Early Warning Systems (EWS)

The EuroScan (International Information Network on New and Changing Health Technologies) members have pooled their experience and knowledge to agree on a number of definitions and criteria associated with early warning activities.

Early Warning Systems

An early identification and assessment system for new and emerging health care technologies, also called early warning system (EWS) or horizon scanning, generally has five main components:

1. The identification of emerging health technologies and new applications of existing technologies
2. Filtration and prioritization to identify those technologies with the potential to have a significant impact in the future
3. Assessment of the impact of these technologies
4. Dissemination of the resulting information
5. Monitoring of assessed technologies.
   

An early warning system focuses on technologies that are:

• New – A technology in the phase of adoption that has only been available for clinical use for a short time and is generally in the launch or early post-marketing stages, or
• Emerging – A technology that is not yet adopted by the health care system; pharmaceuticals will usually be in phase II or phase III clinical trials or perhaps pre-launch; medical devices will be prior to marketing, or within 6 months of marketing, or marketed but <10% diffused, or localized to a few centers, or
• Represent a change in indication or use of an existing technology, or are part of a group of developing technologies that may as a whole, have an impact.

Prioritization and selection criteria

All early warning systems have a set of prioritization criteria to select technologies that may require further assessment of their potential benefits, costs and service impacts. Technologies are generally prioritized when one or more of the following factors are present:

• Significant uncertainties regarding health benefit or cost effectiveness
  
• Some health benefit if the technology diffuses widely:
  1. A technology that is an innovative therapy for a disease or disorder for which no satisfactory standard treatment is currently available; or
  2. A new, potentially more effective therapy, measured by relevant outcomes, than current standard treatment; or
  3. A new therapy with significantly fewer known side effects or long term adverse effects than the current standard treatment.
  
• Significant cost impact if the technology is widely diffused because of moderate to high unit costs and/or patient numbers and/or service re-organization requirements
  
• Potential for inappropriate diffusion (fast or slow) or use of the technology
  
• Other significant impacts such as staff retraining or service re-organization
  
• Significant legal, ethical, political, environmental or social issues are associated with the use of the technology.
  

EuroScan aims

The long-term aim of EuroScan is to establish a permanent network among agencies and organizations in the field of HTA to

• Evaluate and exchange information on new and changing technologies
• Develop the sources of information used
• Share applied methods for early assessment
• Disseminate information on early identification and assessment activities.
• Relevant early warning system websites

Visit EuroScan's website