Integrated approach best for neuroimaging workup.
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Changes reshaping the healthcare delivery system impact capital equipment acquisition decisions within radiology departments. During an era of rapid technological advancement, acquisition decisions often favor new imaging technology with an emphasis on volume and revenue increases. With a slowdown or plateau in new imaging technology and significant changes in the healthcare delivery structure, greater emphasis is now being given to productivity and quality improvement investments. Such investments are aimed at reducing labor and material operating costs through capital investment in electronic alternatives, such as the digital viewing and storage of diagnostic images in lieu of film. This shift in emphasis presents a dilemma for radiology departments because it is often more difficult to show a quality and productivity improvement justification. One approach is to use a formal ¿technology assessment¿ (TA) process wherein a manager considers changes in processes, labor, equipment, space, and consumables, and then assesses that impact on cost, utilization, quality of care, and other factors. A cost model is a useful tool in this process. A review of a number of real world experiences demonstrates the benefits of more timely and informed capital equipment investment decisions. While the direct savings may not entirely offset such investments, TA analysis also evaluates in tangible benefits that may not be quantifiable in economic terms. Both tangible cost savings and intangible benefits need to be weighed against the net investment in a new technology.
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An extraordinary gamut of medical and surgical therapies could be considered "halfway technologies," addressing mere symptoms or manifestations of disease, rather than the underlying pathogenesis. When a "halfway" technology is also lifesaving, its value cannot be underestimated by the individual patient. The example of organ transplantation explored in this column represents a halfway technology. It does not treat the underlying disease itself, but reflects the absolute failure of all efforts at medical and conservative therapy and is a last ditch, gerry-rigged lifesaving solution. And what about "quarter technologies"--the bridge to transplant devices--designed to get the patient halfway to the final halfway procedure?
As health care costs continue to escalate, the assessment and management of medical technologies have become vitally important to health care providers. Evaluation and comparison of the safety, effectiveness, efficiency, cost, and clinical outcomes of new and existing technologies provide the critical information necessary to make appropriate clinical resource decisions in an increasingly cost-conscious environment. Technologies to be assessed include pharmaceuticals, devices, medical and surgical procedures, and health care delivery systems. Clinical trial results, literature reviews, expert opinions, and group consensus are used in preparing technology use decisions, which often include the preparation of background information, specific recommendations, use guidelines, and reimbursement analyses.
In the managed care environment, technology life-cycle management is necessary to minimize costs and maximize the quality of patient care. A careful approach to equipment acquisition and management can help managed care providers reduce the cost of delivering services while ensuring the right technology is available when and where it is needed to best serve patients. Proper management of technology assets from planning and budgeting through acquisition, usage and disposal can help managed care facilities reduce cost and risk, increase control, and improve productivity.
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In an era of diminishing resources, healthcare providers must justify new technology acquisitions. Cost modeling is one method of evaluating the financial impact a technology acquisition will have on a healthcare facility or integrated delivery system. This methodology requires careful data collection and a thorough analysis of both current costs and future cost savings resulting from the new technology. By using a cost modeling methodology, providers will be able to achieve competitive and economic advantages by analyzing both cost and value.
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