Strategic Health Technology Incorporation
Technology is essential to the delivery of health care but it is still only a tool that needs to be deployed wisely to ensure beneficial outcomes at reasonable costs. Among various categories of health technology, medical equipment has the unique distinction of requiring both high initial investments and costly maintenance during its entire useful life. This characteristic does not, however, imply that medical equipment is more costly than other categories, provided that it is managed properly. The foundation of a sound technology management process is the planning and acquisition of equipment, collectively called technology incorporation. This lecture presents a rational, strategic process for technology incorporation based on experience, some successful and many unsuccessful, accumulated in industrialized and developing countries over the last three decades. The planning step is focused on establishing a Technology Incorporation Plan (TIP) using data collected from an audit of existing technology, evaluating needs, impacts, costs, and benefits, and consolidating the information collected for decision making. The acquisition step implements TIP by selecting equipment based on technical, regulatory, financial, and supplier considerations, and procuring it using one of the multiple forms of purchasing or agreements with suppliers. This incorporation process is generic enough to be used, with suitable adaptations, for a wide variety of health organizations with different sizes and acuity levels, ranging from health clinics to community hospitals to major teaching hospitals and even to entire health systems. Such a broadly applicable process is possible because it is based on a conceptual framework composed of in-depth analysis of the basic principles that govern each stage of technology lifecycle. Using this incorporation process, successful TIPs have been created and implemented, thereby contributing to the improvement of healthcare services and limiting the associated expenses. Table of Contents: Introduction / Conceptual Framework / The Incorporation Process / Discussion / Conclusions
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The Incorporation Process
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acquired American American Osteopathic Association and/or Association beneﬁts bidding Biomedical Engineering capital investment challenges clinical engineering competitive products cost of ownership decision makers deﬁned developing countries difﬁcult donated evaluation Evidence-Based Medicine example Figure ﬁnance ﬁnancial ﬁnd ﬁrst guidelines health leaders Health Organization health system health technology healthcare organizations hospitals HTA reports impacts implementation information technology infrastructure initial investment installation institutions International investment costs Joint Commission Kaiser Family Foundation lease lifecycle maintenance manufacturers medical equipment Medical Technology Medicare Modern Healthcare multidisciplinary ofﬁcer operational organization or system organization’s ownership TCO patients performance piece of equipment proﬁt purchasing recurrent costs regulatory require risks root causes safety senior leaders senior leadership sentinel events signiﬁcant staff stakeholders supplier task forces technical speciﬁcations Technology Incorporation Plan technology management technology planning total cost turnkey projects typically Underwriter Laboratories users vendor Wang World Health Organization