One year down.

With a full year as president under his belt, Robert Jensen is no longer the new guy presiding over the AAMI. In addition to discussing the last twelve months and what the future holds, he also spoke candidly with HealthCare Business News about a wide range of current events impacting the AAMI community.

HCB News: Last year when we spoke, you were roughly 100 days into your role as CEO. With more than a full year under your belt, how’s it going?

Robert Jensen: It’s been great. I love my team; I love the work we do. It’s wonderful to have a mission focus in your work life and, therefore, be part of a deeper purpose. I really consider it a vocation. To work around people who want to contribute in a larger sense to health care – it’s been a pleasure and privilege to do that. It’s not just working with the paid employees, but the 2,000 plus volunteers who contribute to standards, educational materials, and the health care technology community.

HCB News: What was the biggest surprise during your first year?

RJ: I think the biggest surprise was the really close working relationships and dedication of staff and volunteers as they plan and execute plans and initiatives to benefit the larger community. There are only 42 staff members, with myself included. With a couple of thousand volunteers, it’s a good-sized challenge. But the volunteers are extremely dedicated and knowledgeable and provide an enormous amount of lift for the organization’s mission.

HCB News: Last year, you mentioned a survey asking members what they wanted from their association. Younger members wanted to increase management and leadership skills while longtime members wanted to give back to their industry. What would you say is the mix of younger and older members?

RJ: It depends on which of the particular cohorts we’re looking at. If we take the age of 40 as a midpoint between earlier and later career, in our standards world, about 80 percent of the members would be over that midpoint. We’re actively working with our standards community to encourage them to bring people in as the more tenured members of the committees and working groups begin to retire. In our education programs, it’s close to 60/40, but we want more young members there as well.

We have several programs that encourage younger people – even as young as high school – to get into a health care technology management career and to earn the certifications and qualifications that will allow them to work in this growing field. It’s a field that’s taking off, but there’s already a shortage of workers in several areas of the nation. We want to encourage students early on – in high schools, trade schools and four-year colleges for clinical degrees – that the HTM field is a place you can come to, contribute and grow as you want to.

HCB News: With the differences you indicated between the standards group being about 80 percent at or beyond the midpoints of their careers and education being about 60 percent, why do you think there’s that much interest in the standards as opposed to the education side from the senior members of AAMI?

RJ: In the standards world, organizations are sending senior representatives to these meetings because standards impact their industry fairly deeply, and they want to be at the table to ensure that they’re on a level playing field with those they compete against. The other groups just tend to be younger because it’s a more balanced set of opportunities across the whole space and career lifespan. We have health care technology managers who are young and immediately out of their trade school or four-year college, and are just taking their first job. There are also managers who have been doing this for most of their lives and have worked their way all the way up through a variety of positions, which is what I would say is more a normative course for employment.

As technology is changing rapidly, so is the opportunity space. Those folks in those positions are being asked to do more to show that they’re not just a break/fix shop for devices. They’re also providing input for capital purchases of devices, and they’re being asked to look at potential insourcing or outsourcing of the maintenance during the acquisition phase. Finally, they’re being asked to do more to support the value proposition of the overall clinical delivery organization.

HCB News: The medical device tax, introduced to supplement the cost of the ACA, was suspended in 2015, reinstated earlier this year and again suspended in January for at least two years. Although it has been critiqued as a thorn in the industry’s side, during the time it was in effect, profits at the 100 largest medical technology companies continued to grow at an average of 7 percent. How damaging do you feel that tax is to the industry and how important is it to have it fully repealed?

RJ: I think it’s important for me to say that I don’t have a close look at medical device company books or how that two percent tax directly affects their bottom line. However, with the recent changes to the ACA and some clear softening to the intent of that particular legislation, I think any reintroduction of that tax should be very carefully thought through, and it should be clear what those funds would be going toward. I think that the medical device industry is exceptionally supportive of health care as a whole, but if they get taxed, I don’t think it’s unreasonable to be told what that money will be used for. I think it’s reasonable to ask that it’s tied to the industry that’s asked to provide that kind of resource.

HCB News: Cybersecurity isn’t currently the front-page story that it was last year for public news sites, but it’s still important for health care. Where does it sit on AAMI’s radar today?

RJ: AAMI has a number of standards related to cybersecurity, and we have one technical information report that is fundamentally a guide and baseline for some of our subsequent cyber standards. Cybersecurity is a truly complex issue for the medical technology community. For manufacturers, it has meant ensuring that devices would continue to function as intended, even in the event of a security breach, so that patient safety would not be adversely affected. From that perspective, security risks are primarily a safety risk.

