
Roundtable: Patient Monitors
TechNation kicked off the new year with a roundtable discussion about patient monitors.
Mon Feb 03 2025
TechNation kicked off the new year with a roundtable discussion about patient monitors. TechNation Editor John Wallace invited several industry leaders to participate in this month’s informative article. Participants are:
Elite Biomedical Solutions’ Glenn Schneider
Integrity Biomedical Services Owner S. Michele Shahbandeh
Soma Tech Intl Biomedical Engineer Mousumi Roy Dutta
Tenacore Biomedical Service Manager Juan Ortiz
USOC Medical General Manager Thomas Wang
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Q: What are the most common types of repairs or issues you encounter with patient monitors, and how do you typically address them?
Dutta: The most common issues with patient monitors typically fall into several categories. First, inaccurate parameter readings often require calibration. If the problem persists, we address it by replacing parameter modules, defective boards (e.g., ECG, SPO2, NIBP, IBP, TEMP), or the related cables and sensors. The second main issue is power supply failure, which is diagnosed by checking the power sources and testing components such as fuses, transformers, rectifiers, and diodes to ensure functionality. Third on the list are display problems, including touchscreen calibration, keypad issues, or trim knob malfunctions, which may require repairs or adjustments. Lastly, failures in anesthetic gas modules and recorders are addressed through calibration, fan filter replacement, or recorder maintenance as needed.
Ortiz: The most common issue we encounter with monitors is failure to boot up. To troubleshoot this, we start by checking the power supply, then the on/off switch, and finally the main board. Another common problem we encounter is the NIBP (non-invasive blood pressure) not reading or not inflating properly. In this case, you may need to replace either the module or the pump, depending on the specific type of monitor.
Schneider: The most common repairs we encounter are physical damage to transport monitors and mechanical failures (pumps, etc.) in monitors and physiological modules. We typically replace the defective parts with new or re-certified OEM parts and occasionally use aftermarket parts that meet our rigid quality standards. Once repaired, we run the device through a complete PM as outlined by the OEM.
Shahbandeh: We receive patient monitoring equipment with broken screens, components not soldered correctly, damaged boards, and some units that are intermittent. We have the skills and time to reassure the biomed that their units have been running for 24 hours. And, since we are a component-level troubleshooting company, we change the components and not the boards.
Wang: The most common type of repair issues we encounter are related to power, display problems, sensor malfunctions, alarm failures, ECG connectivity, software errors, and physical damages. At USOC Medical, we address these issues by first evaluating the issues, identify potential root causes, implementing the appropriate solutions. The key is to accurately diagnose the issue through careful calibration and testing of the unit followed up with swift, effective repairs to minimize customer downtime.
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Q: How often do patient monitors require routine maintenance, and what tasks do you prioritize during servicing to ensure optimal performance and patient safety?
Dutta: Patient monitors typically require routine maintenance at least once a year to ensure they remain safe and reliable. During servicing, we prioritize functionality testing, complete performance checks, and preventive maintenance to detect and address potential issues early. The calibration of all critical parameters is essential to guarantee accurate readings and optimal performance. We also focus on replacing wear-and-tear components (such as cables or connectors) and securing all connectors to maintain operational integrity. We conduct electrical safety inspections, including checking for hazards or malfunctions in the power supply, and ensuring proper grounding and surge protection, are critical steps to safeguard the equipment and protect patient data.
Ortiz: Most monitors require annual maintenance, which includes a full performance test to verify that the device is functioning correctly and meeting OEM specifications. Additionally, we recommend calibrating the NIBP during this service to ensure accurate readings.
Schneider: From my experience, monitors can be separated into two categories; with physiological inputs or displays. The monitors that have the inputs from the patient need to be inspected on a routine basis, depending on the hospital’s Medical Equipment Management Plan. Display monitors that receive inputs from other monitors can be on a much less frequent schedule (possibly no schedule) since they just replicate what the physiological monitor is measuring. All configured inputs must be verified as accurate or calibrated to OEM required tolerances. We perform those tests after every repair our technicians perform, as well as an electrical safety test.
