Recently, the US Centers for Medicare and Medicaid Services (CMS) released its “Clarification of Hospital Equipment Maintenance Requirements,” and has roused the profession, prompting debate and the formation of a coalition that includes biomeds, The Joint Commission, the Association for the Advancement of Medical Instrumentation (AAMI), ECRI Institute, and health care facilities.

The controversy involves the CMS decision to require hospitals to adhere, without deviation, to the maintenance methods recommended by the equipment manufacturers. This strict regulation would remain in place on all equipment until a sufficient amount of maintenance history has been acquired (See more in our January 30 Vitalsigns Top Story).

The strict methodology requirement has not pleased many in the industry. One director suggested it would set the profession back 25 years if carried out. According to an AAMI release (click here for the release and then on the link to read the memo), “It was greeted with dismay by many hospital-based biomeds.”

Do you agree? Let us know what you think.

And, if you have strategy recommendations, AAMI and the coalition would like to hear them. You can share your comments or recommendations on this proposed regulation with AAMI by clicking here.

24x7 recently published its annual Compensation Survey, which surveys members of the biomedical/clinical engineering communities about information concerning their compensation, job satisfaction, and responsibilities, among other topics. An astonishing 91% of respondents reported being happy with their jobs, and altruism remains one of the primary reasons for this enjoyment.

“Taking a philosophical viewpoint, one clinical/biomedical engineer from the South Atlantic region spoke for many respondents when she explained why her job satisfaction remains high: ‘[There are] still enough positives in helping mankind in a time of need.’ ”

I had a chance to speak with members of the Gateway Biomedical Society, a local biomed association serving the Missouri and Illinois regions. Frank Bodenschatz, CBET, imaging tech III at SSM St Clare Health Center, Fenton, Mo, had an interesting comment on a biomed’s approach to his role in the health care setting.

“I’ve always worked on a piece of equipment thinking that my family or friend might actually be on it or be involved with what might come to be with it,” Bodenschatz says. “A lot of times, my family comes to the hospital that I work at. My friends are the same way. That’s one thing that I think most biomeds that I’ve met feel.”

Does this sense of contribution to the health care system and altruism drive your enjoyment or pursuit in clinical engineering? Bodenschatz cites family and friends utilizing his facility. Do you find this scenario in your job? If so, does it similarly push you to consistently perform at your highest level?

One of our readers would like some feedback on how other departments handle repairs. Curious about a possible trend, he asks:
“As OEMs tighten their service and support models, are biomeds using the tape gun instead of the screwdriver more than ever?”

He helps clarify by defining a tape gun service model as: “All a biomed can do is put it in a box and ship it out if it breaks.”

With the shifting economy, has your service model changed? Have you seen a transition to the tape gun model?

I have the opportunity to talk with owners of countless third-party service providers and invariably, one of the questions I ask them is how frequently they work with biomeds. Most of them cite daily interaction with biomeds to assist with troubleshooting existing systems, and on some occasions, for the sale of new equipment or replacement parts. This seems to follow logic: on their Web sites, third-party providers often boast free, 24/7 troubleshooting.

However, in my conversations with biomeds, rarely do they mention interaction with those third-party providers—which is not to say that they do not interact with them. How often do you contact your third-party service provider for technical assistance, if ever? What are some of the aspects of that troubleshooting that they do well? What else would you like to see from them to improve their service?

Marcus C. Harris, CBET, and VP of the Indiana Biomedical Society (IBS) has taken a step to further strengthen the clinical/biomedical community by creating a new Web site, BiomedChatter.com (BC), to connect biomed associations. In addition, it also has a Twitter account (@BiomedChatter), created to help promote and relay information about the health care technology management profession and the BiomedChatter.com Web site.

We asked Marcus a few questions about the new sites:
24x7: What is your goal and what sort of information do you plan on sharing?
Marcus: The goal of BiomedChatter.com is to be a resource for biomedical societies. The function allows group collaborations for sharing information and resources that I hope will help promote and grow our profession. I feel that the ability to reach out and connect with others enhances the individual’s ability to grow. This is evident in efforts made by CABMET over the years offering Web-based study groups for the ICC CBET, CRES, and CLES examinations.

BiomedChatter.com provides the platform for transparency among groups. I, just like many of our 150 members and 30 student associates, have never been to a biomed conference or a symposium outside of the state of Indiana. As a board member of the IBS I strive to bring the best conference each year to our members. In past years, we have had the luxury of active members of the biomed community, Kelly VanDeWalker, Phil Diehl, and Karen Waninger who have provided insight into the new trends taking place across the country. In the information technology age, ideas can be relayed instantly, and hopefully BC can be the preferred platform.

24x7: And you have the social media aspect too.
Marcus: The idea to utilize Twitter as a resource came from positive results from the IBS’ Twitter account (@IBS_INBiomed).

24x7: How would you like to see the profession participate?
Marcus: On the official launch date (1/2/2012), e-mails were sent to a majority of society leaders across the country highlighting the availability and functionality of the Web site. I hope to see members from all over use BiomedChatter.com as a primary resource of social industry collaboration and engagement. We have BC blogs for the opinionated individuals, like me; BC forums; and BC chat for all biomeds to share their experiences, as well as groups to discuss topics and subjects with people of similar interest.

Also, I feel there should be a big push to encourage students and new members of the profession to participate, network, and “Join the Chatter.”

