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VOL. 11
ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL
DIGITAL SUPPLEMENT
STRATEGIC ASSET LIFECYCLE MANAGEMENT elevate performance and lower costs in challenging times
DIGITAL SUPPLEMENT FEATURED INSIDE P2
The Impact of COVID-19 on Operating Margins
P3
Strategic Asset Lifecycle Management
P3
Creating a Complete Asset Management Program
P9
10 Steps to Make Your HTM & HFM Departments a
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DISCLAIMER: MD Publishing (TechNation) takes every precaution to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not those of our company.
THE IMPACT OF COVID-19 ON OPERATING MARGINS
THE IMPACT OF COVID-19 ON OPERATING MARGINS Healthcare organizations face an increasingly difficult challenge. They must ensure compliance with everchanging regulations, drive down costs, improve patient experiences , and at theealthcare same time, do moreface withan organizations fewer resources. Broken service increasingly difficult challenge. processesThey andmust siloed departments ensure compliance with ever-changing regulations, down undermine these outcomes,drive leading costs, improve patient experiences, to a cycle of waste—impacting both and at the same time, do more with fewer rethe patient experience and your sources. Broken service processes and bottom line.
Both Moody's Investors Service analysis and Becker’ Hospital CFO report of August of 2018 reported that before COVID-19, the average operating margins of not-for-profit hospitals the US were an all- by driven byineffi ciencies madeatpossible time lowtransformation. of 1.6%. In addition, 30% of digital Both Moody’s Investors Service hospitals were experiencing negative analysis and Becker’s Hospital CFO operating margins. In the April 2019 report of August of 2018 reported that issue of Modern Healthcare, it was before COVID-19, the average operatreported that efforts to ing margins of not-for-profit hospitals in improve margins such as mergers and the U.S. were at an all-time low of siloed departments undermine these acquisitions, increasing patient 1.6%. In addition, 30% of hospitals outcomes, leading to a cycle of waste— While the COVID-19 pandemic volumes, revenue cycle were experiencing negative operating impacting both the patient experience continues tobottom take a line. heavy toll on improvements, margins. In the cost-cutting April 2019 issue of and your America’s healthcare infrastructure initiatives, productivity boosts, Modern Healthcare, it was reported and operating margins, there are and shift to lower-cost settingssuch as that efforts to improve margins andinacquisitions, increasing also While growing the concerns COVID-19about pandemic allmergers resulted a 10th of a percent patient volumes, revenue cycle improvecontinues to take a heavy toll on increase in operating cybersecurity risks and the effects of ments, cost-cutting initiatives, producAmerica’s healthcare infrastructure and margin. Unfortunately, it is generally the aging technician workforce. tivity boosts, and shift to lower-cost operating margins, there are also accepted that 2.5% is a sustainable Also, fundamental organizational settings all resulted in a 10th of a growing concerns about cybersecurity operating margin. changes are being driven by percent increase in operating margin. risks and the effects of the aging According to Kaufman Hall’s efficiencies made possible by digital Unfortunately, it is generally accepted technician workforce. Also, fundamenSeptember 2020 National Hospital transformation. that 2.5% is a sustainable operating tal organizational changes are being
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Flash Report, the COVID-19 pandemic has reduced average U.S. hospital operating margins by 7.9% since the start of 2020 through August in comparison to the same periodAccording in 2019,toexcluding margin. Kaufman funding Hall’s from the2020 Coronavirus Aid, Relief and September National Hospital Economic (CARES) Act. Even Flash Report, Security the COVID-19 pandemic haswith reduced average U.S. hospital government financial operating margins by 7.9% since the assistance, hospital operating start of 2020 through August in margins are down 2.3% through comparison to the same period in 2019, August, compared with the first eight excluding funding from the Coronavirus months of 2019. Aid, Relief and Economic Security (CARES) Act. Even with government Additionally, 87% of hospitals list fi nancial assistance, hospital operating identifying and2.3% managing cost margins are down through reduction initiatives among the most August, compared with the fi rst eight months of 2019. important performance Additionally, 87% of hospitals list management activities for their identifying and managing cost reduction organization, according to Kauffman initiatives among the most important Hall’s 2020 Healthcare Financial performance management activities for Outlook. their organization, according to Kaufman Hall’s 2020 Healthcare Financial Outlook. SPONSORED BY ACCRUENT SPONSORED BY ACCRUENT
STRATEGIC ASSET STRATEGIC ASSET LIFECYCLE STRATEGIC ASSET LIFECYCLE ELEVATE PERFORMANCE & LOWER COSTS LIFECYCLE
ELEVATE PERFORMANCE & LOWER COSTS
Transformative CMMS &LOWER Asset • increase utilization, availability, ELEVATE PERFORMANCE & COSTS Management, designed exclusively Transformative CMMS & Asset and uptime with automated • increase utilization, availability,
Now more than ever, Healthcare organizations new ways to Now more thanmust ever,find Healthcare increase operational efficiency, organizations must find new ways to more quality, than ever, Healthcare improveow service increase operational efficiency, organizations must find new reduce equipment capital spend improve service quality, ways to increase operational andefficiency, cutequipment operational costs. reduce capital spend improve service quality, reandduce cut operational costs. spend and cut equipment capital Managing the costs. full asset lifecycle – operational from pre-assessment Managing the full assetthrough lifecycle – acquisition and support to final from pre-assessment through Managing the full asset lifecycle – from dispositionand – is support the onlyto way to truly acquisition final pre-assessment through acquisition know and reduce of and disposition – is thethe onlytotal waycost to truly support to fi nal disposition – is the ownership for your assets. know and reduce themedical total cost of only way to truly know and reduce the total ownership for your medical assets.
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cost of ownership for your medical assets.
