Part 3 of a 3-part series 

July 13, 2022

by Kelley Jacobsen, senior vice president of supply chain and shared services 

Medical device maintenance is as essential to clinical operations as ever in a healthcare industry that relies on increasingly advanced technology. The supply chains, service agreements, and platforms that support clinical engineering teams have likewise grown in complexity. Amidst all these pressures, the need to control spending is on every healthcare leader’s mind. Health systems can leverage independent service providers to integrate these crucial support services, optimizing device performance and uptime while also taking advantage of economic efficiencies.

Clinical engineering teams are vital strategic assets to their health systems. The medical devices these technicians service are essential tools for diagnostics, therapeutics, and patient monitoring. As medical technology advances and becomes more complex, so does the work of maintaining and optimizing them. Clinical engineering today goes far beyond responding to work orders and repairs. Technicians must manage or participate in various functions and responsibilities beyond performing maintenance. These include healthcare supply chains, continuous training & education, and even cybersecurity. 

Just as the responsibilities of clinical engineering are expanding, so is the need to scrutinize spending and control costs throughout the healthcare industry. On the surface, these two industry shifts may appear to be at odds. It can be challenging for health systems to expand the services that create effective clinical engineering teams while facing reduced budgets, decreasing reimbursements, and industry-wide staffing shortages.  

However, the right partnership can upend this thinking. Selecting an experienced independent service organization (ISO) can improve the quality and consistency of clinical engineering with full support services. Choosing the right partner to support a clinical engineering program can open new avenues for health systems to control unnecessary costs and protect revenue streams. Where can integrating these services have the most significant impact, and how can health systems achieve these goals realistically? 

Simplifying supply chains 

The ongoing pandemic has revealed the potential fragility and volatility of healthcare supply chains on a wide scale. Constraints on production and shipping, as well as rising prices as demand outpaces supply, have drawn a great deal of attention from healthcare leaders and the public. While recent events have brought this challenge to the forefront of health care discussions, clinical engineering has always directly felt the impacts of supply chain fluctuations. The availability and reliability of medical device parts can make or break the efficiency of any team servicing and maintaining medical devices. 

However, not all supply chain challenges for health systems originate from external factors like a pandemic. Decentralized procurement processes can create uncertainty with consequences that cascade through clinical engineering and the delivery of patient care. One of the most apparent risks is the supply of parts and supplies needed to service devices. Managing multiple supplier relationships and disparate processes can take up much of technicians’ time. The combination of inefficient ordering processes and time constraints can delay repairs and extend downtime.  

The impact extends beyond day-to-day operations as well. Data on purchasing decisions are more difficult to track when procurement is not centralized. These blind spots can leave many costs unmonitored, putting health systems at a disadvantage when looking for areas to increase savings. 

Of course, creating the infrastructure to increase visibility and efficiency in procurement can also prove costly for a health system. Independent service organizations can offer the resources and experience to manage supply chains effectively and the data that can inform financial decisions. The right ISO will provide technology solutions that effectively automate procurement tasks. For example, technicians should have easy, online access to order approved parts and get order confirmations through their computerized maintenance management system (CMMS). The CMMS can serve as a one-stop shop for understanding what parts are needed, how much they will cost, and how to procure them. Instead of a time-consuming responsibility, integrated healthcare supply chain management becomes an asset to proactively service work orders. 

These benefits extend beyond transparency and into actionability. Working with vendors directly can limit a health system’s ability to affect the pricing of parts and materials. An ISO that facilities purchasing for multiple organizations, on the other hand, manages unique relationships with a wide range of original equipment manufacturers (OEMs) and suppliers. Health systems can leverage this consolidated purchasing power to lower costs, better insulating their budgets from market forces. 

Managing medical device costs with focused expertise 

Health systems must pursue savings throughout their organization, not just on parts and materials for maintenance. An independent service organization with a strong background in managing and optimizing medical devices can provide tools to control various costs. Medical devices can have financial impacts long after the initial purchase when not strategically managed. One often-overlooked expense connected to medical devices is service contracts. OEMs can only provide service to the equipment they manufacture. A health system managing multiple OEM service contracts will likely see those costs scale quickly across its device inventory. 

