BME 440

BME – 440 Management of Healthcare Technology Dr. Abeer Syed Department of Biomedical Engineering King Faisal University.

[Audio] The healthcare technology package encompasses various components, including the computerized maintenance management system, which plays a crucial role in ensuring the optimal functioning of medical systems. By implementing this system, clinical engineers can streamline maintenance processes, reduce downtime, and improve overall efficiency. Furthermore, it enables the identification of user/operator training needs, prioritization of scheduled maintenance, and measurement of program effectiveness. This comprehensive approach ensures that medical systems operate safely and effectively, ultimately benefiting patients and healthcare providers alike..

[Audio] Clinical engineers leverage the Computerized Maintenance Management System, or CMMS, to effectively manage the maintenance and upkeep of medical devices, ensuring optimal functionality and minimizing downtime. The CMMS is a crucial component of the Essential Health Technology Package, as outlined in the National Health Policy. By utilizing this system, clinicians can focus on delivering high-quality patient care while maintaining the integrity of their equipment..

[Audio] Clinical engineers ensure that medical systems function optimally by implementing computerized maintenance management systems. These systems track equipment performance, identify areas for improvement, and streamline maintenance processes, enabling CEs to manage their business effectively. When medical systems malfunction, CEs use these systems to quickly diagnose and troubleshoot issues, minimizing downtime and ensuring prompt restoration of performance. By analyzing data from the computerized maintenance management system, CEs can determine when it is necessary to replace major systems, considering factors such as equipment age, usage patterns, and regulatory requirements. Furthermore, CEs collaborate with various stakeholders, including accrediting organizations, the FDA, device manufacturers, risk managers, and attorneys, to ensure compliance with regulations and standards..

[Audio] Computerized maintenance management systems can provide the technology management staff with a wealth of information to help manage various aspects of technology support. This information can be used to assess the reliability of equipment, identify training needs, prioritize maintenance tasks, evaluate the effectiveness of maintenance programs, and select vendors for new products..

[Audio] Each step in the implementation of an equipment management system requires careful planning and execution. The first step is to create an accurate inventory of all equipment that will be managed, including devices that will be serviced by other organizations. Each device must have an equipment control number assigned to it and labeled on the device. If the asset tracking system is incomplete or incompatible with the equipment management system, an independent numbering system may be necessary. Without an effective inventory system, it is impossible to track maintenance and repairs, alerts and recalls, and other equipment-management functions accurately. The inventory must be kept accurate and regularly updated as new equipment is added and old equipment is removed. This process involves policies and procedures that integrate the equipment management function into the hospital's new equipment-receiving and removal-salvage operations..

[Audio] The primary incoming data to the equipment management program includes various types of information such as repair details, scheduled maintenance requests, new equipment deliveries, product recall notices, and reports of incidents and hazards. To collect and organize this vast amount of data, a user-friendly approach is necessary. Each device has a unique identification number assigned by the healthcare facility or its contracted service provider. A separate file is created for each device, documenting all maintenance and repair activities, regardless of who performs them. This ensures a comprehensive and controlled record of the device's history..

[Audio] Computerized Maintenance Management Systems, like any other inventory management system, require a solid foundation of data collection and storage. At the heart of this system lies the core, comprising three essential components: equipment inventory, repair and maintenance history, and work order control. The equipment inventory serves as a centralized repository of all devices included in the system, ensuring accuracy and accessibility. The repair and maintenance history provides a comprehensive record of every repair and maintenance event, regardless of who initiated the request or who performed the service. This allows for seamless tracking and analysis of equipment performance over time. Finally, work order control enables the scheduling and prioritization of requested work, including periodic inspections and preventive maintenance, as well as monitoring the status of pending scheduled and unscheduled work orders. By integrating these core components, the CMMS provides a robust framework for managing equipment throughout its lifecycle..

