By Phyllis Hanlon
Ask any little boy what he’d like to be when he grows up, and you’re likely to get a range of answers that change as the years pass. For Steve Grimes, his childhood dream never wavered. From the age of 10, he set his eyes on a career as an engineer. Time shows that he achieved—actually, exceeded—all aspirations.
His years of service to the clinical engineering industry, staunch advocacy efforts, active participation in multiple professional organizations, accomplishments in risk management and medical device security, and mentoring newcomers to the profession caught the attention of the Association for the Advancement of Medical Instrumentation (AAMI), which bestowed on him the 2016 HTM Leadership Award.
A voracious reader and sci-fi fan, interested in technology and model rocketry, Grimes began his journey toward a degree in aeronautical engineering (AE) at Purdue University in the early 1970s. “But the moon program was winding down at that point and NASA was laying off engineers. My professor said the market for aeronautical engineers in 1974 didn’t look too promising,” Grimes says. “He also happened to be a biomedical engineering professor and suggested I consider a career in a new field called ‘clinical engineering.’ I did some volunteer work as an engineer at a local hospital and I was hooked.”
In 1974, Grimes earned his Bachelor of Science degree in biomedical engineering and entered the workforce, holding positions in various health care facilities in Ohio, Pennsylvania, Massachusetts, New York, and Tennessee. At the beginning of his career, he designed, developed, and implemented the first clinical engineering programs for two Cincinnati area hospitals. But that was just the start.
Grimes had tremendous foresight when it came to technological innovation. Regardless of location, he focused on the convergence of medical and information technologies, technology acquisition management and planning, the evolution of maintenance management, and risk and security management. He explains that hospitals were adopting more and more technologies, and that these tools had the potential to provide equal access to high-level, reasonably priced care to people throughout the world.
“Technology is a leveler. It offers opportunities and better services to a wider range of people,” he says. “I recognized the evolution of technology and what role IT could come to play in the industry.”
During most of its years, clinical engineering (CE)—or health technology management (HTM), as it’s now called—focused on equipment maintenance, which Grimes says is no longer where we see the biggest risk. “Because of design and reliability improvement, only something like 2% to 4% of device failures are due to maintenance-addressable issues. And only an extremely small fraction of maintenance-addressable failures lead to patient injury,” he says. Instead, most of today’s medical failures are attributable to use or processes errors, Grimes explains.
“Now to make reductions in technology-related failures, you really need to look at how technology is acquired, how it is to be applied, what is the workflow, and what training should be given to users,” Grimes says. “Then you have to redesign the workflow and conduct sufficient training to get the real benefits of the technology.” The idea, he says, is to focus on tangible ways to provide more effective care.
“Technology is a much larger player in health care than it was in early days of CE—30 to 40 years ago—and it’s a totally different animal,” Grimes says. “Consequently, I’ve encouraged the HTM community through my writings, presentations, and leadership to better understand the nature of the new environment and to adopt the use of new tools—for example, risk and security management, evidence-based maintenance, etc.—to better support the new health care landscape and its technology.”
While the concept is simple, achieving the goal is not that easy. Grimes notes that getting the appropriate resources and changing a long-standing mindset are the biggest dilemmas. “There are 5,000 hospitals in the country and some, but not most, are up to speed,” he says. “The challenge is making sure CE/HTM services and providers have evolved to support the new technology and to address the real problems.”
While Grimes applied his knowledge and expertise at hospitals across the country, he also had a chance to see the larger world. Accustomed to travel—his family moved so often he attended five different high schools—he has worked with the World Health Organization (WHO) and Pan American Health Organization (PAHO) as an expert consultant. For nearly 15 years, he touched down in several exotic locations, including Brazil, Cuba, Ecuador, Kosovo, India, China, Argentina, and Mexico. “I became exposed to what was going on elsewhere in the world,” he says.
Under the sponsorship of WHO/PAHO, he taught HTM and CE workshops in these countries, experiences that opened his eyes to the similarities the global community shares. “I came to quickly learn that we have more challenges in common than differences,” he says. “Other countries are often leapfrogging over some of the technological steps we’ve had to deal with in the United States. I also came to realize many of the challenges we face are beyond the ability of any one country to successfully address and that often true solutions to those challenges will only be found through a better understanding of our international colleagues and only be achieved through everyone’s collaboration.”
