OBJECTIVES: The current trend in HTA is its application to local medical facilities (called hospital-based HTA or HB-HTA), where HTA methods can foster strategic decisions of the hospital management, especially in employing and/or procurement of new technology. The essence of HB-HTA utilization is to implement processes that allow assessment of the technology considering specific conditions of the hospital. Although there are multiple concepts of HTA implementation that can be tailored to the particular hospital´s needs, establishing a HTA unit seems the most practical in the case of big university hospitals.

METHODS: The models must be tailored for the Czech healthcare system and specific conditions of the particular hospital.  The processes accommodated for evaluating, making decisions about and incorporating technologies are described to supportthe Motol University Hospital'sBoard of Directors. The hospital comprises all medical specialties and shows rich technological equipment including necessary expertize, providing sufficient internal resources for HTA analyses focused on clinical practice.

RESULTS: Based on a management needs survey, assessment requirements are divided into four categories according to their urgency:  1. Urgent, immediate risk of service (device operation) interruption. 2. Technology requires to be substituted due to impracticability of its recovery. 3. Technology requires to be expanded due to existing demand. 4. Incorporation of new innovative technology or planned replacement of obsolete technology. For each category, a flow chart was designed specifying the assessment process and assessment team composition