At a session on the
convergence of the clinical engineering
and information technology (IT) departments during this year’s
Association for the Advancement of Medical Instrumentation conference, I
surveyed the audience to find out how many believed the IT departments at
their facilities had an idea of what a clinical engineer (CE)
does on a day-to-day basis. Less than 5% of the audience said their IT
departments knew what they did. At the same time, nearly everyone in the
audience believed they knew what their IT departments did.
As more and more medical equipment becomes IT-based,
the clinical engineering and IT departments must regularly work together to
install new devices, presenting a situation where it is possible that only
one side of the collaboration knows what the other side is doing. However,
this presents an excellent opportunity for a CE to bring the IT department
up to speed, not only on what a CE does but also on some clinical knowledge
that is often lacking in IT departments.
CE training is both technical and clinical, and
biomeds routinely interact with clinicians and clinical equipment. They
understand what medical devices do, how they are used, and what happens if
they are unavailable.
On the other hand, IT training is almost entirely
technical, with many IT staff coming into health care from other
industries. The good news is that more and more IT departments are hiring
former clinical staff. However, to many IT staff a medical device looks the
same as a PC on the hospital network, and it is often treated the same.
CEs, clinical engineering departments, and users often
believe that they do not understand why IT does things, but they never ask.
At the same time, IT assumes that users understand why things are done a
certain way, because they do not hear any feedback that this is not the
case. If you believe that you are not getting the information you need,
definitely ask.
Given that IT and biomeds now must work hand in hand,
it would be beneficial for the IT and clinical engineering departments to
share at least some basic knowledge of their respective departments with
one another, for the benefit of the organization. This month we will focus
on ways in which biomeds can help educate IT, keeping in mind that this
should be a two-way exchange.
Making a Start
So in which areas can biomeds educate their IT
counterparts? Here are three areas that make a good start: clinical
knowledge, technology evaluation, and asset tracking/management.
Clinical knowledge is second nature to biomeds.
Certainly, it is not necessary to share every clinical detail about every
medical device with IT. However, let’s take a scenario where a CE is
working with IT to install a new positron emission tomography/computed
tomography (PET/CT) scanner. The IT staff may have some knowledge of what a
CT scanner does, but the staff probably has little or no exposure to PET,
let alone a PET/CT. It is unlikely that the IT staff will know that in
addition to the scanner there are multiple additional workstations that
need to be interfaced to allow fusion, to archive and send to a picture
archiving and communication system, to send data to a radiation treatment
planning system, etc. By providing an overview of where the data will flow
and the clinical significance of that workflow, a CE can help IT determine
how the network needs to be configured and potentially how to set up a VLAN
to include all the devices. It may also give IT an understanding of the
different vendors involved for the various systems, and at a minimum it
will give them an understanding that network-setting changes on the PET/CT
can impact a significant number of systems beyond just the scanner.
Even if IT already has a good understanding of all the
interconnectivity and how to configure everything on the network, just a
basic familiarity with what a PET/CT does and some of the basic terminology
can help IT work with the clinical engineering department to set up and
troubleshoot issues with the devices in the future.
Technology Evaluation
IT does an excellent job of evaluating hardware
specifications; however, it is sometimes difficult for IT to analyze an
appropriate technology without an understanding of clinical workflow. For
example, IT may determine that wireless technology works for a certain
application; but clinically, wireless technology may not be the best
solution given specific workflow needs in a department. This type of issue
may be clear to biomeds but less clear to IT because they do not routinely
work in some clinical areas.
Finally, for years the clinical engineering department
has had to be able to locate mobile medical devices. Monitors and infusion
pumps in one area of a hospital may be in a completely different location
the following day. IT, on the other hand, has traditionally had to track
devices that were fixed in a single location because of the need to connect
those devices to specific network jacks. Now that IT technology has moved
into mobile medical devices, IT is starting to face some of the same
challenges of tracking and locating these devices that biomeds have dealt
with for years.
The need for collaboration between the clinical
engineering and IT departments will not disappear. Therefore, it is
critical that these departments share their knowledge so they can more
easily communicate with and understand one another.
Ken Olbrish, MSBE, is an enterprise imaging system
administrator in the Information Services Department for the Main Line
Health System, Philadelphia.