(Bloomberg View) — To obtain better value for health-care dollars, it’s important to evaluate in detail which ones are well-spent and which are not. The $150-billion-a-year market for implantable medical devices in the U.S. — which includes everything from artificial hips to pacemakers — is a good illustration of this challenge and how to meet it.
Examining how well devices are working requires knowing where each one goes. Without tracking, it’s difficult to find out which patients do better with one kind of device, and which ones are better off with another kind.
Effective tracking would also make it possible to recall all those that may turn out to be defective. The Government Accountability Office has found that most recalls of high-risk devices end without all affected devices being fixed or removed. And better tracking would make it easier to detect cases of outright fraud.
It is now feasible to undertake this kind of tracking because the Food and Drug Administration recently began requiring high-risk devices to carry a unique identifier, the equivalent of a bar code. These identifiers are of limited use, however, because they aren’t linked to the people using the devices.
It’s as if each package that FedEx shipped had an identification number, but you couldn’t tell which one was connected to your package.
In some cases, registries are compiled to track specific devices, but these are relatively limited and inefficient because they have to be created one by one for each device, and they often offer no information about or access to the rest of each patient’s medical history.