Early awareness and alert systems for medical technologies in Israel

Background: Throughout the world, decision makers face the need to plan on the basis of uncertainty. Prospective updates on future trends of medical technology usage are tools to improve national health status. In Israel, this challenge is met by several steps taken to promote insight into the realm of emerging technologies. Israel's unique horizon strategy refers to three time spans: the immediate to short-term (for the coming year) updating the National List of Health Services (NLHS) and quarterly scanning; the medium-term (3 years to a decade) revitalizing hospital devices and infrastructure; and long-term planning (over a decade), such as the "Health Israel 2020 Project". Methods: A description of the Israeli setup of different time spans and tiers. Results: The matrix of players, loci, interests, population groups, and incentives creates a complex situation and the Ministry of Health has to regulate the different suppliers and tiers of insurance (obligatory, supplementary, and private), balancing need, equity, and cost containment in preparing for future health care. However, preparedness is not a sterile laboratory and is pervaded by numerous dilemmas and the search for adequate evidence for new less mature technologies is an on-going challenge. Conclusion: Bridging the forecasting chasm for the future requires analyzing needs, reinforcing evidence and seeing "around the corner" when synergizing between all the "actors" in the national arena. Expert consultation and international cooperation with similar horizon organizations can assist in paving the way for more successful planning efforts for future medical technology implementation.