Horizon Scanning as an Early Warning System in Health Technology Assessment: A Conceptual and Methodological Perspective

Abstract

The rapid development and diversification of health technologies necessitate more proactive and structured assessment mechanisms to guide their integration into health systems. In this context, Health Technology Assessment (HTA) emerges as an evidence-based decision support tool, analyzing the safety, effectiveness, cost, and ethical dimensions of new technologies. However, the need to evaluate innovations at earlier stages has led to the advancement of horizon scanning (HS) systems, which serve as early warning mechanisms. This article examines the conceptual foundations, methodological frameworks, and international implementations of horizon scanning in the healthcare context, and proposes a model that may guide national practices in Türkiye. The study explores the components of early warning systems, including identification, filtration, prioritization, and reporting, through a comprehensive review of current literature and country-specific practices. Findings reveal that horizon scanning plays a strategic role particularly in areas with high uncertainty, such as rare diseases and digital health technologies. It is recommended that Türkiye strengthens its current HTA infrastructure by establishing a stakeholder-driven horizon scanning unit, engaging in international collaborations, and adopting a structured national model. These recommendations aim to enhance the country’s capacity for proactive, evidence-informed health policy-making.

Keywords

• health techhnical assessment
• horizon scanning
• early warning

Sağlık Teknolojisi Değerlendirmesinde Erken Uyarı Sistemi Olarak Ufuk Tarama: Kavramsal ve Metodolojik Bir Bakış

Öz

Sağlık teknolojilerinin çeşitlenmesi ve hızla gelişmesi, bu teknolojilerin sağlık sistemlerine entegrasyon sürecinde daha öngörülü ve yapılandırılmış değerlendirme mekanizmalarını gerekli kılmaktadır. Bu bağlamda, sağlık teknolojisi değerlendirmesi (STD), teknolojilerin güvenlik, etkililik, maliyet ve etik boyutlarını analiz eden kanıta dayalı bir karar destek aracı olarak öne çıkmaktadır. Ancak, teknolojilerin daha erken aşamalarda değerlendirilmesi gereksinimi, “ufuk tarama” (horizon scanning) olarak adlandırılan bir erken uyarı sisteminin gelişimini gündeme getirmiştir. Bu makalede, sağlık alanında ufuk taramanın kavramsal temelleri, metodolojik yaklaşımları ve uluslararası uygulamaları ele alınmakta; ayrıca Türkiye için örnek teşkil edebilecek bir model önerisi sunulmaktadır. Çalışmada, erken uyarı sistemlerinin tanımlama, filtreleme, önceliklendirme ve raporlama gibi bileşenleri üzerinden kapsamlı bir değerlendirme yapılmıştır. Literatürden ve çeşitli ülke uygulamalarından elde edilen bulgular ışığında, özellikle nadir hastalıklar ve dijital sağlık uygulamaları gibi yüksek belirsizlik içeren alanlarda ufuk taramanın stratejik bir rol üstlendiği ortaya konmuştur. Türkiye'de mevcut STD yapısının güçlendirilmesi, uluslararası işbirliklerinin artırılması ve paydaş temelli bir ufuk tarama biriminin kurulması önerilmektedir. Bu öneriler, sağlık sisteminde proaktif ve kanıta dayalı karar alma kapasitesini artırmayı hedeflemektedir.

Anahtar Kelimeler

• Sağlık Teknolojisi Değerlendirme
• ufuk tarama
• erken uyarı

References

1. • Ansoff, H. I. (1975). Managing strategic surprise by response to weak signals. California Management Review, 18(2), 21–33. https://doi.org/10.2307/41164635
2. • Aydın, S., & Alkan, A. (2023). Big Data Analytics in Turkish Healthcare: Applications of AI for Early Detection and Decision-Making. Journal of Health Informatics in Developing Countries, 17(1), 45–58. https://doi.org/10.5281/zenodo.8000123
3. • Banta, H. D. (2009). What is technology assessment? International Journal of Technology Assessment in Health Care, 25(S1), 7-9. DOI: 10.1017/S0266462309090323 • Draborg, E., Gyrd-Hansen, D., Poulsen, P. B., & Horder, M. (2005). International comparison of the definition and the practical application of health technology assessment. International Journal of Technology Assessment in Health Care, 21(1), 89-96. DOI: 10.1017/S0266462305050116
4. • European Commission. (2016). Strategic foresight tools for policy-making. EU Policy Lab, Joint Research Centre. https://ec.europa.eu/jrc/en/publication/strategic-foresight-tools-policy-making
5. • EuroScan. (2014). EuroScan Methods Toolkit. Retrieved from https://epapers.bham.ac.uk/2120/1/EuroScan_Methods_Toolkit_October_2014_FINAL_CC_added.pdf
6. • Goodman, C. S. (1998). Healthcare technology assessment: Methods, framework, and role in policy making. American Journal of Managed Care, 4(SP), SP200-SP214.
7. • Gutiérrez-Ibarluzea, I., Otte, M., Dauben, H. P., et al. (2022). Horizon scanning: A matter of collaboration. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/S0266462322000915
8. • Gutiérrez-Ibarluzea, I., Simpson, S., & Benguria-Arrate, G. (2012). Early awareness and alert systems: An overview of EuroScan methods. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/S0266462312000360

