By K. Richard Douglas
A popular social media meme shows the two main characters from the movie “Back to the Future.” Marty McFly and Doc Brown are pictured with the iconic DeLorean from the movie. Doc Brown says to McFly; “Listen carefully Marty; whatever you do, don’t set it to 2020.”
There will be many wishes for 2021 as 2020 winds down, but the most common wish will be that the new year bears little resemblance to the one that is ending. While 2020 started on a strong note, with a thriving stock market and low unemployment, it was quickly downhill from there.
The year saw nationwide protests sparked by the death of George Floyd, technical problems with the Democrat’s Iowa presidential caucuses and historic wildfires in Australia. There was also the impeachment and acquittal of the president, the killing of a terrorist general and increasing tensions between the U.S. and Iran, a Ukrainian passenger jet crash and the death of Kobe Bryant; and that was just the first half.
On January 7, the World Health Organization was notified by the Chinese government that a contagious virus, identified two months earlier, was infecting people in the city of Wuhan. A couple of weeks later, the first case of a coronavirus infection was reported in the U.S. in Washington state.
By the 23 of January, the Chinese government put the 11 million residents of Wuhan in lockdown. And, by the end of January, the United Kingdom officially cut ties with the European Union.
By February, Harvey Weinstein was found guilty and in March, Italy became the first country to implement a nationwide lockdown and a cruise ship off the coast of Japan, with 3,600 passengers went into quarantine. There were 600 infected passengers by the time they were able to deboard.
By March, cases were reported in several states and widespread testing was approved as a national emergency was declared in the U.S. Also, the Tokyo Olympics were postponed until next year.
From that point, the community infection across the U.S. spread and the hospitalization and death toll grew. Many states issued stay-at-home directives. By April, British Prime Minister Boris Johnson was admitted to an ICU.
While the pandemic took center stage, wildfires ravaged California and the stock market realized a major crash in March as murder hornets arrived in the U.S.
The urge to look forward to a new year and the hope for recovery, healing and an effective coronavirus vaccine became commonplace as most people were ready to bid 2020 good riddance.
This was the backdrop as many in HTM leadership joined people from all professions in thinking ahead to 2021. In the past, many biomeds had a particular tool or test instrument on their wish list, but 2020 has shifted the focus.
The hope for the new year is that it is an improvement over the year past and that life will return to normal. That was one of the wishes of HTM directors and managers as TechNation queried them about their wish list for the new year.
Those wishes run the gamut from health care reform and more standardization to the search for new qualified staff and increasing biomed’s role in emergency planning.
“My Christmas wish list would include, like many, that this COVID virus would somehow be controlled and eradicated. Our responsibility to maintain the needs of the hospital could sometimes be difficult to begin with. The virus compounded that. Dealing with self-quarantining, and staff actually infected, changes the way you have to operate,” says Matt Yates, tech manager, BMET III at ISO The InterMed Group in Alachua, Florida.
Yates says that his group divided their staff in two and alternated weeks working at the hospital.
“One half on site and the other half doing what they could from home. Fortunately, I am blessed to have the great team that I have and we were able to provide the service the hospital required,” he says.
Staffing is a Challenge
Yates says that another item on his wish list would be that the HTM field would attract new engineers.
“It is becoming more difficult to find quality candidates. A large number of engineers in the field are approaching retirement age – myself included – and we need qualified candidates to fill these positions. I have been in this for 40 years and have seen many changes during that time period. Some really amazing as the field evolved and some not so good,” Yates says.
That wish is not only proving to be a challenge in Florida, but in Pennsylvania as well.
“Finding good talent and qualified candidates is on my wish list for 2021,” says Salim Kai, senior director of information services-biomedical engineering at Children’s Hospital of Philadelphia (CHOP).
“CHOP is building a new hospital and I will be adding new staff on my team, so finding good qualified candidates is vital to a successful operation,” Kai says.
“Specifically, in the imaging domain, finding a candidate who has been trained by the OEM, for example in MR or CT is highly desirable and would want on my wish list,” he adds.
Not only is the wish for the availability of employees from a particular talent pool, but also employees who understand the importance of the role that they play.
“Managers would like to see new technicians come in with the passion for the job that past generations had for the job. It’s not just a job but a passion/calling. No different than the passion nurses come in with. We think some of this passion is nurtured in their biomed education, but we have more technicians that come into the field with a basic electronics or IT degree who miss having the passion,” says John M. Petersen, MBA, MMIS, senior director of clinical engineering at Trinity Health in Boise, Idaho.
Petersen says it is a challenge to find qualified staff.
“Many of our new hires are not trained in a formal biomed school,” he says.
He says that another challenge is getting staff trained, especially in the COVID environment. Petersen adds that GE Healthcare is one of the first vendors to reach out with some virtual training for biomeds on ventilators.
Increase the Cybersecurity Capabilities of Hospitals
The need to button-down the network, in an age of bad actors and multiple cyber-threats, is an area rife with concerns and this is the wish of many in HTM leadership.
“Medical equipment and hospital networks that have the ability to turn away every cyber threat and risk. Each day health care organizations face a potential breach that could have an adverse effect on one or more patients. This reality is something keeping a lot of people up at night and could have a tremendous impact on patient and caregiver safety,” says Mike Busdicker, MBA, CHTM, system director, clinical engineering at Intermountain Support Services/Supply Chain for Intermountain Healthcare in Midvale, Utah.
