Economic Evaluation of Integrating Technology with Medical Care

Over the last 20 years, advancements in technology have dramatically changed the way medical care is addressed and administered. This ever-growing, exponential growth of innovation has resulted in easier access to care, greater quality of treatments, and even higher levels of patient compliance. However, despite the obviously clear benefits technology has to offer in regards to healthcare, there are some considerable drawbacks produced by the integration of technology and public care. In this essay, I will evaluate whether the cost of combining technology and healthcare outweigh the benefits and how the stigma surrounding this integration challenge its growth.

Since the introduction of advanced machines in hospitals and clinics in the late 1990s, the monetary cost of health care has increased by around 7% each year. (Callahan) Nonetheless, this value of seven percent does not take into account the satisfaction or utility produced by the use of the innovations. As a result, a conclusive decision cannot be made from this data on if medical technology is too high of a cost. Integration of technology can only truly be considered unsuccessful if the costs become higher than the benefits. Consequently, to come to a conclusion we must consider the benefits of the addition of technology to medical treatments such as improvement in the quality of life, increased lifespans, and the ability to go back to work quicker. (Santerre & Neun 83-101)

The increasing cost from the last paragraph, however, depicts another important trend. The higher the cost of healthcare becomes the better the health of the overall society. For example, in 1990 the average life expectancy of a person was 75 years, moreover, as the price of medical care began to grow, so did life expectancy. By 2014, the average life expectancy was up to 79 years. (Arias) A four-year difference may seem insignificant, but over time it adds up to show a positive trend. Yet, despite this data, we cannot be certain that life expectancy rose only due to advanced health care. Thus, bringing up the question; does the benefit of integrative technology in medical care really outweigh the cost to society? To answer this question I found a research study where the benefit and cost of using technologically advanced treatments for certain diseases were evaluated and examined.

The study performed in 2001 by Cutler and McClellan analyzed five medical problems; depression, low-birthweight babies, heart attacks, breast cancer, and cataracts. In the all the five health issues they tested, Cutler and McClellan found that the benefits of technological advancement in medical care are greater than the overall cost. They came to this conclusion by comparing the lifespan of a patient who experienced a medical problem before technological advances were made, to the lifespan of a patient who had access to such advances when their medical problem occurred. They found that when medical innovations were available patients were able to live longer, consequently providing more benefit and utility to society. For example, when doing their calculations for a heart attack victim they found the new technology increased life span by one year. They then equated one year of life to be worth $100,000 and subtracted the values such as cost of treatment ($10,000) and the cost of living ($25,000). By using this formula they found that the cost of treatment (10,000) is reasonable due to the fact that the return benefit is almost 7 times that of the cost. (Santerre & Neun 83-101) As we can see, quantitatively, this study proves that the benefit of integrative technology in health care outweighs the cost.

Another cost I will discuss is one that most people do not consider conventionally; the cost of privacy. One aspect of integrating technology with medical care is the use of health informatics. In this type of technology, all the medical data of a patient is recorded on an electrical file and stored digitally. Examples range from devices such as Fitbits, which store an individual’s weight, sleep patterns, and everyday activities, to actual patient records stored in hospital computers. On either side of the spectrum, there exists a risk of having personal information stolen, leaked, or even lost. For instance, on the 28th of March in 2016, a hospital in Baltimore named MedStar Health was hacked. This form of cyber-attacking left the hospital unable to function and left their electronic health records or EHR frozen and at risk of being stolen. (Hagland)

This shows that the cost of privacy is extremely high and that many people end up making risky decisions on where they would like their data to end up. Often times once a patient’s information is entered into EHR it becomes hard to track or remove. As a result, each individual must weigh the benefit of having a quick, efficient, and effective treatment against the cost of having their privacy violated. In a survey conducted by the Informatics Institute, they found that 94% of people would be willing to risk their privacy in order to get successful treatments for diseases. (Hagland) Thus, according to this survey, we can conclude that, again, the benefits outweigh the cost of technological integration.

As seen from the previous paragraph, there are many things that are meant by integrative technology in medical care. Items that fall under this category are newer medicines, medical devices, medical and surgical procedures, and electronic information systems. Medical devices that count as integrative technology can be anything from adjustable beds to scalpels. More clearly stated, as long as the object served a purpose in a patient's treatment or recovery time, it should be counted as a medical device. Medical and surgical procedures have to do with any physical treatment or procedure done on an individual. It may include surgery, stitches, and even lasering. A good example of technology making health care more efficient is seen in dissolvable stitches. The innovation eliminates the need for patients to visit the hospital or clinic to follow up on their progress; consequently, the individual is able to focus on other things such as work, making him/her have greater economic and utility opportunities. Lastly, electronic information systems are any programs that are used to store your personal information. An example would be EHR, or electronic health records, a system we discussed earlier in the essay. (Santerre & Neun 83-101)

