Hospitals do not need to be reminded of technology acquisition mistakes they may have made in the past. They simply need to look in the operating room to see the pile of abandoned equipment.
Hospitals and healthcare systems can ill afford to make mistakes when evaluating and acquiring health technologies. However, technology by its nature is always changing. New products are constantly emerging but often there is limited evidence on safety, effectiveness, and cost.
If you are considering a purchase that has minimal objective clinical evidence, there are certain guidelines that might help clarify the decision. Hayes, the expert in evidence-based medicine, has published an eBook, “Making Healthcare Technology Decisions with Limited Evidence: Ten Questions to Ask”
According to the eBook, two considerations, need and risk, play a major role.
Is There a True Need?
It can be difficult when a new technology is being pushed by an internal champion who believes in its value. Or the request for new technology may come from patients who have read about a particular technology or seen it advertised.
In the absence of supporting clinical evidence and a reasonable business case, the key question should be whether the technology solves a serious and urgent problem facing the hospital. Ask yourself what the impact would be if you did nothing or delayed purchase. Is there an alternative or nontechnical solution?
Another consideration is whether the technology contributes to the hospital’s reputation and capabilities. If your hospital is trying to build its reputation as a leader in a certain area, then it may make sense to be an early adopter of the technology.
What Is the Risk?
Serious and life‐threatening safety concerns may not emerge until after a new technology has been used by large numbers of patients over a long period of time. Spend some time identifying the worst‐case scenario if your expectations about safety and efficacy are wrong. If nothing else, you should search the government databases for evidence of safety reports and problems. The FDA is one source of information on adverse event reporting.
If there is a lack of evidence, you have several options:
- Postpone your acquisition until more evidence is available
- Extrapolate from the evidence already available
- Generate your own evidence by joining a clinical trial, setting up a registry, or using the technology during a trial period
- Ask an unbiased resource, such as Hayes to conduct an analysis