24x7: Do you see this filling a void?
Marcus: Biomed Chatter does fill a void. There have been many attempts to use social networks such as MySpace or Facebook to connect members. Often times, members are resistant to the idea of mixing their public lives and private lives or there are taboos and stigmas that come with the usage of those social sites. Biomed Chatter is a social network for biomeds by biomeds. It utilizes new technologies, not listservs, on the backbone of a user-friendly platform used by many across the world.

We wish Marcus the best in the new endeavor. Check out Biomed Chatter and let us know what you think.

In early November, on the Biomedtalk Listserv, a biomed said it had been recommended to his facility, in preparation for ISO 9001 implementation, to use stickers on a device to let clinicians and other staff know “equipment status” availability. His question to other BMETs and CEs—that asked what they do in place of using a sticker—sparked numerous responses. In addition to opinions about why or why not to sticker, the responses raised contamination issues as well as ethical and laziness issues.

Apart from these, responses suggested stickers made it easier to identify devices needing PM. In the end, the ultimate goal of the question was to find out if there were any processes in place as an alternative to using stickers.

If you didn’t share your suggestions on Biomedtalk, and even if you did, what alternatives exist that fulfill the same goal of stickers on devices?

In a recent interview with members of the CE-IT Community—an organization that aims to advance the relationship between and education of clinical engineering and IT departments—one of the group’s members made an interesting comment concerning biomeds’ adoption of and education in IT principles and skills.

“Many biomeds and clinical engineers have been hesitant to embrace this change,” says Leanne Cordisco, Healthcare IT Program Manager, Education Services, GE Healthcare. “It’s been a difficult road, but now that we’re through that first wave of adopters in this new blended world, we’re hitting the people that have been pretty resistant to change. What gets those people to move and change is when they see the people that they have respect for operating and succeeding in that new system. They say, ‘If they can do it, I can do it too.’”

Cordisco also noted that as the current generation of biomeds retires, a new group of professionals will enter the field with many of the IT skills necessary for the changing health care environment. This begs an interesting question: What wave of IT adopter are you? Were you one of the first biomeds to jump on the IT revolution or have you been more hesitant to the change? If you’re one of these second-wave adopters, what steps have you taken to begin this crucial education?

Everyone is different and no method is better than another, but reflection serves as a method to progress and help others in similar positions.

I attended RSNA last week for 24x7’s sister publication Imaging Economics and, never shying from an opportunity to talk about biomeds and the service industry, sat down with a member of the GE service division to discuss the company’s new initiatives. One of the first things he mentioned was the current landscape of the service industry and how the company had to find ways to compete with third-party service providers who offered lower contract prices. The most interesting feature he mentioned was the InSite technology that GE offers. Through the software, GE can remotely monitor all of your GE systems and predict when parts will fail/need replacement or should be serviced. This decreases downtime and acts as a service that the third-part providers cannot offer.

Since GE realizes that third-party companies can offer cheaper prices, they are creating new benefits that only an OEM can offer. With features like remote monitoring, would your facility be willing sign a more expensive OEM contract to avoid downtime? Or do you monitor your equipment sufficiently enough that this added service is superfluous?

At a trade show about a year ago, a vendor told me that with so much work shipped overseas these days, it is hard to vouch for the quality of all the components in a medical device. Along these lines, I received a release from UL Environment Inc, a business unit of Underwriters Laboratories. The company released a white paper about environmental product declarations (EPDs). According to the release, environmental product transparency has become important for manufacturers and building operators. It defined an EPD as, “an internationally accepted, third-party reviewed report detailing a product’s environmental impacts throughout its life cycle, and often includes additional performance, health, and company information.” It suggested that an EPD could be considered an environmental “nutrition label.”

Would this make sense for medical devices, to know the content of components and how they affect health and the environment? Does the makeup of devices and test equipment concern you? The release said EPDs promote transparency and facilitate a comparison of impacts among products in the same category. Would knowing the impact of a component sway a purchasing decision?

How would this benefit the profession—or not?

Since graduating in May, Pratyusha Mattegunta has been working on some interesting projects with the medical device plug-n-play (MD PnP) program that works to facilitate the adoption of open standards and technologies for medical device interoperability, based on clinical requirements, at the Center for Integration of Medicine and Innovative Technology, a nonprofit consortium of Boston’s leading teaching hospitals and universities.

Here, she shares some information and asks for your participation:

“Medical device clock errors are pervasive problems that negatively impact the accuracy of time data in electronic medical records and in the reconstruction of clinical events. The issue of synchronization is especially important with the federal push for “meaningful use” of electronic health record technology and the evolving integration of medical devices.

Many medical devices do not set their clocks using a network time reference, but are typically set manually twice yearly for daylight savings time, or when they come in for repair, or sometimes never. The absence of automatic clock-setting capabilities in most devices—and the lack of time synchronization among the wide array of different clocks used in a typical OR or ICU—can result in inaccurate time-stamps on clinical data recorded in the electronic medical record. There is no widely adopted standard for medical device time management and no guidelines are available. Therefore, we are studying this problem and potential solutions.

Two studies are in progress by MD PnP—one to study the extent of the problem by documenting medical device clock errors in hospitals, and the second study to assess the personnel workload/cost required to manually perform DST clock-changes. These studies are being funded by NIH/NIBIB and DoD/TATRC.

We have developed a survey that was distributed to the health care technology management field. You can find more details on the survey in the article on the AAMI Web site. Interested in taking the survey? Click here to participate in this important study. Thank you!”

You can e-mail Pratyusha at vmattegunta@partners.org for more information on the project.