Not too long ago — back in the ‘80s — we were in our infancy as an industry. The original equipment manufacturers (OEMs), such as GE Medical Systems (GEMS), Siemens, Philips, Toshiba, Picker, Technicare, CGR and others controlled the market. In those days an OEM never would think of working on equipment from another manufacturer. The OEMs insisted that if customers wanted their “world class” excellent service, then those customers would have to buy the OEMs’ equipment. No excuses!

The advent of DRGs (diagnostic related groups) managed care and cost-control began to change the healthcare market; in response, many ISOs, (independent service organizations), started popping up all over the country and offering the solution to controlling costs as an alternative to the OEMs.

Enter the advent of the “asset management” era. Remember the GEMS-R2 “tug-of-war” in the late ’80s, early ’90s, regarding the rights to proprietary software by third-party maintenance organizations? To some of us that seemed to go on forever, ultimately coming to an end with GEMS’ purchase of R2, a medical equipment service company (not to be confused with R2 Technology Inc., whose products include a computer-aided detection, or CAD, system for mammography). But it was during that time that GEMS opened its eyes to the potential market for servicing all equipment.

In the ’90s, GE Healthcare Services was born. The company now was touting the excellence of one-stop shopping for all service, regardless of vendor. The ultimate goal of all OEM-based programs was to increase market share within their service accounts. So the concept offered the component of “asset management” or one-stop shopping, but it was missing the one component vital to ISO success: independence.

As other OEMs watched, GEMS developed a comprehensive or multivendor, service offering, calling it “CompreCare,” which provided service to a hospital no matter what vendor’s equipment was installed. GEMS went

on a buying spree, purchasing every company it could to help increase its market share. This approach became so successful that other OEMs pursued the same strategy, offering their own versions of asset management or comprehensive care.

In short order, other industries sat up, took notice and followed suit, in particular, the information technology (IT) industry. Suddenly such companies as IBM, Compaq and Hewlett-Packard were in the multivendor service arena, as well. Whereas the healthcare industry had R2, COHR, Novare Systems and others, the IT industry had DecisionOne, Peak, Wang Global and more. It soon became apparent, however, that it was not as easy or inexpensive for one company to support a wide variety of equipment made by different manufacturers as was originally thought.

Today, there are fewer and fewer true independent service organizations. Most have not been able to survive the changes in the industry; others have been purchased by larger OEM organizations. A handful of ISOs has survived, but only because they were willing to change the services they offer to keep up with the demands of the market.

ISO needs to offer IT
Today, any ISO must offer not only clinical, biomedical and radiology services but also a comprehensive IT offering to remain competitive, including network design, installation, support, wireless services and hardware support. The blending of all healthcare technology and information technology is happening at breakneck speed; witness the Health Insurance and Portability Accountability Act (HIPAA). More than ever before, healthcare entities must integrate their clinical technology equipment to their information technology infrastructure to comply with HIPAA regulations.

The next phase
This leads to the next logical migration within our industry: the migration of in-house clinical support and information technology support functions. Typically a hospital has one in-house group handling clinical equipment and another handling information technology, each with its own management, budget, support and overhead components. The time has come to either combine these in-house functions into one department or outsource to a technology-support company that can handle both clinical and information technology support. An even better solution may be a combination of in-house and outsource technology support.

What should a hospital administrator look for when integrating these two organizations? Here are some ideas:

1. Certifications: Both clinical and information technology certifications.
2. Experience: In both healthcare equipment support and information technology support.
3. Redundancies: Eliminate duplicate tasks and processes that can be consolidated into one function; for example, training, parts purchasing, test equipment, management, service reporting requirements, asset tracking.
4. An understanding of the technology in healthcare and how it interacts.
5. An understanding of, and experience in, the regulatory requirements a hospital must deal with, such as HIPAA and Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Experience in the development, implementation and adherence with compliance and quality programs.

The administrator who looks at the “big picture” will see the logic in a combined technology support concept. He or she will jump on the opportunity to implement a program that saves money — yes — but also increases productivity and efficiencies while improving the quality of care for patients.

Scott McCabe, an educator involved in the technology support industry for medical and information technology for 20 years, is with International Shared Services (ISS of Plymouth Meeting Pa.), an affiliate of Geisinger Health System. E-mail him at scmccabe@geisinger.edu.