Below, five individuals with a vested stake in the computerized maintenance management systems (CMMS) segment—Joseph Happ, MHA, executive vice president and chief information officer of Irvine, Calif.-based Renovo Solutions; Matthew Baretich, PE, PhD, president of Fort Collins, Colo.-based Baretich Engineering, Inc. and co-author of Computerized Maintenance Management Systems for Healthcare Technology Management (AAMI 2017); Vishal Malhotra, chief technology officer at Charlotte, N.C.-based EQ2, LLC; Bryan Christiansen, founder and CEO of Lehi, Utah-based Limble CMMS; and Ben Mannisto, president of Southfield, Mich.-based Phoenix Data Systems—discuss top technologies on the market and how artificial intelligence may change the game for CMMSs.
24×7 Magazine: HTM departments are increasingly being asked to do more with less. How can a CMMS help them achieve this?
Ben Mannisto: A CMMS that provides efficiencies for technicians entering data is a must; our goal is to keep technicians out in the field repairing equipment, rather than spending excess time in the CMMS software. A good CMMS should provide department managers with tools they can use to quickly diminish labor inefficiencies, (e.g. corrective maintenance (CM) work orders closed with “no problem found” or “operator error,” which can be routed back to user training.
The CMMS should allocate wrench time as well as travel time. It should include tools to determine the best practices that support efforts to reduce travel time and increase wrench time, whether it be through PM and CM scheduling, or dispatching work by location.
Bryan Christiansen: There are two major ways that a CMMS helps you do more with less. The first one is productivity. Instant reminders, real-time communication, instant access to equipment history, (re)scheduling, and tracking work progress on the go are just some of the features that help maintenance teams do more in less time.
The second way is reducing overall maintenance costs. A CMMS helps you:
- Reduce inventory costs through spare parts inventory control and forecasting
- Lower labor costs through the aforementioned productivity gains and reducing overtime
- Reduce costs that usually accompany equipment breakdowns by helping you implement proactive maintenance programs
Matt Baretich: There a massive amount of data in CMMS databases that is largely unused. A well-configured CMMS can produce actionable information. For example, alternative equipment maintenance programs can save a lot of PM time, but many CMMS databases are not configured in a way that lets HTM departments maximize savings while preserving equipment safety.
Vishal Malhotra: Hospitals are often looking to reduce expenses. Paradoxically, new regulatory compliance requirements mean that the HTM department actually has more work to do. In the past, there was compliance flexibility (90% to 95%) for monthly preventative maintenance work for non-life (now known as “non-high risk”) support devices. Now, the devices covered under “high risk” has increased, and both high and low risk require 100% compliance. EQ2’s HEMS CMMS, for instance, permits work not completed due to different, albeit valid, reasons—such as “unable to locate,” “device in use,” etc.—to be recorded as compliant.
Joseph Happ: A CMMS that can provide a single platform for our staff to do their jobs most efficiently should be a primary consideration. Integrating our daily workflows seamlessly without jumping into other systems or requiring manual paper processes can reduce administrative burdens tremendously. A properly designed alternative equipment maintenance plan that is supported by historical service data, both local and national, should be a part of any CMMS. And it has the potential to help balance the HTM department’s workload.
24×7: What are the top do’s and don’ts hospitals should keep in mind when purchasing CMMS software?
Happ: Don’t scrimp on system configuration. It is important to dedicate resources (internal or external) to properly configure the new system to utilize its functionality. Assuming your system provides a common device class table, spending time to properly set up and maintain that functionality will improve data consistency while enforcing use (i.e., device make, model, manufacturer, service requirements, manuals, procedures).
Do ensure that the new CMMS truly supports IT Best Practices Integration (security risk assessments, change management, problem management, configuration management) and provides the appropriate fields to capture important equipment configuration like application entry titles, and IP and MAC addresses.
Malhotra: The CMMS vendor should have a vast knowledge of regulations and how they affect HTM and workflows. The vendor’s experience and longevity in the healthcare space largely determines how much built-in intelligence and processes their software provides. Look at how they approach standardization—a lack of experience here results in a messy database, leading to messy workflows and reporting.
Innovations continue to increase CMMS capabilities. A product that can’t be upgraded with new, innovative modules will quickly fall behind the curve. Further, a modular product allows selective configuration, which permits the HTM department to only procure what they need, when they need it. A CMMS product that can be hosted on either a SaaS cloud or a hospital server makes it easy to work with for any IT department.
