History and structure
VSMTVA is a state agency supervised by the Ministry of Health. The agency was established in 1995 to collect and analyze health statistics and to develop health policy recommendations for the Ministry.

It includes the following departments:

• Health Statistics - to collect, maintain, and analyze epidemiological data
• Registry Monitoring - to maintain State registries of healthcare personnel, institutions, and newborns, and to exchange information with health authorities, healthcare institutions, and other registries with target diseases
• Conformity Assessment (certification) - to certify (mandatory) all healthcare institutions in accordance with national legislation and standards. Voluntary accreditation in accordance with higher-level standards is planned to start in 2003
• Medical Technologies - to register medical devices before their introduction on the Latvian market. Only approved medical technologies should be used in Latvian health care
• Medical Devices - to provide market surveillance and implementation of a vigilance system
• Project Appraisal - to evaluate investment projects in health care
• Master Planning - to supervise implementation of the master plan for restructuring of health services in Latvia.

Mission
VSMTVA works to improve the quality of health care in Latvia, mainly by furthering the safety, effectiveness, and cost effectiveness of health services. Our goals are to provide evidence-based information for decision making at all levels in health care - government, institutions, authorities, professionals, and patients.

How VSMTVA works
Any institution or professional organization in health care can apply for approval of a health technology. The key factor is scientific evidence regarding the safety and effectiveness (or at least efficacy) of the technology. To receive reimbursement, applicants must show cost effectiveness. Medical, economic, ethical, and political issues are also discussed with relevant experts before recommending approval of a technology. Technologies of national economic importance are assessed at the request of the Ministry. The assessments rely mainly on evidence of effectiveness from international HTAs and economic evaluations interpreted in a national context. Multidisciplinary teams of health professionals are involved in the assessment process.

Dissemination activities
VSMTVA has a long history of disseminating statistical information to healthcare institutions. Special reports are prepared for policy makers. Information is accessible on our website.

We also organize consensus conferences. The first national consensus conference (diagnosis and treatment of low back pain) was held in 2002. The second consensus conference (diagnosis and treatment of osteoporosis) was held in 2003. VSMTVA participates in several educational activities, most related to healthcare quality improvement and analysis of statistical data. 

Current projects
Main priority now is to assess technologies substantial for implementation of the master plan (for restructuring of health services in Latvia).

Future plans
VSMTVA is planning to share experience, to employ common methodology, and to exchange information with other organizations dealing with HTA. VSMTVA looks for EUnetHTA as sustainable network to inform policy decisions.