A hallmark of the advancement in technology has been smaller, lighter, more portable and sophisticated devices. This can be seen in smart watches, laptop computers, desktop computers, consumer medical devices and digital cameras.
The evolution in computer chips has been a key reason why technology has changed and improved. Newer generations of chips have become cheaper to produce, require less power and are faster. The scale of these newer chips is so small that it becomes hard to imagine. While a human hair is 75,000 nanometers in width, there are chips that will soon be a part of 10-nanometer technology.
Ultra-low-power computer chips will require so little power that their sources of power will not have to be batteries. Radio waves, solar energy or even vibration will be all that’s required.
Computer chips will eventually take on a whole new form as current technology accelerates beyond current design parameters. And, these ultra-small, low-energy chips will be only one advance in the appearance and functionality of technology.
With these changes will come another generation of devices and gadgets that will improve upon the previous generation via incremental improvements in computer chips and other components.
Medical devices have been benefactors of this march toward smaller and faster, including test equipment used on those devices. Today’s test equipment is more portable and less cumbersome. It includes multi-purpose devices and devices that feature more automation. The same increase in speed that might improve a netbook computer also improves many test devices.
Automating features of test equipment is an advance that has allowed for fewer user interactions. Also upgradability, through software updates, helps extend the usefulness of a test device. The same interface characteristic that makes certain computers, smartphones, software and cars popular is the intuitive nature of some products and that goes for test equipment as well. If operation just makes sense, and doesn’t require much training; it’s a winner.
Wireless technology has been a big part of the changes seen in medical device test equipment as well. Continuing the recent trend toward cutting wires in hospitals, along with everywhere else, the need for cables is forever shrinking.
Manufacturers, who consider the practical needs of the biomed community, are designing in features that make their devices easier to use and easier to get to the test site.
“We are seeing a lot more combined test devices, i.e. seeing electrical safety analyzers with also patient ECG simulators. Instead of bringing two devices, the technician can achieve some initial testing with only one device,” says Jeff Ruiz, Aramark technology manager of healthcare technologies at Holland Hospital in Holland, Michigan.
Asked what other features are sought after, Roger Streidl, CBET, biomedical equipment specialist at Soin Medical Center, Kettering Health Network in Beavercreek, Ohio says that portable power helps.
“It depends on what you are testing and what the test equipment is. Most of the test equipment we have has the option of battery power, so that makes portable testing easier and is still important. I can’t think of other features that we would be looking for at this point,” Streidl says.
Neil Feldmeier, MBA, CHTM, director of biomedical engineering for Norton Healthcare in Louisville, Kentucky agrees.
“Test equipment that has a long battery life, and combines many features, is the most preferred. If you only need to travel with one or two pieces, while being able to test a wide variety of medical equipment modalities, it reduces clutter on the service cart and unnecessary trips back to the shop,” Feldmeier says.
Raju Bharaj, CRES, a radiology engineer in the clinical engineering department at Good Shepherd Hospital, part of Advocate Health Care, says that “a digital test multipurpose oscilloscope” is the most practical and time-saving piece of test equipment. He says that his reliable Fluke multimeter is the piece of test equipment he uses the most.
Bharaj says that for a piece of test equipment to be prized above others, is based on “the multiple features it has, and it’s easy to set up and read capability.” A portable digital oscilloscope with built in multimeter and an electrocautery tester are on his wish list.
Mike Raslau, a biomedical supervisor with Advocate Health Care, says he uses “safety analyzers and DMMs” the most. He finds the ProSim 4 Patient Simulator the most practical and time-saving piece of test equipment.
Beyond portability, Raslau says, “the ability to transfer data wirelessly into our database,” is the most important feature that is sought out today. He prizes portability, lightweight and multi-parameter capabilities above other features.
He says that the INCU-II Radiant Warmer and Incubator Analyzer is the piece of test equipment on his wish list.
“Patient simulators have been our hot ticket item recently,” Feldmeier says, referring to test equipment that is most in-demand or most desirable. “As our department grows, the demand for these items has increased. We do a good job of utilizing the equipment that we have. The team does a good job of coordinating service to reduce the wait time for needed test equipment,” he says.
Feldmeier says that the most used piece of test equipment is the electrical safety analyzer.
“Our technician that travels to offsite locations prefers a ESA that includes the 12-lead ECG. Being able to combine test equipment into one case allows for mobility and efficiency,” Feldmeier explains.
He also gives the nod to portability.
“Portability is still an excellent feature in test equipment. Our biggest comment is that it’s easier to perform a lot of PMs when you get on a roll. Being able to test equipment in place and on the spot once available helps get our technicians get on a roll,” he adds.
When it comes to rating certain equipment as prized above others, Feldmeier says that ease of use is high on the list.
“We have done a good job of standardizing the patient care equipment at our five hospitals,” he says.
“Having similar test equipment, or intuitive test equipment, makes it easier for technicians to travel between these sites. We have a dedicated team at each site, but when the need arises to have extra help at a certain location, it helps the supporting technician be productive, by being able to jump right in. Rather than have to learn a new piece of test equipment before servicing the patient care equipment,” Feldmeier adds.
More specialized equipment is on his test equipment wish list.
