Health systems have considered the introduction and withdrawal or elimination of health technologies a linear process in which different actors interact (innovators, industry, regulators, health technology evaluators, reimbursement agencies, health service providers, health professionals, patients and citizens). The lack of interchange of knowledge between phases and the little interest in what happened once the technology has been introduced has generated that this linear process is inefficient. Among the causes of inefficiency someone can find: the lack of knowledge of innovators around health needs, the introduction of health technologies of dubious value, the generation of unjustified variability in practice or the maintenance of no added-value practices.

The cyclical concept of the life of health technologies contributes to a dynamic and context dependent vision of the entrance of the innovation until its obsolescence or overwhelming by competitors or its demonstration of low utility, offering in each moment information for the decision precise and of high quality to all the stakeholders.

From the Ministry for Health of the Basque Country and specifically in Osteba, it has been working since its creation in 1992, in improving the processes of incorporation and use of health technologies and since 2007 in the technological divestment of technologies of doubtful or null value. As a result, the SorTek and ZaharTek programs, the collaboration in the implementation of methodological projects (GANT, GEN, GiNF and GuNFT Guides), the participation in networks such as Redets   and / or iHTS , in FIS funded national projects (http://www.atlasvpm.org/use-procedures-double-value), in European projects (Zinnige Zorg) and international projects (HTAi -IG DEA http://www.htai.org/interest-groups/disinvestment-and-early-awareness.html). Osteba also collaborates with the MAPAC group to improve the clinical practice in the framework of two FIS funded projects.

As part of all these experiences and initiatives, there have been elaborated lists of new and emerging health technologies and fact sheets, Clinical Practice Guidelines (specific section) and records of obsolete or dubious value health technologies. The following are the methodological advances and ongoing initiatives in these areas, in which Osteba has collaborated, in what can be called the "Choosing Wisely" or the "right care" proposal for the Basque Health System.

Support material

• A toolkit for the identification and assessment of new and emerging health technologies (Pdf, 1 MB)
• Documento metodológico (pdf, 458 KB)
• iHTS
• Use of health procedures of doubtful value (SPA)
• Pilot study to identify and assess obsolete health technologies from emerging technologies identification databases.
• Methodology of the Atlas on Use of procedures of doubtful value (PDF, 341 KB)