Institution Profile

title

ACCESS Health International

Country: India
21 Users
19 Dialogues

About

ACCESS Health International is a nonprofit think tank and advisory group dedicated to improving access to high quality, affordable healthcare in low, middle, and high income countries. We advise national and regional governments and the private sector on the design and management of healthcare finance and delivery systems. Our team members reside in country. We establish long term relationships within each country to address both national and local healthcare needs. We identify and develop leaders in healthcare in the countries where we work.

Our Work

ACCESS Health serves as a secretariat of the Joint Learning Network, together with the Results for Development Institute. ACCESS Health also manages the Joint Learning Fund to facilitate practitioner to practitioner learning and exchange. ACCESS Health also supports the Joint Learning Network Steering Group and the Country Core Groups.

Dipal Jain

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Angola
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Mary Joy S. Taneo

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Philippines
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Anna Dirksen

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William A Haseltine

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United States
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Christina Manng

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United States
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Vyoma Dhar Sharma

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India
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Vera Siesjo

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Bhavesh Jain

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Galiana

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US
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Anuradha Katyal

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IN
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Leung Ya Yuan Rachel

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HK
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Fredrik Knoeff

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SG
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Tina Ja

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CN
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Cathie Qing Liu

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CN
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Anjana Jacob

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IN
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Echo Collins-Egan

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GB
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Sofi Bergkvist

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US
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Sreeraj Sasi

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IN
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Sreeraj Sasi

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New Zealand
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Michelle Avelino

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PH
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Sireesha Perabathina

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India
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Recent Dialogues

Dashboard Discussion

A webinar on Health Technology Assessments (HTA) was hosted on February 22, 2017. The webinar was Technically supported and facilitated by Ms. Young Ae Jong, Director International Group, Health Insurance Review and Assessment Service (HIRA), South Korea and Dr. Francoise Cluzeau, Associate Director at Global Health and Development (former NICE International) at Imperial College, London.

Ms. Young has over two decades of working experience in the South Korean Health Systems. Dr. Cluzeau has strategic oversight of the International Decision Support Initiative (iDSI) program where she leads several projects on HTA, clinical guidelines, and quality standards.  She co-led the Quality Track of the JLN previously.  She was the technical adviser for the guidelines program at NICE for eight years and led the AGREE Collaboration of 19 countries.

The webinar was attended by 19 participants from across Ghana, India, Kenya, Mali, Moldova, Nigeria, Philippines, Singapore and Vietnam.

The objectives of the webinar were to share country experiences on HTAs from South Korea, give an introduction to the International Decision Support Initiative (iDSI) and initiate discussions on how to jointly work to support member countries on HTA who have expressed need for technical support.

Ms. Young shared the definition of health technology, how new health technology is classified in South Korea and the purpose of HTA. She presented the background of HTA process in the country along with the different forms of evaluation of health technology. In South Korea, the mandate for HTA rests with Health Insurance Review and Assessment (HIRA) agency.

Dr. Cluzeau (iDSI) shared a brief overview of iDSI presence across countries and key initiatives. iDSI is a partnership between governments, universities, and thinktanks that helps health policy makers make better decisions. iDSI targets low and middle income countries helping them prioritize health interventions as a means toward universal health coverage.

iDSI is an innovative platform of health expertise and cooperation forging North-South and South-South partnerships. iDSI is focusing on flagship countries: India, China, Indonesia, Vietnam, South Africa.She further discussed how HTA fits into the larger goal of health system strengthening for Universal Health Coverage.

The presentations were followed by a series of questions on the HTA procedures at HIRA, South Korea:

  • Source of Funding for HIRA and National Evidence-based healthcare Collaborating Agency (NECA)

NECA is funded out of general tax as it functions under the Medical Service Act. HIRA receives funding from National Health Insurance Scheme (NHIS). The legislation governing both are different and this prevents any conflict of interest in functioning.

  • Possible overlaps between HIRA and NECA

NECA is responsible for safety and effectiveness evaluation. HIRA is in charge of cost effectiveness and coverage related decisions. Both agencies have explicitly defined and linked roles. The separate operation of NECA and HIRA was due to a policy decision in 2005-06 to reduce the number of officials in public institutions. Before 2010, safety and effectiveness assessments were conducted under HIRA.

In most countries, a single agency is responsible for HTA procedures. However participants recognized that more than one agency can be involved in HTA as long as the decision making process for both is integrated.

  • Decision making on coverage and reimbursement rates

An expert committee at HIRA reviews and decides the reimbursement rates and listings. This is subsequently reported to the Ministry of Health. The deliberation committee at the Ministry internally review, discuss and finalize coverage and reimbursement rates.

  • Rationale for conducting HTA at HIRA e.g. develop national clinical protocols, guidelines; new medical technology to be included in the list of benefits etc.

