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Implications for Time Savings Using New Intraoperative Measuring Technology

      Objectives

      Intraoperative threshold measurement is a part of the cochlear implantation procedure and in the current setting conducted by the clinicians with a standard set-up. The newly released CR220 Intraoperative Remote Assistant is a handheld device and can also be used by someone already in the operating theatre (OT). The aim of this study was to compare measurement time with the new CR220 and standard set-up and to investigate from the clinic’s perspective any cost-savings created as a result of time-savings with the new device.

      Methods

      Stages of the measurement process are identified and the time is measured for each stage during 113 patients' implantation procedure. A literature review was conducted to identify the reimbursement level of this process in order to translate any time-savings to cost savings.

      Results

      When the clinician travels to the OT, the mean time spent per procedure with CR220 is 8.4% less than the computer set-up (163.7 minutes vs 149.9 minutes). If the measurement is conducted by someone already in the OR, the measurement time is reduced by 95.5% with the CR220 (163.7 minutes vs 7.3 min). Literature review revealed that the fee for measurement as $18.99-22.57 per 15 minutes in the US setting and in most of the other settings this procedure is not reimbursed separately but covered under cochlear implantation.

      Conclusions

      The analysis showed that considerable time is spent for the clinician to travel to OT and waiting in the OT. This “unproductive” time is not only wasteful, but also means the clinician is not available in the clinic seeing patients where their expert skills are of most value. Moreover the clinic is either underpaid or is not paid at all for this expertise and time demanding process. The new CR220 gives clinics the opportunity to allocate their limited resources efficiently.