Fort Benning, near Columbus, Georgia, may be one of the best known military bases in the country. The U.S. Army base includes the Maneuver Center of Excellence. It is a massive base, supporting more than 120,000 active-duty military, their families, reserve soldiers, retirees and civilian employees on any given day.
The base’s official mission statement recognizes that warfare has become more sophisticated; “The Maneuver Center of Excellence and Fort Benning provide trained, agile and adaptive combat-ready Soldiers and Leaders; develop the doctrine and capabilities of the Maneuver Force and individual Soldier; and provide a world-class quality of life for our Soldiers, civilians and Army families to ensure our Army’s Maneuver Force remains the world’s premier combat force ready to ‘Win in a Complex World.’”
It was the home of tank maneuver warfare under General George Patton and airmobile tactic during the Vietnam War. The base is, and has been, the training home for generations of trained combat soldiers.
Providing health care services on the base is the Martin Army Community Hospital (MACH). It is a state-of-the-art 250-bed medical complex, which opened in 1958. According to the hospital’s webpage, MACH maintains a “fully accredited laboratory service, diagnostic radiology with computerized tomography and nuclear medicine, extensive pharmacy service, and many other ancillary support services.”
Tasked with servicing and repairing all the medical equipment associated with the facility is the hospital’s clinical engineering department.
“The clinical engineering section has 13 clinical engineers, one contracting officer representative, one office automation clerk and one supply technician,” says Staff Sergeant Nomar DiazLebron, clinical engineering shop foreman.
DiazLebron says that the Martin Army Community Hospital consists of approximately 60 sections within the facility.
“There are about 24 outlying clinics, which includes Troop Medical Clinics (TMCs), dental clinics, blood banks, industrial hygiene, veterinary clinics, optical fabrication and the Military Entrance Processing Station (MEPS),” DiazLebron says.
He says that his group services and repairs specialized equipment such as vital signs monitors, diagnostic imaging, anesthesia, ventilators, laboratory refrigerators, sterilizers, dental equipment as well as surgical and preventative medicine equipment.
Determined Even When You Wannacry
The 13 HTM professionals in the clinical engineering section keep busy addressing work orders and keeping all networked equipment safe from uninvited guests.
“The clinical engineering section workload includes, between 800-1,000 scheduled work orders each month, unscheduled work orders (repairs), technical evaluations for equipment that’s either damaged beyond repair or exceeds the life cycle (between 8-10 years), recalls on medical equipment (from the manufacturer), and acceptances (analyzing new equipment),” DiazLebron says.
Specialized equipment is under service contracts with manufacturers.
“The clinical engineers do their jobs by using Test Measurement Diagnostic Equipment (TMDE). TMDE is used to service and verify calibration for specialized medical equipment,” he says.
The department has also tackled cybersecurity threats recently.
“We just completed a 100 percent inventory of all medical devices with Windows OS (operating system) to ensure the equipment is not vulnerable to the WannaCry ransomware. In order to mitigate this, we had to ensure all medical devices that used Windows OS were on Windows 7 service pack 3 or above,” DiazLebron says.
Just as in civilian hospitals, cybersecurity is a major focus in military health care settings. The ransomware project was approached methodically.
“On the WannaCry project, we received an order from the Department of the Army that all medical devices need to be inspected for mediation. This resulted in 8,700 work orders open on one day. From here, we had to divide and conquer. We used two clinical engineers during this task and a deadline of 30 days. First we started with simple medical devices; for example thermometers and scales, that we knew did not need an operating system to work,” DiazLebron explains.
He says that this portion took about six-hours and they did it during one sit, “We started the project once we received the order which was around 10:00 (10 a.m.) and we didn’t stop until 22:00 (10 p.m.) when our eyes could not hold any more – this took us to 20 percent in just one day.”
“We still had a long ways to go but it was a good starting point,” DiazLebron says. “From there, we went to the units that we knew required an operating system, but it was a firmware. For example, monitoring systems like Welch Allyn, had the capability of connecting to the network but did not have a Windows operating system.”
DiazLebron says that the problem they ran into was that this equipment was in use most of the time.
“We adjusted our timeline for the technicians in order to get to the equipment. After a couple weeks, we were very close to resolving our deadline but we hit a big obstacle. Some units would need logins and keys in order to get the information required. This took us the longest, especially when the manufacturer required technical training in order to provide the information,” DiazLebron says.
He says that it took the two technicians five-weeks to complete the task with a lot of overtime hours and many headaches.
“Our lessons learned from this task were that we need to be more proactive instead of reactive. Because [of the] multiple tasks during this, we could not afford more than two techs gone at the same time. We did not meet different deadlines, but we provided a reasonable explanation for this,” DiazLebron adds.
“The major problem to solve was time management and production management by me losing two techs to this task. I had to adjust the entire shop production in order to meet our requirements on scheduled services. We had technicians cover and leave their comfort zone in order to cover the different areas that the techs used to cover. Thankfully, patient care and hospital readiness was not affected with this task and we never compromised our levels or standards,” he says.
With the ransomware mitigation project as an indicator of their tenacity, the clinical engineering department at Martin Army Community Hospital embodies all the great qualities the Army expects.
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