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for Healthcare,designed enables exclusively organizations Management, workflows assignments and uptime of with automatedand • increase utilization, availability, CMMS organizations & Asset to:Transformative for Healthcare, enables escalations. workflows of assignments and and uptime with automated Management, exclusively for • automatedesigned Alternative Equipment to: • escalations. make data-driven decisions on workflows of assignments and Healthcare, enables(AEM) organizations to: Maintenance • automate Alternativeprograms. Equipment equipment purchase and on • make data-driven decisions escalations. • automate Alternative Equipment • Maintenance track, identify, respond, and (AEM) programs. replacement informed by equipment purchase and • make data-driven decisions on Maintenance (AEM) programs. mitigate medical device and utility • track, identify, respond, and reliability algorithms replacement informed by realequipment purchase and from • track, identify, respond, and systems security risks. mitigate medical device world work order by data. reliability algorithms from realreplacement informed mitigate medical deviceand andutility • systems optimize the equipment and service security risks. • world ensure compliance with reliability algorithms utility systems security risks. work order from data. experience. • optimize the the equipment real-world work order data. •request optimize equipmentand andservice changing policies, laws, • ensure compliance with and • request improve equipment lifecycle • ensure compliance withlaws, changing service request experience. experience. regulations. changing policies, and policies, laws, and regulations. • improve equipment lifecycle decisionsequipment with peer lifecycle and system• improve regulations. with peer and sysleveldecisions datawith maintenance and decisions peer and systemEXPLORE NOW ► tem-level data maintenance and operating cost data. level data maintenance and EXPLORE NOW ► operating cost data. operating cost data.
ACCRUENT | DIGITAL SUPPLEMENT
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ARTICLE ARTICLE
CREATING A COMPLETE ASSET CREATING A COMPLETE MANAGEMENT PROGRAM ASSET
CREATING A COMPLETE MANAGEMENT PROGRAM ASSET MANAGEMENT PROGRAM
proforma. Healthcare Technology Management in your database, having input (HTM) and Healthcare Facilities into purchasing contracts, etc. While this is very detailed and Management (HFM) departments ownership (TCO) and engaged projectedand capturing them possible inclusion Technology complicated, a highly have ealthcare long provided key post-ManLet’s review the for asset life cycle and utilization in some version of a proforin your database, having input into agement (HTM) and Healthbusiness-savvy HTM or HFM acquisition support and how you can contribute to each ma. purchasing contracts, etc. care Facilities Management department can provide background management of medical equipment segment. this is to very detailed andproforma. (HFM) departments haveplanned long providandWhile knowledge lend significant and facilities assets with and Healthcare Technology Management in your database, having input complicated, a highly engaged ed key post-acquisition support and value to this process. Having and corrective maintenance throughout TECHNOLOGY ASSESSMENT (HTM) and Healthcare Facilities into purchasing contracts, etc. business-savvy HTM or industry HFM departLet’s review the asset life cycle and how management of medical equipment connections with other peers their useful life. While these are This function entails a review of While this is ment can provide background and you can contribute to each segment. and facilities assets with planned and Management (HFM) departments in organizations that have already extremely important functions, there emerging technologies and knowledge to lend cant value to corrective maintenance throughout implemented thesesignifi technologies can are some missed technology advancements to the asset complicated have longsignificant provided key postLet’s review life cycle and this process. Having connections with TECHNOLOGY ASSESSMENT their useful life. While these are exprovide insight into the TCO and opportunities if departments are not determine whether the latest and business-sav acquisition and howfor to high-dollar each other industry peers in organizations This function entails ayou review of contribute tremely functions, there are potential landmines. Your involvedimportant in all support phases of asset greatest equipment anycan given that have already implemented these emerging technologies and technology some significant missed opportunities finance department can also help department management—from of clinical or facility service line would management of pre-planning medical equipment segment. technologies provide insight into the advancements to determine whether the ifassets departments are not involved with revenuecan projections and other to the point of their final in all provide an advantage in patient care, and knowled and facilities assets with planned and TCO and potential high-dollar landlatest and greatest equipment for any phases of asset management—from financial analyses. Finding out who disposition. Being an integral part of productivity, or market share. Most to this mines. Your nance department can given clinical orTECHNOLOGY facility servicehave line aASSESSMENT pre-planning of assets to the point corrective maintenance throughout provides thisfiservice and gettingvalue the capital evaluation, assessment, top healthcare organizations also help with revenue projections and would provide an advantage in patient of their final disposition. Being an involved will raise your connections and receiving on the front areperson or group of people dedicated their usefulofprocesses life. While these This function entailsactively a review of other fi nancial analyses. Finding out care, or market integral the capital evaluation, visibility and value. end andpart reallocation and disposal to thisproductivity, either in Supply Chainshare. or in organizati extremely important functions, there emerging technologies and who provides this service and getting Most top healthcare organizations have assessment, and receiving processes processes on the back end brings specific clinical areas. Most also seek actively involved will raise your a person or group of people dedicated to on the front end and reallocation and As the ultimate additional to your missed assistance fromtechnology a consulting advancements are somevalue significant to managers of implemente visibility anditvalue. this either in Supply disposal processes the back end technology, makes perfect sense to organization. It alsoon solves a lot of organization or theirChain groupor specific provide insig opportunities if departments not areas. determine whether the latest and the ultimate managers technolclinical Most also seek assistance brings additional value tothat yourhave organi- are be aAscontributor rather than of just the longstanding challenges purchasing organization (GPO) to help potential hig ogy, makes perfect sense to be a from these a consulting organization or their zation. also a lot of longstandinvolved in solves all phases of asset with group that isgiven left to deal with the greatest equipment foritany plaguedIt many support departments, analyses. It usually involves contributor rather than just the group group purchasing organization (GPO) ing challenges that have plagued many bad serviceline cost and aftermath of a finance such as knowing what’s coming and an assessment of return on depa management—from pre-planning of clinical or facility service would that is left to deal with the service cost to help with (ROI), these analyses. usually support departments, as knowing investment decision. when being notified ofsuch all equipment the total It cost of assets to the point their provide an advantage patient andin aftermath of acare, bad decision.with revenue involves an (TCO) assessment of return on what’s coming and when of being notified acquisitions, and capturing them forfinal ownership and projected investment (ROI), the total cost of of all equipment acquisitions, and financial ana possible inclusion utilization version of a or market share. Most disposition. Being an integral part of in some productivity,
