With more and more spine technologies entering the market, the decision whether to invest can be met with challenges between physicians and other stakeholders. It’s a problem that Philip Louie, MD, said he wants to change.
“Every time we bring in a new technology, it’s like a fight,” Dr. Louie, of Seattle-based Virginia Mason Franciscan Health, said. “Sometimes it’s like who has the loudest voice and who has the most endurance. Surgeons want one thing but the hospital administration might say it’s not possible … We don’t have a good process, and every hospital has a different sort of value assessment and there’s no universal way to start a conversation.”
His solution? Developing an enabling technology value index.
Dr. Louie likened the ETVI to the Kelly Blue Book or Consumer Reports that serves as a conversation point for stakeholders including patients, surgeons, hospital leaders, payers and industry. The goal of it is to break down key factors for stakeholders and help parties avoid arguments over tech decisionmaking.
“You just lay it out there,” he said. “I think that we would basically say for example ‘Here is this technology … Here’s are the surgeon’s priorities, here’s the priorities of the hospital leadership, etc.’ There’s very few perfect technologies that score super high for every stakeholder group, but it starts the conversation and shows where the deficits are.”
Laying out these strengths and deficits may let physicians and leaders know how to account for them and come to a compromise.
“But you can’t really compromise or have a discussion until you understand what the other parties are interested or need, and this just sort of creates the initial floor to move on from,” Dr. Louie said.
Dr. Louie has been working on a Delphi study involving multiple stakeholders from surgeons to hospital leadership, payers and medtech workers.
“The reception to it has been fun as people are interested in the surveys that we’re developing to try to hone things down,” Dr. Louie said. “I think everyone recognizes that it’s a really challenging process and that there needs to be some uniformity between them … I’m not saying this will cure all of that by any means, but at least I can help start it. We all know that the costs are crazy right now, and healthcare doesn’t have a ton of money, and systems are losing money, and this helps the responsible evaluation of spine technology.
