By Chris Hayhurst
With 2019 coming to a close, 24×7 Magazine asked four industry leaders for their thoughts on where medical technology is headed, and for the trends that they think will impact HTM in 2020 and beyond. Here’s what they had to say.
Home Care Will Continue to Grow
The rapid growth of the Internet of Things (IoT) along with technologies that permit medical device integration is fueling a corresponding boom in home care, and that has implications for the HTM profession. “We’re seeing more and more Wi-Fi-enabled devices that allow remote monitoring in patients’ homes,” notes Danielle McGeary, MS, BME, CHTM, PMP, AAMI’s vice president of HTM. “That really affects HTM because tradition- ally we’ve been trained to maintain devices within the hospital, but now we’re redefining what a medical device is.”
Perhaps the biggest challenge associated with home care will involve issues related to cybersecurity, McGeary says. “A home network is never going to be as secure as a hospital’s network, and that’s something health systems really need to think about.”
As HTM professionals take on new responsibilities related to the distribution of devices to home- based patients, they will need to ensure that patient data is protected, McGeary says, “and that the devices themselves cannot be manipulated.”
Barry Kohler, senior project officer in the Health Devices Group at ECRI Institute, also points to home care as a top issue for HTM. (One recent report predicted the global market for home care will expand 8% per year between now and 2026.) “The transition to home care brings up all kind of new complications,” he says. “Who owns the device the patient is using? Who is going to maintain it? How do you ensure that whatever you’ve chosen to deploy gives you reliable and accurate results?”
Solutions, Kohler predicts, will at least in part require work from HTM (and additional certifica- tions, like CompTIA A+ or Network+) that was previously left to those in IT. “It’s becoming much more important to have networking skills,” he says.
HTM Will Have to Do More with Less
According to AAMI’s McGeary, not enough new biomeds are entering the workforce to replace those who are retiring. “And at the same time, technologies are becoming more and more complex, so the demand for HTM professionals is higher than ever,” she says.
AAMI’s own research shows that health systems will need about 5,000 new HTM workers in the next three to five years, and yet only around 400 people are joining the profession annually. Meanwhile, about 60% of those currently in the field are over the age of 52, so in 10 to 15 years the imbalance will become even worse. (AAMI reports the U.S. medical device industry is valued at $173 billion in 2019 and is expected to reach $208 billion by 2023.)
“We’re looking at a potential mass exodus of people due to retirement, and right when we’re going to need them the most,” McGeary says. “We need people to not only replace those bodies, but also to replace all the knowledge that will be lost.”
The good news, McGeary says, is that innovations in HTM training should help new and experienced professionals alike do their jobs as effectively as possible. “I think technologies like virtual reality [VR] will really make a difference,” she says, especially when it comes to modalities like CT and MRI. McGeary predicts colleges with BMET training programs will increasingly look to VR (and augmented reality) as well. “It will never completely replace the need for hands-on training,” she says, “but it’s an effective and efficient way to introduce people to the technical aspects of the work.”
AI Will Improve Patient Care
The healthcare industry, notes George Gray, chief technology officer at North Andover, Mass.-based Ivenix, must improve medical device interoperability so that data can be made available “at the point of care” and ultimately improve the patient experience. (Ivenix created the first large-volume IV pump to be cleared under revised FDA guidelines intended to address skyrocketing injuries, pump recalls, and cyberattacks.)
“While today’s medical vendors are doing well at sending data from one system or device to another,” Gray says, most are unable “to create the necessary clinical insights and present that information at the right point in the care process so that it truly improves clinical decision-making and prevents critical errors.”
The solution, Gray predicts, will almost certainly involve artificial intelligence (AI). (According to research by CB Insights, health sector investments in AI surpassed $1.4 billion in the first six months of 2019. Another report, from Signify Research, estimates the world market for AI in medical imaging alone will hit $2 billion by 2023.) “Through the incorporation of AI and rules-based decision-support engines, medical devices will be able to provide clinical insights and allow clinicians to focus more time on the care of their patients,” Gray says.
Equipment Maintenance Will Become More Software-Centric
Anyone who’s been in HTM for more than a few years can attest to the changing demands of the work, which leads to the next trend highlighted by our experts. “Maintenance when I started my career involved screwdrivers and soldering irons,” says Jonathan Gaev, MSE, CCE, HEM, PMP, senior manager of international engineering at ECRI Institute. “But now a lot of the work is software maintenance—checking a device’s functionality, making sure my patches and virus protection are up to date, and recording everything in the computerized maintenance management system.”
One of the challenges associated with this new paradigm, Gaev says, has to do with HTM’s reliance on external vendors. “You have software tools that require passwords to run, and license fees” to pay to access the equipment. Manufacturers that offer remote diagnostics are providing HTM a helpful service, but that capability can lead to security concerns that hadn’t been a problem when biomeds did the work on their own, he says.
“On the one hand, it’s great; they’re sensing the equipment and they can tell when some- thing is wrong,” and in many cases they can even intervene to prevent a minor problem from becoming serious. “But on the other hand, if that device is on your hospital network, that’s a potential vulnerability.”
Cloud Computing to Raise Cost Concerns
To streamline medical data management, device manufacturers and healthcare organizations are increasingly turning to cloud services for data storage, Gaev says. The trend is to be expected, he adds (the U.S. market for cloud computing in healthcare reached $8.5 billion in 2018 and is expected to exceed $55 billion by 2025), but providers should be sure to do their due diligence before they commit to a service that may have strings attached. “You might take your ultrasound probe and see the image on your smartphone, but then when you want to store that image, what are they going to charge for that storage? And what about next year when they raise the price?”
The problem, Gaev says, is “you’re not in control, whereas just a few years ago, that wasn’t on the table. You had your images, you stored them inside your hospital, and you were in charge of both price and security.” This is an area where HTM professionals can make an impact by insisting that any contracts they sign with vendors include long-term guarantees related to cloud services, he suggests. “That needs to be part of the procurement process—determining total cost of ownership of that device or service.”
More Devices Impacting Healthcare Are Not ‘Medical’
The final major trend highlighted by those we interviewed involves equipment commonly used in the hospital environment that isn’t necessarily classified as “medical devices” by FDA and the Centers for Medicare & Medicaid Services, and isn’t required to comply with well-established and effective management practices for medical devices.
“If you look at things like hand hygiene systems and portable UV disinfection units,” Kohler says, “these devices are extremely important for reducing hospital-acquired infections, but they’re usually handled by housekeeping, not clinical engineering.” Similarly, he says, “smart” beds aren’t considered medical devices and are therefore typically handled by facilities management, but they, too, are in “this gray area” because of their role in patient monitoring.
Chris Hayhurst is a contributing writer for 24×7 Magazine. Questions and comments can be directed to chief editor Keri Forsythe-Stephens at [email protected].