Medical devices are vital components of care diagnostics and delivery. Their network connectivity and resulting special security precautions often drive the decision to integrate biomedical services into the IT department. However, as with any organizational structure change, this decision should not be made lightly.
Get 3 key imperatives for developing an IT governance charter
In practice, we see three primary reporting structures for the biomedical services or engineering group:
- A centralized group which reports to the CIO;
- A centralized group which reports to the CMO or CMIO; and
- A distributed model where the responsibility for medical devices is spread across departments that use the equipment (e.g., oncology, cardiology, radiology, lab, etc.).
However, health care organizations should evaluate each approach to fit their specific needs. Here are some positive and cautionary aspects of each reporting structure.
Approach 1: Reports to the CIO
- Pros: This reporting structure enables better alignment with infrastructure (especially network and security) and applications.
- Cons: However, it requires a significantly greater degree of collaboration with clinical departments than any traditional IT function; responsiveness to problems is more urgent and required clinical knowledge is much greater.
Approach 2: Reports to the CMO or CMIO
- Pros: Under this approach, physician leadership is better positioned to make decisions about medical devices.
- Cons: However, there's a lack of experience with IT infrastructure standards.
Approach 3: Distributed model
- Pros: This structure puts the responsibility for the device into the hands of those who understand and use it the most.
- Cons: However, there's a less efficient use of labor as each department must supply its own staff.
In addition to reporting structure, there are several key operational issues to consider. Below are benefits and challenges that organizations should weigh carefully.
Benefits of IT managing biomedical
- IT tends to be more disciplined about—and have more mature processes for—inventory management, vendor selection, and budgeting;
- Most biomedical devices (e.g., CT machines, MRI machines, IV pumps) are connected to the network and interface with applications, so it can be beneficial to have IT manage the entire process;
- The help desk function within IT can leverage the field engineers who support the distributed desktop and network environments to share the load with the biomedical technical support staff;
- IT project managers can assist with medical equipment acquisition and implementation; and
- IT could get a better view into the clinical world if they support medical devices.
Challenges of IT managing biomedical
- IT staff often do not have the specialized skills and knowledge required for full support of all medical equipment;
- There is a risk that biomedical is understaffed and under-resourced, and there may be an expectation that IT would make up the difference out of existing resources;
- Typically, biomed processes are less formal and more personal than IT processes. For example, staff may be used to contacting the biomedical support person directly instead of calling the help desk. There can be a perception that biomedical is more responsive to clinical needs;
- It can be difficult to prioritize selection and replacement of medical equipment due to contention between clinicians and departments. IT is not well positioned to make those choices;
- The inventory of medical equipment tends to be very large and often poorly documented, requiring IT to spend resources on a thorough inventory; and
- IT will need to learn the importance and priority of the various medical devices to ensure appropriate levels of attention are applied (e.g., maybe it cannot wait until morning or maybe the requestor just thinks that it cannot).
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Next, get 3 key imperatives for developing an IT governance charter
With so many stakeholders invested in IT-related projects, having a sustainable structure for decision-making is key. To guide your decision-making process, distribute responsibilities among committees, and encourage shared accountability, we recommend creating an IT governance charter.
Business leaders and IT executives should use our toolkit to determine the critical components of a charter based on their organization's distinct needs. How should you structure committees? How often should members meet? How will you measure productivity?
First, review our recommendations and examples, then answer 10 questions to develop the framework of your own charter.