TechNation contacted several experts to find out the latest about computerized maintenance management systems (CMMS) in the health care sector. Participating in this roundtable article are EQ2 LLC President and CTO Navneet Agarwal, Medigate by Claroty Director of Product Marketing Samuel Hill, Nuvolo Vice President of Healthcare Marketing Strategy Heidi Horn, Fluke Global Software Product Marketing Manager Mitch Kruse, Phoenix Data Systems, Inc. CEO/ President Ben Mannisto and TruAsset LLC Director of Business Development Amanda Moser.
How can a CMMS help HTM professionals address cybersecurity concerns?
Agarwal: Cybersecurity awareness and preparedness are critical for HTM professionals. They need to know what actions a CMMS vendor has taken to prevent an attack and what actions will be taken for recovery should an attack affect the CMMS directly. In addition, integrations of the CMMS with third-party cybersecurity applications such as Ordr, Medigate, Armis, etc. help to keep medical devices and other networked applications properly monitored for existing and new cybersecurity concerns.
Hill: HTM professionals are starting to become highly involved in cybersecurity, as the devices they maintain pose serious risk to the hospital. The first way HTM can address cybersecurity is to maintain the CMMS as an accurate and complete inventory of every medical device. With the CMMS inventory accurate, the HTM team can fully support the cybersecurity work of patching vulnerabilities. Finally, when compliance audits occur, the CMMS will contain the record for every device inspected, without any surprises. The CMMS is useful for cybersecurity, if the device inventory and details are accurate.
Horn: It obviously depends on the CMMS. Most legacy CMMS products can only identify what devices your hospital(s) have inventoried in their CMMS but will not be able to correlate which devices are actually affected. It’s then up to the HTM department to manually look at each device to figure out next steps. When integrated with a network passive monitoring application, Nuvolo’s OT Security product simplifies the process and takes a proactive and automated approach by giving HTM departments the tools to automatically update the asset inventory when a device is identified on the network; assess the security risk of your devices; match the threat with impacted devices and create work orders if HTM or IT action is needed; enable coordination with IT; and provide cybersecurity dashboards, reports and compliance documentation.
Kruse: It starts with a cloud-based CMMS system built on a world-class cloud infrastructure such as AWS or Azure. Second, there needs to be user- and role-based authentication built into the system login and specific data type access for the system. And, most importantly, there should be policies around personal information being entered into the system to minimize exposure.
Mannisto: A good CMMS must have opportunities to manage and evaluate extensive cyber security risk points for each piece of equipment that is in the CMMS software. These points need to be readily visible and reportable such that any cyber security issues can be recognized and remediated quickly. Phoenix has built into AIMS 3 extensive opportunities to identify data security issue points on each piece of equipment in the AIMS system. There are approximately 185 data points that can be used to identify risks or conditions that require monitoring.
Moser: A CMMS solution should be able to provide links to security applications and track version numbers of medical equipment to provide a one stop location to access the information pertinent to maintaining that equipment. It should allow easy searching and alerts as to potential security issues.
What features should HTM professionals look for when purchasing a CMMS?
Agarwal: Along with core CMMS software solutions – such as work orders and basic maintenance management functions – reports and dashboards to aid in maintaining compliance, and cybersecurity preparedness are important. The ability to integrate or interface with third-party solutions is increasingly becoming necessary. These include procurement systems or service documents and the ability to interface with IoMT and cybersecurity devices. Automation ensures a standard workflow process and ensures that the work is performed consistently. Finally, electrical safety tester interfaces and real-time locations service (RTLS) systems improve the work order processes for the medical system.
Hill: The first thing I would look for is the way the CMMS transitions from asset inventory to workflow. To gauge this, I would ask questions like these:
How easy is it to find the most up-to-date information?
Is the user experience simple to use?
Does it automate manual work?