Another of Busdicker’s wishes, looking forward, would be for standardized HTM practices and data collection processes across the entire industry.
“The ability to compile data for trending, simple analysis, or other data points, could be significant in the improvement of medical equipment use and service. Part of this Christmas wish includes the willingness of the industry to share data – anonymously, of course – to improve health care and patient safety,” he says.
Bob Meninno, director of biomedical engineering for Hoag Memorial Presbyterian in Orange County, California, says that cybersecurity concerns require necessary resources and that is a wish for the future.
“Staffing and resources to address the cybersecurity issues surrounding medical equipment is for me a must have. The complexity of administering a comprehensive cybersecurity management plan is much greater than the administration of patches and making software back-ups,” Meninno says.
He says that the sustained effort to support the acquisition, information gathering, maintenance and planning activities is daunting.
“It is all the more so in consideration of the impact to the biomedical equipment technicians, clinical engineers as well as the integrated systems management (ISM) teams and the workflow needed to bring it all together,” Meninno adds.
The wish for more technological capabilities also extends to artificial intelligence (AI) that has been successfully used in applications across many industries. A third-party application that has a more universal application in biomed is another wish.
“Artificial intelligence that is not necessarily vendor-specific to assist with things like proactive maintenance, device utilization, alarm settings and notifications, user adaptability, and patient safety issues. I know there is a lot going on with this type of technology, but it would be nice to have something tied to the EMR and to a CMMS,” Busdicker says.
Reflections of a Pandemic; Wishes for Preparation
Many in leadership lamented the challenges of limiting useful visitors to their facilities. Others spoke of the challenges of training in the face of these unique times.
“I think one immediate need is for biomed to be involved in emergency planning for the facilities. Sure, there’s a lot of experts handling the planning but things are now happening that weren’t thought of before. During this pandemic, vendors have not been allowed in the facilities. This means more training will be required so biomeds can handle the equipment needs themselves,” says Jorge Contreras, CBET, director of biomed and procurement at Sonoma Specialty Hospital in Sebastopol, California.
Contreras also says that he would like to see more back-up units.
“There was a massive surge in patient loads and there have simply not been enough vents, infusion pumps and even beds. Patients have been moved to other facilities simply because they don’t have the right amount of space, equipment or staff. Biomeds can bring units out of retirement. In order to use them, we’ll need a strong amount of supplies. I’d like to see more involvement in emergency planning,” he says.
“I’d also like to see more biomeds stepping up and using the connections they have. I was able to secure beds because I kept contact with someone who helped out three years ago during the first Sonoma fires. We were able to accept patients from other facilities because of the preemptive planning I had created,” Contreras says.
He suggests that biomeds not wait for the risk management team to solve problems.
“We should be presenting solutions to them,” he suggests.
The right to repair issue has been highlighted by the circumstances that biomeds find themselves in.
“As I reflect on the impact of COVID-19, the thing I keep coming back to is the support we receive from manufacturers, in particular training. We must and will be empowered to directly support our equipment with a minimum of reliance on the OEM for on-site support,” Meninno says.
Meninno says that far too many equipment manufacturers either refuse to provide meaningful training on the maintenance and repair of their equipment or the cost of the training is completely out of line with the value received.
“Our program is outsourced with Renovo Solutions and OEMs frequently claim that training us is ‘against their policy.’ This push-back from vendors against training our staff is unconscionable. I take biomedical engineering’s role in capital equipment planning very seriously and I will be measuring the value of training provided. The willingness of vendors to provide meaningful training will rank high on the list of criteria for capital equipment purchases,” Meninno says.
The right to repair wish was echoed by Petersen. “Manufacturers giving in-house biomeds the tools and passwords to maintain our medical equipment. Even if there was a cost for the tools and training it should be available,” he says.
He also has hopes for more efficiency with available resources.
“The days of large shops are over and as an in-house team we need to be more productive and efficient; incorporate lean processes into the work,” Petersen says.
Succession Perfection
AAMI comes through, answering the wishes of many managers and directors with its “Succession Planning Guide.” With departures triggered by retirements and career changes that are commonplace, the guide might find itself on many wish lists.
AAMI’s new guide is designed to help HTM leaders develop a succession plan for staffing at every HTM career level. AAMI’s Healthcare Technology Leadership Committee (HTLC) was instrumental in developing this guide.
“No manager should be scrambling to fill a position when someone suddenly leaves or retires,” said Danielle McGeary, AAMI’s vice president of HTM. “A succession plan allows HTM managers and directors to evaluate who on their staff is ready for promotion and how soon – and, for employees who are not ready, to determine the skill sets and development they need to be ready for a promotion.”
The guide provides a comprehensive tool for leaders to assess their team and identify opportunities to support growth, as well as to fairly and clearly explain a pathway forward to their staff. It includes a succession planning template to track the current and potential next roles, competencies, training needs and aspirations of an entire HTM team.
The guide is available online at https://bit.ly/2Ebl2tD.
After a trying year, many in HTM leadership just hope that morale and commitment remain.
“My last wish would be that we all maintain the enthusiasm we had when we came into this field – sometimes that’s hard to do – and remember how important the job we do is for the safety of patients and staff every day,” Yates says.