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David and Jahnke: Planning Medical Technology Management in a Hospital

instruments, materials, systems, and facilities. Of all the To implement an effective plan, one will be expected to
factors and resources that will shape the future of the know how the present state of technological deployment
health of mankind, the one that most often stretches the should be assessed, and to have a good rapport with the
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imagination is medical technology. But yet, it is also research and development industry to be able to provide a
blamed for contributing to the escalation of health care forecast and review of emerging technological innovations,
costs without receiving recognition for improving access the impact that they may have on the particular institu-
to and quality and efficiency of the system. tion, plus have the ability to articulate justifications and
It is, therefore, expected that the only winners are provisions for adoption of new technology or of the needs
those who use superior strategy and execution. Generally, to enhance or replace existing ones. Because tomorrow’s
a superior strategy is the result of the use of market-based clinical devices are in the research laboratories today, a
demand forecasting. Market-based demand forecasting is medical equipment manager should be considering visits
a method of estimating future demand for a health care to such sites as well as to the exhibits areas of the major
organization’s services by using a broad range of data that medical scientific meetings. To facilitate the process, the
describe the nature of demand within the organization’s current state of the health care organization’s inventory
service area. This provides a fundamental link between should be assessed and quantified by the clinical engineer
strategic planning and financial planning and thereby based upon numerous criteria. This process is aided by
provides a rational basis for assessing how many patients the existence of both Biomedical Engineering equipment
may be expected to use services and what level of capital and Finance capital equipment databases. The technol-
12 ogy management process would include an assessment
resources is needed to provide those services. This
would define the types and volume of equipment needed using a multi-year template of when and if equipment
to meet demand. Equipment is categorized by its function will need upgrading, replacement, and when new acqui-
and owner department requirements in an assets list sitions are to be added. Clinical engineering should then
developed by the user and equipment planner as part of calculate a life-cycle for each asset. Using cost accounting
Biomedical Engineering validation of meeting appropri- analysis that includes a review of the impact equipment
ate clinical standards and institution integration prior has on reimbursement methodologies such as cost based
to purchase recommendation. The plan must be layered or case based, and in conjunction with a market-based
with present organizational capital asset requirements for forecasting model, each prospective piece of equipment
replacing and upgrading existing inventory to maximize should be priced and an overall annual cost of maintain-
effective use of the existing capital equipment matrix and ing the organizational inventory assessed as well as new
for appropriate systemization of medical processes. At additions supporting the strategic plan. Given the limits
this point, it is the managers who have to link technical of an organization’s resources, an overall prioritization
capabilities to clinical requirements. Too often planning can then be developed so that the most important medi-
is the result of a crisis, a situation that does not permit cal technology related to the strategic plan are procured,
thorough analysis and usually it is a time when it is too thereby enabling the organization to satisfactorily meet
late to begin a plan. Managers are expected to understand its service obligations, maximize financial returns, and
why their institution’s values and mission are set as they attain goals.
are, to pursue their institution’s strategy and business plan The past decade has shown a trend of increased legisla-
through that knowledge and to act in a way that effectively tion that supports more Federal regulations in health care.
allocates resources for which they are responsible. One These and other pressures will require that deployment
may not necessarily be a part of the organizational level of, and justification for, additional or replacement medical
that develops the institution’s strategic plan; however, technology is well planned. If you subscribe to the saying
one must be familiar with it, one must understand and that you cannot manage what you do not measure, and
believe in it, to be able to develop an action plan at that you cannot measure what you do not define, then the need
level that supports the institution’s mission. for the development and the maintenance of a systematic

J Global Clinical Engineering Special Issue 1: 23-32; 2018 26