Using the analytic hierarchy process as a clinical engineering tool to facilitate an iterative, multidisciplinary, microeconomic health technology assessment

Many articles have been written about applying decision support to clinical tasks, but little has been published about the complex problem of capital equipment decision making in healthcare. This problem has become the domain of health technology assessment experts, but there are few decision support systems reported in the literature. Technology assessment practitioners generally evaluate whether appropriate scientific studies exist to justify implementing a technology, or consider the macroeconomic implications that adopting a new technology may have on existing populations, economies, diseases, drugs, procedures, or devices. Following the confirmation of a technology's utility, however, the published materials available to assist the individual hospital or health system in their microeconomic health technology assessment (HTA) are very limited. In this study, the analytic hierarchy process is used to support and document the evolution of the multidisciplinary and interdisciplinary process of selecting neonatal ventilators for a new women's health hospital. Although the best ventilator had the highest purchase price, its safety, clinical and technical features, plus lower operating cost factors led to its high score. This study demonstrates the AHP's ability to facilitate an understanding of the underlying criteria and priorities, and to successfully support the hospital's purchasing negotiation. For these reasons, the AHP should be considered for use as a decision support tool for future HTA projects.