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Science and technology information management of medical technology revolution

Font Size: [Big][Mid][Small] 2016-6-6    Views: 1161    

  Nader in March 1971 as the family female magazine to write an article, expounds the harm of micro electric shock, this article profoundly change the way hospitals dealing with information technology, the effect is immediate, springing up all over the country, the biomedical engineering department medical technology management also ushered in the dawn.

  Nader wrote, thousands of engineers began to test the micro shock damage to electronic equipment. These tests help? The answer is not sure. However the whole American society seems to ignore a more subtle problem, Nader indirectly indicates: under the extremely complex engineering environment, hospital nursing of the patients with the lack of a consistent and coordinated management. Today the hospital is equipped with different categories and more sophisticated equipment, from the technical level has greatly increased the working efficiency, however, the complexity of technology application often make nurses, biomedical and clinical engineers become more difficult, in the day of the hospital to buy expensive equipment is unsustainable.

  Technical and administrative staff are working hard to improve the safety of medical equipment, the quality and efficiency. For patients to ensure medical equipment and system integrity, reliability, and security, and to maximize income, to increase its availability. They include the idea of medical technologies to realize a highly integrated and interactive operation management.

  Today mobile service is out of the "fault - repair cycle. In the past decade, between the equipment and technology, more and more interconnected and interdependent. Support medical equipment IT network is no longer a small island. Today's technical manager is to carry out the plan of main equipment key stakeholders, they help the team to make the right decision, configuration and especially can help cash-strapped medical organizations to cut costs. This also raises a question: after forty years of development and after one million times of electrical safety inspection, whether we can master the key technology of health-care facilities effectively?

  Ilir Kullolli is Kaiser Permanente clinical system engineer of the company. He participated in the relevant improving physiological monitoring alarm, medical devices and infusion pump and EMR integration project.

  Bedside monitoring system originally produced in 1975, when the BD   Electrodyne introduced into clinical monitoring system (CMS), to the bed and biochemical monitor into a minicomputer. A complete device including the bed computer terminals, prescription drug system, breathing machine and infusion pump connecting line, the system has some very sophisticated function at that time. CMS is soon the optical academy of medical sciences and multiparameter alarm system (computer) arrhythmia monitoring system, namely system today of the so-called "smart" alarm function. Siemens "Simon" system USES the size of a shoebox terminal of the head of a bed and a hex keyboard entry to enter the vital signs. In the middle of the 1978 academic papers say the current monitoring techniques have been out of date. Until 2011, however, still does not change much monitoring technology, multi parameter alarm is still a challenge, no one can risk it is used as the bed medical workstation.

  In 1984, the researchers set out to monitor the vital signs, ventilator, infusion pumps, such as equipment, association of electrical and electronics engineers (IEEE) institute has set up a working group, making communication between health care equipment "common language", referred to as "medical information express". The end is called "IEEE 1073" passed in 1990, the data communication standards, however, this standard is largely ignored by people, because many suppliers are for ward "last one kilometer" of the fire control network. One reason is that the surge of the special equipment to read the manufacturer's business sense is more and more strong, rapid rise, they are no longer using an open protocol, and instead develop close agreement is called a "black box". Today, there are more than ten different device interface type, change is the result of the market standard hundreds of independent equipment suppliers and more products consultant. This also no wonder, substantial product advice is no longer on the existing deficiencies in repair, but instead to develop new products, after again in the loop. Only companies with large medical institutions customers, such as Kullolli didn't have the ability to employ full-time clinical engineer.

  "Once they find a short-term solution, tend to be tasted, continue to do other things, when we look back at that time the solution, we often and easily satisfied," he said, "only the results become bad when people began to change thinking."

  Nader, disclosure of "man bites dog" story, the media for medical attention in the field of electronics. American readers for most health problems are very sensitive, using new equipment is used for diagnosis and treatment in patients with medical institutions still caused heated debate. Medical institutions across the country over the past year has seen infusion pump failure, CT scanning radiation overdoses and patient monitor failed to report to the police, these have all been as front-page news published in the New York times, the Los Angeles times and the Boston globe. Hospital is an urgent need to the medical security good public opinion, but they in public image is often poor. Medical institutions are often too, just caught the short-term interests, but ignore the management of hospital culture construction. Eager to solve the problem is often wasted effort.

  "We still have a lot of technical personnel check every day many tedious details, such as instruments, the percentage of the leakage current," Baretich founder, senior clinical engineering consultant Matt    Baretich said, these are offered a so-called "electric shock" is the result of Nader. He thought at that time, the theory is flawed, it now seems more nonsense, Nader, and I will be the blame "inertia" academic, accuses him of people the aim is to keep your job.

