I work for a company called Capsule Tech. In the brochure, it says Qualcomm Life. We’ve just had a quick change in company ownership and I won’t go into any of that, but basically we’re a company that’s been around for the last 20 years. And what we’re dedicated to is to be delivering intelligent care by integrating medical devices so that you can realise the data and be able to do miraculous things for all clinicians out there. So that’s a brief introduction about what we do, and I’ve been in health care for the last 12 years almost now, and I love it. And I love the challenges that it represents and I love the fact that we stand for what we do and how we help people.
So we know that in the last decade or two that the world has significantly changed, and what’s really changed is about our expectations, and our expectations is that we have data readily available to us instantly. Who here doesn’t do online shopping? In fact I probably should have said who does then you can all engage and you can all put your hands up yeah OK. So everybody here does online shopping. And when you access via your tablet or your phone or laptop, you expect the data to be there instantly for you. You expect to Google and, you know, no longer have we got the old dial up internet and we’ve got all the time lag, you know, we expect the data to be instantly there, available to us when we’re in our home personal environments. And we have a lot of connected devices, so the few that I just mentioned there, and within those we have an enormous amount of data. And that data is now driving more and more analytics to be able to change our behaviours, to be able to look at what we purchase and what we choose to do as well.
Obviously I'm American. So I'm going to do my best to speak slowly. I'm going to do my best to also speak without using American sports analogies. So if I get lost, please help me. It's a wonderful thing that you invited us here. I bring greetings from the US. It's really amazing as well. I know that I'm about to present this topic and Nana has a question from Bath that says tell me about device interoperability. Makes me excited that you are interested in what we see is not necessarily what's coming, but what's now. So I'm very excited to tell you about what that means. So the way my presentation is going to break down is in two ways. First, I'm going to level set what interoperability means for those who don’t know. Then we're going to talk about the state of cybersecurity. And then we’ll give you some pointers so you can ponder how to verify if your device vendor is doing the things that are needed to make sure that you're safe. Good?
So, while this is up, I'll give you the background. My name is Terrence Carroll. I'm global director in infusion systems for ICU Medical. The name may not be completely familiar to you. We were once Legacy Hospira. Before that, we were the Abbott Hospital Product Division. So we went from Abbott to Hospira to Pfizer to ICU Medical all in about a 14-year period. We are globally known for our infusion therapy and technology. We are celebrating 10 years of this achievement: making the device talk to the EMR, to the e-prescribing system. So 2008, two hospitals - one in Lancaster, Pennsylvania; one in Baton Rouge, Louisiana - started the process with us and Cerner to make smartpump programming where you take the complete physician order and put it on the pump. Then in 2010, the next advent came, between us and Cerner as well, and at this point no other vendor has decided to join this space. So we decided to do this infusion documentation, taking all the data that’s generated off the system and putting it to INOs, patient charts, what have you. We’ll continue on that push of growth. The next part for interoperability for ICU Medical is also including Alert 40. OK. So where the industry is going in the US is to talk about alarms, alerts and how do you move them smartly in an escalation path to the clinician.
I’d like to do a wee bit more of an interactive session guys. So we’re going to have a wee bit of fun with this, I hope. So first of all just to say thank you very much for inviting me here, to John and to Ruth and to the team. And it’s really nice for me to be here on the 10th anniversary. It’s also really nice to be here because it’s the Marshall Arena and one of my passions is playing the electric guitar. And I’m probably one of the few guys in here who’s actually met Jim Marshall who invented the Marshall amplifier. And I’ve got two things to thank Jim Marshall for. One is all the pleasure I’ve had over 40 years of playing the electric guitar and the second thing I have to thank him for is the fact that I now wear two hearing aids. Anyway, so I had to come up with a snazzy title of something a little bit different and I came up with does our opinion count?
So the way things worked in the old days, we’ll come to in a minute, but first of all, as part of this interaction, what I would like to do is I want you all to imagine that you are the House of Commons. So I already see a couple of folk who are actually asleep at the back there anyway. So wake them up please. So I’d like you all to act like a complete shambles. Now, what we’re going to do is we’re going to have an indicative vote here. I would like, you’re going to get three options here, and your options are, you’re going to tell me, are you busy, that’s your first option, and secondly are you very busy, which is your second option, and your third option is that you’re too busy to get involved with equipment procurement. So let’s have a show of hands on option one, who’s busy? OK, right. Who’s very busy? Oh that’s a bit more popular. And who’s too busy to get involved in equipment procurement? Oh you took your hand down awful quickly there, yes. So what that does tell us is that we’re all busy. We’re definitely all busy, but we should be getting involved in that and we’re going to talk a wee bit about why.
