Tuesday, May 13, 2008

When Lower Quality is Better – Medical??

What’s better than the very best medical imaging device? How about 100 smaller, cheaper, newer technology (maybe even hand held) imagers at the same price??

The issue at hand is that for many years a number of factors (chief amongst them lawsuits) have pushed medical equipment down a one-way street of reliability at any cost, and safety at any cost. This sounds like a good thing on the surface, but the unintended side effects are literally killing us.

Let me enumerate the downside for you:

  1. Price – from my own personal experience working in engineering at a respected medical imaging device manufacturer, I came to see the problem that I summarize as “Your medical dollars at play”. Cost was so far down the priorities and expectations lists as to be no consideration in designs. Costs that you ultimately pay, which probably make you hesitate to get medically imaged.
  2. Old reliable technology – the very newest technology is always less tried and true than last year’s hardware, so the priority for ultimate reliability effectively kills any consideration for brand-new (read: more powerful, smaller and less costly) electronics.
  3. Premium performance requirements – most middle-of-the-road newer tech devices can beat older top-of-the-line ancestor devices at half or less of the cost. However, since cost is not really an object, the usual knee-jerk response to such design decisions is to go right to the top shelf.
  4. Slow fielding – dramatically unlike retail devices of similar complexity, it can take years to get a medical device from initial engineering to the doctor’s office. For retail consumer devices, mere months.

Lest you get the image of a shoddy, squeaking CAT scanner dumping God-knows how much X-ray radiation into you in the place of that humming smooth model in the hospital, let me add some sanity checks.

Fail-safe, meaning “If you fail, it will do no harm” is a far easier design criteria than “Thou Shalt Not Fail”. Add to that the fact that having a cheap back-up unit is better than an expensive single unit and you begin to see where I am coming from.

Very much like computers of 1980 (remember the air-conditioned shrine of the VAX?), medical imaging devices have their own rooms with acolytes (I mean, medical technicians) and priests (doctors).

Now picture Dr. McCoy’s medical Tricorder from Star Trek, only everyone gets one, and it’s like the digital thermometer in the medicine cabinet at home…

That’s what quality at all costs has cost you.

No comments: