Four of biomed’s top luminaries ruminate on 2020
How do you measure a year—particularly one that has been as life-changing as 2020? It’s a tall order, and one 24×7 Magazine asked four of HTM’s rising stars to tackle.
Below, Maggie Berkey, a senior biomedical equipment technician for CommonSpirit Health; Danielle McGeary, CHTM, vice president of healthcare technology management at AAMI; Jeffrey Ruiz, TRIMEDX, technology manager, healthcare technologies, Holland Hospital in Michigan; and Nathan Lynch, a biomedical cybersecurity advisor for Kaiser Permanente; discuss how the pandemic has disrupted operations in the HTM sector and why the new “normal” may be here to stay.
24×7 Magazine: The coronavirus pandemic has obviously dominated the headlines in 2020. From an HTM perspective, what were the biggest changes COVID-19 brought to the industry?
Jeffrey Ruiz: The ability to communicate virtually was really brought to the forefront. Not only did we have to communicate virtually with our own respective teammates, but also with various [hospital] disciplines, outside sources, and manufacturers. We also shared ideas via social media. Best practices that were identified overseas were quickly shared to hospitals in the U.S. Technology and sharing of ideas have no boundaries, and that was really great to see in the HTM community.
[Another change brought on by COVID] was the use of 3D printing. With COVID, we had to think outside the box. Our hospital, for instance, ran out of touchless thermometers. As these devices became scarcer to source, our hospital was in an unfortunate position of not having enough thermometers to scan patients and staff, negatively impacting patient care. With HTM’s “can-do” spirit, our team developed 3D replacement parts that kept the fleet of thermometers up and running. Although we are in the early stages of 3D technology, we will see how it can best serve the HTM field.
Danielle McGeary: When COVID first hit hard in March, one big challenge for HTM professionals was access to PPE since PPE was being saved for clinicians, due to its scarcity. This then expanded into access of medical equipment parts and service for all types of medical equipment—not just ventilators. Many states, including those in the Northeast, had (and still have) very strict quarantine rules for out-of-state travelers—and this created challenges for getting immediate service and contracted PMs completed since field engineers who had to travel into these states were required to quarantine for two weeks, in some cases.
COVID also heavily impacted HTM academic programs. Most programs that were designed to be delivered in person had to go 100% remote, and this robbed many BMET students of precious lab time and hands-on learning via internships. For a field that is already facing a workforce shortage, having the future generation of HTM professionals’ education disrupted, in terms of hands-on learning, is concerning.
Maggie Berkey: One of the most visible changes is that standard precautions have taken a higher priority as PPE during every encounter is becoming second nature. Healthcare systems continue to face ongoing operational changes—so much so that we are now discussing our “new norm.” Many facilities have creatively transformed existing spaces to accommodate more patients or keep COVID-19-positive patients distanced from the general population. And most of us have felt the impact of the shutdowns, with backordered or delayed parts shipments and longer turnaround times for OEM service requests.
I hope the biggest change that will come from the pandemic is a boost in our manufacturing sector. Today, we are keenly aware of how crucial healthy supply chains with access to a variety of supplies is to maintaining patient care. We must never again be at such a costly and dangerous disadvantage, especially when it comes to basic PPE and critical supplies.
Nathan Lynch: The biggest changes COVID-19 brought to the industry were equipment utilization and an increased awareness of biomed, in general. COVID-19 will bring increased visibility to equipment utilization and capital planning as we continue to move forward. We saw the need for visibility and utilization of critical devices for COVID-19 patients, and this increased visibility will result in better management of devices and greater collaboration of biomed within the hospital.
24×7: Do you think the healthcare industry—and HTM, in particular—will ever go back to the way things were pre-COVID?
Ruiz: I certainly hope so—as humans, we are social creatures. I think of past AAMI Exchange meetings and the great collaborations that [took place] between presentations. Such encounters are invaluable to the HTM community and to healthcare, in general. Hopefully, we will return to live, face-to-face interaction. Until then, we will have to use technology, such as social media, to help share best practices and ideas across our HTM landscape.
Berkey: No, and I think that’s OK. We can use this as an opportunity to sketch an outline for what we want the future of our industry to look like. We have been trying to do “more with less” for a while now. We have opportunities to impact and drive down the cost of business when we have the tools, support, and resources needed to thrive.
Having strategic organizational plans that focus on value-added activities—paired with proper training, service literature, and strong collaborative networks—will ultimately drive up the value of HTM departments while simultaneously lowering operational costs. Personally, I think we should use COVID-19 as a turning point in our industry to showcase our natural ability to bring practical solutions to complex problems.
Lynch: I think the specifics (i.e., which devices are critical) might change, but, overall, I believe the changes brought on by COVID-19 are here to stay. But I do think better management of devices, understanding device utilization, and an increased awareness of biomed are all positive changes that will benefit the industry and hospitals alike. COVID-19 has been devastating across the world, but I do think it has brought about positive changes to the field and helps demonstrate the value we bring to hospitals.
McGeary: I’m not sure the healthcare industry will ever go back exactly to the way it was before the pandemic. At a minimum, COVID has redefined how we all view infection control and the types of technology hospitals are utilizing to offer care outside of a traditional hospital setting. The pandemic has also changed who is required to be physically at work 40 hours a week. With space being at a premium inside hospitals, I would not be surprised if hospitals took a hard look to determine which positions could stay remote.
Finally, healthcare took a massive financial hit due to the pandemic, and cost-saving measures will be at the forefront of health systems’ strategic plans in 2021. And this will certainly impact HTM departments, which will be asked to do the same or more with less funding. It will most likely impact travel and training budgets as well.
24×7: Career-wise, what were the biggest lessons that you learned in 2020?
Lynch: Change is an inevitable part of your career—how you deal with change and embrace it will go a long way in making you better equipped for future challenges.
McGeary: I certainly learned that we are all more agile and capable than we think. Just when we think something is not possible, we can pivot and still make it happen—such as working from home with no childcare. It is amazing how connected you can feel to your organization and what you can execute remotely, even when you have not seen your colleagues in-person for almost nine months.
Berkey: The need to be proactive and anticipate customer needs is a lesson that has been blaring in 2020. This continues to be a challenge, with the tasks of prioritizing respiratory therapy equipment maintenance and stocking parts that might be needed next week while simultaneously balancing routine repairs and the regular preventive maintenance load. We are all striving to keep critical devices available as we keep watching our census numbers climbing.
Ruiz: Don’t underestimate the value of your team. There is no greater experience than gathering your team and working together to solve problems. At HTM’s basic core is our ability to solve issues. It was great to have these types of problem-solving sessions with the team and hear their ideas and suggestions. If you can provide an environment that allows you to tap into the diverse background of your team, it will help provide a framework to handle future challenges.
24×7: What emerging healthcare technologies are you most excited about and why?
Lynch: I am very excited about applications of blockchain technology within the healthcare industry. I see a lot of value in this new technology that poses a lot of opportunities to revolutionize healthcare technologies. Blockchain technology is still in its infancy, but we will see more and more uses of it as time goes on.
Ruiz: For the past few years, there has been a lot of discussion about telehealth. With COVID-19, we have seen many healthcare organizations and manufacturers work together to utilize telehealth to their full advantage. Telehealth has been a very valuable tool to provide a front line, outside of the hospital, to care for and triage patients.
McGeary: The advent of “hospital at home” and increasing telehealth capabilities. If COVID has taught us anything, it’s that you do not necessarily need to be face-to-face to receive care, depending upon what the health concern is, of course. I also strongly feel that 3D printing is going to become more and more prominent in healthcare and in HTM. Many HTM departments across the country have utilized 3D printing during the pandemic to assist with healthcare needs. One specific example is creating ear guards for clinician face masks.
Berkey: I’m really excited to see us start to maximize the technology that has existed for a while now. Virtual meetings provide a platform to gather remotely which, in turn, helps us be more inclusive and collaborative. I am also excited about how the telemedicine and home healthcare markets are blooming. At the same time, we are seeing more devices with smaller footprints. This introduces new, exciting challenges for HTM and forces further innovation and outside-the-box thinking.
Technicians today are being tasked with learning at the speed of technology. I’ve got to give a shout out to AAMI for leading the way. During the pandemic, AAMI has continued to provide guidance and share resources to keep front-line professionals abreast of what is coming around the bend. After coaching kids in VEX robotics and seeing a brief introduction on how we can utilize artificial intelligence to forecast equipment maintenance needs, my eyes were opened to just how bright our future is.
