There is no debate that great advances in medicine have been made over the last 100 years; however, not every drug, test, or medical device that comes to market works well or is safe. To determine whether a medical technology safely improves patient outcomes, when and for which patients it should be used, and how it compares with existing treatments, we need to study it in clinical trials. If it demonstrates a benefit in clinical trials, then we need to use the technology in the way in which it was intended—for the appropriate disease and patient population. Only when we have this evidence can we make a true assessment of its clinical value.
In this era of economic uncertainty, hospitals around the world are scrutinizing costs and being forced to make tough decisions affecting patients and their own financial status. When adopting new technologies decisions are becoming increasingly important as the costs associated with making wrong decisions continue to escalate. With the array of new technologies clamoring for attention, the need for good evidence has become paramount.
Making decisions about which medical technologies to acquire is not easy. When considering new technologies, especially those associated with cardiology, bariatrics, orthopedics, and the operating room, navigating the myriad of information needed to drive a decision can be difficult.
Choosing technologies that will optimize patient outcomes, control costs, and satisfy all of the internal stakeholders are a complex process. Attempting to satisfy competing requirements of a host of internal stakeholders is tricky, and the clinical evidence of efficacy and safety can be overlooked or dismissed in the process.
The impact of a decision may not come to light for months and is often exposed on the hospital’s profit and loss line. A decision may be deemed wrong by one or more stakeholders because of erroneous projections of uptake of a new technology, unanticipated lack of reimbursement from payers, or overestimation of improvement to patient outcomes compared with currently available technologies. Whatever the reason, poor decisions of the past drive the choices of the future.
Here are some of the pitfalls to avoid when making technology-acquisition decisions so that your goals to enhance the quality of care, control costs, and improve operational efficiency are met. Does your hospital fall into any of these traps?
- Relying on free, public Internet searches as a reliable source for information.
- Confusing opinion or consensus with scientific evidence.
- Ignoring financial and other conflicts of interest that may be driving a request for a new technology.
- Allowing strong physician preference for a specific technology to influence decision making.
- Failing to understand what criteria insurers will use to determine coverage policies.
- Accepting the manufacturer’s information on technical specifications without demanding the best available clinical evidence that illustrates what impact (positive or negative) the technology will have on patient outcomes.
- Ignoring what the evidence is saying about which specific patient population will benefit from the technology.
- Failing to identify the worst-case scenario if your assumptions and expectations about patient outcomes and reimbursement are wrong.
- Failing to proactively define and track the metrics needed to determine whether the technology acquisition was a good decision.
- Using ad hoc decision-making procedures rather than systematic, transparent procedures.
- Believing that newer means better.
About the Company:
Hayes, Inc., an internationally recognized leader in health technology research and consulting, is dedicated to the delivery of high-quality healthcare and improved outcomes through the integration of evidence into decision making and policy development. The unbiased information and comparative effectiveness analyses we provide enable evidence-based decisions about acquiring, managing, and paying for health technologies. Our worldwide clients include hospitals, healthcare systems, government agencies, health plans, and employers. Hayes, Inc. is a certified woman-owned small business (WOSB).
