This paper considers the concept of value in health technology assessments conducted in the public hospital sector, with a specific focus on robotic surgery for hip and knee replacements. This includes what constitutes value in arthroplasty care, issues around evidence and data flows, the effectiveness of local and international bodies and committees, measurement of patient outcomes and experience, appropriate funding mechanisms, encompassing an innovative culture with strong clinician leadership and ensuring equity of access.
The creation of a robotic surgery program at Metro North Hospital and Health Service in Queensland is used as an example of how robotic surgery, specifically the Mako robot for hip and knee replacements, was assessed and implemented in a major metropolitan public hospital. The case study is used to highlight key success factors, as well as limitations in identifying and implementing a new technology in the public hospital system and whether the value of the technology can be demonstrated.
Recommendations are provided for incorporation into health technology assessments to ensure that patient outcomes are considered as well as cost in order to demonstrate the value of the new technology to the whole public health system.