This paper is aimed at exploring the role of the HB-HTA ecosystem as an important pathway for popularizing the implementation of innovations in healthcare organizations. The scientific debate has largely been focused on the rising importance of HB-HTA and the principles guiding the process. Solutions implemented by individual countries differ, which may be rooted in historical, cultural, and institutional differences. Our understanding of the impact of individual countries’ healthcare systems on HB-HTA solutions and infrastructure still lacks a basis in interpretative studies. A conceptual framework is proposed to assess the aptness of the HB-HTA model designed for hospitals operating in a country or region, focused on the concepts of adaptiveness and responsiveness to features of the healthcare system present there. A tool is proposed for investigating factors that are likely to assist the successful implementation of the HB-HTA ecosystem. A dynamic SWOT analysis on the case of the HB-HTA model designed for Poland provides interesting insights into the building of the conceptual framework. The results of this study help explain how to create an HB-HTA model that is best adapted to the regional or national healthcare system, including potential risks and opportunities.

Objectives: The objective of this article is twofold. First, to present a comprehensive internal assessment of the hospital by different groups of stakeholders and, second, to determine whether there are common needs and wishes that, if incorporated in the hospital vision, will enable future development. Background: The Children’s Memorial Health Center is the largest children’s hospital in Poland. The hospital began operations in 1977 with a vision to be a modern healthcare facility that provides comprehensive care for children. That vision has not changed over time but everything else did. Methods: Six design thinking sessions were conducted with 83 employees and 40 respondents who used health services in the hospital in the past, along with in-depth interviews with 25 representatives of management to gather data for the hospital assessment. Results: Sixty-three features influencing future development were identified. Seven groups of features were classified to be either transformation drivers (four groups) or enablers (three groups). We focused on features that were indicated by all groups of respondents to define a common vision for future development. Conclusions: Depending on the respondent’s role in the healthcare ecosystem, the list of variables within each of seven groups defining the “hospital of the future” was different while evaluating the healthcare services. Therefore, all stakeholders must be engaged in the ideation process to create a strategy for a future care model driven by innovation.

Introduction Integrating digital health technologies to improve the overall performance of healthcare systems counts among the top priorities of the WHO. As evidenced in recent research, there are specific factors that may decisively determine the effective implementation and development of innovative digital health solutions. This review attempts to recognise and map the existing body of research and evidence to identify the determinants that either favour or hinder the deployment and use of digital health technologies by patients and physicians in primary care. Methods and analysis The scoping review will be conducted in accordance with the JBI Manual for Evidence Synthesis (2024 edition introducing nine stages) and with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Search strategy will be conducted in PubMed, Embase, Cochrane Database of Systematic Reviews and Scopus in November 2024. The review will include quantitative, qualitative, mixed-methods studies, systematic, scoping or umbrella reviews, as well as text and opinion papers. The study selection process will be conducted by two researchers using Rayyan. The data will be analysed using MAXQDA and extracted into a tool prepared by the researchers. This review will summarise the existing data and will help create a list of potential and determinant barriers and facilitators that may be useful in conducting empirical research on embedding new digital health solutions and sustaining their use. Ethics and dissemination As no primary data will be collected for the purposes of this study, no formal ethical approval is required. Results will be published in a peer-reviewed journal. The findings will be used to conduct further research (HORIZON.2.1;grant:101095424) on the determinants of digital health implementation in primary care at the national level and to prepare recommendations for key stakeholders, as well as to develop recommendations on health policy in the European Union.

Objectives: The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms. Methods: Researchers used mixed-method research–with legal documents and data analysis on utilisation of ophthalmology services between 2010 and 2019 and in-depth semi structured interviews with fifteen health experts from Hungary, Poland, and Ukraine. Interviewees, five from each country, were representatives from healthcare providers and payers with at least 10 years’ experience in ophthalmology care and knowledge about financing schemes in each country of residence. Results: We identified significant differences in healthcare delivery and financing of ophthalmology services between Hungary and Poland, despite both countries rely on Diagnosis-Related Group (DRG) based systems for hospital care. Good practices for financing specific eye treatments like cataract, glaucoma, age-related macular degeneration (AMD), diabetic macular edema (DME), cornea transplantations, and vitrectomy are identified. The financing scheme, including financial products and incentives, can influence the volume of treatments. Access to ophthalmic care is a key concern, with differences in treatment schemes between Hungary (ambulatory care) and Poland (hospital care), leading to higher costs and the need for centralization of complex procedures like cornea transplantations. Conclusions: The article highlights the importance of incentivizing quality improvements and removing financial barriers in Poland, while Hungary should focus on continuous monitoring of treatment methods and flexibility in reimbursement. For Ukraine, the research findings are significant due to ongoing healthcare reform, and the country seeks optimal practices while considering the experiences of other countries.

Background: This scoping review maps published evidence on financial incentives linked to hospital payment mechanisms and on the hospital-behavior endpoint categories examined in the literature. It provides an evidence map for subsequent systematic review work within the FLASH project, rather than estimating the direction or magnitude of effects. Methods: The review was reported in accordance with PRISMA guidelines. Authors searched PubMed and Cochrane for English-language records published between January 2013 to February 2023. Data was independently screened and extracted by two authors. In total, 140 full-text records were included and classified country, publication year, payment mechanism, financial-incentive category, and endpoint category. Results: Since 2015, the number of publications on financial incentives in healthcare has generally increased. Most included publications covered changes in the United States, Taiwan, China, and the United Kingdom. The identified incentives were mapped within payment-mechanism categories, including Activity-Based Payment, Incremental, Consolidated, and Budget mechanisms, following WHO/OECD and Urban Institute classifications. Activity-Based Payment was the most frequently studied category; the endpoint categories most often examined in this group were efficiency of spending funds (42 publications), access (27 publications), and hospitals' finances (22 publications). Studies of incremental mechanisms, mainly Pay-for-Performance (P4P), most often examined quality (41 publications) and efficiency of spending funds (24 publications), while consolidated mechanisms were represented less frequently across endpoint categories. These counts describe the distribution of the literature and do not indicate effect direction, magnitude, or statistical significance. Conclusions: The review identifies where evidence on hospital payment mechanisms, financial incentives, and hospital-behavior endpoint categories is concentrated and where gaps remain. The most researched endpoint categories are linked to efficiency of spending funds, quality, access, and hospital finances. Payer spending and budget-based mechanisms are comparatively less represented. We identify priorities for subsequent systematic review and for a database that extracts the direction, magnitude, and context of reported effects.