[Audio] When new equipment arrives, a biomedical equipment technician inspects and tests the device according to the manufacturer's instructions, ensuring that the order is complete. The technician then decides whether the device requires inclusion in the equipment management program based on its type, the organizational inclusion criteria, and clinical engineering policies. If necessary, the technician enters the new item into the database or completes a form for data entry..

[Audio] The integrated history record concept provides a service provider with independent date-and-time-tagged repair and maintenance history associated with each service event. This record contains essential information about the work done, including the original problem or request, work order type, open date and time, start and end dates and times for each task, status of the work order, labor hours, parts and materials cost, and down time. This information is crucial for tracking and analyzing maintenance and repair activities, identifying trends and patterns, and making informed decisions about future maintenance and replacement strategies..

[Audio] The work order subsystem of the typical computerized maintenance management system consists of several key components. These include an unscheduled work order manager, a technician dispatcher, and an inspection and preventive maintenance scheduler. This module allows for the documentation of incoming requests for repair services and tracks the status of each work order until its completion. Tracked information typically includes details such as the requester's name and phone number, the affected equipment, the nature of the problem or service required, the equipment's location, and the priority of the work order, which determines the urgency with which the work must be completed. Furthermore, the maintenance scheduler initiates and manages scheduled inspections, parts replacements, and preventive maintenance tasks..

[Audio] Each device in a typical computerized maintenance management system (CMMS) has associated with it scheduled inspection data that includes various details. The provider responsible for completing the inspection and preventive maintenance is specified, along with the interval between inspections, whether the schedule is fixed or floating, the synchronization date for fixed scheduling, the most recent completion date, and the next due date. Scheduled inspections are typically conducted on-site and do not require removing equipment covers. Periodic part replacements involve replacing specific parts at predetermined intervals, such as replacing defibrillator batteries every two years. The next due date is calculated based on either a fixed or floating schedule. A fixed schedule ensures that the work is scheduled at the same time each year, regardless of when the last inspection was completed. On the other hand, a floating schedule determines a new due date based on the inspection interval and the date the last inspection was completed. Upon request or at fixed times, the inspection scheduler generates a summary of detailed work orders that outline the scheduled work for the upcoming period..

[Audio] Repair parts can be categorized into three main sources: stock parts, parts purchased directly from a vendor, and parts supplied by the vendor as part of their service package. Stock parts are stored locally for future use, and clinical engineering departments maintain a stock of common hardware and device-specific parts. This classification helps track services and costs, regardless of the service provider..

[Audio] All clinical engineering departments cannot provide 100% of the equipment service that is required, 100% of the time, on 100% of the equipment inventory. To control the cost and quality of vendor medical equipment repair and maintenance services, it is necessary to control and coordinate vendor equipment services. Vendor services can include non-billable warranty work, service performed on a fee-for-service basis, service performed under a prepaid service contract, billable services performed under a prepaid service contract but outside the prepaid terms and conditions, and other billable and non-billable services. All costs, including prepaid, billable, freight, tax, parts, and labor, should be tracked. Vendor service work must be coordinated and tracked similarly to in-house work. Vendors typically submit service reports upon completing a task or leaving the site, even if the task is incomplete. These reports are essential documents for data collection. Service reports should be required by and provided to clinical engineering for all vendor work, both billable and non-billable..

[Audio] Clinical engineers utilize computerized maintenance management systems to optimize the functioning of medical systems by identifying areas where user/operator training may be necessary, prioritizing scheduled maintenance tasks based on risk to the patient, measuring the effectiveness of these programs, determining when it's necessary to replace major systems, and ensuring optimal levels of performance and safety in healthcare facilities..

[Audio] The essential healthcare technology package, or EHTP, is a comprehensive set of healthcare technologies designed to provide optimal patient care. Its development involves identifying the most critical technologies needed to deliver quality healthcare services. These technologies are then implemented and justified through a thorough analysis of their benefits and costs. The EHTP offers several advantages, including improved patient outcomes, enhanced healthcare provider productivity, and reduced healthcare costs..

