Do you really need that technology? Think first

By Stephen W. Earnhart, MS|
President and CEO
Earnhart & Associates
Austin, TX

No one — absolutely no one — likes gadgets and electronic toys more than me. Forget food; the fastest way to my heart is by giving me the latest and greatest gizmos. When I can afford it, I will indulge myself in a binge of credit card charges. When I cannot afford it, I pitifully look at that which I cannot have, right now anyway. That should (emphasis on the "should") be the case at our facilities.

Is technology getting to be a bit too much? How many monitors and diodes do we need to do a hernia repair, especially when we are dealing with healthy patients? Is there an end point? Actually there is. It’s called "reimbursement."

How do we know when enough is enough? Do we need three 25-inch monitors in the operating room for the typical patient who will be going home in a few hours? Are we going just a bit overboard? When a physician recently was asked what he wanted in the new surgery center in the way of technology, he said that he wanted it to be "at least as good as what the hospital has, if not better." Well, sure, I would agree with that statement, but who is going to pay for all this technology? Certainly Medicare won’t. And what is "as good as the hospital?" Is it the people, technology, or the equipment that makes it "good"?

Three goals for any surgical facility (or any business) are:

  • patient/customer safety;
  • quality of patient/customer experience;
  • increasing profitability.

Throwing money after overkill technology does not necessarily add to patient safety.

Is there some sort of yardstick to determine what technology to buy? Depending upon your organizational structure, it might be the physician members of a surgery center, the information technology department of the hospital, the CEO, the physician users, or the staff who determine the spending habits on technology. Whoever it is also needs to determine who pays for it and the criteria for the payback.

Health care costs are beginning to spiral out of control again, just as they did in the early 1990s. We need to regulate ourselves and practice a bit of fiscal control — or someone else will come in and do it for us. But, you ask, what about those occasional patients who really need this technology because they need the type of intensive monitoring this technology can buy? Don’t they deserve it? You know, maybe that patient should be handled in the hospital and not in the surgery center.

We are continuing to do more and more intensive procedures in the ambulatory setting — but how long can we continue if we lose money on each case?

A good rule of thumb: If you think the equipment is excessive or the technology a bit overkill — it is.

(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 8303 MoPac, Suite C-146. Austin, TX 78759. E-mail: Web: