1. Advanced Healthcare Technology Management Workshop Mombasa, Kenya — 9-12 August 2006 IFHE Replacement Planning Jennifer McGill, M.Eng., CCE

2. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 2 Outline  Typical replacement process  Why replacement planning?  Replacement Factors/Criteria  Technology Replacement Plan  Technology Replacement Reports  Process  Supplemental Materials

3. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 3 Typical Replacement Process  When it fails at a critical time  Safety and regulatory issues  When the physician returns from a conference and states the current technology is obsolete  When a donor decides to send something

4. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 4 Why replacement planning?  Limited funds – need to prioritise  Removes subjective, anecdotal and political reasons for replacement  Able to anticipate major repairs  Competitive pricing

5. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 5  Standardization  Reduced consumable costs and fewer training issues  Standards of Care  New procedures/methods to optimize patient care (change in practice )  Utilization  Low vs. high utilization rate Why replacement planning?

6. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 6  Technology status  Obsolete  Unsafe  No support  Cost advantages of new technology  Consumable use, patient throughput, staff productivity, patient satisfaction,..… Why replacement planning?

7. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 7 Example Weighting System for Equipment Replacement Factors FACTORVALUE ASSESSMENTRANGEWEIGHT Unresolved safety issue Expert evaluation0-35 Support not available Expert evaluation or in database Absolute Regulatory Prohibition Expert evaluationAbsolute ReliabilityDatabase analysis0-34 Standard of careExpert evaluation0 or 33 Maintenance cost Database analysis0-33 AgeDatabase analysis0-32 StandardizationDatabase analysis0 or 32

8. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 8 NWT MERS Criteria  AGE vs. Lifespan  Condition  Obsolete (no parts or no service support)  Physical Risk Score  Failure can cause misdiagnosis, injury or death  Incidents/Recalls  Device Mission Critical Status  Backup Device Availability

9. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 9 Weighting Replacement Factors

10. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 10 Technology Replacement Plan  Strategic replacement planning  Align with strategic plan of organisation  Look at 5 years to 20 years  Create good arguments with supporting evidence  Safety  Clinical benefit  New and emerging technologies  Technical support  Standardization  Budget (cost benefit analysis)

11. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 11 Technology Replacement Plan  Urgent - immediate  Priority 1 - following fiscal year  Priority 2 – two years  Priority 3 – three years  Advisory  Product line changes, published end of support, regulatory

12. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 12 18912ECG INTERPRETIVENIHON KOHDEN AMERICA INCECG006391991SR2004 34851OXIMETER,PULSEOHMEDA3700FMAV000181992SR2004 18951OXIMETER,PULSEOHMEDA3700FMAS019591991SR2004 18949OXIMETER,PULSEOHMEDA3700FMAQ034261991SR2005 27890SCANNER,ECG,LONG TERMMARQUETTE ELECTRONICSCENTRAC5H90830F1995R2005 12566OXIMETER,PULSEOHMEDA3700FMAU017781992S2005 14445OXIMETER,PULSEOHMEDA3700FMAS019421991S2006 18950OXIMETER,PULSEOHMEDA3700FMAT017231991S2006 27951VENTILATOR,VOLUME SIEMENS MEDICAL SYSTEMS,PT CARE30005242S111995R2006 24998ECG INTERPRETIVENIHON KOHDEN AMERICA INCECG8350A000621994R2007 27891 TREADMILL,STRESS EXERCISEMARQUETTE ELECTRONICST200C5441880F1995R2007 24753OXIMETER,PULSEOHMEDA3700FMAS019871993S2007 33434PMS,EEG MODULEBRAEI---1997R2008 ControlTypeManufacturerModelSerial Year AddedJustification Replace Year Technology Replacement Report

13. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 13 Process  Submit report to hospital administration with a list  Base the list on allocated budget towards technology replacement  Prioritize – with evidence  Discuss with nurse managers and physicians before submission  Stay involved in purchasing process

14. Replacement Planning – Jennifer McGill, M.Eng., CCE Advanced Healthcare Technology Management Workshop – Mombasa, Kenya – 9-12 August 2006Slide# 14 Supplemental Materials  Replacement or Repair at Duke University  ECRI Tech Assessment and Replacement  NWT Medical Equipment Replacement Score  NWT Technology Management Plan

15. Advanced Healthcare Technology Management Workshop Mombasa, Kenya — 9-12 August 2006 IFHE Replacement Planning Questions? Comments?