Hospitals & healthcare
Health technology assessment before purchase template
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Preview — Organised table
Health Technology Assessment before Purchase
Date: Date
Technology
| Item | Details |
| --- | --- |
| Device or Technology | Device or Technology |
| Supplier | Supplier |
| SFDA Registration | SFDA Registration |
| Requesting Department | Requesting Department |
Clinical need
| Item | Details |
| --- | --- |
| Clinical Problem | Clinical Problem |
| Patients per Year | Patients per Year |
| Current Alternative | Current Alternative |
Evidence and impact
| Item | Details |
| --- | --- |
| Evidence of Effectiveness | Evidence of Effectiveness |
| Safety | Safety |
| Workflow Impact | Workflow Impact |
| Training Needed | Training Needed |
Cost
| No. | Item | Amount |
| --- | --- | --- |
| 1 | Item 1 | Amount 1 |
| 2 | Item 2 | Amount 2 |
| 3 | Item 3 | Amount 3 |
| 4 | Item 4 | Amount 4 |
| 5 | Item 5 | Amount 5 |
Recommendation
| Item | Details |
| --- | --- |
| Decision | Decision: buy / trial / reject |
| Rationale | Rationale |
Assessment Committee: Assessment Committee
Medical Director: Medical Director