TechNation asked several companies to share their insights regarding patient monitors for this roundtable article. Those participating in the forum are PM Biomedical Inc. Quality Assurance Manager Alex Chreidah, Tenacore Senior Director Capital Equipment Sales Brad Hejazi, MedEquip Biomedical and MIT Labs President Michael Lipson, Avante Health Solutions Monitor Tech III Ricky Ly, Elite Biomedical Solutions CBET/Biomedical Engineer Tech III Alero Olomajeye, Integrity Biomedical Owner Michele Shahbandeh and USOC Medical Services Director Kevin Wyatt.
Q: What capabilities should biomeds insist upon when purchasing patient monitors?
Chreidah: When purchasing patient monitoring equipment, biomeds should insist on capabilities such as pulse oximetry, ECG, and NIBP, as they tend to be commonly seen within our repair facility. Patient monitoring capabilities are critical for ensuring accurate and comprehensive readings, enabling health care professionals to detect and respond quickly to any changes in a patient’s condition. Also, biomeds can specify on different types of capabilities to fit their hospital’s needs. If they require any guidance, PM Biomedical’s support team can ensure you are purchasing the right product.
hejazi: The capabilities of a patient monitor are completely tied to the needs of the clinician, department and facility. The most important part of this equation is to choose a supplier capable of delivering on those needs. When selecting a service provider, decision makers should ask if the vendor has the necessary industry experience. Does the vendor employ technicians specialized in specific patient monitors? Has the company invested in OEM training? Does the company follow an established procedure for specific devices? Does the vendor have the proper testing equipment to ensure devices are ready for patient use (Ex. OEM calibration gas, calibrated testing equipment, and necessary networking equipment to ensure units will be compatible with the facility’s current networking infrastructure). Does the service provider provide post-sale services (warranty, troubleshooting, installation and integration)? Does the service provider have an established quality management system that ensures patient outcomes?
Lipson: Biomeds should insist upon monitors with standard ECG, NIBP, SpO2 and invasive pressure and depending on use, other parameters might include, End-tidal CO2 and cardiac output and printing capabilities. Telemetry if needed. The patient monitor should be compatible with existing systems within their facility, including EMR/EHR and alarm management systems. Good battery life on certain monitors is also important.
Ly: The Philips IntelliVue X3 Patient Monitor is capable of measuring ECG, SpO2 (using Philips FAST-SpO2, Nellcor OxiMax SpO2, and Masimo Rainbow SET SpO2), respiration, non-invasive blood pressure (NBP), invasive pressures, and CO2. With the IntelliVue measurement extensions, the monitor can also measure up to four invasive pressures and take two temperature readings. In addition, the X3 has the ability to measure cardiac output (right-heart and PiCCO), microstream CO2 and LoFlo sidestream CO2. The X3 comes with a battery pack and handle, making it a compact and dual-purpose transportable patient monitor. It features intuitive smartphone-style operation and offers a scalable set of clinical measurements.
Olomajeye: When purchasing patient monitors, biomeds should insist on the following as basic capabilities: ECG, Respiration, SpO2, End Tidal CO2, NIBP and Temperature. More capabilities, such as cardiac output, IBP, ICP, can be added in more critical areas such as emergency department, ICU and OR. Furthermore, biomeds should seek input from the medical staff.
Shahbandeh: We typically see them requesting, wireless, ECG, NIBP, SpO2 options NELLCOR, MASIMO, or in our case Spacelabs, Varitrend, St. Segment, with recorders and be portable.
Wyatt: When selecting patient monitors, biomeds should ensure that the devices have the necessary capabilities to meet the medical facility’s requirements. Some critical capabilities to consider include the ability to measure blood pressure (NIBP), oxygen saturation levels (SpO2), body temperature, cardiac output, and non-invasive ventilation. These capabilities are essential for monitoring patients’ vital signs accurately and providing timely treatment.
Q: What are some new features they should seek out when purchasing patient monitors?
