Hospitals have been using computerized maintenance management systems (CMMSs)  for decades, but the technology has been improving over the years to place a wealth of organizational insight into clinical engineers' collective hands.

When leveraged properly, a CMMS can give back time and money to an organization's purse strings. Clint Abernathy, administrative director of operations, Texas Health Presbyterian Hospital Dallas, part of Texas Health Resources, found the use of a CMMS cut the time spent looking for medical equipment by 50 percent. Texas Health Dallas utilizes a real-time location system using radio-frequency identification tags to track all pieces of biomedical equipment from MRI scanners to ultrasound machines across the hospital. If a recall is demanded, Abernathy can easily enter the CMMS and find a device and its information (including software, type, common name, scientific name, serial number, asset number).

Saving Time, Saving Money

Enhanced features are enticing organizations to revisit their CMMS strategy and the work is paying off. With equipment-sharing and utilization tracked across the organization, Texas Health Dallas's CMMS has been directly tied to saving the organization more than $1.7 million in annual rental costs as well as reducing annual purchasing costs of new medical equipment by $500,000.

Whereas Texas Health Dallas has been using their CMMS for two years since May 2010 healthcare life cycle technology planning and management services organization Technical Services Partnership (TSP), part of University of Vermont in Burlington, has been using theirs since 1984. Enhanced continually since the organization began using the system, updates have focused on the needs of management planning and ease of data entry, says Tobey J. Clark, director of instrumentation and technical sciences at TSP.  As a result, the CMMS currently hosts a number of functions from tracking equipment, their costs and related patient safety issues to logging recall incidences.  The system also can provide schedules of use and preventive maintenance inspections. "Being able to know the cost of parts, having labor contracts in the system and knowing equipment activities among staff is a huge help for a manager," Clark says.

The CMMS manages records on about 50,000 devices at TPS. In addition to providing insight on equipment use (how long, what department and what work orders are attached to a device), the CMMS allows Clark to scan for billable opportunities. Ilir Kullolli, area clinical technology manager, Kaiser Permanente in Santa Clara, Calif., has found their CMMS automatically generates repair orders with vendors when sending equipment out for repairs. Deploying a new CMMS a year and a half ago, this functionality bypasses the need to fret about a vendor getting paid. "A CMMS needs to connect to accounts payable," says Kullolli.

Report Runners

Organizations replacing their CMMS have been finding new systems easier to use than ever before. Converting from its system of 14 years, Baystate Health in Springfield, Mass., made a CMMS switch in September 2009. Jim Bosman, clinical engineering financial specialist, says the tool out of the box is "head and shoulders above where we were," with simpler application access and reporting capabilities.

With remote accessibility, clinical engineers can access the CMMS on a mobile device and look up inventory demographics such as place, device, model information, work orders, schedule maintenance and program reports. Its mobile capabilities allow technicians to show a device's history on a tablet and new inventory records can be processed on the fly. "This has been a huge time saver," Bosman says.

Another time saver has been the added ability to auto-populate a work order with multiple device information. In their previous system, individual devices each had to have separate reports. Using an import wizard, spreadsheets can capture complete information and with a click of a button, automatically generate an incoming inspection work order. The CMMS also has the ability to use pre-defined text in the work order. Using the same phrases over and over again saves time and increases standardization, helping to eliminate inconsistencies or erroneous captured data.

Harnessing the CMMS's capabilities, technicians at Baystate can run reports to assess future preventive management workloads. "If you know someone is taking vacation at a certain time, you can anticipate your oncoming workload," he says. "The system's reporting capability is very important to us," says Ploypan Jensen, clinical engineer planner analyst at Baystate. "Since we don't know what kinds of reports we are going to be asked to produce in the future, the ability for us to be able to access information from the system is very important."

Having a central information storage place is a big deal, Bosman says. PDFs of vendor service reports or a service manual of a device can be attached to work orders or inventories in the CMMS. A vendor's end-of-support letter could be attached to a device and, when it comes time to replace the equipment, an engineer can easily access that document.

While still learning the nuances of the application, Baystate is looking at continual upgrades to the system, including a possible mobile app and client-facing portal for clinicians to submit work requests.

So as CMMSs mature, functionality is building out robustly.

U.S. medical devices to get unique patient identifier

While signed into law in 2007 as part of the FDA Amendments Act of 2007, the initiative has been notably slow. James P. Keller, Jr., vice president, Health Technology Evaluation and Safety, ECRI Institute, spoke about UDI's impact upon medical devices. What are the benefits of having a unique medical device identifier? A unique identifier will provide a better way for hospitals and health professionals to track medical devices. This will be particularly useful when recalls happen.   What are some of the drawbacks? I would expect that costs for medical device manufacturers will go up in the short term as they will have to change their processes for naming and labeling devices. It's likely that those costs will be transferred to hospitals through higher prices. Do you see implementing this on old medical devices being an issue? From everything that I've seen about likely implementations for UDI, older medical devices are not included. I don't expect manufacturers will be re-labeling and re-identifying devices they have already sold to hospitals. This won't be much of an issue for supply products since they have a relatively short shelf life. But hospitals have a lot of capital equipment that is five or 10 years old or more. That older equipment will continue to be identified using traditional methods.  What resources are needed for a hospital to tag all of their medical devices? I think it's too soon to tell how many resources will be needed for hospitals to gear up for UDI implementation. One thing that will likely be required is a re-naming of items in supply and capital device inventories to match up to the new identifiers.   What organizational issues would this initiative solve? UDI should help hospitals have a better understanding of the medical devices they have on hand and should help hospitals do a better job of managing inventory levels to meet clinical demand.