health technology strategy briefing to the portfolio committee on health 02 march 2011
DESCRIPTION
HEALTH TECHNOLOGY STRATEGY Briefing To The Portfolio Committee On Health 02 March 2011. PURPOSE. To brief the Portfolio Committee on the Health Technology Strategy. HT STRATEGY IN BRIEF. The main purpose of the strategy is to ensure that: Appropriate Health Technologies are available; - PowerPoint PPT PresentationTRANSCRIPT
N.T. Molai23/02/11
HEALTH TECHNOLOGY STRATEGY
Briefing To The Portfolio Committee On Health
02 March 2011
N.T. Molai23/02/11
PURPOSE
α To brief the Portfolio Committee on the Health Technology Strategy
N.T. Molai23/02/11
HT STRATEGY IN BRIEF
α The main purpose of the strategy is to ensure that: β Appropriate Health Technologies are available;β Fully functional; β Pose minimal risk to patients;β While reducing the systematic inefficiencies and associated wastage
α Has 5 Strategic Objectives (SO1 – SO5)β SO1: Promoting Equity In Access & Distribution Of HT (HT
Planning)β SO2: Reduction Of The Unnecessarily High Cost Of HT (HT
Acquisition)β SO3: Ensure Safety and Efficacy of HT (HT Asset Management)β SO4: Ensure Appropriate Introduction, Adoption and Continued
Use Of HT (HT Assessment, Evidence Based)β SO5: Development of Relevant Legislation (HT Regulations)
α Underpinned by a vigorous capacity building drive and review of governance structures
N.T. Molai23/02/11
HT DEFINITION
Health Technology (HT) includes devices, drugs, medical and surgical procedures and the knowledge associated with these in the prevention, diagnosis and treatment of diseases, as well as in rehabilitation, including the organisational and supportive systems within which health care is provided
THIS STRATEGY HOWEVER FOCUSES ON MEDICAL DEVICES
N.T. Molai23/02/11
HT PLANNING
Challenge Intervention
-Poor planning-Disjointed & chaotic eqpnt infrastructure
Develop and Implement HT Planning strategy - Norms & Stds- HT distribution )
No rational basis & mechanisms for HT replacement & procurement (sales people driven)
Comprehensive HT Audit - HT Asset register - Asset Mngt System- HT Functionality- Eqpnt age analysis- HT distribution pattern etc)
High tech equipment purchased, unused (skills shortage)
Build planning capacity
- health planners
- HT economists)
Mismatch b/n the need and available technologies
Multidisciplinary HT Planning Committees to be established at all levels
Strategic Goals Develop a Technology Planning
mechanism (Norms & Stds) Develop a National HT Plan (HT
distrib for Pub & Priv) Build planning capacity (Health
Planners & HT econmst) Establish national HT inventory
(HT distributions patterns) Develop relevant HT packages
(EHTP, EELs etc)
N.T. Molai23/02/11
Current Challenges Being Addressed in the Planning
New Radiological/ Fluoroscopic Unit unused for 2YrsWorth US$78’000Age: 2 years
Oxygen Tent Made from an old aquarium
No Sharps Containers/Waste-Disposal Units. Each Cost US$ 28Hospital requires 300 NB: US$78’000 => 2785 containers
N.T. Molai23/02/11
HT ACQUISITION
Challenge Intervention
Inability to determine HT cost drivers
HT value chain analysis
Fragmented medical device acquisition & poor controls
Strategic sourcing incl-central procurement,-bulk procurement-HTs, Standardization)
Possible price variation b/n provs & between Public & Private Sectors
Challenges related to BEE
HT pricing review & transparent HT pricing
Creation of HT budget item in SCOA
BEE reviewing
Strategic Goals cost reduction strategies, incl
bulk buying discounts restructuring of the
procurement process Strategic sourcing partnerships SA to become a Regional HT Acquisition
CoE Develop a mutually beneficial
relationship with HT industry Strengthen BEE Analysis of HT pricing issues Develop local manufacturing capability
liaise with DTI,DST, Treasury Nurture HT industry through local
acquisition
N.T. Molai23/02/11
N.T. Molai23/02/11
HT MANAGEMENT
Challenge Intervention
- Low maintenance rates incl budget vs high purchase
- Outsourcing costs @ 8% higher than inhouse) rates-High equipment downtime at +/-25%
Optimize maintenance (outsourcing vs inhouse)
Review HT Structure & strengthen CE
Low HT management baseline
Deteriorating clinical engineering
Strengthen national CE infrastructure
(CE workshops; Maintenance budget)
Dearth of CE skill (high vacancy rates, no investment in HT -HR development
Nation wide capacity building drive (Electr Engineers/Techs CE)
Strategic Goals Strengthen clinical engineering infrastructure Establish standards of usage including maintenance Set and enforce training standards Develop and adopt an optimal mix of in-house & outsourced maintenance Build technical capacity
N.T. Molai23/02/11
0
20
40
60
80
100
120
140
160
EC
FS
GP
KZ
N
LP MP
NC
NW
WC
REQUIRED
VACANT
FILLED
Critical shortage of
technical capacityPublic Sector Statistics
Private Sector equally challenged
N.T. Molai23/02/11
HT ASSESMENT
Challenge Intervention
Rapid rate of technology influx incl - +/-28000 new devices registered p.a.by FDA-Leads to HT cost escalation
Adopt a national HTA Model
Establish HTA Agency (funding)
Establish HTA structure in NDoH
Over servicing and perverse incentives in the use of technology,
Lack of comprehensive HT Scanning mechanisms (risk of obsolete technology dumping)
Strategic Goals Development of HTA Mechanisms Development of relevant
structures Institutionalizing of HTA Foster International HTA
collaboration Develop HT forecasting and HT
Scanning mechanism
N.T. Molai23/02/11
12
1,400 Capital Equipment products
2,000 Surgical Instruments
450 Implantable devices
Single Use Disposables
The Universe of Medical Devices
•5,000 generic entities•More than 1,000,000 brands, models & sizes•More than 10,000 manufacturers•RSA info however not available
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Resultant effect of -Poor maintenance-Poor user training-Poor equipment selection
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Pad site burn
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Regulation in three areas
Needs Assessment
Health Technology Assessment (HTA)
Qualified userSafe/Effective use
Good Management Practice (GMtP)
I II IIIMARKET SELECTION UTILISATION
Market AvailabilityClassification
Safety & PerformanceGHTF Guidelines
Post Market Obligations
N.T. Molai23/02/11
Three Levels of Medical Device Regulations
Needs Assessment
Health Technology Assessment (HTA)
Qualified userSafe/Effective use
Good Management Practice (GMtP)
I II IIIMARKET SELECTION UTILISATION
Market AvailabilityClassification
Safety & PerformanceGHTF Guidelines
Post Market Obligations
Current Focus on Safety
N.T. Molai23/02/11
THANK YOU