As president of Healthcare Technology Management Solutions LLC, industry veteran (and 24×7 editorial board member) Dennis Minsent was looking for a challenge. Minsent worked on B-52s in the United States Air Force before retraining into the biomedical engineering field and serving there for 38 years, most recently as director of clinical technology services at Oregon Health & Science University. Now, as a retiree and volunteer on several committees for the Association for the Advancement of Medical Instrumentation (AAMI), he has launched his own consulting business to help small and mid-sized hospitals adjust to the rapidly changing world of healthcare technology management. We spoke with him about the pressures facing healthcare organizations, how they should prioritize their spending, and how his experience has shaped his approach with clients.
24×7: What is the focus of your business? What services do you provide?
Minsent: Healthcare Technology Management Solutions LLC provides consulting services to a wide array of healthcare businesses. Healthcare is evolving at a rapid pace and staff is working feverishly to keep up. Being able to have a qualified consultant to assist and advise on specific projects or programs can be a huge benefit to an organization, as well as not having to hire additional full-time employees to meet their current needs! Some areas of service focus include clinical system and electronic medical record integration, strategic technology planning, patient safety, healthcare technology management (HTM) program evaluations, and healthcare technology selection.
24×7: Who are your clients, and what sorts of issues are they facing?
Minsent: Clients include small, medium, and large hospitals, healthcare systems, outpatient clinical practices, and manufacturers. Reduced reimbursement, growth of managed care organizations, and huge growth in IT spending reduces the money available to replace, upgrade, or add new healthcare technology. Making good strategic and tactical decisions on where to spend the resources available on healthcare technology is critical!
Clinical alarms have been on ECRI Institute’s Top 10 Health Technology Hazard list for the last 4 years and are a Joint Commission National Patient Safety Goal. That’s certainly an area of intense focus this year. Cybersecurity and recall and safety alert management will be other dominant themes for HTM in 2015.
24×7: What do you bring to the marketplace that similar companies haven’t?
Minsent: Certainly, having been in the healthcare technology business for over 38 years gives me a sound foundation for understanding the healthcare issues we face today. Having retired from the Air Force as a senior health service administrator and having been trained as a biomedical engineer allows me to bring tools from both the management and engineering disciplines to resolve the complex issues we face today. I had the opportunity to spend 16 months as a risk management specialist and patient safety officer. That additional background and passion has really changed my outlook on HTM’s impact on patient safety! Being a small business allows me greater flexibility in working with customers to develop projects to meet their specific needs.
24×7: Why did you decide to start this business?
Minsent: Having just retired from full-time work, I had a desire to stay engaged in the healthcare technology profession. I’m working with AAMI on several committees and subcommittees but felt I could really do more. There are many small- and medium-sized hospitals that just don’t have the need for a clinical engineer on their staff full-time, but could use the benefit of one’s expertise on a periodic basis to help provide guidance to the local HTM staff. My consulting business allows me the ability to do that at my own pace and schedule.
24×7: What is the biggest challenge that you’ve faced as a small business in this area?
Minsent: For me, it was going through the start-up process for a new business. Having worked for healthcare organizations for my entire career, I’ve not had to deal with creating a limited liability company (LLC), business licenses, Internal Revenue Service tax identification numbers, professional liability insurance, designing business cards and documents, and researching other aspects of setting up and developing my own business. Then you have to consider tax implications of your work, set up a record-keeping system, and marketing your services to your target customers. This has really given me a new respect for those that deal with these challenges at organizations I have worked for in the past!
24×7: How did you first get interested in healthcare technology management?
Minsent: When I first entered the Air Force, I worked on B-52 tail gun systems, radars, and target positioning computers. As I was finishing my enlistment, I had the opportunity to retrain into another career field. Since there were no tail guns on commercial airliners, I decided to find a new discipline that had a civilian counterpart for when I did leave the Air Force. I had heard about the biomedical equipment repair field from others that had tried for years to retrain into it with no success. I went to the hospital and talked to the technicians to see exactly what the job entailed. It seemed like a great fit. The day I went to apply to retrain, the job had just been posted with positions available. I immediately applied and was accepted.
24×7: How was your experience with HTM in the military different compared to your time in the private sector?
Minsent: Overall, the job is much the same as its civilian counterpart. Policies and procedures were identical wherever you were stationed. One difference is the scrutiny of the program. All facilities were Joint Commission-surveyed every 3 years. The Air Force also had several additional inspections that occurred yearly. Consequently, we were always preparing our programs for inspections that would occur with no notice. It made you constantly stay on top of all aspects of your program! Then you have the wartime component that can occur without notice, deploying resources to any part of the world. The men and women that dedicate their lives to protecting our freedom are true heroes!
24×7: How does your practical background in clinical technology shape your approach with clients?
Minsent: Working in HTM requires you to have an understanding of all disciplines that use technology. That pretty much encompasses the entire organization. Projects seldom involve only one department. Understanding how all the pieces in healthcare fit together and what their focus is helps in designing solutions that work across all the disciplines affected. In my last position, my department reported up through the department of nursing. Having spent nearly 10 years in that organizational structure, I have a solid understanding of the issues and challenges nurses, our biggest customers, face in dealing with technology. Being married to a nurse for the last 32 years helps as well!
24×7: How did your work in risk management affect your approach toward equipment management and patient safety?
Minsent: Over the first 25 years in HTM, I only ever saw four to five hospital incident reports total. That changed to 450 to 500 per month in my role as a risk management specialist and patient safety officer. I was astonished at the diversity of issues that were identified and reported. The Institute of Medicine book, To Err is Human, really highlighted the patient safety issues in the healthcare system. The entire culture of reporting changed based on this book. Having the opportunity to see the whole patient safety picture changed how I look at and analyze issues. Sometimes you have to connect the dots through several different reports to get to the root cause of a problem.
24×7: What do healthcare organizations need to realize, or in what ways must they change, that they haven’t yet?
Minsent: Changes in how healthcare is paid for will require a major shift in thinking. For years, traditional healthcare organizations were reimbursed based on the tests and procedures they performed. With accountable care organizations, you are given a fee for each individual covered. If the individual needs little or no care the hospital keeps the fee; if they need a lot of care, the hospital is responsible for covering it. Healthcare organizations will be challenged over the next few years as this transformation takes place. This will impact how they plan and budget, as there will be patients under both models of care that they will have to plan and account for as they build their budgets, affecting both capital for equipment and operating expenses in HTM departments. Increased focus on patient satisfaction and outcomes will also continue to drive changes in how healthcare is measured and delivered.
24×7: What do you think are the most important strategic areas for HTM spending?
Minsent: This is really dependent on the organization and where they are currently with their technology. Certainly IT spending will be high on the list in order to meet the requirements for the meaningful use mandate from the Centers for Medicare & Medicaid Services. With service moving from inpatient to outpatient, there will be some required spending there. There will be a great deal of pressure to reduce supply chain costs that can affect technology purchases.
Jenny Lower is associate editor of 24×7 magazine. Contact her at [email protected].