department altogether, although currently at least some paper documentation, such as fetal monitoring strips, is being kept. We evaluated five OBDMSs, one of which is no longer on the market and which we did not rate. Of the remaining systems, three were rated Acceptable; the fourth was rated Acceptable-Not Recommended because it lacks several important features and functions. This Evaluation also includes a Technology Overview, in which we discuss how OBDMSs function. The Overview incorporates a supplementary article, "Obstetrical Care Monitoring and Documentation," describing the monitoring and documentation typically performed during a pregnancy. And in the Selection and Use Guide, we discuss issues involved in choosing, purchasing, and implementing an OBDMS.

Computer Systems↗

Health-care technology transfer: expert and information systems for developing countries.

Computer-based technologies such as information systems and expert systems have an undoubted contribution to health-care development in developing countries. This paper addresses the appropriateness of these technologies for developing countries, the criteria to be used in selection of the technology to be transferred, and the need for a systematic approach to evaluation. A conceptual model for assessing transferability so as to achieve an effective transfer, has been introduced. This requires not only an attempt to amplify the role of information and expert systems in health-care improvement and for socio-economic development, but the analysis of prior experience in transferring these technologies to developing countries. Following this approach, and using operational research techniques such as the Analytic Hierarchy Process, a subjective assessment model has been described that can systematically guide decision-making about computer-based health-care technology to be transferred to developing countries.

Developing Countries↗

Technology for health in the future.

Developments in biogenetics, medical devices, information and communication technologies, and in environmental technologies will have a profound impact on health in the coming decades. However, there are major barriers to the appropriate and effective utilization of current and future technologies, particularly for developing countries. This paper intends to strike a balance between the exciting potential of technologies and the conditions that need to be fulfilled to ensure that technologies are utilized appropriately and effectively. It will emphasize the significance of knowledge associated with technologies, the importance of technology assessment and the need for a broad and comprehensive technology management policy.

Forecasting↗

Assessment and validation of imaging methods and technologies.

In summary, the group identified many challenges and opportunities facing those wishing to conduct rigorous assessment and validation of imaging technologies. Specific needs and recommendations were outlined by the group. Overall, it was felt that the field has made great progress in the past several years, and that the future is promising.

Biomedical Technology↗

Role of the Biomedical Engineering Department in William Beaumont Hospital's technology assessment process.

Biomedical/Clinical Engineering Departments with expertise in engineering and technology management have a vital role to play in determining the potential for implementation and cost effectiveness of new medical technologies through technology assessment. Technology assessment offers the essential bridge between basic research and development and the prudent practical applications of medical technology. Because of the recent explosion of healthcare technologies, it is almost impossible for any single individual to stay abreast of these new technologies, much less provide an adequate assessment. To meet this need for comprehensive technology assessment, a multidisciplinary team approach is desirable. This paper deals with the assessment of medical technologies in a hospital environment and explores the possible roles biomedical engineering departments can play in the technology assessment process. It shares the experiences of the Biomedical Engineering Department of William Beaumont Hospital, a major, tertiary-care teaching institution currently involved in the technology assessment process utilizing a multidisciplinary team approach.

Biomedical Engineering↗