EBME
infrastructure (especially within smaller hospitals) is an issue: “The infrastructure is a big challenge… if clinical engineers had some involvement when infrastructure is put in place, we could help negate potential issues, in the future, when we put in new equipment that is more connectivity oriented,” one delegate asserted. Infrastructure is going to require capital planning, but also “cascades into a lot of other departments which need insight and approval,” they observed. Other challenges included the fact that manufacturers of patient monitoring equipment, and other healthcare technologies, have their own proprietary networking systems. “Clinical engineers are not trained in how
to manoeuvre or operate these networking systems,” another delegate observed. They explained that this can lead to challenges when a fault occurs – such as monitors not communicating with a central monitor. “You may find the connector, the internet cable, and all the IT are working fine, and the monitor shows there is a network, but there’s nothing displaying on the central monitoring system. So, you contact your local IT team who say ‘everything is fine’, but when you contact the manufacturer, they give you a whole new story…The clinical engineer needs to be trained on how to use these manufacturer networks and how to manoeuvre between them, so when there is a problem, they know where to go,” the delegate continued.
Who is responsible? Iain Threlkeld went on to pose the question: “From a clinical engineering perspective, where do you feel that your job role stops? Is it at the wall outlets; is it the network cable? Are we just hardware or do you feel that we should be supporting the back engine of the networking and connectivity?” “For me, I think we stop at the outside point,”
one of the participants answered. “However, having an idea of the networking could help in the case of an emergency [such as anaesthesia monitors not displaying on the central monitor]. If you have an idea of the background in terms of the networking, you’ll be able to troubleshoot exactly what the problem is and explain and report it to the manufacturer or the ICT team,” they continued. Another attendee commented that there needs to be a better working relationship and
trust building between clinical engineers and IT teams: “I feel that our role stops at the wall, but we need to have a close relationship with our IT team, so that we can negotiate barriers relating to IT login systems, because this can end up being quite time consuming. If we have close contact, we can work with the networking team and make progress.” Another delegate said: “When somebody
has a problem with a piece of equipment, it doesn’t matter whether it’s a switch cable or the equipment itself, they want to be able to ring you and say ‘I’ve got problem, solve it’…All too often, the equipment user will ring EBME who will say: ‘sorry it’s not our problem, you’ve got to ring IT’. They then ring IT, who will say, ‘we can’t find anything wrong with it’. “Often, IT will make some changes in the network, and they think it hasn’t had an impact on anything, but it has. Realistically we’ve got to be able to look at it and be able to identify the issue, so we’ve got to have some access.”
Need for training and closer collaboration on IT The attendees also highlighted a need for engineers to not only be biomedically and electrically trained, but to also “learn the basics of networking”.
We need to be able to look at the systems and say, ‘is data coming out or not?’, and ‘what do we need to do about it?’ There needs to be more learning from our side.
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“We need to be able to look at the systems
and say, ‘is data coming out or not?’, and ‘what do we need to do about it?’ There needs to be more learning from our side,” one attendee commented. They highlighted the high stakes and urgency
involved, when a patient’s life or diagnosis depends on the availability of the equipment. The IT department’s priorities were perceived to be different and delegates suggested that IT may not always understand or appreciate the urgency and impact on the patient, as they do not have the same background as EBME. While training will be vital going forward, it also poses challenges, as departments are already short staffed – releasing individuals for 4-5 days of training can create added pressure on already over-stretched EBME teams. It was noted that Eastwood Park are now
offering relevant training sessions and one EBME lead reported that they are currently looking to “start the journey, for some junior technicians”, in order to tackle this knowledge gap and bring this skill set into their department’s mix. One of the delegates also highlighted the
value of a study day that was previously run by IPEM, a number of years ago, which focused on clinical engineering and IT working together. They pointed out that this is something that would be very beneficial to run again, as it helped to “understand each other’s perspectives”. Rather than training every EBME engineer in
IT, it was suggested that Trusts could hire an IT specialist into the EBME department, to operate
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