“C-suite leaders need a concise way of seeing where new and emerging health technologies fit, if at all, in their health systems,” said Diane Robertson, director, health technology assessment, ECRI Institute, in a statement. “Backed by our unbiased, evidence-based research, our annual Watch List helps hospital leaders make technology and infrastructure decisions based on clinical evidence and cost.”

The first topic the institute examined was disinfection robots. One in 25 hospital patients has at least one hospital-acquired infection (HAI) on any given day, according to the Centers for Disease Control and Prevention (CDC), and 75,000 deaths per year are due to HAIs. ECRI made several recommendations regarding disinfection robots, including introducing disinfection robots into intensive care units and considering trials with robots to assess their value.

The institute also examined 3D printing and middleware (messaging systems such as smartphones). The institute recommends considering patient safety issues, including sterilization and infection risk. When examining middleware, the institute advises to assess alarm loads, determine which systems need middleware and consider architectural layout, among others.

Another focus for the institute was post-discharge clinics. Federal initiatives are causing hospitals to change their perspectives on patient discharge procedures. The main question hospitals should be asking themselves, according to the institute, is whether clinics are preventing readmissions and saving money.

Google Glass and anti-obesity devices are two other pieces of technology the institute examined. Used during surgery, Google Glass could allow off-site surgeons to provide guidance to on-site surgeons. And, according to the institute, there are three minimally invasive anti-obesity devices in development that C-suite leaders should keep an eye on.

The institute also looked at two treatment considerations, including caring for millennials with cancer — whether hospitals create adolescent and young adult cancer centers to improve outcomes — and fecal microbiota therapy, a treatment option whereby donated fecal matter from a healthy patient is transferred to an ill patient to reestablish normal microbial diversity in the colon.

The final two areas of focus from the institute were artificial pancreas device systems and telehealth. The institute asked what’s coming after the first-generation system for artificial pancreas device systems, and whether telehealth has finally broken free of return-on-investment concerns.

“Hospital leaders must carefully examine their strategic and operational plans and assess the relevance of these new technologies or infrastructure initiatives for their organizations. Our list shows them what’s coming around the bend so they don’t miss out on the newest innovations or get caught up in hype that can lead to a costly mistake," said Rob Maliff, director, applied solutions, ECRI Institute, in a statement.

The full ECRI watch list can be found at the ECRI Institute website.

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To help hospitals reduce technology-related risks, the institute publishes an annual list, Top 10 Health Technology Hazards. The 2015 list highlights 10 safety topics that the institute labels as crucial for hospitals to address in the coming year.

The published list is available for a free download at ecri.org. The list goes into detail about the following hazards:

• Alarm hazards: Inadequate alarm configuration polices and practices
• Data integrity: Incorrect or missing data in electronic health records and other health IT systems
• Mix-up of IV lines leading to misadministration of drugs and solutions
• Inadequate reprocessing of endoscopes and surgical instruments
• Ventilator disconnections not caught because of a mistake in setting or missed alarms
• Patient-handling device use errors and device failures
• Dose creep: Unnoticed variations in diagnostic radiation exposures
• Robotic surgery: Complications due to insufficient training
• Cybersecurity: Insufficient protections for medical devices and systems
• Overwhelmed recall and safety alert management programs

“Technology safety can often be overlooked,” said James P. Keller, Jr., vice president, health technology evaluation and safety, ECRI Institute, in a statement. “Based on our experience, there are serious safety problems that need to be addressed. ECRI Institute recommends that hospitals use our list as a guide to help prioritize their technology-related safety initiatives.”

Each hazard in the list includes an overview of the issue and recommended action steps to aid health care facilities in their efforts to maintain a safe environment for patients and health care workers.

For the fourth year in a row, clinical alarm hazards are at the top of ECRI’s list. This year, a report that describes hazards on the list draws particular attention to alarm configuration practices. ECRI Institute points to several deaths and other cases of severe patient harm that may have been prevented with more effective alarm policies and practices.

Recall management, which appears on the list for the first time, highlights overwhelmed recall and safety-alert programs as a potential for serious consequences for healthcare facilities and patients. Experts at ECRI are concerned that existing hospital recall tracking programs are not keeping pace with the growing number of medical device recalls issued each year. FDA reports that the annual number of medical device recalls nearly doubled between 2003 and 2012, from 604 recalls to 1,190 annually.

For each topic, ECRI Institute describes the hazard, presents recommendations for minimizing the risks and lists resources that readers can access to learn more about the topic.

To develop the annual list, ECRI Institute looked to a staff of engineers, scientists, nurses, physicians and patient safety analysts. The team of experts used resources at ECRI, as well as expertise and insight gained through testing and analyzing health care technologies. This process included examining health technology-related problem reports from hospitals and health systems and reports received through the ECRI Institute Patient Safety Organization.

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ECRI Institute used its Selectplus User Experience Network, a service that helps medical technology purchasers with vendor and product information, to gauge MRI operators on what they thought of vendors’ image quality, coil selection and setup, ease of use, patient throughput and vendor support. The results include function, feature and service ratings for each model, grouped by vendor.

“Hospital leaders and technology purchasers need all the supporting data and market insight they can get to make informed buying decisions, with a keen focus on safety and quality,” said Jennifer L. Myers, ECRI Institute’s vice president of Select Health Technology Services, in a statement. “We rely on our partner health care organizations’ end-user experiences as one of the many tools hospitals can use to help make cost-effective purchasing decisions.”

Key findings of the survey show that MRI models with the highest overall user rating scored high in ease-of-use and image-quality criteria. MRI models with the lowest overall user rating scored lowest in reliability and vendor service.

MRI systems are grouped into three general categories based on magnetic field strength: 3T scanners, 1.5T scanners and low-field (1.2T or less) scanners. On a scale of 1 to 5, with 5 being the best, the average user rating for image quality across all 3T systems was 4.3 compared to 4.2 for all 1.5T systems.

When comparing the four MRI market leaders and their 1.5T MRI systems, the survey found the GE Optima MR450w had the highest average list price at approximately $3.5 million, and the Toshiba Vantage Titan 1.5T was the lowest at about $2.1 million. The system with the highest average quoted price was the Philips Ingenia 1.5T at $1.7 million compared to the Toshiba Vantage Titan 1.5T, which again came at the lowest price at $1.3 million. The highest average annual service price was for the Philips Ingenia 1.5T at $153,015 and the lowest price was for the Simens Magnetom Aera at $115,201.

The full report is available to ECRI Institute members on its website.

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