TechNation reached out to industry leaders for their insights regarding CMMS, how it can help clinical engineering departments and what to expect in the future. The panel for this roundtable includes: Greg Doherty, Executive Director of Clinical Asset Management for UnityPoint Health; Phil Englert, BA, National Director Technology Operations, Clinical Engineering for Catholic Health Initiatives; Alan Gresch, Vice President of Client Success at Mainspring Healthcare Solutions; Dale Hockel, Senior Vice President, Operations for TriMedx; Bhaskar Iduri, Manager, Clinical Engineering & QA for Renovo Solutions LLC; Robert Maliff, Director, Applied Solutions Group, ECRI Institute; and Eric Sacks, Director, Healthcare Product Alerts, Health Devices Alerts, ECRI Institute.
Q: What should HTM professionals look for when purchasing CMMS software?
Doherty: Aside from a system that meets the existing business needs it is important to have flexibility, integration with IT and ERP systems, and growth capability that aligns with the organization’s strategic goals and regulatory agency compliance.
Englert: There are so many important features in current CMMS. When considering the features of a CMMS, the organization should first look for features that can be linked to meeting the strategic goals of the organization. If a strategic goal is to improve the patient experience, look for features that can be linked to equipment availability and reliability. If a strategic goal is to reduce expenses, look for features that identify how resources are expended. Look for the system that fits the way your group does business without a lot of work-arounds. The CMMS should accommodate your organization’s business processes with ease and grace rather than require a shoehorn.
Gresch: Scalability and the ability to support where the department is going to be 10 years down the road, as it may be that long before you look at replacing the system again. As Gretzky cited, “Skate to where the puck is going to be.” Great HTM departments need to think beyond just the PM/break-fix function (any CMMS can do that) and determine what other ways they can bring value to their organization. Can their CMMS help take them to that next level? Can they provide mechanisms to reduce expenses, increase staff efficiencies, and improve customer service like parts management, dispatch functions and customer surveying capability? Does it have an extremely robust reporting tool to create good management dashboards, provide for internal and external benchmarking, and support optimum compliance with TJC and CMS regulations? Does it have auditing capabilities to insure ongoing data integrity? With all the hospital consolidation and acquisitions, can it support a true enterprise application?
Hockel: CMMS should provide regulatory readiness and expertise to ensure compliance with all regulatory agencies. It should track all medical device performance records, preventive maintenance schedules, safety issues, equipment recalls and manufacturer recommendations to ensure the highest level of patient safety related to potential device malfunctions and lowest level of risk related to compliance.
Iduri: It has to be a web-based application. It should be user friendly (easy to operate and train). The response time should be instantaneous when accessing the information. It should have the ability to customize reports. It should be flexible to be customized to meet future demands and standards.
Maliff: Flexibility with reporting – how easy is it to create customized reports and how easy is it to establish a dashboard of metrics? Also, how might it integrate with financial/materials management systems like the hospital asset database, service contract database and C-level dashboards? Look for demonstrated/proven installation sites.
Q: What are some of the basic uses of CMMS for HTM professionals?
Doherty: Tracking, analyzing and reporting on inventory, preventive maintenance (PM), break downs, work orders, equipment maintenance, performance, regulatory compliance and productivity (equipment and employee).
Englert: The primary purpose is to document service events on regulated medical devices. The ability to reconstruct a device’s lifecycle is a CMS and JCAHO requirement. Additionally, the CMMS should be able to schedule and record periodic inspections and service activities as well as “on-demand” service events.
Gresch: Any CMMS must be able to schedule maintenance work (preventive and corrective) and adequately capture all the relevant information about every device the department maintains.
Hockel: CMMS should maintain service records and provide routine schedules and reports. Such reports should document life-cycle maintenance costs, monitor equipment performance and track inventory. By having this holistic equipment life cycle view, you can optimize and extend the use of equipment.
Iduri: It should function as a central repository to store and access data related to medical equipment maintenance activities and to run reports and the ability to perform equipment life-cycle planning.
Sacks: Basic uses include: maintain a complete inventory of capital and durable medical devices; quickly identify and locate devices that are the subject of a recall, field correction, or other alert; and schedule and manage routine maintenance and repairs.
Q: What are some more advanced uses of CMMS software?
