In The Line Of Sight: Evaluating Imaging Technology
This article appears in the April print issue of Surgical Products.
There's no easy way to determine if the time and price is right to invest in new, cutting-edge imaging equipment because the clinical value to be gained by acquiring it is no longer enough to justify the cost to obtain it.
There are a wealth of factors that affect the purchasing process and determine how the acquisition of imaging equipment will be evaluated over the long term.
Recent estimates indicate more than 65 percent of surgical procedures utilize minimally invasive techniques and this percentage is only expected to increase with time. This statistic supports the widely-held belief among industry experts that the imaging technology that best allows the surgical team to see exactly what is happening inside the patient without (or with little) opening will be preferred by both hospitals great and small.
However, a hospital's proper evaluation of how the latest imaging technology compares with what the facility has on site is never truly complete. Technology always changes with time, as do the needs of clinicians. Informed, reasoned purchasing decisions that take into account input from a variety of sources prevent hospital facilities from falling behind the times or making unnecessary investments.
“You don’t need a Lamborghini to go to the corner to buy bread,” says Michael Foldes, General Manager, Eastern Region, FSN Medical Technologies. “Facilities managers and procurement personnel working with physicians, nurses, biomed technicians and others have to determine what’s needed most and then do what they can to fulfill identified needs.”
The complexity of these purchasing decisions makes it all the more important than ever that those tasked with making them are confident about what equipment best fits their respective facilities and provides them with the most value of their investment. To do so, many hospitals – particularly large institutions call on several types of personnel to weigh in on investment opportunities. Each decision-maker offers a unique perspective and a different set of relevant criteria.
“Surgeons remain the most influential decision makers, with clarity of image, ease of use, and the capture and storage of surgical information being important characteristics,” says Mark Schneider, Director of Sales, Surgical Products, NDS Surgical Imaging.
However, according to Schneider, hospital finance and administrative managers now provide more input in equipment decision making, with cost of acquisition and measurable return on investment being key factors in how their opinions are formulated.
The hospital CIO and IT management teams are also involved in the imaging equipment decision making loop. The video and images generated by the equipment needs to be captured and sent to the hospital network for storage and retrieval. Thus, open architecture, ease of connectivity into the HIS, and simple integration into the OR’s integration platform are important factors.
But those aren’t the only ones that determine whether or not an investment is made. If new technology offers patient care that the facility does not currently provide, or if it is a component of a long-term plan to improve patient care, surgical outcomes, or market leadership, then acquisition is more seriously considered.
Nevertheless, sometimes facilities are unwilling to make a purchase, and most facilities will hold onto their imaging equipment for five years or so before replacing it. Healthcare facilities face rising costs in salaries, insurance, legal, and other G&A expenses, and they are under increasing pressure to wisely apply capital budgets.
According to Schneider, concern for the ongoing impact of the Affordable Care Act can also affect purchasing behaviors. This is partially because an implementation may require other improvements and upgrades.
Newly-acquired technology often needs to work as a component of a hospital's information management system to be effective. OR often must be connected to a facility’s information management system.
“This requires more than simply adding pieces of equipment to the OR,” he says. “Video cabling, routing, and streaming infrastructure is required to enable real time and stored surgical data to be viewed during a procedure. Hybrid rooms are a good example of this. This larger capital investment may hold some hospitals back from purchasing new equipment.”
An evaluation may convince certain hospital facilities to invest in 3D and 4K imaging systems. The potential benefits of this type of technology may be worth the wait for certain hospitals.
“We predict that 3D will eventually be as ubiquitous as HD in the laparoscopic OR setting and will become the standard of care over the next three to five years,” says David Colvin, Executive Director of Marketing, General Surgery and Imaging, Olympus Corporation. “As administrators look at new ways to attract and retain top surgeons while still containing costs, 3D will become increasingly attractive. 3D-ready and 2D-to-3D-upgradeable systems will make the switch from 2D to 3D even easier.”
There is reason to believe 3D technology will be adapted to more applications across more specialties. According to Colvin, 3D/HD and 3D with articulating scopes offers the potential to broaden surgical procedures performed laparoscopically by increasing precision, speed, and ability to obtain critical views of anatomy not previously available to surgeons while providing the depth perception of an open procedure.
The healthcare industry will demand more from OR visualization technology with time. This is because surgeons want new and innovative ways to perform minimally invasive procedures. As a result, visualization technology will have to rise and meet the present and future needs of the surgical community.
“Demand for improvement is everpresent, whether in image capture, signal distribution and management, or even in the shape of the blade a surgeon uses to open a patient on an operating table to insert a scope,“ says Foldes. “Companies around the world are engaged in developing technology solutions for problems most of us haven’t even thought about yet.
As these forward technologies arise, the cost of current technology will go down, and the healthcare industry's race to keep up will go on,” he adds.
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