[Audio] Global economic, political, and social changes, as well as an increased and changing disease burden, have driven the need for healthcare systems to adapt and improve their efficiency, equity, and effectiveness. This has led to a paradoxical role for technology in healthcare, where it is both a significant contributor to rising costs and a vital tool for improving healthcare provider performance..

[Audio] The imbalance of funding towards tertiary care and expensive technologies, rather than primary care and basic interventions, leads to inefficiencies in resource utilization. As a result, the rising costs of healthcare create inequities in access. This highlights the need for the essential healthcare technology package, ensuring that resources are allocated effectively..

[Audio] The Essential Healthcare Technology Package, or EHTP, is a methodology and a tool designed to enhance and optimize healthcare technology planning and management. This approach is built upon the idea that effective healthcare delivery can only be achieved if all healthcare technologies, including medical devices, drugs, human resources, and physical infrastructure, are readily available and properly managed to provide quality care..

[Audio] The burden of disease refers to the impact of illness on individuals, communities, and society as a whole. Understanding this concept is crucial in determining the need for effective healthcare technologies. Identifying areas where healthcare technologies can make a significant difference in improving patient outcomes and reducing costs is possible by grasping the burden of disease. The cost-effectiveness of healthcare technologies is another critical factor in evaluating their value. Not only the initial investment but also the long-term benefits and costs associated with each technology must be considered. Community preferences play a vital role in shaping the development and implementation of healthcare technologies. Stakeholders must be involved, and input gathered from various groups to ensure that technologies meet the needs and expectations of the community. The capacity of the health system to deliver healthcare services effectively is a key consideration in evaluating the success of healthcare technologies. A robust healthcare system with adequate infrastructure, trained personnel, and sufficient resources is necessary to ensure the successful implementation and maintenance of healthcare technologies..

[Audio] The Essential Healthcare Technology Package (EHTP) enables the assessment and successful implementation of technology interventions in the health sector reforms process. By providing governments, donors, policy formulators, and decision-makers with necessary tools, it facilitates improved management of healthcare technology, ensuring cost-effective and equitable interventions at all levels of healthcare delivery..

[Audio] In order to create a strong link between health policy and healthcare technology packages, it is crucial to explore the significance of this connection. This integration enables the effective implementation and utilization of technology, thereby ensuring it aligns with organizational goals and objectives. By combining health policy and healthcare technology packages, resource allocation can be optimized, processes streamlined, and patient outcomes improved..

[Audio] The generic template chapters of the Healthcare Technology Package focus specifically on the Computerized Maintenance Management System, which plays a crucial role in ensuring the optimal functioning of medical systems. This system allows clinical engineers to identify areas for improvement and implement necessary changes, thereby streamlining their workflow, reducing downtime, and improving overall patient care..

[Audio] Disease classification plays a crucial role in ensuring accurate diagnosis and treatment in the field of clinical engineering. The International Classification of Diseases, version 9, or ICD-9, is a widely used disease classification system that categorizes diseases into specific chapters, such as Chapter 45, which covers diseases of the musculoskeletal system. By using standardized classification systems like ICD-9, clinicians can quickly and accurately identify the underlying causes of a patient's condition, leading to more effective treatment and improved patient outcomes..

[Audio] The mission of health care planners and policymakers is to ensure that health technology is harnessed to its fullest extent as one of the tools to improve the delivery of health services and to devise a strategy that facilitates appropriate utilization of health technology for the South African health system. The desired outcome is a unified and harmonious HT system that ensures optimal distribution of the limited HT resources and facilitates equity in access, with the ultimate aim of improving the quality of health services..

[Audio] Clinical engineers ensure optimal functioning of medical systems by implementing Computerized Maintenance Management Systems. These systems can be used to identify user/operator training needs, prioritize scheduled maintenance, measure the effectiveness of scheduled maintenance programs, and determine when to replace major systems..

