Rationale

A common and contemporary issue for health service managers are the constant changes due to the development of increased technology. This is seen in device, prosthesis and pharmaceuticals products which can be expensive, disrupt current practices and lead to other flow on changes and costs.

New technology needs to be introduced in a manner which ensures that it is safe, effective and efficient. In the contemporary health care environment there is often pressure on managers from clinicians wishing to have access to the most 'up-to-date' technology, from providers to equip sites with their version of this technology, and from insurers who are concerned at the rising costs associated with this technology. However, it is often the case that the evidence supporting the new technology is sparse, inconclusive, funded by those with vested interests, or lacking in cost-effectiveness analyses.

Scenario

A few (five out of 10) of the Urology surgeons in your private facility would like to start using the Da Vinic Robot for routine prostatectomies. The new robotic equipment has been approved by the TGA and proposes to use technology that ensures smaller, more precise incisions, is purported to reduce the risk of bleeding and lead to faster rates of recover.

The new procedure will incur extra costs for the hospital, not all of which can be shared by the patient as an out of pocket expense, as it is not fully covered by the major health insurers as yet.

The Da Vinci robot has been in used for some 10 years, but despite this the evidence is not conclusive of the benefits of the equipment, although some clinicians vouch for this. Not all the surgeons want to use the new device, therefore it will be additional to the hospital inventory. In addition, as is the case with new equipment, there will be flow on effects; the training staff of staff, ensuring there are enough equipment sets in theatre and in order to rotate through sterilising, more ‘advisors’ from the manufacturers in the theatre, etc.

Task

Your assignment is to:

1. Develop a business case to use as a decision guide. Your business case should include (this is not an exclusive list):

 Evidence to support the use of the technology

 The identification and rating of the risks and benefits for such an introduction.

 Clinical factors: Safety, Efficacy and suitability of patient group

 Financial impacts: costs, value for money, and funding.

2. Make a recommendation to your manager, based on the business case and risk assessment, on whether to introduce the equipment and procedure.

3. Outline how you would communicate such a recommendation to the stakeholders including the surgeons and the manufacturer.

4. Outline any policies and procedures necessary and training processes to commence the use of this new technology.