A progressive biomedical program is always searching for ways to save money and increase its value. I think now, more than ever, the in-house biomedical engineering department needs to grow its services. Hospital facilities continue to face financial challenges in today’s changing environments including decreases in Medicare payments and sharp increases in the cost of new medical technologies. CFOs are looking at every line item as they try to contain costs. This situation allows for the opportunity to explore alternative service solutions for equipment that may have been “off limits” to us. We need to be aware that our leaders are feeling the pressure so now is a prime time for the biomedical engineer to propose alternative service delivery or a third-party repair company in areas that have been OEM only.
We have traditionally used third-party service to repair our scopes in endoscopy with great success. We have saved 50 percent off the OEM cost and 99 percent of the time we can get all problems repaired. We have also recently expanded this to OR scopes and have managed to realize a 50 percent reduction in repair costs in that area. These programs are fairly easy to execute and many of the third-party repairers offer education and online tracking of repairs. When planning to propose this to the department, you need to be aware that the OEM salesperson will strongly discourage this to your department heads and it can get ugly. If you do run into some objections, I would suggest asking to take on a couple of scopes to illustrate that you can manage them and the repairs will be good quality.
Another area we have uncovered that lacks biomedical engineering’s involvement, is operating room (OR) instrument repair and sharpening. I polled several of my colleagues and none of them were involved with OR instrument repair. This prompted me to investigate how OR instruments are repaired and who coordinates the service. What I found is that many ORs have their own person assigned to the task. Their job is to coordinate and follow up on all instrument repairs. I also found that a majority of them use the OEM to repair instruments. So this person must coordinate all repairs and work with many different manufacturers for repairs. This proves to be a daunting task and it is the most expensive option.
A suggested option is for the biomedical department to work with the person in the OR to help facilitate some form of third-party repair service. Since the biomedical department has more experience dealing with these vendors, they can help ensure a quality program is established. Most third-party OR instrument repair companies charge at least 50 percent less than the OEM. A second option is to see what you can do yourself. Due to our health system’s new affiliation, I now have access to individuals who know this business. They helped us build our own sharpening and repair shop specifically for OR instruments. Our cost to setup and outfit the shop was around $50,000, plus we added a technician. Even with these expenses we are on track to save over $100,000 this year. When you factor in the improvement in customer service and increased life cycle of our instruments, this was a worthwhile endeavor for us.
In closing, even if you cannot convince anyone to try a different repair strategy, at least you are trying and learning what options are available. Separating someone from their belief that the OEM is the only company that can repair something takes patience and timing. However, if you can score a small win it is worth it. Consider this, if you save $30,000 and your hospital has a 3 percent operating margin, it takes $1,000,000 in gross revenue to equal that $30,000. When you think of it this way, I think we can all agree that every little bit helps.
Jim Fedele, CBET, is the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments via email at firstname.lastname@example.org.
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