24×7: In addition to the fallout and second wave of COVID-19, what do you think will be the biggest issues in the field in 2021?
Berkey: Unfortunately, the talent shortages are ongoing. I remain hopeful that this issue will ultimately drive up demand, and thus, pay discrepancies in our industry. I am proud to report that I led an AAMI Technology Management Council subcommittee that worked with the Department of Labor to submit a proposal earlier this year for a national apprenticeship program, including an on-the-job-training outline, which will provide another option for BMETs to enter healthcare technology management without going through a formal institution to earn a degree.
Ruiz: For all practical experiences, we are in the second wave. Communities that appeared to miss the brunt of the first wave have been hit with a vengeance. As much as we hoped and prayed that COVID-19 would fade a bit, for at least the foreseeable future, we all must continue to manage and adapt to the challenges COVID-19 presents. This makes causes like the Right to Repair take center stage.
My continued hope is that manufacturers, ISOs, third-party vendors, and regulatory agencies can find some common ground and provide concrete solutions to servicing medical devices. All parties involved will need to offer some productive concessions in the name of patient safety. I feel that we still have a long way to go, but we are starting to make strides.
McGeary: Cybersecurity is going to continue to be a major concern as we head into 2021. Many hackers are seeing COVID-19 as an opportunity to capitalize on healthcare systems’ security gaps.
Lynch: I think COVID-19 has brought increased awareness of device utilization, which will be here to stay. I think this will continue to be something hospitals focus on as we move forward. But besides the pandemic, [I agree that] cybersecurity will be at the forefront of every biomed department.
Each year, we have seen an increase in security issues specifically related to medical devices. This trend is not disappearing and will only worsen as we move forward. Even as biomed is spread thin with the consequences of the pandemic, we still need to be diligent in preparing for cyberthreats. It is easy to lose focus on cybersecurity during the pandemic, but it will pay dividends to continue putting forth effort now for a more secure future.
24×7: What do you think are the biggest misconceptions about the HTM field and why?
Ruiz: I think there is still some mentality that we are a “break/fix” industry. Although we will always have this responsibility, we are so much more than this. Our collaborative relationships with IT, facilities, and clinical teams provide so many solutions to the healthcare community. In the many meetings and roundtable discussions I’ve attended, HTM is almost an afterthought. Then, as the discussion builds and we share our experiences and lessons learned from previous challenges, it becomes very evident the value the HTM community provides.
Unfortunately, our value is usually felt in times of stress or in a pandemic. The more we can share our experiences, as well as the wins that we have each displayed this year, the better position we will be in to continue to support the healthcare community. We owe it to our patients to do so.
McGeary: The biggest misconception is the lack of knowledge that the HTM field exists at all—if you consider that a misconception. When ventilators were in short supply, everyone tried to help. While this was all well intentioned, it can be very dangerous. The general population does not realize that there are skilled professionals who have gone through rigorous training to be able to work on critical, life-support equipment.
Berkey: There are no guarantees that our profession will exist (and certainly not as it is today) 25 years from now. Sure, things will always break, but we continue to see more and more disposable technologies that have already impacted how we monitor and care for patients. We must embrace evolution and never take for granted the importance of service excellence. It is imperative that we continue to provide quality and value-based maintenance, innovative solutions, as well as support for every customer.
The greatest advantage we can give the future of our industry is collaborative partnerships with OEMs. As the Right to Repair debate continues, we are learning that in order to secure the projected growth in this field, we must advocate for our trade and showcase our credentials. There is a greater need than ever before to validate competence within our profession to ensure that we continue to have access to OEM support and resources.
Lynch: I think it is easy for people outside the industry to lump us in with facilities or IT departments. I’ve seen it both ways, and it increases the confusion around who does what. I think COVID-19 has brought about more awareness for the field and helps differentiate us from facilities/IT. Along with cybersecurity issues, the overlap with IT will increase, which will continue to muddle the waters for HTM.
Another misconception is the fact that a lot of the time HTM professionals aren’t the ones buying medical equipment. Hopefully, the increased collaboration will apply to equipment purchases because HTM can provide valuable insight to hospitals from a cyber or device utilization perspective.