Bridging the IT and clinical engineering gap

Richard Neff, US Head, GE Healthcare Services Division

Consider the journey of a patient who enters a hospital for treatment. His stay will be impacted by a number of factors from the time he is admitted to the time he is discharged. Key among those, as the patient works his way through treatment, is how quickly his information, such as waveforms, test results and medications, is logged, processed and shared. In this regard, the burgeoning use of mobile and other network devices has become an enabler, as it enables faster information flow, quicker decision-making and ultimately better patient care. However, these same technologies can also present significant challenges for healthcare providers, especially when coupled with complex and often changing regulatory requirements.

The bring-your-own-device (BYOD) culture has exploded. A survey¹ conducted last year by Epocrates, a medical application developer, found that 86 percent of clinicians are using their smartphones for professional activities, and 53 percent of those clinicians are also using tablets.These devices require wireless networks to support the applications physicians rely on. While many healthcare providers have recognized this trend and allow their clinicians to use mobile devices, fewer are engaged in regulating use. According to a recent Healthcare Information & Management Systems Society (HIMSS) survey², 83 percent of providers report that their physicians use mobile technology to provide patient care, but only 59 percent have a policy in place that regulates the use of these devices and outlines a mobile strategy.

So, what does all this mean for hospitals? The responsibilities of the IT and clinical engineering departments at hospitals have converged due to this new technology. This translates into two realities. First, the increased use of clinical devices on the same network that also supports the increased use of mobile devices is placing significant demand on these networks, creating a potential risk profile that could fail if not properly assessed and maintained. Second, it also creates a potential gap in whom among IT and clinical engineering cares for the systems that carry information from the patient’s bedside to the nurses’ station to the EMR system.

Herein lies the crux of the issue: Both IT and clinical engineering operate in their own silos. Historically, they have different skill sets and training consistent with different missions and purposes within the organization. Naturally, each group sees a new technology or innovation as an opportunity to expand its role or protect its space.

However, the convergence of new technologies and innovations is forcing these groups to each address a few simple, yet critical questions: Who takes care of which part of the system? How do people know who to contact? Who is actually going to respond? How does the help desk know how to get the appropriate contact once a problem has been identified?

So, how will hospitals bridge the gap? Here’s a long-term and cost-effective solution: Break down the silos. This task is being accomplished, with great results, in hospitals of all types and sizes around the country, but not without deliberate effort. Six Sigma tools, change management practices and action workout techniques prove valuable in this type of situation.

Here are a few best practices I’ve seen work with our customers or have gleaned from others while following this issue:

Merge the Biomed and IT departments, placing them on the same team. The care of these technologies requires the IT and clinical engineering teams to work together, in sync, at all times so that information flows securely and efficiently.
Develop a dedicated team, with representation from clinical engineering, IT and clinical informatics, to counsel on the implications of technology choices. That same team follows through with implementing those choices and maintenance.
Create a detailed escalation process for each sophisticated system, perhaps even each component, in the instance of a breakdown.
Establish a central destination for support to avoid callers being rerouted to one department or another in search of help.

In my opinion, developed from the perspective of a manufacturer of medical devices as well as a service provider to hospital IT departments, this alignment is the foundational step toward identifying and bridging the gap appropriately.

I am often asked if there is an alternate solution. My response to that question is an emphatic “no.” A systemic change in hospital operations culture is imperative. With the tremendous financial pressures hospitals face these days, delayed information flow could result in loss of patient data, which can adversely impact the quality of patient care as well as result in lower reimbursement rates.

It’s not business as usual. The stakes are much higher today than they were a few years ago, and with patient care and revenue both at risk, healthcare providers can no longer afford to operate as before. The change has to begin now, and progressive healthcare providers are leading the way.