Health care providers, who manage patient data and the networks, are also worried about patient safety, but they have to worry, as well, about data security based on the HIPAA regulations and ensuring patient data confidentiality is not compromised. So security risks around that particular issue are also privacy risks.

“Bad actors” have appeared in recent years who attack medical devices or health IT networks maliciously. As was the case with WannaCry and ransomware attacks, there’s also a risk associated with the whole clinical enterprise being able to carry out its business. So we really approach the cybersecurity challenge from multiple directions. Because of the merging of digital environments in health care delivery organizations, where all things digital end up being connected on a network, we deal with the security, the privacy and the enterprise risks all at the same time. Our overall goal is really to align these different perspectives and the risk tolerances that go with them, and then try to facilitate a means of managing and responding to each of those different types of risks. There’s no real single solution that works for everybody – the device manufacturers, the network managers, or for that matter, the entire enterprise. But we try to use all the tools that we have to meet each of their needs.

HCB News: Over the last 12 months, we've seen a lot of movement on the FDA's investigation into third-party equipment service, and two fairly polarized viewpoints on the issue. AAMI has done a valiant job of maintaining neutrality in this ongoing debate. What is your message to stakeholders firmly planted on either side of the conversation?

RJ: I appreciate the compliment, that’s what we try to do. As you probably know, we don’t lobby. Our stakeholders are from different areas, and our neutrality allows us to bring them together and try to get them to work together. If they come to the table and are willing to truly talk and negotiate, I think there’s a way to work this out. On the other hand, if different parties are stuck in a position where they’re not willing to negotiate, I think that we ’ll continue to see the problem until there are legal challenges and case law to set the precedents that move things forward. We have been looking at a way to bring the parties together and get some work done toward a solution. However, it’s my role to make a judgement on whether or not the parties will come together and earnestly negotiate in good faith, because I can’t waste our members’ resources on efforts that don’t look like they’ll succeed. That’s been our message so far. We’ve spoken with the FDA and had conversations with all of the parties engaged in this discussion, and I’m really waiting to see if there’s going to be a point where everyone is willing to negotiate.

HCB News: You had previously talked about a three-year strategy for AAMI. Are you able to share the priority list for the association’s focus going forward?

RJ: Our board approved our strategic plan in November, and we’re executing the first year of that plan as we have this conversation. We have three goals. Our first goal is around community. It’s described as AAMI having a broader community of engaged stakeholders. Within that broad goal, we’re focusing on increasing our global constituency, and I have a couple of people working internally to establish some increased international relationships to see how we can help in some parts of the globe that are influential in health care and make sure that these countries are getting the benefit of what we are providing here today. Another part of this goal is broadening the engagement of the entire health care technology management profession. It’s about helping establish a career pipeline that starts as early as STEM students in high school, all the way up through mid- and end-career folks, to make sure that the value proposition that we talked about earlier becomes clearer in health care delivery organizations.

The second goal we internally call infrastructure, and it’s about changes we need to make as an association, including optimizing the information technology in our facility to support AAMI initiatives. We will be moving at some point this year to a new building where we’re going to expand our ability to host education and standards meetings and other events fairly dramatically. We’re also improving our work culture to make sure we continue to be a place that people want to contribute and be committed to.

The last goal deals with knowledge. We are working to become the essential resource for high-quality knowledge and learning in health technology. This goal relates to specific definitions of programs for the future that we may or may not have now, or programs that need to be updated or modified, resources that need customizing, as well as the development of new products and services. At the same time, we’re looking to make sure we’re not spending resources on things members don’t want or don’t use.

HCB News: Has there been any medical device or technology introduced or being talked about today that you’re particularly excited about?

RJ: I think the area of genomic testing is going to continue to grow. In cancer, they’ve started making progress with genes involved with breast and ovarian cancer. In terms of medical devices, those that utilize both hardware and drugs are exciting. People will get treatment very specific to themselves, rather than treatment based on the holistic view of the population at large.

HCB News: What is your big audacious goal for 2018?

RJ: I seldom think of those types of goals as a one-year thing. It’s more like a 10-year goal. Because we operate in three-year cycles, my number-one priority is to develop or hire strong leaders. Business continuity really depends on excellent succession planning throughout anyone’s tenure, and I think we’ve made strides in that area during my first year, and that work continues. We’ve spent considerable hours not only in executive-level training but also in providing opportunities for my colleagues in the trenches. I’m a big believer in training people to develop management skills even as they build their technical skills.

This community is incredibly supportive. It’s been a true pleasure to work shoulder to shoulder with these folks, and I know my staff feels the same way.