By Keri Forsythe-Stephens

Implementing a truly risk-based maintenance program remains a work in progress for many healthcare technology management (HTM) teams — especially when reliable safety data is limited. But according to Scott Skinner, who presented “Is Your Risk-Based Program Really Based on Risk” at the 2025 AAMI eXchange in New Orleans, there are practical ways to reduce subjectivity and sharpen the program’s focus.

“Collaborative approaches can be helpful in evaluating risk,” Skinner said. “Involving clinicians, IT, patient safety, risk management, and other areas can leverage diverse opinions to arrive at consensus opinions. Starting small with a subset of the inventory could also be helpful.”
Despite cross-functional input, organizations often zero in on rare, catastrophic failures while overlooking smaller, recurring issues that quietly affect safety and performance. Skinner acknowledged the challenge of balancing “rare but severe” against “frequent but minor” risks, especially when priorities differ across departments. He noted that HTM teams can support more objective conversations by presenting clear data; and that tools like failure modes and effects analysis, or FMEA, can help guide those decisions.

Still, while risk models are designed to guide decisions, they don’t always reflect real-world outcomes.

“I’ve seen examples where risk is assessed mainly from the perspective of the device not working at all,” Skinner said. “Ideally, you would consider all possible modes of failure, some of which can cause direct harm to the patient.”

That’s where HTM teams — particularly frontline staff — make a difference. Their firsthand knowledge is essential to building effective, data-driven risk assessments, Skinner stressed.

“The voice of the frontline team is crucial,” he said. “The team knows what’s happening in the real world, not just the theoretical view. Frontline teams can really help through good quality documentation. Things like use errors can move from anecdotal opinion to hard data if [computerized maintenance management system] tools are configured to capture good quality information.”

When smaller, recurring failures are documented properly, they become actionable, and that data can then fuel broader improvement efforts. “Configuring your CMMS to capture good failure cause code data can be helpful in building data that can be analyzed and become actionable,” Skinner said.

Technology is also reshaping how organizations manage risk.

“There are certainly a number of well-established risk management frameworks applicable to medical equipment,” Skinner explained. “Cybersecurity risks are certainly not that new, but there’s more we can be doing to draw them into our risk-based management.” He highlighted emerging tools like AI-driven predictive analytics as especially promising.

Still, bridging the gap between clinical perception and data reality is critical, regardless of the tools in use. To Skinner, it starts with open communication. He recommends holding joint HTM-clinical reviews of equipment performance data and using real-world case studies to highlight outcomes. Involving clinical leaders in the development of risk models and maintenance strategies, he said, fosters mutual trust. When clinicians feel their feedback is both valued and impactful, they’re more likely to embrace data-driven decision-making.

At its core, a risk-based program should be understood for what it is and what it isn’t, Skinner stressed during his presentation.

“Organizations need to keep in mind that risk-based approaches are generally imperfect and, often, estimations of perceived risk,” Skinner said. True risk-based management, he said, is dynamic—adaptive, guided by evidence, and requiring regular review and refinement.

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