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Clinical engineering in an age of reform

by Brendon Nafziger, DOTmed News Associate Editor | May 30, 2013
From the May 2013 issue of HealthCare Business News magazine

Scott Bosch: Traditionally, our workflows have been structured around the manufacturers’ recommendations, so the CMS recommendations didn’t impact us all that much. If there ever was a large disparity — I say we have to do it once a year but the manufacturer says we have to do it once the rationale is. Overall, while I’m glad to see the CMS take a role in putting some rigidity in the performance expectation of equipment, I think everyone has to work together to understand workloads.

Patrick Lynch: Not being in a hospital, I can only relate what I hear. Most people are not doing the full manufacturer maintenance, or else costs would almost double in most hospitals. And the ISOs cannot be doing the complete PMs, because staffing would have to rise. I think most are taking a wait-and-see attitude and risking a CMS write-up, which, given the number of hospitals in the U.S., is a slim chance.

Fred McMurtrie: Well none, but it could if CMS digs its heels in. I have been following this with some interest because the potential impact for our hospitals and on our state could be a very hard pill to swallow.

However, it is my understanding from the information that I have gathered, that The Joint Commission will still use policies as normal and if your hospital happens to be audited or directly inspected by CMS that they still may cite you, but if your action plan is that you follow TJC standards that no further action will be required. At least, that is the understanding that has been reached. The CMS clarification will stand, pending more data and discussions. AAMI, ASHE, ECRI and TJC will continue to work with CMS to come to some form of resolution. So we will stay tuned.

DMBN: Hospitals can rely on a mix of third-party outfits (ISOs), in-house teams and OEM service contracts. What’s the current breakdown of use among these options for hospitals, and has there been any noticeable change recently? If so, why?

Greg Mika:
If you investigate some of these systems and get the training, you can maintain a lot of these systems in-house with your own staff, cheaper than on a service contract. That being said, you do take on the potential of some high liabilities. Let’s face it. You’re paying for a service contract to cover the total failure of that device and a huge expense. If something really big like that happens, the service contract’s going to cover it. If you do take it off, you’re saying there haven’t been these big catastrophic failures, and [the service contract] doesn’t make sense for us.

The hospital has to understand there’s potential for something huge to happen that may cost a large amount.

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