A quality CMMS is a tool that benefits every biomed. It provides assistance with everything from preventative maintenance schedules to equipment disposition. In this issue of TechNation, experts from several CMMS providers share insights regarding the newest features, capabilities and cybersecurity concerns.
Among those sharing expert knowledge regarding the latest CMMS offerings are TruAsset President Jason Byers, Agiliti Director of Modality Services Russ Lang, Phoenix Data Systems Inc. President and CEO Ben Mannisto, EQ2 LLC Product Manager Rich Sable and Nuvolo Senior Solution Consultant Dustin Smith.
Q: How can CMMS help HTM professionals with capital planning and prioritizing what equipment should be recommended for replacement?
Byers: TruAsset can assess usage/abuse levels of equipment based on work order history and give feedback to administration about assets that may be end of life sooner than originally expected. This can utilize age, labor hours, downtime, usage level of the equipment, equipment abuse and parts cost to give an overall picture of what that asset is costing the facility and the trends for the unit.
Lang: Assisting with capital equipment budgeting is one of the best ways HTM can show their value in a health care facility. A well-designed CMMS system will have fields to collect date of manufacture, date of installation and end of service dates. It should also be able to track service costs annually and compare those costs to the estimated acquisition value of the medical device. With those components, HTM can provide the capital planning committee with a 3- to 5-year plan for replacement based on age, support and repair trends. This allows department managers to make fact-driven decisions on where to apply their limited capital.
Mannisto: The CMMS must have a robust life cycle component, providing the ability for the user to enter not only the date the equipment was purchased and put into service, but also the manufactured date. This assists with a more accurate baseline for the expected life and replacement date. The ability to analyze past and projected costs to repair assists with capital replacement planning, as some equipment may cost more to repair than to replace over the expected lifetime. Reporting using a combination of standard replacement projections with repair versus replace analyses provides a solid capital replacement program for management.
Sable: First, a CMMS captures all the necessary metrics to perform capital planning such as purchase date and cost, life expectancy and all service costs over the asset’s lifespan. Armed with this data, HTM leaders can review the cost of service ratio (COSR) for the asset, failure rates, total cost of ownership and device obsolescence. Finally, the CMMS provides the necessary reports and analytic tools to make informed decisions for capital planning and not just “age-based” replacement models.
Smith: A CMMS should give the ability to identify your assets that are not performing well and start to be less cost effective. It should also assist you in identifying the assets that are going to be ineligible to get parts or receive service. With this information you should be able to serve as a consultant to not only clinicians, but also to capital planning teams to get the appropriate capital funds to ensure your medical equipment inventory serves your clinical needs. Additionally, it should help you with the utilization of equipment and the integrity of what you own. Also the CMMS can help determine the need to relocate devices to areas or departments where they could be better utilized and potentially avoid the need to purchase new devices.
Q: What network information can be documented via your CMMS offerings?
Byers: Any parameters of the network for a device can be recorded in custom tabs within the views for the asset. Any parameters that are not in the default configuration can easily be added by the onsite administrator.
Lang: Today, CMMS systems need to track more than just service events. We need to identify devices capable of storing PHI and network security data. The Agiliti system tracks the type of data stored, how it can be transmitted and what security options are in place to keep it secure. We also track network settings, patch levels and operating systems for items that connect to the hospital network.
Mannisto: AIMS included Equipment Information Services Tab helps users easily manage IS related information and IS devices associated with an equipment tag, including sub-devices for complete parent/child relationships. With more than 200 fields for hardware, software, network, security, recovery, location and support for both main and sub-devices, users and IT have all information required to ensure security for networked equipment.
Sable: HEMS is EQ2’s product name. HEMS Enterprise provides over 100 IT fields to document network information. First, we provide a wide range of network information such as multiple IP Addresses, MAC Addresses, Subnets, Host Names, wireless information (SSID), and VLANS to name a few, for imaging devices or sophisticated medical devices. Second, we provide fields for device software, including operating systems, installed software, and antivirus applications for determining critical programs and versions. Third, HEMS contains fields for additional asset specific data elements such as wall jacks, vendor site IDs, storage locations, and additional device, network, and computer specific data. Finally, we provide an equipment IT Fields report that allows the HTM leader to quickly filter their data to identify critical devices based on security alerts. This data can also be made easily accessible for technicians from within all products.
