As the healthcare payment system increasingly focuses on value of care delivery over volume, hospital perspectives on technology ROI are changing. Within this new landscape, technology should be evaluated from a broader perspective - one that takes into account indirect methods by which technology can lower costs, such as reducing length of stay, improving outcomes, supporting shorter recovery, and reducing rÉadmissions.
"As healthcare executives evaluate emerging technologies, they will find It increasingly Important to examine abilities to improve quality and Influence overall cost of care," notes
With this in mind, this Buyer's Brief, sponsored by MD Buyline, the second In a two-part series, looks at emerging technologies that should be on the radar of healthcare executives in 2014. MD Buyline selected the technologies based on their likelihood of Impacting healthcare delivery in light of changing trends. For a list of the technologies in part one of the series, see hfma.org/top1 Otechnologiespartl.
* Nanobots/Stroke Therapy
Nanobots, technologies the size of a blood platelet, are being studied for a wide range of diagnostic and therapeutic applications, including the ability to bind with blood clots in damaged vessels and deliver thrombolytic agents to reverse the effects of ischemic stroke. Researchers have found nanobots coated with thrombolytic drugs can open blocked vessels within 5 to 29 minutes. Such capability is significant, as time is a key factor in treating stroke patients. Research has found prolonged blockage increases the chance of tissue damage.
What healthcare executives should know: Stroke is the fourth-leading cause of death in
* Oncolytic Virus/Smart Virus
Oncolytic viruses are genetically modified viruses designed to target and destroy cancer cells, often enlisting the help of the body's own immune system and offering limited side-effects when compared with other treatment methods. Current studies are targeted at difflcult-to-treat cancers, such as skin, ovarian, pancreatic, prostate, and head and neck cancers. Although a number of studies have shown encouraging results, especially when the viruses are used In combination with other therapies, only one effective phase III clinical trial has been conducted to date.2.3
What healthcare executives should know: With more than 1.6 million Americans expected to be diagnosed with cancer, clinical efficacy and ability to provide value will be key concerns with any new therapy. If approved, oncolytic viruses will be offered at a premium, but providers will see savings In the form of improved clinical outcomes and lower long-term cost than with traditional therapies. Another key factor is a decrease in the number and severity of side effects. Side effects significantly increase the cost of cancer treatment, sometimes by several thousands of dollars.
* Electromagnetic Acoustic Imaging
Electromagnetic acoustic imaging (EMAI) works by measuring and converting vibrations into an Image by means of ultrasound detectors. Different tissue types vibrate at their own unique frequency when stimulated, and cancerous tissue is 50 times more electrically conductive than normal tissue. EMAI offers images approaching magnetic resonance Imaging (MRI) quality, allowing physicians to distinguish between malignant and benign lesions at a fraction of the cost of higher-end systems, such as MRI or positron emission tomography. EMAI also has the ability to detect and localize tumors as small as 2 mm in diameter and is considered safer than computed tomography.
What healthcare executives should know: Although use of MRIs to diagnose cancer will continue to be the standard of care for the near future, the demand for effective, low-cost alternatives among providers and payers is high. Several factors will help EMAI achieve high utilization and produce an attractive revenue stream for providers, including its ability to offer MRI-quality images at the same price point as an ultrasound and in a portable format with quick turnaround. Also, unlike MRI, EMAI provides a physiological parameter that could help reduce biopsy rates. Depending on the site of the suspicious lesions, biopsies frequently add anywhere from
* Neuro Interface/Brain Computer Interface
Chief complaints regarding prosthetic arms and legs are limited mobility and lack of tactile feedback. Also, prosthetic limbs typically require users to expend 10 to 30 percent more energy for movement than with normal limbs.4 Advancements in biocompatible electrodes could overcome some of these challenges and allow prosthetics to function more like natural limbs.
Bicompatible electrodes, which are implanted in the peripheral nerves of the patient, allow two-way communications between the prosthetic device and the patient's brain that support sensory functions of touch and limb position. One technique known as targeted muscle reinnervation allows for the reattachment of severed nerves to existing muscles that are then attached to sensors that control the prosthetic device. Flat interface nerve electrode is a more advanced process, whereby sensors are attached directly to the severed nerves. The process allows for two-way communications that can simulate touch. The process has been developed both to control artificial prosthetics and to treat spinal cord injury patients.
What healthcare executives should know: As it is with any new technology, payment is key. Although next-generation bionic limbs will be priced higher than existing prosthetics, there already are CPT codes in place for electrode placement. Also, both private insurance and CMS reimburse for existing prosthetic technology, which sets a precedence of need that will help new technology in the field gain acceptance. One consideration for this technology is that it will require a range of clinical and surgical specialties to coordinate care to be successful. However, this team dynamic may make the technology's use particularly well-suited to organizations where integration is a source of market differentiation.
* Microbial Nanoscopy
Bacterial cells are so small that their functions have been difficult for scientists to view in real time. This barrier may be changing, however, with microbial nanoscopy. This next-generation technology, which is based on atomic force microscopy techniques, involves using a microscopic probe to scan a cell's surface. Changes in the cell's surface are measured and converted to an image, which allows clinicians to view microbial cell walls as small as 2 nm. Viewing cells with this perspective has helped expand researchers' understanding of pathogen-drug and pathogen-host interactions. In the future, researchers may be able to use this knowledge to develop more effective drugs to treat resistant bacterial infections.5
What healthcare executives should know: According to the
1 Brinjikji, W" Rabinsteain, A" Cloft, H., "Hospitalization Costs for Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis in
2 Karapanagiotou, E.M., et al, "Phase l/ll Trial of Carboplatin and Paclitaxel Chemotherapy in Combination with Intravenous Oncolytic Reovirus in Patients with Advanced Malignancies,"
4 Herr, H.M., Grabowski, A.M., "Bionic Ankle-Foot Prosthesis Normalizes Walking Gait for Persons with Leg Amputation," Proceedings of the Royal Society B: Biological Sciences,
5 Alsteens, D., Dupres, V, Dufrene, Y.F., "Frontiers in Microbial Nanoscopy," Nanomedicine,
6 The Superbug Threat: The Emergence of Antibiotic-Resistant Bacteria and Its Impact on
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