Chreidah: Biomeds should seek out patient monitors that come with new features, such as wireless connectivity, customizable settings and advanced analytics capabilities. By seeking out these new features, biomeds can provide their health care partners with the most up-to-date and innovative patient monitoring solutions. Additionally, features like touchscreens, high-resolution displays and intuitive user interfaces can improve ease of use and enhance the end-user experience for health care professionals.
hejazi: Each project is different and has its own specific details. When purchasing patient monitoring equipment, it is important to understand which hospital department the monitor is intended for (emergency department, intensive care unit, critical care unit, maternity and obstetrics, neonate intensive care unit, operating room, post anesthesia care unit, etc.). Tenacore provides support throughout the continuum of care. Our commercial team has been trained to ask all the necessary questions when assisting with various patient monitoring projects. Can the patient monitor be used for intra-hospital transport? Does the patient monitor have the necessary software package installed to be used for the intended hospital department? For example, if you are purchasing a patient monitor to install on an anesthesia machine you must make certain that the patient monitor has the proper software package installed to measure anesthetic agents. Another important feature to seek are the required accessories for the project. For example, will your project necessitate modules that measure physiological parameters, respiratory modules (end-tidal CO2, mainstream CO2, or sidestream CO2), or anesthetic gas modules that measure anesthetic agents during anesthesia cases?
Lipson: When buying new, cybersecurity has become top priority for OEMs offering new equipment. Interoperability and connectivity within hospital patient data management systems. Mobility of the units can be important in some cases.
Ly: The Philips IntelliVue X3 is an easy-to-use monitor that operates similarly to a smartphone, making it an ideal option for biomeds when choosing monitors to purchase. Its user-friendly interface allows users to simply swipe the display to browse through a wide selection of screens tailored to various clinical situations. Each screen can be customized to present the information that the user wants to see and in the format they prefer. The intuitive user interface of the X3 builds on Philips’ market leading IntelliVue patient monitors, which have been validated and continually improved over 15 years. Regardless of where the user is in a hospital, it’s crucial to be able to see the patient’s vital signs immediately. To view IntelliVue X3 measurements on a standard high-resolution large display, the user can connect the X3 to an IntelliVue XDS remote display. When purchasing X3 monitors, it’s important for biomeds to understand the device’s software. The Philips X3 monitor comes with Software L, M, and N only. The monitor options available include:
- A03, A04, A05 for waveform
- C01 for full arrhythmia
- C09 for parameter histograms
- C12 for conventional 12-lead ECG
- C13 for ST/STE-Map
- C15 for full networking
- C20 for external monitor customization
- C23 for timers
- C44 for alarm visualization
- C45 for smart alarm delay
- C51 for QT analysis
- C54 for HEXAD
- X00 for XDS connectivity
- X30 for XDS clinical workstation
- X40 for XDS database
- YDN for suppress INBP support
Olomajeye: New features to seek out when purchasing patient monitors are: easy and automatic connection to EMR, WLAN (including mobile devices) and LAN capabilities, long-term patient data storage (on the monitors and servers), portability, interface to download patient data from wearables, tablets and mobile phones, interface to nurse-call and nuisance alarm-reduction software as well as resilient chassis that is resistant to most harsh cleaning products used in hospitals. The IT department should be contacted to ensure that the network and cyber-security requirements are met.
Shahbandeh: Most are wireless and portable.
Wyatt: When purchasing patient monitors, biomeds should seek out new and exciting features that can enhance patient care and streamline workflows. Features like wireless connectivity, cloud-based data management, advanced analytics and EMR system integration can make it easier for clinicians to access patient data, monitor patients from a distance and make better informed decisions about patient care. Some of the latest patient monitors even leverage artificial intelligence and machine learning algorithms to predict and detect clinical events before they happen, which can improve health outcomes for patients.
Q: When it comes to end of life, what steps can be taken to help further extend usefulness of patient monitors?
