To facilitate implementation by interpreting medical and TA languages, culturally sensitive, multilingual people should be used. The implementation should be treated as educational rather than directive, to help the owners of the technology feel less vulnerable and defensive. The owners of the technology then will be more willing to do research to further explore the effectiveness of the tool, and they may be more accepting of the guideline. Health plans use a particular TA as a rational basis for coverage decisions, developing clinical practice guidelines, methods for controlling costs, considering support of clinical trials, and defending potential disputes over coverage. Disputes over coverage have led some companies or organizations to override the evidence on which the TA is based to provide coverage for experimental treatments that have not yet been established as effective.
Disputes usually arise concerning treatments for life-threatening or severely disabling conditions.
Therapeutic options in these cases are often limited, increasing the demand for new, experimental treatments. A credible, scientific, consistent process for TA is critical. The process requires physician involvement, which in turn requires physicians to be educated in the TA process. How society should deal with costs as a part of the process, particularly as technology becomes more and more expensive, remains unclear. This progress, however, is not without its difficulties when pressures have contributed to efforts by politicians to overrule science when faced with unpopular findings.