One alternative to OEM contracts is an entirely in-house clinical engineering program. Yet the breadth of complex devices that hospitals need presents another challenge to this approach. Technicians require unique training and skillsets to maintain all modalities and clinical areas. The full range of training and education needed to maintain the level of expertise can be quite costly. The level of focus that ISOs bring in this area means that much of the needed expertise is already part of the partnership. As new devices are acquired and technology advances, ISOs can offer the resources to keep developing technicians’ skills. 

There are a variety of other difficult decisions health systems face throughout the lifecycle of their devices. These include allocating devices to maximize utilization and finding ways to disposition aging or surplus devices. The technology solutions that ISOs offer can inform confident decisions on the department or facility where a particular device would be most needed. With objective device utilization data from these platforms, decisions become more strategic and aligned to the goal of streamlining patient care. It can prove costly to remove when a device is no longer needed due to age or other internal factors. An ISO can bring experience that minimizes the cost of disposition and even source opportunities to resell devices. Through these channels, health systems can continue to maximize the return on their investments beyond daily clinical use.  

Taking advantage of technology innovations 

Cybersecurity has become impossible to ignore in health care, yet there are gaps in many clinical engineering programs that can leave health systems exposed to threats. 60% of all medical devices impacted by cyber vulnerabilities do not have an OEM-validated response or patch. This lack of coverage reveals another challenge in relying on OEM service contracts. Without adequate cybersecurity measures, health systems often face the potentially costly choice of retiring a needed device, replacing it with capital resources, or leaving the device vulnerable to cyberattacks. 

Remediating vulnerabilities not covered by an OEM often requires the development of new software patches or other compensating controls. In health systems where cybersecurity is typically handled by IT, creating the necessary processes and training for in-house clinical engineers to deliver this service may not align with the organization’s structure and policies. 

An independent service organization that expands clinical engineering services with a serious commitment to cybersecurity can help bridge these gaps. The right ISO addresses cybersecurity as an essential part of modern medical device maintenance, and they supply technicians with the knowledge and resources to carry out remediation strategies. ISO technology platforms are once again a crucial tool in this process for automating device monitoring, vulnerability detection, and alerts to trigger prompt responses with work orders. Health systems can leverage the ISOs of industry knowledge, diligence, and technology to take more control over their cybersecurity strategy and even their capital decisions on purchasing medical devices. 

One of the most valuable criteria for evaluating an ISO is the ability to continue innovating. Just as technicians must continually develop knowledge and skills, an ISO’s technology platform should also undergo continuous improvement that benefits health systems. Greater automation can streamline work orders and preventative maintenance. Live device monitoring can alert health systems to act on cyber vulnerabilities or potential compliance risks. 

The philosophy of continuous improvement extends to every service that supports clinical engineering, not just technology. The true advantage of an ISO partnership is not just maintaining price stability through a clinical engineering service contract. It is also the ability to take advantage of evolving support services. This means ensuring that all device modalities that health systems and their patients depend on, as well as staying on top of the latest developments in device technology. A data-driven clinical engineering service optimizes and automates processes like scheduling maintenance to avoid peak hours and best fit the needs of clinical operations. 

The pressure on health systems to control costs is greater than ever. Yet that does not have to come at the expense of a robust clinical engineering service. The truth is that maintaining modern medical devices relies on a broad range of functions, from procurement to training. Treating each of these as disparate cost centers can obscure the value clinical engineering can deliver throughout an organization. Yet when integrated into a strategic program for optimizing device inventories, health systems can create efficiencies and generate savings. Partnering with the right independent service provider can provide the resources to streamline maintenance work orders, stability in the face of volatile markets and supply chains, and data-driven insights that inform financial decisions from daily operating expenses to capital planning. 

 

Read Part 1 of the series – 4 Strategies to recruit and retain clinical engineering technicians

Read Part 2 of the series – Considerations when searching for software tools to streamline biomedical engineering services