Horn: The acronym CMMS – computerized maintenance management system – is an outdated concept heralding from the days when biomed shops were only in charge of maintaining clinical equipment. Today’s HTM departments do so much more than just maintenance, and so their CMMS should, too. In addition to what most CMMS applications can do – inventory equipment, schedule PMs, issue and track work orders, report on compliance – CMMS systems that meet the needs of today’s HTM departments also should automate many common workflows (i.e. enable equipment users to request service through a service portal and automatically assign work orders to the proper technicians), have the ability to manage technician productivity and service contracts, prioritize equipment capital planning and replacement needs, manage your AEM program, identify and coordinate response to cyber threats, monitor device utilization, manage your parts and stockrooms, track maintenance costs at the device level, monitor vendor performance, and the list goes on. If you are supplementing your CMMS with spreadsheets, it’s time for a new CMMS.
Kruse: The CMMS software should be flexible enough to be configured to the specific workflows needed for HTM maintenance. It should comply with any relevant industry regulations. Robust reporting and PM scheduling are important for most HTM applications. And, of course, having the ability to closely track and manage maintenance inventories is valuable.
Mannisto: HTM professionals should be concerned about a number of points when considering a new CMMS. All historical data should be brought forth to the new CMMS. That data should be cleaned and normalized such that the historical HTM department experience can be recognized and potentially evaluated and remediated where appropriate. A good CMMS must also have a comprehensive API to be able to interface with any other third party software. Most importantly, the CMMS should facilitate efficient technician workflow processes since the technician is typically between 65-80% of the HTM department budget. Technician efficiency is critical to long term success and cost containment or reduction.
Moser: The primary focus of any CMMS should be the ability to maximize technician efficiency by streamlining the PM process and allowing required data to be accessed in an expedient manner. The HTM community is facing the same staffing issues other industries are and time management is more vital than ever. The same holds true from an administrative standpoint, as management also needs the ability to quickly review technician productivity, PM and repair completion, and reporting metrics to maintain the efficiency in the organization they oversee.
Can you tell readers a little about what your CMMS offers?
Agarwal: EQ2 is one of the few CMMS vendors where both the company and the product are committed solely to the health care market and as such our core competencies of health care expertise, product quality and customer service are strong. HEMS is built on its own platform so we can modify and meet the needs for health care clients as the needs arise, and our system is not dependent on the hospital’s use of any enterprise platform. Yet, we integrate or interface with numerous third-party applications, improving workflows and making information accessible in multiple systems. We just released “HEMS Web,” providing an enhanced user experience that significantly reduces the IT resource time needed at implementation time.
Hill: Medigate does not sell a CMMS, rather we integrate with the leading vendors in this space to provide up-to-date device info to the CMMS.
Horn: Nuvolo Connected Workplace for Healthcare solution is unique in the market, because it’s a combination of software products – all built on the ServiceNow platform – that enable hospital departments to collaborate versus work in silos. Nuvolo’s HTM Asset Management is one such product. Nuvolo’s HTM Asset Management is a modern CMMS that meets the needs of today’s HTM departments with tools to efficiently manage your equipment, technicians, vendors, costs and compliance. Other products included in the Connected Workplace for Healthcare solution support OT Security, Capital Equipment Planning, Facilities Maintenance, Projects, Real Estate, Space Management, Warehouse Management, Calibration, Field Service Dispatch, and Sustainability.
Kruse: eMaint is a leading CMMS software that has been serving health care customers for years. It is a highly configurable system that allows customers to modify screens to work the way they want to work. eMaint excels at maintaining compliance for customers and provides robust tools for reporting and dashboards. eMaint also comes with an API for the enterprise edition that enables integration with other HTM-related software, making the maintenance function even more efficient.
