By Jim Fedele, CBET
It is amazing that in a relatively short time, we have become dependent on the connection of medical equipment to networks. I can easily remember a time that patient monitoring was either a stand-alone device or a simple system with a central station that combined a group of monitors together. Nurses printed reports and manually documented the vitals in the patient chart. Now equipment can be connected directly to the medical information system and be set up to automatically document in the record with just a click of the button. We recently transitioned to a new medical information system. In one very large project, we worked to connect as many devices as possible to the system. I would consider the energy and activity needed for preparation to be more involved than what we did for the Y2K transition. I learned a lot and think this is likely a scenario many other biomeds will be facing soon. So, I wanted to share a little of the experience.
The initial preparations for our project (to convert all six of our facilities) started over a year in advance. The IT team had a lot of work to do to identify and evaluate all our networks. They evaluated everything from the wireless infrastructure to the routers, switches and access points. For us, things did not get busy until we were about six weeks out. The integration team needed equipment inventories, to know which models we had and their age and condition. It was a mixed bag of equipment types and vintages over six facilities. However, the project team developed plans to replace and repurpose any equipment that couldn’t be connected to the new system.
Three weeks before go live things became extremely busy. Our existing integrated monitoring systems needed a lot of work. Also, there was also not a good way to test the connection to the new system. Since our monitoring systems were in use, we couldn’t just turn them off to make changes and see if it would work. This created quite the challenge for me and my team. We weren’t sure how the system was going to react when making changes. We also had to visit every piece of imaging equipment and change labels and settings on them, and then test. For imaging equipment, we were able to make changes to some equipment ahead of the go live day. I am glad we did because we found issues we had not thought about. Whenever I would try to help and make changes on equipment; it took hours to resolve as opposed to the minutes it should have taken. We had the full gamut of issues with our equipment from password access issues to equipment needing full operating system reloads after changes were made.
When we got two weeks out, my team and I started meeting twice a week. We were brainstorming any issues that may not have been thought of or worked out. One big issue was how patient information was pulled into our monitoring system. We found that the monitor vendor and the new medical record team had not been working together to get that solved. From a task perspective, the problem is small and just needs some setting changes to point to the new system. I could not find the project manager that had this task on their list. After many emails, phone calls and pleas for attention, I finally got to the right person. They set it up 24 hours before the go live.
As I am writing, we are now 48 hours past the go live and our systems are up and running. Issues have tapered off and there are just some minor problems that need attention. Here are a few things we did that I think were very helpful in preparation for our event.
My team and I talked about this at every weekly staff meeting. I tried to over communicate it.
We listed all our equipment that was connected to the network and gathered as much network information as possible.
We listed equipment and systems we knew were problematic and discussed them with the project managers.
I met with nursing managers monthly and then weekly to walk through their work flow with equipment to identify any processes that would be affected by the change.
We created a schedule to know what each tech was doing during go live and what time they would be doing it.
We made changes ahead of go live on any system we could.
We engaged our vendors at least two months before go live so they could schedule support.
Some issues that were challenging specifically for me were getting purchase orders for vendor support and storing the large amounts of equipment that was needed to support the change. For instance, we received 20 pallets of EKG machines in one shipment that certainly would not fit in our shop.
Currently, I feel confident stating this was a successful project. My team was awesome. They worked hard supporting everyone with a smile on their face and a helpful attitude. They all rose to the occasion and in my mind made it look easy. Our vendors were also very helpful and did everything we asked and more. I feel that it is worth stating that for me this was an incredibly stressful project. In my mind, I had visions of the entire monitoring system not working, X-ray equipment crashing and computers needing to be replaced. I mention this to just say that our minds always make things worse than they are and don’t account for the teamwork and support that occurs during projects like this. I hope this is helpful and please feel free to contact me if you have questions.
Jim Fedele, CBET, is the senior director of clinical engineering for UPMC. He magazines six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations. Send questions or comments to Editor@MDPublishing.com.
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