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the capital evaluation, assessment, and receiving processes on the front end and reallocation and disposal
DIGITAL SUPPLEMENT | ACCRUENT 4
DIGITAL SUPPLEMENT | ACCRUENT
provides this top healthcare organizations have a SPONSORED BY ACCRUENT actively invo person or group of people dedicated visibility and SPONSORED BY ACCRUENT
PROJECT MANAGEMENT PROJECT Whether aMANAGEMENT single hospital or an PROJECT MANAGEMENT
Even a simple purchase order (PO) is Which devices are out of support (OOS) from the manufacturer? Which Even a simple order (PO) is a contract andpurchase a vendor ships Which devices outthe ofmanufacturer? support contracts. Even aifsimple purchase order support (OOS)are from devices thatthe exceed their AHA life or (OOS) from manufacturer? aproduct contract if and aPO vendor ships ships onand that that vendor is (PO) is a contract if a vendor Which devices that exceed theirWhich AHA are or OOS but stillbut dostill a good of or devices that exceed their life product onthat thatby PO that vendor legally on bound the terms and product PO that vendor is is life are OOS doAHA ajob good job delivering their primary function are OOS but still doprimary a good function job of ofof legally bound bythe theterms terms and conditions contained on and the PO. legally bound by of delivering their patientcare care relative newtechnology delivering their primary function of conditions contained onthethe PO. More extensive andoninvolved conditions contained PO. More patient relative totonew technology and are supportable with patient relative with to new More extensive and involved purchasing such as a extensive andcontracts involved purchasing and arecare supportable second source • increase availability second source parts? Which Transformative CMMS Asset technology anddevices are supportable with purchasing contracts such as a your contracts such asutilization, a strategic agreement parts? Which are still&devices within strategic agreement between are still within their usable life, but • increase utilization, availability and uptime with automated second source parts? Which Transformative CMMS &devices Asset Management, exclusively between your organization and their usable life, butdesigned are costing the strategic agreement between ayour organization and a particular areManagement, costing the organization a relative lot are still within usable life, butto and uptime with automated workflows of assignments and designed exclusively for Healthcare, enables particular vendor, provide a tremenorganization atheir lot to maintain organization and a tremendous particular vendor, provide maintain relative to the norm? are costing theWhich organization a lotWhich to workflows of assignments and escalations. for Healthcare, enables organizations to: dous opportunity to negotiate uptime to the norm? devices have been vendor, provide a tremendous opportunity to negotiate uptime devices have huge drains on maintain relative to theresources norm? Which • escalations. make data-driven decisions on organizations to: • drains automate Alternative Equipment requirements, service levels, parts and huge onbeen service that opportunity to negotiate uptime requirements, service levels, parts service resources that your devices have been huge drains on • make data-driven decisions on equipment purchase and • organization automate Alternative Equipment Maintenance (AEM) labor discounts, service training, and your should notprograms continue requirements, serviceservice levels, parts and labor discounts, organization should not continue to service resources that your equipment purchase and replacement informed by (AEM) programs • Maintenance track, identify, respond & mitigate access to diagnostic software. You to buy? and labor discounts, service training, and access to diagnostic buy? organization should not continue to replacement informed by reliability algorithms from realmust develop a very strong relationship • track, identify, mitigate training, medical devicerespond security&risk and access diagnostic software. You mustto develop a very buy?• medical with your Capital Purchasing Departreliability algorithms from realworld work order security risk optimizedevice the equipment and software. You must develop a Capital very strong relationship withdata. your ment•or Supply Chain group to ensure world work order data. ensure compliance with • optimize the equipment and service request experience strong relationship with your Capital Purchasing Department or Supply that•you have compliance a voice in these negotiawith changing laws andhave request experience • service improve equipment lifecycle Purchasing Department or Supply Chainensure group to policies, ensure that you tions. changing Service terms and discounts can Which devices pose risk to Which devicesequipment pose safety risksystemto lawsyou andhave regulations • improve lifecycle decisions withaasafety peer and Chain group to policies, ensure that a voice in these negotiations. have a huge impact on the organizapatients or staff, if not replaced? These patients or data staff, if not replaced? Which devices pose apeer safety risksystemto regulations decisions with and level maintenance and aService voice interms theseand negotiations. discounts can tion’s bottom line, your equipment are alllevel questions good HTM HFM These are questions goodand HTM and patients or all staff, if notdata. replaced? data maintenance and operating cost Service terms and discounts have a huge impact on the maintenance budget, and your can equipdepartments should readily beHTM ablebe to HFM operating departments readily These are all questions good and costshould data. have aTCO. huge Again, impact onnot the organization’s bottom line, your ment’s do wait to be answer and will contribute to your able departments to answer andshould will contribute HFM readily beto organization’s bottom line, your equipment maintenance budget, invited to the negotiating table. Set up organization making the best possible yourtoorganization the bestto able answer andmaking will contribute equipment maintenance budget, and your equipment’s TCO. Again, a meeting with the individuals that capital replacement decisions. Do not possible capital replacement your organization making the best and your equipment’s Again, do not wait to be invited tothe the provide this function andTCO. sell wait to be asked for thistoinformation. decisions. Do not wait be asked for possible capital replacement do not wait to be invited to the negotiating table. Set up a meeting benefi ts that you can bring by being Make sure you have solid data and offer this information. Maketosure you have decisions. Do not wait be asked for negotiating table. Setthat up aprovide meeting withofthe part theindividuals process. it upinformation. as a resource toityour leadership. solid data and offer up as