By John Noblitt, MAEd, CBET
Lately I’ve been talking about the process of purchasing new equipment and the need for these purchases to fit into an organization’s strategic plan. In January’s installment of PrepTalk, I will share information about equipment replacement purchases and some factors that go into this process—and how this information could show up on your Certified Healthcare Technology Management (CHTM) exam.
To fully prepare you, I will expand on the topic of equipment purchasing to include replacement of older equipment and some of the issues surrounding this type of purchase. Arguably one of the first things a HTM professional must know is that replacement of existing equipment must be a well-thought-out process with multiple factors, and these strategies must fit into the organization’s overall strategic plan. Equipment should not be purchased on a doctor or nurse’s whim—but instead should undergo a detailed evaluation and replacement procurement process.
Factors for Consideration
When considering which devices to replace, a HTM professional should focus on potential cost savings, patient safety, and IT interfacing. After all, given today’s healthcare budget constraints, administrators are always looking to provide the best healthcare in a fiscally responsible way. So if significant savings can be documented, equipment replacement is very likely. The cost savings could come from many areas, such as disposables used by the device, utilities to run the equipment, or possible space requirements. Still, patient safety is always at the forefront of any healthcare delivery organization.
As Toby Clark and Raymond Forsell said in A Practicum for Biomedical Engineering and Technology Management Issues, “At a point in a device’s life cycle, it crossed over from being beneficial to being detrimental.” With users reporting numerous device-related adverse events, this is an area that should be heavily scrutinized as a potential justification to replace older equipment. To add to this list, device integration into the healthcare IT network is another major justification for device replacement.
With IT issues affecting HTM departments, such as Health Level-7 standards, the emergence of electronic medical records, middleware. and more, HTM professionals will be required to understand that device integration is a major factor in healthcare equipment purchasing.
All healthcare institutions should have an equipment replacement plan in effect—and they should encompass certain standard information to help guide the process of when to replace older equipment. But identifying major areas of consideration for equipment replacement is only part of the battle. A more complex issue may be how to categorize equipment with a simple evaluation tool to accomplish sound equipment planning.
Sticking to the Plan
In 2003, Malcolm Ridgeway published a list in his “Preliminary Equipment Replacement Planning Report” that is still applicable today. (Even so, your department or organization may have other factors for consideration in the process.) According to Ridgeway, there are seven areas of equipment evaluation: Age and condition of the unit, utilization, clinical acceptability, technology status, parts availability, projected reliability, and projected annual maintenance costs. Note: I can envision possible questions dealing with this type of information on your CHTM exam.
The exam could ask questions about how and/or who evaluates the medical devices for the replacement plan. Anyone sitting for the exam should be aware that the clinical staff will likely assess the age and condition, utilization level, and clinical acceptability of the equipment. The HTM department will gather and provide other parameters such as technology status, parts availability, projected reliability, and projected annual maintenance costs.
Questions could also be asked about how to calculate reliability and projected annual maintenance costs. HTM professionals must realize that by utilizing data captured in the clinical management maintenance system (CMMS), much information can be gained. For instance, HTM professionals can determine the reliability of a piece of equipment by analyzing their CMMS data and counting the number of unscheduled repairs over the life of the equipment. Although this will only provide an estimate of the reliability of the device, it is based on factual data.
The projected annual maintenance cost is also available via CMMS data—and it can be calculated by taking the overall cost of maintenance divided by the purchase price. Still, one must be sure to include all costs—such as labor and possible service contract costs—rather than just parts costs.
In conclusion, medical equipment replacement plans can be very basic or extremely detailed. The bottom line is that organizations need to implement a plan that determines when and how to replace equipment. As for HTM professionals wanting to be certified, knowing which data to use and how to manipulate that data in the CMMS can help determine if and when devices need to be replaced.
Any decent CMMS will have a complete and accurate inventory of all equipment, along with the device type, location, age, purchase price, manufacturer, serial number, and service information (i.e., repairs and costs associated with the repairs). Such information will be critical in helping to determine replacement schedules.
I hope you find this information useful as you continue your quest to become a certified HTM professional.
John Noblitt, MAEd, CBET, is the BMET program director at Caldwell Community College and Technical Institute, Hudson, NC.
1) Equipment replacement plans in the healthcare industry can derive much of the needed data from which resource?
a) The National Fire Protection Association
b) The Joint Commission
d) A hospital CMMS
2) Equipment replacement plans often look at a device’s total cost of maintenance to help determine when replacement is needed. Which of the formulas below could determine the total cost of maintenance?
a) Cost of parts/purchase price
b) All costs of parts and labor/purchase price
c) Costs of parts and operator labor rate/purchase price
d) Purchase price/parts p
3) Which categories should be evaluated to determine medical device replacement?
a) Potential cost-savings
b) Patient safety
c) IT integration
d) All of the above
4) A medical equipment replacement plan must be consistent with which hospital-planning document?
a) A disaster plan
b) An emergency management plan
c) A strategic plan
d) None of the above
Answers: 1—D, 2—B, 3—D, 4—C