In the 1940 Walt Disney movie “Pinocchio,” character Jiminy Cricket (voice actor Cliff Edwards) sang the movie’s signature song; “When You Wish Upon a Star.” The song later became the official anthem of The Walt Disney Company.
In the movie, the wooden puppet Pinocchio wishes to be a real boy. The song has been recognized as one of the greatest songs in film history. The concept of wishing or hoping is as old as humankind, but it endures in the evolution of new discoveries, medical breakthroughs and New Year’s resolutions.
For this story, when asked about wishes for the coming year, those HTM professionals who responded, had very few wishes for a thing or possession and more wishes for the profession or their ability to provide exceptional service.
Most wishes for the new year did not involve a multitool or addition to a tool belt, but instead a wish for change or action, technology and even legislation.
This is in contrast to some previous wish lists that included tools or calibration devices as common wishes for the coming year. A previous wish list story, which received input influenced by the experience of the pandemic, included wishes of those in the HTM community for a healthier world and a better new year.
The earlier wish list story pointed out that there was a much-needed hope for “optimism” in the coming years. Many of those “wishes” were really the wishes of all people who were focused on herd immunity, an improving economy and a reduction in consumer prices.
In the earlier gathering of “wishes,” there were themes that covered “the need for change in the field, standardizations and unshackling biomeds from restrictions.”
Yet every year brings something new with expectations of things known and surprises that were not anticipated.
This coming year, 2024, will see a total solar eclipse in April, many new model cars and trucks will be released with more EVs, political party conventions will take place in July and August with an election in November, the summer Olympics in Paris in July, and of course, the Apple iPhone in September.
It will be a year that will satisfy some wish lists, although inflation-adjusted amounts in the tax code will increase in the U.S., and taxes increase for 2026, so not all wishes can be granted.
Intangibles
The wishes of HTM technicians and management align in many ways with the greatest number of wishes fitting into the intangibles category. It appears that most HTM professionals share a mutual focus on a wish for those things that can improve the profession, working conditions, staffing and legislation.
A common request that bridged a December 2021 wish list story and this one are wishes for more right to repair laws that favor the technician and the DIYer.
Not every wish has to be discerned by the five senses. Some are elusive and some only quantifiable.
“My wish is for more time! I know it’s impossible, but maybe be able to manage my time better. I know it’s something that is accomplishable,” says David Scott, CBET, senior biomedical equipment technician at University of Colorado Hospital in Aurora, Colorado.
Scott, who is well-known in the HTM community for his work with CBET preparation, also has some more elusive, but achievable wishes on his list.
“I wish for the right to repair to be resolved. I wish for more virtual ways to network/interact with other BMETs. This includes training, and maybe biomed association meetings, conferences or other opportunities that I haven’t thought of. Virtual ways to make training and events more affordable or easier,” he adds.
While 2024 brings many intangibles for HTM professionals to aim for, a trip to MD Expo in Las Vegas in April should certainly be one of them. Add that one to your wish list if you haven’t already. Find out more at MDExpoShow.com.
The Director and Leadership List
HTM leadership shares some wishes with supervisors and technicians, as well as having some wishes that relate more directly to their responsibilities.
“I would say a large topic has to be full-time employee (FTE) availability and also the ability to hire FTEs with the current state of health care economics. I don’t have much in this fight because I’m more on the IT side, but I know every health system keeps opening more surgical centers and medical office buildings,” says David Soffer, manager of the Medical Device I.S. Specialist Team at WellSpan Health.
He says that biomed/HTM FTEs are never part of that expansion discussion.
“Equipment count increases and site numbers grow; but FTEs remain the same,” Soffer says.
Along with staffing, there are wishes for training opportunities and funding.
“Training budgets: we need to stop relying on service contracts and show our worth to the C-suite,” says Matthew Kenney, CHTM, director of HTM and EVS at Aiken Regional Medical Centers in Aiken, South Carolina.
Kenney says that his other wishes would be better pay to gain new techs to the field and to retain the ones they train, along with IT cross-training.
“More equipment is becoming networked. Easier access to conferences. All techs should have that opportunity,” he says.
Some wishes go to legislative and executive branch decisions as they impact the nation’s health care system.
“I wish the Biden administration repeals the 3.3 percent cut to Medicare for 2024. Hospitals are at a razor-thin margin (if it’s even positive) and this affects biomed departments in staffing, training and the acquisition of new (replacement) equipment,” says Samantha Jacques, Ph.D., FACHE, AAMIF, vice president of McLaren Clinical Engineering Services (MCES) at McLaren Health Care in Michigan.
Another of Jacques’ wishes relates to legislation, but more specifically, that other legislation should have broader application.
“On December 29, 2022, the Consolidated Appropriations Act, 2023 (Omnibus) was signed into law. Section 3305 of the Omnibus – “Ensuring Cybersecurity of Medical Devices” – amended the Federal Food, Drug, and Cosmetic Act (FD&C Act) by adding section 524B, Ensuring Cybersecurity of Devices (Section 3305). Manufacturers are required by the FDA, for newly submitted devices, to have a robust cybersecurity plan. I wish manufacturers applied those plans to existing supported and end of support devices so that hospitals had patches, plans and alternate remediations to limit cyber risk to the hospitals,” she says.
