Proactive Strategies for Managing End-of-Life Medical Devices

An ever-expanding spectrum of medical technology now enhances all aspects of patient care. Medical devices are part of diagnosis, treatment, monitoring, rehabilitation, health management, and data capture across healthcare specialties. Today's hospitals collectively own 10-15 million medical devices, most of which are connected; a 500-bed hospital probably owns about 7500 machines.

With all the above in mind, it’s fair to say that capital equipment planning has become a complex game in which the rules seem to change frequently.

In such a game, end-of-lifecycle planning can feel incredibly mysterious, and quite frustrating. Decisions about the final phase of a device lifecycle are based almost entirely on predictions — how long it will last, depreciation, market value at the time of retirement, replacement options, cybersecurity, and many other factors. Unfortunately, this often means that end-of-lifespan planning receives less time and effort than the earlier lifecycle phases.

Every healthcare organization has specific capital equipment needs requiring a unique strategy. Larger health systems may have an infrastructure tied to vendor partnerships and ISOs, allowing them strict adherence to a multi-year capital asset replacement plan. However, a small to mid-size hospital may be more reactive, i.e., if it breaks, then we either fix it or replace it.

Regardless of size, some choices about the end of a biomedical device's lifecycle can have far-reaching impacts for providers and their patients. However, proactively managing the end of medical device lifespans increases ROI, provides better control over capital budgets, minimizes asset downtime, and ensures that only safe, reliable medical equipment is available for patient-centered care delivery.

Following are suggestions for getting ahead of the game when preparing for clinical asset retirement.

Conduct annual retirement assessments on medical equipment

Ignited by the COVID-19 pandemic, health tech is evolving at breakneck speed. Five-year capital equipment assessments have been the norm for over a decade, but hospitals can no longer afford to stick with business as usual. Over five years, too much can change regarding technology upgrades, recalls, cybersecurity, platform compatibility, treatment protocols, the usage demands of the hospital, and the overall healthcare landscape.

At best, these changes will cause issues that may result in underutilization, undermining ROI. At worst, such issues can lead to an adverse patient event or create vulnerabilities to cyber threats, potentially causing widespread harm.

In an annual plan, capital equipment is evaluated yearly based on criteria such as:

• Age of device
• Recall history
• Clinical application
• Itemized repair costs
• Software upgrade history
• Supportability
• Parts availability
• Cybersecurity

When assessing parts availability, remember that devices for which OEMs no longer make parts can be repaired using components made by 3rd-party biomedical manufacturers. Finding a trusted 3rd-party manufacturing partner can safely extend the lifespan of medical devices.

After gathering data and intel, replacement priority is then determined by giving devices a numerical score in each category and using weighted factors to standardize the data across devices. The existing 5–7-year replacement plan is then updated, and the latest assessment is entered into the CMMS. After the initial year, that information is readily available and accessible to all stakeholders each year going forward.

Consolidate hospital asset retirement plans

A multisite health system might see a scenario where infusion pumps at different facilities are slated for retirement in 2025, 2026, and 2027. Adjusting the plan to retire all these devices in 2026 could equate to substantial savings when purchasing replacements.

Ashley O'Mara, CCE, MS, VISN, discussed decommissioning strategies in an article published in Biomedical Instrumentation & Technology. "We get more value if we do a consolidated equipment buy for eight facilities than we do when we're just buying for one. So in that case, it would make sense to plan a consolidated purchase and earmark funds that anticipated fiscal year," said O'Mara, the VA New England Health System's chief clinical engineer.

For standalone hospitals, consolidation might take some creativity. For example, one telemetry model is retiring in three years and another in five. If a single newer model can replace both, retiring the older versions together in one year would boost the number of replacement devices needed, which typically results in lower prices during purchase.

Take advantage of medical equipment trade-ins

Trade-in agreements with new equipment vendors are common. Trading in used devices when purchasing new assets takes the burden of resale or disposal off the healthcare provider. When healthcare organizations don't prioritize trade-in agreements, they miss out on substantial savings in labor, time, and money. Hospitals can leverage the trade-in offer when fostering partnerships by requiring it to be included in the quote or RFP. When manufacturers see trade-ins given priority, they know they must impress in that area to seal the deal.

Avoid storing retired medical assets

Working with an ISO or ISM partner to sell previously owned equipment can be lucrative. Be sure to create those partnerships before a scheduled retirement so both partners can be ready when the time comes.

Most of the time, storing assets in the hopes of selling when the hospital has no concrete plans or partners in place ends up causing a financial and logistical burden. They take up valuable space, and disposal costs may increase the longer the device is stored.

Collaborating for a well-informed strategy

Interdepartmental communication is critical for an effective asset retirement strategy. Not only does this eliminate issues arising from siloed medical equipment data, but it provides a more complete picture of the health and relevance of the devices in question. Input from BMETs, clinicians, risk management, compliance, quality, and admin guarantee that decisions are made with the best possible intelligence in service of operations, staff, and, most importantly, patients.

Elite Biomedical Solutions makes affordable replacement parts of OEM-level quality. We proudly manufacture our parts in the USA. Contact us to discover how our parts and repair support services keep patients safe and extend device lifespans.