For hospitals, it is replacement of outdated equipment. For example, when a telemetry system is replaced, there is no additional revenue for the hospital. The cost of replacement is purely expense, with no revenue to offset it. From a healthcare technology management (HTM) perspective, the major issue continues to be a lack of quality leadership. When departments are outsourced, or not allowed to hire additional staff, or send existing staff to training schools, it can be traced directly back to inadequate leadership in the HTM department. Biomed leaders are not schooled in business decision making and therefore tend to use technical justifications to convince nontechnical people to act. Business leaders, including our hospital administrators, are taught a very specific way of making business decisions. HTM leadership does not usually have this capacity.
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