a resource this Make sure you have If with the individuals that provide this function and sell the benefits you do not have this data readily to your youasdoa resource not have solid dataleadership. and offer itIf up EQUIPMENT ACQUISITION available today, Data this and sell benefits thatfunction you can bring bythe being part of this data readilyAccruent’s available today, to your leadership. If you do not have Another benefi t of having a rock-solid Insights can provide data that compares that you can bring by being part of the process. Accruent's Dataavailable Insights can provide this data readily today, relationship your base your against data on the process.with your Supply Chain data equipment that compares equipment Accruent's Data Insights can provide group is having ACQUISITION the ability to develop a over 10,000 unique models, drawn from basethat against data onyour overequipment 10,000 EQUIPMENT data compares process for notifi cation on every over 1,700 hospitals. unique models, from over base against datadrawn on over 10,000 EQUIPMENT ACQUISITION Another benefit of having a rockequipment acquisition. This isa importMost healthcare organizations have 1,700 hospitals. unique models, drawn from over Another benefit ofwith having rocksolid relationship your Supply ant not only with capital but non-capia capital committee of some sort that 1,700 hospitals. solid with the yourability Supply Chainrelationship group is having to tal, trial, and rental equipment as well. consists of fi nancial, administrative, Most healthcare organizations have a Chain group is having ability to develop a process forthe notification and clinical representation. Find outa capital committee of some sort that Most healthcare organizations have develop process foracquisition. notification on everya equipment who that group is and get involved. consists of financial, administrative, capital committee of some sort that on every equipment This is important notacquisition. only with Knowing is important to them and clinical representation. Find out consists ofwhat financial, administrative, This is important not onlytrial, withand capital but non-capital, and how they prioritize (i.e., safety, whoclinical that group is and get involved. and representation. Find out capital but non-capital, trial, and rental equipment as well. throughput, additional revenue, or Knowing what isisimportant to them who that group and get involved. Being an integral part of the rental equipment as well. growth will help you and howopportunities) they is prioritize (i.e., safety, Knowing what important to them capital evaluation, assessment understand how you can best bring throughput, revenue, or and how theyadditional prioritize (i.e., safety, value to that group. They will welcome growth opportunities) will help you throughput, additional revenue, or and receiving Being an integralprocesses part of the on the the information willbest helpbring raise understand howand youitcan growth opportunities) will help you Being an integral part of the capital evaluation, assessment front end and reallocation and your and value. valuevisibility to that group. They will bring understand how you can best capital evaluation, assessment and receiving processes on the welcome thegroup. information and it will value to that They will disposal processes on the and receiving onand the back front end and processes reallocation help raisethe your visibility and welcome information andvalue. it will front and reallocation and disposal processes on thevalue back to your endend brings additional CONTRACT NEGOTIATIONS help raise your visibility and value.
STRATEGIC ASSET ASSET LIFECYCLE LIFECYCLE STRATEGIC ELEVATE PERFORMANCE & LOWER COSTS
integrated delivery network (IDN), Whether single hospital Whether a asingle hospital oror anan integratthere is always some construction delivery network (IDN), edintegrated delivery network (IDN), there is goingis on, whether is building there always someit construction always some construction going on, additions, remodeling, new clinics, going on, is building whether it iswhether buildingitadditions, or new hospitals. This again is a additions, remodeling, new clinics, remodeling, new clinics, or new function where numerous or new more hospitals. This is a where Now than ever, Healthcare hospitals. This again is aagain function equipment decisions are made. function where numerous Now more than ever, Healthcare organizations must find new numerous equipment decisions areways Whether your organization hasways its equipment decisions are organizations must findmade. new to increase operational efficiency, made. Whether your organization has own project management team your organization has its itsWhether own project management team or to increase operational improve service quality,efficiency, and or contracts with an outside firm, most own project management team or contracts with an outside fi rm, most improve service quality, andspend, reduce equipment capital Attainia partner with a company like contracts with an outside firm, most partner with a company like Attainia reduce capital and cutequipment operational costs.spend, to to provide a standard template and Attainia partner with a company like provide a standard template and and cut operational costs. equipment to start with. to providefootprint a footprint standard template and equipment to start with. From Managing the full asset lifecycle – From the group work with equipment footprint towill start with. there thethere group adminisManaging thewill fullwork assetwith lifecycle – from pre-assessment through administrators and clinical and with From there the group will work trators and clinical and facilities from pre-assessment through acquisition and support to final facilities to leadership to amend administrators andthat clinical and that leadership amend footprint. acquisition and to final disposition – is support the only way to truly footprint. Getting facilities leadership tocan amend thatcan Getting involved earlyinvolved helpearly drive disposition – is the only way to truly know and reduce the total cost of help driveGetting standardization, planscan for footprint. early standardization, planinvolved for network know and reduce the total cost of ownership for your medical assets. network identify help driveintegration, standardization, plans for integration, and identifyand potential ownership for your medical assets. potential service andand installation network identify service andintegration, installation issues that could issues that could preclude aexpenses lot of potential service and installation preclude a lot of unnecessary unnecessary expenses down issues that could preclude aby lotthe of down the road. Working side side road. sidehelp by down side readily with unnecessary the this with thisWorking groupexpenses can you groupWorking can help youby readily identify road. side side your with this identify what is coming into what is coming into your in facilities group can helpit you readily identify facilities, when is coming and whenisitthe is coming inyour and facilities provides what coming into provides ability to plan strategies theresources ability totoplan when it is coming instrategies and provides and ensure that alland that resources to ensure that all and that the abilityisto plan strategies equipment properly installed, is equipment isensure properly resources thatinstalled, alldatabase, that is captured in to your equipment captured inisayour equipment equipment properly installed, is and is put on regular maintenance database,inand put on a regular captured youris equipment schedule.
