Hospital-Based HTA in a Public-Sector Tertiary Hospital in Singapore

Abstract

The Changi General Hospital (CGH) is a public sector tertiary hospital serving the population of Eastern Singapore as part of the Eastern Health Alliance regional health system. A strength of the hospital’s planning and budgeting cycle is its Marketplace exercise, an innovative process in which departments desiring to start a new service or use a new technology have to make a presentation of their proposal before hospital management and heads of department. The CGH Medical Devices Oversight Committee (MDOC) was formed in 2014 comprising a multidisciplinary team of stakeholder representatives to oversee the implementation of national standardised lists of medical implants and to monitor their utilisation. In addition, the MDOC formulates policies on medical devices and implants in the hospital and reviews evidence for new medical devices and implants. Health technology assessment plays a role in supporting decision-making on new services and technologies. The Eastern Health Alliance Health Services Research team conducts health technology assessment for CGH, whether it is as part of the Marketplace or in support of the MDOC, or at the ad hoc request of hospital senior management. Challenges in implementing hospital-based HTA include the time needed to garner stakeholder buy-in and the need for integrated processes to support governance of new services and technologies. While only recently introduced to CGH, the hospital aspires to become a centre of excellence for hospital-based HTA.