1.  Toolbox for the New HTM Director  (New, Upwardly Mobile, or Experienced) 1 Patrick K. Lynch, CCE, CBET, CPHIMS, HIT Pro/PW GMI (Global Medical Imaging) Charlotte, NC : MD Expo Reston, Virginia April 4, 2013

2. Mary Logan, President of AAMI William Hyman, TSTC Professor retired Karen Waninger Dick Felton Jenifer Brown Manny Roman Dave Dickey Glenn Scales Rick Hampton Pat Lynch, Blogger, writer 2

3.  www.BMET.wikia.com www.BMET.wikia.com  www.CMIA.org www.CMIA.org  www.NTBA.org www.NTBA.org  www.AAMI.org www.AAMI.org  www.patientysafety.org www.patientysafety.org  www.educationaltechnology.com www.educationaltechnology.com  www.Healthcarecommunication.com www.Healthcarecommunication.com  3

4.  SVR  COSR  CMMS  CMS  JC  Risk-Based  Preventive Maintenance (not Preventative)  BMET vs. CE  HTM  ROI  ?? 4

5.  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) 5

6.  DITEC  Pronk  GMI  Dunlee 6

7.  CBET  CRES  CLES  CCE  CPHIMS  HIT Pro / PW  A+  Net+  Sec+ 7

8.  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 8

9.  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 9

10.  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. 10

11.  EMR  E.H.R.  CPOE  CDSS  DICOM  HL7  Ping 11

12. 1. Have a complete inventory of all patient care devices at my hospital/health system 12 Monitoring Central Sterile IV Pumps Xray Rooms Portable Xray Mammo Processors/printers Linear Accelerator Laboratory automated analyzers Leased Equipment Scopes Ultrasound Xducers Potential future

13. 2. Assign Acquisition Cost to all equipment items 13 Why? 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?

14. 3. Consolidate all Equipment Maintenance under a single budget 14 Why? HTM is the only professional maintenance manager in the hospital. Control.... of what is done of vendors of service providers of coverages of add-on charges of when service is performed of costs of upgrades made to machines

15. 4. Know my Cost of Service Ratio (COSR)- Overall and by department and by equipment class 15

16. 4. Know my Service Value Ratio - Overall and by department and by equipment class 16 MetricMeasure 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

17. 5. 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 17

18.  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 18

19. 6. No one in the hospital can sign a service agreement except the Director of HTM 19 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).

20. 7. Get free lifetime passwords and updates to all medical devices Pre-purchase Negotiation Anything is possible Get everything you can. Free school, updates, manuals, CDs, software upgrades, tools, test jigs, PM procedures, calibration procedures, tech support, etc., etc., etc. 20

21. 8. JC (or DMV or CMS) visits are a non-event for HTM and HTM staff 21

22. 9. Have a means to stop capital payments if all required items are not delivered. 22 How? o Know Accounts Payable Person o What is his/her job? o Ask them to stop payment. o Done!

23. 10. Every customer in the hospital is delighted with HTM's performance (and the performance of all of the staff) 23 Annual Customer Satisfaction Survey Monthly Meetings with Major Customers Open-door policy Anonymous Comments Box Above all, excellent service. FIX THE CUSTOMER.

24. 1. Have a complete inventory of all patient care devices at my hospital/health system 2. Assign Acquisition Cost to all equipment items 3. Consolidate all Equipment Maintenance under a single budget 4. Know my Service Value Ratio - Overall and by department and by equipment class 5. Have a BMET Training budget that is 5% of the total HTM Budget 6. No one in the hospital can sign a service agreement except the Director of HTM 7. Get free lifetime passwords and updates to all medical devices 8. JC (or DMV or CMS) visits are a non-event for HTM and HTM staff 9. 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) 24

25.  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 www.mdexposhow.com/dc  Download complete Presentation  after April 4, 2013 at http://HTMA- SC.wildapricot.orghttp://HTMA- SC.wildapricot.org  plynch@gmi3.com 704-941-0116 plynch@gmi3.com  Watch my blog at www.gmi-blog.comwww.gmi-blog.com 25