A quality mix: using evidence and experience to evaluate new technologies

Area of Science:

• Health Services Research
• Healthcare Management
• Clinical Decision Support

Background:

• Healthcare technology assessment often lacks sufficient evidence for widely used interventions.
• Integrating provider experience is crucial for evaluating technologies where empirical data is limited.
• The Institute of Medicine emphasizes evidence-based healthcare delivery.

Purpose of the Study:

• To describe BlueCross BlueShield of Tennessee's (BCBST) methodology for blending scientific evidence with clinical experience.
• To demonstrate how provider input enhances the assessment of healthcare technologies.
• To highlight the implications of this blended approach for health plan delivery and evidence-based practice.

Main Methods:

• Utilizing formal provider panels and a modified Delphi approach to gather expert clinical input.
• Incorporating provider experience to assess technologies lacking robust scientific evidence.
• Developing clinical decision tools informed by both evidence and practical experience.

Main Results:

• BCBST achieved a successful model for technology assessment by combining evidence and experience.
• Provider input proved invaluable in evaluating both novel and established healthcare technologies.
• The developed clinical decision tools offer a practical solution for members, providers, and the health plan.

Conclusions:

• Blending scientific evidence with provider experience offers a comprehensive strategy for healthcare technology assessment.
• This integrated approach addresses gaps in evidence and supports evidence-based healthcare delivery.
• The BCBST model demonstrates a practical and effective method for improving health plan operations and patient care.