Common sense is probably the biggest factor to use as a guide when looking to buy new medical technology and equipment. However, sometimes emotions, territorial department heads, old-school resistance to change and personal preferences influence or override the decision-making process in any profession. To overcome these issues, the basis for any medical evaluation committee should make it a priority to answer one central question: What is best for the patient?
When I attended the 2007 American Society of Anesthesiologists annual meeting in San Francisco in October, I listened in on a refresher course for evaluating new technology, presented by John Abenstein, M.D., Department of Anesthesiology at the Mayo Clinic, Rochester, Minn.
He said committees need to establish criteria for evaluating new technology. The key questions include: Does the technology work, what studies confirm its effectiveness, can the technology work in a real-life situation as opposed to a clinical research facility and will it make clinically relevant differences in outcomes?
A committee should consider if the old equipment still has technical support and if spare parts are available. Will the new equipment do more and will it save time and money? What problem is the new technology going to solve? Dr. Abenstein suggests visiting the factory to see how the devices are made. Is the factory clean and organized? If not, he questions the quality of the machines.
He says to figure in the stability of a company. If a company is not in business three years after you purchase equipment, it will not help your long-term use of the equipment.
All sorts of justifications will be used to sway people to believe new technology is needed. Dr.Abenstein said people should not buy into emotional appeals that the technology is needed for children's or women’s health or else the hospital will not be supporting those causes. He says the bottom line is to ask if the new technology works and if it will significantly improve outcomes and be cost effective.
Some will argue equipment is needed to meet a regulatory mandate. If that argument is used, committees should ask to see the mandate in writing. Dr. Abenstein said many times it is not a mandate, but rather a suggested guideline.
Committees should also look at patient safety issues and consider standardization as a goal. If a hospital uses numerous types of machines for the same function it can lead to errors due to confusion between the different operabilities, or people not knowing how to use a machine they are not used to.
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