Page 3 - Vol0_No02_2018

David and Jahnke: Planning Medical Technology Management in a Hospital

system is being subjected to mounting pressures from the This illustrates that hospitals are experiencing a continual
needs to first identify its goals, secondly select and define increase in the number of medical devices used on a per
priorities, and finally allocate the limited resources. bed basis. It is therefore imperative that in an industry
Hospitals’ rising investment demonstrates their belief where the only constant is change, there is a program that:
a. provides for a guiding strategy for allocation of limited
in the importance of and the benefit from the deployment
resources
of technology. Health care organizations have been using
a variety of evaluation methodologies to provide alterna- b. maximizes the value provided by resources invested in
tives in the delivery of care. They are driven by medical medical technology
innovation, prospective reimbursement, and societal c. identifies and evaluates technological opportunities or
expectations. In this environment, evaluation method- threats
ologies only work if an organization is truly prepared to d. optimizes priorities in systems integration, facility
cancel a project after the initial investment. The flaw in preparation and staff planning
the theory is not its complexity, as some have said, but e. meets or exceeds standards of care
in the fact that it ignores the psychological and political
f. reduces operating costs
6
realities of capital investments. It becomes imperative
g. reduces risk exposurecreates
for providers to make good resource allocations decisions
at the outset of their capital budgeting process and often h. better care environment.
those decisions are biased towards equipment that has a
Whereas both knowledge and practice patterns of man-
positive impact on reimbursement. Health care providers
agement in general are well organized in today’s literature,
spent $8.25 billion on capital equipment in 1988, com-
the management of the health care delivery system and
7
pared with $8.21 billion in 1987. A survey of hospitals’
that of medical technology in the clinical environment is
spending plans for capital budgets, one that includes
more fragmented and has not yet reached that level of
equipment and construction, indicates that spending rose
integration. However, we are beginning to understand
8
during 1992 by 15%, reaching $23.6 billion.
the relationship between the methods and information
However, the increasing scarcity of available resources that guide the decisions regarding the management of the
within the hospital community on the one hand and the medical technology that is being deployed in the highly
demand for quality health care on the other, promoted complex environment of the health care delivery system,
a public debate and awareness of such a paradoxical including the variances among users, applications and
economic perspective. New tools for cost and outcomes cultures from one hospital to another.
management include disease management and patient
The health care delivery system presents a very complex
9
safety initiatives. It is in such an environment that
environment where strategy, facilities, equipment, drugs,
hospitals have begun to manage their fixed assets (i.e.
information and the full range of human interventions are
capital investments) and equipment-related operation
interacting. It is in this clinical environment that patients
expenditures better than ever before. As the deployment
in various conditions, staff, temporary skilled labor and
of medical equipment continuously evolves, its impact on
the wide variety of technology converge. The technology
the hospital operations and on the consumption rate of its
that has been developed for and is deployed in the health
financial resources increases. The ability to forecast and
care delivery system ranges from the “smart” facilities
manage this continual evolution and its subsequent impli-
within which care is being provided to the products that
cations has become a major component in all health care
are used around the provision of healthcare services, and
decisions. In a survey of three large hospitals in Houston,
to its regulation and management. “Technology means
Texas, with a combined licensed capacity of about 1400
merely the use of tools, that is, the involvement of any
beds, the average number of medical devices being used 11
agent which assists in the performance of a task.” Such
per licensed bed has increased between 1982 and 2002
tools have been introduced at an increasing rate during
10
from four devices per bed to over 17 devices per bed.
the past 100 years and include the use of techniques,
25 J Global Clinical Engineering Special Issue 1: 23-32; 2018