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Non-invasive, continuous measurement of oxygenation reduces the use of invasive methods to obtain blood samples for analysis. Nihon Kohden in Japan invented the pulse oximeter in 1974 that a practical measurement device was conceived. The photo shows the finger probe attached to a physiological monitor with pulse oximeter capabilities. Pulse oximeters display oxygen saturation, pulse rate, pulse strength, low battery, and alarms.
Clinical Effectiveness - The extent to which a specific intervention, procedure, regimen, or service does what it is intended to do under ordinary circumstances, rather than controlled conditions.
Health Technology - Any intervention that may be used to promote health, to prevent, diagnose or treat disease or for rehabilitation or long-term care. Technology assessment is a critical step in the healthcare technology management diagram shown below. Technological and clinical obsolescence occurs over various timeframes according to the technology. Technology assessment determines the clinical value, risk-benefit ratio, and cost-effectiveness of new healthcare technologies.
An excellent resource on the web is NIH's HTA 101: Introduction to Health Technology Assessment.
Macro HTA is an evaluation of the safety, efficacy, and cost-effectiveness of new technologies within a health system or country, considering legal, social, economical, cultural, and ethical aspects. To prevent premature adoption of unproven technologies that may not be efficacious nor cost effective. To maintain a proper order of priorities for allocating clinical services within a geographic area.
It assesses the value of the technology and its significance against the other healthcare needs of a nation. International Network of Agencies for Health Technology Assessment (INAHTA) - the network of non-profit organizations promoting the exchange and collaboration, information sharing of HTA data.
As was previously discussed in the Planning topic, the Council on Technology and Innovation (CTI) at the Centers for Medicare & Medicaid Services (CMS) oversees coordinating coverage and payment processes for Medicare with respect to new technologies and procedures. Some of the HTA activities are clinical assessment, networking - current user surveys and site visits, understanding the level of technology required, e.g. Strategic Plan - what is the correlation and impact on the hospital's or health system's strategic plan? The HealthIT agency from the federal government estimates the costs for an electronic health record looking out over a 5 year total cost of ownership at How Much Is This Going To Cost Me? Are you worried that your employees at office or your kids at home might be visiting unwanted websites.

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It is commonly used in the hospital in the continuous mode for critical applications and intermittently for less critical patients. This includes the pharmaceuticals, devices, procedures and organizational systems used in health care. This optional reading covers assessment directed to any type of health technology from drugs to medical devices.
The goal of health technology assessment is to provide input to decision making in policy and practice.

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The private insurer, Blue Cross and Blue Shield, has a Technology Evaluation Center to help make decisions on coverage and payment for technology procedures. TCO encompasses all costs associated with a technology from the time the first expenditure is made to purchase the technology to the point where the last expenditure is made, e.g.
For example, laboratory analyzers using reagents have a large percentage of the costs going to consumables.

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A second paper by Katalus Advisors, surveys healthcare executives as to their perspectives on total costs in Total Cost of Ownership - Electronic Health Record Systems.
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Pulse oximetry is frequently incorporated into vital signs monitors measuring heart rate, blood pressure, and temperature. Making these determinations of regarding the expected life of technologies is part of technology assessment.
Information is available in the clinical research literature, but this data has to be qualified based on the unique aspects of the local situation. Appropriate technology cost analysis requires consideration of not only purchase price but also installation, operating, financing, disposal and other costs over the working life of the device. Magnetic resonance devices using active magnets have astronomical electrical and water cooling costs.
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Cobalt radiation therapy devices are associated with a high disposal cost for the radioactive source. An example is CT Scanners where the slice count keeps increasing with some manufacturers gantries (see photo below of a CT gantry with the covers off) not being adaptable to the upgrade.

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