Smith: IP, Mac, Hostname, Discovery Location, OS, Software Revision Level, Security Risks (assessment information), PHI, and additional network adapter information (DHCP, connection type, i.e.). CMMS’s should also be flexible enough to add to or remove these fields. In the case your operational technology (OT) monitoring vendor, like Medigate, Ordr, Zingbox and others can pass you other automated data that needs a new field to be held.
Q: Does your CMMS system interface with the other software applications on the market? If so, what does your software integration offer as a benefit?
Byers: We currently have integrations with Pronk Technologies test equipment, and oneSOURCE document. All our integrations have been built to accommodate customer requests at no charge to the customers.
Lang: Several years ago, Agiliti integrated our CMMS system to RTLS/RFID systems. Since then, we have integrated to ERP systems and other CMMS systems. These integrations benefit us by allowing direct links for service information, inventory changes and contract updates.
Mannisto: AIMS can interface with any third-party software, including
ServiceNow. Many customers utilize a variety of interfaces for cybersecurity, document management, parts, purchasing, RTLS, device testing, and IT work orders, creating efficiencies by removing the necessity of entering duplicate information into multiple applications.
Sable: Yes, we have several Application Programming Interfaces (APIs) that we use to interface with other information systems such as OneSource, Lawson, PeopleSoft and Glassbeam to name a few. Also, EQ2 is one of the only CMMS vendors with Integrating the Healthcare Enterprise – Patient Care Domain (IHE-PCD) interface capabilities, for connecting to numerous systems and smart medical devices including RTLS. Using this interface, the HTM team can easily determine the “current” physical location of medical equipment, order parts directly from within their work orders and seamlessly locate service manuals from their desktop or mobile device using HEMS Enterprise or Web Enterprise (a module for HEMS). With IHE-PCD and Glassbeam, the medical devices can create their own utility-based maintenance or corrective work orders providing a more proactive versus reactive maintenance program.
Smith: Our software can be easily integrated to ERP and RTLS offerings. These can produce tremendous efficiencies in accurately tracking cost and locations. RTLS integrations can save large amounts of time when trying to find mobile medical equipment and can assist in mitigating unnecessary capital purchases. An open API architecture is critical to a modern CMMS as most third-party applications that benefit from CMMS integrations, or visa versa, use a variety of different integration mediums.
Q: What features does your CMMS use to help manage the cybersecurity of the medical device inventory? Do CMMS products have any integrations with vendors of IoT/IoMT tools?
Byers: Our current system does not have a method to manage IoT/IoMT. We are currently developing a module to better support scanning networks and devices and collecting information in a more active fashion.
Lang: In order to manage cybersecurity within the medical device inventory your CMMS needs to first store all the relevant communication and software information. You can also associate your CMMS to any number of interrogators that will alert you of excessive traffic on the network. This will only provide you with potential risks. In the end, you need cooperation between IT security and HTM to develop and implement a risk-based approach to cybersecurity.
Mannisto: The included Equipment Information Services component manages all aspects of cybersecurity by providing complete network information for every device. Integration with cybersecurity applications provides the opportunity for AIMS to automatically create a work order and notification for any found issues. This enables the user to immediately take compromised equipment offline. All CMMS applications with an API can integrate with IoT/IoMT third-party software.
Sable: HEMS Enterprise devotes an entire section in the inventory module to documenting network information, which makes it easy to identify assets with reported symptoms of malicious activity from your network security team. Additionally, the CMMS allows HTM managers to define a network risk level for a model or set model specific network IT fields, and this is displayed on the equipment inventory dashboard or within the mobile products. By documenting and reporting this type of information, the HTM manager can partake in the organization’s cybersecurity program. HEMS Enterprise also supports integrations with IoT/IoMT vendors which will further enhance your cybersecurity program for medical devices, especially when interfacing with network-based cybersecurity “appliances” using the CMMS’s API.
Smith: Nuvolo provides an OT cybersecurity solution that enables security orchestration and automated response workflows for all connected medical devices which includes our Intelligence Hub with prebuilt integrations to all the major OT security providers on the market. It enables additional visibility to all needed support teams (IT, HTM and Facilities) and automated actions which make it much easier to get appropriate hands on deck for particular alerts, hazards and even recalls. It also allows for seamless asset creation and review when new devices are discovered on the network.
Q: What features, tools and design ergonomics does your CMMS product have to make it as easy as possible for technical staff to document all activities on a daily basis, including data entry, work order opening/closing, purchase order requests, etc.?
Byers: The entire system was designed with portability in mind. Users can finish data entry immediately on a handheld device. This includes direct links to purchase orders, field service reports and service requests. The implementation of the AEM module has allowed us to make PM frequencies and procedures even easier to manage.
