The Technology Managers’ Forum at this year’s Association for the Advancement of Medical Instrumentation (AAMI) conference in Baltimore focused on some of the ongoing initiatives of the CE-IT Community collaboration between AAMI, the American College of Clinical Engineering (ACCE), and the Healthcare Information and Management Systems Society (HIMSS). This session clearly highlighted the importance of cooperation between clinical engineering and information technology as medical equipment begins to look more like a networked PC. And while collaboration between these departments is essential, one of the topics within the sessions also stressed the importance of another form of collaboration that is equally important—the collaboration between medical device vendors and hospital staff, whether in clinical engineering or IT.
Certainly, collaboration between medical device vendors and hospital staff has always been important, but now more than ever this is so. I have often spoken with other hospitals as they are looking to purchase new medical devices and systems, and they consistently ask what they should look for to differentiate among various systems. One thing that I always point out to them is that with increasingly complex information system-based solutions that are being deployed—even for what were previously simple medical devices—it is much more difficult to quickly swap out one system for another system or one device for another device than it was in the past for stand-alone systems.
Due to the complexity of the systems, the time required to build and test interfaces to these systems, and the overall cost of these systems, once a health care facility makes a decision to implement a particular vendor’s technology there is a good chance that the technology will remain in place for a long time. As a result, I always point out that today you are not only purchasing a technology, but you are purchasing a relationship with a vendor, and you need to feel very comfortable with that vendor as you could be in that relationship with it for a long time.
One of the CE-IT Community workgroups is working on producing a spreadsheet of all the questions a health care facility should ask a vendor about medical device integration. This appears to be a very thorough spreadsheet that includes dozens and dozens of questions to address all aspects of medical device integration. If a vendor answered all the questions in the spreadsheet, facilities would have a very good understanding of what type of integration they were getting into when they installed the particular device.
The question that I raised during this discussion was, how likely is it that vendors would want to answer such a thorough document, particularly if a substantial number of customers asked them to do so? I asked this question not because I felt the vendors would not provide the information, but that given the substantial volume of questions the vendors would not be able to handle a large number of similar requests.
The overall feeling was that if vendors were aware that they would consistently receive the same set of questions, then they could answer the questions once and either post the information on their Web sites or have it available to send out to customers who requested such information.
I agree that this is a tremendous step forward if vendors could easily provide such information, and I eagerly await a time when the CE-IT Community releases the spreadsheet and vendors have such information available. However, I am also cautious about the process, for it is rare to find two hospitals that share all the same characteristics in terms of installed systems, network infrastructure, and support staff. A standardized response only goes so far and requires that both hospital staff and vendor staff take the extra effort to look beyond the standardized responses to understand the uniqueness of every hospital. This is where the importance of establishing a relationship with a vendor is critical.
As medical devices become more complex and more interfaced it becomes increasingly difficult for hospitals to have enough expertise in-house to be able to correctly set up, configure, interface, and deploy these devices. This is true despite the increasing proliferation of standards within the medical device industry. As a result, hospitals are much more dependent on medical device vendors to assist in the deployment of their medical devices. And over time, as more and more devices are interfaced, the types of problems that arise can become much more complex than at any time previously.
Vendors bring specialized expertise to address these problems. This is not to say that a clinical engineering or IT department should not be involved with the setup or support of new devices. As always, they should definitely stay involved. But there will definitely be a time in the life of the devices that a health care facility must depend on a vendor to handle some aspect of the deployment, configuration, or troubleshooting with the device. Therefore, it is the responsibility of the clinical engineering and IT departments to ensure that when the time comes that the vendor must be called upon for support, a comfortable relationship exists with the vendor so that changes, fixes, or updates can be deployed in a quick manner.
In some cases, clinical engineering or IT may have a long-standing relationship with a vendor and the necessary comfort level may exist. In cases where a hospital is choosing among vendors where such relationships do not exist, clinical engineering or IT can play an important role in the selection process by aiding in the assessment of whether or not the vendor is one with which a strong relationship can be developed moving forward. Does the vendor provide a level of responsiveness that will meet the needs of the hospital? Has the vendor shown a level of commitment to other customers with similar characteristics to the hospital? Is the vendor willing to work with the hospital even before the sale to assess the hospital’s particular infrastructure and requirements to ensure that they are delivering the best solution for the hospital? These are the types of questions that clinical engineering and IT should try to obtain answers to as part of the selection process.
Read previous Networking articles in the archives.
With today’s medical devices, hospitals are no longer just purchasing a medical device—they are purchasing a long-term relationship. And like any good marriage, you want to make sure you are marrying the right one.
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 .