Framework

The Life Cycle of Health Technologies 2.0 – A shared framework for connecting knowledge across the health-technology ecosystem

The Life Cycle of Health Technologies 2.0 is a framework for understanding how health needs, technologies, evidence, decisions and learning are connected over time.

It provides a shared, horizontal perspective across processes, disciplines, organisations and stages that are often treated separately. Rather than viewing health technologies as products that move through a simple linear pathway, the framework recognises that knowledge is generated, applied, challenged and renewed throughout their life cycle.

The framework helps make the connections between specialised expertise visible — from the identification of health needs to innovation, research, development, implementation, real-world use and reassessment.

The Life Cycle of Health Technologies 2.0 connects knowledge across the full life cycle — not only across individual stages.

Why a life-cycle framework is needed

Health technologies are shaped by many actors and decisions.

Public authorities, patients and citizens, healthcare professionals, researchers, innovators, manufacturers, regulators, health technology assessment bodies, payers, healthcare providers and policy-makers all contribute different forms of knowledge and responsibility.

However, these contributions often take place in separate systems, processes and institutional settings.

For example:

Health needs may be identified in public-health, care-delivery or patient settings.
Research priorities may be set through research funding, academic programmes or innovation initiatives.
Evidence may be generated through clinical, technical, economic, organisational, social or ethical research.
Regulation, reimbursement, procurement and implementation may be handled through separate decision pathways.
Real-world evidence and lived experience may not consistently inform earlier priorities, research agendas or future technology decisions.
Technologies that are already in use may remain insufficiently reassessed as evidence, practice, costs, alternatives and societal needs change.

The Life Cycle of Health Technologies 2.0 supports a more connected view. It makes transitions, interfaces, evidence needs and opportunities for learning visible across the full health-technology ecosystem.

A framework built through collaboration

The Life Cycle of Health Technologies 2.0 is the result of decades of international collaboration across the health-technology ecosystem.

It has evolved through exchange among public authorities, health technology assessment bodies, researchers, healthcare professionals, industry, innovators and other stakeholders. It draws on practical experience and methodological knowledge from throughout the life cycle of health technologies.

The framework is informed by the work of the EuroScan / international HealthTechScan (i-HTS) community, whose members work across early awareness, horizon scanning, health technology assessment, reassessment, health policy, innovation, evidence generation and implementation.

EuroScan/i-HTS brings together public organisations and individual experts from diverse health-system contexts. Through international exchange and collaborative methodological development, the network connects specialised knowledge that is often distributed across organisations, sectors and countries.ihts+2

Six interconnected phases

The Life Cycle of Health Technologies 2.0 consists of six interconnected phases. Each phase has distinct questions, evidence needs, actors and decisions. Together, they form a continuous system of knowledge generation and learning.

1. Needs

Identify and prioritise health needs.

The life cycle begins with people, populations and health systems.

Needs may arise from gaps in care, disease burden, unmet clinical needs, inequities, risks, service pressures, demographic change, environmental conditions or broader societal priorities.

The Needs phase involves identifying, describing and prioritising these demands. It translates them into collective action through policies, funding programmes, research calls, service specifications, procurement approaches or other system-level priorities.

Key questions include:

What health, care or societal need requires attention?
Who is affected, and how are they affected?
What burden, risk, inequity or gap in current care exists?
Which needs should be prioritised, and according to what criteria?
What forms of knowledge, evidence and participation are needed to define the need responsibly?
How can identified needs guide research, innovation and service development?

Examples of relevant activities

Population-health and burden-of-disease analysis.
Needs assessment and patient-experience research.
Priority setting.
Foresight and scenario planning.
Health impact assessment.
Policy development.
Research and innovation agenda setting.
Service planning and procurement specification.

2. Idea

Identify and describe emerging technologies and potential solutions.

The Idea phase concerns the recognition of emerging technologies, approaches and potential solutions.

Ideas may emerge in response to defined health-system needs. They may also arise through scientific discovery, technological innovation, entrepreneurial activity, clinical practice or wider societal and technological change.

The task is not simply to identify “new products”. It is to understand the potential technology, intended use, target population, proposed value, maturity, uncertainties and relationship to existing care pathways.

Key questions include:

What is the technology or potential solution?
Which need or opportunity does it address?
Who is the intended population, user or beneficiary?
How might it change current care, service delivery or decision-making?
What is known, and what remains uncertain?
What early evidence and development pathway may be needed?
Which stakeholders should be engaged at an early stage?

