In the competitive and highly regulated business environment within the healthcare sector, acute care facilities are required to establish creative ways of managing the costs of owning their equipment while maintaining compliance with existing standards. The management is particularly challenged with the navigation of health institutions across several competing forces such as suppliers, competitors, and the patients. By considering these forces, it is necessary to establish a competitive advantage through investment in primary business competencies and optimizing costs (Wilson et al., 2013). One particular area of focus is the lifecycle management of capital assets needed for operations from the acquisition of the asset, maximizing the operation, maintaining performance, and the final disposal of the equipment. Healthcare engineering technology management (HETM) involves the interaction with medical staff and equipment to sustain enhanced performance. Through commitment to supporting and maintaining healthcare equipment, HETM is able to promote safe and effective patient care (Chyu et al., 2015). Therefore, HETM is an essential function as it helps in cost optimization in every step within the lifecycle management of medical equipment.
Acquisition Costs
During the acquisition of equipment, one of the most important things to consider is the cost associated with the procurement and purchasing of medical equipment. Developing a well-organized process of acquiring these medical equipment is essential as it can help healthcare organizations to save financial resources. At the moment, there is no specific process of acquiring equipment is identified across the world. To ensure that costs are optimized during the acquisition of medical equipment, HETM conducts several considerations. Some of these considerations include advancements in technology that can improve patient care and changes in physician staff. HETM is often engaged in conducting a proper market assessment to ensure that healthcare organizations obtain fair and equitable prices during the purchase of items. This is particularly essential for replacing fleet and technical and high-cost equipment like CT scanners. Based on an understanding of the organizational needs of the health facility, the HETM function can present clear specifications that avoid the need for additional equipment once the primary equipment has been purchased.
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During the acquisition stage in the lifecycle of medical equipment, HETM is essential for ensuring that all needed regulations are followed to minimize fines or heavy fees from regulatory environments. HETM employees also focus on costing all logistics components, including transport and comparisons between suppliers. They conduct premarket research to make sure that the organization obtains the best prices and can conduct reviews of the equipment before the purchase (Iadanza et al., 2019). Lastly, the HETM personnel uses relevant expertise and available information to decide between out-sourcing equipment, leasing equipment, and purchasing equipment. By conducting an assessment of which function combines optimal costing and superior patient care, this function is able to ensure that financial resources are effectively managed within this step.
Installation and Commissioning Costs
Equipment installation involves preparing or making it ready for use. Equipment commission refers to the process of ensuring that all systems and components within a facility are designed, installed, and operated in accordance with the operational requirements of the owner (Wilson et al., 2013). This involves the space to store the equipment, doors that are large enough for the entry of the equipment, and the water and power suppliers are available. There are costs associated with the preparation of rooms and making sure that employees have knowledge of what needs to be done and that the functional and safety tests are conducted on time.
During the installation and commissioning cost stage, the HETM optimizes the associated costs by performing a needs assessment. A needs assessment includes the evaluation of the available resources within the organization and the existing support for medical equipment. Based on the needs assessment, pre-installation work can then be conducted to minimize the damage that is caused to equipment (Chyu et al., 2015). Besides, during this step, HETM personnel plans for user approval once the equipment is delivered. This approval includes ensuring that there is no damage, the equipment is properly installed, and is functioning appropriately. This minimizes the receipt or installation of defective equipment, which will then result in additional costs for the organization.
The HETM personnel should be available when the supplier installs and tests the medical equipment to ensure that the equipment is working as expected. Additionally, the HETM is engaged in establishing financial penalties and insurance based on delays, damage, and any form of malfunctioning equipment. This ensures that the costs associated with the issues that arise during the installation and commissioning of equipment. Through awareness of warranty conditions, the HETM function is able to ensure that all the conditions are honored and the organizations do not incur additional costs (McConalogue et al., 2019). This may include the application of contract compliance, which presents the benefits of a robust warranty and service terms while increasing the visibility of the associated prices.
Personnel Costs
Once medical equipment is purchased and installed, the health institution is also required to invest in training and skills development. The medical staff requires full medical training and access to continuous professional development both at the management and lower-base employee level to ensure the effective use of the equipment. Failure to conduct the training effectively means that the skills acquired may not support the effective utilization of medical equipment. If the employees lack the knowledge and skills that they need for the application of the equipment purchased, the equipment may be damaged or not optimally used. This lack of proper use results in heightened costs associated with the equipment, such as the need for replacements or patch-ups to existing components of the equipment (Iadanza et al., 2019). As training should always be conducted and repeated in relation to any changes in the medical equipment, the HETM function is responsible for ensuring that the training programs established by the HR have effective coverage on the skills and competencies needed for effective utilization of equipment. This limits the financial resources that a health facility has to direct towards replacing equipment, making corrections, and carrying out patch-ups to specific equipment.
Personnel costs also include administrative costs associated with the management of the lifecycle of medical equipment. By establishing clarity and understanding of the organizational needs in regards to equipment, the HETM function is able to minimize the associated equipment costs. As the management does not have to allocate significant portions of their time to assessing the use of the equipment and providing logistical support to the application and maintenance of equipment across the health facility, costs can then be minimized. The HETM function, in this step, is crucial to ensuring that costs associated with human resources while managing the lifecycle of equipment are minimized or lowered.
