5. • Standard accounting practice for
determining ROI
• Spread out fixed costs of capital over the
timeframe in which revenue is generated
• Hospitals allocate fixed costs to the
responsible department
Decision to Purchase a Robot Decision to Use a Robot
• Not standard practice for calculating
costs/profitability of specific procedures
Allocate fixed
robot costs
only to
robotic cases
Costs/case
increased
for robotics
More cases
done open/
laparoscopc
Decreased
volume of
robotic
cases
Sunk cost fallacy
LIMITATIONS OF LITERATURE: AMORTIZATION OF CAPITAL EQUIPMENT
6.
7.
8.
9.
10.
11.
12.
13. AVAILABLE SAFEGUARDS
Totally endoscopic (TECAB)
Minithoracotomy
safety frontier
Unsafe
Safe
Robotic Heart Surgery Tradeoffs
LESSINVASIVENESS
Sternotomy
• Standardized, automated
• Prerequisites understood
• Easy access to safety net (CPB)
LESSINVASIVENESS
AVAILABLE SAFEGUARDS
Safe
14. Totally endoscopic (TECAB)
Minithoracotomy
safety frontier
Unsafe
Safe
Robotic Heart Surgery Tradeoffs
Sternotomy
• Standardized, automated
• Prerequisites understood
• Easy access to safety net (CPB)
safety frontier Unsafe
Safe
Culture of safety
- “no blame” approach
- psychological safety
- collaboration
LESSINVASIVENESS
AVAILABLE SAFEGUARDS
16. Conclusions
1. Control for costs that are dynamic or sunk
2. Focus on the opportunity costs
3. Tie value into the “big picture”
Rational economic analysis of robotics:
Editor's Notes
However, the expert recognizes that limitations of available technologies, the team and organization where he/she operates causes a trade-off btw safety and less invasiveness and this creates a frontier. is Attempting to operate outside the frontier by performing less invasive surgery on patients that require more safeguards than inherently available is a hallmark of inexperience.
However, the expert recognizes that limitations of available technologies, the team and organization where he/she operates causes a trade-off btw safety and less invasiveness and this creates a frontier. is Attempting to operate outside the frontier by performing less invasive surgery on patients that require more safeguards than inherently available is a hallmark of inexperience.
