By Greg Doherty

When a CT or MR scanner fails unexpectedly, the resulting downtime can forfeit several thousand dollars per day in scan revenue, to say nothing about the cost of an emergency repair.

As health care executives can attest, that is often the tip of the iceberg. The effects of unplanned downtime can ripple out to include staff and clinician dissatisfaction, a decline in referring physician confidence, harm to the hospital’s reputation and loss of patients to competing institutions.



This is why my organization subscribes to remote proactive monitoring for many of its three dozen CT systems and 19 MR scanners. Proactive monitoring can detect anomalies in device operations, enabling us to be notified so that repairs can be scheduled before a failure occurs. This form of monitoring has significant value to our organization and to health care in general.

Full utilization of diagnostic devices is paramount. There is substantial value in being able to predict when failure might occur and thus preventing unplanned downtime. A less measurable, but still meaningful, benefit is peace of mind that critical devices are being watched and that our staff will receive an alert if something is amiss, even if from the users’ perspective all seems to be functioning normally.

Proactive monitoring is part of a spectrum of online service offerings that also include device software upgrades, remote technical support and remote diagnostics with online fixes that do not require a field engineer visit. An added benefit of remote technology is that when a service visit is required, the field engineer can arrive prepared with all necessary parts and tools and with an action plan to make a prompt repair.

Over the years, UnityPoint Health has experienced both unplanned scanner downtime and the benefits of proactive monitoring. The in-house clinical engineering team provides service to an organization that delivers coordinated clinic, hospital and home-based care for more than 5 million patient visits each year across Iowa, Illinois and Wisconsin.

Proactive monitoring is an automated process that measures a set of system parameters and uses fault recognition algorithms to detect errors and malfunctions. On detection of a potential event, such as the failure of a CT tube, a message is sent automatically to a technical expert who makes an evaluation and, if warranted, notifies the clinical engineering team and recommends corrective measures. The service then can be scheduled during idle times, such as overnight, so that patient exams are not affected.

One consequence of equipment failures is erosion of the staff’s morale and their ability to deliver optimum care. In a way, this is no different from owning a vehicle that cannot be relied upon. We do not want our clinicians and physicians to be frustrated while at work. They are highly educated professionals who need to perform at the top of their class. To do that, they need to have the right equipment available at the right time to deliver the necessary level of care.

Furthermore, in a health care environment that is replete with consumer options, patient confidence and satisfaction are paramount. Patients who experience a delay in care or a referral to another care provider because of an equipment failure may never return to our network. No patient wants to be denied appropriate care due to loss of uptime in a device important to his or her treatment and evaluation. For a person entering through the ER, a diversion to a competitor means the loss of all the other services that would have come along with an admission, and we may never see that patient again.

In the case of more routine care, we want to avoid disruptions that are patient-facing, and these include unplanned delays caused by equipment downtime. In such cases, most likely the patients have already fasted and otherwise prepared for their exams, and they have taken off work to be there. Now we face inconveniencing them again because of something we likely could have prevented. Avoiding those situations is part of the value of proactive monitoring. We may not always avoid an adverse event, but we significantly increase the probability of doing so.

Another benefit of remote monitoring is the collection and compilation of device data into reports that have value for our clinical engineering teams, as well as for organization leadership. On the maintenance side, we can gain insights to how the units are performing and whether there are errors that can be mitigated with simple software adjustments or a reset of a device. We also get more sophisticated information in the form of device utilization and workflow reports. We can use those in our business reviews with manufacturers to make sure we are optimizing the devices’ performance and using them to their fullest capacity.

The benefits of proactive monitoring accrue not just to device users, but to manufacturers as well. The service helps them protect their brand, ensure that their equipment is performing optimally and gather performance information they can use in design and engineering of new products and versions.

Like most health care technology, proactive monitoring is constantly advancing. Manufacturers are looking to extend the capability to additional diagnostic modalities where avoidance of unplanned downtime has substantial value. UnityPoint Health looks forward to a day when proactive monitoring becomes more universally available and deployed. In the health care industry, we all want our capital equipment to perform at its highest level for as long as possible to serve our populations and our communities.

As we face the challenge of optimizing care in a consumer-driven environment, we still have work to do. For device manufacturers and clinical engineering teams the question is: How do we embrace the monitoring technology that is available and put those platforms to optimum use?

About the author: Greg Doherty is executive director of clinical asset management with UnityPoint Health in Des Moines, Iowa.