Roundtable Discussion: Infusion Therapy Equipment

This month, TechNation asks second-source infusion therapy equipment experts to discuss new technology, equipment trends and the challenges to service and maintenance. Joe Cramer, President of IV Technologies, Inc.; Sarah Shannon, National Accounts Manager at Ardus Medical, Inc.; and Bob Caples, President of Med-E-Quip Locators, Inc., each share their insight into an industry that has recently garnered both FDA and media attention due to a high incidence of medical errors associated with the device.

TechNation: What are the biggest trends currently affecting the service of infusion therapy equipment right now?

Joe Cramer: A current trend in the infusion therapy industry is wireless drug scanning with barcode administration. This technology has been designed to reduce the number of medication errors that are occurring at an alarming rate in our hospitals. The only problem is the cost of this technology. Hospitals are suffering from the lack of reimbursement from the government and private insurers.

Sarah Shannon: During the last couple of years, I have noticed two strong trends affecting the infusion equipment industry: The first is maintaining equipment to elongate the lifecycle of what they currently use. With the economic downturn, the healthcare community recognizes that preserving their infusion pumps is an easy way to save on capital expenditures. The second trend has been the growth of independent service organizations. Hospitals recognize that outsourcing the repair and/or preventive maintenance of their IV pumps with an ISO is far more economical than using their own biomed department. Now, their biomed department can spend their time repairing more complex medical equipment, which maximizes both their hourly salary and their skill level.

Bob Caples: The biggest trend affecting infusion therapy is the new “smart pump” technology, such as the Alaris Medley technology, Hospira MedNet Technology and B. Braun DoseScan technology. All these major pump suppliers have this proprietary technology, which helps them control aftermarket selling. It’s done like this: The smart pumps are sold to the hospital, and the hospital then has to buy and register the license.

            Another word used to describe “license” is “software,” which is installed and controlled by the manufacturer. The license, or software, is the smart pump technology the hospital will use to help control and alleviate dose calculation and medication errors, which may result in wrongful deaths and erroneous medication deliveries.

TechNation: How has the servicing of infusion therapy equipment evolved in recent years? How do you think it will change in the future?

Cramer: The infusion equipment industry has evolved from infusion pumps that allowed “free flow” to the most advanced “wireless-safe” technology, which is reducing medication errors.

Shannon: I have seen the basic “volume over time” device evolve into something that resembles a computer, in that it now incorporates smart pump technology. An IV pump employing this software will notify the clinician if the barcode on the drug to be infused doesn’t match the patient’s wristband. Not surprisingly, having this software in place brings peace of mind to all parties involved.

            With today’s environment as litigious as ever, I imagine that in the future all hospitals will be required to use safety technology. Not only does this software promote the prevention of improper infusion due to clinician error, it also records keystrokes that may be viewed through the software’s history log. In the event of a patient incident, the root cause can be traced back to either a user error or perhaps something more serious, such as a design flaw.

TechNation: What are some of the biggest challenges of servicing infusion therapy equipment?

Cramer: As far as servicing infusion therapy equipment goes, we have one major problem with the testing equipment. In my opinion, Hill-Rom’s Certamatic recertification system is the best system available, providing complete documentation of all test results and ascertaining that the equipment being tested meets or exceeds manufacturers’ specs. This system reduces the time to perform these preventative maintenance checks and saves money in manpower and time.

            However, Hill-Rom has pulled the plug with no support or even returned phone calls. Once the software license runs out, the Certamatic is dead. This system cost us $22,000 several years ago, and we were hoping to get more use out of it.

Shannon: Servicing infusion therapy equipment can present some challenges, which can be attributed to the age of the equipment. Older IV pumps can be easier to service because they are easy to troubleshoot; however, the challenge may be how to source parts if the OEM no longer supports the device. In addition, newer technology requires more education and training on how to troubleshoot a unit that is software-driven. Plus, newer units have many tightly engineered, complex circuit boards, increasing its potential to require service.

