Implementation Science and new HTA regulation: two very different subjects

31 Oct

The implementation of improvements, changes in procedures, the introduction of good practices in specific health contexts and the new regulation regarding the assessment of health technologies, respectively, are subjects on the agenda at the AQuAS. Today, we will look at them in broad terms and in the future we will delve into them in more detail from this space.

To learn more about “implementation science” or “research implementation” we held a workshop at the headquarters of AQuAS with Laura J. Damschroder, an expert consultant in implementation science and researcher in the United States.

From her talk we highlight the idea of building collective knowledge and identifying the barriers and facilitators in implementation, the time factor and the value of assessment.

It is also important to know the theoretical and conceptual framework of implementation and the “basics” of implementation science which is useful for any project being implemented, as is designing and following an adequate plan of action.


The workshop proceeded by looking at different examples of the implementation of good practices in the context of REDISSEC, the Health Services Research on Chronic Patients Network.

It all stems from the annual meeting of this network held in Madrid last week at the Instituto de Salud Carlos III, in which the idea of organising this workshop was put forward in order to bring some of the contents of the meeting closer to the Catalan context, with the participation of the AQuAS, the Hospital del Mar, and the Fundació Avedis Donabedian.

In terms of the AQuAS, three talks were given on projects in which implementation research is being done, with a different perspective in each case:

  • Quality standards in implementation by Vicky Serra-Sutton from the European project on dementia Act on Dementia Joint Action. The AQuAS team involved in this project was in fact given a mention this week at the Alzheimer Europe Conference which was held in Barcelona
  • The transfer of good practices and impact assessment by Elisa Poses-Ferrer from the European Project CHRODIS PLUS on chronicity
  • The assessment of projects for improvement in integrated care by Jillian Reynolds from the European project SUSTAIN on integrated care for older people.

Regarding the Hospital del Mar, we heard a talk by Maria Sala on the personalisation of screening for breast cancer and regarding the Fundació Avedis Donabedian, we heard a talk by Carola Orrego and Marta Ballester, who brought reflections on aspects of improvement and lessons learnt in implementation.

This workshop was a good opportunity for speakers and attendees to share experiences and knowledge.

Moving on to the second subject.

In terms of the new European HTA regulation, which is in its final stages of discussion in the European Parliament, Iñaki Imaz, from the Instituto de Salud Carlos III in Madrid gave a seminar which we were able to follow live at the AQuAS.

It was very interesting for many reasons. Situations were contextualised that justify the need for health technology assessment (HTA) as a starting point, which is always present in our context.

The emphasis was also placed on the complexity of assessment and the different possible scenarios (or levels). On the other hand, aspects being discussed regarding the proposal for legislation which would allow for, among other objectives, joint clinical assessment at a European level, were commented on in detail.

The seminar can be found on the following link:

Imaz I. The future of health technology assessment in Europe. Regarding the proposal for regulation passed by the European Parliament. Madrid: Agency for Health Technology Assessment. Instituto de Salud Carlos III, 30 November, 2018.

Talking about HTA in Europe, a lot has been done (more than 30 assessments available within the framework of EUnetHTA), there is work in progress and, above all, there is the desire for all to gain in terms of confidence, guarantees, transparency and the sustainability of health systems. What is especially sought after is to avoid duplicities and to share knowledge and methodologies.

We will keep track of all these subjects.