Many factors influence the decision for incorporation of new Technologies: physician's opinions, recommendations of professional's organizations, manufacturers sale management, the introduction of novel technologies in private or prestigious institutions, and the demands of patients. At the same time, there are other aspects which difficult the adoption of new technologies, such as the fast development of new technologies or the monetary restrictions.
Typical reasons for the incorporation of technology in radiation medicine services are:
• To establish a new service not available at the moment in the health area, thus increasing population's access to them;
• To increase the current or expected demand of services which lead to inacceptable waiting times for patients.
• need for increasing the technical capacity and the diagnostic and therapeutic quality, incorporating new non-existing methods
• The lack of spare parts for the existing equipment or the impossibility of repairing them because they have become obsolete, among others.
Thus, a justifying study should be made in order to facilitate decision-making for technology incorporation. This study, called in some countries feasibility or pre-investment study, should include an analysis of the offer and demand of current services in the area of Influence, the projections of demand to be fulfilled during the expected life of the technology, the necessary human resources and its real availability, the necessary elements for an adequate maintenance, the infrastructures that will be necessary to construct or modify, the estimated costs of procurement and maintenance, the estimated costs of medium-term operations, the expected number of patients, as well as the expected costs for procedures in those conditions.
According to the results of the feasibility study, the competent authority will adopt the corresponding decision regarding the incorporation or not of the technology. If the decision is favorable, a technical group should be created for the contract or bidder process and for the commissioning. This group should at least be composed for one representative from the administration of the health area or institution, one medical practitioner, one radiographer/technologist, a biomedical engineer and/or a medical physicist. The inclusion of an informatics engineer or another professional with competences in this area could be an assent when analyzing the acquisition of digital systems.
More information in this topic could be found in the following links and documents:
• Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA).
• Asociación Española de Evaluación de Tecnologías Sanitarias (AEETS).
• Health Technology Assessment Handbook. Danish Centre for Health Technology Assessment, National Board of Health.
• Center for Health Services Research. Singapore health Services.