Karl Ruiter

Karl Ruiter

A BMET’s and clinical engineer’s job requires a host of tools and devices. Often, these tools are one-size-fits-all devices, designed for many different markets and applications, rather than being designed just for biomedical/clinical engineers. However, Sun Valley, Calif-based Pronk Technologies, influenced by its founder’s time in the patient monitoring industry, tailors its product line of test equipment specifically for BMETs and clinical engineers. 24×7 recently spoke with Karl Ruiter, president of Pronk Technologies, about the company’s history in patient monitoring, supplying products for a targeted audience, and some of the challenges currently facing the clinical engineering community.

24×7: Can you tell me a bit about the history of Pronk Technologies?

Ruiter: Most of the people at Pronk Technologies were originally part of a Los Angeles-based patient monitoring company. Twenty years ago, that market consisted of a whole bunch of small companies. There were probably 15 or 20 companies that grossed $100 million or less. That market completely consolidated. Most of those small companies are gone, and patient monitoring is dominated by huge international corporations.

Since it’s very difficult to be a small company in that market, we looked for an adjacent market and found the biomedical test equipment market. We started about 9 years ago and first started doing consulting and contract development projects. Finally, when we decided to launch our own product, we opened Pronk, which makes tools for biomeds.

24×7: Those industries were analogous enough that making the switch was not a problem?

Ruiter: Yes. We actually learned a great deal from our role making patient monitors, and we got to know a lot of biomeds, many of whom are still active. So not only did we understand the technology, but we also knew potential customers. Also, in that role, since we were producing medical devices, it became very clear to us how critical the role of biomeds really is in the hospital. The biomeds are who keep the medical devices working and working right. We were familiar with biomeds and the technology, and had a real appreciation for the job that biomeds do.

24×7: What is the company’s mission?

Ruiter: In a way, it started out as a bit of an accident, because our patient monitoring company focused on making small, rugged patient monitors. So when we moved to test equipment, we started thinking about small, rugged, portable test equipment. I think this equipment design has an extra significance in the biomed world because it increases the flexibility of the biomeds and allows them to work in different modes and in different scenarios. One emerging scenario is biomeds doing more of their work out on the clinical floors and increasing their visibility and contact with the rest of the clinical community.

Another aspect of our mission is making quality biomedical test equipment more accessible. We price our products at a point which is dramatically less than they could demand, with the idea being that we’d like to have every tech have his own set of tools. Before we came into the market, because of the price and size, you would often see a scenario where biomeds were forced to share tools.

24×7: What services does Pronk provide?

Ruiter: We offer service for our products, including calibration and repair. One of the things that we’re particularly proud of is that we can usually return a product that comes in for service in a few days. Since we offer a 4-year warranty, most products are serviced with no charge. When products eventually go out of warranty, our service prices are very good.

Service has been a point of pride with us since our prior days as a patient monitoring company. At the time, we didn’t have any field service at all; we did all of the service in our factory. But people said that the speed and quality of our service rivaled the larger companies who had field service teams. When we formed Pronk, we maintained that focus on excellent service.

24×7: What’s the typical turnaround time for a repair?

Durmis: Typically, the repair time for us is 3 to 5 days. The challenge lies in when a customer will give up their product to us after they get a loaner, how quickly they get their damaged product back to us, when they approve a repair, etc. So a lot of it ends up being a logistics process. But the applied time on our end is 3 to 5 days.

24×7: Can you tell me a bit about the SimCube?

Ruiter: It’s the product that started it all, although the OxSim definitely rivals it in terms of popularity. The SimCube was the first small, rugged, easy-to-use NIBP simulator. It’s interesting because when we had the idea to enter this market, we had a different product idea for a simulator that we wanted to do. We went to a meeting of a local professionals’ society called the CMIA [California Medical Instrumentation Association]. I was doing a presentation there, and during the intermission, I did another presentation about this simulator. The response we got from the biomeds was that we had it all wrong. It wasn’t what they wanted. They took us aside and told us specifically what they wanted from the product. A couple of people really went out of their way and coached us, saying, “This is what the product needs to be.” We took this to heart and built the SimCube around what they requested. We discovered that they were right, of course.

The SimCube took off from there. I would guess that it’s the most popular NIBP simulator on the market. The market has changed since we introduced it, and other manufacturers have started introducing small NIBP simulators, but I think the SimCube is still the smallest, most rugged, easy to use, and probably the most popular. So our familiarity with biomeds and the industry helps us design the products, and SimCube was our first successful proof of that approach.

24×7: How does your low pricing point affect the way that you design your products?