Doherty: Key Performance Indicator (KPI) reporting, project management, purchasing and supply chain analytics are the most popular. Many systems now either integrate with Enterprise Resource Planning (ERP) or can be used to schedule, staff and manage HR functions within HTM.
Englert: Advanced features include integration with testing equipment, mobile platforms enabling service recording at any location, clinical user service request system, ad-hoc report generation and interfacing with organization’s requisition, ordering and accounting systems.
Gresch: Some advanced uses of CMMS software include: parts management (ordering connectivity to materials management information system, automated part cost capture on work order, ability to tie PM kit ordering to PM schedules and initiate automatic ordering); dispatch and response capture to be able to determine response time, turnaround time, and equipment uptime; and advanced reporting tools.
Hockel: Advanced software can report on performance trends, safety concerns and training needs. Some of those trends include: uptime; service response; PM; customer satisfaction; significant events; capital planning and budgeting; and equipment utilization. This type of data provides true business intelligence and analytics to support the entire system’s needs today and in the future.
Iduri: Some advanced uses include real-time tracking of the assets, automated login/logoff for users, monitoring/reporting the resources utilized like parts cost, labor hours, travel time, etc., against the equipment, project management and advanced reporting features like YTD spend, downtime, life-cycle planning and compliance reports.
Sacks: Advanced uses include: monitor device performance; uptime, frequency of repairs, repair costs; plan for medical device purchases based on age and performance of existing inventory; look for opportunities to standardize both to maximize negotiating leverage when purchasing and to provide staff with consistent user interfaces; and monitor staff productivity: device inspections and repairs, etc.
Q: How can HTM departments get the most out of its CMMS software?
Doherty: Quite simply – by investing effort equal to or greater than the desired output. Other than acquiring the correct software it is important to develop standards and spend time caring and feeding the system on a continual basis. CMMS software is an important tool to the success of any HTM professional.
Englert: Identify key business rules and processes before shopping for a CMMS system and then set up the CMMS system to drive process integrity within your organization. Inconsistent and incomplete data lead to unreliable decision making. The data recorded for similar functions must be consistent and complete. CMMS systems allow for a great deal of process variation to accommodate different customer needs. Turn off the features you aren’t ready to implement or utilize.
Gresch: Put a significant emphasis on data integrity. Create rules around data entry, with drop-down selections as much as possible. Create a mechanism for ongoing auditing of data. In order to provide a good foundation for capital planning, and to do any meaningful benchmarking, you must have clean data.
Hockel: Using CMMS to capture specific data to help manage networked devices and align device security/compliance will ensure you’re getting the most out of the software. However, collaboration between clinical engineering and IT is paramount in delivering programs that meet patient satisfaction and organizational strategies.
Iduri: By implementing it, I should be able to effectively manage service, financial and reporting areas in my department.
Sacks: A big change over the years has been the way CMMS systems allow the clinical engineer to control data to ensure consistency in a system used by multiple staff members. For example, in the past, the entry of new asset records was pretty informal. So you might end up with the same model of device spelled multiple different ways (abbreviations and misspellings) and categorized under multiple device type descriptions. Today’s CMMSs support creation of model profiles so that each time an additional unit is commissioned, it is set up using the model profile as a template. Different users are provided different levels of permissions based on their role in maintaining the database: setting up new model profiles, entering individual new assets, completing maintenance and repair work orders. Establishing such consistency within an individual hospital is a big effort. Many medical devices remain in service for more than 10 years. So even if you implemented effective data controls five or more years ago, you may still have “dirty data” in the records of devices that were commissioned earlier. And in today’s world of health care system consolidations, merging inventory databases from multiple facilities presents an overwhelming challenge. That is why ECRI Institute has developed the ECRI Product Catalog that establishes a standard naming and categorization for thousands of medical devices.
Q: How can purchasers ensure they are making a wise investment in CMMS? What are the most important features to look for when it comes to CMMS software?
Doherty: Performing an internal gap analysis prior to conducting an RFP or search for a new or replacement system is important. Aligning the gaps and business strategy with the ability of the CMMS to meet or address existing and future needs. It will also be important to test systems during the evaluation process to ensure they will meet business needs upon purchase rather than just meet needs defined on paper.
