Originally Published in
July 2013
This month, TechNation asked infusion therapy equipment experts to weigh in on the latest trends in purchasing and service. Responders include Greg Alkire, Vice President of Sales and Marketing for Pronk Technologies; Andrew Davis, Account Manager for Tenacore Holdings and Dr. Tim Vanderveen, Vice President of the CareFusion Center for Safety and Clinical Excellence.
TechNation: What are the biggest trends right now in the infusion therapy equipment market?
Alkire: There has been a focus in the industry to improve the safety and effectiveness of infusion devices by integrating them into the hospital information network. Having infusion pumps connected to the hospital network provides additional safeguards prior to infusing the patient such as verifying the medication matches what was prescribed by the physician and reviewed/released by the pharmacy. This can also provide additional tools to the clinician for configuring the infusion device to ensure it is programmed according to the patient’s electronic records. In addition, it has the potential to capture errors in infusion therapy providing the biomedical engineer with additional information regarding the infusion pumps performance and error codes to aid in servicing and maintaining the device.
Vanderveen: With an estimated 65 percent of the U.S. market having already adopted smart IV pumps, most hospitals are now focused on maximizing the safety afforded by infusion technologies. Adopting wireless connectivity to infusion pumps has facilitated management of drug libraries, provided continuous quality improvement data, and created new opportunities for interoperability between the pumps and other elements of the medication use process.
TechNation: How will the market for infusion therapy equipment evolve in the next five years? How will that affect service of the equipment?
Alkire: Infusion devices are becoming smaller, more portable with advanced techniques for achieving greater accuracy of flow rate and volume delivered more quickly than previous designs. These devices are being placed throughout the hospital and are a challenge to find and service. Biomedical engineers are looking for tools to perform the necessary testing with a high level of accuracy, traceable to National Institute of Standards and Technology (NIST), which enable them to maintain a 4:1 testing accuracy ratio relative to the infusion device specifications. Having very accurate test equipment, that is also portable, will enable the biomedical engineer to go to the infusion pumps in the clinical departments to perform the service work instead of having to bring them back to the repair shop, thus increasing their efficiency in servicing these critical devices.
Davis: It appears that medical device manufacturers are focusing on designing pumps with more controlled safety features to reduce medication error. Many smart pumps nowadays record every keystroke in the history log. Some medical companies such as CareFusion and B Braun have even come out with pumps that require purchase of proprietary software in order to use them.With this proprietary software, the medical companies have more control of the servicing market, which will affect third-party repair vendors since they will not have access to the software.
Vanderveen: Integrating infusion devices into healthcare information technology (HIT) systems will be the primary focus over the next decade. Without this integration, it will be difficult to realize additional safety and productivity gains.
At the same time, integrating infusion pumps with computerized physician order entry systems, expanding bar code medication administration system to infusion pumps, directly documenting therapies from the pumps to the patient’s medical record, and incorporating pump alarms into “smart” alarm systems are high priorities and will usher in a new era of infusion therapy.
TechNation: What are some of the biggest challenges of purchasing and servicing infusion therapy equipment today?
Alkire: Our customers are telling us the biggest challenge is the large quantities of infusion devices requiring service/ maintenance involving a huge amount of labor hours relative to available resources. This in combination with the lost time in having to locate and bring the infusion devices to and from the biomed shop is causing the service of these products to be a large drain on manpower. Resources are being stretched even farther and finding efficiencies in maintenance is a big need right now.
Davis: The biggest challenge would have to be when the OEM decides to stop support on pumps. Finding alternative sources to purchase replacement parts becomes the real challenge.
Vanderveen: When purchasing infusion devices, hospitals must ensure the infusion pump they select will be compatible with their enterprise HIT system and other information technology solutions in order to create a seamless system that maximizes safety, efficiency and effectiveness. The average infusion pump should last between seven to 10 years, so hospitals also need to consider the vendor’s customer support and service, as well as their future capabilities to adapt and respond to changing technology so the devices do not need to be replaced prematurely.
TechNation: Please share your advice for people in hospitals that are faced with these challenges.
Alkire: Visual inspections are critical as infusion pumps are largely a mechanically controlled device, subject to quite a bit of wear and tear in
the clinical environment. Inspecting the products for physical damage, particularly in the area where the IV set is placed within the infusion pump, can help avoid free flow or over infusion problems when in use. Just as important, is to ensure test methodologies are being utilized that will provide faster and more accurate results.
Davis: There are many choices when it comes to service organizations. Do your due diligence and look for quality standards, national, standard of performance and customer service.
Vanderveen: The challenges of achieving infusion integration system-wide include cost, technology, implementation and culture. Of these, cultural barriers can be the most difficult to overcome. The level of service required varies widely, depending on the connectivity function. However, any hospital wanting to have a wireless system that incorporates infusion safety systems should plan for full auto-programming, since this important safety capability will undoubtedly become widely available over the next several years. Auto-programming requires both the necessary technology (near-real-time wireless connectivity) and a fundamental change in clinical workflow at the point of care to associate both the device to a patient and a caregiver to the device. It also requires image recognition (currently barcode scanning) to initiate the programming process.
TechNation: What else do you want TechNation readers to know about purchasing and servicing infusion therapy equipment?
Alkire: It is important to do your research when considering purchasing infusion devices. Talk to your colleagues on their experience with an infusion device your facility is considering purchasing. The same is true for test equipment needed to maintain infusion devices. There are a number of tools available, make sure you are investigating the latest technologies available to help ensure the best accuracy and efficiency, as well as overall value.
Davis: Due to the down economy, we see a lot more focus on the cost of repair rather than the quality. That can sometimes resort to the use of vendors who are not even qualified or properly trained to repair certain pumps. Although cost should be a factor, it is also important to remember that these are life saving devices, and quality should always come first.
Vanderveen: Although pump interoperability is considered by many to be the “holy grail” in IV infusions, this interoperability has not come easy. In addition to having a vision and strategy to achieve the next level of safety and productivity, biomeds should remain realistic in their expectations as regulated devices and non-regulated HIT systems begin to merge. Wireless connectivity to pumps was first introduced in 2004, and seven years later, the number of fully integrated pumps and HIT systems is very limited. In addition, interoperability will increase interdependencies – and the need for very close cooperation – between the hospital’s biomed staff, the information technology team and the infusion vendor.