[Audio] Clinical engineers play a crucial role in ensuring the optimal functioning of medical systems by identifying user/operator training needs through computerized maintenance management systems. These systems enable prioritization of scheduled maintenance, measurement of the effectiveness of scheduled maintenance programs, and determination of when to replace major systems. Collaboration with accrediting organizations, the FDA, device manufacturers, risk managers, and attorneys is also vital to ensure compliance with regulations and standards..

[Audio] Clinical engineers use standardized terminology, specifically Current Procedural Terminology (CPT), to accurately document and communicate technical information related to medical devices and equipment. This ensures clear understanding among various stakeholders, including healthcare providers, regulatory bodies, and industry partners. By adopting CPT-2017, clinical engineers can streamline documentation processes, facilitate effective communication, and enhance overall quality of care..

[Audio] The implementation process starts by training trainers for EHTP implementation, ensuring they understand its principles and objectives. Identifying counterparts who will oversee the national-level implementation is the next step. These individuals play a vital role in managing the entire process. The generic EHTP is then modified to accommodate specific needs, considering local circumstances and requirements. Lastly, information about the implementation is promoted and disseminated, keeping everyone informed of progress and goals..

[Audio] The implementation of an electronic health technology package may face various barriers including lack of resources, inadequate infrastructure, insufficient funding, limited technical expertise, and resistance to change..

[Audio] Clinical Engineers face several challenges when implementing Computerized Maintenance Management Systems (CMMS). These include lack of implementation funds, shortage of skilled personnel, no monitoring and evaluation of the implementation process, omission of guidelines, and inability to detail the realities of lower healthcare delivery levels..

[Audio] The tool provides a comprehensive framework for healthcare technology planning, which enables the identification of essential healthcare technology elements required to reduce the burden of disease. This framework links international disease classifications to promotive, preventive, and rehabilitative procedures, facilitating the development of targeted interventions and treatment plans. Furthermore, the tool offers various valuable features, including lists of health interventions with typical time requirements, dynamic essential lists for specific levels of healthcare delivery, and simulations of costs for medical devices, human resources, and drugs. These features allow healthcare professionals to make informed decisions about resource allocation and optimize healthcare outcomes..

[Audio] Many countries lack the health technology resources necessary to improve their populations' health. Developing a clear policy framework is crucial for identifying, acquiring, and managing necessary resources in healthcare delivery. This policy should cover all levels of the national healthcare system, ensuring effective and efficient use of health technology..

[Audio] The rationale behind national health technology policy is to maximize limited financial investment in health, minimize quality waste, maximize loans and donations, and ensure rational use of health resources. This approach aims to optimize the allocation of resources, reduce unnecessary expenses, and promote efficient use of funds by enabling healthcare providers to deliver high-quality services while minimizing costs..

[Audio] The political dimension of the Health Technology Program (HTP) emphasizes its connection to national health policy and health reform initiatives through the Ministry of Health. This linkage enables internal communication within the health system and external communication with technical aid supporters and donors. The HTP focuses on national health priorities, grounded in epidemiological data about the population. A rational methodology for planning and management is employed, with consensus among a multidisciplinary expert panel. The program integrates planning and management across all health technology resources. The HTP establishes and supports a technology assessment program, incorporating ongoing input from evidence-based medicine. It guarantees that the country conducts a comprehensive health technology management process, spanning planning, acquisition, and the entire lifecycle of resource utilization. The HTP fosters the development of health technology management capacity in the country and ensures ongoing activities aimed at enhancing quality, reducing risks, and promoting patient safety related to health technology. Finally, it promotes the creation of a regulatory and legal framework for health technology resource research and development, as well as business ethics and resource quality assurance..

[Audio] The population of South Africa has significant health problems, including high infant mortality rates, maternal mortality rates, malnutrition among children under five, and low health expenditure compared to the global average. The leading causes of mortality in the country include acute lower respiratory infections, HIV/AIDS, diarrhea conditions, and perinatal complications..