Before I move on to the stigma surrounding combining technology with medical care, I first need to clarify how innovations change the healthcare field. Usually, as newer forms of technology and devices are introduced to the market, the demand for them increases. As a consequence, clinics and hospitals are forced to upgrade their older infrastructure to keep up with the demand and competitiveness of the medical market. For example, in the early 2000s a new form of dental braces (fastbraces) were created which promised to straighten teeth in half the time of traditional braces. Due to this advanced technology, people started to favor offices where fastbraces were offered rather than their regular offices. This demand spurred almost all dental offices to switch to using fastbraces and leave behind the traditional braces.(Gelijns & Rosenberg 28-46) This switch from old to new technology is known as the treatment substitution effect. (Santerre & Neun 83-101)

The treatment substitution effect is linked to increasing the efficiency and quality of results in medical treatments, however it also increases the cost of the treatments. Another way technology alters the medical field is linked to its ability to increase the access to information and treatments. This growth in the reach of medical help is known as the treatment expansion effect. As more and more effective medications and cures start to emerge for a certain disease, more people are likely to be prescribed or treated with the new medications or procedures. For example, as the process of open-heart surgery improved and showed higher rates of success, the more frequently it started to be performed. This expansion of treatments is primarily a result of people wanting to be free of their medical problems in an efficient and easy way. But it is important to keep in mind that as treatments increase in success the higher their monetary cost and overall benefit. (Gelijns & Rosenberg 28-46)

Together the treatment substitution effect and the treatment expansion effect help determine whether or not the integration of technology with medical care is a positive or negative change. They do this by giving us a pattern we can apply to the three-legged stool model of healthcare. The model was created on the idea that each leg of the stool; cost, quality, and access all be balanced and strong enough to support a well running healthcare system. In the case of adding technology into the healthcare system, we see that the quality of care grows immensely. The use of technology makes the quality of care provided at every visit equal, as there is no room for human errors. Moving on to access, we see from the treatment expansion effect that there is an increase in distribution of treatments, procedures, and medications. As a result, people who usually would not have access to such medical care would now have access. Lastly, there is the cost leg. Due to the fact that quality and access have such positive and strong values, the cost of healthcare in general does go up. This can be a big potential drawback as many people already struggle with making ends meet. Overall, this model depicts how the cost of healthcare is increasing as the quality and access to healthcare combined with advanced technology is increasing. (Santerre & Neun 83-101)

When it comes to incorporating technology with medical care there will always be a pushback from certain groups and demographics of people. These groups of people are characterized by having conservative ideals and are predominantly made up of an elderly population. This reluctance to integrate health care with new technology is due to a number of reasons. Firstly, older populations are more used to the traditional way medicine was performed. Consequently, they have a certain sense of stigma against having treatments prescribed to them virtually or without the actual consolidation of a face-to-face meeting. They find this new method alarming as they do not understand how a machine could consider all their unique problems and create a successful treatment for them. Secondly, with this new era of easily obtainable information, patients are able to learn more about themselves and the disease or condition they may have. This increase in knowledge may also make some patients a little wary of trying new medicines and procedures over treatment plans that have long been used by them. Most people tend to favor things that are familiar to them rather than new and foreign things.

Moreover, patients sometimes find it uncomfortable to record their information into electronic devices or machines. This is because they do not really know what is happening with the information they entered and how far it could spread. Furthermore, some individuals do not like the idea of a robot or machine treating them or even coming up with solutions to their disease or problem. They feel it is too unpersonalized and therefore, the treatment will be ineffective. When all these factors come together, we then see a struggle to get advanced technology to every sector of healthcare. (Gelijns & Rosenberg 28-46) A way to combat this issue, I think, would be to increase public knowledge about the benefits of the advanced treatments. Information could be spread using social media outlets, flyers and even during regular check-up visits. This way people will be more informed about how the new wave of technology-based medicine works and consequently, less hesitant to try out the new treatments and procedures.

My opinion in regards to integrating technology with the medical field is quite supportive. I believe that without the innovations technology has to offer the health field would stay in a stagnant position and never improve. Even the smallest items that we may not consider to be breakthroughs have their start due to medical technology. Let’s take a band aid for example, it seems to just be an adhesive strip of synthetic material, but without it billions of people would be at risk for infections and loss of blood. Additionally, combining technology with healthcare creates more efficient processes which could help increase the quality of and access to treatments. In recent years there has been a great increase in patient neglect and care. By using technology in place of manual devices, patients will be more likely to receive consistent quality care rather than pay hundreds of dollars to receive a faulty treatment plan. It is true that the more technological aspects a procedure or treatment has, the higher its price, however, I believe that we must all make an investment in our health early on in order to obtain long term benefits and maximum utility.

With the new technologies available in every aspect of healthcare, patients are able to get access to their treatments in a faster, easier, and more efficient way, however due to this ease of access and increase in quality, the cost healthcare rises. Despite this raised cost, when evaluating cost against benefit we see that technological integration is a desired factor due to its net benefit being greater than the net cost. In conclusion, the use of advanced technology should continue being implemented in medical care in order to create a healthier and more economically productive society.