Chreidah: When a patient monitor reaches its end-of-life, there are steps that can be taken to further extend its usefulness. One option is to refurbish the patient monitor by replacing any worn out or outdated components with new ones. This can help lengthen the life of the device and ensure that the unit operates with its OEM set parameters. Another option is to partner up with trusted third-party vendors, like PM Biomedical, for end-of-life replacement parts and repairs that may no longer be supported by the OEM.
hejazi: Prevention is always the best step to take. Making sure that your devices are calibrated and serviced on time will ensure lengthened life of the device. Tenacore specializes in providing certified and tested parts for end-of-life patient monitors. We provide various internal components such as mainboards, power supplies, battery boards, touch screens and external cosmetics such as front bezels, back housing, battery doors and handles. Partnering with a service provider that has full repair capability, access to quality-tested parts and certified replacement units will allow your facility to extend the use of your current fleet and avoid costly upgrades.
Lipson: Regular preventative maintenance, cleaning and calibration is important. This can help identify potential problems. Finding a good third-party company to support your facility for repair service and/or parts is also important. Third-party service companies can help greatly extend the life of the monitors.
Ly: As the Philips IntelliVue X3 monitor is still relatively new to the market, it’s too early to predict what the end-of-life process will be like. However, when the time comes for the monitor to reach its end of life, Avante can repair or refurbish any circuit boards to extend its usefulness.
Olomajeye: When it comes to end of life, no need to worry. Biomeds should start stockpiling as many as possible of the most frequently used parts, as soon as the end-of-life letter is received from the OEM. They can reach out to ISOs, especially Elite, who manufacture end-of-life parts; keeping patient monitors as good as desired.
Shahbandeh: Find a qualified ISO 9001-2015 repair facility to maintain your equipment. Obtaining this certificate or 13485 shows their QMS and risk factors for their own company.
Wyatt: When patient monitors reach the end of their useful life, there are several steps that can be taken to extend their usefulness and minimize waste. Biomeds can send their devices to a service facility like USOC Medical Services to refurbish and repair patient monitoring devices that are still in good condition or recycle components that can’t be repaired. Donating devices to organizations that provide medical care in underserved areas is another good option.
Q: With systems transitioning, how can biomeds ensure that monitors are compatible?
Chreidah: When existing patient monitoring systems are transitioning, biomeds can take the necessary steps to ensure that existing units maintain compatibility. Firstly, they should conduct some research to identify patient monitors that are compatible with the existing hospital system. This may involve consulting with manufacturers or reviewing technical documentation. Secondly, biomeds should perform comprehensive testing of the patient monitors to ensure they are compatible and can communicate effectively with the existing hospital system. This testing should include compatibility with existing interfaces and data transfer protocols. Finally, they should provide training to health care professionals on how to use the new patient monitors and integrate them with the existing system. By following these steps and with the help of PM Biomedical, biomeds can ensure a smooth transition and compatibility of patient monitors with the existing hospital system.
hejazi: It varies by manufacturer. It is critical to factor compatibility of all equipment when purchasing a fleet or adding on to an existing installation. Some manufacturers make it difficult to add new devices to an antiquated installation, forcing the hospital to upgrade the entire network and infrastructure. When upgrading patient monitors it is critical to check that all additional accessories and infrastructure such as central stations, physiological parameter modules and anesthetic gas modules will be compatible. Having knowledge of compatibility can prevent unnecessary expenses and retraining of staff.
Lipson: Biomeds should evaluate system requirements of any new tech platforms within the facility. Work with clinical and IT staff to understand their needs and to make sure there is compatibility with any new systems, test compatibility and identify workarounds if needed. Stay up to date with software and any trends and developments.
Ly: Biomeds should be aware that the Philips MP Series monitors are compatible with each other as long as they are using the same software version (for example, SW M to SW L will be compatible). The X2’s mainboard can load software from F to M, with the serial number held on the power board. The X3’s mainboard can load software from L, M, and N, with the serial number held on the mainboard.
Olomajeye: In order to ensure that monitors are compatible, biomeds should engage all departments such as IT, Nursing, EMR and other related staff as well as the OEM in the installation process. Testing is key. Different monitor type combinations and scenarios should be thoroughly tested in units before patients are moved in.
