It does not seem that long ago that during an AAMI meeting in Boston, I was asked by a publisher of a meditech magazine to sit in on a discussion about creating a new publication to serve biomeds and clinical engineers. That was in 1993. A few years later, 24×7 entered the field and continues to this day to be a great source of information for working biomeds and clinical engineers.
Over the past few years, working mostly on international projects, it has become clear to me that technology is passing me by. Unfortunately, it has passed many others by as well, but they have not realized it yet and haven’t tried to get caught up with technology. Just think about what is coming down the tech highway at us. How about the 3D printer that can create new organs, vessels, and guts? Or the gene splicing that creates cells to attack most of the cancers and other debilitating problems that the human body falls victim to? Who is going to take care of all these new instruments and services? Who, you ask, is the most qualified to handle these tasks? Just look into a mirror. That person you see is the one who is and will be the most qualified to manage all this new technology.
But in order to take on this new responsibility, we need to review our present workload and dump a good portion of it—not to someone else, but into the trash bin. The first candidate for the garbage is electrical leakage testing. Talk about a no-value item. We have been so concerned with this issue for over 40 years that we have forgotten that no verified death has ever been attributed to electrical leakage from a medical device. But we spend very little time and effort on mistakes made by medical personnel that kill between 5,000 and 400,000 patients per year, depending on which study you believe.
Next to go, in my opinion, is preventive maintenance testing on most of the equipment in hospitals. How often have you ever found a problem during the PM process? Although there are some devices that do require PM inspections, many problems are user ones. A better solution would be to get friendly with the training personnel at you institution and work with them to clear up the problems.
The next item to be dropped is the incoming inspection of a newly purchased medical device before its delivery to the end user. You take it out of the box, plug it in, hit the test button, enter it into your inventory system, put it back in the box, and deliver it to the purchasing department. Think of all the time that would be saved if that inspection were done as part of the installation. You would get to check all the interconnections, determine if other equipment was interfering with this new device, and whether the new device was causing problems with existing systems. You would likely also be asked, “While you’re here, can you look at such and such?” You would be able to deal more efficiently with problems before they arise.
One of the problems many of us are struggling with is how our equipment interconnects with the electronic medical record, electronic health record, or whatever else it is called. We have all heard stories about these systems crashing when someone changed a password, not being able to get new patients into the system, or getting stuck with a system that is impossible to use. Millions of dollars are being spent on train-the-trainer classes. Some last for several weeks, but once the trainer’s training is completed, the person is often not given the time to observe the users and develop training methods specific to that hospital or clinic. We still have to put in the time to make sure that users understand what is needed, why it is needed, and how it impacts patients.
Communication is the key to our ability to address these issues, and 24×7 has been at the forefront of good communication in our field. In that original meeting about 24×7, Jack Spears, the original publisher, said he wanted the magazine to be a “bathroom reader.” According to him, that meant short, readable articles without footnotes, peer reviews, and big words. Through many editors, this publication has generally stayed true to its founding vision. As a result, many in this industry have a better understanding of healthcare technology, its application, and how to communicate with people who do not care about, nor can understand, the technology being used in patient care. For that, on behalf of all readers I say thank you to the staff of 24×7.
As I step away from the editorial board, I would like to thank all the readers who have sent me comments or talked with me at meetings about what I have written over the past 20 years. I hope that I have shared my knowledge, humor, and predictions for the future, that it has made your lives a little easier, and that I have helped make you proud of our shared profession. With that, I say goodbye and be well.
Dave Harrington, PhD, is a healthcare consultant in Medway, Mass. For more information, contact chief editor Jenny Lower at [email protected].
Bravo Dave! Thanks for all of your contributions during a great career and thanks for always telling it like it is. Your voice will be missed.
Have enjoyed your articles over the years Dave and totally agree with your latest . Thank you !
Thanks, Dave. For your work here and all your contributions spanning the decades.
I recall first meeting you at an AAMI Meeting in Dallas some years ago. We’ve only bumped into each other a few times since. There aren’t too many people whom I’ve met just a few times who have left a lasting first impression on me like you did. And that first impression was one of leadership.
Another article posted with this one provides evidence that the field can be confident in our successors to lead going forward. You’ve helped establish the foundation for that and provided a peek at a vision going forward. So again,
Thanks.
I have long enjoyed Dave’s articles; his philosophical mix of relevant content and humor will be missed. Regarding his comments on wasted efforts, I could not agree more.I entered the biomedical field in 1992 and, my first day on the job, I was lectured on “the importance of electrical safety testing”. Advances in technology, in conjunction with marketplace forces and regulatory pressures, have resulted in medical devices that are vastly superior to anything on the market in the “tube-ozoic era”. I beleieve that most ESTs and most so-called “PMs” are driven more by corporate legal teams than by engineering analysis. They are a complete waste of time. I propose a new definition for “SWOT Analysis” – if it’s a “Stupid Waste Of Time” , don’t do it; let the lawyers be damned. Just my opinion.
