EBME
to people who struggle with technology – they simply press a button, then results go off to the hospital via WiFi. When the patient is finished with the equipment, it goes back into the box. A courier collects it and a third-party gets the box ready for the next patient. The third-party company retains the ‘pool kit’ in an off-site workshop.
Using this approach, the hospital can obtain vital signs information from the ‘virtual ward’, either prior to coming in for an operation, or to reduce the need to take up hospital beds post- operatively. The patients’ home environments also vary greatly which can present challenges with regards to medical technologies and the provision of therapies at home. For example, water quality and water pressures vary from house to house. The cleanliness of a patient’s house can also affect the management of equipment. “A key consideration is whether the device has
a filter,” another EBME expert pointed out. “The cleanliness of patients’ homes isn’t necessarily what your home would be and if they have a lot of dust and nicotine, etc, things can get clogged.” The state of the patient’s home will dictate
the frequency of the maintenance required. So, how can this be assessed and managed in the community? Who will undertake this environmental assessment? Would it be a clinical engineering team or the manufacturer? And how can we sensitively manage discussions with patients about the cleanliness of their homes? “For visiting engineers, there’s quite an
emotional challenge as well because they get to know the patient really well and then they pass away. They have to go to the home and take the equipment out and the family is still mourning. It’s a really difficult situation,” one delegate shared. The resilience of equipment also needs to be considered. While hospitals have back-up generators, what happens when there is a power cut to a patient’s home? In the case of home dialysis, it is not time critical – the patient can simply wait until the power is back up. But the virtual ward will ultimately be limited in what it can deliver due to constraints around the home infrastructure. As one delegate pointed out, “You can work
around a potential power cut for renal, but if you’re going to put an ICU at home, somebody is going to have to monitor that. You’ve got to have connectivity. What if the internet drops out? What if the power drops out, and the ventilator stops working? We are going to have to draw a line at some point. “The people around this room need to advise
the Trust and say, ‘you can’t do that, even if it looks like a great idea on paper, because these
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are the practical considerations…’ We need to be the people that are listened to and have that respect, when we say ‘no’.” “When it comes to technologies, let’s be honest, we haven’t got a crystal ball,” another delegate interjected. “We don’t know what’s coming in the next decade. I think a lot of it will be about managing people’s wellbeing through prevention and managing long-term conditions – it will be about keeping people out of hospitals because it’s nicer to be at home. “I can imagine a situation where someone with a long-term condition wakes up, does their blood pressure, does their monitoring, does all their blood tests themselves and all of that gets transmitted through to some sort of central monitoring.” The panel highlighted that if we are sending patient information across the network that also needs to be secure. “I think the challenge is going to be knowing what you’ve got and where it is. I think that’s still a big challenge. It is easier in an acute setting to do tracking, but there are some GPS technologies emerging. The price is still too expensive and can cost more than the asset, however,” one EBME leader commented. If the cost starts to come down, this may become more of an option in the future, they suggested. “We already have wearable
technology coming through. It’s only a matter of time, I think,” another delegate commented.
Conclusion In conclusion, the panel highlighted that many of the issues discussed were not simply ‘clinical engineering issues’ – they are ‘common issues’. There is a need to make all stakeholders understand that clinical engineering is about medical device management and patient safety. The lifecycle of medical devices management needs to addressed, as a whole, by working collaboratively. Ultimately, medical technology management must be everyone’s concern – as patient safety is the overriding priority for all. Solving the issues highlighted in the
Workshop will require a coordinated, multi- disciplinary approach. EBME experts need to have a strong voice and show effective leadership, if the government’s ambitious 10- Year Health Plan is to be delivered safely and cost-effectively. There will be significant challenges ahead
in moving care out of hospitals, and the EBME sector needs to highlight these at an early stage and advise on potential solutions – before the ‘proverbial horse has bolted’. For further details on EBME Expo 2026 and
future workshops, visit the event webiste at:
https://ebme-expo.com
EBME and procurement of HealthTech
Procurement of health technologies was also discussed during the Workshop. It was suggested that EBME departments need greater influence and control over procurement. “We try to get our procurement department
on board to stop the purchase of medical equipment, if it doesn’t come through medical physics or EBME. Often, they’ll knock back items, but they need to be able to identify what it is – if these items just come in as model numbers, it can get a little bit more chaotic. “Things like scales or BP monitors, get knocked
back by procurement, so they end up not going through the system at all. It’s total chaos now that people can buy little BP monitors from anywhere – from Boots and Amazon. We try to at least have them on our system for inventory purposes, so that if there are safety notices released, we can let people know,” one of the delegates explained. Another pointed out, “How can you maintain
these devices on an annual basis if you don’t know where they are? A lot of the time it just says they are in ‘the community’ and, once it’s in the community, the reliance is on people bringing them back to us if they suspect it’s faulty.”
While there is some guidance from the MHRA on medical device management, there needs to be specific guidance on managing community- based medical technologies. It was suggested that a Special Interest Group could be formed to address the lack of guidance. The plethora of items available on NHS Supply Chain also presented issues for EBME departments, in terms of managing medical devices. Emphasising the need for a more centralised
approach and more control over the medical devices coming into Trusts, one delegate observed: “Procurement departments are coming at it from ‘how can we get stuff to end users as soon as possible and at the cheapest price?’ They are not looking at medical devices in terms of all the extras that we look at. So, why isn’t there a central team checking this? “Rather than every single organisation doing
this work, we could have a central team doing all the groundwork and saying, ‘we have looked at this and it’s okay’. Then as an organisation, you could choose what you’re going to standardise on. If we had this, it would save a lot of work and it would give more reassurance and safety.”
CSJ
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