ELEVATE PERFORMANCE & LOWER COSTS
maintenance database, and schedule. is put on a regular maintenance schedule.
CAPITAL PLANNING
CAPITAL CAPITAL One ofPLANNING thePLANNING biggest values an One ofofthe values anan HT/HFM HT/HFM team can provide to its One thebiggest biggest values team can provide to its organization organization to bring to bear HT/HFM teamiscan provide to itstheis toorganization bringthat to bear data that indicates data indicates where that is the to bring to bear the where that organization should organization should applythat forapply its data that indicates where for its limited capital funding it have will limited capital funding so for it so will organization should apply its have the biggest impact. the biggest impact. limited capital funding so it will have Which devices are oldest compared the biggest impact. toWhich the estimated useful life? compared While the devices are oldest American Hospital Association (AHA) to the devices estimated While Which areuseful oldestlife? compared provides useful category information the American Hospital to the estimated useful Association life? While for calculating depreciation, real-world (AHA) provides useful Association category the American Hospital useful life will vary by manufacturer information foruseful calculating (AHA) provides category and model. Which devices are out life of depreciation, useful information forreal-world calculating
will vary by manufacturer and model depreciation, real-world useful life
will vary byBY manufacturer SPONSORED ACCRUENT and model SPONSORED BY ACCRUENT SPONSORED BY ACCRUENT
ICONTRACT am not talking about service conNEGOTIATIONS tracts here, but rather I am not talking about purchasing service CONTRACT NEGOTIATIONS
here, about but rather purchasing I contracts am not talking service contracts.here, but rather purchasing contracts contracts.
disposal processes onvalue the back end brings additional to organization end brings additional value to your organization your organization
ACCRUENT | DIGITAL SUPPLEMENT DIGITAL SUPPLEMENT | ACCRUENT 5
DIGITAL SUPPLEMENT | ACCRUENT 5
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How many devices are in your inventory that you have the responsibility to maintain that fall below the capital threshold? In most organizations that represents a significant number of devices. How many devices were brought in on a trial that somehow never left? How can you ensure that you are capturing all those items and getting them on your inventory? You should strive to create automated notifications of all capital equipment acquisitions through an online process for both capital and non-capital. It is vitally important to sell the benefits to Supply Chain and work with them to co-develop the processes to ensure you have visibility of every medical device acquired. The first requirement of any successful Joint Commission or DNVGL survey is a complete and accurate equipment inventory. It becomes nearly impossible to provide that if you don’t have these processes in place. You can virtually eliminate the instances of finding equipment in departments that have snuck in without you knowing about them.
Clinical engineering veterans say that effectively managing medical equipment requires a wellconceived strategy with Biomed playing a role even before specific devices are purchased
RECEIVING More often than not, the procedure for receiving medical equipment amounts to a box-counting exercise. No one that works in distribution management has the expertise to determine whether 6
DIGITAL SUPPLEMENT | ACCRUENT
everything on the packing slip is actually there. So they will count the boxes and mark the shipment into your materials management information system (MMIS) without validating that what is supposed to be there actually is. Then they will either deliver it to CE or the clinical department for them to figure out if everything is present. If it is delivered to the clinical department, you may not be notified in every instance. That process can create many issues, especially if there are installations and timelines scheduled around the delivery. By setting up a process that gives your department access to MMIS and having your team do the receiving into the system, it ensures two things: 1. All equipment is either delivered to your department or you will receive notification that the item has been delivered and needs to be checked in. This is an important part of getting everything into your database and risk ranked for possible inclusion on a maintenance schedule. 2. Everything on the packing slip is verified before it is officially received. This represents no additional work for your staff other than accessing your MMIS, since they would perform the check-in function anyway, provided they are aware of the delivery. Here is another example of the importance of having a great relationship with Supply Chain. A check with your internal audit group to ensure that segregation of duties is maintained is also recommended. Good accounting and financial practices dictate that issuing a PO for goods or services, receiving those goods or services, and approving the PO for payment are performed by different individuals or departments to prevent malfeasance.
INSTALLATION AND ACCEPTANCE TESTING Most vendors of major fixed medical equipment have an acceptance form that the customer signs, verifying the unit is properly installed and working. This typically initiates the release of the final payment or start of lease payments if the item is being leased. By developing your own acceptance form with a checklist and having your department be an integral part of this function, it ensures that the proper steps have been followed, the installation has been completed from an engineering as well as a clinical perspective, and validates all contracted acceptance criteria have been met. It also helps ensure you meet the regulatory requirements related to placing equipment into service. There should also be language on your POs that indicate the warranty clock does not start until the unit has been clinically accepted. Most vendors start the warranty clock when the unit leaves their dock. This may not seem like a huge deal in most cases. However, if you are receiving and staging products for a project, there could be months of warranty burned without the device ever being put to the test or providing benefit to a patient.