I agree with Dr. Harrington in regards to PMI. Customers don’t want to book down a perfectly good working system for a portion of the day, field engineers despise doing them (ask anyone who walked up to a perfectly well functioning system and walked away after a PM with a down system situation), and dispatchers are saddled with trying to book a service call that neither the customer nor the FEs want to perform.
Bottom line, it is a regulatory requirement. The problem is the scope of the inspection that is typically required. I truly believe that regular inspections by a qualified and trained eye is a good thing. Experienced technicians know what to look for and can usually make a visual inspection fairly quickly. Worn and damaged parts should be replaced, hardware inspected and tightened. These are clearly safety issues and should be performed on a routine basis, especially for mobile applications.
We can certainly make a lot more sense out of what we are doing for routine inspection. Dr. Harrington stated that we have the data. We have been collecting it for many years. It is time to make some decisions based on that data and improve the process.
Finally, many thanks to Dr. Harrington for all his wisdom and guidance in all things clinical through the years. I wish you well!
Mr. Harrington, I couldn’t disagree with you more. I’ve served twenty plus years in preventative maintenance, including the medical field and you couldn’t be farther from reality. Machines are not repairing themselves yet, and, until they do, we are the one who will need to look after them. One recent glaring example in the news was the Littoral combat ship. With all the technology the Captain ignored a preventative maintenance measure and cost taxpayers, combat readiness and the captain’s job. The ship is now limping back to the U.S. for a $23 million dollar repair. I know this isn’t combat, nor is this a ship, but nevertheless, you’re steering in the wrong direction. You forget that on the other side of those machines are people. You say that you haven’t found any leakeages, but I’ve found three in the last one-and-a-half years on initial evaluation and preventative maintenance. You say that that preventative maintenance isn’t necessary, but everyday, here in my hospital I find issues that need addressing with machines that nurses have bypassed or ignored that shouldn’t have been. Anecdotal, you might say. Well, I might also say this about your article, because nowhere do you site real statistics or figures, just your own word. I fervently don’t agree.
Another ditto and thanks, Dave, for keeping us mindful of our roots and basic founding mission. Yes, the technology has been rapidly changing and passing many of us by, but your wisdom and contributions will remain timeless.
First, thanks for your work, Dave.
I agree that inspections can and should be done on install. Things can fail, just by packing and unpacking.
I must disagree about PM testing. With the imaging equipment I worked on, I often found minor things that, left unrepaired, could cause later system failures.
As for electrical safety testing, it’s unfortunate that even a small jolt from an ungrounded IV pump could stop an already weakened heart. Biomeds must carry on.
I have enjoyed and continue to enjoy this magazine! It is a staple for all x-ray engineers and radiology employees to read and is full of needed information. Thanks for doing such a great job with this publication!
Dave: As you move off the 24×7 editorial board, I look forward to staying in touch and hearing about your ongoing consulting activities. I love the fact that your final Soapbox set off a miniature flame war about PM. The more things change the more they stay the same! – Matt
While I know you’re not hanging up the hockey stick just yet, I appreciate you’re giving yourself some well deserved time to enjoy family and get to some more of that landscaping.
I’ve thoroughly enjoyed our years working together and being able to share ideas with a loveable curmudgeon. You’ve been an inspiration and your efforts to keep us all on track are much appreciated. Please continue to pop up once in awhile to give us a swift kick as necessary.
Be well, my friend!
Well said, as usual, my Yankee brother. As someone said at this past weekend’s AAMI in Tamps, we should be chasing Cybercriminals instead of microamperes. I hope to read many more of your pithy commentaries from “The Penalty Box”. Keep us all in line and focused on what is important. It has been a fun ride. Sincerely, Redneck.
Dave,
It is now September and another year begins for the college students enrolled at “Benjamin Franklin Institute of Technology” in Boston. I thought it appropriate to make this point, as this program might not have begun without your intervention and foresight many years ago. During a Medical Device Society meeting in the 1990’s you approached me to continue to teach and manage this program at BFIT. I did so in tandem with other Engineers and the program has continued with much success; again because of your insight! There have been many graduates who have now found much success working in our field of Biomed, none of which could have come to fruition if not for your discernment to begin and teach this program, which would prove to be a valuable resource for the college.
Dave, you’re a unique and gifted individual who always sought out any opportunities to help educate others. Thanks for your early intervention helping to set the standards of what has become a successful and respected career path for many. It has been a privilege to have known you!
Wishing you all the best!
Bill Purtell