That's a very, very good question.
A huge number of health care technology assessments are done. Depending on how they're done, they may be theoretical exercises that have to be contextualized to every individual hospital, and because of that theoretical nature, they may not be immediately usable by people across the country.
Having said that, though, there are health care technology assessments that are contextualized. Is something that's done for the University of Toronto applicable to McGill? Probably. If you do it for a Toronto hospital, is it applicable to a tiny community hospital? No, it's not. If you do it for a tiny community hospital in Ontario, is it applicable to Alberta? Yes, it is.
I think there's an element of having to be much more careful to contextualize the HTA and to do it in such a way that it's easily transferable. That has not been the history, and that's why a lot of CADTH stuff has not been widely documented.
As well, the not invented here syndrome is very big. CADTH is seen as national, and in fact all the provinces see themselves as owning health care and not being ones to be dictated to outside of their own spheres. It's a challenge, but I think having a collaborative cross-provincial kind of thing, such as pCODR, the pan-Canadian drug review, would be a really good step towards trying to get it all used.