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Technology in Health Care: Villain or Hero?

by Vince Kuraitis

Hello, I’m Vince from e-CareManagement and I’ll be one of your bloggers today. I’m honored to be invited to comment at the World Health Care Blog.

Today’s special is “technology”. It comes prepared two different ways on today’s menu.

  1. Technology that increases quality, but also increases costs (how most people equate techology in health care today)
  2. Technology that increases quality AND lowers costs

In a recent article in Health Affairs, Harvard Business School Prof. Clay Christensen describes the two varieties of technology:

There are two ways that technology can get deployed in health care. One is to help the experts in the health care system do even more sophisticated things that historically were not possible to do, so ultrasound or MRI [magnetic resonance imaging] screens allow people to see things in greater detail and at an earlier stage that historically just weren’t possible. When you bring technology to the experts to do more sophisticated things, in fact, it does bring a lot of cost into the system. But when you deploy the technology to commoditize the caregiver, to enable a lower-cost provider to do something that historically had required higher cost, then it actually takes cost out of the system.

Writing in California Medicine Man, John Ford provides an example of #2: CRNAs (Certified Registered Nurse Anesthesiologists) who can extend (or replace) anesthesiologists. In the process CRNAs wind up making more money than many primary care physicians.

Personally, I recommend #2, even though the “commoditizing the caregiver” part has a bittersweet taste to it.


  Emily DeVoto wrote @ April 3rd, 2007 at 10:44 pm

I’d add two other types of technology that should be avoided: 3. Technology that doesn’t increase quality and 4. Technology that causes harm (both of these irrespective of financial cost). Bring on the randomized controlled trials!

  Michael McGarry wrote @ April 4th, 2007 at 4:13 pm

I believe that any discussion about the role of technology in medicine must include the impact the promise of technolgy to “cure” has on the peceived responsibility of the individual to manage and maintain their health. If I know gastric bypass is available will I be less likely to adhere to a diet and exercise plan? If I know Lipitor is available will I be less likely to manage my cholesterol with lifestyle changes? Unfortunately, I have seen many examples that support the notion that a belief in technolgy to cure reduces the responsibility one takes in managing their health. Considering the estimates that 60-70% of diseases are preventable with lifestyle changes it seems like the easiest way to save health care dollars is to just stay healthy.

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