How to decide on technology purchases
How to decide on technology purchases
Standardized process helps you avoid mistakes
It’s easy to tune out the commercials we see on television that promise "the newest, the latest, and the best" products. However, a same-day surgery manager can’t tune out the physician, staff member, or sales representative who walks in the door praising the newest equipment that, in their words, "must be purchased now if the program is to stay competitive."
How can a same-day surgery manager evaluate new technology purchases within the constraints of tightening budgets? Before you can evaluate a potential purchase, you have to identify your priorities.
Physicians at Naugatuck Valley Surgical Center in Waterbury, CT, receive a letter every September asking them to submit a "wish list" of new equipment, says Betty Bozzuto, RN, MBA, administrator of the freestanding center. "We ask them to include how the equipment can improve service and if it will increase their volume," she says. "We also ask the physicians to prioritize their lists, because budget restrictions make it impossible to purchase everything."
Different ways to evaluate
Other ways to stay current on new equipment is to listen to sales representatives, says Vangie Dennis, RN, CNOR, advanced technology coordinator for Promina Gwinnett Health System in Lawrenceville, GA. "Everybody is busy, but you have to maintain a good relationship with your vendors to stay current, and that means taking time to meet with sales representatives."
Dennis also recommends visiting the vendor booths at professional conferences and staying involved with professional organizations.
Once you’ve identified new technology that will benefit your program, how do you evaluate it to make sure it’s the right purchase for your program?
There are two approaches, Dennis says. She is responsible for evaluating equipment for the surgical services department that includes one freestanding outpatient surgery center and a hospital-based outpatient surgery program. Promina Gwinnett primarily looks at potential purchases from a cost basis and value-added perspective, but some programs also look at purchase of new technology from the perspective of gaining a competitive advantage, she explains.
Conducting literature searches and asking the manufacturers for information on the technology is a good way to start collecting information on performance, uses, and safety, says Dennis. (See story on safety information, at right.)
"I talk with peers in other surgery settings to see if there is similar equipment made by other manufacturers that I should evaluate," she says.
Determine physician interest
"When we consider new technology, I look at area demographics to see how much demand for the surgery exists," says Dennis. "Then, I talk with physicians to see if there is any interest in using the new equipment or supplies in their own procedures."
Knowing the level of physician interest is important, says Bozzuto. "If only one out of 10 physicians want the new technology, we usually don’t pursue the purchase," she says. "The exception is when the one physician is a surgeon who performs a lot of procedures that would utilize the new technology."
If there is a market for the surgery and physician interest, Dennis collects the CPT codes that apply to the surgery and looks at expected reimbursement from payers with whom her institution has contracts. If the procedure is an elective procedure for which payers don’t generally reimburse, such as some plastic surgery, Dennis looks at the typical fees charged patients in her geographic area.
Determining the costs of using the new equipment means looking at staff, supply, and training costs, says Dennis. Also, look at how the new technology might affect volume, because volume affects cost and revenue, she adds. (See story on cost evaluation, p. 87.)
After the numbers are gathered, have the physicians and staff evaluate the equipment. "We have our physicians use the equipment by arranging for it to be set up in the operating room for about two months," says Bozzuto. This trial gives physicians and staff an opportunity to see how the technology works and evaluate what might be needed in terms of extra supplies, time, or staff to use it effectively.
Day-surgery program managers need to be aware of potential liability if they allow sales representatives to be in the operating room during a procedure, Dennis points out. You need procedures that specify patient consent and the role of the sales representative, she adds. (See position statement, p. 88.)
Who’s using the equipment?
After choosing the technology that physicians and staff approve, check the manufacturer by calling references the vendor provides, as well as others who might have the equipment but are not on the manufacturer’s list, says Bozzuto. Use your informal network, she advises. You might discover that there are problems with the technology or with the vendor’s support from someone not on the vendor’s list, Bozzuto explains.
The key to making a good decision is to do your homework and prevent one person from driving the decision, says Bozzuto. "Although I make the final decision, I obtain input from everyone who might use the equipment," she explains.
For more information on technology evaluation for purchase, contact:
• Betty Bozzuto, RN, MBA, Administrator, Naugatuck Valley Surgical Center, 160 Robbins St., Waterbury, CT 06708. Telephone: (203) 755-6663. Fax: (203) 756-9645. E-mail: [email protected].
• Vangie Dennis, RN, CNOR, Advanced Technology Coordinator, Promina Gwinnett Health System, 1000 Medical Center Boulevard, Lawrenceville, GA 30045. Telephone: (678) 442-4188. Fax: (678) 442-2936. E-mail: [email protected].
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