You’re familiar with the phrase, “same song, next verse.” That’s the case with medical device management: there are a number of issues that are constants year after year. They never go away. They never improve. They’re just “same song, next verse.”
I came across a 2013 study by the Association for the Advancement of Medical Instrumentation (AAMI) that listed the top ten medical device challenges for hospitals. Now, some of the issues, such as battery management (noted by 50% of survey respondents) and maintenance of infusion pump systems (48%) aren’t going to go away. They are just part of the clinical engineer’s life. But four issues that were named made me wonder, “Why are hospitals still struggling with that?” because there are solutions available that can put a stop to the endless refrain of “same song, next verse.”
The #1 Problem: Managing Devices and Systems on the IT Network
Nearly three quarters (72%) of respondents to the AAMI study five years ago named managing devices and systems on the IT network as a challenge. The same problem plagues hospitals today.
To help eliminate this challenge, you need to constantly ask the question, “Will connecting this device improve the health and well-being of patients?” This should be your primary driver. Otherwise, you will end up connecting every medical device: overwhelming the hospital’s infrastructure and inundating healthcare providers with less-than-meaningful data. Devices should only be connected if the real-time information they provide will contribute to more efficient, more cost-effective, better care for patients.
Sometimes, connectivity is requested for business or marketing purposes. For example, an MRI may send data back to the manufacturer to help them improve device design and functionality. But does that mean this data needs to be routed through the hospital network? No, it does not. A separate and discrete communication path can be established that enables the manufacturer to collect data without a direct connection to the hospital network. Again, the bottom line should always be, “Will connecting this device improve the health and well-being of patients?”
Too Much Noise: Improving Alarm Management
When a car alarm goes off, what crosses your mind? No one thinks, “Oh no, someone is trying to steal a car!” I’ve heard them so often I rarely pay attention anymore.
Alarm fatigue occurs in hospitals, too, which is why 49% of AAMI respondents cited alarm management as a problem in 2013. And now, in 2018? Same song, next verse.
But with today’s technology, we can cut down on the noise. Machine learning can be applied so that the hospital network literally learns what is “normal” – not in general across all people, but for each specific patient. For example, Bob might warrant an alarm if his blood pressure exceeds 140 over 90, whereas Gwen might not require an alarm until her blood pressure spikes to 170 over 110 because of their differing physical conditions. With fewer alarms going off, healthcare providers can deliver better, faster care to the patients who need it.
Healthcare’s Achilles’ Heel: Securing Medical Devices against Cyberthreats
Cybersecurity of medical devices and systems was named by almost half (47%) of AAMI respondents as a challenge. That number would likely be even higher today, given how hackers have been targeting healthcare organizations.
Medical devices are healthcare’s Achilles’ heel when it comes to cybersecurity, since most devices have little or no built-in security – and the security they may have is not robust enough to counter today’s sophisticated attacks. While more secure devices are coming from the manufacturers, legacy devices will be around for a long time.
Some hospitals react by shutting down network connectivity in favor of security, but this defeats the ability to use real-time device data to improve patient care. Other hospitals set up an elaborate system of firewalls and network access controls. But, while these work in static environments, they tend to be less than effective in the dynamic, mobile healthcare environment.
What is needed – and available today – is a medical device management system that incorporates microsegmentation and data encryption to address security issues by making your network invisible to hackers, including even older, less-secure medical devices.
Expect the Unexpected: Setting Preventive Maintenance Strategies
The fourth preventable challenge is setting preventive maintenance strategies, named a problem by 44% of AAMI respondents. Certainly, every device has a preventive maintenance schedule for recalibrating, refilling, etc. But that doesn’t stop devices from failing unexpectedly and potentially impacting patient care.
However, predictive failure analytics are now available to help hospitals expect the unexpected. These algorithms augment preventive maintenance strategies by alerting clinical engineers to devices that have not yet failed but are likely to do so imminently.
For example, suppose a hospital has 300 infusion pumps that are the same brand. Analytics can be used to monitor these devices to look for trends and patterns in fault codes that can then be converted into probabilities that a given device will fail in a certain timeframe. The device can then be serviced before failure occurs, eliminating patient impact.
Same Song – Last Verse
By leveraging today’s technology, I firmly believe we can eliminate these four challenges that have hung on for far too long already. We can work smarter, more efficiently, and more cost-effectively – and deliver better care to patients by doing so.
That doesn’t mean other challenges won’t appear to take their place. As a prime example, BYOMD – bring your own medical device – is approaching with the velocity of a speeding train. We’ll look at that in our next blog and (spoiler alert!) see what technology can do to fix the problem before it takes hold.