telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Change enabled by marketing telehealth to patients, clinicians and and building a community of practice. Williams and Bryan 2007 [8] Mixed-methods study. To explore how Other factors influenced the In order to be useful, cost - Qualitative local committees operate when committees, such as the effectiveness analysis case studies of four making technology coverage perspectives of committee needs to better reflect the committees including decisions, the information they members, especially constraints of the local documentary analysis, use clinicians. Some environment. observation of committee and the extent to which respondents felt that the meetings (n=11), and interviews economic evaluation committees were susceptible to Decision-making environment with committee members featured in this. powerful personalities on, or appeared to militate against (n=31). Survey in primary and attending, the committee. emphasis on cost-effectiveness secondary care to collate analysis, including unclear information relationships with resource proformas used by allocators, an explicitly political committees decision-making when considering proposed new process, and poorly specified technologies. decision-making criteria. Wye et al (2015) [48] Qualitative study of four To identify the reasons that Commissioners acquired -Competing proposals for Decisions need to stand up to commissioning organisations in prompted commissioners to seek information through funding (persuasion needed). external scrutiny (locally and England, using interviews information, to clarify which conversations, stories (clinical -Organisational processes nationally) (n=52), meeting observation sources and types of knowledge and patient) and documentation change the original information. (n=14), and documentary commissioners commonly (especially bulleted summaries analysis. consulted, and to describe the to capture attention) use of research evidence in decision-making.
telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Change enabled by marketing telehealth to patients, clinicians and and building a community of practice. Williams and Bryan 2007 [8] Mixed-methods study. Qualitative case studies of four committees including documentary analysis, observation of committee meetings (n=11), and interviews with committee members (n=31). Survey in primary and secondary care to collate information proformas used by committees when considering proposed new technologies. To explore how local committees operate when making technology coverage decisions, the information they use and the extent to which economic evaluation featured in this. Other factors influenced the committees, such as the perspectives of committee members, especially clinicians. Some respondents felt that the committees were susceptible to powerful personalities on, or attending, the committee. In order to be useful, cost effectiveness analysis needs to better reflect the constraints of the local environment. Decision-making environment appeared to militate against emphasis on cost-effectiveness analysis, including unclear relationships with resource allocators, an explicitly political decision-making process, and poorly specified decision-making criteria. - Wye et al (2015) [48] Qualitative study of four commissioning organisations in England, using interviews (n=52), meeting observation (n=14), and documentary analysis. To identify the reasons that prompted commissioners to seek information, to clarify which sources and types of knowledge commissioners commonly consulted, and to describe the use of research evidence in decision-making. Commissioners acquired information through conversations, stories (clinical and patient) and documentation (especially bulleted summaries to capture attention) -Competing proposals for funding (persuasion needed). -Organisational processes change the original information. Decisions need to stand up to external scrutiny (locally and nationally)
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