Technology: driving health care costs – both up and down

Ira Brodsky

Western medicine is sometimes criticised for its dependence on expensive equipment for the diagnosis and treatment of illnesses. But, with careful use and application, sophisticated medical technology could actually help make health care more readily affordable.

Everyone wants the best medical care that money can buy. Diagnostic imaging systems let doctors peer inside the body – often detecting health problems in their earliest, most treatable, stages. Implantable pacemakers and defibrillators restore the heart’s proper rhythm. Cochlear implants help many people hear, and retinal implants are just a matter of time. But the best medical care that money can buy involves some costly technology. 

In fact, sophisticated medical equipment is widely seen as one of the chief reasons that today’s health care is so expensive. While consumers want access to the latest advances, critics say we have become too dependent on expensive technology and that people in wealthy nations are over-diagnosed and over-treated. Given the high cost of medical technology, a number of policy-makers have concluded that we should ration access to the most aggressive treatments. 

But exactly why is medical technology so expensive? There are several reasons. Patients insist that the health care industry performs flawlessly, so we subject new medical systems and devices to a phalanx of certifications, regulations and clinical trials – all of which add cost. But the main reason is that the industry has been so busy integrating computers and communications into medical products that the technology is only now beginning to stabilise and mature. 

Developments in four key areas will drive down the cost of health care: high-end medical systems are being equipped with productivity-enhancing features; remote solutions that let specialists apply their skills at a distance are being deployed; mobile solutions that enable physicians to save time and money are coming to market; and personal health technology that helps consumers stay healthy and manage chronic medical conditions is starting to take off. 

Manufacturers of diagnostic imaging systems (ultrasound, CT, PET and MRI scans) know that the best way to increase their sales is to grow the market. One approach is to develop less expensive models targeting specific applications. Another is to make highend models more productive through workflow improvements; for example, by equipping an ultrasound machine with a more intuitive operator interface and functions that automate common tasks, a 40-minute examination can be completed in half the time. Likewise, faster CT scanners and workstations can serve more patients per day. Higher productivity translates into lower costs per patient. 

The switch to digital technology has also made diagnostic imaging more productive. Traditionally, imaging departments have had to stock, process and archive films, and patients seeking the advice of doctors elsewhere have had to obtain printed copies. With digital imaging technology, there is no film to order, develop, store, and duplicate-everything is done by computer. If a patient wishes to consult with a specialist, the image can be sent as an email attachment. An added benefit is that digital images can be enhanced, analysed and compared more quickly and effectively. 

Productivity improvements are coming to the operating room too. Surgical information systems ensure that supplies, sterilised instruments and personnel arrive on time, reducing delays between operations. In addition, voice recognition technology allows surgeons to adjust lighting and change views on video displays while their hands continue to operate. Dedicated imaging systems help surgeons navigate and permit them to check their work. For example, ultrasound can be used in the operating room to evaluate heart valve repairs, reducing the likelihood of follow-up surgery. Advanced technology also allows for more minimally invasive procedures; some artificial heart valves can now be deployed through catheters, while robotically assisted heart bypass surgery requires smaller incisions and avoids cutting the breastbone. 

Remote technology allows hospitals to use highly paid specialists only when needed. Not every hospital requires a radiologist on site overnight. Remote services permit specialists working the day shift in their own location to interpret scans and provide expert advice for hospitals in distant time zones. These remote services don’t just save money – a fresh pair of eyes can also spot mistakes. In the future, surgeons may even perform operations remotely using broadband links and surgical robots. 

Hospital stays can be shortened or avoided altogether with remote technology. Caregivers can monitor chronic medical conditions in the home – vital signs can be checked, reminders to take medicines can be sent via text messages, and wearable devices can allow patients to call for emergency assistance. 

Mobile technology is making health care more responsive and cost-effective. In hospitals, it is being used to track and locate valuable assets such as IV dispensers and wheelchairs. Wireless handhelds with automatic ID technology ensure that the right medicine is administered to the right patient at the right time. Physicians can pull up test results and order medicines and additional tests at patients’ bedsides. Doctors in remote and rural areas can use smartphones with special hardware attachments to screen patients for vision, hearing, heart rhythm and other problems. One company, MobiSante, even makes a ‘smartphone-based ultrasound imaging system’. 

Personal health technology is also producing a wave of cost savings. By logging on to the Internet, patients and their families can learn more about medical conditions. They can tap into patient support networks, share their medical records with specialists and even obtain online consultations. Inexpensive blood pressure monitors, pedometers and weight scales that connect to PCs help consumers keep track of their health. 

With digital electronics boosting performance and reducing costs in industry after industry, surely it can do the same for health care. Encouraging and supporting technological innovation is the best way to drive down prices and, consequently, ensure that everyone has access to the best health care available.

About the author:

Ira Brodsky is the author of The History & Future of Medical Technology, published by Telescope Books


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