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Toolbox for the New HTM Director (New, Upwardly Mobile, or Experienced)

Patrick K. Lynch, CCE, CBET, CPHIMS, HIT Pro/PW

GMI (Global Medical Imaging)Charlotte, NC

:MD ExpoReston, VirginiaApril 4, 2013

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People to always read on Biomedtalk or TechNation

ListservsMary Logan, President of AAMIWilliam Hyman, TSTC Professor retiredKaren WaningerDick FeltonJenifer BrownManny RomanDave DickeyGlenn ScalesRick HamptonPat Lynch, Blogger, writer

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Websites to visit Regularly

www.BMET.wikia.com www.CMIA.org www.NTBA.org www.AAMI.org www.patientysafety.org www.educationaltechnology.com www.Healthcarecommunication.com

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Terms to Know

SVR COSR CMMS CMS JC Risk-Based Preventive Maintenance (not

Preventative) BMET vs. CE HTM ROI ??

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Free Resources TechNation Magazine HTM Magazine 24x7 Magazine AHRA Free electroninc Journal TechRepublic Free Newsletter BiomedtalkListserv TechNation Listserv MedTech AdvanceWeb - Health Information Professionals AdvanceWeb - Imaging and Radiation Oncology Imagetalk Listserv LinacTalk Listserv AdvanceWeb Executive Insight Frank's Hospital Workshop ITC Magazine Radiology Management HTMA-SC CDC Blog Patient Safety (NPSF.org)

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Great Partners

DITEC Pronk GMI Dunlee

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Certifications to have

CBET CRES CLES CCE CPHIMS HIT Pro / PW A+ Net+ Sec+

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Paid Resources

ECRI Institute AAMI Membership Local Biomedical Association ACCE Membership Journal of Clinical Engineering Magazine Modern Healthcare HIMSS AHRA CLMA ASRT META Any Local Association within Driving Distance for Training

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LinkedIn Groups to Be a Member of

The AAMI Community META ACCE HIMSS AHRA BMET Wiki Medical Devices and the FDA X-ray & C-Arm Equipment Service Engineers Biomedical & Clinical Engineering Biomedical Specialist Clinical Engineering / HTM

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Rules of Thumb

Annual cost of a Service Contract runs from 18% to 25% COSR for contracts with manufacturer is 18% to 25% COSR with In-house Service Most Biomed Departments are in the basement. The average cost of each item is a complete inventory of a hospital

is about $11,000. The Average time to complete an electrical safety test is 15

minutes. The average number of items that can be excluded from PMs using

a risk-based analysis is 33%. The average PM takes about 40 minutes. The average Repair takes about 1.0 hour. Experienced Biomeds in the same job can take care of

approximately 10% more equipment each year. Staffing - Biomeds can maintain approximately 1.700 items or $5M

(general biomed equipment) or $12M for Imaging. The fully loaded cost of a Biomed is approximately $90.00 per hour.

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Healthcare IT Terms to Know

EMR E.H.R. CPOE CDSS DICOM HL7 Ping

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10 Goals to have1. Have a complete inventory of all patient care

devices at my hospital/health system

MonitoringCentral SterileIV PumpsXray RoomsPortable XrayMammoProcessors/printersLinear AcceleratorLaboratory automated analyzers Leased EquipmentScopesUltrasound XducersPotential future

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10 Goals to have

2. Assign Acquisition Cost to all equipment itemsWhy?

How do you compare yourself to others?

Bed size?Number of pieces of equipment?Scope of Work?Number of ORs?Number of Patient Visits?Number of Discharges?Patient Acuity?Square footage of buildings?Dollar value of Equipment Maintained?

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10 Goals to have

3. Consolidate all Equipment Maintenance under a single budget

Why?

HTM is the only professional maintenance manager in the hospital.

Control . . . .of what is doneof vendorsof service providersof coveragesof add-on chargesof when service is performedof costsof upgrades made to machines

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10 Goals to have

4. Know my Cost of Service Ratio (COSR)- Overall and by department and by equipment class

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10 Goals to have

4. Know my Service Value Ratio - Overall and by department and by equipment class

Metric Measure of

Value of Equipment Maintained

Volume of Work Required

Total Cost of Service

Cost to perform Work Required

COSR (Cost of Service Ratio)

Efficiency of maintenance operation

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10 Goals to have5. Have a BMET Training budget that is 5% of the total HTM Budget

BMET Training is an INVESTMENT, not a COST

$5M budget = $250,000 training = 15 people = $16.7k per

$10M budget = $500,000 training = 25 people = $20k per

1-2 weeks per technician

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10 Goals to have Where to get training?

Manufacturer Training Company (DITEC, RSTI, Laser Institute) Online Courses (Open Courseware, Prof Messer) Local Association National Association (AAMI, MD Expo) Nearby Association Free Magazines Paid Magazines

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10 Goals to have

6. No one in the hospital can sign a service agreement except the Director of HTM• All Service Agreements are paid

from the HTM Budget• Must have a policy that is signed

by both the CEO and the Director of Materials Management

• Never sign a service agreement for greater than 1 year.

• Any Contract can be cancelled with 90 day’s notice for any reason or no reason.

• Never bundle operating costs (reagents, service, supplies, training) in capital expenses (purchase, software, rebuilds, upgrades).

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10 Goals to have

7. Get free lifetime passwords and updates to all medical devices

Pre-purchase NegotiationAnything is possibleGet everything you can.Free school, updates, manuals, CDs, software upgrades, tools, test jigs, PM procedures, calibration procedures, tech support, etc., etc., etc.

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10 Goals to have

8. JC (or DMV or CMS) visits are a non-event for HTM and HTM staff

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10 Goals to have

9. Have a means to stop capital payments if all required items are not delivered.

How?

o Know Accounts Payable Persono What is his/her job?o Ask them to stop payment.o Done!

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10 Goals to have

10. Every customer in the hospital is delighted with HTM's performance (and the performance of all of the staff)

• Annual Customer Satisfaction Survey• Monthly Meetings with Major Customers• Open-door policy• Anonymous Comments Box• Above all, excellent service. FIX THE CUSTOMER.

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10 Goals to have1. Have a complete inventory of all patient care devices at my

hospital/health system2. Assign Acquisition Cost to all equipment items3. Consolidate all Equipment Maintenance under a single budget4. Know my Service Value Ratio - Overall and by department

and by equipment class5. Have a BMET Training budget that is 5% of the total HTM

Budget6. No one in the hospital can sign a service agreement except

the Director of HTM7. Get free lifetime passwords and updates to all medical

devices8. JC (or DMV or CMS) visits are a non-event for HTM and HTM

staff9. Have a means to stop capital payments if all required items

are not delivered.10. Every customer in the hospital is delighted with HTM's

performance (and the performance of all of the staff)

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Thank you For the complete Presentation, Come to

MD Expo, Reston, VA April 2,3,4

Free for all hospital employees www.mdexposhow.com/dc

Download complete Presentation after April 4, 2013 at

http://HTMA-SC.wildapricot.org

plynch@gmi3.com 704-941-0116 Watch my blog at www.gmi-blog.com