Imaging leaders and experts replied to questions from ICE Magazine to share their asset management insights with readers this month. This Director’s Circle article is a companion piece to the Product Focus feature that highlights some tools and services that health care facilities can use in regards to the asset management of imaging equipment and devices.
Top-notch imaging leaders providing their thoughts and knowledge include members of the ICE18 Leadership Summit recently held in conjunction with the Imaging Conference and Expo (ICE) in Irvine, California. For more information about the ICE conference, visit AttendICE.com. Participating in the April 2024 Director’s Circle are:
- Jessica Chambers, MHA, RT(R)(CT), Regional Service Line Director of Imaging, SSM Health St. Joseph Hospital
- Michelle Dossa, Ph.D., CRA, RT(R), Radiology Director-West Market, University Hospitals of Cleveland
- Nancy Godby, MS-MHA, MA, RT(R)(M) ARRT, CHC, Director of Radiology, Cabell Huntington Hospital Inc.
- Katherine A. Mohr, DBA, MA, BS, CRA RT (R) (CT), Director, Sinai Hospital
Q: What are the automation tools you use to track your asset’s performance and utilization?
Chambers: Currently we do not have a good source of truth for asset utilization, we are currently evaluating some solutions yet haven’t landed on one to invest in yet. I do track all imaging equipment on a replacement roadmap that we pull downtime hours from our biomed partners and age of equipment to help estimate replacement strategies.
Dossa: We are currently able to pull data from our EMR as well as use Power BI tools. We have a specific set of KPI based on engagement, quality, and finance that we track/report for all of our imaging sites across our system. We develop system-wide S.M.A.R.T. goals each year that are tied to our organizational goals and our results are tracked and reported – some on a weekly basis while others are monthly.
Godby: I maintain an Excel spreadsheet listing all equipment/assets and we receive monthly and quarterly reports of repairs made.
Mohr: TMS. We do not track utilization.
Q: How do you incorporate these metrics into your overall department goals?
Chambers: We track the appointment fill rates in our outpatient imaging departments to understand our capacity in these departments. Most of our other goals are around volume and NOI and due to the lack of utilization dashboards in our organization we are unable to form dedicated goals around utilization. If we are blocking appointments from down equipment, then it will have a direct impact on volume and net operating income therefore the asset itself is identified as a gap and we will use that data to assist us in escalation for replacement.
Dossa: This year, we have a team working on a green/red dashboard that will display our S.M.A.R.T. goals and KPI so we can track our performance. We build action plans around our results.
Godby: We utilize information for equipment planning and purchases.
Mohr: Uptime is tracked globally, not just for radiology devices.
Q: What is the strategy for managing aging equipment, especially when there are budget cuts?
Chambers: I have a 10-year roadmap forecasting when we will replace equipment. I work with each hospital VPO to determine the order in which we will ask to replace the equipment across the region. We are given a regional budget to spread across the seven hospitals and therefore it’s a collective effort to determine what we need to replace first. We still have quite a bit of aging equipment, so we are still in the catch-up phase. We hope with this more proactive strategy of replacing before the equipment is limping along, we will see better outcomes in the future.
Dossa: We have been working on a non-obsolescence plan with key equipment vendors. Our plan has helped us declare specific equipment configurations for each modality as well as prioritize replacements over the course of 10 years. We look forward to this planned structure vs. piece-by-piece replacements.
Godby: I include on my Excel sheet a future date for which I believe we need to begin to plan to replace each piece of equipment.
Mohr: We maintain service contracts or use an insurance program.
Q: As an imaging leader, which departments do you work with when it comes to asset management?
Chambers: Purchasing, since we have a pre-established equipment roadmap our purchasing team will use the estimated replacement numbers to negotiate pricing. Additionally, if I am transitioning vendors, I will connect with biomed to verify they are trained to service the equipment. If not, we will make sure their training is included in the equipment quotes. I have to work with IHT to perform a technical assessment on the equipment to verify it is safe for the network.
Dossa: Equipment replacement requires collaboration with many – radiologists, technologists, physics, radiology IT, research, ordering providers, HTM, vendor, facilities, finance, leadership, supply chain, strategy.
Godby: Materials management, contracting, risk management for contract reviews and each of our radiology leadership to determine how best to proceed.
Mohr: Clinical engineering.
Q: What modality will you be replacing next? What features are a must-have for the new devices?
Chambers: MRI. Our equipment is very out of date. We do not have a lot of the fast-scanning technologies within our scanner. We feel we can actually grow volume with a newer scanner as new technologies will allow us to shorten scan times.
Dossa: We hope to be adding a CT in an ED space. We are looking for cardiac and neuro capabilities in additional to the ability to perform more traditional ED exams, i.e. chest, abdomen, pelvis. We must have ease of use and fast reconstruction ability for our technologists to ensure quality throughput.
Godby: We do not have any plans for replacement for the next fiscal year.
Mohr: MRI, standard 1.5T with breast imaging capabilities.
Q: What else can you share with ICE Magazine readers regarding asset management?
Chambers: In the recent years, we really have changed our focus from a replacement of “broken” equipment mentality to a more forward-thinking proactive approach. The development and collaboration of the roadmap has really helped us with engaging the key stakeholders and keeping everyone updated on the progress of new equipment purchases. I would like to see us get to a point one day that we are able to replace equipment to keep up with technology versus using equipment far past its life expectancy and missing out on multiple generations of advanced technology.
Dossa: Have one source of truth when it comes to equipment inventory. We found that many had lists but did not always track the same information and/or accurate information. We found physics to have the most accurate inventory. From there, we touched each piece of equipment to validate information. Asset management is a team sport. Be sure to include all key stakeholders when developing and executing a plan. And, don’t be afraid to have those difficult conversations when needed around what may be needed and where in your health care system. Be smart about using capital assets. •
