Once a problem squarely in the realm of IT, cyber attacks on medical devices—including viruses and information-stealing malware—are now a threat looming large enough to necessitate biomed intervention. As hackers get smarter about infiltrating health care networks, hospitals need to get more organized in how they deal with them.

While medical devices haven't been targeted specifically by hackers yet, they may become corrupted or damaged just the same if a hospital's network is breached, according to Axel Wirth, national health care solutions architect with computer security company Symantec Corp, out of Sunnyvale, Calif.

"Medical devices tend to be a weak spot" in a hospital's network, he says. This is especially true of older equipment. Since device configuration lies in the hands of the manufacturer in the US, biomeds need to cement a good working relationship with their vendors to make sure equipment is properly patched and up to date. Hospitals with several of the same older device are especially vulnerable. If networked, all devices could be affected during an attack.

24x7 will be focusing more on the growing threat of cyber attacks in an upcoming Focus On article, but first we want to hear what you've seen and heard at your facility. Have you spoken to your IT department? What's the best way to approach this subject? Also feel free to share any tips for working with corrupted equipment.

When Southeast Alabama Medical Center (SAMC) in Dothan, Ala began to hear about the difficulties in finding hospital assets in a timely manner from patients and staff alike, the complaints did not fall on deaf ears.

For one thing, biomeds found the process of performing preventive maintenance cumbersome. “As the month goes on there’s less and less PMs that are due for maintenance and it gets tougher and tougher to find them,” says one SAMC biomed.

Furthermore, patients were also getting lost in the shuffle. “There were certain instances where patients were at the front door waiting for wheelchairs and they were starting to get disgruntled,” says Scott Lapham, senior network engineer at SAMC.

The hospital evaluated the concerns and implemented a wide-reaching RTLS, which tracks a variety of equipment and non-equipment assets, helping to clear up these issues—particularly helping biomeds with PM compliance. And people have started to notice, as Lapham says he hears staff praise these new efficiencies almost every day.

We’re interested in hearing other best practices for evaluating feedback and making changes. How is feedback given and received in your facility? And feed free to share any specific instances.

If you’ve been spending time on the Internet the past few years, you’ve likely run up against the growing influence of social media sites like Facebook, Twitter, and LinkedIn to help manage our ever-growing personal and professional lives. More recently, however, these same sites are now allowing biomeds to bring their once isolated profession into greater connectivity.

Specifically, biomed associations like the Intermountain Clinical Instrumentation Society are using interactive sites such as Yahoo to reach out to members about association activities.

Social networking can even give biomeds a single source from which to keep abreast of industry changes. Currently, the FDA/CDRH, AAMI, and even The Joint Commission all provide updates to followers on Twitter.

Recently, we’ve even been hearing about how social networking is being used to help job seekers connect with employers, and vice-versa.

24x7 (not surprisingly on both Facebook and Twitter) is interested in how you’ve used social networking in your job or association. Has it helped busy biomeds save time? Leave a comment and share.

When Southeast Alabama Medical Center (SAMC) in Dothan, Ala, was looking to implement a real time location system (RTLS) to track assets in their hospital, they took a step we mostly associate with HR departments looking into a new hire—they checked references.  

“When we started talking to a few of the references, they gave us a few of the key takeaways that they’ve learned, like how to set up a map to be more efficient,” says Scott Lapham, senior network engineer at SAMC. “By hearing what other people are doing, you may or may not go down that route but it at least gives you that thought process to make sure you’re thinking about everything that comes into play.”

When it came down to making the decision, the hospital had a lot of honest feedback to work with from others in similar situations. “We heard good things about certain vendors and we heard bad things about vendors and we had to take that into account regarding our unique situation,” Lapham says.

In addition to helping them choose the best RTLS, it also opened the door to a working relationship with peers. Since every hospital is in a unique situation, Lapham used RTLS as a common bond. “The way I look at it is it’s nice to be able to talk to your peers not necessarily from a reference standpoint, but to see their pains too,” he says. “A few people that we’ve talked have said things about what they’re looking at tagging that we hadn’t even thought about. It's a reference call but it’s more of a relationship with our peers trying to learn the whole process.”

How does your team connect with other biomeds and hospitals one-on-one, and what’s the easiest way to break the ice? We invite your suggestions.

Our February Focus On column references an emergency exercise at Westchester Medical Center in Valhalla, NY. In the exercise, doctors, biomeds, and other hospital staff ran through all the necessary steps of dealing with a hospital-wide pandemic flu emergency, from checking patients in, to setting up equipment, to stemming the spread of contamination.

Joint Commission regulations require facilities to undertake regular emergency exercises to test how plans on paper will fare during an actual emergency situation.  

While the staff at Westchester Medical performed well in the drill, there were still some bumps in the road. "There were a couple things, like finding outlets for the equipment and running phone lines to the right places, that until we actually put the physical structures in place, we didn't think about," says Garret Doering, the hospital's director of emergency management.

On the heels of an upcoming Joint Commission conference on effective emergency preparation strategies, we invite you to share your department’s experience with emergency equipment plans. What are some of the strategies your hospital is putting on paper and what are the most efficient ways to test it?  

When working on an unfamiliar or particularly challenging piece of equipment, sometimes just finding the problem to fix can be a bit tricky. Resources such as service manuals, advice from colleagues, or even the Internet can all be indispensable when troubleshooting, but sometimes an out-of-the-box solution can yield the best results.

When biomed and clinical laboratory equipment specialist Jon Sears with the Baltimore VA is having difficulty, oftentimes he will go straight to the equipment vendors themselves.

“It’s just a matter of getting through the tech support people,” he says. “If you can get through the front lines to the engineering group, they’re just like any other engineering group out there. They don’t mind pointing you in the right direction to work on things. A lot of times most of the engineering is reserved for most of the company’s field service representatives, but a lot of times they’ll talk to you.”

Sears also uses his background to build rapport with vendors. Taking time to build a relationship and a level of trust with vendor service departments has paid off for Sears, who turns to them for more than just troubleshooting advice.

“A lot of times I’ll call them up and I’ll take to them about reference manuals or files I need. A lot of the time they have it on their computers and they’ll just e-mail the file."

We’re interested to hear about any go-to troubleshooting techniques and tips you’ve picked up. Have you opened any doors thought previously closed?

In our October Focus On column, we explored the CDRH’s radical new approach to spotting medical device safety issues before they become problems. The CDRH has reorganized its safety reporting methods to involve every employee throughout the center, by incorporating Matrix organization elements.

A Matrix design places staff members from different departments under new supervisors who oversee a specific part of a particular project. The unique organizational structure gets its name from a Matrix table, where all elements are represented in both rows and columns. Employees continue to report to their existing manager, but also work closely with other project managers who oversee aspects of a particular project.

A Matrix approach is ideal for special, temporary, or ongoing projects that rely on cooperation from multiple departments. In a hospital, for example, organizing staff into a Matrix structure may be suitable for researching, purchasing, and setting up new equipment, or for special projects requiring close interaction between biomeds and IT.

Have you used a Matrix reporting structure for any project? Any tips on the best way to organize it? What works for keeping everyone on track during special projects—and, likewise, what doesn’t?