Navigating Numerous Changes Together 

To say that Tucson Medical Center’s (TMC’s) clinical engineering (CE) team has undergone change in recent years would be a vast understatement. A few years ago, the Ariz.-based department transitioned from utilizing a multi-vendor service agreement to performing in-house service. Below, several members of TMC’s CE team—Guillermina (Mina) Garcia, BMET II; Mark Weltz, senior diagnostic imaging engineer; Walter Cahill, lead diagnostic imaging service engineer; Dirk Call, BMET III; and Jim Pangrac, BMET III—discuss the ramifications of this decision and why they believe taking over hospital service has streamlined operations.

24×7 Magazine: What were some of the key challenges of bringing the department in-house after employing strictly vendor service?

Guillermina (Mina) Garcia: One of the biggest challenges we faced was right-sizing the budget and staff. The third-party service provider didn’t perform some of the work that we currently do, so the dollars and full-time equivalents (FTEs) for that work resided in individual departments. It required assistance from numerous areas to identify all the money being spent on medical equipment and bring those dollars and FTEs back to the clinical engineering (CE) department. Each year, the CE budget and staffing improved to include those costs; and now after three years, we think we are right where we need to be.

Other things that were needed after the exit of the third party included test equipment and an asset management system. An interesting struggle we faced after the departure of the third party was the relationship with other hospital employees. They were used to the CE department telling them: “No, we don’t take care of that.” These days, they know we are here to help—which has significantly improved the relationship between CE and other departments.

24×7 Magazine: Cybersecurity is a huge issue in HTM. What steps is Tucson Medical Center’s CE department taking to thwart cyberattacks?

Mark Weltz: At TMC, we are ever-vigilant in our efforts to ensure top-level security for our systems. We continually invest in cybersecurity efforts because protecting the information entrusted to us is a top priority. What’s more, TMC’s CE team reports to the information systems (IS) department—and our two departments currently enjoy a solid working relationship. Also, our computerized maintenance management system has a tab to log such data as media access control addresses, protected health information status, and more, for each piece of medical equipment.

In CE, one thing remains clear: The most effective method to secure our data is to have everyone remain vigilant and practice safe behaviors, such as not clicking links in unexpected e-mails, not providing anyone with passwords, not downloading any programs, etc. Together, we can keep our patients and their data safe.

24×7 Magazine: Tucson Medical Center’s CE department has certainly evolved a lot in the past few years. How do you expect the department to evolve even more in the future?

Walter Cahill: Recently, we expanded our imaging services program to include servicing cath labs, CT systems, and mammography devices. The basics of an imaging program have been in place for the last few years; however, we recently hired additional people so we can start servicing some of the more complex imaging modalities. As you can imagine, we have been able to recognize significant savings in contract cost reductions due to this change.

Looking to the future, I’d like to see additional integration with our IS counterparts and possibly tackle the world of surgical robots.

24×7 Magazine: In your opinion, what are some of the biggest issues currently affecting HTM and why?

Dirk Call: Two concerning things from my perspective are the aging of the HTM population and cybersecurity. The only local college that provided biomed training in Tucson is closing its doors—a move that is in line with the numerous other biomed school closures across the country. I’ve long said that most people don’t even realize that there are people working in a hospital that care for medical equipment.

My question: What’s the best way to get the word out to high school students and others about the need for people in this industry? Students with a technical aptitude are often guided toward computers and/or networking. In some cases, there are major wage differences between computer-related jobs and HTM positions—thus compounding the problem. I know I’m preaching to the choir, but more people need to be entering the HTM field.

Like we discussed earlier, cybersecurity is another concern for the HTM community. Many large companies are on board with finding solutions to this issue, although getting information out of them isn’t always easy (although they certainly understand the need for securing their devices). The problem is that the information is often not offered in a proactive manner, which means the customer needs to search out the right people for help. Getting the necessary information can be a long, drawn-out process.

24×7 Magazine: What else do you want 24×7 Magazine readers to know about Tucson Medical Center’s CE department?

Jim Pangrac: Tucson Medial Center is a standalone community hospital, not part of a large corporation. For the CE department to evolve into the department we are today, it took a great deal of commitment from the director of the department and the TMC Executive Team—along with a lot of patience from the members of the department. There were a lot of ups and some downs along the way, but they made us a better team.

One of the best parts of this journey was being able to implement policies and processes that work best for TMC. In many respects, we basically started a new department. We’ve changed a great deal from where we started and we look forward to continuing to evolve to meet the ever-changing needs of TMC and our field.