Wednesday, December 28, 2011

Balancing progress and costs

We always need to balance costs vs progress. When does it make sense to repair your car or trade it in? How about total high tech operating rooms which give doctors real time data on the patient's status? They even have a fancy name: AMIGO - an acronym for advanced multimodality image-guidance operating.

"It has it all: an MRI device that can be rolled into the operating room via a ceiling-mounted rail system; a positron emission tomography-computed tomography (PET/CT) machine to reveal biochemical or metabolic activity; an angiography X-ray machine to view arteries and veins; an X-ray fluoroscopy machine that uses dyes to show blockages; and an ultrasound system for tumor identification and targeting.

All the devices are integrated through an electronic system made by Winnipeg-based IMRIS Inc., which pulls together many of the imaging technologies for viewing within the central operating room."

It is not the first time that all these technologies have been used in operating rooms but the first time they are used simultaneously and integrated together.The benefits are great - doctors are better able to operate and monitor the patient.

But what about the cost? It is a $20 million room. There is one at Brigham and Women's Hospital in Boston and more are planned. It has been used for 30 operations since it opened a few months ago. It is not supposed to be considered an operating room but a research lab. So I guess it sits empty and unused the rest of the time. All that fancy imaging equipment isn't used on other patients who are waiting to have a test scheduled in the coming weeks.

$20 million is not small change. If it is a research lab how long till we see results? How long until the machines need to be upgraded or repaired? Will we see any results before all the technology is out of date? In the day and age of spiraling medical costs, is this a step in the right direction? I am not sure. I am all for medical progress but this seems very concentrated on a very small number of patients.

Maybe its the limousine that is used to go to the grocery store mentality - yes it does the job but its very expensive and more than necessary. I don't know. I just wish that progress made it so that all this expensive equipment could be used for others instead of just sitting there.

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