To those heavily invested in a certain sector of stocks, technology recently has become a “four-letter” word. Initially, the lure of technology stocks was nearly irresistible-compounding profits by investing in the future. This type of “bubble” is nothing new; four centuries ago a similar scene unfolded with the Dutch tulip mania of the 17th century. Some individuals invested their entire fortunes in a single bulb and, in 1637, lost everything.
As one with more than 1,000 tulip bulbs in the ground this year-and without a personal digital assistant in my pocket-perhaps I just have a greater affinity for tulips than for the other t-word. Regardless of whether I personally lean more to the technophobe or technophile, it is certain that the general view of technology in 2002 is more grounded in reality than in recent years. This more pragmatic view allows for a balanced assessment of what technology products can do for us, with emphasis on understanding their advantages, disadvantages and the necessity of successfully implementing technology in our lives and in our profession.
A Practical Context for Technology
This issue of the Bulletin explores technology that can and will affect our practices. Contributors have been asked to provide an overview of and context for their topics, but more importantly to give practical advice about how a resource can be applied.
Neurosurgeons are familiar with the advantages of technology in the clinical realm. I am reminded of this most graphically when the powered cranial perforator malfunctions and a burr hole must be completed with a hand perforator. This simple example illuminates what is good and bad about technology: It can make the job easier, but it also can be relatively costly and prone to failure.
It is my personal perspective that successful implementation of technology is the key to our specialty’s continued success. At a time when reimbursement for medical services is declining or at best staying stable, enhancing office and clinical efficiency can buoy our practices. Annotated patient records and computer-based prescription services hold hope in lessening medical errors and the problems in patient care that result from those errors. New technology in the OR and for diagnosis can improve patient outcomes. Computer-based claims managers can result in a higher percentage of “clean” billing submissions. However, this promise of technology must be evaluated in light of problems involved with implementation.
First, careful planning must precede implementation of new technology; optimal use requires an appropriate level of support. Second, not all new products deliver as promised and the optimism at purchase might be replaced by disappointment, dissatisfaction, and ultimately disposal of unused equipment. Careful evaluation and service contracts can help avoid this pitfall. Third, technology is costly. At a time when healthcare costs are 14 percent of the gross domestic product, any substantial increase in technology could affect the amount available for physician reimbursement. In this environment, thoughtful, cost-conscious evaluation of the benefits and disadvantages of technology is the business equivalent of informed consent.
AANS Tech Initiatives Are Bold, Balanced
The AANS long has recognized the importance of technology to its mission. The annual meeting showcases technology in its scientific sessions and in its exhibit halls where neurosurgeons can sample the newest products that industry has to offer. Newer technology initiatives by the AANS include 1) the Digital Technology Committee, aimed at keeping the AANS and its members at the leading edge of technology; 2) the use of new technology to communicate with its membership, primarily through E-News and its Web site, www .aans.org; and 3) the business partnership with Outcomes Sciences, Inc., in the Neuro-Knowledge Network that has broadened AANS’ involvement in outcomes studies by connecting members to sophistiicated clinical data collection capabilities.
While the AANS’ bold involvement with technology is appropriate and consistent with serving the membership, the AANS also is mindful of the complexity and cost of technology. This balanced approach to the association’s investment in technology is a sure sign of a mature organization with a foundation built on a tradition of excellence, but with its eyes on the future.
A. John Popp is editor of the Bulletin, president-elect of the AANS, and Henry and Sally Schaffer Chair of Surgery at Albany Medical College.