1. Global Clinical Engineering Success Stories Maintenance of medical devices Name: Ledina Picari Affiliation: CED Collaborator Location: Tirana, Albania E-mail address for contact: ledinapicari@yahoo.com Submitted by

2. January 2016 Country Estimates in Brief PopulationThe population of Albania on January 1st, 2015 was 2,893,005 Population Growth Rate0,546% Life Expectancy at Birth80,3 – females 76,1 - males Infant Mortality Rate9.3/1000 (live births under 1 year) Number of Health Centers in Country580 primary health care centers (56 specialty centers) 5 - University Hospitals 11 - Regional 23 – District Total Expenditure on Health as % of GDP 2.8% of GDP (2015) from state budget, 6% in total including private sector Global CE / HTM Success Stories2

3. Country's Health Technology Program Design of new procedure for maintenance of high tech diagnostic equipments - Background Before September 2014  No standard procedures  No standard contract  Maintenance of MD done by each hospital  Some of the spare parts (x- ray tube etc.), not included  Different prices for the same devices  Short term contracts  Gaps between contracts Results:  Frequent device failures causing delays in medical diagnoses and treatments  High costs due to frequent interventions  Long downtimes causing increased waiting time, delays when referred to other healthcare public institutions or increased patient costs when referred to private clinics  Maintenance costs for very short period not full risk contracts varying 10-12% of the purchase price  Difficult relationships with the service providers due to service denial upon lack of payment caused by bad budget planning January 2016Global CE / HTM Success Stories3

4. Country's Health Technology Program What we did... Design a new approach based in the best international practices and recommendations – Full risk, 2 years service contract Negotiation process regarding price and conditions Manufacturers representatives meetings to present our new approach and for authorized distributors confirmation Open tender procedures for international participation - to avoid speculation of a monopoly situation January 2016Global CE / HTM Success Stories4

5. Conclusions and Action Plan Outcome Increased access to diagnostic devices (Linac, MRI, Ct Scan and Angio) Facts: At Durrës Regional Hospital, Number of Ct Scan examinations 3545 at 2013, 3157 at 2014 increased to 6602 at 2015 Increased availability to local health care diagnostic service. Facts: At Durrës Regional Hospital, downtime Ct Scan 115 days at 2013 and 137 days at 2014 decreased to 0 days during 2015. Efficient use of the public funds Facts:Maintenance cost decreased from 10-12% of the purchase price to 8%. Budget guaranteed due to fixed price Action Plan Increase contract period from 2 to 4 years Improve some contract conditions to avoid contractual problems during implementation January 2016Global CE / HTM Success Stories5