Using Healthcare Technology Management Tools to Improve Efficiency & Safety
When: Wednesday 18th November 2020 - 1pm
Speaker: Rob Davies - ECRI
Synopsis With increased pressure on healthcare organisations around the world to deliver a safer service more efficiently, it is now more important than ever to make the best use of the tools that are made available.
Knowing what technology you have is only the beginning, it is vital that it is available to use, is fit for purpose, can be easily located and people know how to use it and when it should be replaced.
This is information that everyone within the healthcare environment needs easy access to. Healthcare Technology Management is no longer a responsibility that is just dealt with in the basement with screwdrivers and soldering irons.
I was interested in what Rob was saying about equipment connectivity. Perhaps honourable mention could also be made of the "Internet of Things" (you know, where the toaster and the 'fridge get to exchange jolly banter in their off-duty moments). We could also use terminology like "equipment feedback" and (perhaps better still) "condition monitoring". This last mentioned (condition monitoring) has been used in industry at large for many years; temperature sensors on critical bearings, for example - with signal cabling back to the Control Room (in factories, power stations, ships and what-have-you).
We have touched on this stuff here on the forum before. What data needs to be collected; what signals need to be fed back? Battery condition? PM due (by date, hours run etc.)? Error codes? ... ?
And what can the humble suction pump (for example) be expected to bring to the party, especially when compared with (again, for example) the haematology analyzer?
It would be interesting if we could hear from the biomed Illuminati about this issue. Can we come up with a rational approach across the board, or should each type of equipment be considered independently (syringe pumps -versus- patient monitors -versus- anaesthesia machines ... etc.) (I tend to this approach in my own mind); or should we simply let the manufacturers just get on with it (this being the most likely outcome anyway).
Data can also usefully flow in the other direction, of course, as Rob mentions. Remote fault finding (already well-known in major imaging equipment), and "global" updating of software being two examples.
Standardization sounds like a good idea, but off-hand I cannot think of a single case where "official" standards (AAMI, ANSI, IEC, ISO and all the rest) has led the way. It has usually (always?) been industry that has blazed the trail of innovation. There are countless examples:- Centronics, RS-232, ISA, PCI, USB, indeed the IBM PC, Ethernet, Bluetooth, Wi-Fi ... even (my favourite) PP-3. Not "re-inventing the wheel", Rob ... but rather clever blokes (mainly) taking "genius" steps forward (aka innovation).
Lastly, let's hear it for the "basement dwellers". I'm sure I'm not the only one who only saw the sun when I emerged for chai and a well-earned falafel. But we were the custodians of equipment data even back then - even if it was only a box of equipment record cards (one for each item - but grouped for minor items) and another box (or if you were lucky, a set of Kardex file drawers) for job cards. Stock cards (for spare parts etc.) in the stores. The PM schedule was the calendar on the wall (a user department or two each month) - Pirelli preferred.
I might add that folk were talking about "coming out of the basement" (metaphorically at least) "coz we don't get no respect" at least 45 years ago. I never really saw all that as an issue, myself. "Turf wars" remain, however (demarcation issues with "Estates", facilities, IT and even Nursing); as I have mentioned on here a few times before my "answer" to all that remains having a Technical Services Director in every hospital with the Biomed (Clinical Engineer, if you insist) as the prime candidate for that position.
Finally, a word about ECRI. One of the good things about those happy years working overseas (mainly the Middle East, in my case) is that we came to hear about - and admire - ECRI. The famous "Health Devices" PM system; and the "Product Comparison System". Back then, I found nothing of that quality in the UK (and indeed rarely came across anyone who had even heard of ECRI).
I believe we can also throw into the mix such headings as Telemetry (something that most of us would have come across in the hospital setting), as well as RFID ... and, indeed, the whole subject of Data Logging; all these are what we may call "known methodologies".
Not to mention Cerner, and the variations of the "medical equipment bus" (BMDI, MIB - ANSI/IEEE 1073 et al) - variations being one of the points made by Rob, of course.
Although I guess that Rob was really talking about the hospital - or even "the bedside" - scenario, many of us will also be interested in other settings ... such as "the community" (patients' homes), clinics, and remote locations (eg, out in the desert). Regarding places such as these, I was pondering some years ago about how equipment could "call for help" (bleat?) - without any need for user intervention - via SMS.
At that time I was thinking in terms of relatively simple stuff:-
1) Battery condition (how to ascertain?) 2) Dropped flag (a tilt switch, maybe) 3) PM due flag (by date)
The idea being to make best use of manpower by only sending out a visiting technician when the equipment actually needed some TLC.
In moments of advanced pipe-dreaming, I was also wondering about picking up an accurate time signal from Anthorn (in the UK), plus a few other things (especially when considering infusion pumps).
... but how to actually obtain (engineer) such data from each item of equipment? Some sort of interface box stuck on the side (or better, still - inside)?
We could also consider feedback from "Personal Health Devices" (PHD - see ISO/IEEE 11073) and "Point of Care" (PoC) equipment.
When you think about it, there are many technologies which could be applied ... the "problem" being which one to go for (and invest in); and, as already mentioned, what data needs to be gathered and posted out (back). And there again, there is the cost - and cost-benefit analysis - in other words:- is it worth it?