EBME
should be extended, where appropriate, to include general practitioners, residential and care homes, community-based services, independent hospitals providing services for NHS patients, managed care providers, Private Finance Initiative (PFI) organisations and other independent contractors. It is important to establish who is accountable, and where there is a need for joint accountability arrangements. Healthcare organisations should appoint Medical Device Safety Officers (MDSO). Part of the MDSO role is to report adverse incidents to the MHRA and other official agencies. The lines of accountability should include reference to the appointment of such safety officers. Healthcare organisations should set out a long-term approach and objectives for the management of their medical devices, including strategic replacement and equipment procurement planning. This should include an overarching medical
devices management strategy setting out medium to long-term organisational requirements of assets taking account of cost, performance and risk across the entire equipment lifecycle. This strategic approach should also align with the responsible organisation’s overarching business / strategic plan.3
Many healthcare executives are unaware
of the MRHA guidance. They do not have a long-term investment plan for their healthcare technology that is linked to their business objectives. Without this plan, equipment is often bought in an ad-hoc way by individual budget holders, with little investment committee involvement – the “he who shouts loudest” approach.
Looking back over more than 30 years of working with healthcare technology, and with multiple healthcare organisations, I have rarely seen real understanding at executive level of how technology impacts on their business plans, clinical outcomes, patient throughput, and overall costs.
Long term Operational Goals
Healthcare Technology Strategy
Successful Investment
Figure 1. There is a tendency to focus on the cost
of the technology itself, rather than the cost of clinical efficiencies – i.e. using technology to improve patient throughput and therefore reducing organisational costs. Through the smarter use of emerging
technologies, healthcare providers can also move services from generalised to personalised care delivery. As part of this, it is important to develop clearly understood strategies for buying products that can deliver their strategic plan. All technology plans must be underpinned by
standards to ensure that technology systems can “talk” to each other. New technologies can also help us to offer more dignified and independent care to people in their own homes, keeping them out of hospital if they don’t need to be there. We have an increasingly ageing
Device integration Connected devices
EPR / Cloud / Patient Accurate Clinical data
Improved decision making / better outcomes
Clinical Utilisation
Future Clinical
Activities
population – in the United Kingdom, nearly one in seven people is projected to be aged over 75 by 2040, with more and more comorbidities. Technology can do so much to help these people live independent lives and minimise the time they spend in clinical settings. One issue that is often recognised is around the impact of poor acquisition of technology. The World Health Organization sponsored research concluded that: ‘Improving Healthcare Technology Management (HTM) saves lives and money’.4 Some of the issues identified were:
l 20-40% of medical equipment remained unused or under-utilised.
l 30-50% additional costs for extra spare parts and maintenance workload.
l 10-30% unplanned costs. l 25-35% of equipment out of service. l Loss of 30-80% of the potential lifetime of equipment.
These findings are no surprise to me. For many years, I have been saying that investment in the right technology, then aligned with the long-term business plans of the organisation, will deliver better outcomes for patients and be more cost efficient.
The future?
In the 1980s, asset management involved recording of the individual items of medical equipment within the healthcare organisation, and making sure it was serviceable, with the main management focus being repair and maintenance.
Optimisation Figure 2. organisational optimisation 32
www.clinicalservicesjournal.com I May 2024
Better use of resources / more efficiencies
In the last 20 years, medical devices have become not only things you can touch, but also software components, such as Health Level Seven or HL7, which refers to a set of international standards for transfer of clinical and administrative data between software applications, used by various healthcare providers. Hospitals and other healthcare provider organisations typically have many different computer systems used for everything from billing records to patient tracking.
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