Mannisto: AIMS 3 is the fifth AIMS rebuild and assemblage of over 35 years of CMMS user needs blended with today’s software and hardware technology. The primary focus of AIMS 3 is user ease and efficiency, especially for technicians who represent 65-80% of labor costs. The software is constantly evolving and optimizes HTM department user’s workflows and changing needs. Phoenix serves approximately 3,000 hospitals in 22 countries with between 50,000-60,000 who use AIMS every day.
Moser: TruAsset was built for the HTM community. We offer a fully customizable service request system, contract management, parts inventory management, AEM functionality and many of the “little things” that save time when it matters most. We excel at providing all the features of an Enterprise CMMS and the user-friendly interface of a simpler program. We offer this with continual support to our clients and accessibility to our team for a rapid response to any questions and an opportunity to learn about new features.
How do you work with customers and potential customers to upgrade a CMMS to meet the ever-evolving needs of healthcare?
Agarwal: We assess new needs that have evolved since their last upgrade. Clients have new goals they are trying to achieve, along with plans for how to achieve them. This can be everything from improved contract management and equipment downtime reporting to a 24/7 call center with automatic assignment and escalation. Often, they are looking to unify different lines of service so that HTM or Facilities data is connected throughout the enterprise, leading to better planning for workflows, procurement, risk mitigation and compliance.
Horn: One of the reasons why Nuvolo has been so successful is it is built on a highly configurable platform that allows us to continuously make enhancements and add capabilities and integrations to meet the ever-evolving needs of health care and HTM departments. We are now providing customers with two major releases per year with enhancements, ensuring our product doesn’t become obsolete and need to be sunsetted. When there are new releases, Nuvolo works with our customers to help them understand what new capabilities are in the release and determine when they will want to upgrade it. These new software upgrades are included as part of a customer’s software subscription, and therefore there is no extra cost to benefit from the new capabilities. The process for upgrading is relatively simple and can be performed over a weekend with almost no downtime.
Kruse: eMaint has a world-class customer support and services organization ready to help customers or prospects modify eMaint to meet their specific needs. eMaint can handle the modifications for customers, or customers can opt for training to modify their own systems. The health care industry is constantly changing, making the flexibility and configurability of eMaint valuable. It can meet customers’ needs today and into the future.
Mannisto: Phoenix views the AIMS 3 user and the Phoenix Implementation Team as partners to achieve optimum HTM department efficiency from both the software and the workflows of existing technicians. Phoenix hosts a yearly AIMS User Group where users suggest to the AIMS product manager what is needed to keep them current with industry compliance as well as what can make their jobs easier and more efficient. Phoenix commonly adds user requests to software in two upgrades per year. It is common for Phoenix to add hundreds of enhancements to the AIMS software every year.
Moser: We frequently communicate with our customers to understand what their needs are. Our program is continually being improved upon and we implement new features continuously with no charge to our customers. We monitor the data metrics that regulatory agencies like The Joint Commission, DNV and numerous others are requesting and ensure that we can simplify that data reporting to ensure smooth surveys.
What are Periodic Automatic Replenishment (PAR) levels and how do they help HTM professionals?
Agarwal: PAR levels are established so that parts and devices do not fall below minimum levels and do not exceed maximum levels. CMMS reporting helps alert the HTM professional when they are getting close to either level so that they can respond accordingly. Having enough parts and devices on hand lowers the risk of running too low when there is a surge of need on either. At the same time, carrying too much inventory can be costly.
Hill: PAR levels are a bit like the difference between intention and impact. We might intend to have a certain number of devices, or a PAR level, in a specific unit, but the impact (or felt experience by our front-line care teams) may be that they do not have enough. PAR levels need to be dynamically updated, based on current needs, to truly be effective. When done right, PAR levelling serves to instill confidence in front-line staff that they will have the devices and tools they need to get the job done.
Horn: Some CMMS vendors – including Nuvolo – enables HTM departments to manage the quantities of items moving into their stock rooms when received and out of the stock room when used. In addition, you can determine what you want the minimum quantity of certain parts, supplies and equipment to have on-hand in your stock room – known as PAR levels – and then set auto replenishment alerts to reorder when quantities fall below PAR levels. Having stock room management with PAR-level capabilities in your CMMS can help ensure you have critical parts, supplies and equipment available when you need it and reduce down-time.