Shahbandeh: We thoroughly go through each device that is sent in. We do not just repair and send it back without going through the complete unit with QC and burn in time.
Wang: Patient monitors typically require routine maintenance every 6 to 12 months to inspect and calibrate sensors, test the monitor’s alarms, and maintain components to ensure consistent performance. At USOC, we take every step of the repair process seriously from initial inspection, calibration, physical repair, software update, cleaning, and quality control. At USOC Medical, we follow a thorough inspection, repair, and quality control process on all customer units with a first-pass yield of 98% for the year. Our technicians are thoroughly trained to protect our patients’ safety by ensuring all repaired units pass our quality testing before shipping them out to the customers.
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Q: Have you noticed any particular challenges with newer models of patient monitors, such as software reliability, compatibility with other devices, or ease of repair?
Dutta: Newer models of patient monitors often come equipped with advanced software features that significantly benefit health care facilities. However, upgrading to the latest software versions can sometimes present challenges, as it requires careful consideration of compatibility and system requirements. Service manuals are invaluable resources for addressing these challenges, as they provide detailed guidance on installation and troubleshooting. While these advancements enhance functionality, they can also complicate repairs, making technical expertise and manufacturer support crucial for effective maintenance.
Ortiz: Yes, we notice that some of the newer models have issues with the NIBP readings being high. It appears to be a software problem, as the readings remain elevated even after calibration.
Schneider: The software on newer models seems to be very reliable. At times, the challenge is software and hardware compatibility conflicts. As the device ages and updates/modifications are made to them, versions can force incompatibility and require replacement of something that is not defective. For example, if a software update is needed, it may require a PCB to be replaced, even if it operated fine on the previous software version.
Shahbandeh: If we need a CPU that has the current software and we don’t have it in stock, we let the customer know and it is their decision to let us do the repair by offering to get it from the OEM and just charge what the OEM would charge us, with the labor to put it in.
Wang: Yes, newer models of patient monitors have challenges such as software glitches, frequent software updates, and more complex software architecture. Compatibility issues can arise with these newer patient monitors despite their advancements in accuracy, connectivity, and functionality. While the improvements on new models can be significant, they also bring higher costs, increased software reliability concerns, and potential compatibility issues. We recommend that health care facilities ensure proper training, establish robust maintenance protocol, and communicate with the OEM and service providers to ensure smooth integration of newer models.
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Q: How do you handle the calibration and accuracy testing of patient monitors, and what steps do you take to ensure that the equipment provides reliable readings?
Dutta: Calibration is critical for maintaining the precision and reliability of your monitors. To ensure accurate and reliable readings, we use OEM-certified calibrated simulators. The calibration process involves adjusting and verifying measurement parameters, as well as calibrating sensors and transducers. If the initial calibration does not match the desired result, a recalibration is needed. Furthermore, we meticulously record all calibration data and maintain proper documentation to ensure compliance and facilitate future servicing.
Ortiz: We follow all calibration steps outlined in corresponding service manuals and use the recommended test equipment. We also ensure that all calibration and test equipment is functioning properly and recalibrated according to manufacturer recommendations in order to maintain accurate readings.
Schneider: We test every device serviced against the MFR tolerances and all parameters as a minimum. Our ISO certification has traceability requirements on all repaired/PMed devices as well as test equipment. The technicians are required to document the test equipment used as well as its next due date on each work order. So, verification within the required recalibration period is confirmed.
Shahbandeh: Each of our technicians has their own devices that are calibrated and tested each year. We have provided the equipment and training to use each device.
Wang: At USOC Medical, we know reliable and accurate readings are critical for patient care. We carefully review the OEM’s guidelines closely before performing any calibration or testing. We then follow established testing procedures to verify the monitor’s performance against our calibrated equipment to ensure that it provides accurate readings according to a known standard. Additionally, we conduct accuracy testing validation process to ensure that the monitor provides consistent, accurate readings under varying conditions. All of this is supported by thorough documentation and routine maintenance at our facility for process consistency.
