Under cost pressure, providers today are weighing their options when it comes to servicing their medical equipment. Increasingly, the one-size-fits-all approach to maintenance is being displaced by a more customized approach based on specific needs. For non-OEM servicers, whether they be independent service organizations (ISOs) or multivendor service (MVS) organizations, this trend creates an opportunity to stand out from the fray.

While original equipment manufacturers (OEMs) can generally maintain and repair their own equipment, the cost of their services, along with the need to maintain solutions from multiple vendors, may push healthcare practices toward third-party providers for their servicing needs. In some cases, the OEM may have stopped offering service on a piece of equipment, making third-party service the only option.

ISOs typically support equipment from one or more manufacturers at lower prices, many of the best ones have field service engineers with experience and skills comparable to the manufacturer for certain modalities, and some even offer training to hospital in-house teams. MVS organizations offer similar services, but have the backing of one of the other equipment manufacturers.

"Quick fix or support (traditional service) will still be a foundational element, but the reality is that the preferred service providers in the future will offer more flexible solutions,” Aaron Goryl, vice president of GE Healthcare strategic service solutions, told HCB News. “They will always consider the user’s need and desired outcomes before and after they may purchase equipment and services.”

What to look for in a non-OEM service partner
Providers must convey clearly what they are seeking in a service agreement to get one well-tailored to their needs. This means recognizing their current requirements, as well as their long-term objectives. While certain problems may be beyond their expertise, ISOs possess certain advantages over manufacturers.

Altima Diagnostic Imaging Solutions, based in Dallas, Texas, services Siemens MR and CT scanners, offering parts repair and replacement, installations and deinstallations, magnet quench support, and site planning. CEO and president Larry Knight says the company’s relatively small size gives it more flexibility to customize agreements and provide support where it is most needed. “Facilities may already have agreements in place for cryo components, helium, or chiller service, which allows us to scale those agreements even more by excluding already covered components,” he said.

Since provider needs are constantly changing, non-OEM servicers should update their contracts frequently to reflect a practice’s growth and its capabilities, according to Jason Crawford, president of Block Imaging parts and service, in Michigan, which services new and refurbished imaging equipment. “As an in-house service team builds capacity over time, they’ll be ready to assume more risk,” he said. “Block Imaging facilitates a transition from full-service coverage to an escalation and parts support role.”

Healthcare organizations that prefer OEM partners may want to consider going with a multi-vendor service organization, a manufacturer that services their own equipment as well as solutions from other vendors. Philips has its own MVS division and training center in Nashville, providing customized training and intellectual property that can be licensed to in-house service teams. The Nashville facility also houses AllParts Medical, one of the world's largest suppliers of used medical equipment parts.

“The biggest key differentiating factor of our multivendor service is that it provides customers with a one-stop-service for all their equipment across their organization without subcontracting — it is all done directly in partnership with Philips, without the need for third-party support,” said Rob Stevens, service operations leader for Philips North America.

Training a new generation
Labor shortages have left hospitals and healthcare systems with fewer in-house technicians on hand to monitor equipment. And with thousands expected to retire in the next few years, the U.S. Bureau of Labor Statistics predicts there will be nearly 3,000 unfilled biomedical equipment technician positions by 2029.

Efforts are underway to replace them with new recruits. Indiana-based TRIMEDX recently launched the SkillBridge program with the U.S. Department of Defense to help military personnel find employment in healthcare technology management (HTM). The company deploys its own technicians to serve as the in-house team for hospitals, allowing them to work directly with caregivers and patients.

“TRIMEDX’s comprehensive program supports the on-site technicians with data, technology, and centralized support via supply chain, and quality and regulatory compliance, among others,” said LeAnne Hester, chief solutions and marketing officer at TRIMEDX. “This is a key differentiator between our approach and that of servicers who may only dispatch technicians to a site when a specific repair is needed.”

The GE Healthcare Institute, the company's 250,000 square-foot facility in Wisconsin, provides training on both GE and non-GE devices, teaches customers and field engineers in the same classes. It trains them in person, remotely and through a hybrid approach that incorporates both on-site and online classes.

"Training is especially important as staffing challenges are felt across the industry,” said Goryl. “It may require different types of training, more cost-effective ways to train and also more effective ways to train individuals, while considering those that are potentially from a younger generation, so these students learn in a way they are most comfortable with.”

Preventing problems ahead of time
Predicting issues in advance allows providers to intervene early and prevent them from occurring in the first place. Associated cost savings and reduced downtime have driven this demand, creating the need for servicers to invest in remote monitoring and predictive technology.

In addition to reducing unnecessary downtime, many ISOs use remote monitoring technologies to help providers prepare for an on-site visit from a field service engineer (FSE). In some cases, issues can be resolved entirely remotely, without requiring a technician to be deployed, said Shelby Lemler, executive vice president of operations at MXR Imaging, which resolves 20% of all issues that way.

“By embracing these technologies, it allows the customer to get their issues resolved quicker and results in less of an impact on their facility,” said Lemler. “We have also found these interactions to be beneficial even if we are not able to remotely resolve the issue and an FSE needs to be dispatched to the site.”

As the number of network-connected medical devices grows exponentially, so does the risk for cyberattacks. Legacy devices, which are still common among hospitals, are especially at risk. As a result, clinical engineers who specialize in this area will be needed to help hospital IT prevent attacks.

ISOs can help by providing cybersecurity expertise, like TRIMEDX’s Dynamic Risk Score, which provides real-time assessments of medical device vulnerabilities. “This allows health systems to adjust their priorities in real time to address the most pressing needs across the entire device inventory, and monitor the improvement in medical devices month-over-month,” said Hester.

Service is changing
In the last few years, mergers and acquisitions have turned small third-party providers into larger organizations with capabilities that resemble the OEMs. Block Imaging’s Crawford expects to see more of this, and said ISOs will continue to gain more of the service market in the U.S. because hospitals will be better equipped to partner with them.

New players, such as private equity firms, will continue taking up more stakes in the market, making it even more competitive, according to Philips’ Stevens. Meanwhile, remote monitoring and preventive maintenance solutions will also continue to grow, with healthcare organizations looking to decrease downtime as much as possible.

“More of our upgrades are being done remotely and off-hours for the customer to ensure that they can maximize the use of the equipment during hours of operation to care for patients,” said Stevens. “Using this remote service program, we can handle multiple upgrades from a single command center rather than sending an FSE to each individual site to update software.”

Cybersecurity protection will also grow as a demand, along with the FDA already asking Congress for more explicit power to implement requirements for protecting medical devices. Both the House and the Senate are set to vote on the Protecting and Transforming Cyber Health Care (PATCH) Act, which would require manufacturers to provide critical cybersecurity safeguards and design, develop, and maintain updates and patches throughout the life cycle of their devices.

The need to recruit and find new ways of training younger generations on how to service medical equipment will also be a priority. In addition, the “right to repair” debate will continue to be a focal point in the industry that will affect training, as well as access to affordable servicing of medical equipment.

Effective servicing of any kind is a two-way responsibility between service providers and healthcare organizations, according to Goryl. Servicers, OEM or otherwise, must be able to adapt to the changing landscape and demands among healthcare organizations, while medical practices must communicate where they require the most help from these entities.

"I encourage all customers and HTM in-house customers to be upfront and honest about their challenges, so that we can continue to establish a level of trust and identify effective ways that we can progress and succeed together,” he said.