Healthcare Technology Management Systems

Towards a New Organizational Model for Health Services

Rossana Rivas, Luis Vilcahuamán

• Publisher: Academic Press
• Year: 2017
• Print ISBN: 9780128114315
• eBook ISBN: 9780128115602
• Topic: Technology & Engineering
• Subtopic: UI/UX Design
• Index: Technology & Engineering

Healthcare Technology Management Systems provides a model for implementing an effective healthcare technology management (HTM) system in hospitals and healthcare provider settings, as well as promoting a new analysis of hospital organization for decision-making regarding technology. Despite healthcare complexity and challenges, current models of management and organization of technology in hospitals still has evolved over those established 40-50 years ago, according to totally different circumstances and technologies available now.The current health context based on new technologies demands working with an updated model of management and organization, which requires a re-engineering perspective to achieve appropriate levels of clinical effectiveness, efficiency, safety and quality. Healthcare Technology Management Systems presents best practices for implementing procedures for effective technology management focused on human resources, as well as aspects related to liability, and the appropriate procedures for implementation.- Presents a new model for hospital organization for Clinical Engineers and administrators to implement Healthcare Technology Management (HTM)- Understand how to implement Healthcare Technology Management (HTM) and Health Technology Assessment (HTA) within all types of organizations, including Human Resource impact, Technology Policy and Regulations, Health Technology Planning (HTP) and Acquisition, as well as Asset and Risk Management- Transfer of knowledge from applied research in CE, HTM, HTP and HTA, from award-winning authors who are active in international health organizations such as the World Health Organization (WHO), Pan American Health Organization (PAHO), American College of Clinical Engineering (ACCE) and International Federation for Medical and Biological Engineering (IFMBE)

Chapter 1

Healthcare Technology Management (HTM) & Healthcare Technology Assessment (HTA)

Abstract

This chapter presents the different types of health technology that must be managed in a hospital, as well as the life cycles associated with the technology either during its generation in the market or during its application in the hospital. In this context, the chapter describes the main processes for technology management and the organizational requirements of the hospital in order to have a functional technological environment in each of clinical services. In the second part, health technology assessment—HTA is defined as a multidisciplinary process that summarizes information about the medical, social, economic, and ethical issues related to the use of a health technology aimed to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve the best value. Part 2 includes HTA’s levels of intervention and influence; protocol, report, and the relationship between health systems and HTA.

Keywords

Healthcare technology; healthcare technology management; clinical engineering; life cycle; health technology assessment; making decision process; health policies; innovation

The task is to maximize the benefits and minimize the risks of technology in hospitals.

Healthcare Technology Management—HTM

The technology has been used in hospitals since their inception. However, the study of the impacts of technology on people’s health, the cost analysis, and management of its operation has not been fully structured and systemized in hospitals. Two trends that have been developing in recent years are healthcare technology management (HTM) and clinical engineering (CE), and healthcare technology assessment. The last topic will be developed in the second part of this chapter.

1.1 Healthcare Technology Management and Clinical Engineering

It is natural to think that at the beginning of the concept of the hospital, especially when the first electrical medical devices appeared, the need for engineers and technicians to handle its operation was apparent. With the increasing number of medical devices and technological complexity, an area of engineering expertise was created, often associated with the electrical engineer or electronic engineer. This new professional field later formed the CE and biomedical engineering. The first one closely associated to the work within hospitals and the second one with a greater emphasis on research and health technology design. CE can be considered as a specialty in biomedical engineering, although in some places the CE begins to take its own course. However, one could say that what most distinguishes between a biomedical engineer and a clinical engineer and the more traditional engineers are their training in physiology making use of a thorough study of biology, physics, chemistry, and mathematics. The traditional training of doctors in clinical services bypasses this approach, so it could be argued that the clinical engineer and biomedical engineer are sufficiently different from other engineers and doctors themselves. The American College of Clinical Engineering (ACCE) defines a clinical engineer as: “A Clinical Engineer is a professional who supports and advances patient care by applying engineering and managerial skills to healthcare technology,” definition since 1992.

On the other hand, the HTM is a specialized form of management. Given its approach to technology in health, it would be considered doubly specialized. This discipline nourished in the fields of management and administration has been developing quickly and in this case, guides much of the work of clinical engineers. HTM is defined as “the systematic process in which qualified healthcare professionals, typically clinical engineers, in partnership with other health-care leaders, plan for and manage health technology assets to the highest quality care at the best cost.” Clinical Engineering Handbook, J. Dyro, 2004.