DEVICE REPAIR AND ANALYSIS We have now gotten to the point where most HTM and HFM departments begin their asset management process. You’ve got the item inventoried and you either begin providing direct support of the device over its useful life, or you manage the contract that does the same. During this phase, you should collect and analyze all the data relevant to the support of the device, beyond the typically reported environment of care (EOC) metrics, such as planned maintenance (PM) completion, user errors, in-use equipment, and “unable SPONSORED BY ACCRUENT
TRANSFORMATIVE CMMS DESIGNED TRANSFORMATIVE CMMS DESIGNED EXCLUSIVELY FOR HEALTHCARE EXCLUSIVELY FOR HEALTHCARE • •• •• •• •• • • •
Consolidate HTM, HFM, IT, and more to a single user experience Automate Alternative Equipment Maintenance (AEM) Consolidate HTM, HFM, IT, and more to a single user experience Build automation with drag and drop workflow and report creation Automate Alternative Equipment Maintenance (AEM) Medical Device Cybersecurity Build automation with drag and drop workflow and report creation Request Management Medical Device Cybersecurity WATCH DEMO ► Customer Management Request Management WATCH DEMO ► Customer Management
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DIGITAL SUPPLEMENT | ACCRUENT 7
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care (EOC) metrics, such as planned maintenance (PM) completion, user errors, in-use equipment, and “unable to locate” (UTLs). Do you know all of the expenses incurred over the life of a including labor, and todevice, locate” (UTLs).parts, Do you know all costs?incurred Do you track, ofcontract the expenses over the life and report uptime on the ofmonitor, a device, including parts, labor, and contract costs? Do you track, major modalities you support? monitor, and response report uptime onIfthe What about times? you major modalities you support? support more than one facility,What do about response times? you benchmark similarIf you support more than oneto facility, do you departments identify benchmark similar departments to opportunities for cost reductions? identify opportunities for cost Are there opportunities in the reductions? Are there opportunities parts acquisition realm? Are you in the parts acquisition realm? Are getting the best price and quality you getting the best price and quality on your replacement parts? Do you on your replacement parts? Do you track dead-on-arrival (DOA) rates track dead-on-arrival (DOA) rates on on parts and thereby steer clear of parts and thereby steer clear of parts parts vendors that have higher vendors that have higher DOA rates, DOA rates, which cost you uptime which cost you productivity, productivity, andcustomers? good will and good will uptime with your with your alltrack Having all customers? the data youHaving need to the data youand need to track service service costs performance, and costsusing and performance, and imthen then that data to drive using that data to drive provements in both will protect you improvements in both willItprotect from outside competition. will also give you many opportunities to It you from outside competition. promote your department’s value to will also give you many your leadership and allow you to opportunities to promote your expand and take on new challenges. department’s value to your The more readily available inforleadership and allow you tothis expand mation is to your customers and and take on new challenges. The leadership, theavailable better. Ifthis you are more readily doing the right things, transparency information is to your customers is a good thing. Once again, here is and leadership, the better. If you where Data Insights can also provide are doing the right things, valuable comparison data. transparency is a good thing. Once again, here is where Data Insights can also provide valuable comparison data.NEGOTIATIONS AND SERVICE CONTRACT
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MANAGEMENT SERVICE CONTRACT Hopefully, your team is involved in NEGOTIATIONS AND the negotiations for every service MANAGEMENT contract for the equipment you Hopefully, your team is involved in manage. First and foremost, evaluate the negotiations for every whether you can provide theservice same service better, faster, cheaper. contract for the equipment youIf not, work with clinical department leadership to help outline all the specific deliverables of the contract. 8 DIGITAL SUPPLEMENT | ACCRUENT What does the contract include in the way of software and hardware
?
of
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DIGITAL SUPPLEMENT | ACCRUENT
manage. First and foremost, evaluate whether you can provide the same service better, faster, cheaper. If not, work with clinical department leadership to help outline all the specific deliverables of the contract. the you updates? SimilarWhat to thedoes metrics contract in the of should beinclude collecting andway tracking for your own and service, what is the software hardware updates? vendor’s performance Similar tomeasured the metrics you shouldand be guaranteed uptime? How it own collecting and tracking forisyour measured and is reported? The same service, what the vendor’s questions apply for response measured performance and time. Look closelyuptime? at exclusions. guaranteed How isWhat it are the coverage hours? Can you measured and reported? Theget same discounts on labor outside of the questions apply for response time. coverage hours? If it is a shared-serLook closely at exclusions. What are vice agreement, make sure each the coverage hours? Can you get service group’s responsibilities are discounts on labor outside of the clearly outlined. coverage hours? If it is a sharedservice agreement, make sure each service group’s responsibilities are clearly outlined.
RECALLMANAGEMENT MANAGEMENT RECALL Most of of us us have a good handle onon Most have a good handle taking care care of of the the recalls recalls and taking and hazard hazard alerts alerts that that involve involve replacing replacing aa component on a device component on a deviceand andmailing mailing back a response card to the back a response card to themanufacturer to close ittoout. What about the manufacturer close it out. What alerts that outline a potential safety about the alerts that outline a risk by using a device wrong potential safety risk bythe using a way or using the wrong supply item with device the wrong way or using the it? Do you have a process that wrong supply item with it? Do you ensures a high level of accountability have a process that ensures a high for follow-through and completion level of accountability for followwith your clinical department? If through and completion with your not, spend some time with your risk clinical department? If not, spend management leadership to develop somea time withThis yourprocess risk such process. needs to management leadership to clinical develop identify individuals in each suchwho a process. process needs area would This be responsible for to identifythe individuals in each receiving notifications and clinical area who wouldconfirmation be providing documented responsible of follow-up.for receiving the notifications andlevel providing Without this of accountability and closure,confirmation you have noof assurdocumented followance that any action was taken. up. Please beware: Accountability is not always a popular thing, especially in a busy workplace. But it is absolutely necessary for an effective process.