Englert: Identify what problems you want the CMMS to solve for you and then look for the system with features that solve those problems. Avoid looking at CMMS systems without knowing what features are important to you to avoid buying features you don’t really need. Today’s complex CMMS systems come with a broad spectrum of features. They all do the basics fairly well. Choose the program that best fits your most basic needs within the business processes of your organization. It will have the features to grow with you.
Gresch: First, as previously mentioned, make sure the CMMS will support you in the future and not just where you are today. Ideally, it will help take you to another level. Second, make sure you are going to get substantial ongoing training and support.
Hockel: Always partner with an organization whose mission and vision align with your strategic goals. Be sure the software not only comes with adequate training, but also has proven and detailed performance metrics of medical devices over the years. CMMS should have a comprehensive inventory; inclusive of service history data, device alerts/recalls, operations benchmark metrics, and documentation of all service costs during the life of the asset. These will ensure appropriate maintenance is performed, equipment is accounted for, and devices are safe for use in patient care, per regulatory and accreditation standards.
Iduri: Software should be able to meet your requirements and should be flexible enough to be able to be customized as per the department needs. It should be a real-time application. It needs to follow nomenclature in accordance with the standards of accreditation agencies. It should track the status of the open services/repairs, order. It should have the ability to run the reports by modality like biomed, imaging, laboratory, etc., by risk levels.
Sacks: Bring in multiple vendors to showcase their products. Look carefully at reporting features to ensure that they meet your needs. Carefully assess each vendor’s commitment to servicing your account and get references from similar sized health care provider organizations in your region.
Q: What are the main benefits of implementing a CMMS program?
Doherty: CMMS programs allow for the implementation of best practices and standards. Examples are: regulatory compliance, improved information, control of inventory and service activity, planning and scheduling, and reporting. Additionally, CMMS reports allow HTM departments to report on successes and performance that contributes to the goals of their organization.
Englert: A well implemented CMMS system can teach you about your program and that information can be used to make more informed decisions about equipment support, service quality, staff effectiveness, and service delivery efficiency so that the value of your HTM group can be maximized.
Gresch: There is an old adage that you can’t improve what you can’t measure. Implementing a good CMMS will provide the basis for capturing all the relevant data around service and support of your medical equipment. Once you have good data, you can determine ways to improve service, increase productivity and reduce cost. The data will also be a good way to protect you from arbitrary staff reductions.
Hockel: CMMS provides valuable information regarding inventory, downtime, productivity needs and regulatory issues. It can also be used for capital planning and budgeting, to consolidate contracts, to better manage the lifecycle of equipment, and possibly bring some services in-house in the future.
Iduri: Some important benefits include accurate inventory, consistent nomenclature of the devices, ease of workload distribution, effectively manage the department under budget allocated, effective replacement planning.
Q: What else would you like to add or do you think is important for biomeds to know about CMMS and its uses?
Doherty: Be an active participant in the development and growth of your CMMS. Data entry is merely the entry point. Provide active feedback as users to your support and leadership teams that allow for adequate adjustments. Leaders need to know how changes in the CMMS affect daily activities. As leaders, it is also important to engage technicians prior to change implementation and to clearly explain why changes or measures are being implemented. This impacts the data and the results any CMMS can produce.
Englert: Don’t try to drain the ocean. I recommend turning off features until the basic cost-saving and quality processes are ingrained into the HTM organizations DNA. Then, periodically evaluate additional features that either further support the organization’s strategic goals or enable the next level of service delivery based on customer needs. Lastly, each data element has a cost; a cost to enter, a cost to maintain, a cost to analyze and a cost to report. Choose data elements sparingly and wisely. Choose them because they provide a “need to know” and have a return on investment and rather than a “nice to have.”
Gresch: Understand what your department needs now and down the road and don’t settle for less. Often, a CMMS acquisition can involve multiple departments like HTM, facilities engineering, IT and EVS. Don’t settle for something that may be easy to use for one of these other departments, but doesn’t provide the critical data and data analysis you need to optimize your department and its value to your organization.
Hockel: CMMS is the most effective way to organize data. CMMS can help track several key factors – all of which help the management team make informed decisions and accurately forecast. CMMS is critical to success in a hospital system.
Iduri: Biomeds needs to know that the CMMS software should meet their daily needs like the ability to track the location of the equipment, monitor the order status, view open task orders assigned, enter amount of hours spent and run monthly PM reports, etc.
Maliff: Think more broadly about how the system ties into other IT management systems.