Grimes’ international travel and teaching experiences proved to be both personally and professionally rewarding. “No matter the audience, they were yearning for knowledge,” he says. “There’s nothing better for a teacher or consultant to have that kind of response. It drives you to the top of your game. You have a chance to share your expertise.” The few challenges he encountered—language and logistics—proved to be minor hurdles as the host country worked with him to iron them out.
Throughout his career, Grimes has actively participated in many professional organizations and has been recognized as a fellow by the American College of Clinical Engineering (ACCE), the Healthcare Information and Management Systems Society (HIMSS) and the American Institute for Medical and Biological Engineering (AIMBE), particularly for his work in risk management and medical device security. At ACCE and HIMSS, he wrote the ACCE/ECRI guide for medical device security and also served on the ACCE board for more than 10 years, including two as president.
As chair of the HIMSS medical device security workgroup, Grimes conceived of and led the team that developed the “manufacturer’s disclosure statement for medical device security” (MDS2) that subsequently became a NEMA (The Association of Electrical Equipment and Medical Imaging Manufacturers) standard. He was also part of a team that brought the clinical engineering community to the HIMSS table and was involved in the development of a successful run of CE-IT leadership symposia that preceded each HIMSS conference going back to 2006.
“In 2006, I conceived of and lobbied HIMSS and ACCE for a joint industry award that was subsequently adopted and has been given at the annual HIMSS awards ceremony since 2007 as the ‘ACCE/HIMSS Excellence in Clinical Engineering and Information Technology Synergies Award’,” he says.
In addition to his involvement with ACCE, AIMBE, and HIMSS, Grimes has been an active member of the Institute of Electrical and Electronics Engineers-Engineering in Medicine and Biology Society (IEEE-EMBS) and a member of the American College of Healthcare Executives.
As a long-standing member of AAMI, Grimes has served on many task forces and future forums, as well as on the Equipment Management standards committee. And he now sits on the AAMI Credentials Institute (ACI) board.
Grimes’ fingerprint can also be found on credentialing policies. For instance, he has been a long-time board member and is now the current vice chair of the Healthcare Technology Certification Commission, which oversees clinical engineering certification. Until their functions were replaced last year by the ACI, he was also a board member of both the US and International Certification Commissions, which governed certification for BMETs and related professionals.
And his business sense was put to good use when he served on review panels that made recommendations on applications for the National Institutes of Health-National Institute of Biomedical Imaging and Bioengineering grant funding. Not only has Grimes been influential in creating and implementing industry manuals, standards, and protocols, for several years he also penned a regular column for EMB, an IEEE publication, and is currently an editorial board member for 24×7 and BI&T.
Today, Grimes serves as principal consultant for Strategic Healthcare Technology Associates, LLC. During his career, he has worked as director of clinical engineering for academic medical centers and multi-institution enterprises, and held leadership positions, including chief technology officer, at several independent service organizations.
Paying It Forward
In the late ’70s and early ’80s, Grimes had the good fortune of working at ECRI Institute with Joel Nobel, MD. “He was a genius and helped me learn to think out of the box,” Grimes says. “Working at ECRI with Joel and so many industry leaders was like learning at the best university. It allowed me to do things as a young engineer that I would never have had the opportunity to do in other organizations.”
Grimes also credits Ray Zambuto of Technology in Medicine for taking him under his wing in 1982. Zambuto continued to help shape Grimes’ professional path for the next 20 years. “I learned about the importance of commitment to community, service, and quality in your work [from Ray],” he says.
As a way of “paying it forward,” Grimes has done his fair share of mentoring. “During my professional career, I have been involved in mentoring through a range of activities that included managing interns [who were] working on their clinical engineering degrees to working with colleagues, who were looking to expand their HTM/CE experience,” he says. “I enjoy watching minds light up as they come to realize the practical implications and benefits of what we do. It’s gratifying being able to share [my knowledge], but I also learn a great deal from others.”
When AAMI awarded Grimes the 2016 “HTM Leadership Award,” his daughter, proud of her dad, viewed the honor with a practical perspective. “My aeronautical engineering daughter suggests this is akin to the industry connotation as a ‘greybeard’ … someone who’s been around long enough to have soaked in some reasonable store of knowledge/experience,” Grimes says.
Fortunately, all the knowledge and experience he has acquired doesn’t only benefit him—instead, he’s passed it on to other members of the HTM community.
Phyllis Hanlon is a contributing writer for 24×7. For more information, contact Keri Forsythe-Stephens at [email protected].