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NEWTAC not your average CON group
The New Medical Technology Advisory Committee marked its fifth anniversary last summer. The group was established by the state’s Certificate of Need Commission in 2006 to help identify the latest services and technological advances that are appropriate to be included as clinical services. The idea is to highlight these offerings in the earliest possible stage of development.
NEWTAC has eight members, including Grand Valley Health Corp. President Ron Palmer. He has served on the committee for the past two years as a representative of the Alliance for Health, where he sits on the Evaluation Board. From his time spent on the committee, Palmer feels NEWTAC’s value lies more toward the theoretical side than the practical approach most CONs employ.
“The value in it is not what most people would think because I don’t think they’re really reviewing technology that is ready for implementation, and I would call that new technology. They are far more getting into the review, and the review is far more around the people who are currently anticipating doing something in three years or something like that, or a technology that they are considering and want to find out whether this is going to be a technology that might be approved,” he said.
“From the standpoint of it being a regulatory type of a committee, it’s far more informational and really quite esoteric. What people might really want from it is an answer to the question: Is this really a positive, cost-effective technology? It’s going on a much more theoretical level than that,” he added.
Palmer said most of the time NEWTAC doesn’t receive requests for new technology like other CON bodies, such as the local Alliance for Health, do, where a specific item with a specific cost and number of jobs is listed from a specific medical provider.
“It’s not like that at all,” he said. In fact, Palmer said NEWTAC can meet for months before the group has something of significance to review.
“Most of the time, there aren’t any. In other words, when it’s been reviewed and all of that, they haven’t really come up with anything that they feel needs to be reviewed by the committee,” he said. “And when there are things that people are asked to look at, it’s very sophisticated, very preliminary technology.”
One item Palmer said NEWTAC recently looked at came from the University of Michigan, which wanted to work with a private firm that has a technology it wants to advance and had agreed to pick up the tab to have its offering on the campus. Doing that would mean U-M would become the only location in the nation for the advancement.
“It was theoretical technology. There wasn’t any proven use for this technology. So it wasn’t the kind of evaluation that says, ‘We know this has worked some of the time. Is it cost effective? Is it a positive technology to go forward with?’ It’s really almost at the first level of the clinical trial type of things, and we have to have the technology to even be able to do the clinical trials,” he said.
The main question that NEWTAC is seemingly charged to answer is whether a new technology is a potential solution to a medical dilemma or to an existing procedure, like possibly using the latest sound-wave treatment to kill cancer cells instead of continuing with chemotherapy and radiation. Members have been given criteria to guide their reviews, and one is whether a new technology will or will not significantly contribute to health care cost inflation.
Palmer said the group’s members haven’t gotten to that criterion in his time on the committee. He added that most of the technologies are so new and untested that to try to extrapolate how much a technology would actually impact costs would be impossible. He pointed to Positron Emission Tomography scanner systems as an example. When the scans first emerged, a basic question was, how would the PET technology be used?
“There were very, very, very few things that it was looked at for being useful for, so the question was, should anybody have a PET scanner? Of course, the orientation is we probably should have one in the state. But might this become very costly? Well, the answer is how many uses there are for it,” said Palmer.
“So if this became expensive for some things that aren’t used very much, the overall impact in the state probably wouldn’t be much. But if this ended up with a lot of different uses, and people started using it a lot, it could be. So it’s very difficult to get into that level of discussion until you almost have a proven technology.”
But Palmer said NEWTAC plays an important function in that it brings someone in who has an idea for a new medical technology while the technology is in the early stages, so he or she can get feedback on it and its potential use from other people who work in similar fields.
“This is a group of Ph.D.s and M.D.s who are really looking at what might be called very emerging technologies in the beginning stages,” he said. “They’re looking at it not from the standpoint of the application of a technology, but rather from the theory of a technology, and from their perspective, whether they think theoretically that this technology can be effective.”