By K. Richard Douglas
Laredo is a city in southern Texas that sits on the border with Mexico and is on the north back of the Rio Grande River. It is home to the U.S.’s largest inland ports of entry between the two countries. As a result, the city of Laredo has a blend of the two cultures.
The term “the streets of Laredo” has been found in everything from a cowboy ballad to a TV miniseries. It has brought the name of the city to a much bigger audience and conferred upon it thoughts of the cowboy days.
The city’s health care needs are handled by Doctors Hospital of Laredo, a 181-bed acute care facility that offers a range of medical services. The hospital includes cancer care resources, comprehensive women’s services and a heart and vascular center. The hospital invested $2.7 million to expand its advanced cardiac surgical suite.
Medical equipment at the facility is managed by the six-member healthcare technology management (HTM) department.
The department consists of HTM Director Tito Rodriguez; MSET III Ruben Reyes; MSET III Jorge Perez, CBET; MSET II Isai Ledezma, CBET; MSET I Jose Daniel Carrillo, CBET; and MSET Leonel Hernandez II, R.T.(R) ARRT, HM L08A, CBET candidate.
In addition to handling the medical equipment needs at the main hospital, the HTM team supports many other facilities, including the 101-bed Fort Duncan Regional Medical Center in Eagle Pass, Texas, along with clinics such as the Nueva Vida Maternity Clinic, North Laredo Diagnostic and Therapy Center, the Providence Health Center, Calton Road MRI, the South Laredo Diagnostic Center and the Doctors Hospital Emergency Room South and the Doctors Hospital Emergency Room Saunders.
The department’s coverage also extends to the Doctors Hospital Cancer Treatment Center, the Doctors Hospital Medical Office Building and the Doctors Hospital Mobile Clinic.
Dealing with Challenges
The biomed team has had some real challenges; both from a cybersecurity perspective and, in July of 2021, had to deal with a citywide water boil (two weeks), which presented a challenge for dialysis services which Ledezma directly monitored and assisted with.
“He ensured that the dialysis units functioned accordingly by monitoring the chlorine and total dissolved solids (TDS) levels daily,” Rodriguez says.
Rodriguez says that if the levels were too high, he would change the carbon block filter if needed. This would ensure that the dialysis machines were functioning properly with reverse osmosis (RO) water.
The team also dealt with a ransomware cyberattack in 2020 that affected all UHS affiliated clinics.
“The HTM department worked in conjunction with IT to recover and restore medical information. The process took about two weeks of 14- to 16-hour days and consisted of re-imaging every single computer and medical network device at each UHS facility and bringing in outside services to re-image servers,” Rodriguez says.
“Oversee the scheduling, corrective maintenance and reports for all diagnostic imaging equipment, PM inspections and physicist evaluations,” he adds.
The team transitioned from outsourced biomed services to in-house biomed services in October of 2016. They also contributed to the set-up of ER South (August 2015) and ER Saunders (November 2019).
Rodriguez says that the team also supplied and integrated medical equipment into two new ER facilities.
“Mobilized all the equipment. Connected, installed, tested, validated Cerner, BDMI, Alaris, monitoring system connected, updating inventory, set up lab equipment with vendors, set up radiology equipment with vendors (scheduled/recorded physicist evaluations, etcetera),” he says.
The team contributed to the re-modeling of Providence Health Center by expanding surgical services to this facility.
The department also assisted with moving, connecting, installing, testing and validating all systems as well as updating inventory.
“This resulted in expanding surgical workload and abilities to handle the Laredo market growth the last 2 years and meet community demand,” Rodriguez says.
Another project was the da Vinci robot setup and installation of da Vinci Robotic Surgical System Si.
“The unit was moved from a sister facility and Isai Ledezma assisted surgery directly by collaborating and planning with central processing in regard to how the detachable surgical arms would be sterilized. He also ensured we collected all prior PM reports and unit paperwork to reflect accurately in our AIMS system. His contributions resulted in ensuring the robot was safe for use prior to proceeding with providing the first robotic surgeries to the community,” Rodriguez says.
Team members also oversee the scheduling, corrective maintenance and reports for all diagnostic imaging equipment, PM inspections and physicist evaluations.
“Leonel Hernandez II and Jose Daniel Carrillo directly oversee the physicist evaluations and PM inspections with Philips, Canon, Hologic and BC Technical for all diagnostic imaging equipment are scheduled by coordinating with radiology, cath lab, and affiliated clinics directors and supervisors,” Rodriguez says.
He says that they maintain all PM reports, physicist evaluation reports and all service reports concerning physicist discrepancies and/or recommendations. In addition, he works closely with field service engineers during repairs and ensures FDA forms are recorded for major component changes and new evaluations are scheduled to re-assess unit safety for patient use.
The department oversees the corrective maintenance and repair of all ultrasound probes and surgical/endoscopy Stryker and Olympus flexible/rigid scopes and camera heads.
Carrillo directly oversees all probes, flexible scopes, rigid scopes and camera heads by coordinating with surgery and radiology directors and supervisors for equipment repair services/sending out equipment. His contributions and coordinating results in minimal down time and patient exams are completed/conducted with functioning and safe equipment. Throughout the COVID-19 pandemic the department is able to maintain its inventory to be stocked. Items are readily available by providing fast service as soon as one of the units is down and in need of service.
The team also works to ensure COVID-19 ventilator uptime.
“Throughout the COVID-19 pandemic, Jorge Perez was the task leading force in maintaining and troubleshooting ventilators for Doctors Hospital of Laredo. As soon as a ventilator was down, he was able to troubleshoot and send it back to the floor, minimizing downtime for our respiratory technicians taking care of our community. Doing this was a challenge as sometimes we had to work with what was available in the facility due to a national shortage and back-ordered parts for most of our ventilators. Mr. Perez coordinated with multiple rental vendors and ensured the respiratory department had units at the ready to service the needs of the community,” Rodriguez says.
He says that Ruben Reyes has been a great asset to the Fort Duncan Regional Medical Center facility.
“Not only has he been taking care of general biomedical/X-ray repairs, but he also attends to the facility’s administrational meetings every day. Since COVID-19 started, he tackled all of the usual tasks as far as ventilator repairs/rental equipment for keeping up with the respiratory technician’s workload. With the assistance of DHL co-workers he has been able to upkeep the balance for all the workload in the department and requests from directors/staff,” Rodriguez says.
This small team who walks the streets of Laredo would make any cowboy proud. They keep all the equipment running in this border town and back-up the clinicians and patients who rely on them.