By Ben Lewis, MBA, CHTM
Getting a pallet of new equipment at your shop’s doorstep that you and your team knew nothing about is not unheard of in the HTM field. In fact, if that has never happened to you, you have likely had a fairly short career. There are many reasons that your HTM department should not only be aware of incoming equipment, but HTM should also have an active role in the screening and selection of medical devices.
For those who are not involved in medical equipment procurement, or for those who are involved but not to the extent that they should be, it is up to the HTM leadership to make a case to capital purchasing committees and to administration regarding the importance of HTM’s role in the selection process. Whether you are a single biomed in a stand-alone, 100-bed hospital, or a system director in a 10-facility system, it is up to you to make a case for your involvement and the importance of your input.
Making your case
For those who are DNV certified, NIAHO standard in PE 7 SP.1 states that, “The organization shall establish a Medical Equipment Management System that provides processes for the acquisition” of equipment. Provide this information to the appropriate committee and up the appropriate chain of command and this should allow you to become involved in medical equipment selection.
Prior to July 1, 2016, The Joint Commission has made a case for the HTM department to be included on equipment purchases. EC.02.04.01 states in the first element of performance that, “The hospital solicits input from individuals who operate and service equipment when it selects and acquires medical equipment.” However, beginning in July, over 130 EPs will be deleted and will be no longer scored. Hospital discretion was given as the reason for the deletion of EC.02.04.01 (prior to 7/1/16) with regards to whose involvement is needed in the selection of medical devices.
Outside of regulatory reasoning for your inclusion into the acquisition of medical equipment, you may also want to provide leadership with other reasons why there is a need for your input on medical equipment selection. Here is a short list in no particular order:
• Budgeting Purposes: Being involved early will allow you to build a more accurate service budget. While many of your purchases will come with a one-year warranty, there are often costs that can hit earlier, like a PM or software contract. Being involved in purchases will allow you to maintain a more accurate budget.
• Negotiation of Service Related Options: Go buy a car, cut a check, and then tell them you would like a new set of tires at no cost to you. There is a very high chance you will be breaking out your checkbook again if you are going to get new tires. The same principle applies with the acquisition of medical equipment. The time to negotiate an extended warranty, a lower cost service agreement, or free or reduced education is before the purchase and no one is better equipped for negotiating such things than the HTM department. If you are not involved early, it’s too late.
• Software Upgrades: I am not telling you that you will be able to get all of your future software upgrades for free, but you can’t get something without asking. Software to consider at the point of purchase is the life cycle of the operating software. Windows 7 is at end of support in less than 4 years, so, if you are on a network transmitting PHI with the equipment you are purchasing now, there will be no security patches released without updating the OS on equipment you buy today running on Windows 7. Getting an agreement to keep your equipment on a secure OS is something that you can reach for, as the FDA is already putting pressure on manufacturers to provide postmarket management of cybersecurity vulnerabilities. I advise that any such agreement be added to the purchase contract and the purchase order.
• Continuity with existing systems: Compatibility with existing systems is an issue that the HTM department will be best equipped to handle and could save your facility considerable costs. The ICU director may want to order her new monitors from Vendor X, however, Vendor Y is already in-house in other departments and the infrastructure is already in place to support your monitoring. Bringing this to the attention of the purchasing committee or administration by showing the hefty savings of sticking with Vendor Y will not only make you look like a fiscal hero, but keep your services streamlined by reducing the number of vendors you are servicing. Something as simple as catching a proposal that has the wrong type of cuff connector for your facility will save you and the clinical staff time and grief in the future.
When you are linked in to the purchasing of medical equipment at your facilities, consider adding a HTM section to your capital purchase form to provide continuity across the purchases. Questions to be answered on the form may include:
- Is there a contract need for this equipment? Price of contract?
- Is education needed and available? Price of school, travel, and accommodations?
- Expected impact to service budget?
- Does this equipment operate on the network? Does it store PHI?
- Does this equipment run on operating software? Which one? When is the end of support of OS?
- Does this equipment use accessories that Material Management stocks? Example: cuffs, SP02 cables, EKG leads, etc.
Knowing the answers to these questions can save you time, money, and headaches in the future by allowing you to plan and negotiate accordingly. Understanding what equipment is coming to your facility and gaining influence on what comes through the door will make you a valuable contributor beyond just the service of medical equipment.
Hopefully, your administration can see the importance and value in the early involvement of HTM departments regarding medical equipment purchases and that HTM contribution is a regulatory, operational, and financial win for both your department and your organization.
