[Consensus conferences in Israel--a collaborative model for national policy making]

The determination of an integrated national policy on controversial issues is a challenge for health systems worldwide. A common method to reach agreements for national policies in different countries throughout the world is group discussion that involves all stakeholders. A structured model of discussion on medical technologies started in the 1970s, mostly in North America, spreading to Europe and in the last decade also crossed borders to India, South America and Israel. Public discussion in the format of a consensus conference is a complex process that includes a thorough literature review for technology assessment, combining academic information using a technique of close consultation with experts, extensive panel discussion and dialogue with representatives of the public. At the end of the process a broad consensus is determined facilitating national-level policy implementation. The multiple factors involved, the issues addressed, the nature of the health system where the intended results will be applied, as well as political and social characteristics, produce variations among different countries. Therefore, this process requires flexibility in adjusting the classic model according to the awakening needs. The advantages of this method include encouraging the appropriate utilization of existing technologies, contemporary assessment by leading experts, aligning between all involved parties, public sharing and more. The initial model of the consensus conference was implemented in an orderly, systematic, structured process which allowed broad discussion, and many factors for thorough preparation. The disadvantages are its complexity, length and cost. In order to cope with the dynamics of the health system in israel, forcing policymakers to make decisions in real time, parts of the model were adjusted to address the issues arising in the system. Hence, a new process was developed--a derivative of the original Israeli model, with an emphasis on professional reviews, group discussion, and involvement of leading factors in the system. The participation of patients and the public in the process requires a thorough examination.