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Q: What are some of the most important considerations for health care facilities when selecting a patient monitor, particularly regarding serviceability, cost, and long-term reliability?
Dutta: When selecting a patient monitor, health care facilities should prioritize a balanced cost-to-performance ratio to ensure they receive high value without compromising quality. Rapid and readily available service options are equally important, as timely maintenance and repairs minimize downtime and ensure continuity of care. Long-term reliability is critical, with consistent performance over time being a key factor in both patient safety and operational efficiency. By considering these elements, facilities can make informed decisions that meet both clinical and budgetary needs.
Ortiz: We recommend choosing a reputable brand for the particular health care setting in which it will be utilized, ideally a manufacturer that makes their parts available to the end-user for serviceability. Some manufacturers do not offer replacement parts, or make it very difficult to obtain them, which can make repairs challenging and more costly.
Schneider: Do your homework. Software compatibility between the monitoring and IT portions of the systems make things very complicated. My approach has always been to contact the hospital HTM department referred to by the OEM, as well as organizations that have the systems you’re considering, but not referred to by the OEM. Do a five-to-ten-year cost of ownership (COO) evaluation on each brand. Be aware of tactics used by sales to sway the clinicians. I’m aware of at least one vendor that tells them that software upgrades are free. What they fail to divulge is that many times a costly hardware upgrade is required to move to a new software revision. Every organization has specific needs for clinical monitoring but has a limited budget.
Shahbandeh: Ensure you have a service provider at least ISO 9001-2015 certified, which assures them the company they choose to send their equipment adheres to those standards. Your equipment will need service, the cost matters, the warranty matters, and if they are reliable, you can count on your patient monitoring to be reliable.
Wang: When selecting patient monitors, health care facilities should consider the total cost of ownership of the units, product reliability/durability, user-friendliness and, most importantly, serviceability and maintenance needs. It’s essential to identify a reliable third-party service partner because a good service partner is the most cost-effective way to maintain your equipment in the long term. At USOC Medical, we pride ourselves on our high-quality repairs, exchanges, rentals, and we demonstrate this with some of the best warranties in this industry.
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Q: What else do you think TechNation readers need to know about purchasing and servicing patient monitoring devices?
Dutta: TechNation readers should evaluate the total cost of ownership when purchasing patient monitoring devices, including the initial investment, maintenance expenses, and potential software or hardware upgrades. Service support options are another critical consideration, as reliable and accessible support is essential for maintaining functionality and accuracy. Compatibility with existing systems should also be assessed to prevent integration challenges. Additionally, the device’s ease of use can significantly impact training time and overall patient care quality. At Soma Tech Intl, our dedicated sales, customer support, and operations teams are ready to assist with every step, from purchasing to shipping. For more information, call 800-438-7662.
Ortiz: There are a few factors to keep in mind when purchasing and servicing patient monitoring devices. First, compatibility and integration are important as you will need the equipment to work seamlessly with existing systems in the facility Second, consider opting for recertified devices which can offer all the performance needed at a fraction of the cost without compromising quality. Lastly, choose a brand that supports the servicing of their products by offering training, documentation such as service manuals, and parts availability to the end user.
Schneider: HTM plays a major supporting role and should provide all information available related to projected support costs (including staff training) to clinical and hospital leadership when deciding to purchase a patient monitoring system. It’s the most pervasive system, after the Electronic Medical Record (EMR), the hospital will purchase.
Shahbandeh: Service companies have a core competency, know who you are sending your patient monitoring to. Make sure they are the ones doing the job.
Wang: Having a reliable partner like USOC Medical is critical because we will ensure all your needs, whether it be repairs, parts, or replacement units are met consistently. At USOC Medical, we take pride in providing our customers with comprehensive and robust solutions to our customers’ patient monitoring needs. Our customer service team is available from 5 a.m. to 4:30 p.m. PST to support your inquiries, and we employ Lean and continuous improvement methodologies to ensure efficient, fast turnaround times on repairs. Above all, our commitment to quality and customer satisfaction makes us a trusted, well-established partner that stands by our work with an industry-leading warranty.