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.

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?

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?

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.

Like cell phones, ubiquitous mobile computing devices, such as the iPad, have also found their way into health care and hospitals. As the use of mobile devices in hospitals continues to expand, the potential security risk also increases. iPads enable physicians to view patient information from remote locations or at the bedside, which accelerates diagnosis and treatment. In our April 2011 issue, biomed manager Randy Berlin shared how implementing iPads in his department saved money and time.

The Healthcare Information and Management Systems Society, or HIMSS, recently polled its members and found that 75% of responders—the majority of which came from health care—identified secure configuration and deployment as the number one iPad IT management challenge.

Has your department been involved with issues relating to iPads or other mobile devices like this? Have they caused any of the concerns cell phones did in relation to interfering with medical devices? Has your IT department raised any concerns or come up with security solutions?

And, does your department expect to provide them for your use? Let us know how this technology is affecting your hospital and your department.

In the August 16 edition of the Weekly Jolt, we wrote about the Healthcare Technology Foundation’s (HTF) call to action for all members of the profession to take its new survey to determine changes in the health care profession’s perception of clinical alarm problems, improvements made at their facilities, and priorities for future action.

J. Tobey Clark, MSEE, CCE, director of instrumentation and technical services, University of Vermont, and HTF president, said, “Clinical alarm challenges continue to lead to a significant number of adverse patient events.” He added that the organization had surveyd the field in 2006, which led to the publication of an important white paper—“Impact of Clinical Alarms on Patient Safety,” and it was now re-surveying the field to determine changes in perceptions, priorities, and actions taken related to clinical alarm issues.

The HTF completed the survey of 4,278 health care professionals on September 10 and the full report on is now available. To read the results on the HTF Web site, click here. The report offers comparisons of responses between 2006 and 2011 and also lists new questions asked for 2011. One new question’s response indicated that almost 1 in 5 institutions experienced adverse patient events over the last two years, in relation to clinical alarms. Have a look at the survey results and compare activities of your department with the results.

If you didn’t catch our September issue, click here to have a look at what BMETs and CEs can do to help combat alarm fatigue.

Conversation abounds about automation, whether in relation to interconnected devices that automatically feed to the electronic medical record, or the latest test equipment that automatically analyzes and stores results, all of which reduce the need for manual documentation. In reality, how many departments actually utilize these new technologies when it comes to PMs and repair documentation?

We have a new poll on our home page that asks this question: What technology do you use to eliminate or reduce manual data entry and/or the use of paper scratch sheets to log PMs or repair documentation?

Did your biomed department, “cast off their pencils and clip boards and run for the digital horizon,” as one of your colleagues asked? Our previous poll asked if your department supplied you with a smartphone to take advantage of apps that may help streamline your work and the majority said no.

Where does the average biomed department stand in relation to these advances? Are the handheld bar code readers with Wi-Fi, RFID integrated technologies financially accessible to clinical/biomedical engineering departments, or are they out of reach? Could these devices integrate into computerized maintenance management software platforms you may already use?

Who’s minding this store and leading the way to adopt this type of technology? As the economy continues to struggle and dollars remain locked, these investments could go a long way to improving efficiency.

What automation has your department adopted? How did you get there? What would you like to see developed, such as a “Quick-PM” or “Rapid Repair Order” app, as a colleague suggested. Also, you can click here to get to our home page, then scroll down to take the poll.