Finally, make the CMMS a main hub of data and workflows. The hospital environment continues to become more and more connected, so it is important that the CMMS supports integrations of all types: medical devices; testers; real-time location systems; Integrating the Healthcare Enterprise-Patient Care Device; enterprise resource planning applications like Lawson and Peoplesoft; cybersecurity detection like Zingbox; and others.
Baretich: In the CMMS planning projects that I’ve been part of, the key success factor seems to be the development of a comprehensive “requirements document.” That takes time and effort. But if you don’t know exactly what you need and want from your CMMS, you’re unlikely to get it.
Mannisto: A new CMMS should keep current, if not ahead of, healthcare’s changing requirements as well as technological advances. The CMMS should be mindful of the customers’ requirements, wishes, and needs and act on them through updates to the software. Conversion of historical data is very important. Without it, technicians will have to use two CMMS’ to complete day-to-day tasks. Additionally, complete repair history helps technicians with future repairs and is required for equipment replacement forecasting.
Christiansen: This should be obvious, but don’t go for the cheapest option. Take your time to review all the available options. There are a lot of CMMS solutions on the market and they all say the same thing: “We have a modern solution that is simple to use.” Unfortunately, many of our customers that have tried other tools speak differently.
I recommend that you define a list of “must-have” features,“ as well as “nice-to-have” features, along with your price range. Use that to narrow down the field. Next, look at reviews and select about five of the most promising solutions and test them out through demos and free trials. Most providers offer an array of similar features, so take a hard look at how they are implemented—how intuitive the system is, how many clicks you need to get to important information, how customizable the solution is, and even how responsive their customer support is.
24×7: How are artificial intelligence and machine learning affecting the CMMS segment, and how do you see them impacting the sector in the future?
Mannisto: Artificial intelligence (AI), machine learning, and big data activities are growing dramatically and will affect all aspects of the healthcare institution. In the future, the CMMS will be required to interface with AI, and will also analyze information to better predict failures.
Christiansen: AI and machine learning are going to indirectly affect the CMMS sector by helping organizations move more from reactive to predictive maintenance. What this means for the CMMS sector is that more and more organizations will look for CMMS solutions that can communicate with condition-monitoring sensors and integrate with specialized predictive analytics tools.
Happ: While most systems today do not include native tools to utilize AI, I think we can expect that to change in the future. The resources required to set up and manage an AI platform [can be extensive]; however, the potential impact to HTM operations and even patient safety is significant if it can be used for predictive maintenance. Data preparation should start now if you plan to use AI down the road.
Baretich: AI holds tremendous promise for turning CMMS data into useful management information. It’s also a way to bring information closer to real time, allowing us to move from reactive to proactive decision-making. We’re already starting to see text analysis of work order notes. Arleen Thukral, [a VISN 2 healthcare technology manager at the New York/New Jersey VA Health Care Network], for instance, has done some fascinating work using neural networks and machine learning.
Malhotra: AI/machine learning applications can help to more accurately predict component failures. Integrating these type of AI applications with the CMMS can auto-generate predictive failure avoidance work orders, saving money on repairs and reducing downtime. HEMS integrated with Glassbeam to provide this functionality. EQ2 is now working on using AI to help prepare recommended equipment replacement schedules.
Medical device manufacturers will also implement AI to predict failures and alert the user, so a CMMS needs to be able to accept these messages and take the appropriate action. One important way to do this is through Integrating the Healthcare Enterprise-Patient Care Device interoperability.
24×7: As we enter a new decade, how else do you think the CMMS segment will evolve in the coming years?
Malhotra: More built-in intelligence and back-end automated processes will evolve to assist HTM professionals, thereby making their jobs easier and more productive. Tools to maintain and track compliance will be mapped directly to specific regulatory requirements and standards so that the CMMS reflects changes and updates as they come.
Happ: We have noticed an increase in requests from C-suite executives demanding clean and accurate asset information from the CMMS. The segment is likely to evolve from a traditional siloed inventory and maintenance management system to an integrated information platform, either as a hub or a spoke with other business data systems. The value of making this data available outside of HTM leaders should support decision making around financial and capital planning and cybersecurity/IT device management.
