The clinical engineering department has spent years developing excellent relationships with its medical-device vendor representatives, just as the information technology (IT) department has spent years developing similar relationships with its vendors. Now that IT must assist in setup, support, and maintenance of some components of medical equipment, IT is often at a loss in terms of tracking down an appropriate resource at a vendor that can answer questions, provide support, etc.

When IT runs into a dead end trying to track down appropriate vendor resources, it may turn to the clinical engineering department and ask for additional vendor contacts. As soon as this happens, it opens the door to potential conflicts and/or additional work. Does the biomed department want to hand over the names of contacts with which they have spent years developing good relationships? Does it believe that issues do not warrant escalation to the more senior contacts? Does it want to have to accept additional responsibilities to track down resources and stay on top of issues that are not the biomed department’s? Does it want to potentially have to discuss and escalate issues for which it has limited or no knowledge? Does IT try to pass off responsibilities to the clinical engineering department, saying that it does not deal with medical devices or medical-device vendors? Does information get lost in the handoff between IT and the clinical engineering department so that incorrect information is passed to the vendor or back to IT, or is not transmitted at all?

Third-party communication is very tricky and may potentially cause one of the biggest conflicts in the growing need for better collaboration between these two departments. Recognizing the potential pitfalls up front and defining roles and responsibilities can minimize these conflicts before they arise. The clinical engineering and IT departments should work out who will contact third parties in various scenarios and how the escalation process will be handled. This should be clearly documented and shared with all appropriate staff in both departments as often as such decisions are finalized to make certain that the decision is shared with the actual individuals who need to place the calls.

Know What You Want
Before this meeting ever takes place, the clinical engineering department needs to determine what it wants to bring to this meeting. It is easy to say that the biomed department has managed these vendor relationships for years and wants to continue to do so. However, the workload of managing these relationships can become significant, and the department must be prepared to handle this additional workload if it wants to handle all vendor communications.

Let’s look at a scenario to see how this plays out. Let’s say there is a major OS patch that corrects a significant security flaw. IT can test and push this patch out to the hospital’s PCs quickly and will want to do the same with vulnerable medical devices. It may be that there are hundreds of devices from dozens of vendors that require the patches. The good news is that more and more medical-device vendors are posting security updates on their Web sites, but someone still needs to locate this information. Of course, there are still vendors that do not post this information that need to be contacted, possibly multiple times, to get an appropriate update. To make this more complicated, the vendor may not be familiar with the patch and may ask specific questions about what the patch applies to, where to find it, etc. The clinical engineering department may have limited information that was provided by IT, but not enough to answer all the vendor’s questions. Now it takes longer because the biomed department needs to go back to IT to get the follow-up information and get it back to the vendor.

Another scenario that may arise is that the vendor insists that the patch is not needed; yet IT believes it is needed and requests a follow-up with the vendor. Once all the devices and patches are identified, there may still be significant coordination with the vendor and the clinical engineering department to get the patches installed. Now take all these tasks and realize that these devices need to be patched as quickly as possible, and you can start to see the amount of effort involved in vendor coordination to apply a single patch. This can be very burdensome to a clinical engineering department just to try to preserve vendor relationships.

In addition to the above scenario, there are regular OS and application updates to be applied, issue escalations that bridge IT and the clinical engineering department to be managed, incoming devices that need to have additional security set up on them—and the list continues. A clinical engineering department will need to determine how much staff to dedicate to these tasks and then take this information when meeting with IT. Since the workload is probably too large for one department to manage on its own (unless it wants to dedicate someone specifically to that task) and the expertise is shared between departments, this will most likely remain a collaborative effort and will mean that the clinical engineering department will need to allow IT to work with its vendor contacts. In exchange for handing over the contacts, the clinical engineering department should make sure that it specifies who can call and in what scenario.

The clinical engineering department should also ask to be notified when items are called in to these contacts, and particularly when issues are escalated through these contacts, to be able to have an understanding of the entity’s relationship to the vendor. (Similarly, the clinical engineering department should notify IT when network changes are being made to devices.) In another alternative, the biomed department could provide entry-level contacts and ask IT to allow the biomed department to coordinate calls or meetings with senior vendor contacts if escalation is needed.

The bad news is there is no correct answer. It is really a trade-off between what the clinical engineering department is comfortable in allowing IT to do with medical-device vendors versus how much of the management workload the clinical engineering department can handle on its own. The good news is that by sharing some of these responsibilities, the IT and clinical engineering departments will stay in better communication with one another and will gain a better understanding of what is needed to best meet the needs of the enterprise.

Ken Olbrish, MSBE, is an enterprise imaging system administrator in the Information Services Department for the Main Line Health System, Philadelphia. He can be reached at kolbrish@hotmail.com.

Read previous Tech Talk articles in past issues of 24×7 at www.24x7mag.com.