OBJECTIVES: The institutionalization of health technology assessment (HTA) remains a major challenge for many countries. Normative, political and social variations across nations limit the transference of HTA institutionalization models that have been implemented elsewhere. The “Knowledge to action” (KA) model has proven to reduce the “evidence-practice” gap through a systematic method of linking evidence to implementation and monitoring processes. The objective of this study was to analyze how the KA model could be institutionalized within the HTA framework. METHODS: We conducted a systematic search on “KA” theoretical approaches and empirical evidence. Based on a comparative analysis of relevant articles, and over a series of discussion meetings with different stakeholders, we generated an adjusted KA model fitting the purposes of HTA.  Then, we identified the key institutional questions that would be relevant for the institutionalization of the adjusted KA model in the context of HTA. RESULTS: The evidence on the KA model focuses on solving real problems, the use of evidence from different sources, and the need of including preferences of evidence users in real life, all elements included in the adjusted version. The institutionalization of KA within the HTA framework is challenged by, at least, the following questions: (i) which is the right way of choosing representative evidence users (e.g. healthcare team), stakeholders (health policy makers), and those affected by evidence use (patients); (ii) how to monitor the adaptation of guidelines to local contexts, (iii) which are the sets of rules that model the stakeholder´s behaviour, (iv) and which are the implied outcomes that are expected from these rules. CONCLUSIONS: The KA model adds important elements to HTA, which can be useful for the institutionalization processes in many countries of the world. This piece of research identified the main components/questions that need to be addressed to undertake this institutional process.