10 Technologies for Hospital C-suites to Watch

Hospital executives want to ensure their organizations are at the cutting edge of technology and investing their scarce dollars wisely. So which technologies are hot for 2009 and beyond? The ECRI Institute, an independent nonprofit organization that researches which medical procedures, devices, drugs, and processes are best equipped to improve patient care, released its top 10 list of technologies that hospital executives should keep an eye on.

The top 10 technologies are:

1. Electronic Medical Records. This should not come as a surprise to C-suite executives given the funding for health information technology that is included in the American Recovery and Reinvestment Act. Hospital executives should be determining which IT projects they need to accomplish before they can adopt an EMR, so they can be prepared to hit the ground running once the government defines meaningful use. Organizations that already have a strong foundation in IT and have implemented an EMR can probably continue along their IT path and make any adjustments required once meaningful use is defined later this year.

2. Ultrahigh-Field-Strength MRI and Premium-Slice CT. The magnetic resonance imaging market has been moving toward use of more ultrahigh-field-strength and open high-field-strength systems, which have a stronger magnet (3.0 T). They can provide a higher signal to noise ratio than the 1.5 T systems, so clinicians can obtain better quality images faster. However, they also come with a hefty price tag. But do hospitals really need these now? Most MRI magnets last 10 to 12 years and today's high-end scanners will likely dominate the market in the next five to eight years. Healthcare executives will need to decide if they should purchase the costly UFS or open HFS systems or the more reasonably priced 1.5 T systems that may be outdated before reaching the end of their expected life cycle.

Similarly, there are now 320-slice CT scanners on the market and 64-slice systems are becoming the typical new purchase. But 64-slice and higher-slice systems can cost upwards of $1.5 million, whereas basic systems of 16 or fewer slices and reduced specifications still provide adequate image quality for 90% of clinical applications, according to the report. "Given the current economic climate, most hospitals should consider purchasing the basic systems because they will meet the vast majority of clinical needs," said ECRI researchers.

3. Physician Preference Items. The cost of these implantable items such as cardiac stents, pacemakers, orthopedic implants have grown to roughly 50% of the hospital's total supply costs. It is crucial for hospital administrators to provide physicians with objective information about the clinical evidence, safety, and costs so that they can make decisions based on real evidence-based clinical benefits.

4. Robotic-Assisted Systems for Surgery and Endovascular Catheterization. The pressure for hospitals to acquire a robot has increased with the new generation of surgical residents, requirements of residency programs, and the need to stay competitive. Not to mention there are new surgical applications that are emerging in pediatrics, gynecology, and general surgery. Still the systems have a five to six year life cycle, cost $1 million to $3 million and have annual maintenance contracts that are upwards of $100,000. So how many robots does a hospital really need? Executives will need to carefully assess the high capital costs of a second or third robot against the possible growth of surgical volumes, the ability to accommodate robots in OR suites, scheduling issues, and the market advantage of providing robot assisted surgery, ECRI researchers said.

5. Radiation Oncology. Proton therapy is becoming more available to hospitals nationwide—a commercially available single room proton therapy system is on the horizon at a cost of $20 million. So how important is it for hospitals to be able to offer the "most advanced" radiation technology, and will proton therapy live up to all the hype? Medicare has listed proton therapy as one of its top 10 priorities this year, and it will be taking a close look at its effectiveness to determine what its coverage may be, according to the report.

6. Radio-Frequency Identification Technology. There is a lot of promise surrounding RFID—it can improve patient safety, efficiency, and save money—however the return on investment can oftentimes be difficult to track. Senior leaders should focus on "tracking medical devices that are critically needed but often in short supply because of hoarding or bottlenecks in handling between uses," the report says.

7. Alarm Integration Technologies. Effectively managing and responding to patient alarms is a serious challenge for hospitals. According to the FDA's Maude database, 150 deaths related to physiologic monitoring alarms occurred from 2002 to 2004. A complex alarm integration system that incorporates many alarms like physiologic monitors, ventilators, infusion devices, and medical telemetry can help enhance alarm notification and coverage by notifying a clinician's wireless device, for example.

8. Hybrid Operating Rooms.Having a room where a patient can undergo open-heart surgery, as well as, angioplasty that requires fluoroscopic imaging can help improve outcomes because they do not have to be moved between two sterile rooms. Senior leaders will need to determine whether their organization has sufficient cardiovascular and neurosurgical procedures to justify a new $800,000 C-arm system and how many operating rooms should have that imaging capability. Leaders should also prepare for turf battles that may erupt between surgeons and interventional radiologists.

9. Therapeutic Hypothermia after Heart Attack, Stroke, Spinal Cord Injury.There is a lot of promise in technologies that can rapidly cool a patients' core temperatures after a life-threatening cardiovascular and neurologic event. Therapeutic hypothermia, which uses a special intravenously administered slurry to rapidly cool a patient, has shown to contain and prevent damage to the heart and brain. Hospitals that do not have a TH protocol in place for patients who have suffered cardiac arrest should consider implementing one as a standard of care for out-of-hospital cardiac arrest in patients who have an initial rhythm of ventricular fibrillation, the report says.

10. Rapid Tests for Deadly Infections. With Medicare and third-party payers refusing to pay for healthcare-acquired infections, hospitals and other healthcare facilities should look at their infection control protocols and figure out where rapid tests that give results in two hours rather than the 48 hours fit into their infection-control guidelines, the report says.

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