Stephen Grimes: How HTM Makes Its Mark

I’ve been involved in clinical engineering nearly 45 years, and I remain as enthusiastic as ever about our industry. I am enthused because I see the potential for technological advances to greatly improve the quality of healthcare and to widely extend the availability of that quality healthcare to a higher percentage of the world’s population (at ever lower costs).

However, I also recognize that regardless of how advanced or sophisticated our technological advances are in healthcare, their mere existence does not guarantee a beneficial result. Ultimately achieving the hoped-for benefits of our evolving technologies depends on how new technological advances are used and how effectively they are supported. That is where we in clinical engineering (CE) and healthcare technology management (HTM) must be involved.

The healthcare industry and providers of CE/HTM services must recognize that:

  • While many new healthcare technologies have great potential, they may not be appropriate for every situation at every provider (or at least there can be a wrong time and a right time for their implementation).
  • CE/HTM must have new processes, partnerships, roles, skill sets, and tools to support existing and future generations of healthcare technology.
  • CE/HTM must actively work with clinicians, IT, risk management, supply chain, finance, vendors, and other stakeholders to ensure the aforementioned services are delivered effectively.
  • CE/HTM must make a concerted effort to avoid complacency and accept that change is the new norm.

As CE/HTM professionals, we should:

  • Assist our organizations in formulating their strategic vision with respect to the selection, adoption, and support of new healthcare technologies—those technologies that will achieve specific, measurable improvements in safe, effective, and quality patient care.
  • Reorganize and re-align CE/HTM programs (i.e., staff and services) to meet organization’s changing needs.
  • Recognize the reality of integrated medical and information technologies and establish effective collaboration between the traditional CE/HTM and IT supporters of those technologies.
  • Drive financial reform, trimming unwarranted services and focusing on delivery of services that enhanced organization’s ability to deliver high-quality and cost-effective patient care.
  • Manage and collaborate with multidisciplinary stakeholders in HTM operations and projects.
  • Formulate new and updated guidelines and processes (including the adoption of quality management systems) to ensure HTM support services remain relevant and effective.

As CE/HTM professionals, we can make the difference in whether or not the coming advancements in health technology will lead to universal improvements in the quality and availability of patient care. A lack of attention and innovation on our part could lead to major disappointment.

I’m betting on us to do the right thing.

Stephen Grimes is managing partner and principal consultant for Strategic Healthcare Technology Associates, LLC, and a member of the BI&T Editorial Board.

8 thoughts on “Stephen Grimes: How HTM Makes Its Mark

  1. I agree with all of the above and would add. There are and will be many companies looking to get into the healthcare technology business and create revenue streams that exploit our caregivers needs related to technology. HTM will also have a critical role to play as a facilitator gatekeeper and guide to caregivers and c-suite deciders. Key among the tools we will need to have and acquire is digital and physical “right to repair”. Each building block of technology infrastructure must be transparent to HTM and we must have the knowledge, access, tools, and documents needed to do the many facets of the jobs of today and tomorrow. Key to this is a very strong and unambiguous definition of what tomorrow’s “service manual” should be coupled with a clear directive from our FDA that the OEMs must and shall provide it to HTM. Alongside this, we need our FTC to give industry clear guidance that using access to or pricing of parts both physical and digital as a means to monopolize service business or restrain HTM from participating in the management of the device lifecycle will not be tolerated. These are tall orders for sure. Yet, the foundation of the future of HTM depends on this IMHO. I for one don’t want to become a coat holder for OEM reps nor do I want to give up my tools and replace them with a tape gun and shipping label. IMHO, HTM is facing a long uphill climb into our next digital age metaphorically like the challenges faced by the army rangers who had to scale the cliffs, under fire on Ohmaha Beach to take out the German artillery battery that had our troops pinned down in the surf. But who among us (HTM) will be the ones to take on the job securing the future of HTM’s place in the coming digital technology future? Who might be HTM’s Eisenhower ? Will we have our own VE Day ? A day where a future BMET can make a call to an OEM and never even think a request for service information and buying a part would be refused? I hope that such a day may arrive. What do you think?

  2. I do not see the need for HTM the further Medical Technology becomes connected, integrated, and easily replaced as consumer electronics. Medical devices have become far more reliable, precise, accurate, safer, and just plain cooler. The replacement of digital circuits with microprocessors has led to a technology that has far greater functionality than the original device was intended and that includes self-diagnostics.
    Every device has at its basic 1. biological interface it measures (through a transducer) 2. Some anolog to digital conversion (because the body is analog), 3. Some microprocessor/signal conditioning, 4. Filtering, and 5. Display.. of course devices vary by extra features like communication circuits, etc.
    Numbers 2-4 on this basic functional block listing is usually now on an integrated circuit board much like a computer.
    Now what has this contributed to medical device improvement? They’re easily upgradeable, they’re more familiar to the average user, they can be serve multi functions, their feed back systems can lead to better measurement’s by filtering artifacts, and maybe they bring some comfort to the patient when the patient sees a sophisticated device performing the function that a far cheaper device could easily do. Patient perception of care.
    So this might be where we might unintentionally help improve quality of care. If you’re not familiar with the nocebo effect, it is when a patient will get worse simply because they believe the treatment (be it pharmaceutical or technical) is ineffective.
    I’ve heard the argument of different manufacturers requiring different protocols for maintainenance and how this leads to greater frustration.
    Advanced medical device functions that matter to the patients diagnosis and treatment will come first from physiologist, biologists, biochemist, and biotechnologist. Then clinicians will have they’re contribution. Maybe clincal engineers will contribute to the innovation and design of the final product.
    Right now we as a whole need to be closer to the patient and in order to do that we need need to be closer to the clinical staff until we are considered part of the clinical staff.

  3. Thanks, Steve for your enthusiastic post. I’ll add that regional and national professional participation will greatly enhance the ability to achieve these goals. Collaboration and cooperation beyond your facility’s wall will pay off.

  4. Those were the days of the green or orange bouncing ball and the BMET was mixed in and thought to be the janitor. And you would only need to get equipment every 10 years. Those days are long gone. Things were so easy but so complex because we were trying to get trends and making changes like standardizations in equipment, so we don’t have a 4 different manufactures for 4 different department that are similar in function. Then trying to get service and training for each thing.
    My problems today is when an equipment manufacture devices we had for 10 years and after buying some more 4 ago the parts are proprietary. The company obsoletes equipment with no service a year after.

  5. Its nice to envision ourselves in the forefront of healthcare advances, but what is the evidence that it is true? Similarly what is the evidence that the things Mr Grimes says need to be enhanced actually do need to be enhanced, and that such enhancement (as yet undefined) will matter? Who is going to measure what?

  6. There are imperatives for the CE, however, how do you deal with the hierarchical structure of most healthcare facilities, and the non-involvement of CEs in the decision-making processes?

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