Hospital and physician partnership in the acquisition and use of high-cost niche technology.

The addition of the ventricular assist device to the compliment of interventions within a high-quality cardiovascular program can be justified based on the potential reduction in ICU days for patients with right ventricular failure and/or left ventricular failure following open heart surgery. The improved outcomes associated with appropriate patient selection further serves to strengthen the justification. Close cooperation among physicians, administrators, manufacturers, and competing centers can make even highly specialized technology a valuable and cost-effective addition to the community.