Issue link: https://beckershealthcare.uberflip.com/i/1531585
24 CMO / CARE DELIVERY 1 chief nursing officer's business case for $1M tech investment By Erica Carbajal For many hospital leaders, deciding which technology investments to prioritize while balancing tight budgets is a tall order. At Carson Valley Medical Center in Minden, Nev., Chief Nursing Officer Andrea Highfill, DNP, RN, approaches this challenge by starting with a fundamental question: Is there a significant demand for the technology? If the answer is yes, the next step is collecting data to weigh the product's price tag against what it could cost the organization to forego the investment. Dr. Highfill and her peers recently followed this process, aer surgeons began requesting a $1 million orthopedic surgical robot. "Once we started hearing this buzz that it was in high demand, we wanted to capture that in data," she said. "How many patients are we seeing now? How many patients are being sent away" because surgeons are taking their cases to another area hospital that does have the robot? To quantify the potential impact of the investment, Carson Valley leaders worked with the vendor to gather data on patient volumes from nearby hospitals using the robotic system. ey also reviewed community health trends, including the prevalence of orthopedic conditions, and anticipated future demand for joint replacement surgeries. e financial modeling process involved estimating how many surgeries the hospital would need to perform monthly to offset the robot's cost. is included calculating the expected revenue from increased surgical volumes and comparing it to the hospital's actual capacity. Factoring in ongoing maintenance expenses, Carson Valley leaders built a robust ROI projection. "We did the calculations, and data did show that we would be losing quite a bit if we didn't keep up with this technology, and would be gaining quite a bit if we did acquire it," Dr. Highfill said. Carson Valley leadership ultimately approved the purchase aer the business case was presented. "We don't want to be fiscally irresponsible, but we also don't want to fall behind the benchmark; we don't want to fall behind in technology," Dr. Highfill said. n Physicians tread 'minefield' of abortion bans, hospitals silent By Paige Twenter I n states with total abortion bans, federal law requires physicians to provide an abortion if it stabilizes an emergency condition, but hospitals are leaving physicians to fend for themselves to navigate this "minefield," according to a Senate Finance Committee report. In September, the committee sent letters to eight hospitals after receiving "concerning reports of pregnant women being denied or experiencing delays in accessing emergency, stabilizing health care at their facilities," the report said, from hospitals in Florida, Georgia, Louisiana, Missouri, North Carolina and Texas. Five things to know: 1. Citing declining birth rates and legal challenges, several hospitals and systems have shuttered labor and delivery services. One Idaho hospital said on Facebook that it closed its obstetric services due to the state's legal and political climate. "Highly respected, talented physicians are leaving," the hospital said. "Recruiting replacements will be extraordinarily difficult. In addition, the Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care. Consequences for Idaho Physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines." 2. Emergency medicine clinicians, OB-GYNs and family medicine physicians told the committee they receive limited communication from hospital leadership on navigating the conflict between state laws and Emergency Medical Treatment and Labor Act, a federal law passed in 1986. A family physician who provides obstetrics services in a Texas hospital said the organization was "conspicuously and deliberately silent" on guiding employees through this tension. 3. At the same time, abortion laws are becoming murkier across state lines. Texas' attorney general filed a lawsuit against a New York physician of allegedly providing a Texas woman with abortion medication via telehealth. 4. Even in states where abortion is legal, health system policies can lead to confusion. In California, which does not have an abortion ban, the state's attorney general acted when a hospital allegedly denied abortion care to a woman experiencing an obstetric emergency, forcing her to seek care elsewhere. 5. The Supreme Court has refused to weigh in on several lawsuits that question whether EMTALA supersedes state law for abortion care. Idaho physicians are allowed to provide emergency abortion care, but Texas physicians are not. n