Who plans equipments..

Medical Technology Manager Job responsibilities:

Equipment planning Audit of current medical equipment

management practices Research & develop products & services that will benefit customers

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Educational Background
Bachelor in Engineering (Biomedical

engineering/Electronics) Masters in Engineering Science (Biomedical Engineering)

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Work Experience
1. Review of Capital Equipment Funding

Strategy for Hospitals 2. Hospitals Medical Equipment Project 3. Medical Equipment Asset Evaluation

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Introduction
When and why to buy what from

whom for how much! Avoid: buying what you dont need for a high price and at the wrong time Buying the right equipment, for the lowest price, for the right reasons and at the right time.

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Medical Equipment Technology

Technology to improve clinical

outcomes, reduce costs, and improve quality of life for patients Major asset of the health care industry Health care compression Increasingly important to manage medical equipment to control costs & improve quality & performance

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Why Plan?
A significant portion of equipment

(i.e. 25%-50%) that exists in developing countries cannot be used Main causes:
Lack of funds Improper management

Preventative Medicine approach

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Medical Equipment Planning Cycle

1. Planning- What? When? 2. Assessment- Why? Who? 3. Acquisition- How? Cost? 4. Disposition- What? When?

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Equipment Lifecycle
Installation Acceptance testing and approval Clinical Use Planned Maintenance and Unplanned

Maintenance (Corrective) Decommissioning/Disposition

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Medical Equipment Planning Cycle

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Medical Technology Advisory Committee (MTAC) Multi-discipline- clinical and non-clinical

staff Advises hospital strategic planning committee and capital budget committee Manage all medical technology including medical equipment planning process

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Equipment Planning
What? When? Systematic approach to determine the

hospitals equipment needs Need a complete, accurate and up-todate medical equipment inventory

Purchase Cost Purchase Date Equipment Type Department Name

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Medical Equipment Inventory

Prioritizing equipment needs and

determining equipment replacement; Identifying how and when maintenance is to be conducted and how much this costs; Utilization records; Maintenance and repair records; Acceptance testing; Ease in locating medical equipment; and Minimizing safety risks
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Planning Considerations
Clinical Effectiveness ii. Cost of Ownership iii. Strategic medical technology direction iv. Client and Medical Staff Perception
i.

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i. Clinical Effectiveness
Availability (MTBF) how often it breaks Downtime duration Age - over 7 years very difficult to get

parts from anywhere thus may result in longer downtimes Accuracy/Effectiveness of diagnosis and treatment Speed of procedure Spare critical equipment for emergency use
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ii. Cost of Ownership

Consumables consumption (cost,

volume and usage frequency) Speed (faster studies = more patient thorough put) Medical Expenditure Limit- Cost of Maintenance and Repair versus Replacement 2nd hand resale value/trade in price

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MEL Example
Grapht D t rm M Fa or fromP ce U ful LifeRe a o e e ine EL ct re nt se m ining
80 70 60

MEL Factor

50 40 30 20 10 0 20 30 55 65 70 80 100 0 5 10 15 25 35 40 45 50 60 75 85 90 95

Percent Useful Remaining Life

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MEL Case Studies

R e m a in i n g L i f e % U s e fu l E s tim a te d E q u ip m e n t M EL L i f e E x p e c t a nRc e m a i n i n g y R e p la c e m e n t L ME Type F a c to r (m n th s ) (m o n th s ) L ife o C ost U lt r a s o u n d 8 4 96 8 7 .5 65 7 , 0 0 0 , 0 0 05 5 0 , 0 0 4, MRI 0 72 0 10 4 5 , 0 0 0 , 0 0 4 5 0 ,0 0 0 0 C T Scanner 24 72 3 3 .3 2 6 .5 2 0 , 0 0 0 , 0 5 ,03 0 0 , 0 0 0 M o b ile aXy -r 48 96 50 40 9 0 0 , 0 0 0 3 6 0 ,0 0 0 U n it H e m o d ia ly s is 24 96 25 20 6 2 0 , 0 0 0 1 2 4 ,0 0 0 U n it

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iii. Strategic medical technology direction