[Audio] The level of health service delivery has not improved significantly despite substantial investments in introducing new technologies and the costs associated with maintaining them. Ensuring a consistent supply of skilled health technology managers is crucial. This workshop aims to guide policymakers and planners in tackling the complexities surrounding the planning, development, lifecycle, transfer, management, and utilization of healthcare technology, ultimately informing the development of educational, training, and placement strategies for health technology management professionals..

[Audio] Clinical Engineers play a vital role in guaranteeing the optimal operation of medical systems. They accomplish this objective by implementing Computerized Maintenance Management Systems (CMMS) to simplify maintenance procedures, minimize downtime, and enhance overall system performance. By utilizing these systems, CEs can pinpoint areas where user/operator training might be required, prioritize scheduled maintenance tasks, evaluate the effectiveness of maintenance programs, and decide when it is time to replace significant systems. This proactive approach allows CEs to work efficiently with healthcare providers, regulatory agencies, and other stakeholders to ensure conformity with pertinent regulations and standards..

[Audio] The mission of health care planners and policymakers is to ensure that health technology is harnessed to its fullest extent as one of the tools to improve the delivery of health services and to devise a strategy that facilitates appropriate utilization of health technology for the South African health system. The desired outcome is a unified and harmonious HT system that ensures optimal distribution of the limited HT resources and facilitates equity in access, with the ultimate aim of improving the quality of health services..

[Audio] In the late 1990s, Brazil underwent significant changes in its national health system, shifting towards decentralization and unification of both public and private health services. This transformation necessitated the creation of a new Hospital Technology Program, designed to serve the needs of Sao Paulo State's extensive network of hospitals, clinics, and research facilities. With over 560 hospitals, approximately 85000 beds, 2,100 clinics, and 10 research and manufacturing facilities catering to the healthcare needs of 33 million people, the program aimed to provide comprehensive coverage. To achieve this goal, the Office of Equipment Advisor to the Secretary of Health was established, under the guidance of Binseng Wang, who served as advisor from 1987 to 1990. Wang implemented a structured approach that encompassed every stage of the equipment lifecycle, including planning, procurement, acceptance, commissioning, maintenance, refurbishment, and decommissioning. Furthermore, regulation and research and development were integrated into the plan to ensure the safe and effective utilization of medical equipment..

[Audio] The clinical engineers face various opportunities while implementing Health Technology Programs. They must plan carefully due to insufficient financial resources, involving all stakeholders. When faced with inadequate infrastructure, they must find creative ways to utilize existing resources efficiently. The lack of trained human resources presents an opportunity for investing in education and training. Difficulties in sourcing spare or repair parts for high-tech equipment through alternative means require innovative solutions. Moreover, missing equipment documentation may lead to including specific requirements in acquisition agreements and seeking help from global colleagues..

[Audio] To achieve success in Health Technology Planning, it is essential to keep decision-makers well informed about the progress and outcomes of the planning process. This ensures transparency and accountability throughout the project lifecycle. Creating a strong link between health policy and HTP enables alignment with organizational goals and objectives. Securing wide stakeholder support fosters collaboration and buy-in among key players. Transparent and rational methodologies for planning, management, and support of technology promote trust and confidence in the outcome. A robust evaluation system incorporating feedback from various stakeholders ensures that lessons learned are applied to future projects. Emphasis on education and training builds capacity for the long-term, while planning for equipment replacement and continuous equipment service support ensures continuity and minimizes downtime..

[Audio] The references provided offer valuable insights into the world of clinical engineering. The Clinical Engineering Handbook edited by Dyro provides comprehensive coverage of various aspects of clinical engineering, including the implementation of computerized maintenance management systems like CMMS. This handbook serves as a reliable resource for professionals seeking to stay updated on the latest developments and best practices in the field. Similarly, the chapters on EHTP and NHP offer expert guidance on the importance of linking health policy to technology and the role of national health policies in shaping the future of healthcare. I would recommend exploring these resources further to gain a deeper understanding of the subject matter..