By Joseph Fishel
Inventory loss is occurring with more frequency. This is because of theft, hoarding and the improper documentation of equipment when it is disposed of or traded in. This has impact in several ways such as clinical assets no longer being available to support patient care. This can create a need to rent additional equipment to meet a facility’s needs. Also, HTM teams can use up valuable time trying to locate equipment for maintenance. When maintenance isn’t performed in the prescribed time frame, the equipment is no longer in compliance for use.
Let’s look at several factors that help address this issue. There are networked and non-networked devices as well as devices with PHI and those that don’t contain PHI. So, what do they all have in common? Each of them should be included in your Medical Equipment Maintenance Plan (MEMP). They should be in your inventory and they should have been evaluated for a PM frequency or risked into an AEM program.
Have you updated your Can Not Locate (CNL) policy or are you still waiting three PM cycles to declare a device lost, missing or stolen? Years ago, when devices were not networked, we performed monthly, bimonthly and quarterly PMs. When we could not locate a device, it went two more PM cycles before we declared it missing/lost or stolen and retired it from the inventory. Back then, the maximum amount of time was 9 months before a resolution was determined. Since then, the time between scheduled PMs has increased. Devices could go a year or two before a scheduled PM, and if they are on an AEM program they may not be inspected at all.
With devices now being networked and having PI/PHI information on them this has significantly changed the urgency to locate. When a device containing PI/PHI can’t be found it needs to be reported to outside agencies within a short period of time.
We no longer have the time to wait three PM cycles. We have less than 30 days with today’s HIPAA laws for devices with PI and PHI on them. Also with the price of equipment going up and budgets getting tighter, you need more control or visibility of equipment leaving the premises.
I know of one facility that had 30% of their IV pumps stolen in a migration type of manner over a period of time. When PM time came, the missing ones were put on the CNL list. After three PM cycles (totaling 3 years) they were retired. The total amount lost was around $2 million in equipment. While they didn’t have PI or PHI, they were networked and could be seen, or in this case not seen, as they disappeared from the network. Because there was no immediate follow up, the hospital ended up having to rent additional pumps because the clinical staff assumed that the clinical need had them in use.
So, what can be done for networked devices? There are reactive measures such as searching for them using an Internet of Things (IoT) application to see if the device is still on the network and where on the network. A more proactive approach would be to implement or create settings on an IoT tool to monitor networked devices so that if they go offline for a certain period of time the IoT tool will notify you of the loss of connectivity. Once notified, you can verify why it is not connecting to the network.
What about devices that aren’t networked? You can have devices such as point-of-care ultrasounds that have PHI and PI on them, but they aren’t networked. How can you track them? This is where an RTLS/RFID system comes into play. By attaching a tag that can be seen on the network you can create filters similar to network devices that notify you when the device isn’t seen by the network or leaves the building. I would also suggest attaching the tag inside the device so it can’t be easily removed.
CNL is becoming more prominent in resolving where did it go or where is it than before. Like I said before, if it has PHI on it the loss needs to be identified and an investigation needs to start immediately. I would suggest that you start involving your facilities security department as well. This should also start being reported as part of the environment of care (EOC) meetings because it could put the facility at risk. This risk needs to be elevated so that leadership is aware and provides support. Department heads need to be involved as well. It’s their equipment, so they should know where it is. Getting EOC buy-in on the importance of this (both from the PHI and financial standpoints) can assist when you have to go to department managers with your CNL list because you don’t have the tools and apps to locate equipment.
Joseph Fishel, CBET, MBA, is a Nuvolo Business Process Consultant, Healthcare IT Leaders LLC. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.
