What Patients Don’t Know and Hospitals Can No Longer Afford

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  • Jun 24, 2016

It’s hardly surprising that many patients experience fear and anxiety when entering a hospital, placing their lives in the hands of the clinicians delivering their care. But most patients don’t think about the care delivery that starts long before that moment: the evaluation of medical devices and clinically sensitive supplies.

Although ignorance is bliss in some cases, it shouldn’t be so for patients who have no idea that the process that they use when buying a new car or flat screen TV is often more rigorous than the process hospitals use to decide which implants to put in their bodies. In fact, the findings of recent Procured Health research indicate only 28 percent of hospitals consistently review critical safety information such as adverse events and product recalls prior to selecting devices.

And if the potential harm to patients is not enough, the omission of such a review also has dire financial ramifications. Estimates show that hospitals will overspend on supplies and devices by as much as $35 billion in 2016—and on top of this overspending, the United States still ranks last in outcomes according to a 2014 Commonwealth Fund Report. Clearly, these dollars aren’t benefiting patients or hospital margins.

The good news is that hospitals are starting to pay more attention to their selection processes because value-based care is prompting them to pursue strategies to improve both costs and outcomes. The less good news is that many hospitals are struggling because they haven’t undertaken this work before. They’re falling prey to three common misconceptions that are hindering progress.

Misconception No. 1: If a physician asks for a specific medical device or clinical supply, the hospital must provide it. Hospitals have a long-standing history of approving medical devices and new technology requests based on physician preference alone. Why? Hospital administrators often fear that physicians will leave the hospital if they don’t have unrestricted access to devices. However, a recent survey of 101 physicians found that physicians are not nearly as intransigent as hospital administrators believe. Only seven of the physicians had ever left a hospital based on device selection, and even in those instances, it was the last straw rather than the motivating factor.

The survey also found that physicians rank other health system characteristics as more important than unrestricted access to medical devices. Nearly 90 percent of respondents said that efficient operations were either very or extremely important, and hospital reputation came in higher as well, at 75 percent.

Misconception No. 2: Physicians always know best. The massive amount of research being published makes it nearly impossible for physicians to keep up. Further, physicians rely heavily on device vendors as their primary information sources even though the physicians recognize that the information isn’t unbiased and trustworthy. Hospital administrators can help by providing a comprehensive overview of peer-reviewed literature on requested devices as well as the comparable products on the market.

Misconception No. 3: “New” always means “improved.” Device vendors are constantly boasting that products are more innovative, groundbreaking, and unlike anything else on the market today. And of course, every hospital wants to have the best. Yet in many cases, the clinical evidence associated with these technologies doesn’t demonstrate superior outcomes.

For example, vendors touted that there was less wear and increased longevity with the introduction of ceramic on ceramic bearings in total hip replacement, but the evidence found no improvements in revision rates. In fact, there were increased rates of implant fractures and squeaking in up to 8 percent of patients.

Patients don’t care if they’re receiving the newest, most expensive medical device; they just want the device that will ensure a better quality of life. Delivering that end result is at the heart of what hospitals promise to do, and it’s what every patient deserves.