Good morning everyone and thanks for inviting me to do this talk at the 10th EBME conference. That’s really exciting. It’s been really lovely to see some old faces and ex-colleagues, clients, and just generally I feel like the conference has got a real buzz about it so I’m delighted to be part of it.
So, today, I am going to be talking about procurement and the transformation agenda, but I’m going to hopefully but a little bit of a different spin on it to perhaps what you would normally expect. So we know that procurement’s role is actually changing. So the first and hopefully obvious statement is that procurement is more than purchasing. So I think for many of us we’re very experienced with the transactional nature of procurement. I call it the tap-tap function - I think Mike Giles will probably be familiar with where that terminology comes from - and that is really around placing orders and all of the tasks that are necessary to do that. And that’s not what I’m going to talk about today. I’m going to talk about procurement more in terms of the transformation and where we need to be going for the future.
Hopefully many of you will recognise some of the stages of the procurement process and hopefully will be involved in most of those. But I’ve got a feeling that we’re not as involved as we should be. And I think that’s probably the key message that I’d like to get across during this presentation and perhaps in the discussion. I think rather than go through those stages, because some of them are very obvious, I think as you go towards the lower part of that slide you will actually recognise that you do get involved in helping to set up trials and evaluation and implementing new technology into use. And that’s generally, because let’s be honest, when you find out that something has arrived someone has to do something about it. And that’s not really good enough. So what we need to do is make sure that we’re in right at the beginning of the process, and the beginning of the process is about actually identifying what’s needed in the first place. And what’s needed in the first place is not necessarily what the clinician thinks they need, it’s not necessarily what the finance director thinks you need. So actually we need to put more intelligence into actually looking at what’s required in the very first place.
I’ll introduce myself in a minute because the first few slides kind of do that. So thanks for inviting me to come. When John asks you to come to this it’s a couple of months ahead so I’ve become quite skilled at coming up with titles for talks that means absolutely nothing so that you can change them on the day. And so that’s what I’m going to do. So hopefully the slides, we can make them work. Now I think the best introduction for the talk I actually got from a comment I got from Ted last night. So I was talking about my 16-year-old son who has to make the decisions about what courses or what subjects he’s going to do through school and university now. And Ted said that actually kids these days have to think about having three careers, because the pace of change is so fast that really you have to think about, and, you know, what is that, it’s such a weird thing to be doing, to be trying to decide whether you’re going to do maths or history now.
And so that really stuck with me, and I actually think that’s a really good introduction for this talk. Because what I’m trying to do with my colleagues in Ireland at the moment is a bit of a social experiment. We’re trying to imagine what is clinical engineering really going to be in the next 10 years, and you’ll see why in a minute. The same son I recently had a conversation with about actually whether we were geeks or dorks. So this is my only joke, right, just picking up I’m not going to try and do jokes after Ted. Whether we were geeks or dorks and we were having this conversation and then my 13-year-old daughter turned round and said it’s very clear you’re both at the same time. So I think that kind of did it for me.
Just by way of introduction and to give some context to my talk this morning, I first met John back at the end of 2014/15 when we were reviewing how we were going to go forward with biomedical device management, not only around maintenance but actually around procurement as well. And so my presentation this morning is in that context. We began the journey back in 2014 and I’m going to bring you forward to where we are now. I appreciate that some of you, you may be where we were back in 2014 and some of you may be well ahead of where we are now and perhaps some are in the middle, but hopefully for all of you there will be something you can take out of what we’ve embraced at the RNOH.
So, very briefly, I’m responsible to our executive directorate for the oversight of outsourced services, and that includes clinical engineering, pathology and a number of other clinical supplementary services, like vascular surgery and cardiology. I oversee the capital and revenue budgets for medical device replacement, and I also oversee the revenue budget for ongoing maintenance and planned periodic maintenance periods. So we are the largest hospital in the UK. That’s the Royal National Orthopaedic Hospital. We are the largest orthopaedic hospital in the UK. We are regarded as a leader in the field of orthopaedics, and we train approximately 20% of the UK’s orthopaedic surgeons. So it is our thing for want of a better term.