Kruse: Par Levels are the optimal level for inventory on hand values based on day to day operations. Par levels can change depending on the inventory usage and work being performed throughout the year. eMaint can track inventory usage and trend on parts usage. Par levels can be updated based on review of inventory usage.
Mannisto: Through the Phoenix Data subsidiary, Superior Analytics, Phoenix uses extensive KPIs to provide a view of how well a department is doing per KPI from Superior’s database. This often informs HTM professionals where they can save labor time and thus control if not reduce labor costs.
Moser: PAR levels set the minimum alert trigger and can be applied in several ways. It could be by alerting when certain commonly used parts need to be ordered due to low stock, or when integrated to an RTLS system to alert your team when too many pumps are stacking up and need attention. Setting these levels correctly and managing the information provided allows the HTM professionals to be proactive and not reactive.
What else should TechNation readers know about CMMS?
Agarwal: CMMS systems such as EQ2’s HEMS are evolving quickly to meet a rapidly changing landscape. Hospitals are requesting more and more integrations for cybersecurity, for financial and procurement systems, and for single sign-on. The CMMS is becoming “smarter,” meaning intuitive interfaces with the overall product becoming easier to use and dashboards and reports quickly providing actionable data at the fingertips, and with mobile apps that can work both online and offline so that work can be completed anywhere – even without a connection. The increased sophistication of some of these needs could make it seem like CMMS systems are costly. But that is not always the case as EQ2 recently put together a package called “HEMS Essentials” which provides the most basic modules at an affordable price based on bed size.
Hill: As the future comes at us quickly, an accurate and detailed inventory in the CMMS can support improved decision making around device life cycle management. While the CMMS is difficult to keep up to date today, there are some positive strides around integrating with health care IoT security tools that consistently provide the CMMS with accurate and detailed data.
Horn: The CMMS is the primary tool for HTM departments to manage and prioritize all the work they are responsible for – whether that work is maintaining equipment, managing vendors, mitigating cyber threats, ensuring regulatory compliance, prioritizing equipment replacement, performing rounds, ordering parts and the list goes on. If you are finding that you need to supplement the capabilities of your CMMS with spreadsheets, it’s time to look for a new CMMS. Similarly, HTM departments work with the facilities, IT, EVS, construction, real estate and other support departments almost daily, so you want your CMMS to help you better coordinate with the teams you work with in order to work smarter, not harder.
Kruse: CMMS is a highly competitive sector with many products to choose from. That competitiveness benefits customers. With a CMMS, maintenance and repair operations can become a profit center in companies through extending the life of assets, eliminating catastrophic production failures, and gaining efficiency through technology. The adoption of IIoT and emerging technologies such as AI increases the value of a CMMS as a critical component within a connected reliability program. A CMMS can give companies greater insights than ever before into the health of their organizations.
Mannisto: Often, decision makers will listen to a polished and effective sales pitch without asking the pertinent questions about delivery and implementation. This can cause meaningful disappointment by purchasers of some CMMS systems. More specifically, as said above, technician’s labor is between 65-80% of the HTM department budget. You will want to partner with a vendor who is committed to a quality product and implementation that facilitates labor efficiency and potential cost reduction. AIMS was specifically created by healthcare engineers for healthcare clients and has been a CMMS system explicitly dedicated to the healthcare industry for over 35 years.
Moser: The CMMS at its base function can maintain asset and PM history, but beyond that there is a tremendous amount of value that can be added to this through service request systems, time management, and reporting. We strive to help customers build processes that can make management of clinical engineering easier. Additionally, contract management, parts inventory tracking and automated functions within a system can save time on each PM that adds up through the course of a year.