• What are your minimum performance requirements? Categories to con-
sider include image quality, the availability of advanced imaging
modes, ease of use and safety (including scope heating from the light
source). Letting your surgeons trial several systems is likely to high-
light many of the shortcomings in these categories. Pardon Kenney,
MD, chief of surgery at Brigham and Women's Faulkner Hospital in
Boston, which recently renovated its ORs to include a new 1080p
endoscopic imaging system, says that when trialing a new endoscopic
system, get as much buy-in from staff as possible. "We looked at a
variety of companies and made them bring in test versions so the sur-
geons could use them," he says. "Then, we sent out a poll to surgeons
and had them vote, so it was a democratic process. We also made the
companies aware that they were competing, which got us the best
price possible."
• What is the total cost of ownership of the system? This includes service
requirements and parts replacement. Forwards and backwards compat-
ibility of the components may help to reduce or distribute the cost of
upgrading over a longer time period, says ECRI. Reprocessing require-
ments — autoclavability is generally helpful — and interoperability of
the video system with your facility's PACS (picture archiving and com-
munication systems), s and OR integration systems are also keys.
Try to stick to a single vendor, if possible. Dr. Kenney notes that
before their renovation, Brigham's ORs had equipment from one com-
pany and hardware from another, which led to big problems when
there was a failure. "When a wire would break inside the booms, the
one company would blame the other and vice versa," he says. "When
we went with new rooms 18 months ago, our business manager insist-
ed that the room be done by a single vendor to make things easier."
• Where is the system in its life cycle, and what technology will be coming
along next? Many manufacturers market a device for about 6 years;
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