Healthcare Technology Management Week (HTM Week)

May 22 @ 8:00 am – May 28 @ 5:00 pm

The annual Healthcare Technology Management Week celebration from AAMI, held May 22-28, is designed to promote the awareness of—and appreciation for—the critical work of biomedical equipment technicians (BMETs), clinical engineers, and others in the healthcare technology management (HTM) field.

AAMI’s Technology Management Council (TMC) has developed several resources and ideas for 2016 to help HTM professionals mark this appreciation week in their community or at their workplace, including:

Contest—Every year AAMI hosts a contest for the best celebration of HTM Week. The 2015 winners can be viewed on the AAMI website.

Free Posters—New poster designs for 2016 are available on the AAMI website.

Creative Ideas—A few ideas for celebrating HTM Week in the workplace.

Resources—These tools will help biomeds kick off their celebration.

Source: 24×7 Magazine

Managed facility contracts in the NHS – Trends and benefits

Given the current financial climate, many NHS Trust are looking at their facilities, assets and services with increasing concern at how they will keep their service quality with current levels of funding available. All NHS Trusts are focussed on delivering improved healthcare services whilst also looking at ways of reducing costs and improving productivity. Senior executive are seeking new ways to update facilities, assets, and services to enhance their patient services whilst minimising their costs; maximising the value delivered through their facilities, assets and services.

The worldwide facilities management outsourcing market will be $1.314 trillion in 2018. (Glenn Hodge, 2014)  Managed services (including the provision of capital equipment) form part of this growth and is estimated to grow from $107.17 billion in 2014 to $193.34 billion by 2019, at a Compound Annual Growth Rate of 12.5%. North America is expected to be the largest managed services market in terms of revenues generated, but Asia-Pacific is expected to emerge as a high-growth market. (MarketsandMarkets, 2016)

Growth is evident across all outsourcing markets, from North America and Europe to Latin America and Asia Pacific. The market is not just expanding, however; it is evolving, with growing public- and private-sector demand for managed facility solutions that are both global and integrated.  Along with this evolving market, customer expectations are broadening to include more value-added services; customers increasingly expect service providers to assume responsibility (i.e., accept risk transfer) for regulatory and labour law compliance, for example, and to take an active role in advancing the healthcare organisations strategic mission (Alexander Redlein, 2014). To this end, current service providers have to evolve from being service providers to becoming strategic partners.

Moving from traditional in-house to contracted-out facilities

Hospital executives and politicians have to respond to increased social, economic and regulatory pressures. Their decisions whether or not to outsource can have a significant impact on the productivity and organisational costs. Having modern facilities with modern equipment and Information Technology can allow greater throughput of patients, thereby impacting on revenues and costs. Within these modern facilities, NHS staff can access cutting edge healthcare technology, such as up-to-date Magnetic Resonance Imagers (MRI), with high speed connectivity enabling improvements in organisational efficiencies.

FM 1

NHS Trusts are working with companies that can partner with them to enhance the effect that technology has within their facilities, providing assets (MRI) and services (Maintenance and training) as part of the facility has a positive impact on staff morale, patient care, and budgetary control. An outsourced managed facility, such as an MRI facility can bring benefits to their core business of the Trust by increasing diagnostic capabilities. These managed facility type partnerships work best through development of strategic relationships with companies that are facility and asset management experts.


NHS Trusts are also looking to save money through simplification of procurement processes and have a target to deliver £1.5Billion on non-pay spend by the end of 2016 (NHS England, 2013). This simplification can be accelerated by working with facility management partners that have experience and scale to deliver a broad range of healthcare management services, including multi-year refreshment planning and replacement of assets within the facility. Another benefit under current Treasury rule is the ability to reclaim VAT on a managed facility contracted out service.