9. • Henshall, C., Oortwijn, W., Stevens, A., & Granados, A. (2009). Informing decisions: a practical guide to horizon scanning for health technologies. International Journal of Technology Assessment in Health Care, 25(S1), 16–24. https://doi.org/10.1017/S0266462309090339
10. • Hiltunen, E. (2008). Good sources of weak signals: A social constructivist approach. Futures, 40(3), 247–260. https://doi.org/10.1016/j.futures.2007.11.005
11. • Khan, S. K., Gonzalez-Moral, S. G., Lanyi, K., Ogunbayo, D., & Craig, D. (2023). Closing the loop between horizon scanning and health technology assessment. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/s0266462323000491
12. • Nazarkina, V., Nemchenko, A., Podolsky, I. M., et al. (2024). Problems of creating an effective system of health technology assessment at the early stages of the drug life cycle. https://doi.org/10.24959/sphhcj.24.317
13. • Ng, Z. L., Ju, H., Ng, J., & Ng, K. (2022). Horizon scanning to nominate subsidy evaluation topics for medical technologies: Early experience from Singapore. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/s026646232200277x
14. • Ng, Z. L., Ju, H., Ng, J., & Ng, K. (2023). Increasing emergence of novel digital health technologies identified through horizon scanning. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/s0266462323001976
15. • O’Rourke B, Oortwijn W, Schuller T, the International Joint Task Group (2020). The new definition of health technology assessment: A milestone in international collaboration. International Journal of Technology Assessment in Health Care 1–4. https://doi.org/10.1017/ S0266462320000215 Erişim Tarihi: 07.05.2025
16. • OECD. (2013). OECD science, technology and industry outlook 2012. OECD Publishing. https://doi.org/10.1787/sti_outlook-2012-en
17. • Popper, R. (2008). How are foresight methods selected? Foresight, 10(6), 62–89. https://doi.org/10.1108/14636680810918586
18. • Ruggeri, M., Cadeddu, C., Roazzi, P., et al. (2020). Multi-Criteria-Decision-Analysis (MCDA) for the Horizon Scanning of Health Innovations: An Application to COVID-19 Emergency. International Journal of Environmental Research and Public Health, 17(21), 7823. https://doi.org/10.3390/IJERPH17217823
19. • Simpson, S., Hyde, C., Cook, A., Packer, C., & Stevens, A. (2004). Assessing the accuracy of forecasting: Applying standard diagnostic assessment tools to a health technology early warning system. International Journal of Technology Assessment in Health Care, 20(3), 381–387. https://doi.org/10.1017/S0266462304001229
20. • T.C. Sağlık Bakanlığı. (2019). Ulusal Sağlık Teknolojisi Değerlendirme Strateji Belgesi. https://shgmargestddb.saglik.gov.tr/TR-64045/ulusal-saglik-teknolojisi-degerlendirme-strateji-belgesi.html Erişim Tarihi: 11.05.2025
21. • T.C. Sağlık Bakanlığı. (2023). Sağlık Teknolojisi Değerlendirme Raporları. https://shgmargestddb.saglik.gov.tr Erişim Tarihi: 16.06.2025
22. • T.C. Sağlık Bakanlığı. (2019) https://shgmargestddb.saglik.gov.tr/TR-64042/stdhta-nedir.html Erişim Tarihi: 07.05.2025
23. • Wong, W. Q., Lin, L., Ju, H., & Ng, K. (2020). Towards greater impact in health technology assessment: Horizon scanning for new and emerging technologies in Singapore. International Journal of Technology Assessment in Health Care. https://doi.org/10.1017/S0266462320000343