Ken Olbrish, MSBE

One of the primary support differences between IT and clinical engineering is that traditionally, IT supported applications and hardware remotely with only limited customer interaction, whereas clinical engineering supported devices directly by visiting the department and interacting with users. Historically, this method of support worked well for clinical engineering, as they needed to troubleshoot individual, stand-alone devices in a clinical department. However, as medical devices increasingly begin to resemble computers and increasingly interface to other medical devices and IT systems, it may be difficult for clinical engineering to support devices as they have traditionally done. Oftentimes, issues are widespread, impacting multiple devices and/or departments. As a result, it may be difficult to troubleshoot an issue within the department given the global nature of the problem. Furthermore, there may be many impacted devices and users from a single issue, and it is not possible for clinical engineering to visit all these users simultaneously while trying to resolve the issue.

This creates a new challenge for clinical engineering. Luckily, this is one area where clinical engineering can benefit from IT’s experience with addressing this type of issue. Namely, through the introduction of a help desk system of support, clinical engineering can provide better support for its customers while at the same time potentially improving its overall ability to respond to and address issues quickly and effectively.

In many clinical engineering departments, support is provided by having customers call or page an appropriate clinical engineering resource directly. That resource would then respond and go to the department to begin investigation on the issue and to work with the customer. For a single, isolated incident this works extremely well. The individual with expertise responds and provides valuable face-to-face customer support. Certainly, this level of support is appreciated by clinical departments, and they come to expect this level of support for all issues. Now let’s say that there is an issue with a clinical system that simultaneously impacts multiple users in multiple departments at once. It is possible that a single individual in clinical engineering is now receiving numerous pages at one time. Given the type of issue, it is very difficult to troubleshoot and resolve the issue while being located in a clinical department because it may involve a network or server that is located away from the impacted department(s). Now the individual with expertise is challenged with trying to return multiple calls at one time, providing some level of direct customer interaction because it has become expected, and trying to resolve a remote issue. It is easy to see how issues with new computer-based technology challenge the current support model. This does not even consider what would happen if the particular individual with the most expertise in clinical engineering were at a remote site for the day or happened to be away. This is where a help desk support model can prove beneficial.

Centralized Assistance

Most help desks in operation today rely on some type of help desk application that allows staff to log issues and track them through resolution. From an end user perspective, if there is a centralized help desk number to contact, the user’s call can be answered and logged without that user wondering if a page or voice mail message will be answered. Most help desk applications allow either a Web page or e-mail notification that allows users to have an indication that their issue was logged, and it can even provide them with status updates on the resolution of their issue.

A centralized help desk can streamline service calls and increase efficiency.

In the case where many users call to report the same issue, the help desk system allows these tickets to be logged quickly and also allows anyone supporting the help desk number to get an indication of the extensive nature of the problem and to find out where it stands in terms of a resolution, etc. This means that the expert can be working on the problem while other staff are merely fielding calls and providing updated information. From the end user’s perspective, this also means that there is a single contact number for clinical engineering regardless of the problem. Therefore, if there is a bad infusion pump or failed CT scanner, there is only one number to call to report the issue, and the help desk will then triage the issue appropriately. This provides less confusion for the customer who tries to remember who to call depending on the device that has an issue, the time of day, or whether or not someone is on vacation, etc. In the help desk model, the customer is assured that nothing is being missed because they can always get an update on an issue either electronically or by contacting the help desk again.

Multiple Advantages

From the clinical engineering department’s perspective, the use of a help desk also has some significant advantages. First, by logging issues centrally there is now an easy-to-use record of issues that allows the clinical engineering department to identify service trends and look for ways to be proactive in addressing issues before they arise. Second, it allows for better coverage. If the individuals within the department with the most expertise document how they address specific issues, then even if these individuals are away someone else could review this information and have knowledge on how to resolve the issue when it comes up again. Third, there is a structure in place to allow clinical engineering management to get a quick look at ongoing issues, type, and number of issues being reported and to be able to adjust staffing as needed based on this data. Furthermore, it would allow for a mechanism to escalate issues easily to management should an issue require escalation. Finally, it provides a central view of all current clinical engineering activity that would allow a clinical engineering team member—regardless of location—to get an idea of any currently reported issues to see if it is a global issue or an isolated incident. This can be particularly useful if there is a single clinical engineer at a site that is part of a larger enterprise.

Most enterprises already have an IT help desk in place, so clinical engineering should discuss best practices with IT in terms of finding out how to roll out its own help desk support model. It may be possible for clinical engineering to leverage the existing IT help desk to also field clinical engineering calls and then triage them to clinical engineering, or at least be able to utilize existing IT help desk software. In the end, the help desk model is not difficult to set up; however, it can be challenging to staff, particularly for smaller sites or during off hours. By collaborating with IT, clinical engineering may be able to take advantage of help desk staffing already in place to address some of these concerns.

Finally, it should be noted that one of the big advantages to traditional clinical engineering support is that customers actually see clinical engineering staff in their departments working on issues. Clinical engineering should be careful that moving to a help desk model does not lose this aspect of customer support. Clinical engineering staff should still try to visit with customers directly as much as possible. Even in the case where there is a broad, systemwide issue, clinical engineering staff should still try to visit individual departments after the issue has been resolved to continue to foster the good relationships they have established with clinical departments. And if clinical engineering is learning help desk best practices from IT, it could return the favor by teaching IT best practices for customer support.

Ken Olbrish, MSBE, is an enterprise imaging system administrator in the Information Services Department for the Main Line Health System, suburban Philadelphia, and is a member of 24×7’s editorial advisory board. For more information, contact .