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Medical Devices Controlling Costs and Creating Tag Registries for Implanted Devices Could Help

Posted Nov 09 2009 10:01pm

Creating registries is one possibility with having an area for physicians to look and compare.  When it come to using a device, the hospital doesn’t have the ultimate say here in most cases it is the doctor, and for reasons outside of just cost.

When doing a procedure, he/she may choose a device they are familiar with and know the procedures required.  Also, the physicians are familiar with their own results and what works for them and the patient, as success is what is overall the end result with life saving devices.  Hospitals have a difficult time with cost in this area as it is the doctors who are basically on the front line with their knowledge and of course we want that as a image patient.   You can maybe see where this is going with a tug of war over the hospital trying to maintain cost, and yet use a product that is going to produce the best results for the patient, so somewhat of a catch 22 with some of this. 

There are other issues that come up too, like recalls that come into this area, so add this factor and you have a tough nut to crack here.  In additional to recalls, there are new safety issues that need to be considered as well, so does the marketing and cost area take advantage with some of this?

Recently I made a post about a “free” service that would help bring this information to light on recalls and safety issues, using 2D scanning, done with any Smartphone, BlackBerry, etc.  I sent it off to the FDA and suggested to a couple manufacturers as well, have heard nothing yet. 

Tracking Medical Device Recalls – Sounds Like A Good Place for a Microsoft Tag Data Base at the FDA

“This is a fairly simple answer that could keep a tags listed  in a data base that anyone could access as we are not talking about confidential information here, we are talking about a device.  The great thing about Microsoft Tags is that you can go online, find the tag and as long as you havethe free software on a cell phone, you can get the information.  Hold the cellphone right up to your computer screen and get the information.”

Why something that is free and simple has not been started yet to monitor these issues is beyond me, especially when the service is free.  The tags could be used in a registry as well.  Like all good things though it takes a while for those who are technically challenged to perhaps grip the idea and the only way to check it out would be to participate.  It took only one story about a man who died as a result of being implanted with a device to create this idea.   This would make information more easily and immediately accessible too. 

So when we talk registries, use some 2D bar-coding to make the process easy and save some lives too.

“Experts say such deaths are the result of a major weakness in the nation's system for recalling thousands of medical devices routinely implanted in people's bodies, ranging from screws and plates to artificial knees and hips.

"There is no system for being informed of what the problems are with the products you have in your body. Even your physician may not know," said Terry Fadem, president of the Biomedical Research and Education Foundation in Philadelphia.

Doctors later realized that that several batches of the same hip system - though not the one in Stone's body - had been recalled eight months earlier because of similar reports of breakage.

I think having not only product but safety information immediately available with a simple scan with a phone stands to save lives and it would also create registry information in one place to be evaluated by physicians and eventually cost issues may lower in this area, again with information availability and use, like anything else though, participation is needed.  BD  image

When makers of heart defibrillators wanted Medicare to vastly expand the types of patients eligible to receive the devices, which can cost upward of $25,000, agency officials were skeptical. It was not clear how many of those patients would actually need a defibrillator, a device that can deliver a life-saving shock to restore a faltering heart to normal rhythm.

Medical devices pose unique challenges for lawmakers. Medicare does not set or negotiate prices for the implants. Instead, it pays a flat rate to a hospital for procedures to give a patient a defibrillator or a hip, leaving it up to the hospital to negotiate the price of the device with the maker — a negotiation in which hospitals may have little leverage.

Unlike other hospital products, implants are so-called physician preference items, meaning that doctors — not the hospitals — often choose which manufacturer’s implant to use. It is a decision that can be skewed by a doctor’s relationship to a company and can also undercut a hospital’s ability to negotiate the best price, experts say.

Outlays on implanted devices stand at about $76 billion annually in this country and are rising at a rate faster than the cost of drugs, according to a recent study by the McKinsey Global Institute, a consulting group.

Medical devices pose unique challenges for lawmakers. Medicare does not set or negotiate prices for the implants. Instead, it pays a flat rate to a hospital for procedures to give a patient a defibrillator or a hip, leaving it up to the hospital to negotiate the price of the device with the maker — a negotiation in which hospitals may have little leverage.

However, unlike a car buyer, who can see a vast array of comparative information about competing products, a cardiologist or an orthopedic surgeon has little if any comparative data when choosing a device.

The Work-Up - Costs Surge for Medical Devices, but Benefits Are Opaque - Series - NYTimes.com

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