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  • Question on Consultation

    Has all of the relevant evidence been taken into account?

  • Question on Consultation

    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

  • Question on Consultation

    Are the recommendations sound and a suitable basis for guidance to the NHS?

  • Question on Consultation

    Are there any equality issues that need special consideration and are not covered in the medical technology consultation document?

  • Question on Document

    Please could medical professionals with relevant experience consider the list of outcomes in the evidence generation plan and provide feedback comments?

Evidence generation plan for HTG10887 Digital platforms to support preparation before and rehabilitation after primary elective hip or knee replacement surgery: early-use assessment

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6 Implementation considerations

The following considerations around implementing the evidence generation process have been identified through working with system partners:

Evidence generation

  • The companies should provide training for staff in using the technologies, when support is needed. The training and implementation period should be before the data collection period and be sufficient to account for potential learning effects.

  • Evidence generation should be overseen by a steering group that includes researchers, commissioners, practitioners and people with lived experience. 

  • The evidence generation process is most likely to succeed with dedicated research staff with sufficient expertise, to reduce the burden on NHS staff. 

  • Sites should be carefully selected to maximise data collection, when appropriate, and ensure that services representative of those in the NHS are included.

  • Careful planning of the approach to information governance is vital. The companies should have appropriate structures and policies in place to ensure that the data is handled in a confidential and secure manner and in line with appropriate ethical and quality standards.

  • Variation exists in local surgical pathways, including increasing use of ambulatory or same-day discharge surgery, when patients may receive little or no inpatient rehabilitation before discharge. This may disrupt the comparator pathway and its in-hospital physiotherapy resource use. These pathway differences should be captured and adjusted for in the analysis, particularly for the cost-effectiveness assessment.

  • If there are changes in the pathway during the data collection period (for example, increase in ambulatory surgery), suitable evidence should be collected and submitted because it may influence outcomes, resource use and cost-effectiveness results.

Equalities

  • Variable levels of digital literacy and access to digital hardware or the internet, may affect the uptake and use of the technologies. 

ISBN: [to be added at publication]