Vendor Attraction to Improve the PTM System: A Commentary

Advancement in healthcare technology has shaped modern healthcare delivery. For example, a paramedic can now take a blood pressure reading using automated devices while loading medication. They can also view the capnography values or waves to check whether the endotracheal tube remains in position. Although the above are well- known examples, they are not unique to Prehospital and Transport Medicine (PTM). Perhaps a more specific example would be the replacement of a manual stretcher with an automated one, which was a response to the numerous incidents of injury sustained by paramedics: comparing the cost of rehabilitation after fracture or injury, combined with work absence, made automated stretchers the more cost-effective choice [1- 3]. Openness to ideas and critique, and a proactive approach to new technology will improve the existing system. So often, we rely on proactive agencies’ mod- els of how technology has improved their practice; perhaps it is time we appraise this role.

Vendors that supply advanced technology are profit- driven [4,5], but at the same time, their profit is contingent upon awareness of, and acceptability of, their products. On the other hand, as healthcare providers, we focus on patient outcome. Between those two poles of interest lies a common goal of improving the efficiency of healthcare. Unfortunately, this common goal is often obscured by the prejudice of profitability

Sharafaldeen Bin Nafisah is with Emergency Department, King Fahd Medical City, e-mail: Sbinnafisah@kfmc.med.sa (Corresponding author).

System: A Commentary

and conflict of interest [6,7]. For example, at one conference, a pharmaceutical vendor struggled to remain calm while fielding many questions about the findings of their published articles from the aspect of hidden profit, rather than the efficacy of the drug itself. This human paternalistic instinct is probably driven largely by conspiracy stories and the movie industry.

Recently, several advanced technologies have been made available. Portable ultrasound, a portable vein finder for intravenous access, automated chest com- pression systems, radiation detection for first re- sponders, and even Artificial intelligence in airway management [8]. Undoubtedly, any advanced tech- nology will need testing and enhancement before becoming a standard of care. However, the inability to reach a broader market made competition less likely, and the cost remained high. Several companies have not received any critique on their products simply because they were not given a chance to be tested beyond their research and development departments. Representatives had difficulty communicating with agencies to show their products, several of which were free to try (and the trial period may extend for months). This is an advantage to our practice, where cost/benefit analysis can be conducted [9,10]. For example, we tried several ultrasound machines before we agreed on one of them. We were also able to try and conduct virtual reality training for tactical medicine before we agreed on which of the companies to choose. And, just a couple of months ago in Italy, telecom companies offered – at no cost an entire communication system for use in field hospitals during a mega code disaster training event.

Cutting-edge technologies are seemingly limitless in our era, and the healthcare industry should become more proactive and open-minded toward such technologies. Vendor attraction will improve the PTM system and should be integrated into health reforming plans. We should maintain our standards regarding what is best for our patients, while being impartial and independent. Instead of being reactive, proactivity should be part of our daily culture.