The third step—analyse—is the heart of the IHSI horizon scanning methodology. Here, potential high impact topics (i.e., pharmaceuticals) are identified, drafted as profiles, reviewed by medical experts, and detailed in the HIRs. As mentioned earlier, potential high impact topics are those expected to cause significant impact to healthcare for IHSI member countries in some way, including, but not limited to, impacts on healthcare use, infrastructure, service delivery, disease management, patient health outcomes, and healthcare costs.
To detect these potential high impact topics, our data specialists and horizon scanning analysts, assisted by our automated processes, continually monitor the pharmaceutical data and watch for signals that portend high impact (e.g., efficacy data that show a clear and dramatic benefit to patient health, cost information suggesting very high cost or great cost saving, or changes to healthcare delivery, process, or infrastructure needs). When such signals are detected for a topic, it is written as a brief summary (called a profile) and sent to a panel of medical experts for review.
Managed by the IHSI stakeholder engagement specialist, the IHSI medical expert review process utilises a modified Delphi panel format to engage, for each topic, five medical experts with knowledge of the specific disease state addressed by the pharmaceutical topic. The experts review a copy of the profile then complete a brief survey indicating their perspectives on the potential for the pharmaceutical topic to cause impact. The data from these surveys are collected and analysed to determine whether the topic should be included in a HIR. Those selected for inclusion are those for which experts reviewers agree have high potential for high impact to the healthcare system.
Topics selected for inclusion in a HIR are drafted as summaries, similar to those sent earlier to reviewers, but fleshed out to include a detailed intervention description, highlights, relevant context and background (e.g., patient population and disease information, unmet clinical need), and perspectives on potential impacts gathered from both the experts and the horizon scanning team. Once a summary is drafted, it undergoes extensive scientific review before being compiled into the appropriate HIR. After the HIR is compiled, an overall summary is written for the appropriate clinical area, the report is edited, copyedited, and then sent to two qualified medical experts for quality review before it is finalised and delivered to IHSI in final draft form.