“As we continue to grow our in-house program, by adding even more specialized modalities, we are finding the need to acquire more proprietary test equipment directly from the manufacturers,” Feldmeier says.
While intuitive operation is important, one of the most important components of any piece of test equipment is the instruction/user manual. Not reading the manual, before using the test device, is a recipe for problems. The irony, of course, is that it is easy to get upset with end users of medical equipment because they don’t look at the operator’s manual.
Along with understanding operation, many test devices will gather some dust in-between uses. Streidl says that the piece of test equipment most in-demand or desirable can fluctuate based on need.
“It depends on the day and what pieces of equipment are due for PM during the month. When defibs are due, then the defib analyzer is in demand, etcetera. The items that are in most demand, we have multiples of, such as safety analyzers and digital multimeters,” he says.
When it comes to practicality and saving time, Streidl offers some suggestions.
“Most of the test equipment we have is required to complete PM procedures per the manufacturer requirements, or to help troubleshoot machine problems. The BC Biomedical PS-2010 Patient Simulator is a compact simulator that has combination posts with snaps or openings with rollerball bearings that make it easy to check 10 lead ECG machines with any type of lead end,” he says.
“The SIM Cube is very practical for use in checking patient monitors as it can simulate most of the parameters we need to check. The Fluke Sigmapace 1000 saves time when checking external pacers versus checking them with an oscilloscope,” Streidl adds.
He also has a favorite ECG simulator that he uses a lot because it is compact and light, and he can hook up the leads to it quickly.
“Size and ease of use make test equipment prized in general in my opinion,” Streidl says.
Dennis Duck, CBET, a senior BMET with Baylor Scott and White in Grapevine, Texas says that he uses electrical safety analyzers the most and finds that patient simulators are the most practical and time-saving testing devices.
Asked about which test equipment he sees as most in-demand or desirable, he says; “Those that are compact, have digital displays, and multifunctional (electrical safety analyzers, patient simulators, pressure meters, precision thermometers, etcetera).”
Which test equipment would make his wish list?
“An additional test lung for ventilator testing, a second phototachometer, an additional electrical safety analyzer, an additional patient simulator, a replacement NIBP tester, and a replacement ESU analyzer,” Duck says.
He says that test equipment that offers “accuracy/precision, portability and purchase cost,” are prized above others.
The SlimSim, SimCube and OxSim from Pronk Technologies and the 232D Fluke electrical safety analyzer are the pieces of test equipment used the most by Michael Howell, a senior biomedical technician with ProHealth Care in Wisconsin.
Howell feels that the SlimSim and OxSim from Pronk Technologies, the Certifier FA plus from TSI and the DPM3 from Fluke Biomedical are the most practical and time saving. He agrees with Duck regarding features and says; “Portability is very important, especially if the device can test/simulate multiple parameters and it is easy to use.”
On his wish list are the ProSim 8 and Impulse 7000.
Some well-known vendors see the features/benefits equation much the same as their customers do. The makers of test equipment are driving improvements in the usefulness of these devices.
“Portability remains important especially for the smaller ISOs, when a quick test is needed on-site, in a hospital room or OR. At the same time, having stand-alone operation has gained attention as well for easy data capture. Advantage is amount of equipment, e.g., computer, one has to carry on site,” says Jack Barrett, national business development manager at Rigel Medical.
Barrett says that the qualities that make one test device prized are “ease of use, simple operation, functionality.”
From the east coast to the west coast, those providing test equipment see the world through the HTM world’s eyes.
Greg Alkire, vice president of sales and marketing for Pronk Technologies Inc., agrees that portability is important.
“Clinical engineering departments now have more responsibilities, including supporting multiple facilities and remote clinics, so having portable test equipment is incredibly important. The industry is also facing challenges caused by inadequate staff to manage the workload, so test equipment is being scrutinized for gaining efficiencies as a vehicle to bridge that gap. Test equipment companies, focused on the needs of HTM community, are striving to respond with new design solutions that help drive efficiency,” he says.
What has changed with test equipment in recent years?
“Old standby products driven to obsolesce with new cost-effective alternatives being available,” Barrett says. “Test automation is becoming popular with performance analyzers, internal memory for capturing test results.”
Alkire says that competition has helped spur change.
“In the last 10 years, some changes in test equipment design occurred abruptly due to new companies emerging into the market, driving these devices to be much smaller than what was available at the time,” Alkire says.
“Others happened more gradually and were not as noticeable, such as improvements in accuracy and precision of various measurements such as pressure and flow. New features have reflected innovations in medical devices. Lastly, capturing electronic test records with connectivity to computers, tablets and CMMS systems is becoming more prevalent with some devices that provide measurement values,” he adds.
What does he believe makes a particular piece of test equipment prized above others?
“Test equipment designed small enough to be handheld with easy user interfaces that provide maximum flexibility to the users are prized above all others,” Alkire says.
“Being able to rapidly answer a service call with the tools needed to identify and fix a problem, without being forced to push a big cart of equipment to a department on the fourth-floor is ideal, enabling the HTM community to be flexible and to allow for a faster response time,” he adds.
With the accelerating pace of technology, one thing can be certain for the HTM community; makers of test equipment will have something that makes their job easier just around the corner.
For more information about test equipment, read the Roundtable article in this issue of TechNation.
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