Personalized sedation system: boon or liability?
A move by the Federal Drug Administration (FDA) to reconsider approval of a computer-assisted personalized sedation system is causing tumult among anesthesia providers. The system provides automated, minimal-to-moderate propofol sedation for patients undergoing colonoscopy and upper GI procedures. It will also allow gastroenterologists and nurses to administer propofol without the supervision of an anesthetist.
While some anesthesia experts are skeptical about the safety of the device, others aren’t sold on its cost cutting benefits. Most agree that putting price and convenience before patient safety can have catastrophic results. At a time when more and more anesthesia providers are implementing CQI programs to enhance anesthesia service quality and reduce medication errors, using a personalized sedation system seems more of a liability than a way to deliver positive patient outcomes.
Let us examine the benefits of Monitored Anesthesia Care (MAC) versus the personalized sedation system both for the patient as well as the medical center.
MAC vs. personalized sedation system
- Liability: The greatest benefit of MAC done by an anesthesia services company lies in the transference of liability from the medical center to the anesthesia provider. This makes the anesthetist/CRNA responsible for patient’s safety and encourages more positive patient outcomes. Opting for the personalized sedation system would shift responsibility back to the medical center as anesthesia would be kept in-house.
- Cost to medical center: Outsourced anesthesia services like MAC are paid for by patients and/or their insurance companies. They are not a cost to hospitals, ambulatory centers and office-based practitioners. Healthcare facilities will need medical professionals to administer anesthesia through the personalized sedation system. The nurse or medical practitioner who performs this service will have to come from the medical center and be paid by them.
- Patient care: A CRNA or anesthesiologist working for an anesthesia services provider is trained to deliver quality patient care and performs the role of an anesthetist and nurse. This has been a boon to medical centers as they can allot their own staff to other areas that need attention. The new system will create a need to increase staffing or reduce the number of procedures performed as they will no longer bring in a company to do their anesthesia for them, which means that staff will be unavailable to them.
- Patient safety: Anesthesiologists and CRNAs are trained to deal with complications that may arise with propofol usage. In the absence of a qualified professional, unexpected outcomes could have deadly consequences. Remember what happened to Michael Jackson?
- Patient flow: Fewer complications and faster recoveries under the capable care of qualified anesthetists has led to a significant improvement in patient flow, increased number of procedures and revenue. One of the serious criticisms of the personalized sedation system is that the propofol it administers produces the effects of general anesthesia which means that patients will take longer to recover. This lowers patient satisfaction and reduces the number of patients returning for follow-up procedures.
Slower recovery times, additional staffing requirements and lower patient satisfaction are bound to impact the income as well as reputation of the medical centers using these personal sedation systems. Even if the system does reduce the cost of colonoscopies and upper GI tract procedures, the fact that it compromises patient safety and well-being is hardly going to be welcomed by the patient themselves. If the computer-assisted personalized sedation system doesn’t benefit the patient or the medical center, then what is its real value?
Tell us what you think about the personalized sedation system.