Shahbandeh: That is extremely hard to do today, with the software issues for compatible monitors. Older to newer.Â
Wyatt: When health care systems transition to new equipment and technology, biomeds play a vital role in ensuring that existing patient monitors are compatible with the new systems. To achieve this, they should conduct thorough research into the compatibility of the monitors with the new systems, utilizing equipment manuals and consulting with manufacturers. Testing and evaluation should be carried out to confirm compatibility. If compatibility issues arise, biomeds can upgrade or replace equipment or configure the new systems to work with existing monitors. When purchasing new equipment and transitioning systems, USOC can help ensure that existing patient monitors are compatible with new systems. We conduct thorough research, utilize equipment manuals and consult with manufacturers to confirm compatibility. Our experienced sales team and biomeds can quickly upgrade or replace equipment or configure new systems to work with existing equipment if any issues arise. We strive to provide health care facilities with the best possible equipment solutions and improve patient care.
Q: What else do you think TechNation readers need to know about purchasing and servicing patient monitoring devices?
Chreidah: When it comes to purchasing and servicing patient monitoring devices, TechNation readers should keep in mind a few key considerations. Firstly, they should prioritize patient safety by choosing devices that comply with regulatory standards and are tested for accuracy and reliability. Secondly, they should consider the total cost of ownership, including the initial purchase price, ongoing maintenance costs and potential repair costs. Choosing devices that are easy to maintain and repair can help to reduce long-term costs. Lastly, they should work with reputable vendors such as PM Biomedical who provide excellent customer service, quality and support. This can help to ensure timely and effective repairs and maintenance when needed. By considering these factors, TechNation readers can make informed decisions when purchasing and servicing patient monitoring devices to provide the best possible care for their patients.
hejazi: Ensuring patient outcomes should always be at the heart of every purchase and service performed. When choosing a vendor or service provider ask yourself the following questions: Who is servicing your devices? What are their core values? What steps have they taken to ensure patient safety? How long have they been in the industry? Do they take the necessary steps in hiring and training specialized technicians?Â
Lipson: Make sure that you are getting a solid warranty, quality service and support when purchasing patient monitors, whether it be through the OEM or third party. While maintaining your monitors, ease of reaching tech support, quality repair service, quick turnaround time and availability of replacement parts are all very important. When using a third-party make sure they have a quality system in place.
Ly: When purchasing Philips IntelliVue X3 monitors, biomeds should be aware of the type of SpO2 technology they want to measure. Philips IntelliVue patient monitors offer a range of SpO2 technology options, including Philips FAST SpO2, Masimo SET SpO2, Masimo rainbow SET SpO2, and Nellcor OxiMax SpO2. Your choice of SpO2 technology is integrated into your Philips patient monitoring system to provide SpO2 information where and how you need it.
Olomajeye: Patient monitors have come a long way! Due to innovation, basic vitals such as non-invasive blood pressure, pulse oximetry and ECG that used be observed within the confines of a hospital are now available anywhere with a flick of the wrist on a watch or on a tablet or mobile phone. This has allowed patients to be aware of their health in a more succinct way. Furthermore, such access has led to early diagnosis, treatment and the outright prevention of diseases. I am excited for the future of patient monitoring and how artificial intelligence and robotics will be incorporated into its innovation.
Shahbandeh: We have a core competency, there is not a company who can do it all. Look at the company’s expertise, quality, on time completion, warranty percentages and cost for the best solution in having your equipment repaired.
Wyatt: Purchasing and servicing patient monitoring devices can be complex and costly. However, with the help of expert biomedical technicians, these challenges can be overcome. At USOC Medical, we specialize in repairing and maintaining patient monitoring devices, ensuring optimal functionality and patient care. Our services are customized to fit the unique needs of each medical facility, and we offer fast turnaround times and affordable pricing. Choose USOC Medical for reliable repairs and exceptional customer service. Â