HIRA focuses on conducting comprehensive assessment of new health technology especially from the view point of cost effectiveness. Mechanism for follow up evaluations is relatively weak. This remains a pertinent challenge in the country’s health system

  • Setting up an HTA unit/department – priority setting; structural and resource requirements

Like many nations looking to set up HTA at present, South Korea did not have assessment protocols and staff members who possessed the requisite skills or experience to undertake such assessments. To establish a fair and objective system on HTA, systematic review was adopted as the assessment method. To build experience in this area, the team conducted benchmarking exercise on other countries, trained staff and planned pilot evaluation over a period of two years. A pool of 400-500 professionals - clinical and HTA experts – was also engaged since the beginning.

At present, two divisions under HIRA conduct HTA wherein a total of 20 staff members are devoted to the procedure. Similarly, NECA houses a team of 20-30 HTA research staff.

Ms. Young emphasized that political will, personnel capacity building, funding support along with systematic review are key factors to set up HTA.

Participants shared experiences and identified needs in terms of setting up and institutionalizing HTA to inform decision making in their respective countries. Some of the concerns raised by participants included - getting political buy-in, lack of standardization, resource constraints, and lack of relevant legislation.

The participants proposed conducting a situation analysis in select countries to identify key stakeholders and understand the key factors in setting up Health Technology Assessment. Next steps in this direction will be communicated to participants soon.

Please find the presentations attached for review. Webinar recording can be accessed at https://we.tl/JDma9LTMVy

Dashboard Discussion

JLN Webinar: Health Technology Assessment - Experiences from South Korea

Many countries including, India, Indonesia, Ghana, Kenya and Philippines have expressed interest in learning about Health Technology Assessment (HTA) and how it can be used for informed decision making. India, Kenya, Philippines and Vietnam are currently in the process of planning, designing, or implementing HTAs in their countries. The countries showed keen interest to have a collaborative learning approach to jointly learn about models of governance structures for HTA, engaging partners and institutes for HTAs, setting up HTA units in their countries and how to conduct HTAs.

During the network wide meeting held in July 2016 in Malaysia, participating countries discussed their challenges around HTAs and expressed need to learn from each other and from an advanced system.  In response to the discussion, this webinar is planned to be hosted to share country experiences on HTA from South Korea as a beginning to the ongoing dialogue on HTAs within Network member countries.

Ms. Young Ae Jong will be sharing the HTA conducted in South Korea. She will give a brief history of setting up HTAs, governance structures, will explain the decision-making process using HTAs. The webinar will highlight the key challenges faced by South Korea in establishing HTAs and how South Korea found solutions to those challenges around HTAs for decision making.

The group also requested on how to use existing global resources available on HTA for technical assistance and guidance for the JLN community. International Decision Support Initiative (iDSI) is one such initiative to provide demand-driven practical support and knowledge products that are useful for decision-makers and researchers. The core members of iDSI are NICE International, The Health Intervention and Technology Assessment Program (HITAP), Center for Global Development and PRICELESS SA. The platform is providing technical support to establish HTA in developing countries including India, Indonesia, Ghana and Vietnam. Dr. Francoise Cluzeau will share about iDSI and share brief profile of their engagement with these countries.

 

About Speakers

Ms. Young Ae Jong, Director International Group, Health Insurance Review and Assessment Service, has over two decades of working experience in the South Korean Health Systems.

 

Francoise Cluzeau is the Associate Director at Global Health and Development (former NICE International) at  Imperial College , London.  She has strategic oversight of the International Decision Support Initiative (iDSI) programme. She leads on several iDSI projects relating to HTA, clinical guidelines, and quality standards, including in India, Vietnam, Thailand, Ghana.  She co-led the Quality Track of the JLN in its early days.  She was the technical adviser for the guidelines programme at NICE for eight years and led the AGREE Collaboration of 19 countries.

The participation is open to the interested individuals outside of JLN portal. Please share this announcement with your colleagues and professional circle.

Date: February 22, 2017 Time: 7.00 AM (EST)/5.30 PM IST/9.00 PM KST

Location: GoToMeeting details provided below

 

Please join meeting from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/579963597

 

You can also dial in using your phone.

 

United States: +1 (646) 749-3129

Access Code: 579-963-597

 

We would also encourage you to Try a test session: http://help.citrix.com/getready

You may download GoToMeeting app on your mobile and connect using the access code given above:

Android: https://play.google.com/store/apps/details?id=com.citrixonline.android.gotomeeting&hl=en

iOS:https://itunes.apple.com/us/app/gotomeeting/id424104128?mt=8

Dashboard Discussion

Webinar: Health Technology Assessment - Experiences from South Korea

Many countries including, India, Indonesia, Ghana, Kenya and Philippines have expressed interest in learning about Health Technology Assessment (HTA) and how it can be used for informed decision making. India, Kenya, Philippines and Vietnam are currently in the process of planning, designig, or implementing HTAs in their countries. The countries showed keen interest to have a collaborative learning approach to jointly learn about models of governance structures for HTA, engaging partners and institutes for HTAs, setting up HTA units in their countries and how to conduct HTAs. The group also requested on how to use existing global resources available on HTA for technical assistance and guidance for the JLN community.

