At a session on the convergence of the clinical engineering and information technology (IT) departments during this year’s Association for the Advancement of Medical Instrumentation conference, I surveyed the audience to find out how many believed the IT departments at their facilities had an idea of what a clinical engineer (CE) does on a day-to-day basis. Less than 5% of the audience said their IT departments knew what they did. At the same time, nearly everyone in the audience believed they knew what their IT departments did.
As more and more medical equipment becomes IT-based, the clinical engineering and IT departments must regularly work together to install new devices, presenting a situation where it is possible that only one side of the collaboration knows what the other side is doing. However, this presents an excellent opportunity for a CE to bring the IT department up to speed, not only on what a CE does but also on some clinical knowledge that is often lacking in IT departments.
CE training is both technical and clinical, and biomeds routinely interact with clinicians and clinical equipment. They understand what medical devices do, how they are used, and what happens if they are unavailable.
On the other hand, IT training is almost entirely technical, with many IT staff coming into health care from other industries. The good news is that more and more IT departments are hiring former clinical staff. However, to many IT staff a medical device looks the same as a PC on the hospital network, and it is often treated the same.
CEs, clinical engineering departments, and users often believe that they do not understand why IT does things, but they never ask. At the same time, IT assumes that users understand why things are done a certain way, because they do not hear any feedback that this is not the case. If you believe that you are not getting the information you need, definitely ask.
Given that IT and biomeds now must work hand in hand, it would be beneficial for the IT and clinical engineering departments to share at least some basic knowledge of their respective departments with one another, for the benefit of the organization. This month we will focus on ways in which biomeds can help educate IT, keeping in mind that this should be a two-way exchange.
Making a Start
So in which areas can biomeds educate their IT counterparts? Here are three areas that make a good start: clinical knowledge, technology evaluation, and asset tracking/management.
Clinical knowledge is second nature to biomeds. Certainly, it is not necessary to share every clinical detail about every medical device with IT. However, let’s take a scenario where a CE is working with IT to install a new positron emission tomography/computed tomography (PET/CT) scanner. The IT staff may have some knowledge of what a CT scanner does, but the staff probably has little or no exposure to PET, let alone a PET/CT. It is unlikely that the IT staff will know that in addition to the scanner there are multiple additional workstations that need to be interfaced to allow fusion, to archive and send to a picture archiving and communication system, to send data to a radiation treatment planning system, etc. By providing an overview of where the data will flow and the clinical significance of that workflow, a CE can help IT determine how the network needs to be configured and potentially how to set up a VLAN to include all the devices. It may also give IT an understanding of the different vendors involved for the various systems, and at a minimum it will give them an understanding that network-setting changes on the PET/CT can impact a significant number of systems beyond just the scanner.
Even if IT already has a good understanding of all the interconnectivity and how to configure everything on the network, just a basic familiarity with what a PET/CT does and some of the basic terminology can help IT work with the clinical engineering department to set up and troubleshoot issues with the devices in the future.
IT does an excellent job of evaluating hardware specifications; however, it is sometimes difficult for IT to analyze an appropriate technology without an understanding of clinical workflow. For example, IT may determine that wireless technology works for a certain application; but clinically, wireless technology may not be the best solution given specific workflow needs in a department. This type of issue may be clear to biomeds but less clear to IT because they do not routinely work in some clinical areas.
Finally, for years the clinical engineering department has had to be able to locate mobile medical devices. Monitors and infusion pumps in one area of a hospital may be in a completely different location the following day. IT, on the other hand, has traditionally had to track devices that were fixed in a single location because of the need to connect those devices to specific network jacks. Now that IT technology has moved into mobile medical devices, IT is starting to face some of the same challenges of tracking and locating these devices that biomeds have dealt with for years.
The need for collaboration between the clinical engineering and IT departments will not disappear. Therefore, it is critical that these departments share their knowledge so they can more easily communicate with and understand one another.
Ken Olbrish, MSBE, is an enterprise imaging system administrator in the Information Services Department for the Main Line Health System, Philadelphia.