Ruiter: We design the products to be simple. That is, we aim for well-thought-out operation, easy-to-use user interfaces, reliable design, and reduced complexity in terms of manufacturability and service. By making the products simple and well thought out, we’re able to offer a competitive price point.

24×7: Do “simple products” have fewer functions and necessitate a wider range of products?

Ruiter: Within the focus of a single market, I would say no. Many manufacturers design products that are not totally focused on a single market. They’ll design one product and market it to manufacturers, training clinicians, salespeople, and biomeds. We don’t take that approach. We design products much more narrowly focused. The result is a small set of products that meet almost every biomed’s needs, but are less expensive because they don’t have a whole bunch of extra features that biomeds don’t need. And the product is easier to use because all of those unneeded features don’t get in your way.

If you broaden the question to multiple markets, then yes, we do sometimes have to build a wider range of products. Our multiparameter simulator is an example of that. The biomed version, the SimSlim, has testing features like static IBPs that a biomed needs. It is compact and rugged enough to carry in a pocket, which is important because many biomeds have said they want to have a basic multiparameter simulator in reach at all times so they can quickly respond to something like a telemetry call without having to go back to the shop—but it does not have every possible blocked rhythm and ST elevation value. There is also a clinical version, the EasySim, which has a lot more complex rhythms and a big color-coded remote, which makes setting up complicated clinical simulations easy—but no testing features such as static IBPs—and with the remote it is not quite compact enough to carry in a pocket.

So that’s a situation where we offer two different products where other manufacturers might offer one. We think this makes the clinical product better for the clinical folks and the biomed product better for biomeds.

24×7: Is it more work to focus on one market?

Ruiter: It takes a lot more thought to make simple products that really work. We put a huge amount of time into thinking about exactly which features to include.

24×7: Besides your products designed specifically for biomeds, do you have another focus?

Ruiter: Our primary focus is test equipment for biomeds. It’s very tailored. We do sometimes offer configurations of our products to manufacturers and clinical staff, but when we do, they are separate products.

24×7: Does Pronk still interact and communicate with the biomedical community?

Ruiter: We do. We attend regional meetings whenever we can to give presentations. For example, we have presentations that we deliver on blood pressure monitoring, and not just focusing on the simulator but focusing on how blood pressure works and digging down into the technology, as well as a presentation that we do on IV pump testing. They’re really not sales presentations; they’re educational presentations. They’re very well-received, and we love to give them.

24×7: What are some of the challenges facing biomeds today, and how does Pronk help solve those issues?

Ruiter: I think that biomeds face many challenges, but I think some of them are linked. Biomeds have always been challenged because there’s an awful lot to do and resources are often scarce. Our making test equipment that has a higher value helps those issues because we allow them to get the equipment they need in a way that fits in their budget.

Another aspect is visibility, because the biomed department, when it’s down in the basement, can sometimes become invisible. When that happens, it can be harder for the biomed department to get the recognition and budget it needs. One of the things that we like to see—or create the opportunity for—is biomeds doing more and more of their work on the clinical floors and less in the basement. We think this increases the visibility of the biomed department and that this has a lot of advantages.

Another advantage comes from the fact that biomeds know so much more about the medical devices than anyone else in the hospital. I remember one case where I was in an OR working on something in my patient monitoring days. The biomed was there with me, and the nurse said to the biomed, “The doctor hates this monitor because the waveforms are red and he can’t see red.” The biomed quickly went to work and changed the waveforms to blue, and the nurse’s jaw dropped because she had no idea that that could be done. There’s a vast body of knowledge that biomeds have about their organization’s medical devices that no one else has. If the biomeds are in contact with the clinicians, there are thousands of great little training opportunities that can happen all the time.

24×7: Have you heard any responses from administrators about biomeds working in the clinical setting?

Ruiter: I haven’t had that discussion, but I know that with our products, biomeds do work more up on the floors. They don’t do this with the goal of increasing their visibility, or to perform training, but to work more efficiently. Rather than dragging the equipment to be tested all the way to the basement and then dragging it back up, they can just test it in place, which makes their work go much more quickly. Of course, this efficiency helps with their problem of having too much work and not enough resources. But I really think that the increased visibility and training are important side effects.

24×7: What new products/services do you have planned for the future?

Ruiter: I don’t want to go too much into specifics, but our new products will continue along the same general lines. I think that if you’re familiar with our products now, and you happened to see one of our new products without any branding on it, you would still immediately know it was one of our products. You would see the family resemblances: the small size, the portability, the ruggedness, and the ease of use. All of those features will remain our focus.


Chris Gaerig is the associate editor of 24×7. Contact him at .