Jackson Health System is one of the largest public health systems in the United States with a mission to provide one standard of high-quality care for all Residents of Miami-Dade County regardless of their ability to pay.
In Jackson, Charles Berberette, Director of Clinical Engineering Systems, manages
a team of 29 clinical engineers team, who maintain more than 45,100 medical devices across four hospitals, multiple urgent care centers and correctional, rehabilitation, transplant, outpatient and behavioral health care settings.
The Public Health Trust Board was established by the county board in 1973 as a group of volunteer citizens who develop policy for Jackson to ensure the health system is responsive to community needs.
As a civic group, the group leads a joint program of medicine between Jackson Health System, University of Miami Miller College of Medicine, Miami Dade County and other private and community organizations.
Berberette identified three issues the organization faces with clinical decision support data technology:
Purchasing medical equipment Parts
Jackson previously worked on parts procurement and quality, influencing decision to bring clinical engineering team in-house in 2019 and two factors that create new models of clinical engineering success.
“The health system wants to work with suppliers, allowing us to achieve greater cost savings through multiple negotiations and greater buying power,” Berberette explained explain. “The system-wide parts and service procurement platform will drive standardization, improve quality and increase cost savings and overall efficiency.
”Has With more than 45,000 pieces of medical equipment to manage, we also needed data to analyze the effectiveness of the parts we used and the associated cost and quality issues,” he continued. “We didn’t have that information, but knew our solutions had to deliver The ability to make data-driven decisions. CMMS
Jackson does not have a viable CMMS system, nor does it have an efficient way to create work order tickets. It needed a computer-based system to integrate time and financial systems and link to its CMMS to set up an automated work order system for all employees. CE engineering staff and employees serve the entire hospital.
“For example, someone would call a biomedical store and tell us there was a problem with their equipment,” Berberette said. “Our staff will then log the call and issue and find an assigned technician to provide that information.
” The technician would then manually create a work order in the system, fix the problem, maintain the equipment, and then go back downstairs to our department to close the work order,” he added.
Jackson has no accountability from a true turnaround time standpoint. If a technician forgets to enter a work order when he calls in, he may create it when he’s done
So when Berberette reviewed the order, it appeared that the job was done in one day, even though the clinical staff told us that the equipment had been down for three weeks. The organization There is also no personnel to direct calls and assign work orders to technicians.
ENHANCED Cyber Security Oversight
Jackson does not have an effective patch management program for its medical IoT systems. It wants to deal with This challenge and find an AI-assisted program.
“This is always a priority for any health system because the network Security incidents can cost as much as $10 million on average, and I always look back at the numbers when I talk about this,” Berberette noted. “Anytime you can prevent IT infrastructure outages, that’s important. That’s what we want to do with AI-assisted programs. “
“Wasting money is my biggest pet peeve,” says Berberette. “Through Supplier PartsSource, Jackson has streamlined the procurement process and worked with one supplier to access many different products from multiple companies.
“PartsSource and Jackson agree on good quality standards which means we can rely on receiving product ready to use and working order,” he continued explain. “The parts supplier also completed Jackson’s supplier vetting process, which is a requirement we follow as a public health system.”
Additionally, Jackson would like CE staff to be more efficient in procuring parts and managing orders. The parts supplier’s platform provides granular level of visibility, helping technicians track and trace their parts orders, manage internal uptime expectations, and track returns and core exchanges, which means less wasted time and money Organized at .
“Ultimately, high-quality patient care is our primary goal here at Jackson and the Clinical Engineering Department,” Berberette said. “Knowing that we have access to quality parts through the parts supplier’s platform is also critical to meeting clinical needs.”
Work order ticketing system
CE team maintains consistent cooperation with IT business Partner and developed software that allowed Jackson to upload database and asset information into the system. Each asset has a technician assigned to it. This is the first step in the process before implementing the system.
“For example, if the clinical staff has a problem with their equipment, we enter the information, the asset number, and the department,” Berberette explained. “The system automatically links back to our CMMS to identify the technician assigned to that department or facility.
