Medical Technology and the Health Care System A Study of the Diffusion of Equipment-Embodied Technology (1979) / Chapter Skim
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INTRODUCTION AND SUMMARY
INTRODUCTION AND SUMMARY
Pages 1-13
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For example, in l967 the National Academy of Engineering's Committee on the Interplay of Engineering with Biology and Medicine was established to "investigate how technology can contribute to the achievement of health care goals."83 In l972, a conference sponsored by the National Institutes of Health explored factors underlying and particularly inhibiting the spread of new medical technology, and the National Center for Health Services Research and Development held a conference to consider priorities for development of health care technology for the l980"s. More recently, the President's Biomedical Research Panel, as part of its major inquiry, investigated how the movement of research findings into practical use could be enhanced.131 The problem of how to facilitate the transfer of new technology to the practice of medicine remains a major concern today.
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From page 2... ...
Technology purportedly follows its own imperative, eluding effective control by regulatory or financing agencies.96 Most important, new technology is accused of raising the cost of providing health care. Gaus,35 for one, has observed that: the long-term cumulative effect of adopting new health care technologies is a major cause of the large yearly increases in national health expenditures and in total Medicare and Medicaid benefit levels.
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• Coordinative technology -- that used to facilitate and support the provision of health care services but not directly associated with patient care, including administration, transportation, and communication both within and among health care facilities. Other health care technology, including educational and research technology, have important functions, but they are not central to our study.
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There is also a dearth of information on how much equipment-embodied medical technology emerges from the upgrading or reworking of existing technology that has been developed in other industries. Certainly, the use of digital computers and nuclear medicine, which have wrought a revolution in health care, came in large part from developments wholly outside the field of medicine.
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No clinical trials to test the value of automated drug infusion have been conducted, and, indeed, the technique has not yet been firmly established in health care delivery. The concept of automated drug infusion emerged from efforts to deliver cancer chemotherapy at decentralized facilities.
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By contrast, there are many other instances of technology developed from scratch by commercial firms. Diffusion of New Equipment-Embodied Technology The diffusion process for new medical equipment is often expressed as the number of health care providers adopting a new technology as a function of the time or distance from its first availability on the market.
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From page 10... ...
Although developers and marketers can and do influence individual adoption decisions, the ultimate success or failure of a technology to diffuse rapidly and thoroughly to the user community is a function of the health care community's characteristics, including the payment system. The Management of Technical Change The development and diffusion of new equipment-embodied technology are everywhere influenced and shaped by public and quasipublic policies, some expressly designed to facilitate or control the process and others with unintended consequences.
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From page 11... ...
Technology transfer encompasses the dissemination of information to physicians about promising innovations and patent policies. In later chapters, public management policies that fit within this definition of technology transfer will be evaluated, although the policies will not be identified as such, because technology transfer is a special case within the array of management alternatives that are available to influence the process of technical change.
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From page 12... ...
Because reimbursement policy is central to all aspects of containing health care costs and directly affects the redistribution of wealth and income, the precise avenues of reimbursement reform must be chosen in a larger context. Prospective reimbursement of hospitals and the capitation method of payment are especially promising in altering incentives to adopt and use new equipment-embodied technology.
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From page 13... ...
Finding The process by which new equipment-embodied technology is developed and introduced into the health care system is already greatly affected by myriad regulatory programs at federal, state, and local levels. These regulations are costly, administratively burdensome, duplicative, and often conflicting.
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