TRIMEDX President of Clinical Engineering Robert Moorey was recently featured in an article published in AAMI ARRAY. With continued technology advancements as well as increasing numbers of connected devices within health systems, it’s more important than ever for HTM associates to have some level of IT knowledge to go along with the day to day. The published article, as it appeared May 18, 2023, is below.
For years, experts have discussed the convergence of clinical technology and information technology (IT). Today, the blurred line between healthcare technology management (HTM) and hospital IT has all but disappeared.
Systems, networks, and infrastructure that used to be distinct from medical devices are now integrated. Departments that used to be clearly divided are more connected and collaborative. Disciplines like cybersecurity, which wasn’t a focus for HTM 15 years ago, is a top priority.
“As healthcare evolves, the technology that supports it evolves, as well,” said Robert Moorey, president of clinical engineering for TRIMEDX, an independent asset management company that provides clinical engineering, clinical asset informatics, and medical device cybersecurity services. “As healthcare and its technology change, we have to do things differently than we did before.”
HTM and IT: More Integrated than Ever
The demand for remote capabilities in healthcare is a prime example of this technological shift. Rising prevalence of cloud-based applications, telemedicine, and mobile devices is noted in multiple industry reports over the last several years. At the same time, medical device innovation has evolved to include both hardware and software, with both standalone digital health products and devices with software components entering the market.
Pacemakers can now monitor activity using a smartphone. Digital stethoscopes transmit audio via Bluetooth to the cloud, where AI looks for patterns of abnormal activity. Even the innocent hospital bed contains integrated sensors and software to monitor patients’ movement, weight, and other data.
“Technology is more prevalent and more deeply ingrained in healthcare than it ever has been,” said James Stanger, PhD, chief technology evangelist for The Computing Technology Industry Association (CompTIA), a leading voice and advocate for IT professionals. “In the past, data was stored on a server in the hospital. Now hospitals are using software that lives in the cloud, as well. It’s important for HTM professionals to understand the implications of cloud environments for medical device and diagnostic tools.”
Advancing technology has also led to more grey areas between HTM, IT, and facilities departments. A recent AAMI survey of HTM leaders showed hospital nursery cameras and gaming systems for patient use, for instance, were notably split between HTM, Facilities, IT, security, or other departments. Telehealth equipment falls under IT only about 60% of the time according to the survey. In other instances, responsibility for its maintenance and repair falls primarily to HTM departments.
The evolution of healthcare and medical devices has blurred the lines between HTM and IT. How do professionals on both sides fill that gap? Moorey has seen the emergence of hybrid-type roles for clinical engineers.
“IT can or will go only so far toward a medical device,” he said. “And if that gap isn’t closed, the device can’t function properly. Someone has to resolve that, and I see a number of individuals working toward the middle, closing that gap to make sure devices are properly supported.”
When a software-based imaging device misbehaves, for example, the HTM professional needs to understand whether it’s a cache issue, a software issue, or something else. Stanger refers to this understanding as digital fluency. “Digital literacy means you know some of the basics,” he said. Digital fluency is the wherewithal to choose the right tech for the right healthcare situation. It’s a paramount skill.”
Why an Expanded Skillset Matters
A mix of clinical engineering and IT skills are necessary in an environment pushing toward digital transformation and interoperability. It’s necessary not only for the efficiency of the facility, but for patient safety.
Consider a device that includes both hardware and software that’s integrated into the hospital network. HTM, IT, and the OEM all have some level of responsibility for the management and maintenance of that device. If it goes down, and it can’t be replaced, it’s a risk to the network as is. What then?
“Having the right people at the table working together for the benefit of the patients will go a long way toward finding a solution,” said Moorey. Sometimes it requires a third party, like an OEM, and sometimes it requires HTM and IT working together to create a solution.”
Where to Get IT
HTM training opportunities have expanded to meet the demand for IT skills. Some educational institutions have added more technology and/or IT-focused courses to biomedical engineering programs, while non-profit associations offer more in-depth resources.
Indiana University’s Purdue School of Engineering & Technology, for example, offers associate’s and bachelor’s degrees in HTM as well as a certificate in medical device cybersecurity. St. Clair College in Windsor, Ontario, recently overhauled its HTM program to include courses on virtual and extended reality, 3D printing, and cybersecurity.
AAMI offers a “Cybersecurity 101” course for HTM professionals as well as a BMET Apprenticeship. The apprenticeship is a two-year program that includes IT and cybersecurity as part of its formal learning. CompTIA is one of the partners in that program.
CompTIA offers dozens of certification programs for individuals and teams. For HTM professionals who want to expand their skillsets, Dr. Stanger recommends starting with IT Fundamentals, which provides an overview of operating systems, network connectivity, and software applications as well as security and web-browsing best practices.
Network connectivity is another area where HTM can expand their skillset. “When I started, physical cables connected devices. Today you can connect a device in one building to another device in another part of town,” said Moorey. “Those devices communicate across a sophisticated network. Clinical engineers need to understand how that works as well as the terminology to help facilitate a fast resolution.”
Security and cybersecurity training are essential skills. Subspecialties related to data privacy, endpoint protection, and social engineering (e.g., how staff behave and responds to threats) are especially valuable.
CompTIA offers certifications in both networks and security, while TRIMEDX offers custom training for organizations to increase competency and career paths for HTM teams. It also offers a coursework as part of AAMI’s certification program and partners in the BMET Apprenticeship program.
To learn by way of information exchange, HTM professionals can connect with peers via the Health Technology Alliance. HTA is a collaborative effort formed between AAMI, the American College of Clinical Engineering (ACCE), and the Healthcare Information and Management Systems Society (HIMSS). Previously known as the CE-IT Community, HTA members can share best practices and access educational resources and tools designed to advance industry knowledge. Membership is free for members of the three sponsor organizations.
On the Horizon for HTM: IoT and Security
As healthcare facilities adopt new technology, HTM and IT responsibilities will become even more intertwined. Exactly how depends on the pace of technology adoption within healthcare organizations. Dr. Stanger recommends HTM professionals stay on top of the Internet of Things (IoT) as wearables and other Bluetooth-enabled devices work their way into healthcare organizations. He also sees an emerging need for patch management.
“Think of how many devices are being used now. They all have IP addresses and multiple ways to connect to those IP addresses,” he said. “Patch management and IoT device management could become a profession of its own.”
Bridging the Gap
According to Moorey’s observations, as technology has become more integrated, the people that keep it all running are collaborating more closely than ever. “People are clearer on roles and responsibilities, and there’s more teamwork between the two groups.”
With continued communication and training, HTM will continue to serve healthcare’s medical equipment needs as technology advances. “The best way to move forward with confidence is to allow the machines to do their job and let the technicians think laterally and anticipate problems,” said Stanger. “The way you do that is by understanding the technology itself.”