By Mark Newell
Health care providers are challenged with limited capital dollars and shrinking reimbursements. In addition, many are looking at ways to comply with sustainability compliance and doing their part for conserving energy and environmental resources.
Maintaining the security of networked medical devices adds an additional burden to an organization’s finances. The right to repair, being the ability for one to repair and maintain items by means other than the original equipment manufacturer, helps provide a practical solution to these challenges.
Are you seeing an increase in the number of products becoming “end of life” or “out of support” even though they are fully functional and meet patient care needs? It seems this is inherent in the design of newer devices – to have shorter life cycles, and in turn have continuous revenue. This results in customers being mandated to replace their equipment prematurely, in turn incurring a higher capital costs for a health care organization for said replacement, and in many cases, a higher operating cost too because of limitations in support options for the newer devices.
Not all patient care devices may have manufacturer-provided solutions to address operating system obsolescence or other cybersecurity threats, more so when there is already a deflated short support life. When the manufacturer as the only support option states they have no remedy for an issue, considerations for mitigation is sometimes pushed aside and a costly replacement is presented as the only solution.
The fabrication of medical devices uses natural resources. The premature disposal of equipment puts a demand upon such resources as not all parts of a device may be recyclable for re-use or environmentally friendly for its disposal. For most medical equipment, this cost for removal and proper disposal is borne by the health care facility.
Health care providers are caught in a quandary when they have limited options for how to support the medical equipment they own. They have higher operating and capital costs tied to artificially shorter lifespans for items they cannot self-maintain, and are lacking timely access to a trained service provider. If one cannot train their own staff or find a qualified alternate service provider, this impacts two critical aspects of a health care organization: providing timely care to the patients it serves and ensuring equipment is being maintained and inspected on schedule. Cancelled patients means lost revenue, customer dissatisfaction and a physician dissatisfier. Delays in any scheduled preventative maintenance can also increase downtime impact for the health care providers’ regulatory compliance.
A lack of in-house or aftermarket service options to repair and maintain owned equipment means that any service-related needs now become a waiting game. Effectively, any planned or scheduled maintenance can only be done when the manufacturer is available. That may mean cancelling patients during the day when patient volumes are the highest, or by paying a premium for afterhours or weekend service. Based upon net operating margins of most health care organizations, any premium service costs cut into a health care providers bottom line very quickly and more pronounced than regular service rates.
Many manufacturers are reinforcing their communication to health care providers that non-contract customers come last for response to any service requests. Ironically, several manufacturers are now also extending out their response times for contract customers, too, in light of no longer having external competition. Many have gone from a two-hour onsite response for a full-service contract customer to a four- or eight-hour onsite response. If one wants the two-hour response, the premium is very costly. For demand service a few manufacturers have extended it out to 24 to 48 hours onsite response. For niche products where the manufacturer offers no training, this is also starting to be seen as the new normal for products under a full-service agreement. This impacts hospitals in their mission of providing timely patient care to those in need and recouping their investment in the equipment.
The lack of right to repair has widespread impact. Shrinking revenues means less money to replace capital. Lack of support options for maintaining equipment means items are being replaced at a schedule a manufacturer may dictate, not that of the equipment owner based upon what the owner can afford. Lack of competition, be it through third-party or trained in-house staff means higher operating costs and delays in care when something is not available for patient use. Lastly, equipment being replaced prematurely is negatively impacting the environment and related resources to produce that equipment’s replacement.
A long-term holistic solution for medical equipment service is needed for health care to better steward resources and ensure patients get the care they need when they need it. The right to repair helps address these challenges. What one can do to support this is to help get out the message by working with his or her organization’s senior leadership, the organization’s government relations staff and supply chain leaders, insurance providers, and any group purchasing organizations their health care organization may belong to. It comes down to awareness as to how not having options really drives up costs for health care.
Mark Newell is director of operations support for HTM/CE at Advocate Support Center.