Reflecting on Jacques’ wishes for legislation, another recurring them for wishes is right to repair.
“There are several items I know that HTM managers would love to have going into 2024, but I believe a right to repair legislation is right at the top for me (and for most),” says Tony Cody, CHTM, Tech Management/ENTECH Director at Banner Health in Colorado.
He says that he would like to see the following:
“A CMMS that delivers on what is advertised seamlessly, a mature system that links PM procedures with test equipment (one with a significant number of prebuilt procedures that is updated to OEM standards), a pipeline of qualified BMETs, a return of the quality certification by AAMI and an adoption of unified codes, failures, etcetera by the HTM community that makes benchmarking feasible,” Cody says.
“Technicians with on-the-job experience coming into the role, HTM tech school and certification, involvement when equipment is being ordered/delivered and service reports from manufacturer/third-party within three working days,” are wishes suggested by Stephanie Drake, clinical engineering manager with Intermountain Health.
Staffing challenges are a common concern and wish by leadership as we enter a new year.
“I would wish for an increase in the amount of viable candidates in my local area. It has always been hard to find candidates where my hospital is located, but after COVID, it seemed to be even more difficult and took a long time to fill our vacant positions,” says Ryan Harris, CBET, director of healthcare technology management at Texoma Medical Center in Denison, Texas.
With the focus on budgetary concerns that come along with leadership responsibilities, it is no surprise that these concerns make the wish list.
“[I] wish to see a reduction in the number of device alerts/recalls that the OEMs are currently generating. The time and overhead that these cost the typical in-house CE department for follow-up is cumbersome,” says Paul Gudenau, CBET, CHTM, regional manager of the southern region, clinical engineering services at McLaren Healthcare Inc.
Gudenau also says that he wishes there were more capital dollars available to replace legacy/end of support capital assets.
“It is a huge challenge, these days, trying to keep end of support, mission critical systems functioning,” he adds.
Working capital also made the wish list of Martin Poulin, M.Eng., P.Eng., FCMBES, director of biomedical engineering for Island Health/Royal Jubilee Hospital Site in Victoria, British Columbia, Canada.
“I want an affordable CMMS that is efficient for my staff to enter data both from laptop and mobile phone. I want to be able to get reports out of the CMMS that I have confidence in the data to help guide the efficient management of healthcare technology,” he says.
“I’d also like our health system in Canada to adequately provide capital dollars to replace healthcare technology in a timely fashion. Emergency capital replacement is how we plan for capital replacement these days,” Poulin adds.
The Technician List
Technicians, leads and supervisors, reflected some of the wishes of directors and senior leadership along with wishes that are more specific to their duties and routines. There were mentions of intangibles that dominate these lists.
“For every HTM professional to know how special and valued they are for all of the hard work and long hours they put in each and every day. We may not get enough thank yous or kudos from the medical staff we help, but we have to always remember to lift each other up and to be each other’s cheerleaders,” says Allison Woolford, CBET, biomedical equipment specialist/clinical engineering–periop team lead at Duke University Health System.
Woolford also wishes for increased exposure to the HTM world to help get more people interested and aware of the field.
“I always wish for more techs to become certified and elevate their career. Look at their ‘job’ as a ‘career’ and themselves as a medical professional. I wish for more new techs coming into the career field to replace all of us ‘old guys,’ ” Scott says.
Eric Baltazar, CHTM, CBET, supervisor of clinical engineering at the Cleveland Clinic Martin Health in Stuart, Florida, says that his wish list could change from time-to-time depending on his surrounding demands, although some items that remain constant include the following.
“Standardize clinical engineering and IT department relations to better service and support networked medical equipment,” Baltazar says.
He also wishes for some level of automation and expectations for vendors to get back field service reports to CE departments for documenting PMs and corrective work.
“An industry perk program that caters to HTM professionals only (i.e. auto insurance discounts, cell provider discount, uniforms discounts) and offer college grants for individuals pursuing careers under the HTM umbrella,” Baltazar adds.
Woolford has other wishes that fall into the intangible group.
“The ability to go to vendor training, standardization of job titles, descriptions and requirements across the HTM field. Salaries that match the cost of living and to be able to call the vendor for help and not need a purchase order,” she says.
“HTM and IT finally working together in harmony. Hospital staff finally realizing what clinical engineering does and doesn’t work on. It is hard to go back to sleep after a 1 a.m. page because the room is too cold,” Woolford adds.
She also has a couple of tangible items on her wish list.
“Test equipment that syncs together and puts the results directly into the CMMS database. CMMS mobile interface that is actually user friendly,” Woolford adds.
The wishes of most in the HTM community are really unselfish and are hopes for things that will benefit all biomeds and the profession. The change from the wish list at the end of 2021 reflects a post-pandemic refocus on what is necessary to move into the future for all biomeds.