Equipment standardization- bundled

consumables/service contracts/ ease of user training, etc Technology & lifecycle of the equipment Latest medical technology- marketing value Connectivity- internally and externally Mobility and portability- multi-location
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iv. Patient and Medical Staff Perception

Age Appearance Technical look/feel

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Advantages of Planning
Facilitates introduction of new

technology Standardization of equipment Coordinated purchasing approach Multiple site/facility service contract agreements

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2. Equipment Assessment
Why? Who? Collecting data for assessment
Lifecycle cost analysis Historical utilization and consumption data Installation and construction needs Manufacturers profile/background On-site demonstration, clinical trials & bench tests Upgrading current technology-forklift upgrade Alternative technologies

Involve ALL key stakeholders Well documented, transparent and 04/10/12

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Forklift upgrade
A forklift upgrade is considered a

large-scale upgrade where large parts of the existing infrastructure must be overhauled. A forklift upgrade requires investing in or buying new hardware and possibly the hiring or contracting of on-site technicians to complete

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Advantages of Assessment
Select the correct equipment to

purchase All the hospitals requirements will be met Quicken the assessment process for the same equipment type

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3. Equipment Acquisition
How? Cost? Manage the acquisition process
Investigate best acquisition option Refining quotations from equipment

suppliers Negotiating with suppliers

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Acquisition Options
Purchase Outright Operating Lease Finance Lease Vendor financing Rental (pay per use) Revenue sharing Group Purchase

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Group Purchasing Organizations (GPO)

Central body that manages the purchasing

process for its members Scope: medical consumables and medical supplies, pharmaceuticals, and medical equipment HIGPA (Health Industry Group Purchasing Association) reported Health care providers report they save between 10-15 % by channeling purchases through GPOs, totaling USD19-33.7 billion in savings for 2002
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Advantage of Managing Acquisition

Investigate best financial option for

the hospital Save money

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4. Equipment Disposition
Final step, but also the 1st step-

medical equipment planning & lifecycle Identification of equipment that can no longer serve its primary purpose Assessment of a secondary and/or tertiary purpose within the hospital Balance of the need for NEW versus USED
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Disposition Options
Relocation Trade-In Sell Donate Dispose/Scrap

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Advantages of Managing Disposition

Ensure complete and effective use of

equipment Asset is formally removed from the accounting records by Finance and Accounting

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Medical Equipment Planning Process (1)

1. Initial audit of existing medical

equipment in the hospital [January February] 2. Conduct a medical technology assessment for new and emerging technologies to fit with current or desired clinical services [March-April] 3. Planning for replacement and selection of new technologies [May-June]
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Medical Equipment Planning Process (2)

4. Prioritizing for technology acquisition

[July August] 5. Provide input to the capital budgeting process [SeptemberOctober] 6. Implement equipment acquisition and monitor ongoing utilization [ongoing] 7. Dispose of equipment [on-going]
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Example Short Term Project

Profile all medical equipment in the

hospital with a purchase cost above 50,000 Analyze utilization, technology trends, hospitals strategic and clinical directions Project their replacement costs into a 5-year capital expenditure plan

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Example of Long Term Capital Budget Planning

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Conclusion (1)
Medical equipment inventory
Complete Accurate Up-to-date

Set-up a Medical Technology Advisory

Committee Develop medical technology strategic direction

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Conclusion (2)
Develop in-house medical equipment

planning, assessment, acquisition and disposition policies and procedures Develop a 5-year major medical equipment capital budget

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Benefits of managing technology

ownership costs

Reduction in medical technology

Purchase cost Maintenance and repair costs Replacement parts and consumables cost User training cost

Increase in lifetime of equipment-

reducing capital expenditure Long term medical equipment capital budget expenditure Increase the availability of equipment, and reduce the downtime
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Excellent References
ECRI
(http://www.ecri.org)

MD Buyline
(http://www.mdbuyline.com/)

NHS Executive, The Management of

Medical Equipment in NHS Acute Trusts in England, June 1999

(http://www.nao.gov.uk/publications/nao_report

s/9899475.pdf)

Auditor General, Victoria, Managing

Medical Equipment in Public Hospitals, March 2003

(http://www.audit.vic.gov.au/reports_par/medic

al_report.pdf)

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