Lab Equip Techs take root

According to association for the Advancement of Medical Instrumentation (AAMI), “there are about 95 current certified laboratory equipment specialists (CLES) — at approximately 85 sites.” The tide is slowly shifting and the numbers of healthcare technology management (HTM) professionals, who are servicing lab equipment, is coming in-house. The operative word may be “slowly.”

One exception to the slow transition may be the ARAMARK Healthcare Technologies team at NorthShore University HealthSystem in Illinois. In our profile of NorthShore’s clinical engineering department in June, it was revealed that the team at NorthShore included five engineers who are part of their Laboratory Equipment Team.

“Four of these engineers have close to 20 years each working in the lab for various vendors. One of the engineers is homegrown under the tutelage of these four,” says Mike Karalius, B.S., CBET, CRES, senior corporate director of clinical engineering. “These engineers also help the lab to continue to pass the specific certifications they have for their areas. We have been at this for more than four years and have some happy customers. It’s a lot easier to work in the lab when you can talk lab.”

The move toward dedicated or highly trained lab equipment techs does hold out very real benefits for a hospital. “Hospitals are always looking for ways to avoid delays in patient care and save money,” says Carol Wyatt, MPA, CBET, manager, biomedical engineering, Baylor Health Care System. “On-site biomed techs with the skill set offer the most efficient way to complete a repair quickly and save money.”

Karalius agrees; “The lab is an opportunity for clinical engineering to expand and provide more service, quicker service in the facility. There are lots of things that we are able to do. When vendors come in, they basically do their work and leave. But, we’re here and we help them (the lab) look at entire systems and workflows. We can help them when they are doing projects.

We can help them when it comes time to buy more equipment. We can help them when it comes time to get certification, to look at policies and procedures and help streamline a lot of things that you’re not going to get when you have a contract.”

According to Rick Dillon, B.S., clinical engineering manager for the Trimedx-managed shop at Sacred Heart Hospital in Pensecola, Fla., the in-house tech can maintain the lab’s work flows when an OEM engineer might hold them up.

Dillon echoes Karalius and Wyatt’s opinion of the benefits of lab-trained techs on staff.

“Given the fact most hospital laboratories have little or no equipment redundancy and run their high-end analyzers 24/7, lab technologists are looking for quicker service response times. Utilizing in-house capabilities eliminates the manufacturer’s travel time and saves the hospital tens of thousands of dollars each year in repair costs,” he says.

“With this increase in demand for quicker response times, hospitals are also looking at reducing costs systemwide. To meet these needs, clinical engineering will continue to expand into all areas, making sure every modality is covered – including laboratory.

As health care continues to change, hospitals will have to identify more innovative, cost-effective solutions to run their operations, including the service coverage of their medical equipment.”

The advent of electronic health records (EHR) has been a game-changer in many ways. Clinical lab equipment can provide real time, or almost real time, information to clinicians. That information must find its way into the patient’s EHR.

From Vortex Genie’s to automatic coagulation analyzers, the range of lab equipment is broad and can include hospital owned as well as reagent rental devices. The clinical laboratory provides a number of functions including the analysis of blood and urine, blood typing to the identification of bacteria and viruses.

Karalius points out that there is one characteristic of lab equipment, and its relation to the clinician, that the biomed tech needs to remember. “One thing that’s different about lab equipment than the rest of the equipment in the hospital is that the users are very familiar with how the equipment operates and they have to get their hands into the equipment to work on it. So therefore, they become very attached to their equipment,” he says.

That independence and uniqueness, found in the lab, is echoed by Jeff Ruiz, biomedical engineering manager at Holland Hospital. His shop is also managed by ARAMARK Healthcare Technologies. “I would equate it to the challenging CE IT relationship,” Ruiz says. “Just as IT can be somewhat isolated at a hospital, the laboratory services also can be isolated. With that being the case, laboratory departments become almost like a self-sufficient entity. They like to manage their purchases and service agreements within the department. It appears very rarely that they seek second opinions.”

“However, with reimbursement cuts, and hospital organizations trying to do more with less, more and more laboratories are seeking consultative-type relationships,” Ruiz says. Here at Holland we respect the laboratory’s knowledge base/expertise. But by blending our resources we can offer alternatives to service. Learning some basic steps from an early best practices meeting within ARAMARK, we learned many ideas to offer value in reducing laboratories service cost.”

Ruiz says that a combination of open lines of communication, establishing a valid equipment inventory with respective service agreements, documentation (even when service is provided by the OEM) and evaluating your data all go a long way.

“As with any evaluation of technology, determine what areas of opportunity are there for service cost reductions,” he says. “This is where documentation is key. Service history plays a role if a device should remain on a service contract or maybe an alternative approach, such as time and materials could be cost effective.”

“Typically, historically, when biomeds find their way up into the lab, they’re dealing with a customer who really knows their equipment and is very defensive,” Karalius says. “Usually the biomeds don’t have enough experience about how the equipment operates (or) how it’s calibrated. They’re pretty good about handling a little bit of a problem here or there, that’s an easy fix that you can fix on any system, but when it comes to the more complicated issues, they really don’t have the necessary background.”

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