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Horizon scanning is an activity undertaken to identify technological and system innovations that could have important impacts or bring about paradigm shifts. In the health care sector, horizon scanning pertains to identification of new (and new uses of existing) pharmaceuticals, medical devices, diagnostic tests and procedures, therapeutic interventions, rehabilitative interventions, behavioral health interventions, health care delivery innovations, and public health and health promotion activities. Health care horizon scanning has typically been performed to inform a variety of strategic planning activities. Formal or informal health care horizon scanning programs have long been used by public or private entities around the world for various purposes, including commercial planning, health service research prioritization, financial or operational planning, controlled diffusion of technologies, and provision of information to policy makers, purchasers, and providers of health care. For example, hospitals and health care facilities have used horizon scanning information to inform their 5-year technology acquisition plans to better understand how their clinical service lines might be affected or disrupted by new innovations. Third-party payer (health insurance companies and government payers) have used horizon scanning information to prepare for coverage decisions they anticipate needing to make in the future. Some, such as the EuroScan horizon scanning (or “early alert”) systems, may also inform decisions regarding primary or secondary research (e.g., Health Technology Assessment).
In early 2010, the Agency for Healthcare Research and Quality (AHRQ) identified an immediate need to establish a national Healthcare Horizon Scanning System to generate information to inform comparative effectiveness research investments made through its Effective Health Care (EHC) Program. Those investments are made in 14 priority areas for which AHRQ commissions comparative effectiveness reviews and research. For purposes of horizon scanning within those priority areas, AHRQ’s interests are broad and encompass drugs, devices, procedures, treatments, screening and diagnostics, therapeutics, surgery, and care delivery innovations—which are referred to generically as “interventions” in the AHRQ Healthcare Horizon Scanning System.
AHRQ has identified the following goals for its health care horizon scanning activities:
- To create and use transparent and clearly defined processes to identify and monitor novel interventions or new uses of existing interventions in health care that might address an unmet need.
- To develop and implement a transparent and clearly defined framework for identifying which interventions could have the highest potential impact on clinical care, the health care system, patient outcomes, and costs.
- To evaluate components of existing horizon scanning systems and their respective protocols to identify best practices and effective methods of horizon scanning.
Prior to this initiative, no publicly available, comprehensive system existed for horizon
scanning in the United States. AHRQ, therefore, implemented a horizon scanning framework and infrastructure that builds on prior private sector work to identify, monitor, and assess target interventions in health care but also includes new methods for determining potential impacts. Although some of the horizon scanning methods and procedures developed for other countries may be applicable in the United States, the ARHQ Healthcare Horizon Scanning System takes into account the unique characteristics of health care in the United States. This document outlines the basic protocol and decision processes being used in broad scanning to identify leads for new interventions, to select topics for in-depth information searches, and to identify interventions that could have the greatest potential impact in each priority area within 2 to 3 years of their availability for diffusion into clinical practice.
In this update, we have also included the protocol for pilot rapid cost analyses of topics assessed as having potential for high impact in the moderate to high range in 2014.