  What is good for patients? Hospitals need someone to advise, inform the hospital need what technology and investment. Baretich in forensic equipment has accumulated experience, to verify the correctness of the theory mentioned above. "I believe that a lot of problems, if done their homework before, it is impossible to happen."

  CTM group sodexo area vice President Vionnta Rivers support for the industry development. "We have no feelings or find health information technology is not reliable, unsafe. Despite a lot of negative news, I think the major medical equipment manufacturers have made many great contributions for technological progress, and set up the public's trust.    When an exception occurs and the same as in the past for a period of time can be a negative comment, it is often viewed as an equipment failure case, and will not affect the industry as a whole."

  Rivers said the biomedical researchers not only security analyst, and should be more, "we have been in many hospitals in different clinical education in the degree of participation," he explained, "our whole plan is about how to reduce risk. Our program is designed to minimize risk, including product recalls involving hospital and patient care."

  Baretich said, "management is a very broad category, everyone must know, what on earth are you doing?" Baretich Suggestions to set up a list of "responsibility", the hospital all the instruments and equipment list, and will be qualified for operating personnel list. However, people in the biomedical and equipment is often hard to be totally in step, and the doctor and IT people how can ensure work together?

  Baretich company, for example, to measure whether a worker can do such as customers and clinical engineering, health care and forensic engineering standard is a person's own background. These people include clinical engineers, technicians, biological medical equipment information technology professionals and clinical informants. "To some extent, these people are doing medical technology management."

  Aramark corp clinical technical services company President Brian Poplin thinks, "we provide service scope expands unceasingly," this to a certain extent, reflects the industrial development. "With the constant development of clinical engineering background, we can effectively repair medical instruments. This is the core of our service, we can carry out preventive maintenance, although a lot of change, but such a transformation is still an important part of a clinical engineering. Using such as equipment distribution and RFID basis, we can help the hospital to the evaluation of key technology and capital planning, can focus on the risk of management and technology related."

  Nate is Larmore Sparling, chairman of the company and IT architecture practice leader. The company was founded in 64 and is currently the largest electrical engineering consultation and design company. Larmore explain his company faces a wide range of business every day. "We are engaged in every technology project process information assets up to hundreds of millions of dollars, we also met with friends from all over the world." Semiconductor and lead the development of the history of anthropology. "It involves Ralph Nader talked about in the 1970 s, the complexity of the enterprise is not only the technology,"     Larmore said, "I will further study on this problem, because it represents the different user types and character."

  Medical information company in the traditional design and construction principle is to interact with a small group of like-minded hospital representatives. Their goal is like a not fallen building. "When you interact with, you are dealing with dozens of stakeholders. They take the responsibility the building upright, once they cannot get information in the building, not repeat, efficient, technical tool cannot be trusted, they will not be able to finish the work process," Larmore warning. If this happens, prove that technical management is very failure.

  Renovo Solutions, chief executive of Sandy Morford said, don't want to medical management of the definition of technology for shallow, in order to avoid weakening the importance of its own, "from the perspective of clinical engineers, these are just different forms of technology." It is necessary to set a boundary. "We have to concentrate on, otherwise it will become too broad," Morford said, "that how to talk?"

  Morford never underestimate the complexity of the equipment in the hospital, but he saw compared with the traditional electronic devices, there is a difference. "These devices is not without its life cycle, they like food equipment and environmental services equipment has a life cycle, but it is different for their management, and the regulation of the clinical imaging diagnosis equipment also differ."

  From Aramark corp companies Poplin, points out that "due to the randomness of medical equipment, it appears that there is no multifarious to our industry at present, this is partly because there are so many unique and dispersed type of service, a variety of challenging devices, but there is still lack of a suitable words to describe our services."

  The success of the management of medical technology has several common factors: smart, self-motivated, love a challenge. "Whether clinical engineers have troubleshooting and problem solving skills, is the premise of the successful cooperation between with the medical staff." Morford said.

  "The complexity of the enterprise is not only a technology," Larmore said, "this is a complex user groups. If from the point of view of traditional engineering users, most people know how to insert the stuff on the wall or adjust the thermostat and the complexity of the user group. The use of an information-based enterprises have more complex type. All this will eventually become the component part of network, and provide the end user."