Recently during the network wide meeting held in July 2016 in Malaysia, participating countries discussed their challenges around HTAs and expressed need to learn from each other and from an advanced system.  

In response to the discussion, this webinar is planned to be hosted to share country experiences on HTA from South Korea as a beginning to the ongoing dialogue on HTAs within Network member countries.

Ms. Young Ae Jong, Director International Group, Health Insurance Review and Assessment Service, has over two decades of  working experience in  the South Korean Health Systems. Ms. Young will be sharing the HTA conducted in South Korea. She will give a brief history of setting up HTAs, governance structures, will explain the decision making process using HTAs. The webinar will higlight the key challenges faced by South Korea in establishing HTAs and how South Korea found solutions to those challenges around HTAs for decision making. 

Please register your participation HERE 

Date: January 24, 2017 Time: 7.00 AM (EST)/5.30 PM IST/9.00 PM KST

Location: GoToMeeting details provided below

Please join meeting from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/579963597 

You can also dial in using your phone.

United States: +1 (646) 749-3129

Access Code: 579-963-597

You may download GoToMeeting app on your mobile and connect using the access code given above:

Android: https://play.google.com/store/apps/details?id=com.citrixonline.android.gotomeeting&hl=en

iOS:https://itunes.apple.com/us/app/gotomeeting/id424104128?mt=8

Dashboard Discussion

The Medical Audits Collaborative convened for a third time this year between Dec 6-9, 2016 in Seoul and Wonju, South Korea. The objective of the Phase III meeting was to finalize the toolkit outline, format and content and discuss key components and content for the Outcome section. The group also sought to agree on the next steps for the Collaborative in terms of setting up a toolkit Review Committee, printing and launching the Medical Audits Toolkit in 2017.

The third in person meeting of the Medical Audits Collaborative was hosted on the sidelines of the JLN Technical Working Group for Strategic Planning, Dec 5-6, 2016. Medical Audit participants attended the two day conference that focused on advancements in the Korean Health Care System. During the second day, participants also shared their experience from the Medical Audits Collaborative with the larger group.

Over the course of four days, the Medical Audits group reviewed and discussed draft content under Structure, Process and Outcome sections of the toolkit. Separate sessions were devoted to Governance and Administration; Human Resource and Capacity Building; Indicators; Rules and Triggers; Site Investigations; Clinical Verification; Functional Requirements; and Outcomes of Medical Audit. Each session was structured to provide a status update and to allow participants to dive deep into the compiled draft and critically assess content and layout by way of group work.

Each group presentation generated detailed feedback on the chapter's flow, sequence, technical content, country case studies, and overall layout. The next level of revision to the toolkit will aim to improve flow and clarity. It was decided that the content would benefit from detailed examples to support recommendations. The section on triggers needs greater focus and additional information. Presentation of country examples should be consistent across chapters. Another important suggestion was to make clear links with the existing knowledge products of the Joint Learning Network.

The last session of the Phase III meeting was used to present a section wise compilation of broad feedback and suggested changes. Items due for discussion or in need of further input were presented. Over the next two months, the coordination team and Health Insurance and Review Assessment agency (HIRA), South Korea will seek support from participants to revise the draft chapters. During this period a Review Committee will also be set up to examine, fine tune and finalize the toolkit. The Collaborative aims to launch the toolkit by April 2017.

Stay tuned for a deatiled report on the member portal  !!

Dashboard Discussion

The Joint Learning Network Medical Audits Collaborative began the third and final meeting in South Korea from December 6 – 9, 2016. In the spirit of joint learning, the collaborative aims to set up and strengthen medical audit systems in member countries. Since March 2016, the group of participants have been collaborating to develop a Medical Audits toolkit that will synthesize their experiences, challenges and solutions.

With continued technical support from the Health Insurance Review and Assessment Service (HIRA), South Korea, the sixteen participants from Colombia, Ghana, India, Indonesia, Kenya, Malaysia, Nigeria, and Philippines have maintained a sustained virtual engagement leading up to the Phase III meeting. 

The participants have come together to review and fine tune draft sections of the Medical Audits toolkit that have been compiled in the months to date. The presentation of progress and discussion is led by participants. Under Structure of Medical Audits Systems, the participants will look at compiled recommendations, country examples and key takeaways for governance, administration, human resource and capacity building requirements. Under Process of Medical Audits, the group will refine content and recommendations for indicators, rules and triggers, site investigations, clinical verifications and functional requirements of an efficient medical audit system.

The third meeting will also be an opportunity to lay out at a framework and define elements for the use of medical audit results. This session on Outcomes of Medical Audits will focus on cost containment and quality improvement.

By the end of the Phase III meeting, the group will aim to arrive at a consensus on the draft chapters of the Toolkit to be finalized in the next couple of months.