By Jeremy Probst

Since the inception of highly complex and costly medical imaging equipment like MRI and CT scanners, the preventive maintenance and servicing of those systems have gone hand-in-hand with the initial sale. Equipment manufacturers and dealers reap the benefits of long-term service contracts while healthcare organizations endure the loss of flexibility and independence, increased overhead, and reduced revenue due to service delays and restrictive contracts.

In recent years, however, a new solution has quickly gained popularity amongst healthcare organizations and imaging leadership: Onsite imaging service departments, built from within.

Healthcare facilities reconsider the status quo of OEM and ISO service contracts
Medical imaging equipment manufacturers and dealers would have you believe that there are only four different types of vendors for purchasing systems: brokers, equipment providers/service organizations, partners/parent companies, and consultant groups. Almost since the birth of the industry, these buying channels have been the status quo for acquiring a high-end medical imaging system, but each has its downsides in either cost, flexibility, or independence. In addition, the choice of vendor impacts much more than the size of the initial expenditure. It also affects the cost of installation, setup, and testing, as well as ongoing expenses for spare parts, preventive maintenance, and repair. As a result, healthcare facilities become hogtied by restrictive contracts that require them to deal with these costs for the lifetime of their equipment.

Recent changes in the culture, costs, and requirements of medical imaging departments have opened the door to a new paradigm: an imaging equipment service program built from within. By bringing repair and maintenance capabilities in house, many facilities are realizing significant cost savings, reduced system downtime, improved patient care and satisfaction, and renewed flexibility to manage their installed systems to accommodate the rapidly changing needs of healthcare.

Depending on the size and maturity of the facility’s medical imaging program, this model can take anywhere from a few months to a couple of years to implement. The transition can be relatively fast for larger hospitals and imaging centers with one or more existing engineers, well-established maintenance procedures, and a sizable fleet of older installed systems. On the other hand, smaller facilities may have to develop a phased-in approach as they uptrain existing BMETs, create processes and procedures, and most importantly, fulfill their service contracts for existing systems.

In both instances, the commitment to build a service program from within is not an all-or-nothing proposition. The option to pause or stop at any step in the program’s implementation is one of the most enticing reasons to take this approach. In most cases, it’s even possible to create an a la carte program where some service functions are brought in house while others remain part of a smoothly running, existing operation.

Step-by-step guide to creating an in-house imaging equipment service program
For the sake of clarity, let’s look at two possible scenarios for facilities that are part of a larger healthcare system:

Trauma Level 1 & 2 hospitals – Picture a well-established medical facility in a major metropolitan area. Their installed fleet consists of a variety of MRI and CT scanners as well as X-ray machines and other medical imaging equipment. These systems vary in age from brand new to several years old. The department has management and operational personnel, a sizeable team of BMETs, and one or more on-staff imaging engineers.

Considering the potential benefits of bringing their service program in house, they decide to develop a plan and implement it as quickly as possible.

Outreach locations – Imagine a small (but growing) imaging department in a suburban hospital or other healthcare facility. They have a minimal fleet of installed imaging devices, all currently covered by restrictive OEM or ISO service contracts. Some of these systems, however, are nearing the manufacturer’s stated end of life. Staff includes an imaging department manager and a handful of BMETs, but no in-house engineer.

In this care, it makes more sense to create a long-term, phased-in approach with the flexibility to pause and resume the program’s implementation as needed to accommodate differences in the facility’s actual growth versus initial projections.

The step-by-step plan in both cases is nearly identical, with the only difference being the total time for implementation and the expectation of pauses along the way. For the outreach facility, there would also be an increased need to opt for a la carte services based on actual, versus predicted, circumstances.

The resulting plans would look something like this:

1. Working with a reputable provider partner, build a detailed plan for implementation.
2. Evaluate current systems and identify those immediately available (or soon to be available) for in-house service and those which still fall under the restrictions of an OEM or other service provider contract.
3. Create the policies, procedures, and other operational details necessary for the program’s successful implementation.
4. Determine the skillset and experience of existing team members. Then hire and train as needed to meet the requirements of the plan.
5. Establish relationships between in-house staff and the partner’s support engineers and parts consultants.
6. Identify common parts and supplies needed for routine maintenance of installed systems, as well as those most likely to fail. Create an in-house parts inventory aimed at reducing downtime due to shipping delays or a lack of parts availability.
7. As imaging systems under service contracts reach the OEM’s perceived end of life, integrate them into the existing in-house service program.
8. Continue to grow and refine the program with the ultimate goal of being free from all restrictive OEM and ISO service contracts.

The benefits of a 'built from within' imaging solution
Healthcare organizations, whether large or small, who have implemented this model have found the transition to be relatively painless provided they worked closely with a qualified support, training, and parts provider to help guide them through the process. Very few, if any, facilities can develop and implement an in-house imaging equipment service program alone. In almost all cases, partnering with a well-established, reputable, and AAMI-certified company is vital to success. Equally important is to refrain from establishing relationships with different providers for each aspect of the program. The synergies that are achieved by working with a single source for support, training, and parts far outweigh any cost savings due to utilizing multiple companies.

The vision of a new paradigm in imaging equipment service
Creating an all-encompassing, in-house medical imaging service solution that’s truly “built from within” is not only feasible, but also relatively easy and customizable. It puts healthcare facility decision makers back in control of their imaging service program. In fact, this approach is rapidly becoming the norm for organizations that want to break free from the chains of restrictive OEM and ISO service contracts. It promises to provide improved operational flexibility, increase profitability, minimize system downtime, and most importantly, maximize the quality of patient care. All it takes is a vision and the willingness to embrace a new and improved paradigm.

About the author: Jeremy Probst is president and CEO of Technical Prospects and the son of company founder, Bob Probst. Jeremy has spent over 19 years in the medical imaging and engineering field and holds a bachelor’s degree in industrial technology management, as well as a minor in electrical control systems and fluid.