The United States is fortunate to be one of the world’s leaders in the adoption of medical technology. At the same time, American health care is the world’s most expensive.
While technology is not the sole driver behind the cost of care, it does make an important contribution. How important to the quality of our health care is the availability of new technology?
The average lifespan of an American woman today is 79.5 years. For men, it is 74.1 years. These numbers have increased dramatically over the past two decades. Much of this increase is due to the adoption of new pharmaceutical therapies and innovative medical equipment and devices. Many of these advances are driven by ongoing scientific advances fueled by consumer demands for a longer life with enhanced quality of life.
One example of a cutting edge imaging technology is a 64-slice CT scanner. With this new scanner, we are entering into a new era of imaging capabilities. The images are generated quickly – almost instantaneously. So trauma patients, or those who are elderly or confused and cannot hold still, will benefit from this modality.
For specialty studies, the 64-slice has the advantage of acquiring the highest resolution images with considerably more detail. Previously, it took several minutes to scan a trauma patient with a 16-slice CT scanner. The same study now takes less than one minute to perform.
CT images can be thought of as being like slices of bread taken from a whole loaf to help view what’s inside. With previous CT models, the slicing took more time and the slices were thicker. With 64-slice technology, not only are the slices thinner, but they can be viewed in any direction. Even interiors of blood vessels can be seen.
Two years ago, state-of-the-art CT involved a 16-slice scanner that required patients to hold their breath for 30 seconds, which was often difficult for patients who were sick, elderly or injured. The new 64-slice scanner requires a considerably shorter breath hold.
At the same time, its higher submillimeter resolution offers the highest quality three-dimensional images, which can be rotated at numerous angles for complete views. Parts of the body can also be isolated for more detailed analysis.
For physicians, this means new diagnostic power, including the ability to perform rapid tests for emergency department patients with stroke symptoms, chest pain or whole-body trauma.
The speed of the 64-slice CT scanner also enables clear images of the heart and coronary arteries to be obtained. Added to the information obtained by conventional diagnostic tests, CT becomes an excellent noninvasive method of evaluating patients suspected of having heart disease but for whom catheterization is not indicated. It also provides excellent, noninvasive followup of bypass grafts.
Coronary CT has an important advantage over cardiac catheterization in that it provides a positive rather than a negative image. While cardiac catheterization and exercise stress testing are excellent methods of diagnosing significant disease, visualization of the artery walls with high-speed CT can identify unstable plaques that can lead to acute myocardial infarction.
It is likely that 64-slice scanning technology, and any innovations in future CT scanners, could eventually replace cardiac catheterization. This option would be much preferable to any patient undergoing diagnostic analysis of cardiac blockages.
While coronary CT will not replace cardiac catheterization today, it allows more people to have their coronaries assessed by direct visualization. The patient who will benefit most from this test has a low to intermediate risk profile for coronary artery disease with atypical chest pain. Other candidates include asymptomatic patients with high risk for CAD and patients with equivocal nuclear stress tests.
So is this technology worth the money? If you are a patient, you would certainly want it available, and you would most certainly want this technology available for a loved one. The technology’s promise is one of improved speed and diagnostic effectiveness, particularly for those at risk for many life-threatening conditions.
Technological advancements that add to our quality of life and our lifespan are positive for the American work force. We also have the challenge to use them responsibly, balancing the cost and the social benefit.
Cathy Ceccio, RN, MA, MSN, is president of Edwin Shaw Rehab and chief operating officer of Akron General Medical Center. Reach Akron Gnenral Medical Center at (330) 344-6000 or www.akrongeneral.org.