  So the hospital began to transition to the new organization model, they learnt from the experiences of Toyota prius assembly line of efficient, require suppliers must also provide innovative, clinical engineering suppliers must change in order to satisfy the demands of new customers and new market opportunities. "In some of the smaller hospitals, we let the customer request, actively" can take the place of hospital at the front desk for your product? Can you provide us the alternative solution of hardware? "Poplin said," our clinical is parallel to the links between engineering and customer service. "

  For medical devices from traditional biotechnology regulation is a bad thing? Poplin is put forward from different angles the opinion that the ongoing organic cohesion. "Because of the medical equipment is to make the transition to more based on the direction of the software, our team will also become more and more hard working and strong. We are looking for network system and the analysis of network training. As an industry, we tend to focus on a certain title or definition," said Poplin, "technology across, for example, from the infusion pump to the MRI scanner, require clinical engineers and service personnel to integrate the service capacity.   Therefore the boundaries between each technology category is very blurred. In any industry, can only look for opportunities in the future, excellent performance with service to win customers, satisfy customer."

  Poplin intends to follow the trend. "In Aramark corp CTS company, has a team lead us the way forward. When they set out from our customer, put forward the new challenges and new opportunities, we will follow the trend." These are ideas from other large service providers. "We see compared with five years ago, we have senior background greatly increases the demand for IT professionals." River, said, "sodexo increasingly have to recruit engineers with strong IT background as a clinical and technical personnel, because we know that this is the future of clinical engineering."

  Renovo solution is the fusion of clinical engineering and IT. Renovo is an IEC - 80001-1 standard marketing network management software.   "We've created a proprietary software applications, allowing the hospital on the basis of many manufacturers, actively monitor all of these medical equipment network, manage the risk of these devices. It filled the gap of demand." Morford says, because "it's nature is still belongs to the medical apparatus and instruments. So the network server, router, not a lot of traditional engineering involved."

  Brian said Poplin, extravagance and waste have to purchase infrastructure money days are over. "Hospital began to like to try some had never done, they began to see the challenge, this may be because they have never experienced the challenges," he said, "this really is a catalyst, health care reform bill can be used in the clinical management and medical technology management field, 'disruptive technologies' make OEM service contract idea obsolete." For technical manager, company recruitment and no job description and detailed work manual. Baretich said: "if you want to do it, and prepare your roles and responsibilities." Already successful people are like that, "they are attractive and assertive." He added, "once we determine the concept of" medical technology management ", it means that we need through the certification of education background, the real person to fill a variety of roles."

  Sparling is recruiting new nursing project director. "We tried to put the nurse work information," Larmore said. "In many ways, they fully expected to become the next generation of business leaders. This is not my CIO of customers and various other IT staff. They are trying to capture new insights in clinical work, and many of them did a very good job, but if you just with clinical background of medical personnel, and start developing IT technology, then success is really difficult." Larmore illustrates what can make a great technical manager. "You can have a look at the education and experience, these are very important, but personality is absolutely necessary. Because there are so many stakeholders in the attention, when are you going to deployment system in hospital, can not only make a sector involvement." Care to do, the better, the project. "A successful transformation of technology the leaders of the enterprise, should be able to gather the stakeholders, and lead them into new areas."

  In the process of dealing with patients, also can produce some unpleasant questions. "You observe in the hospital and the patients go too close, to create a more comfortable nursing for patients with environmental technician in clinical engineering and usually BMET is more popular," Baretich proudly said, "this is a unique position, in such an environment, traditional IT people may feel uncomfortable, and IT shows a very important rule, help us to fill the position void." Baretich also encourage everyone: "out of the basement, spend more time with the nurses, doctors and other communication, infection control for example to study how to do it."

  It's time for busy

  Spent 40 years has been tried to define the concept of management of medical technology, it is still as usual could only dream of. It is the definition of continuous deformation and extension. In addition, maybe we can never make a definition to the collection, because that would like specified electrical safety becomes banal. Medical technology is very flexible management, we should see the medical instrument of change and innovation, ahead of the problem to create an effective way to manage these systems.

  Management of medical technology has attracted many curious, like challenges, apart from the mediocre person. This is a group of people seems to be full of paranoia and skepticism and youthful idealism but keep a clear mind of teenagers, they never stop steps forward, and scoff at others' questions.

  Poplin said. "it is our task in the residents' health and welfare of the world's most important industry under the pressure of the solution. Now we pay more attention to the clinical engineering, not only including the service we provide, and how to help them more effective management techniques."

  Finally, Baretich, his work time than Kullolli and Poplin together longer, he was careful to avoid the mess of things. "Everything is fine now," he said confidently, "if we keep trying, the result will be good."



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