Implementing the findings of health technology assessments - If the CAT got out of the bag, can the TAIL wag the dog?

Objective: To explore whether more could be done to increase the implementa tion of health technology assessment (HTA) findings. Methods: A literature review was undertaken to identify the main barriers t o implementation, the mechanisms that influence the diffusion and use of he alth technologies, and evidence of the successful implementation of finding s. Results: Numerous barriers to the implementation of HTA findings exist at t he public policy, healthcare professional, and general public levels. Sever al mechanisms for influencing the use of health technologies exist, and the re are some examples of findings being implemented through these mechanisms . However, there are also concerns about the aggressive implementation of f indings. A balanced approach to the implementation of HTAs is required. Conclusion: The main elements of a successful implementation strategy are: a) defining a clear policy question; b) defining a clear research question; c) making recommendations commensurate with the evidence; d) identifying t he implementation mechanism; e) paying attention to incentives and disincen tives; and f) clarifying the roles and responsibilities of the various part ies. Further research is also required into several aspects of implementati on.