Want to know where healthcare tech is heading? Watch the CNESH Top 10 Watch List

The Canadian Network for Environmental Scanning in Health (CNESH) now has all the nominees in for its second annual Top 10 Watch List of new and emerging health technologies.“This year we were very pleased with the nominations—the response was fabulous,” says Rosmin Esmail, chair of CNESH and director of the Strategic Clinical Networks Health Technology Assessment and Adoption, at Alberta Health Services in Calgary. “People really took the time to fill out the nomination form, which is quite rigorous.”That rigour was intentional, because CNESH wanted as much up-front information as possible about the nominee technologies. Esmail says that this year saw a rough 50/50 mix between drugs and devices. Popular areas were oncology, cardiovascular, and diagnostic imaging—not dissimilar from last year.“This year we had a big improvement in the quality of nominations,” say Cédric Jehanno, vice chair, CNESH, who is in Montreal. “I think part of that was due to the amount of detail we provided on our website with regard to what we were expecting.”CNESH plans to announce the top ten health technologies at the 2015 Canadian Agency for Drugs and Technologies in Health (CADTH) Symposium in Saskatoon next April. This is the first evidence-informed list in Canada, with the technologies selected based on the impact on quality of life, patient survival, clinical effectiveness, safety, and cost to the healthcare system, with all five criteria weighted equally.“For selection, we have a prioritization committee and then a pool of experts that we tap into,” says Esmail. “Depending on the area—it could be oncology or infectious diseases—these specialist will provide input to support the medical generalists on the selection committee.”Getting the right data can be a challenge, because these are emerging technologies still in the process of proving their quality and efficacy, with costing-models hard to come by. Nonetheless, CNESH has a budget for verifying nominee claims.“We will compare nominee claims with our own verification process, and make our assessment based on that,” says Esmail. “Most of the time they are bang on, though sometimes there might be a modest exaggeration, or even an underestimation.”When the results are announced in April, decision-makers would do well to pay attention. The chosen technologies have the potential to be game changers, and can help guide decision-makers when setting priorities, particularly for health technology assessment (HTA) agendas and other forms of prioritization.“This is a pro-active way of looking at what’s coming up, and what’s new” says Esmail. “People can take this information and perhaps consider the technology for their organization, and conduct an HTA or a pilot study.”This is a well thought out process developed entirely by the CNESH committee, and is open to nominees from anywhere in the world. Consequently, it can assist those organizations desiring assistance in determining what technologies will offer the best results in the years to come. The technologies themselves are chosen based on their relevance in Canada, and can certainly provide a route for those Canadian healthcare technologies looking to put themselves on the map.“It is very important to understand that this is a pan-Canadian initiative,” says Jehanno, who is also project manager for optimal use of drugs and horizon scanning at INESSS (Institut national d'excellence en santé et en services sociaux), in Montreal. “We have people from Quebec, Alberta, Ontario – a lot of people who believe in this across Canada.”The nominees have aligned well with CNESH’s horizon scanning process, though Esmail notes that surgical devices could perhaps be better represented. We can expect new developments in the years to come. At present, for example, there is no patient involvement – something that is expected to change – and the process excludes e-health technologies.“With regard to e-health, this is mostly because of the framework we started with,” says Jehanno. “It doesn’t have the proper methodology to filter and prioritize potential e-health nominees, or to compare them to other types of e-health technologies.”However, Jehanno says that this will also change in the future – perhaps as soon as next year – with more nominees expected to have a strong e-health component.“The methodology is evolving, and we are getting a lot of feedback,” says Esmail. “We have put significant effort into this, and it is getting better every year. Ultimately, this is an initiative that will help people take a pro-active approach when looking at healthcare technology.”Tim Wilson is principal of T Wilson Associates. Follow him on Twitter: @TimothyEWilson

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