On this page

Nominations

3D scanning for orthotics and burn masks

In 2018, a nomination was received for the establishment of a service to produce a mould for the fabrication of burns face masks and orthotics for a range of conditions.

Committee actions

  • An emerging technology update had been received in 2018 regarding a similar service.
  • The committee advised the district to liaise with those offering the service to further discuss the business model for orthoses production.

Diode laser for intrauterine pathology

In 2018, a nomination was received for diode laser for use in outpatient hysteroscopy. This laser may allow intrauterine pathology to be diagnosed and treated at one outpatient visit as no general anaesthesia is needed.

Committee actions

  • The committee determined that more high level evidence was required to support claims of greater clinical safety and effectiveness.
  • The committee recommended that the district continue to provide the laser under a research framework.

Magnetic resonance imaging – guided focused ultrasound (MRgFUS)

The committee have received a number of nominations for Magnetic Resonance Imaging-Guided Focused Ultrasound (MRgFUS), for a range of indications. MRgFUS is a minimally invasive alternative to surgery for cancer of the brain, liver, breast and prostate and for the management of uterine fibroids and pain from bone metastases. Transcranial MRgFUS is an alternative to deep brain stimulation for patients with medication resistant Parkinson’s disease, essential tremor and dystonia.

The committee recommended that additional advice on both of these technologies should be sought.

Committee actions

  • In 2016 MRgFUS was referred to the former HealthPACT for a health technology assessment. The HTA review was completed in 2017, and found:
    • MRgFUS tended to be well tolerated by patients
    • there was little high level, comparative or long term evidence demonstrating benefit
    • there was also minimal cost-effectiveness data available
  • HealthPACT did not consider the clinical evidence to be sufficient to support the adoption of MRgFUS into routine clinical practice and recommended against public funding of MRgFUS in 2017.
  • An update to this review was finalised in 2019 which found for all indications, the evidence published since the 2017 review had not provided additional support for the adoption of MRgFUS into routine clinical practice.

Orthotics laser scanner and robot carver

In 2018, an update was received for a laser scanner and robot carver to replace traditional plaster casting. The robot has the capacity to produce orthoses for other healthcare services that have the appropriate scanner and software in place.

Outcomes

  • local implementation underway
  • update requested.  

Robot-assisted surgery

The committee received a number of nominations for robot-assisted surgery (RAS) for various surgical specialties, such as upper gastrointestinal, trans-oral, colorectal, urology for radical prostatectomies and gynaecological oncology surgery.

Committee actions​

  • In May 2018, a health technology review of RAS was commissioned which found:
    • RAS may be as safe and effective as conventional surgery when performed by sufficiently skilled surgeons
    • the high cost of RAS is not currently offset by improved patient outcomes or through savings to the health system
    • there remains a lack of high level evidence and limited long term data regarding the benefits, risks and cost effectiveness of robotic surgery.
  • The committee recommended that robotic surgery only be provided to patients under an evaluation framework until further evidence is available.
  • The committee also recommended that sites with existing robotic surgery programs prioritise the collection of patient reported measures as part of their evaluation.

Out of scope

Laser system for the treatment of scarring in patients with severe burns (2015)

The committee advised the technology was not new to the NSW public system.

Emerging technology updates

3D bioprinter

In 2018, an update was received for a 3D bioprinter to produce prostheses for surgical planning. The committee recommended an evidence review of 3D printing with a review of the evidence and an audit to understand the current role of 3D printing in the Australian public health system.

Outcomes

  • local implementation underway
  • evidence review underway.

Lateral arm upright biopsy accessory

In 2019, an update was received for an adjunct to mammography, to allow biopsy of potentially malignant lesions in difficult to reach locations. The TGA recalled this technology in 2017 due to issues with device installation, which were addressed prior to submission of the update.

Outcomes

  • to be provided under a research framework
  • update requested.

Lung surgical planning technology

In 2015, an update was received for software that allows a 3D reconstruction of the bronchial tree to assist with surgical planning.

Outcomes

  • local implementation underway
  • research trial underway
  • update requested.

Organ perfusion system

In 2019, an update was received for an organ perfusion system that may extend usability of organs after removal from the body and prior to transplant.

Outcomes

  • research trial underway
  • update requested.

Pelvic sentinel lymph node detection for endometrial cancer

In 2017, an update was received for a new method to identify sentinel lymph nodes during surgical removal of endometrial cancer.

Outcomes

  • research trial underway
  • update requested.

Photographic fundoscopy

In 2019, an update was received for a device used to photograph the back of the eye to identify changes in intracranial blood pressure that may be associated with stroke.

Outcomes​

  • research trial underway
  • update requested.

Retinal camera

In 2019, an update was received for an electroretinogram which may take digital photographs of the retina for transfer to a specialist centre to be evaluated. This could improve access for patients in rural and remote areas.

Outcom​es

  • local implementation underway
  • update requested.

Transperineal ultrasound guided prostate biopsy

In 2018, an update was received for an alternative diagnostic procedure for patients with previous negative transrectal ultrasound guided biopsy who continue to have increasing levels of prostate serum antigen.

The Ministry sought additional information on this technology from the NSW Agency for Clinical Innovation, which highlighted significant changes in the detection, diagnosis and staging of prostate cancer over the past decade. NSW Health is undertaking a review of methods to detect and diagnose prostate cancer.​

Outcomes

  • local implementation underway
  • evidence review
  • update requested.

Uterus transplantation

In 2019, an update was received on uterus transplantation, which is an emerging experimental option for women with absolute uterine factor infertility who want to bear children.

Outcomes

  • research trial underway
  • update requested.

Xen stent implantation

In 2019, an update was received for an implant to reduce intraocular pressure in patients with glaucoma. Advice was sought from the NSW Agency for Clinical Innovation’s ophthalmology which confirmed demonstrated significant cost savings and operating efficiencies when compared to traditional trabulectomy.

Outcomes

  • local implementation underway
  • update requested.

Out of scope

Ablative fractional CO2 laser (2018)

The committee advised the technology was not new to the NSW public system.

Aqueous shunt implantation surgery (2019)

The committee advised the technology was not new to the NSW public system.

Endoscopic Ultrasound (2019)

The committee advised the technology was not new to the NSW public system.

Contact

New health technology enquiries can be emailed to: MOH-HealthTechNominations@health.nsw.gov.au
Current as at: Wednesday 25 November 2020
Contact page owner: Strategic Reform and Planning