Jim Smith: A Call to Action in Making the ‘Systems’ Work

I learned recently of AAMI’s plans to publish an issue of Horizons devoted to the topic of systems engineering in healthcare. It is vitally important to highlight the requirement that systems be designed around standards-based and nonproprietary interconnectedness in healthcare. Much of the unnecessary cost burden shouldered by healthcare and particular healthcare technology management (HTM) is related to the bunkered, nonconnected, excessively proprietary, nonstandardized nature of processes and systems in healthcare.

A couple of days ago, I was speaking to an imaging team lead at a major university medical center. He was apologizing to me for not getting back to me sooner because, as he said,  “We are finishing up an ICU install that did not go well.” This HTM professional is skilled, dedicated, precise, and a planner. Yet, the team’s diligent effort resulted in a short-term, sour experience. Of course, in time, this dedicated team will get everything ironed out.

Here is my response to this HTM professional:  “Until IHE or someone else provides a standards-based, nonproprietary interoperability for the world of hospital system/device interaction, all ICU installs are prone to complexity overload failure. This is true no matter how heroic the efforts.

“I applaud your team’s efforts in taking on such a complex and difficult challenge. No matter the short-term outcome, without your team’s efforts there would be no hope of bringing online an ICU at a reasonable cost.”

That last bit is the key. HTM must take a leadership and vocal stance in advocating for thoughtful, standardized change. Whether it is an ICU, a CEMS, RTLS system, or device, the complexity and nonstandardization is drowning HTM, IT, and all other service departments in a sea of healthcare complexity and proprietary landmines.

Several groups are working very hard and smartly to standards-based interconnecting of systems and devices in healthcare operations. In addition, every mention and highlight by AAMI adds wind to the sails of these groups. This is especially critical as the diligent and extremely difficult efforts of IHE and others are producing actual systems and devices that move healthcare toward creating a truly interconnected 21st century — an Internet of Things Medical Devices (IOTMD).

That being said, I’d like to issue a call to action to HTM professionals to commit themselves toward advancing the standardized-based, interconnecting that has made the Web so useful, easy, and successful for people. Yes, there will still be plenty of room for intellectual property and medical innovation, but plugging the device in and connecting it to other systems shouldn’t be fraught with error and high cost.

AAMI, ACCE, IHE, and others are only the messengers. It will take HTM professionals, clinicians, and others to show the market that the status quo will not do. HTM professionals suffer from the lack of these systems and standards the most as they are responsible for ‘making them work. Without HTMs strongly voicing their opinion, the status quo will continue, and there will be many more “complexity overload failures”‘ that HTM departments worldwide will have to mop up.

Jim Smith is president of EQ2, LLC.

One thought on “Jim Smith: A Call to Action in Making the ‘Systems’ Work

  1. This issue is a monster our profession created for itself IMHO. We have let the manufacturers drive the bus for way too long. Our industry cannot reliably get many medical equipment manufacturers to provide NFPA-99 compliant factory service manuals. Compounding this is that the NFPA-99 specification for the “service manual” lacks a requirement for comprehensive sections on the devices software systems containing information that a hospital would need to create interoperability. It would be great to get such an amendment to the current NFPA-99 standard. Once past that, we need to drive industry behavior, possibly to the point of having the government impose “right to repair” (and integrate) legislation similar to recent “right to repair” laws passed for car makers. At some point, the feds must step in on this and mandate the medical companies become plug and play, and observe the customers rights to repair for the sake of putting a dent in the rising costs of healthcare to the nation.
    Your thoughts?

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