Operating Costs
The operational costs associated with medical equipment are vast and vary greatly based on the equipment in question. The operating costs of equipment take place once the machine begins to operate and depends on the period of operation, the location of the installation site, and the type and category of the equipment. HETM function helps in minimizing costs within this step-through several activities (McConalogue et al., 2019). One of these activities is conducting consistent or periodic reviews and assessment of equipment to ensure that repairs are performed without delays, and any issues are identified early on to minimize the existence of substantial damage to the equipment (David et al., 2004). Periodic consumption costs can also be estimated by the HETM through an assessment of past records of similar equipment and the existing working conditions. This estimation supports the function of establishing an optimal working environment for specific equipment, enhancing the safety of use for the employees while minimizing the costs associated with operations.
The HETM function can also engage in the development of work schedules and ensuring that the facility and all equipment meet regulations. Health and engineering technology managers encourage briefings and debriefings for the exchange of knowledge to identify any issues in the operation of the equipment and minimize associated errors (Chyu et al., 2015). They are also engaged in conducting safety checks to increase the awareness of employees on safety practices. This minimizes the costs associated with the injury of staff or any legal fees that may arise as a result of lack of safety. The introduction of good practice protocols and engagement in the development of work schedules ensures that operational accidents are minimized, and the organizational culture is focused on the optimal use of all medical equipment (David et al., 2020). Through all these activities, the HETM function is able to ensure that the medical equipment is constantly operational while minimizing any costs that would result from a delay or pause in the operations.
Maintenance Costs
Maintenance costs refer to the funds needed for the repair and maintenance of medical equipment subjected to wear and tear due to the daily operations that are performed. Repair and maintenance costs cover a substantial percentage of the general operating costs. These costs include the costs for replacing parts of the equipment and costs for facilities structured for repair and maintenance of the equipment (Iadanza et al., 2019). These costs are heightened with the length of use with the age of the equipment. Proper and timely maintenance of the equipment assists in decreasing the repair and maintenance costs over time.
The HETM staff support minimal costs associated with the maintenance and repair of medical equipment by ensuring that a preventive maintenance (PM) schedule exists and that this form of maintenance is conducted regularly. This involves establishing a stable and known environment for the medical equipment to be utilized and the implementation of maintenance culture across the staff of the health organization. The HETM staff also closely collaborates with the hospital technicians to ensure that they are constantly enabled to conduct effective maintenance of equipment (David et al., 2004). This collaboration should involve the set-up of an equipped workshop that the technicians can constantly access. It should also involve ensuring that the technicians have access to spare parts on stock within the hospital or ordered in.
Therefore, costs are minimized by ensuring that the associated medical equipment is regularly repaired and maintained to minimize equipment breakdown and the need for the acquisition of new equipment. As each equipment is optimally used to its full capacity, health engineering and technology managers are also able to promote the acquisition of full value from the equipment. The health facility is, therefore, able to fully profit from the use of the medical equipment it possesses while also enhancing patient care.
Disposal Costs
The disposal of medical equipment acts as the last phase in the lifecycle of medical equipment. A large number of manufacturers leave the disposal of medical devices and equipment to operators such as hospitals. For health facilities, this stage presents them with heightened amounts of waste that they require to dispose of. This disposal may be expensive as it involves a wide range of costs ranging from transportation, storage, and the proper handling of hazardous waste. The HETM function engages in identifying the medical equipment to be disposed of and the best time for disposal (David et al., 2004). In this step, the HETM is responsible for identifying disposal channels that are available and identifying the best channel for each piece of equipment. These channels could include reusing, recycling, disassembly, or resale to the supplier (Wilson et al., 2013). Through risk auditing and an understanding of the functioning of the medical equipment, the HETM function can then reduce disposal costs by identifying the best channel for disposal. When purchasing new equipment, the HETM function can establish a contract in which the supplier may take responsibility for the equipment that the organization is interested in disposing of. Through the identification of the best method for disposing of the medical equipment, the health organization is able to profit from the overall acquisition and use of the equipment over its lifetime.
Conclusion
Organizations can save money, enhance the performance of equipment and improve the productivity of the staff through the comprehension of the lifecycle costs as associated with equipment and instrument ownership. This enhancement should also be conducted through the implementation of effective, proactive strategies to optimize the costs associated with the lifecycle management of equipment. At each step of the lifecycle management of medical equipment established, acquisition, installation, operation, maintenance, and disposal, the application of HETM is critical to ensure that costs are minimized. The HETM function minimizes these costs through the analysis, people, processes, and tools within each step to make the most appropriate decisions. Health facilities that apply HETM in the management of the equipment are able to view the TCO holistically and improve their level of profit while also sustaining a competitive advantage. More significantly, the application of this function ensures the safety of the medical staff and the enhanced quality of care for patients.
References
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David, Y., & Jahnke, E. G. (2004). Planning hospital medical technology management. IEEE Engineering in Medicine and Biology Magazine , 23 (3), 73-79.
David, Y., Judd, T. M., & Zambuto, R. P. (2020). Introduction to medical technology management practices. In Clinical engineering handbook (pp. 166-177). Academic Press.
Iadanza, E., Gonnelli, V., Satta, F., & Gherardelli, M. (2019). Evidence-based medical equipment management: a convenient implementation. Medical & Biological Engineering & Computing , 57 (10), 2215-2230.
McConalogue, E., Davis, P., & Connolly, R. (2019). Health technology assessment: the role of total cost of ownership. Business Systems Research: International Journal of the Society for Advancing Innovation and Research in Economy , 10 (1), 180-187.
Willson, K., Ison, K., & Tabakov, S. (2013). Medical equipment management . CRC Press.
