Clinical devices play a central role in a healthcare organization's ability to deliver the best possible care to patients. In recent years, however, the number and complexity of devices has grown exponentially. Biomedical and clinical engineering teams are finding it increasingly difficult to manage and service these assets while also handling device-related regulatory and compliance requirements.
Becker's Hospital Review recently spoke with two specialists from KPMG LLP (KPMG) — Chris Adedeji, director, technology advisory, and Drew Cobb, director, healthcare advisor — about these challenges and the benefits of digitizing the entire clinical device management (CDM) life cycle, and how ServiceNow technology can help:
Note: Responses edited for length and clarity.
Question: What major activities are involved in managing a clinical device?
Drew Cobb: The first question is whether you even need the device. Before bringing a device into the organization, you must perform an evaluation process to justify the need. Determining how to acquire the device is the next step. For example, will you bring in the device on a trial basis or lease before buying to ensure you have the necessary patient volume? Once you bring in a device, you must manage it throughout its life cycle. This includes preventive maintenance activities through to decommissioning.
Q: What are key challenges that healthcare organizations face in managing clinical devices?
DC: Knowing where your devices are located is a challenge, because many devices are mobile. Some organizations implement real-time location services to ensure they can find devices as needed. A lot of devices are also computer systems, so proper security is a concern. This is why many biomedical and clinical engineering departments now report to the CIO rather than the facilities leader. The primary challenge is adapting to the new capabilities of devices — adding them to your network and making sure you have the right cybersecurity around them.
Chris Adedeji: Also, when we think about life cycle utilization, we need to consider inventory management. Do we have the right number of devices based on demand, and can we adapt if needed? Another key question is whether you are managing devices effectively across their life cycles or are they sitting unused in a stockroom most of the time?
DC: You need a preventive maintenance schedule for all devices based on manufacturer recommendations and based on how much you have used them. One primary reason for using a platform like ServiceNow is staying on top of preventive maintenance. Manufacturers of devices are also continually updating their guidance about maintenance, so you need real-time notifications.
Q: What capabilities in the ServiceNow platform can help solve for some of these challenges?
DC: Since biomed has moved into the world of IT, one of ServiceNow's biggest advantages is that it brings many IT capabilities into one universe. Organizations can take a holistic approach to asset tracking, cybersecurity, network management and more. A platform like ServiceNow can help change an organization's culture because it brings together IT and biomed. Workflows like preventative maintenance and corrective actions can be executed in an integrated way across IT and Biomed teams.
CA: Many stakeholders want a platform that provides a single view across the enterprise regardless of the type of asset. A lot of clinical devices are essentially computers on the network, so they face cyber threats. ServiceNow's configuration management database (CMDB) is very flexible and can be used with either clinical or IT devices. ServiceNow also provides a single view so organizations can align different types of asset information on one platform, such as financial, utilization and procurement data.
Q: Why is it so important to understand what's happening — end-to-end — with connected medical devices?
CA: Organizations need to understand what assets are on their networks, where they are, who is using them and whether these devices have been properly sanitized and secured. Also, teams must know that devices and any data residing on them, at the end of their useful lives, have been properly disposed of. Teams need touch points at each of those critical milestones. Since quality of care is front and center, teams need to feel confident they've done all they can to support patients.
DC: ServiceNow has capabilities that can proactively alert healthcare organizations even before a device may have a problem. Since devices are connected to the network and they have onboard diagnostics, ServiceNow can automatically route messages to biomedical engineers about potential device issues. Using ServiceNow proactively, not just reactively, is a huge plus.
Q: What are the business advantages to taking a holistic approach to CDM by leveraging solutions like the KPMG and ServiceNow offering?
DC: We believe that approaching Clinical Device Management from a holistic perspective allows organizations to drive the most value. We start by evaluating our clients’ CDM processes against leading practices. We look for gaps in existing practices to help improve the processes before enabling the processes in the ServiceNow platform. A platform like ServiceNow offers economies of scale so healthcare organizations can leverage their scarce biomedical engineering resources across a wider population of devices. By automating manual activities, employees can focus on higher-value activities.
CA: As part of strategy alignment, understanding the stakeholders is key because the organization is moving to a platform that will be leveraged by multiple teams. KPMG works with organizations on the strategy — we find out what our clients want to do with the data and what workflows need to be factored in. In some cases, users may already have been interfacing with ServiceNow for IT requests. Expanding the use of ServiceNow to CDM provides a single platform view, user experience and workflow. Employees don't have to work across multiple platforms and tools.
We've walked in the clients' shoes and we understand the underlying CDM from a process perspective. It is difficult to do asset management in a vacuum because there are so many stakeholders from finance to procurement, planning and facilities. KPMG helps connect the dots. We bring an enterprise-wide approach paired with Healthcare industry know-how, as well as team of ServiceNow practitioners that specialize in the platform.
DC: With a platform like ServiceNow, teams need to be educated about how to use it and the governance of processes may need to change. It's a cultural shift. We are also very patient centric. We work backwards from the patient to the processes and technologies that engineering will need to support devices. It's about the patient first and foremost; otherwise, why are you doing it?
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