10 Technologies Hospital Leaders Should be Watching

The ECRI Institute has released its third annual 10 C-Suite Watch List. The list was compiled by polling various technical colleagues at ECRI, along with other associates of the company who track hospital and health care operations to figure out which issues were of the most importance to them.

While some entries to the top ten list are repeats from last year, many of the entries are new, as various technologies in certain fields have made great strides over the last year.

1.Electronic Health Records
A big goal for many hospitals is to make sure they are able to certify their electronic health records for Stage 1 Meaningful Use. A concern that has arisen is whether the rush to achieve Stage 1 has affected patient safety.  While few errors involving health information technology have been reported, there have been  instances of patient harm associated with those errors, which included four fatalities. Errors involved data entry into the wrong file, inadequate data transfer between HIT systems, and failure for the systems to function as designed, which has called for hospitals to tighten up these errors in order to keep patients out of harm.

2.mhealth
Mobile applications are widespread across most industries, and healthcare is no exception. Mobile health technologies are mutually beneficial to both physicians and patients, allowing both groups to set reminders, monitor a patient's progress, and stay in communication with the provider.

3.Alarm Integration technology
In some critical care units, alarm fatigue is a major concern, with some hospitals experiencing 350 physiologic monitor alarms per patient per day. In order to help staff combat this dilemma, alarm integration systems are implemented to improve alarm management by sending alerts to a wireless communications device, such as a cell phone or a pager. Doing so not only combats alarm fatigue among clinicians, but provides a quieter environment for patients.

4.Minimally Invasive Cardiac Surgery
The Centers for Medicare & Medicaid Services has issued a coverage determination for transcatheter aortic valve implantation (TAVI) under multiple, specific conditions. While hospitals work toward  meeting these conditions, which include having an on-site heart valve surgery program, and two cardiac surgeons to examine potential replacement patients, they are also assessing efficiencies that may be gained from hybrid ORs or the hybrid cath lab model. 

5. Imaging and Surgery
Full-scale angiography systems are making their way into ORs in order to help hospitals guide high-risk minimally invasive surgery, combine open and minimally invasive surgery, and verify the successful completion of surgery in the OR. The systems contain a CT and MRI and can cost a hospital a lot of money to install, along with devoting assets to necessary trainings and optimal equipment places. While there are there are space and infrastructure needs, with high volumes of vascular and cardiovascular surgeries, hybrid ORs equipped with high-end imaging systems can be an asset.

6.PET/MR
With the PET/CR becoming a mainstay in the field of oncology, another hybrid machine is looking to make a similar impact: PET/MR. Since the FDA approved the first two PET/MR scanners in 2011, the benefits of this hybrid and its improvement over the PET/CR have emerged. Those advancements include greater detail of internal structures and the possibility of helping physicians detect tumors and cancers.

7.Bariatric Surgery
Many patients suffering from obesity also suffer from Type II diabetes. When these patients undergo bariatric surgery in order to maintain their obesity, many find that their diabetes resolves, even before any pounds are shed.  While there are concerns about whether the surgery works long term, interest in a surgical route for Type II diabetes treatment is growing. 

8.Supply Chain: MR-Compatible Pacemakers
The Medtronic Revo MRI SureScan was introduced as the first pacemaker that could be scanned in an MR study. While it was a medical breakthrough, it is also more expensive than a regular pacemaker. With 50-75% of patients with an implantable aortic device needing an MRI in their lifetime, however, the additional cost will be worth it to patients, ECRI suggests, and as the technology continues to grow, hospitals and health care organizations will grow with it.

9. Radiation Dose Safety
With growing talk about the concern of potential harm caused by CT radiation, manufacturers are looking to find new advancements in both CT dose reduction and CT dose monitoring. "Iterative reconstruction," a technique that reduces noise in the image when low radiation doses are used, helps improve image quality, while methods will need to be developed for physicians to monitor the radiation doses their patient receives. 

10.Lung Cancer Screenings
Lung cancer has been a difficult diagnosis for physicians in its early stages, and since the disease is the leading cause of cancer mortality in the country, a screening process has been sought for many years. The National Lung Screening Trial had early success with some studies, showing a 20% lower mortality when using low dose CT screenings in high risk patients, compared with that of a screening with chest radiography. While these results have encouraged hospitals to start their own lung cancers screenings, many questions remain, including situations of false positives, quality of life, and cost effectiveness.