Lang: A CMMS needs to record all relevant service information, be simple to understand and easy to use. Beyond that, it needs to be mobile and fast. We are working with software providers to deliver a mobile solution that allows us to document our services with the least number of clicks. By tracking the documenting effort, we are able to reduce the burden on HTM professionals and drive record keeping closer to real time than ever before.
Mannisto: AIMS is known in the industry as the most robust feature-function CMMS available. It is a tab-based system that allows users to quickly tab through data entry screens, with each “tab” auto-filling numerous defaults of valid entry fields. This valid entry philosophy provides more accurate data and reporting. All system components are fully integrated, removing duplicate data entry (i.e., ordering a part while on a work order automatically adds the on-order part to parts inventory and to a purchase request). Global features allow users to change large groups of information across equipment with a single click, and batches of work orders can be opened and closed for inspections and incoming equipment in a few simple steps.
Sable: To simplify the day-to-day documentation for technicians, EQ2 provides two mobile products: Web Enterprise and HEMS Remote. Both products read barcodes and provide a simple single-page interface to perform daily tasks. In fact, Web Enterprise and HEMS Remote let the technician open/close work orders in the field, procure parts, attach documents, record testers, record PM measurements, review warranty and contract information, access vendor and parts information, and create on-demand work orders. Additionally, HEMS Remote does not require a connection to the organization’s network (offline) to function. With our modular model, it’s easy to add products to your existing HEMS Enterprise system as your workflow needs evolve.
Smith: Our product is made to enable HTM groups to be able to quickly and efficiently complete work orders while still upholding a high standard of data integrity. We have an offline capable mobile offering that is designed for the day-to-day work of engineers and an intuitive workflow to make it easy for clinical engineers to perform their work. We also have a PartsSource integration to assist in the procurement of parts and to decrease variation in parts suppliers while also creating efficiencies for non-HTM groups such as buyers and AP workers. Additionally, an intelligent system can always inherit data from related records to minimize data entry. For example, a lot of information of an asset can be inherited from the model and type of the device.
Q: How does your CMMS product mine data and present reports?
Byers: Our system was started in the HTM field and the reporting reflects this fact. The reports are designed around what inspectors from the primary standards organizations are looking for. As those standards have changed, such as the implementation of AEM, we have updated and adjusted the system to accommodate. Like most systems we have the set of canned reports and regularly add new reports based on user requests. There is the ability for users to create their own reports as well.
Lang: While our CMMS does allow for some reporting in the field, we have found that reports from the data warehouse provide a more robust view to our hospitals and HTM leaders. Having customizable reports in your CMMS does allow for individuals to pull their own reports and configure as needed. In our business, we need consistency in reporting. Operating out of more than 90 locations nationwide, we rely on the BI suite of reports for understanding the performance of our HTM teams.
Mannisto: AIMS has numerous included reports that utilize all data fields. Every included report offers numerous filters, sorts, sub-sorts, and data parameters, to meet management and regulatory requirements. Users can also export data to Excel for data mining purposes. The Report Designer Optional Component provides an opportunity for customers to set up unlimited user defined reports across any data points using simple drill down and drag and drop.
Sable: Many of the management reports in HEMS Enterprise are pre-configured to data mine the correct data elements without requiring additional filtering from the HTM manager. In addition to the reports, EQ2 provides manager and technician dashboards that provide a “live view” of your CMMS data using data mining. When HTM leaders identify the “taboo” devices in the inventory for an alternate equipment maintenance/management (AEM) program and set the risk level for different device types – critical and non-critical – fully configuring the inventory, the dashboard will mine the data, present important information and provide guidance for placing devices on an AEM program while using the device history, failure rate and backup count. Finally, our Performance and Benchmarking Analyzer program provides a direct link to your data using an Online Analytical Processing (OLAP) cube to data mine the CMMS for PM performance, failure rates, COSR by device types, workloads and productivity to name a few.
Smith: Our CMMS has robust reporting capabilities that can use data from any table that is being utilized in the system. It is quite easy to pull information from multiple tables through a join like concept called dot walking. You can also share reports and even schedule them to be pushed out at predefined times. Our reporting capabilities are very quick and fluid to make it easy to report on all aspects of the HTM business. For additional reporting benefits, many customers also set up automated data sources from within the CMMS system to be used in third-party BI tools like Tableau, Oracle BI and others.
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