Examples of relevant activities

Horizon scanning and early awareness.
Emerging-technology identification.
Technology profiling.
Early dialogue and scientific advice.
Early engagement with patients, professionals and service providers.
Feasibility and concept development.
Mapping of potential comparators and care pathways.
Identification of likely evidence requirements.

3. Research

Generate early evidence on feasibility, safety, mechanisms and potential value.

The Research phase develops initial knowledge about whether a technology can work, for whom, under which conditions and with what potential benefits, harms, costs or wider consequences.

Evidence generation may include laboratory, preclinical, technical, clinical, behavioural, organisational, ethical, social, environmental or health-economic research, depending on the type of technology and intended use.

The focus is on reducing fundamental uncertainty and determining whether further development is justified, safe and relevant.

Key questions include:

Is the technology feasible and safe enough to progress?
What is the proposed mechanism of action or pathway to impact?
What outcomes matter to patients, professionals, health systems and society?
What evidence gaps must be addressed before development, regulation or implementation?
What are the likely benefits, harms, costs and resource implications?
What ethical, equity, environmental or organisational questions should be considered early?

Examples of relevant activities

Basic, translational and applied research.
Feasibility studies.
Proof-of-concept studies.
Early clinical or performance studies.
Early health-economic modelling.
Patient-preference and stakeholder research.
Technical validation.
Exploratory evidence synthesis.
Early value assessment.

4. Development

Build and validate the technology for appropriate use and regulatory readiness.

The Development phase concerns the maturation, design, testing and validation of a technology.

This includes the generation of evidence required to demonstrate quality, safety, performance and, where relevant, clinical benefit. It may also include manufacturing, usability, implementation planning, regulatory preparation and evidence-generation strategies for later assessment and reimbursement.

Development is not solely a technical or commercial activity. It is also the stage at which future implementation conditions, evidence requirements, care pathways, access considerations and health-system implications should be anticipated.

Key questions include:

Is the technology adequately designed, tested and validated for its intended purpose?
What evidence is required for regulatory, clinical, HTA, reimbursement or service decisions?
Are studies designed to produce meaningful, transferable and decision-relevant evidence?
What comparators, outcomes and populations are relevant?
What implementation, service, workforce, data or infrastructure requirements should be anticipated?
How can uncertainty be managed through an appropriate evidence-development plan?

Examples of relevant activities

Product and service design.
Validation and performance studies.
Clinical investigations and trials.
Usability and human-factors studies.
Quality-management and manufacturing activities.
Regulatory strategy and submissions.
Evidence-generation planning.
HTA scoping and early HTA.
Implementation and service-readiness planning.

5. Implementation

Support adoption, reimbursement and health-service readiness.

The Implementation phase concerns the transition from availability to responsible use in real health-system settings.

A technology may be authorised or available without being ready for routine adoption. Implementation requires attention to decisions about value, reimbursement, procurement, service organisation, workforce, training, clinical pathways, infrastructure, data systems, equity and ongoing monitoring.

This phase brings together evidence and practical conditions for the technology to be used safely, effectively, equitably and sustainably.

Key questions include:

Is there sufficient evidence to support adoption, reimbursement, procurement or use?
For whom, where and under what conditions should the technology be introduced?
What changes to services, pathways, roles, workforce, training, infrastructure or data are required?
How will access, equity, affordability and sustainability be considered?
What uncertainty remains, and how will it be monitored after implementation?
What decisions, governance arrangements and responsibilities are required?

Examples of relevant activities

Health technology assessment.
Appraisal and decision support.
Reimbursement and coverage decisions.
Procurement and contracting.
Clinical-guideline development.
Service redesign.
Workforce and training planning.
Implementation research.
Change management.
Monitoring and managed-entry arrangements.

6. Usage

Generate real-world evidence, reassess value and support responsible adaptation.

The Usage phase concerns technologies in routine or real-world use.

Evidence continues to develop after adoption. A technology’s benefits, harms, costs, equity implications, acceptability, environmental impact, organisational consequences and relationship to alternatives may change over time.

Usage therefore involves ongoing monitoring, real-world evidence generation, reassessment and structured decision-making about whether to continue, expand, adapt, redirect, restrict or discontinue practice.

This learning should feed back into the identification and prioritisation of health needs, new research questions, innovation priorities and future system demands.

