In an effort to take more ownership in its biomedical engineering, capital equipment and diagnostic imaging assets and operations, Piedmont Healthcare opted to bring all of it in-house.
The Atlanta-based integrated delivery network of 11 hospitals and a multitude of other healthcare facilities wisely decided to take the plunge when it was smaller – as in three hospitals way back 14 years ago – and seemingly more manageable.
“We started using the [Piedmont] model back in 2004 when we bought Piedmont Mountainside onboard, followed by Piedmont Newnan in 2006,” said Jeff Allen, Executive Director of Biomedical Engineering and Capital Equipment. “Both of these hospitals used a third-party company (independent service organization or ISO) for their biomedical services.” The Mountainside and Newnan facilities joined Piedmont’s Atlanta flagship and Fayette facilities at the time. The Henry and Newton hospitals followed in 2012 and 2015, respectively, followed by Athens Regional in 2016.
Allen indicated that Athens represented a special case. “Athens was an in-house model already,” he said. “We just converted them over to our policies and procedures and converted their database to ours.”
Allen lauds Piedmont’s system-wide central equipment database, AIMS by Phoenix Data Inc.
“AIMS is a very good robust database,” he said. “Any [computerized maintenance management system] is the backbone to a biomedical department. Phoenix Data has been a good partner and listens to us when we need a change or an enhancement. We use it for all inventories, [preventive maintenance] schedules, work order history, purchasing data and reports. We have it linked to Excel (Open Database Connectivity) to query live data and use a live real-time dashboard for monitoring.”
Under the first full year of Piedmont’s program, Athens is $1.03 million under budget for the first six months of fiscal 2018, according to Allen.
From fiscal 2013 to fiscal 2018, Biomedical has recorded a 90 percent increase in work orders (nearly 66,500 projected for this year alone), more than doubled its clinical equipment count (to nearly 52,400) and booked a 40 percent increase in inventory value (to nearly $150.8 million).
By the same token, equipment cost of service ratios (acquisition to service costs) have dropped to below 6 percent fiscal 2017 from more than 10 percent in fiscal 2013.
Allen also uses dedicated space in Piedmont’s centralized distribution center to serve as a “central equipment depot” for the system. To facilitate this service, Allen works with VIZZIA Technologies and CenTrak to apply real-time location system tracking to mobile medical equipment, including IV pumps, SCDs, PCA, feeding pumps, beds, IABP, ventilators and defibrillators. RTLS tracking is installed in five hospitals currently with another three in different stages of installation, he added.
Allen’s vision for Piedmont’s RTLS-enabled biomedical operation was simple: “Be our own rental company without the rental cost,” he said. “The obstacles are standardizing equipment throughout the system, obtaining funding to stock the depot, staffing and logistics.” The in-house program costs decreased by almost $2 million to nearly $8.5 million in fiscal 2017, according to Allen, and Piedmont pays about one-third of what it used to pay under the old contracts.
Piedmont’s Biomedical Engineering team includes specialists that maintain such equipment as anesthesia machines, ventilators, balloon pumps, heart-lung machines, CRRT, dialysis and patient monitoring/telemetry units. On the diagnostic imaging side, Biomed handles such equipment as computed tomography, magnetic resonance, cath lab, injectors, ultrasound, linear accelerator, radiography/fluoroscopy and interventional radiology units. They manage but do not maintain rigid and flexible endoscopes, according to Allen.
“Besides our core business of corrective and preventive maintenance on the equipment [mentioned], we report out on equipment recalls, part of equipment RFPs, purchase and service contract negotiations, embedded into construction projects related to medical equipment and give feedback/recommendations to the C-suite for budgeting and replacement planning,” Allen said.
When Biomedical Engineering proposed bringing Diagnostic Imaging service in-house from using outsourced services in 2012, he admitted his team garnered mixed reactions.
“We had excellent support from the C-suite to bring DI service in-house in 2012,” Allen said. “Clinicians and physicians were a little more skeptical. We put in place a lot of communication, follow-up meetings, metrics and transparency to hold ourselves accountable. Both OEM and third-party contracts had been in place for years.”
