By Kurt Woock
When asked about how he feels to have been named AAMI and GE Healthcare’s BMET of the Year for 2013 this past June, Richard Swim’s answer is straightforward: “It means a lot to me,” he says. But when asked to identify what qualities or achievements led to his being awarded the title, the answer becomes less clear. “I don’t think you can point to one thing,” he says. “Even I have a hard time describing what I do.”
That summary captures well the trajectory of Swim’s career. It’s complicated, but it’s not haphazard. Swim’s hard-to-define job description is a reflection of his choosing to take on a variety of challenges throughout his career. As those experiences and resultant new skills piled up, Swim outgrew the narrow definition of the traditional BMET role. In doing so, he didn’t so much veer away from the BMET field as help blaze the trail onto which many others have since ventured—the bridge that connects the traditional biomed world to IT.
New Career, New Field
Swim is the team leader of clinical technology at Baylor Health Care System, Dallas, Tex. When in college in the late 1970s, he chose to study electrical engineering. But, he says he was more interested in applying those skills in a hands-on way instead of using them to design new products. The impetus to consider the biomed field came from his then-future mother-in-law, who worked in the health care arena. She “suggested there was this field that was just coming about—people who fixed medical equipment,” Swim says.
Her forecast proved both correct in a macro sense and influential on the individual level, as Swim decided to enroll in Texas State Technical Institute’s biomedical equipment technology program. The field was a natural fit for Swim, who has had a lifelong fascination with the way things work. “I used to drive my dad crazy when I would take things apart—radios, voltmeters—and not always be able to put them back together,” he says.
After graduation, Swim took a position with the Baylor Health Care System, which at the time was a single hospital. While Swim’s entire career has taken place at Baylor, that was not what he intended when he began. “I thought I could be exposed to a lot of things [at Baylor],” he says. “I grew up in Abilene, Texas. I thought I would go to the big city and then move back to my small town.” Swim was indeed exposed to many new skills and technologies, but he never went back to Abilene. Just as Swim’s skills multiplied, so too did Baylor itself, expanding from a single hospital to 13, along with a number of clinics, during Swim’s 34 years there.
The first role Swim had at Baylor was in the clinical laboratory department. “I was specifically supposed to reduce service costs,” he says. “We brought a service group in-house.” Over the years, Swim also worked in many aspects of medical equipment support, management, process improvement, and CMMS system administration.
Shaped By Change
The period leading up to the year 2000 was transformational. The IT concerns surrounding the Y2K issue highlighted just how deeply embedded computers were becoming in everyday life, even then. Swim says the approach to medical device connectivity was shifting, too. “The industry started shifting toward industry-standard networked equipment for patient monitoring systems, whereas before each manufacturer had their own propriety network,” he says.
To keep Baylor at the forefront of these developments, Swim’s department attempted to hire someone with computer network experience, something Swim says was “very difficult to find around that time.” The decision was made to train the biomed staff in computer and network support. Swim helped launch a program to train biomeds in Comp TIA A+ and Network+ certification courses. Swim says his ability to work with computer networks grew a lot during this time, and he realized that, in the future, everyone would need at least a baseline level of know-how. “Our field needs to understand clinical systems, not just serving medical devices,” he says. “That’s the role I grew into—a clinical systems specialist.”
Today, the team Swim works on is tasked with understanding system architecture—a big difference compared to his first days on the job. In a system as large as Baylor’s, Swim says identifying the skills various staff members should possess is key. “You might not be able to have everyone on your team trained to the architecture level, but you should have at least one or two people on staff,” he says. “We train our technicians how to troubleshoot patient monitors, to make sure that the vitals are flowing all the way through the patient’s flow sheet in the electronic health record.”
About a decade ago, Swim took on another role, a result of Baylor’s continued growth. While the biomeds at Baylor might have shared an employer, there was a time when that was the extent of their unity. “We noticed, over time, that we had these little pockets of medical service groups, even inside of one hospital,” Swim says. “And as we acquired new hospitals, we acquired new biomed groups.” To address this, a group was formed in 2003 to combine six biomed groups that were functioning separately into one group. “That’s where I gained a lot of database and equipment-management experience,” Swim says. “We had to bring everyone’s inventory together into one CMMS.”
Although the six groups shared similar goals, they did not take similar paths to get there. “It was interesting seeing what different groups thought was important to track,” he says. “The different groups would have varied views on what should be included in the medical device inventory and how it should be serviced.” Swim’s goal was to standardize the practices across groups. To this day, Swim is Baylor’s medical device management system administrator.
The shift to an IT-centric model at Baylor has continued. A few years ago, the entire biomed group at Baylor was reassigned to report to the Information Services group. The merger of IT and biomed departments continues to be a topic of great interest, and occasional concern, to almost every biomed. Swim says the trend helps reinforce the concept that biomeds are working with clinical systems, not just individual devices: “You’re not only carrying a voltmeter around, you’re also carrying knowledge to make sure that device is functioning correctly within the system.”
Swim says his experience after joining the Information Services department has been a positive one. “There are no barriers,” he says. “I can just walk up to a server support team or network support team—we’ve established communication.” Contrary to the notion that IT-biomed relationships are less than equal, Swim says the groups have proved to be symbiotic: “Our network teams are working closely with biomeds,” he says.
He added that the IT department is often thinking as much about traditional biomed issues as the biomed department is thinking about the world of IT: “I was trying to bring network experience into biomed group in 2000, and now it’s switching: Our IT group is really starting to understand medical device support. I’ve found that once I explain the clinical system architecture to network support teams, they start understanding what the network is supposed to accomplish.”
Swim says that explaining network architecture to both sides—IT and biomed—has helped open communication channels. When everyone first understands the reasons behind policies and what everybody is trying to accomplish, it’s easier to solve problems. As that relationship develops, Swim says the two teams readily trade best practices back and forth, to everyone’s benefit.
Reflecting on the Past, Looking to the Future
Richard Swim’s career has in many ways been defined by change. The field has changed. He has changed. He has even been a catalyst to change. His familiarity with change is in itself a skill, one that anyone in the field should develop. “I think the only barrier you might have to change is the fear of the unknown,” he says.
His mantra is about seeing the change in the big picture before focusing on the smaller changes: “I continue to teach the role of [today’s] biomed health care technology manager,” he says. “It’s not just service; it’s managing system configuration. I keep going back to that—it’s connected clinical systems.”
The growing presence of IT in the biomed field comes with opportunities for continued innovation.
As someone who has built a career learning and implementing new ideas, being given the BMET of the Year designation might be a bit of a misnomer, he says. “I feel like it’s not for one particular thing—someone called this a lifetime achievement award.” Swim’s decision to continually grasp those opportunities as a way to reinvent the traditional biomed role he learned 30 years ago has yielded not only an award, but also a better Baylor Health Care System.
His career path has been nontraditional in some ways, but in many ways, it’s one that anyone can follow. The way to do so is summed up best by Swim himself: “I believe in learning new skills rather than continuing to fix the same problem over and over again, learning to move and change with the field as it changes.” 24×7 August 2013 Focus On
Kurt Woock is the associate editor of 24×7. Contact him at [email protected]