Mannisto: Smart equipment will become more mainstream in the future, and the CMMS’ ability to connect with that equipment will be more commonplace. Analytics inside the CMMS will provide department managers with real-time information, enabling them to be proactive planners. And maintaining complete medical device IT information inside the CMMS will become even more important as more medical devices are attached to a network and to patients.
Christiansen: A combination of market competitiveness, a tech-savvy younger workforce, and a more streamlined CMMS implementation process is bound to lead to a continuous spike in CMMS adoption by both small and big businesses alike. Besides that, I wouldn’t be surprised to see vendors placing more focus on predictive analytics and, later, integrating it into their package.
Baretich: Essentially, all CMMS software does the basics: inventorying, PM scheduling, and [tracking] maintenance history. The way forward is for the CMMS to be the hub of a network of tools that support HTM program operations. For example, the CMMS inventory needs to be integrated with the configuration management database inventory for IT equipment and systems. That type of integration is already underway, but there are many more opportunities.
24×7: Cybersecurity is a key concern among HTM professionals. How can they ensure their CMMS software is cyber-secure?
Malhotra: A CMMS application on the cloud should adhere to network security standards and be hosted on a secure infrastructure as provided by companies who ensure that security is a top priority. Data should be stored and transmitted using end-to-end encryption. Also, the infrastructure should be audited periodically, with internal and external penetration tests. Finally, a CMMS can help you manage cybersecurity of your devices through networking security protocol integration with third-party applications for visibility into security and threat risks.
Mannisto: There are many cybersecurity vendors in the current market. Healthcare organizations should complete a thorough Request for Information process to ensure their specific needs will be met through their preferred vendor. It is important that the customer have complete IT information in the CMMS for all connected medical devices. It is only through this data integrity that the cybersecurity software can immediately detect a threat and resolve it.
Christiansen: A modern CMMS should use a modern infrastructure and code libraries. If possible, have your IT department do a thorough check with the CMMS provider to ensure that they are following industry best practices.
Happ: Cybersecurity starts with the users practicing appropriate security hygiene, including their own password management. Systems should be designed and configured to support proper policies and role-based access that enables separation of duties (i.e., people only have access to what they need and not everything). Device maintenance and configuration data elements are sometimes seen as low security risks. Today, we are starting to see how that data can be used for targeted social and electronic attacks, so it is important to ensure that all CMMS data is stored and transmitted securely.
24×7: What else should 24×7 Magazine readers know about the CMMS sector?
Christiansen: Every smart CMMS provider knows what you are struggling with on a daily basis. However, not everyone is capable of developing a flexible system that effectively solves your problems. On paper, most solutions look good. Don’t let yourself be sweet-talked into a contract with a bunch of hidden costs. Do hands-on testing and ask the hard questions to find the right CMMS software for your organization.
Happ: As CMMSs become increasingly complex and integral to hospital operations, readers should consider the service and support needed to properly configure and manage their CMMSs. While larger organizations may be able to increase staff appropriately to tackle these burdens, purchasers should look for providers that can provide operations support in addition to simply ad hoc software-as-a-service. A provider that can offer support with parts procurement, database management, HTM quality assurance consulting, benchmarking with other users, and temporary labor resources could add tremendous value to many in-house HTM operations.
Mannisto: When a hospital system purchases a new CMMS, it is conceivable to think that it is “stuck” with that system for three to eight years. Do your homework; there are many CMMS vendors popping up, and it is important to note that many do not cater specifically to the healthcare sector. And that can be a very big factor when the healthcare system’s needs change and its chosen CMMS vendor doesn’t meet them.
Malhotra: A selected vendor should be capable of setting up the CMMS to support the HTM department’s specific processes. Every hospital is different, so a one-size-fits-all CMMS product, or a non-hospital-centric product, will cut corners, even if [no one] recognizes the corner. Equipment risk, determination of assets eligible for AEM (dynamically), test equipment calibration, and reports and dashboards on critical key performance indicators are all highly important. Complete asset lifecycle management, including supply chain processes, contributes significantly to a well-run hospital.
Finally, the HTM department should evaluate the condition of their current data to determine if the data needs to be cleaned up or standardized, and to examine the [key performance indicators] that the department needs to report to the C-suite. The data must be present and consistent before any meaningful reporting can be obtained from the CMMS.
Baretich: Maximizing the value of the CMMS depends on data integrity. We have to clean up our data, implement “data hygiene” policies to keep it clean, and regularly audit data quality.