Monday, March 23, 2009

Technology for Technology's Sake

Yesterday morning I read a newspaper article headlined "Dr.: Lack of copter cost Richardson". It referred to the incident where Natasha Richardson was transported to the hospital by ambulance after she hit her head in a skiing fall.

Typical for today's newspapers, the headline was not supported by the article's detail, where the doctor actually said, "It's impossible for me to comment specifically on her case, but...driving is a 2.5 hour trip...and we don't have helicopters like other places..." (roughly summarized). The doc wants a helicopter, that's for sure.

Yet there's not much evidence that helicopters are that great an idea. In Germany, where helicopters have been used for rescue and ambulance services since the 1970's, the official conclusion is: "research shows that using helicopters to transport patients does not influence greatly their probability of survival, they are costly (between around 0.5 million – 1.5 million euro annually to operate) and not without significant crash risk".

Richardson, unfortunately, initially declined medical treatment and thereby delayed her ambulance transport by two hours. You might think this "denial" issue would get more attention than the helicopter issue, since many people die because they deny their heart attack or other serious symptoms until it's too late to save them. Apparently this "many people" standard does not apply to the assessment of helicopter purchases: pushing technology is much sexier than helping people not to be stupid.

In my experience as an EMT, I've seen firsthand the huge cost of excessive technology use. Time after time, rare occurrances like Richardson's are used to justify purchasing large quantities of technology and technology-related workers. For example, for the annual cost of a paramedic and his/her monitoring equipment, a thousand elderly people could get home visits that identify and deal with early disease symptoms or potential causes of trauma. But trumpeting "prevention" is far less sexy than trumpeting the rare case where a paramedic actually saves a person whose heart has stopped.

Don't get me wrong - I'm no Luddite. Technology is wonderful. I'm typing on a great piece of technology at this very moment! But, cost/benefit analysis is essential when major chunks of public funds are to be allocated. Helicopters may be nice, but are they really worth the trade-off? Not likely.

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