Tackling the rising costs of health care

Faced with the continual tide of new technology, our universal health care system must constantly deal with surging costs. At the same time, hospitals have to operate on fixed budgets. So how can we benefit from the best technologies while ensuring sound health care management? At the McGill University Health Centre (MUHC), the task of balancing the two falls to the Health Technology Assessment Unit (TAU). Since the MUHC founded the TAU in 2002, the unit has done its job so well that most Quebec teaching hospitals have used it as a model for similar projects. An initiative started by Dr. Maurice McGregor, a true pioneer of health technology evaluation in Canada, the TAU is responsible for advising MUHC managers on how to choose available technologies, a term that encompasses nearly everything the industry supplies to the health care sector: diagnostic and treatment tools, testing products, medications, surgical systems, processes and more. Putting technology under the scope The TAU is composed of experts in clinical medicine, epidemiology, biostatistics and health economics. When someone at the MUHC needs to know whether a technology is sound, TAU experts collect all relevant documentation (trials, reports, scientific articles), analyze the technology based on its intended use at the MUHC, and then synthesize the findings into an objective and transparent report that they submit to the recommendation committee. This committee is made up of paramedical staff, nurses, medical personnel, managers and even patients. With the help of the reviewed documentation, the committee studies the MUHC’s options by considering all relevant aspects – from cost-effectiveness, added value, and budgetary impacts to legal and ethical issues. “We create in-depth reports by meticulously assessing available documentation and thoroughly weighing the advantages and disadvantages of a technology. This gives MUHC managers the full facts before they make a decision,” said Dr. Maurice McGregor, Chair of the TAU. Essential assessment Since its creation, the TAU has batted for a great average, with the administration adopting 95% of its recommendations. At the end of 2007, or five years after its creation, the TAU had saved the MUHC approximately $13 million by making recommendations to reject or restrict the use of technologies. What’s more, the technologies that the unit did recommend only accounted for $1 million in increased expenditures for the same period. The overall benefit is crystal clear! “Our primary goal is to help the hospital make intelligent choices in light of patient health needs,” explained TAU Director Dr. Nandini Dendukuri. “Our analyses go well beyond a simple comparison of expenses. We painstakingly evaluate the benefits not only for MUHC patients, professionals and staff but for the entire community we serve.” “Where our Redevelopment Project is concerned, TAU recommendations are critical,” stated the Hon. Arthur T. Porter, Director General and CEO of the MUHC. “As a world-class teaching hospital, we have to offer our patients the best. The conscientious work of the TAU shows our partners and donors that we can realize our vision of cutting-edge health care while controlling costs.” With this philosophy in mind, the TAU has become a key player in the future MUHC. “As a world-class teaching hospital, we have to offer our patients the best. The conscientious work of the TAU shows our partners and donors that we can realize our vision of cutting-edge health care while controlling costs.”  —  The Hon. Arthur T. Porter, Director General and CEO of the MUHC By recommending catheterization for aortic valve replacements, the TAU is providing hope for a better quality of life to people who could not otherwise undergo long and exhausting process of open-heart surgery.