You can’t push a rope

The above statement is a simple one, possibly a little humorous to some. But it tells our story very well.

Several months ago, in an issue of Medical Imaging magazine, there was an article on medical record systems in one hospital network. This was a nine-hospital network and there were nine different medical records systems. In our field we would be out of job so quick if we allowed that to happen with the equipment we are responsible for, but for some reason it is acceptable for our computer colleagues. Maybe they have figured out how to push a rope.

In our local paper there was a long article on birthing centers and how the dominant one in the area had a goal of 10,000 births in 2001. What the article went on to say is that the hospital was losing an average of $140 per birth. I may be only an engineer, but if I were losing $140 on every birth, I think that I would be looking at both cost control and cutting back on that service until the cost problems were solved. But the article went on to say that while the institution tried to limit new physician practices, the existing practices were still expanding. Talk about pushing a rope.

One of the most misused words that we hear is “partner.” We have vendors saying that they want to “partner” with us on a new purchase or service. We have hospitals looking to “partner” together to cut costs and associations or buying groups looking to “partner” with hospitals to get better prices or services. In all too many cases the group proposing the “partnership” is looking for you or your hospital to pay and they partner with you by taking your money.

Recently I had the privilege to sit in on a presentation where a vendor proposed to “partner” with a hospital on an equipment need. After the presentation some questions were asked of the proposed “partner.” Here are some of them.

Will system upgrades be provided? Yes, they will.

What will the cost of the upgrades be? That has not been set.

Is service included? Yes, there is a warranty of one year, but you can purchase additional warranties.

Will you pay for the installation, including riggers, if needed? No, you have to pay for shipping, riggers, any changes to the utilities and buildings, but the installation is free.

What training will be supplied to the users and those maintaining the equipment? We will do 24 hours of in-service training for your staff.

Is that one day of training, all shifts, or three days of training for the day shift? That can be worked out.

Service training? That can be a problem, as we normally do not train a customer’s employees on service.

This is a “partnership”?

Even used-car salesmen aren’t this bold when trying to sell you a car. There were many other questions asked and avoided, but the hospital bought the device, as it was going to be a “partnership.”

After almost 40 years in this medical instrumentation business I am finding that the “brain dead” seem to be in charge, even when better methods are presented to them. One of the functions that we do not do well at is communicating with nontechnical people. Unless we can present well-written, well-thought-out reasons and options to administrators, we will continue to keep trying to push a rope — but now it will be uphill.

Communication is the key to our profession.

Dave Harrington, director of special projects for Technology in Medicine Inc. (Holliston, Mass.), is a veteran educator/clinical engineer/technology manager and 24x7 contributing writer.