Robotic surgery: an example of uncoupling the economics of technology

Abstract

Innovative technology has the potential to improve patient outcomes, but also to substantially increase healthcare cost. Understanding how to evaluate the value of new technology requires an appreciation of the underlying economics and a measure of patient outcomes. If the economic consequences of applying a technology do not measurably improve patient outcomes, then there is an uncoupling of the two. A review of a highly innovative medical technology, the surgical robot, evaluating funding, marketing, use and measures of outcomes and effectiveness. The rational for funding the development and initial implementation of innovative technology is complex. The consumers of medical technologies (physician and patient) are unique in that they are not normally directly impacted by the cost. The purchaser, the hospital, must therefore shift the expense to other sources of revenue. The incentive to use innovative medical technology may not be consistently tied to outcomes. There is a lack of clarity regarding who is in the best position to determine the value of innovative technology in healthcare. Comparative effectiveness research that is transparent and objectively considers the implications of using new technology is needed, not just at the individual level, but also at the system and societal level.