By Christina Orlovsky Page, contributor
February 22, 2013 - Health care technology is clearly top-of-mind for hospital IT departments and many frontline workers putting tech tools to use each day. But for those who spend their workdays in boardrooms and decision-making meetings, hi-tech concerns can be multiplied tenfold. According to a new report released by ECRI Institute, Top 10 C-Suite Watch List: Hospital Technology Issues for 2013, health care executives are faced with challenges that go far beyond health IT implementation and usage into cost, operations and overall quality of care.
“New demands for information and clinical technology are top issues for executives, and objective perspectives are critical,” said Jeffrey C. Lerner, PhD, president and chief executive officer of ECRI Institute, a Plymouth Meeting, Pennsylvania-based nonprofit organization dedicated to improving patient care through evidence-based research on health care processes and procedures.
According to Robert Maliff, ECRI Institute’s director of applied solutions, the list is ranked in order of priority, based on a balloting of selected ECRI staff.
“We surveyed our clinical staff, which includes nurses, biomedical engineers, allied health personnel and many others with experience in providing patient care,” Maliff said. The results draw upon ECRI Institute’s 45 years of experience evaluating the safety, efficiency, and cost-effectiveness of health technologies.
In the number one spot for 2013 is electronic health records (EHR), systems that hospitals nationwide have implemented in order to achieve health care reform’s early requirements for meaningful use. ECRI Institute posed the question to executives: “You’ve achieved meaningful use, but how safe is your electronic health record?”
This top priority draws upon research from a 2011 Institute of Medicine (IOM) report, Health IT and Patient Safety: Building Safer Systems for Better Care, which addresses the fact that some technology has improved safety, while others have not. Executives, the report suggests, need to determine what category their EHR falls into and make changes if risk outweighs benefit. ECRI Institute’s report reads, “What is missing, the IOM report states, is a clear indication of the magnitude of risk that health IT presents to patient safety.”
The report’s full list of top 10 priorities, and the questions ECRI Institute suggests executives ask, include:
1. You’ve achieved meaningful use, but how safe is your electronic health record?
2. Mobile health: What is it and what can it do for me?
3. Alarm integration technology: Will you be able to reduce alarm fatigue and improve alarm management?
4. Minimally invasive cardiac surgery: Is transcatheter aortic valve implantation (TAVI) ready for liftoff?
5. Imaging and surgery: What imaging won’t be done in an operating room?
6. PET/MR: Is this the hybrid that everyone has to have?
7. Bariatric surgery: Is it a cure for type II diabetes?
8. Supply chain: Will MR-compatible pacemakers explode supply expenses?
9. Radiation dose safety: CT dose limbo – how low can you go?
10. Lung cancer screenings: Is there enough lung capacity to get in the race?
Because new health IT often involves a significant cost investment, it only makes sense that a hospital’s chief executives are fully vested in the selection of appropriate technologies that make sense for their specific organization--and that they ask important questions before making these decisions.
“Hospital leaders should ask if new technology or procedures really improve patient care and make it a less costly patient-care experience,” Maliff said.
“The ultimate responsibility lies with the executives and senior leadership at the hospital in regards to technology approvals,” he continued. “Sometimes, it’s a strategic decision to invest in a multi-million dollar surgical device, even though it may not be the best financial investment. A transparent capital process should look at the financials and also the operational needs of the technology, the strategy of the hospital, and the clinical needs and standard of care issues in order to achieve success. Without such a balanced approach, no one will be happy with decisions.”
Maliff added that the implications for nurses--and especially nursing leaders--are equally important.
“Nursing leadership needs to understand the technical as well as the clinical differentiators between various technology systems so they don’t get unduly persuaded during a vendor sales presentation,” he said. “To get more involved, nurses need to not only be the champion for certain technologies but also work on the capital planning committees that are system or hospital-wide.”
For more information or to view ECRI Institute’s free full report, visit www.ecri.org.
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