” and then it Cross-referencing the time management system to see if that person is working hours,” he continued. “If that person is not working hours, the system checks for secondary workers, which means the system knows who is working at any given time. “
Jackson also built the upgrade tree and set limits for critical and non-critical equipment to upgrade without manually calling the next Tier management. It has an internal process to issue work orders without assigning to someone to ensure the work reaches someone.
timestamp helps internal processes route work orders to technicians without human interaction.
” We conducted a risk assessment as an organization , and learned that we needed an artificial intelligence solution tied to medical devices that could identify potential vulnerabilities,” Berberette revealed. “We wanted a more efficient tool to check for vulnerabilities, For example, patches required by the device.
“Introducing AI-based solutions to cybersecurity challenges is a first for Jackson,” he continued Said, “Vendor Cynerio helps protect Jackson’s medical devices from cybersecurity threats, including IoMT devices.”
face the challenge
The entire health system and its thousands of patients depend on CE teams to maintain the clinical availability of mission-critical medical devices. Jackson staff knew that any service interruption that resulted in significant equipment downtime was not an option.
“We introduce PartsSource Pro, their managed service model that combines cloud-based data analytics, best-in-class processes, and logistical support to drive evidence-based parts and service purchasing decisions,” explains Berberette.
“The supplier’s system saved costs and helped improve process efficiency,” he continued. “For example, the platform automatically sends return and core exchange reminders to ordering technicians, and paperwork is self-service directly from the website.”
Work order ticketing system
Jackson built internal CMMS software to ensure regulatory compliance and operational efficiency from the start of this new project.
For example, if a clinician encounters a problem with a piece of equipment, the staff enters that information, the asset number, and even the department to automatically link back to the CMMS system to See who is assigned to that department or that device as a key.
“Then it references our workforce management system, Kronos, to see if that person is at work,” Berberette explained . “If not, the system calls the on-call technician. If that person is not on or off that day, it checks with the secondary technician to see if they are on or off.”
This means that the crew will know who is on site at any given time, and the system will allow the crew to get work efficiently and order to the right people. Jackson also sets limits for critical or non-critical devices to automatically escalate calls to the next layer of management without human intervention. All orders are time stamped with progress notes for easy access by technicians.
Jackson will save $1 million per year on parts purchases from 2019 to 2022.
“The more efficient we are, the faster our equipment turns over, the more equipment available to patients, which reduces length of stay and improved patient satisfaction,” Berberette said. “Our savings have been consistent over four years based on using PartsSource’s data-driven decision-making platform.
” I Always looking for process improvements to drive my team’s success as I know all decisions impact Jackson as an organization,” he continued. “Suppliers monitor quality returns by tracking returns for all items from all suppliers. PartsSource currently has a quality return rate of 0.48%. Our quality return rate target is 0.5%, which equates to a 99.5% quality acceptance rate. “
By using suppliers’ FY22 (Oct 2021 – Oct 2022), Jackson’s parts sourcing spend will increase if he buys parts himself 46%. By using a parts supplier, it was able to save 34% over the market price for parts purchases.
” Additionally, PartsSource representatives We managed 1,850 orders for medical equipment; this allowed us to consolidate 202 suppliers, another example of efficient management based on our procurement model,” noted Berberette.
Advice to others
“Begin a needs assessment and develop a scope of work to enable clinical engineering to function in the way they need within their organization,” suggested Berberette. “This includes scrutiny, enabling them to maximize efficiency and financial stability.
“Then, review your organization’s needs and look for areas of opportunity that encourage growth,” he continued. “Look at past pain points and challenges, then try to develop solutions, especially computer-based, repeatable, and self-sufficient solutions, to help grow your internal programs.”
For cyber security, it is always most effective to choose the best solution for the organization, but also to constantly look for areas of improvement that can increase the efficiency of the organization, he concludes.
Email the author: bsiwick[email protected] Healthcare IT News is a HIMSS Media publication.