The catheterization laboratory and interventional vascular suite of the future: Anticipating innovations in design and function

Abstract

Any attempt to forecast the function and design of the interventional catheterization laboratory and vascular suite presumes that current trends are an accurate window into the future. This must be recognized as a fallacious assumption; indeed, it can be quite amusing years later to review predictions of the future based on then-current proclivities. In fact, cardiovascular practice over the past 25 years suggests that one cannot predict accurately which innovations will succeed and which will fail based either on theoretical considerations or on initial clinical experience. Moreover, the “future” is a nebulous time and place; certainly, it anticipates progress that renders obsolete the current state of the art laboratory. It may be most practical to characterize the “medium” future, perhaps 5–10 years, rather than the “longer term” future, which grows increasingly indistinct. By beginning with certain economic and scientific realities, it may be possible to generate reasonable, educated guesses regarding the design and use of the catheterization laboratory and interventional vascular suite of the future. Despite these inherent pitfalls, the MultiSpecialty Occupational Health Group (MSOHG), a committee composed of practicing physicians representing all of the major cardiac, radiologic, and electrophysiological societies, has prepared this study and is making this document public for two reasons. First, in an effort to represent the needs of each society's members in influencing industry to improve and alter current laboratory designs [1], the committee determined that an attempt to develop a blueprint of the possible future laboratory would assist in such discussions. Second, MSOHG seeks to reach out beyond medical personnel to engineering and industrial interests in an effort to inspire thought, and perhaps invention, to bring a positive future much closer. By gathering together our current thoughts regarding trajectory, the consequent stimulus may lead to even better ideas than those currently conceived. MSOHG believes that a shared vision of the future could synchronize perspectives, whether optimistic or simply pragmatic, and could also encourage a sense of excitement where the potential for positive developments is concerned. The collaborative energy generated from such a dialogue can align physicians, paramedical personnel, and manufacturers in raising their expectations for the future and to actively participate in innovation, development, and positive change, rather than leaving all such constituents to passively react to their environment and wait for others to construct the pathway to an indistinct and nebulous future. Considering a shared vision may result in an energized sense of optimism and proactivity, which could help us move faster and farther than otherwise possible. An intentional conversation regarding the future may cultivate reasonable imagination rather than breed acceptance of relative technological stasis. We therefore consider a proactive open dialogue regarding the future as a constructive, and hopefully catalytic, effort. Naturally, the precepts on which one builds a conception of the future should be coherent and realistic, or the consequent predictions will be flawed. Although inevitably predictions are bright with the vision of limitless innovation and industry, and an ideal economic climate, reality typically is less utopian. A more balanced view, grounded in realistic prospects recognizing that tomorrow's opportunities are today's problems, is therefore more apt to lead to an accurate forecast. In this regard, the committee selected several observations as plausible starting points. Economics will play an ever-increasing role in the speed and nature of which emerging technologies ultimately are incorporated into clinical use. The pressure on physicians and the healthcare delivery system for economic responsibility is only gaining momentum. Few areas of the hospital have seen technology evolve a