iHT2
Phoenix, AZ
Maximizing the Value of Your Healthcare Technology
Management Department
Kenneth E. Maddock, VPBaylor Health Care
System
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Founding Statement
George W. Truet t(In His World War I Uniform)
“Is it not now time to build a great humanitarian hospital, one to which men of all creeds and those of none may come with equal confidence?”
Dr. George W. Truett, 1903 Co-founder
Texas Baptist Memorial Sanitarium, predecessor of Baylor Health Care
System
Baylor Health Care System – By The Numbers
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• Faith-based, not-for-profit health care provider based in North Texas
• 30 owned, leased, JV, or affiliated hospitals
• 196 HealthTexas locations
• 81 Satellite outpatient facilities• 122,000+ admissions • 20,000+ babies born • 409,000+ emergency department visits • 603,000+ outpatient registrations
(excluding ED and home care)• 3,653 licensed beds • 21,000+ employees • 3,200+ physicians on active staff• Largest hospital has 1025 beds; smallest
community hospital has 69 beds
Technology Infrastructure: Responsive, Reliable, & Scalable
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• 2 Primary Data Centers• 2 Secondary Data Centers• 13 Satellite Remote Campus
Communication Centers• 150 Midrange Platforms• 2 Robotic Tape Silos
• 3000 tapes per silo and 300 terabytes of spinning disk
• 200 to 1600 GB per tape• Moving to Virtual Tapes
• 36 Actual Tape Drives In the two Primary Silo’s.
• Disk capacity with some form of RAID• 2 Storage Area Networks (1600
Terabytes)• Imaging storage (2284 Terabytes)• Total DAS and NAS
(1319Terabytes)• 2350+ Windows and Linux Servers• 235+ Citrix Servers
• 1200+ Virtual Desktops, 40 virtualized applications
• 19,000+ workstations and 6,505 printers• 65 wireless controllers, 3100+ WAPs,
supporting over 8,000 clinical wireless devices & 2,500+ guest users daily
• LAN – 390 FON closets, 78,000 Network interfaces , 2,308 switches, 179 routers, 501 Uninterruptable Power Supplies
• Speeds of LAN transmission: 100/1000/10000 megabits per second
• WAN – T1, Opteman, GigaMAN • 2, 1GB internet connections, dual ISPs• 28,600 phones (TDM & IP)• 7,700 centralized voice mail users• 61,000+ biomedical devices• 38,000+ Exchange email accounts
Architecting future technology solutions to assist clinicians in improved clinical outcomes
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Who or what is Healthcare Technology Management?
• AKA Biomed or Clinical Engineering• Strong clinical and technical background
with a focus on patient safety and customer service
• Equipment installation, repairs, preventive maintenance, technology assessment, clinical equipment safety…
• Small team; BIG BUDGET, SCOPE, and RESPONSIBILITIES
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Healthcare Technology Management at Baylor
• 64,000+ biomedical devices with a purchase price of $650,000,000+
• Directors– Biomedical Engineering– Imaging Support
• Managers– Clinical Technology– 5 Biomed Managers– 1 Imaging Support Manager
• 2 Clinical Engineers• Biomedical Equipment Technicians
– 11 Senior BMETs – 25 BMETs
• Radiology Equipment Specialists– 2 Senior Radiology Equipment Specialists– 14 Radiology Equipment Specialists
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How can they help you?
• Include HTM leader in IS leadership meetings
• Learn from their customer service skills• Learn from their cost-savings ideas• Take advantage of their medical
equipment management database• Drive efficiencies
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How can you help them?
• Include HTM leader in IS leadership meetings
• Help them manage their database• Help them develop more effective processes• Help them with project management and
governance• Help them with the nuts and bolts of
financial management• Help them to manage security on medical
devices (not just cybersecurity-HIPAA!)
The Evolution
Biomedical Engineering <> Information Services• Prior to 1990 - We chatted about our hobbies• 1990 to 2004 - We worked independently, sometimes
competitively• 2004 through today - We are unified
Evolution of Biomedical Engineering• Initially device oriented• Devices became “smarter”• Devices were networked
Evolution of CIOs• What’s Biomed?• What are they doing with our equipment?• They want on our network?• Why can’t we work together?
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Strengths – A Biased Perspective
Healthcare Technology Management
• Broad and specific knowledge of medical devices
• Regulatory implications of medical devices
• Direct involvement in Patient Safety activities
• Customer service• Sensitivity to clinical
operations• Independence
Information Systems• Networking• Application creation,
adaptation, and optimization
• Governance• Project management• Collaborative
computing and interoperability - interdependence
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Common Characteristics
• Patient-oriented• Comfortable with technical complexity• Difficulty understanding those who are
not comfortable with technical complexity
• Need for high availability (.99999 or better)
• Not always well understood by their peers
• High marks on the “eccentric index”
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Experiences: The Good, The Bad, and the Ugly
• Separate networks for biomedical equipment and data
• Medical equipment closets not designed for equipment
• Getting a wireless policy into place– Impacts behaviors in areas with medical devices
(rationale for development of WMTS)
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Experiences: The Good, The Bad, and the Ugly
Clinical Engineering• Change control• Financial controls• HIPAA• Security
Information Services• Awareness of clinical
connection• Focus on processes to
the detriment of customer relationship– Governance– Project management
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Experiences: The Good, The Bad, and the Ugly
• Much of the good prevails– Help Desk– Clinical Sensitivity– Modifications to financial processes– Value of project management– Shared culture and shared vision– Awareness on both micro and macro levels related to medical and
information technologies• New good is created
– Understanding, appreciation, and admiration– Co-location– Professional development– Communications and internal marketing– Synergy necessary to improve availability (.99999)– Economies of scale and increased access to resources– Innovative solutions!
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Advice on Management of Shared Organizations
• Honesty• Deliberate and managed interactions• “What can I do to help you be more effective?”• Integration (or not) of processes and
technologies– Governance– Budget management– Professional development– Supply chain processes– Help Desk functions– Escalation procedures and policies– Project management
• Recognition programs 22