The Pipeline

Your PCI readmissions rates are going public—how clinical technology can help

Chris Pericak, Technology Insights

The percutaneous coronary intervention (PCI) business has recently been under microscope. With readmissions rates recently going public, PCI seems like a thorny spot as providers shift toward value-based care.  

Yet, some hospitals may see an opportunity.  An alternative approach, Radial PCI, could improve efficiency, outcomes, and lower costs.  No wonder it’s catching the eye of administrators who are using a new framework for clinical technology investment.

Radial PCI can lower cost of care, shorten LOS, and reduce readmissions

As shown in the infographic below, radial PCI can improve episodic performance by directly reducing the cost of care, improving efficiency with shorter patient length of stay, and reducing readmissions—a crucial clinical outcome.

And the market has responded.  A recent study, published in Circulation, shows a 13-fold increase in radial PCI adoption since 2007, with radial use rate increasing from 1.2% to 16.1%.

As seen in the chart below, studies show that, compared to the femoral access alternative, radial PCI demonstrates reduced bleeding rates, a trend towards lower mortality, and improved quality of life. Moreover, patients who undergo radial PCI instead of traditional femoral PCI, experience a 17% decrease in ICU length-of-stay and a 0.4 day shorter length-of-stay overall. 

These improvements can result in not only higher quality care but significant cost savings when applied to a hospital’s PCI population.  Moreover, Radial access PCI reduces vascular access bleeding, one of the most common post-procedure complications contributing to 12% of PCI readmissions.

What’s the catch? A steep learning curve

Radial PCI may seem like a win-win investment, especially since the technology does not require any additional device costs. Alas, a significant learning curve for radial PCI has made physicians hesitant to adopt. Because of the smaller anatomy, physicians may find it hard to gain access through the radial artery, resulting in prolonged fluoroscopy time. 

Since most physicians are comfortable with standard femoral access PCI, many programs have a hard time justifying the additional training needed to roll-out a radial PCI program. Yet as administrators alter their technology purchasing framework to support value-based care, they must evaluate this important trade-off.

More Help With Clinical Technology Evaluation

What other metrics are there for investing in clinical technologies in the future? What other technologies are well-aligned (or poorly aligned) with new value-based care objectives? Technology Insights members can read the full study, The New Framework for Clinical Technology Investment.