This is where it becomes necessary to remember the concept of health technology referred to in both definitions. We tend to associate the technology only with medical devices and sometimes the technical aspects as was already explained in the introductory chapter. However health technology is much broader and goes beyond the scope of just a specialist. Fig. 1.1 shows the diversity of health technology.

Figure 1.1 Types of healthcare technology to consider in HTM & CE. Modified of Developing Health Technology Assessment in Latin America and the Caribbean—PAHO/WHO.

It can be concluded first that more than one type of specialist is required to address this diversity of health technologies. It must be considered that a hospital contains all types of technology. From the point of view of a hospital and the patient, if we only focus on medical devices, we will be doing a partial job, and even more so if the clinical service is expected to be functional, then it is required that all types of technology are functional. Under these assumptions, the HTM involves all these types of technology, but what should be the scope of work of the clinical engineer? and who is responsible for each type of technology in a hospital?

Various professional profiles are needed to address the technology of a hospital with all having sufficient training in basic sciences and HTM, in addition to training in physiology and clinical aspects associated to the clinical service. In the case of clinical engineer, the matter is interesting because you can define different nuances depending on the objectives to be achieved. In solid and well-structured hospital organization, a clinical engineer with guidance related to medical devices is feasible because other professionals will cover other types of technology. However in organizations with weak organizational structure, as is common in developing countries, a clinical engineer is required with a capacity to conduct various types of technology at the same time. For example a clinical engineer with capacity for management of medical devices and with sufficient knowledge to define and evaluate infrastructure requirements, ICT and management systems, and organization would be very useful in in this situation. Many hospitals have a research mission, in this case the clinical engineer should be involved with the development and testing of clinical procedures, together with medical professionals. This fact raises a somewhat different profile of clinical engineer than usual, which may include postgraduate, but will be appropriate for the current reality.

From the point of view of responsibilities to a technologically functional hospital, this is explained from the technology life cycle in a hospital which we have called “Healthcare technology application cycle.” Processes to incorporate technology, use them and then replace or discard, follow a cycle in time, as happens in many other cycles in nature and organizations. It contains well-established stages from which the tasks, functions, roles, and therefore the positions and responsibilities of technology in a hospital are defined. Before addressing the development of the healthcare technology application cycle, we consider it important to present a more holistic view, as this cycle in turn feeds on another that we called “Healthcare technology generation cycle,” the same cycle in research and how technological products appear on the market. These cycles interact with each other, one impacts the other and vice versa, and clinical engineer should be aware that his work is part of a larger process. Fig. 1.2 shows this view.

Figure 1.2 Holistic view of technology generation cycle and technology application cycle in healthcare.

Healthcare technology generation cycle is driven by the clinical needs and market opportunities which generate technology. This technology is present on the market in turn following a life cycle, called “Technology life cycle,” whose unit of measure is the number of sales versus time. Thus, it is known that a technology appears on the market in a period of introduction, by increasing the number of sales it is in a growth period, then while sales remain it is a period of maturity and finally when the number of sales declines, it is entering in a period of neglect. The complexity is that each technology follows its own cycle and in the market remains a wide variety of technologies, some new and innovative, others established in the market, and others on the way to disappear. Fig. 1.3 shows the life cycle of technology.

Figure 1.3 Typical technology life cycle. Everett Rogers Technology Adoption Lifecycle model.

Naturally the technology that reaches the hospital comes from market and it is therefore subject to variations thereof. When deciding what technology to buy, it will require making an analysis of technology life cycle. For example, obsolete technologies may inadvertently be the option to buy, but neither buying the latest technology would not be the ideal choice until to have opinion of other users. It is also necessary to analyze the technology life cycle to determine the best technology for our clinical needs considering the current reality of the hospital.

From the point of view of the hospital, the technology follows stages desc...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Authors' Biographies
• Introduction
• Chapter 1. Healthcare Technology Management (HTM) & Healthcare Technology Assessment (HTA)
• Chapter 2. Health Technology Policy and Regulation
• Chapter 3. Human Resources and Healthcare Technology Workforce
• Chapter 4. Healthcare Technology Planning and Acquisition
• Chapter 5. Asset & Risk Management Related to Healthcare Technology
• Chapter 6. Quality & Effectiveness Improvement in the Hospital: Achieving Sustained Outcomes
• Chapter 7. Applied Research & Innovation in Healthcare Technology
• Chapter 8. Improvement Healthcare Projects: Meeting Healthcare and Technology Challenges
• Chapter 9. New Organizational Model for Hospitals in the New Technology Context
• Index