 FM 2

 Contracting out rule 45 for VAT recovery:

Operation of hospitals, health care establishments and health care facilities and the provision of any related services:
This heading is concerned with the provision of a fully operational managed hospital; or healthcare facility, where all services relevant to that facility ‘short of medical and nursing services’ are supplied to the NHS by the managed facility provider. It includes the ancillary provision of equipment together with the service of operating and maintaining that equipment, and it includes utilities when provided as a part of the whole package and paid for within the single unitary charge.

When assessing the level of services provided within the facility, it is important to consider the actual use of that facility and that the services provided are consistent with that usage. (Establish if there are sufficient services to facilitate the operation of a hospital, healthcare establishment or healthcare facility).

VAT is recoverable if a full package of services necessary for the operation of that hospital; healthcare facility, etc. – for example estate management, reception, porterage, cleaning, laundry, catering, security, equipment maintenance, technicians. i.e. As outlined earlier, arrangements for MRI scanners and similar medical equipment, within a facility that is supplied with staff presence of labour and expertise, remains eligible for VAT to be recovered under heading 45.

The contracted out services normally require longer-term contracts, Trusts should be looking for provider partners that are strategic thinkers and can deliver increased value through their facility assets and services. Ultimately they are looking for vested partners that are experts to guide them in getting the best out of their facilities, assets and services.

The NHS is already under tremendous pressure to save money. Contracted out services could be a way of replenishing assets at a lower cost with higher rates of efficiency and productivity.

Dr John Sandham CEng FIHEEM MIET


Cover Story: ECRI’s List of Tech Hazards

Posted By: K. Richard Douglas on: April 10, 2016 In: Cover Story, Feature Slider, Magazine

By K. Richard Douglas

A January 2015 article in USA Today detailed several incidents of fatal illnesses in Seattle, Pittsburgh, and Chicago related to a superbug bacteria known as Carbapenem-resistant Enterobacteriaceae (CRE). The bacteria is of real concern to medical professionals because it resists even “last defense” antibiotics, according to the story. In each case, the investigation of the source of the deadly bacteria turned out to be a specific type of Endoscope used on a half million patients annually.

Conventional cleaning of these endoscopes proved to be insufficient to remove all bacteria. This problem leads ECRI Institute’s list of the “Top 10 Health Technology Hazards for 2016.” ECRI points out that flexible endoscopes, and duodenoscopes in particular, are constructed in such a way that makes thorough cleaning difficult. The proper reprocessing of these scopes is critical to the well-being of patients. Biologic debris must be removed prior to sterilization or disinfection. The need for this pre-cleaning step is just one area of concern identified by ECRI Institute in this year’s list.

ECRI Institute’s Health Devices Groups says that the list “identifies the potential sources of danger that we believe warrant the greatest attention for the coming year.” ECRI points out that the list does not necessarily reflect the most frequently reported problems, or those with the most severe consequences, but instead those issues demanding the most immediate attention.

Besides the concerns about flexible endoscopes, the list also includes:

  • Missed Alarms Can Have Fatal Consequences
  • Failure to Effectively Monitor Postoperative Patients for Opioid-Induced Respiratory Depression Can Lead to Brain Injury or Death
  • Inadequate Surveillance of Monitored Patients in a Telemetry Setting, May Put Patients at Risk
  • Insufficient Training of Clinicians on Operating Room Technologies Puts Patients at Increased Risk of Harm
  • Errors Arise When HIT Configurations and Facility Workflow Do Not Support Each Other
  • Unsafe Injection Practices Expose Patients to Infectious Agents
  • Gamma Camera Mechanical Failures Can Lead to Serious Injury or Death
  • Failure to Appropriately Operate Intensive Care Ventilators Can Result in Preventable Ventilator-Induced Lung Injuries
  • Misuse of USB Ports Can Cause Medical Devices to Malfunction

“Some of the most obvious resources for addressing these concerns are the hospital IT and biomed/clinical engineering departments. If the concerns and steps listed previously are going to be addressed and utilized, these two departments are going to need a good working relationship.”

