Our objective was to assess how, and to what extent, a systems-level perspective is considered in decision-making processes for health interventions by illustrating how studies define the boundaries of the system in their analyses and by defining the decision-making context in which a systems-level perspective is undertaken.

We conducted a scoping review following the Joanna Briggs Institute methodology. MEDLINE, EMBASE, Cochrane Library, and EconLit were searched and key search concepts included decision making, system, and integration. Studies were classified according to an interpretation of the “system” of analysis used in each study based on a four-level model of the health system (patient, care team, organization, and/or policy environment) and using categories (based on intervention type and system impacts considered) to describe the decision-making context.

A total of 2,664 articles were identified and 29 were included for analysis. Most studies (16/29; 55%) considered multiple levels of the health system (i.e., patient, care team, organization, environment) in their analysis and assessed multiple classes of interventions versus a single class of intervention (e.g., pharmaceuticals, screening programs). Approximately half (15/29; 52%) of the studies assessed the influence of policy options on the system as a whole, and the other half assessed the impact of interventions on other phases of the disease pathway or life trajectory (14/29; 48%).

We found that systems thinking is not common in areas where health technology assessments (HTAs) are typically conducted. Against this background, our study demonstrates the need for future conceptualizations and interpretations of systems thinking in HTA.

Mixed home care, in which informal and professional actors work closely together, contributes significantly to ensuring home care up to old age. In this context, collaboration applications can considerably enhance the interactions among caregivers. However, although much research is conducted on need and requirement analyses of such applications, little is known about their introduction and use in care models. The purpose of this contribution is to identify studies that evaluate collaboration applications for mixed home care and compare their outcomes.

To identify literature on mixed home care collaboration applications (mHCA) and their evaluation, a systematic literature review was conducted in five bibliographic databases covering the years 2008 through 2019. The results were supplemented by a search in the meta-database Google Scholar. The evaluation approaches of the studies were analyzed and results compared by using the NASSS framework. Finally, a context concretized model was derived which summarizes interrelations.

Twelve qualitative studies evaluating eleven applications could be identified. They report on increased competency in self-management, psychological relatedness, involvement, and understanding. However, most studies conclude that large scale platform tests are still needed to prove significant changes in care processes, communication, or organization.

Among other things, their implementation is rather difficult due to the specifics of the target group. To enable a more targeted and successful implementation, it might be helpful to classify care networks beforehand and assess their communication behavior and needs. To prove the added value of mHCAs standardized assessment tools should be used.

An international joint task group co-led by the International Network of Agencies for Health Technology Assessment (INAHTA) and Health Technology Assessment International (HTAi) has developed a new and internationally accepted definition of HTA.

The task group, consisting of representatives of leading HTA networks, societies and global organizations, developed guiding principles for the process and followed an established consultation plan with the broader HTA community to develop the definition.

The consensus achieved by the international joint task group brings the collective weight of the participating networks, societies, and organizations behind the new definition.

The new definition of HTA is an historic achievement and it is offered to the current and emerging HTA world as a cornerstone reference for today and into the future.