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• W2007526105 abstract "It has long been perceived that medical technologies contribute immensely to the escalating costs of critical care in the United States. 12 Coalition for Critical Care Excellence ICU cost reduction: Practical suggestions and future considerations. Society of Critical Care Medicine, Anaheim, CA1994 Google Scholar , 13 Coalition for Critical Care Excellence ICU cost reduction: Practical suggestions and future considerations (Volume II, Personnel). Society of Critical Care Medicine, Anaheim, CA1995 Google Scholar This perception has been fueled, in part, by the argument that technologic advances in critical care are indeed expensive and have not always undergone rigorous evaluation to address their impact on overall clinical efficiency and patient outcomes. In the current health care environment, intensivists are facing increased pressure to control technology costs while maintaining high-quality patient care. 22 Hassan E. 2010: Critical care, critical time: A synopsis. New Horiz. 1999; 7: 270-274 Google Scholar , 32 Sibbald W.J. Eberhard J.A. Inman K.J. et al. New technologies, critical care, and economic realities. Crit Care Med. 1993; 21: 1777-1780 Crossref PubMed Scopus (15) Google Scholar Economic forces may predominate over clinical priorities in guiding distribution of increasingly scarce health care resources. 10 Chalfin D.B. Fein A.M. Critical care medicine in a managed competition and a managed care environment. New Horiz. 1994; 2: 275-282 PubMed Google Scholar , 28 Massaro T.A. Understanding and managing change in critical care medicine. in: Sibbald W.J. Massaro T.A. McLeod D.M. The Business of Critical Care: A Textbook for Clinicians Who Manage Special Care Units. Futura Publishing Company, Armonk, NY1995: 41-47 Google Scholar In this setting of emphasis on economic evaluations, intensivists, although knowledgeable in the technicalities of technology assessment, 19 Guyatt G.H. Tugwell P.X. Feeny D.H. et al. A framework for clinical evaluation of diagnostic technologies. Can Med Assoc J. 1986; 134: 587-594 PubMed Google Scholar , 24 Jastremski M. Jastremski C. Shepherd M. et al. A model for technology assessment as applied to closed loop infusion system. Technology Assessment Task Force of the Society of Critical Care Medicine. Crit Care Med. 1995; 23: 1745-1755 Crossref PubMed Scopus (22) Google Scholar , 38 Technology Subcommittee of the Working Group on Critical Care Ontario Ministry of Health. Guidelines for Medical Technology in Critical Care. Can Med Assoc J. 1991; 144: 1617-1622 Google Scholar , 39 The Technology Assessment Task Force of the Society of Critical Care Medicine A model for technology assessment applied to pulse oximetry. Crit Care Med. 1993; 21: 615-624 Crossref PubMed Scopus (21) Google Scholar may benefit from a review of corporate skills, management insights, and political “pearls” to guide them through the exigent process of technology procurement for the ICU. 21 Halpern N.A. Pastores S.M. Technology introduction in critical care: Just knowing the price is not enough!. Chest. 1999; 116: 1092-1099 Crossref PubMed Scopus (12) Google Scholar Throughout this article, the term technology is used as a generic representation of diagnostic or therapeutic devices, procedures, protocols and information systems. 16 ECRI Health Devices: Medical Equipment Planning. Plymouth Meeting. Vol. 26. Emergency Care Research Institute, PA1997: 4-12 Google Scholar “New technology” includes both purchase of brand new technology and upgrading of existing technology. Acute care areas include non-ICU locations such as the emergency department, operating room, postanesthesia care unit, and procedural suites. Likewise, the term “hospital” is used to represent a department, an individual hospital, or a healthcare network or system. It has long been perceived that medical technologies contribute immensely to the escalating costs of critical care in the United States. 12 Coalition for Critical Care Excellence ICU cost reduction: Practical suggestions and future considerations. Society of Critical Care Medicine, Anaheim, CA1994 Google Scholar , 13 Coalition for Critical Care Excellence ICU cost reduction: Practical suggestions and future considerations (Volume II, Personnel). Society of Critical Care Medicine, Anaheim, CA1995 Google Scholar This perception has been fueled, in part, by the argument that technologic advances in critical care are indeed expensive and have not always undergone rigorous evaluation to address their impact on overall clinical efficiency and patient outcomes. In the current health care environment, intensivists are facing increased pressure to control technology costs while maintaining high-quality patient care. 22 Hassan E. 2010: Critical care, critical time: A synopsis. New Horiz. 1999; 7: 270-274 Google Scholar , 32 Sibbald W.J. Eberhard J.A. Inman K.J. et al. New technologies, critical care, and economic realities. Crit Care Med. 1993; 21: 1777-1780 Crossref PubMed Scopus (15) Google Scholar Economic forces may predominate over clinical priorities in guiding distribution of increasingly scarce health care resources. 10 Chalfin D.B. Fein A.M. Critical care medicine in a managed competition and a managed care environment. New Horiz. 1994; 2: 275-282 PubMed Google Scholar , 28 Massaro T.A. Understanding and managing change in critical care medicine. in: Sibbald W.J. Massaro T.A. McLeod D.M. The Business of Critical Care: A Textbook for Clinicians Who Manage Special Care Units. Futura Publishing Company, Armonk, NY1995: 41-47 Google Scholar In this setting of emphasis on economic evaluations, intensivists, although knowledgeable in the technicalities of technology assessment, 19 Guyatt G.H. Tugwell P.X. Feeny D.H. et al. A framework for clinical evaluation of diagnostic technologies. Can Med Assoc J. 1986; 134: 587-594 PubMed Google Scholar , 24 Jastremski M. Jastremski C. Shepherd M. et al. A model for technology assessment as applied to closed loop infusion system. Technology Assessment Task Force of the Society of Critical Care Medicine. Crit Care Med. 1995; 23: 1745-1755 Crossref PubMed Scopus (22) Google Scholar , 38 Technology Subcommittee of the Working Group on Critical Care Ontario Ministry of Health. Guidelines for Medical Technology in Critical Care. Can Med Assoc J. 1991; 144: 1617-1622 Google Scholar , 39 The Technology Assessment Task Force of the Society of Critical Care Medicine A model for technology assessment applied to pulse oximetry. Crit Care Med. 1993; 21: 615-624 Crossref PubMed Scopus (21) Google Scholar may benefit from a review of corporate skills, management insights, and political “pearls” to guide them through the exigent process of technology procurement for the ICU. 21 Halpern N.A. Pastores S.M. Technology introduction in critical care: Just knowing the price is not enough!. Chest. 1999; 116: 1092-1099 Crossref PubMed Scopus (12) Google Scholar Throughout this article, the term technology is used as a generic representation of diagnostic or therapeutic devices, procedures, protocols and information systems. 16 ECRI Health Devices: Medical Equipment Planning. Plymouth Meeting. Vol. 26. Emergency Care Research Institute, PA1997: 4-12 Google Scholar “New technology” includes both purchase of brand new technology and upgrading of existing technology. Acute care areas include non-ICU locations such as the emergency department, operating room, postanesthesia care unit, and procedural suites. Likewise, the term “hospital” is used to represent a department, an individual hospital, or a healthcare network or system." @default.
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