By Mark Newell
One of the key tools that aid a health care organization in controlling its medical equipment support costs is by having its in-house healthcare technology management (HTM) team attend technical service training for the products it purchases.
This training, provided by a manufacturer or in some cases an independent service company, helps to address concerns around operating costs and total cost of ownership, timeliness of support and flexibility in when planned or unplanned service can be performed. It also helps to provide options for how to extend the life of equipment when the original manufacturer may limit or end support. This access to technical training is an important part of the right to repair movement, and enables health care organizations to have better control of their overall equipment and related support costs.
The real challenge is when access to this tool is taken away, such as when a manufacture uses the premise of a new product release as the rationale for them to discontinue offering any technical service training to customers — even though that type of training was readily available for the last model product. Some manufacturers may even mention how a recent company merger, or the acquisition of a new product line prevents them from offering technical service training. In practice, what those manufacturers fail to mention is that they still have a process to train their own factory field service staff, especially when they want a health care organization to still buy its products. They may also not inform the health care organization that they will train an authorized distributor or service provider, but not the employees of the health care system that is buying the equipment.
The arguments typically presented by manufacturers generally revolve around how they are “suddenly in flux for their customer-facing training program due to restructuring” or “how they are moving to a new support model for customers due to a shift in corporate business strategy.” What this usually means is that they are no longer offering technical training as there is no longer any compelling competitive advantage for them to do so, especially if they absorbed their competition and they now hold the market share for a particular product type. In health care, when a product is established in the industry as the standard, physicians are not likely to consider other options, in turn leaving health care organizational leadership with zero room for demanding or negotiating something different.
One common problem that you may see is that many manufacturers will try to do a “divide and conquer” approach with customers. They will try to manage the interests of the physician and/or clinical user separately from that of the supply chain team, and what seems to happen more and more, separate both groups from the HTM team. End of the day, a clinical user is using the equipment to treat the patient, and in turn let the health care organization generate revenue. If capital pricing is not negotiated in conjunction with software and service offerings, to include technical training, then the post-purchase support options and costs over the term of ownership generally end up unfavorable to the health care organization.
Presenting and maintaining a unified front is the ongoing challenge that many health care organizations face. Some do much better than others, thankfully. Many health care organizations are working more and more with their respective Group Purchasing Organizations to help gain leverage when dealing with manufacturers and, in turn, raise awareness regarding this issue.
Over the past 20 years, the intertwining of medical equipment with network connectivity and software is driving the need for ensuring compatibility with network infrastructure and applications, cybersecurity needs, and the ongoing cost of software support and product licenses needed for interfacing with software applications. The unified effort of a health care organization’s supply chain, healthcare technology management and information services departments is becoming ever important.
Sales and service have to be addressed concurrently for a health care organization to have the most purchasing power and control the total cost of ownership. For HTM, as more organizations bring that team to the negotiating and capital planning table, the simple message to share with manufacturers is that, “the simpler and easier it is to support a product means the easier it is for healthcare technology management to be the champion for recommending one vendor over another during the final selection process.” The health care organization holds the funds to buy the new equipment. It’s during the time of evaluating and comparing manufacturer products and service offerings that the health care organization has the most leverage; it’s also when the manufacturers will make the most concessions to win the sale and the related down-stream revenues.
Some manufacturers are starting to listen to this message and, in turn, are starting to reconsider offering technical training, while other manufacturers don’t appear to care. This seems especially true for manufacturers who have overwhelming market share and see their customers as a captive audience. In those situations, the manufacturer sets itself to be a price-setter versus a price-taker.
A health care organization having cost and time effective options on how it supports and maintains its patient care equipment is very critical. The right to repair is a right all health care organizations need to fight for, be it when doing a competitive bid between manufacturers while assessing total cost of ownership, when replacing old equipment with newer models, and when talking with its own government liaison staff for raising awareness with state and federal officials.
Eventually insurance providers and the state and federal government may wake up and realize they too are paying too much for procedure reimbursements when a health care provider cannot readily and economically service the equipment it owns. Maybe that is when real change may happen. Until then, HTM professionals need to keep raising awareness around the value of technical service training and the right to repair.
Mark Newell is a clinical engineering-operations support specialist in the Advocate Health Clinical Engineering Department.