Without this level of accountability and closure, you have no assurance that any action was taken. Please beware: Accountability is not always a popular thing, especially in a busy workplace. But it is absolutely necessary for an effective process. ASSET REALLOCATION/DISPOSAL Once you or your clinical customer has determined a device is no longer ASSET REALLOCATION/DISPOSAL being utilized or being grossly Once you or yourisclinical customer underutilized, what happens? has determined a device is noDoes it sit in a hallway or a storage room longer being utilized or is being collecting dust and depreciating to grossly underutilized, what the point where there is no value happens? Does it sit in a hallway or left? Hopefully, is not dust the case. a storage room this collecting and HTM and HFM departments tend to depreciating to the point where know where the needs are in a there is no value left? Hopefully, hospital. Helping to develop a this is not the case. HTM and comprehensive program that makes HFM departments tend to know available capital resources visible to where the needs are in a hospital. all clinical areas has a huge impact Helping to develop a capital on maximizing limited comprehensive programathat makes funding. It also provides mechaavailable capital resources visible to nism for sale, donation, or proper all clinical areas has hugethat impact and legal disposal of aitems no on maximizing limited capital longer have value to your organizafunding. It also provides tion. In many cases, thereais an mechanism to fornot sale, donation, or opportunity only generate revenue theitems cost of proper but and also legaleliminate disposal of deinstallation disposal that is a that no longerand have value to your financial drain on your organization. organization. In many cases, there is This is an asset management and it an opportunity to not only generate cannot be truly effective without revenue but also eliminate the cost your department’sand involvement. of deinstallation disposal that is You may ask the at this a financial drain onquestion your point, “How do I find time to organization. This is an asset do all this stuff?” On many of the funcmanagement and it cannot be truly tions outlined, you are already effective without your department's spending time dealing with issues involvement. generated by not having an effective You may ask the question at this and proactive process in place. point, “How do I find time to do all Spending the time upfront in manthis stuff?” many of the you, agement andOn planning saves functions are already your staff, outlined, and your you organization spending time dealing issues time, money, and stress with in the long generated by how not having an you run. Tracking much time effective andspending proactiveonprocess in are currently place. Spending the time upfront less-than-optimal processes is the in management and planning first place to start. You may saves find that a better you,implementing your staff, and your process will save you time no additional organization time,and money, and resources will be required. For some stress in the long run. Tracking how ofmuch the more processes, such time involved you are currently as reallocation and disposal, work with your leadership to put a SPONSORED BY ACCRUENT business plan together to get the resources you need. With the right SPONSORED BY ACCRUENT
MI’s You may find that implementing a egulations better process will save you time ttee, and and no additional resources will be required. For some of the more y Nowinvolved processes, such as more than ever, Healthcare
• increase utilization, availability Transformative CMMS & Asset reallocation and disposal, work and uptime with automated Management, designed exclusively organizations must find new ways spending on less-than-optimal with your leadership to put a workflows of assignments and for Healthcare, enables to business increase operational efficiency, processes is the first plan together to getplace the to start. escalations. organizations to: improve service quality, and the right resources you need. With You may find that implementing a • make data-driven decisions on • automate Alternative Equipment reduce equipment capitalnot spend, spending on less-than-optimal justification, itprocess should be a real better will save you time equipment purchase and ABOUT THE AUTHOR Maintenance (AEM) programs it should andjustification, cut sell, operational costs. not to processes is of theHealthcare first place to start.atinformed by hard demonstrates andand no itadditional will beAlanidentify, Gresch isrespond Vice President Strategy replacement • track, & mitigate be a real hard sell, and resources it your leadership that you are You may find that implementing a required. For some of the Accruent andsecurity has heldrisk executive leadership roles atalgorithms reliability from realdevice demonstrates to your leaderManaging the to fulldoing asset lifecycle – more medical committed what is best better process will save you time Alpha Source, TriMedx, and Alexian Brothers Health involved processes, such as world work order data. • optimize the equipment and ship that you are committed from • increase utilization, availability Transformative CMMS & Asset forpre-assessment the organization, even ifHealthcare it Now more thanthrough ever, andofnothe additional resources will be System. He ledexperience one nation’s premier Clinical • ensure compliance with request reallocation and disposal, work service acquisition and support to final to doing what is best for the and uptime with automated Management, designed exclusively means a departuremust fromfind or new ways Engineering programs required. For some of Care the more organizations at Aurora Health in policies, changing laws and lifecycle with your leadership to put a • improve equipment disposition – is the only way to truly organization, even if it means workflows of assignments and expansion of your historical role. for Healthcare, processes, as Milwaukee, WI, involved was a enables former chair of such AAMI’s to increase operational regulations and system• Transformative CMMS & Asset plan know andbusiness reduce the total cost efficiency, of to get thedecisions with peer a departure from ortogether expanNow more than ever, Healthcare Healthcare Technology Leadership Committee, and escalations. organizations to:and reallocation and disposal, work improve service and the right level data maintenance Management, designed exclusively ownership for your medical assets. resources youquality, need. With sion of your historical role. organizations must find to new 2019 Healthcare Technology authored thedata. • make data-driven decisions on with your leadership putways a • automate Alternative Equipment reduce equipment capitalnot spend, operating cost for Healthcare, enables justification, it should be a real to increase operational efficiency, for Management Manual business plan together to get the equipment purchase and ABOUT THE AUTHOR Maintenance (AEM) programs andhard cut sell, operational costs. organizations to: improve service quality, and and it demonstrates to AAMI. agresch@accruent.com resources youPresident need. With the rightreplacement Alan Gresch isrespond Vice of Healthcare Strategy at informed by Equipment • track, identify, & mitigate • • automate Alternative reduce equipment capitalnot spend, your leadership that you are justification, it should be a real Accruent and has held executive leadership roles at reliability algorithms from realmedical device security risk Managing the full asset lifecycle – ABOUT THE AUTHOR Maintenance (AEM) programs and cut sell, operational costs. committed to doing what is best and it demonstrates Alphahard Source, TriMedx, and Alexian to Brothers world work order • optimize the equipment and Alanidentify, Greschdata. isrespond Vice President of Healthc from through • Health track, & mitigate forpre-assessment the organization, even if it your leadership that you are System. He led one of the nation’s premier Clinical • ensure compliance with service request experience Accruent and has held executive leader medical device security risk acquisition and support to final Managing the to fulldoing assetwhat lifecyclebest – means a departure from or committed Engineering programs at AuroraisHealth Care inoptimize changing policies, laws and Alpha Source, TriMedx, and Alexian Bro • improve equipment lifecycle • the equipment and disposition – is the only way to truly from pre-assessment through expansion of your historical role. forwith theWI, organization, even if it of AAMI’s Milwaukee, was a former chair System. He led one of the nation’s prem regulations decisions peer and system• service request experience know and reduce the total cost of acquisition support to final meansTechnology a and departure from or Committee, and Healthcare Leadership Engineering programs at Aurora Health level data maintenance and • improve equipment lifecycle ownership for your medical assets. disposition – is only way torole. truly expansion ofthe your historical Healthcare Technology authored the 2019 Milwaukee, a former decisions with WI, peerwas and system-chair of A operating knowcost anddata. reduce the total cost of Management Manual for Healthcare Technology Leadership Com level data maintenance and ownership for your medical assets. 2019 Healthcare Technolo authored the AAMI. agresch@accruent.com operating cost data. Management Manual for AAMI. agresch@accruent.com
EPARTMENTS SERIES
10 STEPS TO MAKE YOUR HTM & HFM DEPARTMENTS A STRATEGIC ASSET WEBINAR SERIES
10 STEPS TO MAKE YOUR HTM & HFM DEPARTMENTS 10 STEPS TO MAKE YOUR HTM & HFM D A STRATEGIC ASSET WEBINAR SERIES A STRATEGIC ASSET WEBINAR Step 1
Step 6
Global data standardization & master
Parts & supplies management &
data management.
procurement.
Step 2 System-wide administration, security, policies & procedures.
Step 7 Third-party service management.
Step 3
Step 8
Asset & work order management.
Environment of care (EOC) rounding. DIGITAL SUPPLEMENT | ACCRUENT 9
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Step 4 Regulatory compliance & preventive maintenance.
Step 9 Interoperability & automation.
Step 5
Step 10
Service performance management.
Enterprise performance management.
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DIGITAL SUPPLEMENT | ACCRUENT 9
ACCRUENT | DIGITAL SUPPLEMENT
9
ELEVATE PERFORMANCE & LOWER COSTS ELEVATE PERFORMANCE & LOWER COSTS DATA INSIGHTS
$100 BILLION IS SPENT BY HOSPITALS ANNUALLY FOR EQUIPMENT LIFECYCLE COSTS $100 BILLION
IS SPENT BY HOSPITALS ANNUALLY FOR EQUIPMENT LIFECYCLE COSTS
87% 87%
OF HOSPITALS INDICATE COST REDUCTION AS TOP PRIORITY OF HOSPITALS INDICATE COST REDUCTION AS TOP PRIORITY
54% 54%
OF HOSPITALS INDICATE THEY HAVE INSUFFICIENT DATA OF HOSPITALS
INDICATE THEY HAVE INSUFFICIENT DATA
Hospitals do not have access to reliable data on equipment to make informed decisions on new purchases, replacements, Hospitals do not have access to reliable data on equipment to service contracts, warranties, and maintenance headcount. make informed decisions on new purchases, replacements, Accruent Data Insights uses real data from 289 million work service contracts, warranties, and maintenance headcount. orders to provide independent reliability insights. Get access Accruent Data Insights uses real data from 289 million work to our exclusive, interactive web portal and data reports to orders to provide independent reliability insights. Get access help your organization reduce equipment downtime, drive to our exclusive, interactive web portal and data reports to better purchasing decisions, and support Value Analysis help your organization reduce equipment downtime, drive teams. better purchasing decisions, and support Value Analysis teams. Accruent Data Insights helps healthcare organizations be more efficient by delivering actionable equipment insights Accruent Data Insights helps healthcare organizations be using unbiased empirical reliability data that aids purchasing more efficient by delivering actionable equipment insights executives and final decision-makers in purchasing the best using unbiased empirical reliability data that aids purchasing equipment, negotiating the best deal, optimizing labor, or executives and final decision-makers in purchasing the best selecting the best service contract for their organization. equipment, negotiating the best deal, optimizing labor, or selecting the best service contract for their organization. GET SAMPLE REPORT ► GET SAMPLE REPORT ► SPONSORED BY ACCRUENT
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WATCH WEBINAR ► WATCH WEBINAR ►
76% 76%
OF HOSPITALS INDICATE RESOURCE CONSTRAINTS ARE OFAFFECTING HOSPITALSFINANCIAL INDICATE PLANNING AND ANALYSIS RESOURCE CONSTRAINTS ARE AFFECTING FINANCIAL PLANNING AND ANALYSIS
Approximately 10k Devices Age of Technology Approximately 10k Devices Reliability Scores/Analysis Age of Technology Life Expectancy Reliability Scores/Analysis Acquisition Price Life Expectancy Labor Cost and Acquisition PriceAnalysis Parts Cost Cost and and Analysis Analysis Labor Comparisons Parts Cost andwith Analysis Full TCO and COSR Comparisons with Benchmarks Capability Full TCO and COSR Security Vulnerabilities Benchmarks Capability Security Vulnerabilities
READ THE PULSE ► READ THE PULSE ►
LISTEN TO PODCAST ► LISTEN TO PODCAST ► DIGITAL SUPPLEMENT | ACCRUENT 7
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