The ECRI Institute considers several criteria when forming its list. Those criteria include severity, frequency, breadth, insidiousness, profile (is it publicly known) and preventability. Nominations for the list come from ECRI Institute’s own engineers, scientists, clinicians and other patient safety analysts.

These experts base part of their nominations from investigating incidents, testing medical devices, speaking with other health care professionals, observing operations, assessing hospital practices and reviewing the literature, according to ECRI.

There should be a preventable element to any item that makes it on the list. ECRI also says that the absence of a topic from a previous year should not be perceived as any indication that it is a hazard that no longer deserves attention.

Continue reading …

Evidence-Based Maintenance Is CE’s Moonshot

Published on April 8, 2016

Binseng Wang

A little over 50 years ago, reacting to the Soviet lead in the space race, President Kennedy decided to rally the nation with the moonshot. He justified his decision to the American public by stating, “We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win, and the others, too.”1

While landing a man on the moon in itself did not yield many tangible benefits aside from a psychological win for the American public, the moonshot brought an unprecedented advance in science and technology, as well as economic growth. Almost everything that we consider indispensable today can be traced back to the moonshot—such as solid-state electronics, satellite communications, and GPS, as well as most medical monitoring, telemedicine, and imaging technologies.

Today, the clinical engineering (CE) community faces a similar challenge. After decades of effort in dispelling the initial false alarm of electric shocks and developing rational methods to improve equipment maintenance at lower costs, CE professionals were able to attain a much lower maintenance-related failure rate than the Six Sigma quality level sought by world-class manufacturing companies.2 Yet, in 2011 the Centers for Medicare & Medicaid Services (CMS) released a new set of maintenance requirements with little, if any, rationale, demanding blind adherence to manufacturers’ recommendations.3

As a token of recognition to the CE community’s achievements and after intense lobbying, CMS agreed in 2013 to allow us to adopt an alternate equipment management (AEM) program for certain equipment (except lasers, imaging, and “new” equipment) if the hospital can provide evidence that it is “safe and effective.”4 Ironically, such a requirement does not exist for equipment manufacturers. While the Food and Drug Administration (FDA) does require manufacturers to prove their products are safe and effective before marketing, it does not require their maintenance recommendations be proven “safe and effective.” FDA only requires that “[w]here servicing is a specified requirement, each manufacturer shall establish and maintain instructions and procedures for performing and verifying that the servicing meets the specified requirements.”5

Since the publication of the CMS mandates and subsequent revision of the standards by its accreditation organizations, including The Joint Commission (TJC), many organizations adapted their “risk-based criteria” to fit the new requirements and redefining risk to conform to the terms “critical” (or “high-risk,” per TJC). In doing so, some CE departments even continued to exclude “low-risk” equipment from their maintenance inventory, in spite of the explicit requirement from CMS to include all equipment.4 Few have thought about how to collect evidence to prove that their AEM programs are safe and effective. Two data-based methodologies have been developed that can prove alternative maintenance strategies are as safe and effective as those recommended by manufacturers. They are reviewed below.


  • Reliability-Centered Maintenance

  • Introducing EBM

Continue reading. . .

Source: 24×7 Magazine

Healthcare Technology Management Week

2015 HTM Week Winners
The Healthcare Technology Management Team at the Ann & Robert H. Lurie Children’s Hospital of Chicago are the 2015 HTM Week winners.

This annual celebration is designed to promote the awareness of—and appreciation for—the critical work of biomedical equipment technicians (BMETs), clinical engineers, and other members of the healthcare technology management (HTM) field.

So how can you celebrate? As you make plans for 2016, check out these ideas developed by AAMI’s Technology Management Council (TMC) to help you mark this appreciation week in your community or at your workplace.

  • Contest—Every year we host a contest for the best celebration of HTM Week.  Meet the 2015 winners on the right.
  • Free Posters Offered —Choose your favorite! Here are the posters offered in 2015.
  • Creative Ideas —A few ideas for celebrating HTM Week where you work.
  • Resources—These tools will help you get the festivities started.


Sponsored by the Technology Management Council