By LeAnne Hester
COVID-19 may be subsiding, but the end of 2021 did not bring an end to the pandemic or the associated challenges it brought for healthcare. Now, four months into 2022, healthcare providers are unfortunately also facing nursing shortages and increasing cybersecurity threats. The question and the opportunity are what role medical devices can play to reduce immediate challenges while supporting larger transformation efforts.
Here is a detailed look at what else 2022 will bring from a clinical asset management standpoint as hospitals and healthcare systems navigate the broader dynamics impacting care.
Health systems will increasingly turn to medical device management as an aid in reducing nursing burnout
Frontline workers such as nurses are frustrated, overworked, worried over risks to their own health, and simply burnt out. Many of them are quitting the profession altogether, leaving critical staffing shortages. Staffing shortages create critical patient care challenges, and hospitals must find ways to keep the qualified staff they have and also add supplemental support, which leads to tighter margins while managing financial constraints.
“Widespread labor shortages are driving up already high labor expenses, posing significant operational challenges for our nation’s hospitals,” says Erik Swanson, a senior vice president of data and analytics at healthcare consultant Kaufman Hall. “Hospitals are grappling with higher labor costs despite lower staffing levels, due to intense competition for qualified healthcare workers.”
Many hospitals overlook the importance of medical devices in nursing satisfaction and retention. A key driver of dissatisfaction includes spending time on administrative items. TRIMEDX research found that most nurses spend 45 to 60 minutes per shift trying to find equipment or ensuring it’s clean prior to use. To give nurses time back to spend on patient care, an organization must first have an accurate inventory of their clinical assets along with the proper processes to ensure cleaning, storage, and availability. By implementing these processes, supported by technology, nursing satisfaction scores have improved by 50%. Nurses can spend more time providing care and less time wrestling with equipment needs.
A sound medical device strategy helps ensure operational funds are not spent on unneeded equipment and instead are allocated to staffing expenses. By analyzing utilization data, clinical engineering teams can ensure devices are available in par levels to meet demand by shifting equipment to the appropriate care settings. This reduces the reliance on operational expenses for rental equipment.
Medical device cybersecurity will become more comprehensive and holistic
The number of U.S. data breaches reached a record high in 2021, according to the Identity Theft Resource Center, which is further troubling news for the healthcare industry, a popular target of cybercriminals.
For hospitals and health systems, increasingly connected medical devices present a unique challenge. Medical devices need expertise beyond IT and network security. Reducing cyber-risk associated with medical devices requires expertise in clinical engineering, including inventory management, device patching, and lifecycle management such as repairs and recalls.
Reducing the risk of connected devices starts with an accurate inventory and profile of the devices and an understanding of whether a cyber-vulnerability is present. This is challenging for healthcare organizations because the task relies on the supply chain working with the manufacturers to gather the data.
The next step is to gather real-time knowledge—critical if a device is connected to a network—about how the devices are being used to identify whether there is suspicious behavior. Many health systems are turning toward using a security operations center (SOC) and an IoT, an Internet of Things platform, as part of their cybersecurity program. Staffed 24/7 by a team of experts, a SOC utilizes sophisticated technology to monitor, assess, analyze, and respond to cybersecurity threats. With the shortage of qualified cybersecurity professionals, many organizations are turning to external SOCs to provide support and are looking for support from one vendor to ensure all areas of the program are working together for maximum protection.
However, being aware of a vulnerability or threat is only the initial step in reducing risk. Providers need trained staff who can bridge the gap between clinical engineering and information technology (IT) to respond when a vulnerability is detected. While SOCs typically focus on network security and may be able to automate a response in some situations, medical devices create unique challenges. To appropriately respond, IT and clinical engineering teams need to work together to apply an approved patch or other compensating controls. The partnership with clinical engineering also ensures equipment is available and safe for patient care.
Health systems will look toward continuously identifying opportunities for savings as new data becomes available and as care strategies shift.
Healthcare providers will seek out ways to control expenses. Some will turn to consultants for sweeping financial improvement initiatives that extend across all departments. But such broadly targeted efforts can prove challenging for department leaders to take charge of and own the results. Rather, cost-savings initiatives focused on specific areas prove more successful because getting management buy-in and controlling project variables are easier.
Consider medical device inventory management. Even before the arrival of the pandemic, the delivery of healthcare was shifting toward more nonacute settings. Ambulatory surgery centers are expected to experience 25% patient growth by 2029, according to healthcare industry analyst Sg2’s 2021 Impact of Change Forecast. Doctors’ offices and clinics will see 18% growth, driven by procedures formerly done in hospitals such as cataract surgery and endovascular procedures. And home-based services will see a 15% surge in patient services. These increases in other care settings will lead to more and potentially different equipment than has been available in the past.
Instead of buying new equipment to address the increasing demand at other sites of care, health systems have an option to reallocate applicable clinical assets they already have in hospitals as volumes move to other care sites. To do this effectively, hospitals will need a benchmark of what number of devices are needed to support patient volumes coupled with the utilization of their devices. Existing hospital inventories often show equipment that is underutilized and above patient volume benchmarks. This information can lead to an informed reallocation strategy for equipment.
Clinical assets account for 25% of health system capital expenses. By reallocating versus purchasing new equipment, those dollars can be deferred to other initiatives. Often, health systems don’t realize their medical device inventory can be leveraged to provide operational savings, staff satisfaction, and capital for other investments. While a clinical engineering program can’t solve all the challenges healthcare providers face today, strategic management of it can provide additional relief as a financial savings lever.
‘Hospital-at-Home’ care will gain momentum in 2022 and underscore the urgency for the complete visibility of medical devices.
As hospitals continue to evaluate the best way to provide quality care, including bed and staffing availability to meet the acuity of patients, health systems increasingly will employ “hospital-at-home” care. The model, which involves providing hospital-level care to acute-level patients in their homes, draws praise from patients for its convenience and comfort while improving outcomes. Hospitals can experience greater cost-savings and more clinical efficiency. Johns Hopkins Medicine says the “hospital-at-home” method yields better health outcomes, shorter lengths of stay on average, higher patient and family satisfaction, and lower care costs by up to 30% compared with traditional inpatient care.
Medical device management, however, can become more complicated in an offsite setting. Keeping abreast of the location and asset status of medical devices in a hospital setting is challenging—maintaining 100% visibility into your inventory as devices are deployed outside the hospital is imperative. Health systems need to know exactly the devices they have so they know which devices can be used for “hospital at home” care and which devices need to remain at the hospital. Wherever the devices are, they must be clean and up to date. A device in the field with a pressing FDA recall or cyber-vulnerability cannot be overlooked.
To sum it up, the pandemic is accelerating changes in the delivery of healthcare. Inside hospitals, nurses will need more financial and structural support to do their jobs well. Outside hospitals, a growing shift toward the “hospital at home” and other initiatives will put a premium on clinical asset management to ensure the safety and availability of medical devices amid this shift in healthcare delivery.