This month’s Roundtable article is focused on infusion therapy and IV pumps. TechNation invited several professionals to share their insights and advice regarding these important health care devices. Those participating are Select Biomedical CEO Tom Fischer, RepairMED Technical Director Red Libao and USOC Medical Biomedical Technician Hana Navarro.
Q: What are the latest advances in IV pumps in the past year?
Fischer: From our perspective, the biggest advances have been in areas of integration and M2M connectivity. The Internet of Things is finally seeing great strides in the medical device industry – especially in the infusion pump world. Connectivity and security will again be hot topics for biomeds in 2019.
Libao: There are really no significant advances in IV pumps in the past year. Over the years, IV pumps have been equipped with drug libraries and wireless connectivity wherein new drugs introduced by the pharmacy can be uploaded into the device with ease. Pumps have been reduced in size and weight which is advantageous to the hospital in terms of maintenance and use.
Navarro: One of the more recent advancements that I have come across this year was the introduction of user-friendly/self-administration pumps. With the latest advancements in connectivity and patient customization, it’s no surprise that a trend for infusion pumps is at-home usage. The latest examples of infusion pumps in the category of self-administration are beginning to resemble devices much like that of a typical cellphone and usually include user friendly interfaces.
Q: What factors should HTM consider to determine cost of ownership?
Fischer: Total cost of ownership should, and in most cases does, include training, parts, software, connectivity, reporting, etc. However, we are also seeing a shift to include opportunity costs becoming part of HTM decision making. As resources continue to be stretched, low-revenue producing fleets/equipment are being scrutinized as to how best to incorporate a longer view of cost of ownership.
Libao: There are no associated repair costs during the manufacturer’s warranty. However, when the warranty expires, replacement parts should be available from the OEM. Biomed techs should be able to replace these parts in-house, upon completion of training.
Navarro: When determining cost of ownership, its important for HTM to consider many different factors and not just the price tag of the unit. It’s important to consider things like cost of operation, maintenance, software, hardware for the EHR, and training for more complicated options. Sometimes we see hospitals that enjoy using pumps that are not smart pumps because they find them easier to use and they don’t rely on software. This can drive the cost of that unit up because of demand for units that aren’t software driven. However, it can still be cost effective because of not having to worry about things like license costs plus base/server costs, client-side cost, training and hardware for EMR.
Q: What are the pros and cons of buying new versus buying refurbished units?
Fischer: In almost all cases where a facility is looking to change OEMs, we recommend going directly with the new OEM to make sure installation, security and training come from the OEM. The pros and cons are of buying to supplant existing equipment, depend greatly from where you are buying the equipment. In all cases of buying refurbished equipment, a facility needs to make sure the product has a longer warranty than OEM, the dealer understands machine-to-machine connectivity and the quality of the equipment meets or exceeds OEM specs (no non-OEM parts). If these rules are followed, buying refurb will be all pros!
Libao: Budget allocation is the deciding factor in buying brand new or refurbished units. With the current market, there are several third-party repair companies that can provide support on refurbished units. Not only less expensive, but these are also certified to meet or exceed the manufacturer’s specifications.
Navarro: It all depends on what the user is looking for. In the case of wanting units that are not smart pumps, you will always have to go with buying refurbished units because OEMs simply do not make these units anymore. However, if the client is looking for top-of-line, latest advancement technology it might be beneficial to buy through an OEM and brand new so that they can ensure they get the whole package (consumables, training, proper installation). Luckily, third-party vendors are also a viable option nowadays when facilities cannot afford to buy from an OEM.
Q: What cybersecurity measures should be taken when it comes to IV pumps?
Fischer: We have seen a large increase in our interaction with IT departments working with biomeds to insure connectivity and security. In most cases, we are acting as interpreters for IT to make sure pumps are secured correctly. Our biggest recommendation is deeper training for HTM professionals.
Libao: There are several measures to ensure cybersecurity on devices. These, however, are dependent on the features of the devices , which the OEM configures into the pump. Common cybersecurity measures are implemented by the IT department of the facility, which typically includes secure Wi-Fi network, cybersecurity policies communicated to the organization, firewall protection, etc.
Navarro: With the introduction of EMR and patient-customized profiles into infusion pump technology it is important to protect the data that is being used with these units. With patients’ lives at risk with dosing errors, it should be a priority to think about securing the data that is being used with smart pumps. This field will need to further advance security of this data when the trend moves to cloud-based data storage.
Q: Can you explain the importance of holding an in-service or clinician training on how to properly use the devices?
Fischer: From our perspective, training is a mandatory step in making sure the set up is complete on all pump purchases. We also provide training on best ways to clean pumps – incorrect handling/cleaning of pumps causes more damage to fleets than any other cause.
Libao: Training on the proper use of devices provides various benefits to the organization which includes extending the life of the device, reduced PM time and maintenance costs. It also prevents improper use, ensuring patient safety.
Navarro: Since infusion therapy has become more and more advanced technology-wise, there has been a rise in the need for clinician training on how to use these advanced machines. It is important for clinicians to be properly trained on these devices because patients’ lives are on the line, but also because it can get very costly to have units repaired due to user error. For this reason, some clinics choose to stick with older units that aren’t as complicated to use.
Q: What else do you think TechNation readers need to know about purchasing and servicing IV pumps?
Fischer: We understand there are a host of alternatives when it comes to pump sales, rentals and service. If we can offer any advice – while price will always be an important factor – we highly recommend also valuing experience in the field and connectivity, warranty/quality, customer service and, finally, how easy are they to do business with. Again, resources are tight. If you have to make a dozen calls to make something right it will cost you 3 to 4 times the original cost of the repair or the pump sale!
Libao: When purchasing IV pumps, the overall costs of ownership, including repair and maintenance, should be taken into account as well as the cost of disposables or accessories. When servicing these devices, users should strictly follow the manufacturer’s recommended preventive maintenance.
Navarro: When it comes to purchasing and servicing infusion pumps, its important to look at factors such as price, turnaround times, customer service and reliability. There are many options when it comes to finding third parties that sell and service infusion pumps. Therefore, it is important to research the company and find that they have good rapport in the field and are up to date on their certifications.
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