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Introduction to PRI-TECH: Policy Brief

Introduction to PRI-TECH

SUBJECT:

Policy and Regulatory Issues in Enabling Health Technology for Older Adults

BACKGROUND:
 

  • AGE-WELL is the acronym for Aging Gracefully across Environments using Technology to Support Wellness, Engagement and Long Life. Funded through the Networks of Centres of Excellence (NCE) program, AGE-WELL is dedicated to the creation of technologies and services that benefit older adults and caregivers. Their aim is to help older Canadians maintain their independence, health and quality of life through technologies and services that increase their safety and security, support their independent living, and enhance their social participation.
  • PRI-TECH (Policy and Regulatory Issues in Enabling Health Technology) is a project funded by AGE-WELL which explores current policy, regulatory, and health system issues relevant to the evaluation, approval, regulation, and reimbursement of technologies to support healthy aging.
  • Dr. Paul Stolee (Health Systems Researcher at the University of Waterloo) and Dr. Don Juzwishin (formerly Director of Health Technology Assessment and Innovation, Alberta Health Services; presently Adjunct Associate Professor, University of Victoria) lead the PRI-TECH project.
  • This project operates on the premise that technologies can help older adults maintain their independence, health and quality of life, and increase their safety and security. However, innovators often struggle to navigate complex innovation and approval processes and bring their technologies to market.

CONSIDERATIONS:
 

  • PRI-TECH conducted a scoping reviewi of peer-reviewed and grey literature from 2000- October 2016. Our review identified facilitators to and barriers related to the Canadian policy context, resources, and partnerships as they relate to technology, development, assessment, and implementation. Research findings showed:
    • This context impacts how scarce resources are allocated, what partnerships get formed (and those that do not), what technologies get developed, how they are evaluated and which populations they target.
    • The barriers outlined result in the development of health technologies without clear applications in the Canadian health care systems, while major health care challenges go unaddressed by technology developers.
  • PRI-TECH conducted a systematic reviewii to investigate whether current evidence on their health and economic benefits is convincing to support adoption of eHealth technologies for chronic disease management in older adults. Research findings showed:
    • Included studies where not conducted exclusively on older adults and had various limitations, including use of generic instruments to measure quality-of-life that might not be responsive to changes that are meaningful for older persons, uncertainty with efficacy/effectiveness and cost data, and short follow-up periods.
    • Given the dearth of high quality studies that have examined the benefits of eHealth technology in the management of a chronic disease in older adults it is difficult to reach any definitive conclusion as to whether the benefits of these technologies outweigh the additional costs.
  • A Masters thesisiii conducted using a case study approach to understanding which factors facilitate or constrain the innovation journey from development to implementation/adoption of AGE-WELL technologies.
  • PRI-TECH has held individual consult meetings to trial our beta websiteiv with AGE-WELL innovators allowed to gather valuable feedback about how AGE-WELL affiliated innovators conceive policy and regulatory processes and what knowledge is required to supplement their understanding and going forward.
  • PRI-TECH has conducted 50 qualitative interviews to understand barriers to technology innovation and adoption in Canada, which is being developed into a manuscript for publication.
  • PRI-TECH has used its understanding of technology adoption challenges within the health system to stimulate discussions between researchers, industry, older adults, policy makers, tech experts and co-design solutions at two regional innovation workshops (CADTH pre-conference workshop, April 2018; Waterloo region, September 2018).

NEXT STEPS:
 

  • PRI-TECH will conduct regional innovation workshops adjacent to events which relevant stakeholders (policymakers, researchers, industry representatives, health care providers, patients, caregivers) regularly attend in order to disseminate research results and seek feedback from experts in health technology innovation.

References
 

  1. MacNeil et al. (2019). Enabling health technology innovation in Canada: Barriers and facilitators in policy and regulatory
  2. Sanyal, C., Stolee, P., Juzzwishin, D., Husereau, D. (2018) Economic evaluations of eHealth technologies: A systematic review. Plos One. 13(6): e0198112, doi: 10.1371/journal.pone.0198112
  3. Koch, M. (2017). Aging-related technologies: Amultiple case study of innovation processes. UW Space. Retrieved from: https://uwspace.uwaterloo.ca/handle/10012/12418
  4. PRI-TECH. AGE-WELL Process Maps. Retrieved from: https://uwaterloo.ca/geriatric health-systems-research-group/age-well-process-maps