By David Francoeur
Federal regulators require all hospitals to track their medical equipment. The goal is modest: to ensure hospitals know what equipment they have, primarily to report and address any problems that might arise. Some hospitals think that requirement—largely met by their computerized maintenance management system (CMMS) means they know everything necessary about their equipment and their healthcare technology management (HTM) program. The reality, however, is it barely scratches the surface.
In general, a CMMS is designed only to tell you what equipment you are using in your hospital, along with a record of how often it’s been fixed or undergone routine maintenance. By default, your CMMS is also a double-edged sword because of how hospitals choose to define what is and isn’t “medical equipment,” which limits how useful this information is. While others might define that solely as “treatment devices,” our TKA teams define medical equipment as anything that can touch a patient—widening our focus to devices such as wheelchairs, stretchers, and nurse call systems.
A comprehensive medical equipment inventory captures a broader spectrum of information to confirm that your HTM program not only delivers on expectations—but helps you find smart paths to improve its performance and value to the organization.
At TKA, we believe that your device inventory should include all equipment and costs related to your HTM program, including many commonly overlooked expenses— including salaries and training—and which vendor does what for you. Of course, we ensure that critical respirators, MRI machines, and other devices are clean, functional, and ready for patient care, but our biomeds may also oversee the disinfection process and ensure that transport and other touchpoints for the patient experience are working, as well.
Assessing your program solely on its tangible assets fails to reflect the greater value it delivers in both patient safety and provider satisfaction. What we’ve learned during our collective 200 years of industry experience is that too many hospitals simply don’t know what they don’t know about the day-to-day execution of their HTM programs. Without the right information, you can’t take the right steps to improve your performance at the best cost—leaving too many opportunities on the table.
Understand the Totality of Your HTM Program
The starting point for analyzing your program’s effectiveness and total value is the medical equipment that your biomed techs clean, repair, and keep operational. But you must dig much deeper to get an accurate, actionable overview of a deeply integrated hospital function— including both what you are doing and how much it costs.
Let’s look next at your overall healthcare organization. Does your campus include an outpatient clinic? Is there an attached ambulatory service? If they’re owned by your hospital, the associated equipment and HTM costs must be included in your medical inventory.
Now let’s look at all equipment—not just what your biomed teams touch. Do you outsource servicing for laboratory or imaging equipment? Does any department have its own vendor contracts? Those dollars, too, need to go into your inventory because they’re part of your overarching HTM program.
Finally, look within your team’s daily operations. Have you factored in their salary and training costs? What about chargeback fees for the square footage—a primary factor for determining service rates and reimbursements—occupied by your workrooms and your share of the utility bills? Don’t forget what you spend on replacement parts, cleaning supplies and even shipping, which can add up quickly when you need overnight delivery to keep life-saving equipment running.
In our experience, most organizations don’t include half of these items in their inventory. If you don’t know your costs down to the penny, how do you know if you’re spending that money in the best way possible? The bottom line is that each of these dollars is part of your comprehensive HTM budget, even if they aren’t all in the same budget line. From experience, those outside services contracts are where most hospitals have the widest blind spots, often leading to significant cost creep when there’s not a spending cap, since your core HTM program doesn’t have insight into out-of-scope billings.
How to Use Your Inventory
A well-constructed clinical asset inventory serves as a centralized resource, which can deliver immediate value to managing your HTM program and gauging its performance.
While your HTM program director should maintain this inventory, be sure to share this tool and its insights to be leveraged strategically across your organization. For instance, your purchasing team can get greater visibility across all contracts to determine duplications or gaps in exposure and align with the service delivery strategy.
Your financial team should look at total cost, not just the HTM team or partner cost, as well as use this data to manage depreciation of your clinical assets. Moreover, your nursing team can help you understand where technology is antiquated or doesn’t put patient safety first. And your senior leaders should use this information to negotiate reimbursements, as well as find opportunities to gain a competitive advantage over the hospital down the street.
Mitigating cybersecurity risks is another important application. More and more devices come with an online interface, opening an avenue for authorized access to patient and hospital information and systems. Working together to identify any exposure, your information technology team monitors the devices on your network and vulnerable access points, while your HTM team works with manufacturers to implement software updates and other remediation tactics.
Each year, start your budget cycle by reviewing your inventory and equipment utilization, especially from a capital purchasing perspective. In one place, you’ll have an accurate, complete inventory of every piece of equipment, how and where it’s used, and its history and current condition.From there, you can make informed decisions on not only when to replace a device, but what to replace it with, since medical technology is constantly evolving. For example, you might see that your biomeds are constantly repairing one device; rather than continuing to pay for that service, perhaps the better choice—which would save money in the long term—is to replace it with another device needing less upkeep.
How Your Inventory Benefits You
Back to those federal requirements. As you know, a key obligation is to complete annual reporting on your medical equipment. To truly deliver the best patient care, commit to a more comprehensive inventory that tells you where you are today. As you compare your performance to peer organizations, this information will help drive you to where you want to go.
Take time to analyze the data and ask critical questions. Do you have the right number of people? Are you providing the right service delivery strategy for your hospital’s current—and planned—equipment and needs? Do you train your people to focus on the right things? Do you have a trusted voice in the capital planning process? Are you making sure nurses and other providers are using the equipment properly (and training them if they’re not)?
In a manner of speaking, this inventory gives you the keys to the store. You get to decide where you go from here. Your ultimate goal is to have information that influences smart actions to improve uptime, lower costs, and increase the availability of critical hospital equipment. If you do all that, you will gain exponentially greater satisfaction with users across the organization, not to mention better patient outcomes.
Assessing Your Program
To help you complete a comprehensive assessment of your HTM program, TKA has developed Your Clinical Assessment Inventory. You can download a copy here: https://content.ii-techknow.com/clinical-asset-inventory where you will be guided on the best way to compile this information and use it to take your HTM program to the next level. Your patients deserve no less.
David Francoeur is senior vice president of marketing and sales at Tech Knowledge Associates. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].