Key questions include:

Does the technology deliver the expected benefits in real-world settings?
Are benefits, harms, costs, quality-of-life effects and equity impacts consistent across populations and settings?
How does the technology compare with new alternatives, changing standards of care or evolving health-system needs?
Is continued use justified, or should the technology be adapted, restricted, replaced or discontinued?
What new questions, needs or evidence gaps emerge from real-world experience?
How can learning be shared across organisations, sectors and countries?

Examples of relevant activities

Real-world evidence generation.
Outcomes monitoring.
Post-market surveillance.
Reassessment and re-evaluation.
Health technology reassessment.
Disinvestment and de-implementation.
Service and pathway optimisation.
Updating guidance, coverage and procurement decisions.
Feedback into priority setting, research and innovation.

The continuous knowledge-generation loop

The six phases should not be understood as a one-way sequence.

Knowledge and experience generated in Usage can change how needs are defined. Implementation can reveal evidence gaps that affect Development and Research. Early awareness can identify emerging technologies that require new policy, research or service priorities. Health-system needs can reshape innovation and research agendas.

The Life Cycle of Health Technologies 2.0 therefore includes a continuous knowledge-generation loop.

Evidence does not end with a decision. It is generated, interpreted and applied throughout the life cycle.

This loop supports learning across phases and makes it possible to reconsider earlier assumptions as evidence, technologies, care pathways and societal needs evolve.

The 2026 LC 2.0 publication describes this as a transition from a product-focused model toward a framework in which the life cycle functions as an iterative knowledge-generation and decision-supporting service.frontiersin+1

Horizontal connections, not silos

The framework does not assume that every actor has the same role, responsibility or perspective.

Instead, it provides a shared reference point for connecting specialised expertise that is usually distributed across different organisations and professional communities.

It can help make visible:

Interfaces between research, regulation, HTA, reimbursement, procurement, implementation and reassessment.
Dependencies between evidence-generation activities and later decision needs.
Differences between local mandates, policy contexts and health-system structures.
Opportunities for earlier dialogue between innovators, decision-makers, patients, clinicians and researchers.
Gaps where knowledge does not transfer effectively between phases.
Opportunities to reduce duplication and build on experience generated elsewhere.

The aim is not to remove institutional boundaries or standardise every decision. It is to improve mutual understanding and create more coherent pathways for generating, sharing and using knowledge.

How to use the framework

The Life Cycle of Health Technologies 2.0 can be used in different ways.

Use	Example
Orientation	Understand where a project, technology, organisation or decision sits in the broader life cycle
Learning and capability building	Build a shared language across teams with different roles and expertise
Process mapping	Map existing workflows, handovers, decision points and evidence gaps
Priority setting	Connect health needs with research, innovation and service priorities
Evidence planning	Identify evidence needs early and link them to future regulatory, HTA, implementation and use decisions
Stakeholder engagement	Identify relevant perspectives and involve them at appropriate points
Implementation planning	Anticipate service, workforce, infrastructure, equity and data requirements
Reassessment	Use real-world evidence and changing context to reconsider established technologies
International exchange	Compare approaches across health systems while recognising different local mandates and contexts

Framework and local context

The framework is designed to support shared understanding, not to prescribe a single universal process.

Health systems differ in their legislation, governance, resources, payment systems, clinical pathways, available data, professional roles, public priorities and local needs.

The framework should therefore be adapted to the relevant context. It can support discussion and structured analysis, but it does not replace local legal requirements, institutional mandates, formal HTA processes, regulatory standards, professional judgement or democratic decision-making.

Learn with the evidence.academy

The evidence.academy translates the Life Cycle of Health Technologies 2.0 into structured education for professionals and organisations.

Explore courses and learning pathways relevant to:

Health needs assessment and priority setting.
Early awareness and horizon scanning.
Evidence generation and early value assessment.
Development, regulation and evidence planning.
Health technology assessment, reimbursement and implementation.
Real-world evidence, reassessment and responsible adaptation of practice.

The Life Cycle of Health Technologies 2.0 – A shared framework for connecting knowledge across the health-technology ecosystem

Why a life-cycle framework is needed

A framework built through collaboration

Six interconnected phases

1. Needs

2. Idea

3. Research

4. Development

5. Implementation

6. Usage

The continuous knowledge-generation loop

Horizontal connections, not silos

How to use the framework

Framework and local context

Further reading

Learn with the evidence.academy