Caples: One of the challenges biomeds will encounter when servicing infusion pumps will be their ability to find OEM parts. Biomedical professionals will need these parts when their older infusion pumps fail or the pump manufacturer no longer supports the parts.

TechNation: Do you have any insider tips for hospital biomeds servicing infusion therapy equipment?

Cramer: When doing preventive maintenance checks, it becomes very repetitious to perform all the tests required, such as accuracy, output pressures, electrical leakage and visual inspection of equipment. But these tests must be done and never overlooked due to time constraints. In fact, I’ve seen people put PM stickers on pumps that haven’t been inspected, just to cover themselves. And that’s scary.

Shannon: Biomeds servicing infusion equipment should always maintain a controlled work environment. For instance, the temperature should remain close to 70 degrees and the humidity should be low. This will prevent erroneous alarm conditions of the device, which can be sensitive to the ambient conditions. Additionally, biomeds should always practice antistatic safety measures while performing any repairs, as this can prevent further damage to components within the device.

            Furthermore, biomeds should check that the proper testing equipment and precision tools are being employed to ensure that the repair has met OEM specifications. It’s also important that test equipment and precision tools receive annual performance verification from a third party to ensure accurate readings.

Caples: My advice is to network with other biomedical professionals in a similar position as you and source third-party companies that manufacturer discounted parts that could be used to repair defective units. Another tip is to source out units that could be purchased at a great discount and used as parts to repair defective devices.

TechNation: Please address any software issues in the infusion therapy equipment industry.

Shannon: Many of the issues that come with using software-based infusion equipment concern wireless communication. With IV pumps now capable of transferring sensitive information wirelessly, biomeds must also learn IT and/or work with the hospital’s IT department. This is important so that the interface between other wireless medical units remains open while also ensuring patient privacy is uncompromised. Also, some infusion devices require the software to be purchased and built specifically for each hospital, which is both costly and time-consuming.

Caples: All smart pump software is registered, downloaded and controlled by the manufacturer through the infusion pump serial number. When a company like mine comes across these devices on the grey market, the hospital looking to buy the used smart pumps will have to contact the manufacturer to see if these units are compatible to the smart pumps already in their possession.

            So, in essence, the manufacturer can either tell the interested hospital “yes” or “no” when it comes time to buy these units from the remarketer. Therefore, this new technology does affect us when we find them on the used market. Like I mentioned before, if you purchase smart pumps, there is a chance that you may not be able to sell them.

TechNation: What else do you want TechNation readers to know about infusion therapyequipment?

Cramer: Over the past 25 years, I have seen this industry grow from two companies to too many to count, all of which are offering lower prices. Case in point: I recently went on a competitor’s website and saw a price for a part go as low as $50, which the OEM sells for $550. That shows me that people are getting desperate.

            To make it in this business, the infusion therapy company has to focus on this business. If you branch out into different markets and spread yourself too thin, both your customers and the entire industry will suffer. Price can’t be the only deciding factor. Track record, quality and customer service have to be included in the decision to pick a company. Therefore, biomedical professionals should ask for several references to verify the company’s commitment.

Shannon: In today’s cost-conscious environment, it’s important to not discount the effectiveness of both pre-owned and non-OEM parts. Often, pre-owned parts are supplied with a warranty and can be an extremely economical option to keeping older technology alive, especially while capital budgets remain frozen. These parts can offer huge benefits from cost savings to stronger plastics that withstand caustic cleaning agents. Hospitals all over are enjoying the benefit of buying non-OEM and pre-owned parts, which both contribute to the life of the infusion equipment they’re placed in.

This month, TechNation asks second-source infusion therapy equipment experts to discuss new technology, equipment trends and the challenges to service and maintenance. Joe Cramer, President of IV Technologies, Inc.; Sarah Shannon, National Accounts Manager at Ardus Medical, Inc.; and Bob Caples, President of Med-E-Quip Locators, Inc., each share their insight into an industry that has recently garnered both FDA and media attention due to a high incidence of medical errors associated with the device.

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Published in the Feb. issue of TechNation Magazine.