Cleveland Clinic’s Top 10 Medical Innovations

Below is Cleveland Clinic’s list of the top ten medical innnovations for their potential impact on patient care in the coming year. (I’ll add my two cents afterward.)

  1. Use of circulating tumor cell technology. Improves adjustments to cancer treatment, particularly for patients with repeat cancer
  2. Warm organ perfusion device. Increases from 4 to 12 hours the viability of donated hearts.
  3. Diaphragm pacing system. Improves breathing for paraplegics, making them considerably more mobile and reduces ventilator-induced pneumonia.
  4. Multi-spectral imaging systems. Enables multiple stained proteins to be visualized; speeds up diagnosis and dramatically improves directed therapy, especially for cancerous tumors.
  5. Percutaneous mitral valve regurgitation repair. One of innumerable advances yielding a minimally invasive procedure to be substituted for a highly invasive one.
  6. Strategies for creating avian flu vaccines of multiple types. Use of mock virus stimulates patient’s immune response, preempting need for variant-specific vaccines.
  7. LESS and NOTES. Use of single site laparoscopy (LESS) and natural orifice (NOTES) is making already minimally invasive endoscopy even less invasive. Faster healing and larger patient population.
  8. Integration of diffusion tensor imaging. Produces 2D and 3D color images to aid neurosurgeons in preserving functional pathways in the brain.
  9. Doppler-guided uterine artery occlusion. Possibly avoid hysterectomy and preserve childbearing ability for women with uterine fibroids.
  10. National health information exchange. Leveraging information technology to decrease costs and increase quality of medical care.

Let there be no doubt that ALL OF THESE technologies directly add to healthcare costs, even the ones, like number 10, which will reduce costs. Herein is precisely the challenge that was discussed in the prior post, Medical Technology Costs: Cause and Solution. These systems cost money to be put in place and, therefore, if assessed for their direct affect on healthare costs, the answer is that they do indeed increase costs (but, for #10, it is the indirect effect of eliminating old, inefficient systems that will lead to lowered costs). Systematically, as one reads through the list, we see the untapped demand of reducing trauma, expanding treatment to the untreated, improving diagnosis and treatment options and other benefits that increase the aggregate cost.

Let there also be no doubt that the compelling need to improve treatment so that it (1) serves more patients, (2) improves that quality of treatment, and, even, (3) lowers healthcare costs, inevitably involves at least an initial increase in costs. There is no magic bullet solution, as is occasionally suggested when the spotlight of cost focuses solely on medical technology. Increasing healthcare costs will demand solutions from many quarters, with a sanguine consideration of the actual benefits of medical technology.

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