Horizon scanning: Is it useful for identifying new health care services?
Researchers at NORCHER, the Norwegian Centre for Health Services Research have studied whether horizon scanning can be used to identify new and innovative health care services.
"Horizon scanning is a methodology used to identify innovative and potentially promising technologies, by using a variety of sources mapping signals of technology development at an early stage," says Eli Feiring, professor and head of department at the Department of Health Management and Health Economics at the University of Oslo says.
"Today, horizon scanning is mainly used in alert systems for new medicines and medical equipment, to allow for innovative medicines to enter the market."
At the European level, European Early Assessment and Alert Systems (EAAS) have been developed by the EuroScan network, of which The Norwegian Institute of Public Health (NIPH) is a member. Medicines and health technologies are assessed using horizon scanning methodologies, in accordance with criteria developed by the members of the network, based on their expertise and experiences.
Through a literature review of various sources, a horizon scanning can make stakeholders aware of early signals about development of new and promising technologies. The sources include scientific literature, official documents and reports, and input from expert groups, committees, surveys, government bodies, conferences, organizations, media and more.
"A horizon scanning is something else than a literature review. Experts and stakeholders are actively used to discuss the results and to assess the potential of the technologies," Feiring says.
A horizon scanning consists of six steps. Based on the results of a horizon scanning, new technology can be tested and evaluated.
- Identification of promising technologies
- Updating information
NORCHER wants to develop sustainable health care services
The purpose of NORCHER is to develop sustainable health care service models in the health care sector. In two recent studies, NORCHER researchers wanted to explore if horizon scanning methodologies could be used to identify new, potentially useful service models.
"We did a mini-horizon scanning of health care services for older people with frailty. There is a great need of developing better health care services for this group," Feiring says.
Frailty is a global health problem. Approximately 20 percent of the world's population will be 60 years or older by 2050. Frailty affects around one out of every six seniors. It leads to a significant increase in comorbid chronic illnesses and functional dependency, which in turn increases the need for complex, costly health care services.
"We need health care services in the future, designed to meet complex care requirements," Feiring says.
The health care services were assessed by an expert panel
The NORCHER researchers carried out a literature review of a variety of sources. Based on the review, nine service models were selected and assessed by an expert panel, recruited through The Norwegian National Centre for Ageing and Health.
"The panel assessed the health care services: How innovative they were, expected results after implementation, their cost-effectiveness, expected reorganization of the services, and whether it was possible to introduce the services in Norway," Feiring says.
"The Walcheren Integrated Care Model (WICM) and the EUFrailSafe Model received the highest scores after horizon scanning. The study shows that horizon scanning can have potential for identifying innovative service models," Feiring says.
Performing a horizon scanning requires pre-existing skills and knowledge
"Horizon scanning is a systematic methodology, that can be used to develop new knowledge and insight. It is a valuable tool for bridging knowledge gaps and questioning established assumptions—based on political priorities," Feiring says.
On the other hand, horizon scanning requires pre-existing knowledge and skills. Time and resources must be arranged for it to be possible to conduct.
"Carrying out a horizon scanning requires expertise in horizon scanning methodologies, knowledge about the field or subject in question, and that relevant stakeholders are involved in the right way," Feiring says.
"A professional knowledge environment is needed, to be able to use horizon scanning to analyze health care services," she concludes.
The studies were published in BMJ Open and BMJ Innovations.
More information: Ashwanee A Kjelsnes et al, Models of integrated care for older people with frailty: a horizon scanning review, BMJ Open (2022). DOI: 10.1136/bmjopen-2021-060142
Malin Nuth Waggestad-Stoa et al, Barriers and facilitators to adopting horizon scanning to identify novel integrated care models: a qualitative interview study, BMJ Innovations (2022). DOI: 10.1136/bmjinnov-2021-000804