Expert Insights: Navigating the New Wave of Technology in Clinical Engineering
Dec 13, 2023
Wed, Dec 06, 2023 8:42AM • 32:15
teams, technicians, enterprise, chaos, today, clinical, hospitals, vendors, steve, devices, number, years, biomed, standardization, organizations, medical devices, connected, biomedical, accelerate, conversation
Steve Ellithorpe, Chyrill Sandrini
Chyrill Sandrini 00:13
Welcome back to HTM Insider, I’m Chyrill with MultiMedical systems, your host, I’m proud to say we’ve been doing this for over two years now, and today is no different. We’re bringing you an industry expert once again. And with no further ado, I’d really like to introduce you to my friend, Steve Ellithorpe. Steve, why don’t you introduce yourself to our listeners?
Steve Ellithorpe 00:36
Yeah, well, thank you, Chyrill. And it’s a real privilege to be here with you today. Thank you for this opportunity. And I’m currently with Providence. I’m an executive director within our Clinical Technology Services Division, which is our clinical engineering and field service teams within Providence. And it’s across our enterprise. And I’m really interested in this conversation with you today and bringing some 36 years of experience to this conversation. I’ve been a technician, I’ve been a manager. I’ve been a Regional Director. And I’ve helped provide strategies at the corporate level for clinical engineering. And so hopefully, something that I have today will resonate with our listeners.
Chyrill Sandrini 01:21
I love it, you know, Steve, and I sat down at AAMI, and we had kind of met here and there at a few conferences. And we happen to be at a gathering that vendors host in the evening. And I happened to get my toe stabbed by a fork, which caused all kinds of drama. But Steve and I got to sit down. And I just really found out how passionate you were about health care, and quality health care and patient safety. And it really just, you know, hit me right here. And I’m like, we need to have you on that on the podcast, Steve. Tell me how many hospitals are in the Providence enterprise?
Steve Ellithorpe 02:02
Yeah, so today, there are 52 that we support across seven states. And so it’s from Alaska to Texas, including Washington, Montana, Oregon, California, New Mexico. And so a very broad footprint. And associated with those hospitals, we also have nearly 1000 medical clinics that our teams are also supporting across the enterprise. And we should be truthful for the audience. She sat down next to me to remove the fork from her toe. So as as fate would have it. But no, we had a great conversation and just, you know, talking a little bit about what we were expecting from the AAMI conference. And then just, you know, we started talking about our backgrounds and what we do. And so it got us to this conversation.
Chyrill Sandrini 02:53
And you know, just so happy you made the time to get on, you’re a busy man. And I really respect that. So taking this time out of your day, to impart some wisdom. This means a lot to myself, and the listeners of HTM Insider. So, let’s get started. You and I have talked a lot about the chaos in the industry right now. And everybody’s feeling it. And things change every day. So navigating that chaos is going to kind of be our topic today, and how we’re going to deal with it in our current environment and your experience, Steve. So what do you see is the chaos in the industry tell us that?
Steve Ellithorpe 03:32
Well, there’s a lot of different factors, I mean, continuing just economic and financial pressures in our environment and just investing into medical devices and even into our technicians. Number one, I think number two more connected devices. And so as the technology and clinical space continues to evolve, more and more devices are being connected. And then that leads us to this third space of with connected devices, cybersecurity, and vulnerabilities within medical devices and technical debt and legacy devices are becoming more pronounced and are happening more and more all the time. And we see stories about it in the news all the time. And I think where the chaos really is coming together for me and especially in my role right now is we have our IS field service teams and our clinical engineering teams and our network architecture teams and all of these groups that are coming together to work with our clinical service delivery. There is just a lot that our different teams need to understand about what we do within our specific expertise, but also how do we do it in a way that we can communicate clearly with each other to get good results at where care is being provided. And that is the part that just you said that where my passion lies is safe environment and safe for the organization and how do we continue to continue to do that? Which is all these opposing tensions.
Chyrill Sandrini 05:05
I think you hit one right on the head. I mean money.
Steve Ellithorpe 05:10
Yeah, yeah. Yeah. You know, medical device space is a space that has lacked investment over the years. And we have very talented clinical engineering and biomedical technicians that are in the field today that they have heard this more than one time probably this month already. Is, can we can’t Can you make it work one more year? Can we go another year? How much longer can you support it? And that has really put extra pressure on our teams and created more risk. And now we’re trying to figure out and scramble. How do we remediate that, you know, at cost effectively and efficiently? So we’re not disrupting care. Yeah.
Chyrill Sandrini 05:51
Yeah, and is there… I know, a lot of hospitals across the nation, like privileged enough to go into a lot of facilities, whether it be rural health, to very large tribal hospitals. Is there an infrastructure that’s part of that chaos? Is there an infrastructure, even within the building the devices, the age of devices? With everything that’s coming out right now, you mentioned the cybersecurity, what’s, what’s the chaos that you’re seeing? Because I think there’s a lot there that Baumeister really don’t have control over but they’re dealing with the daily.
Steve Ellithorpe 06:27
Yeah, I think it’s really it’s the connectedness. And the domino effect is that what we’re finding as we move forward is that making a change? At some point, any point within the infrastructure has impact… impacts across the infrastructure. And so we do have legacy infrastructures as well. And so you’re navigating that it’s, it’s almost like, as you’re having these conversations, and you want to do something different, you have to bring in all of those related teams to find out, where is the point that you continue to remediate, update, replace, remove, whatever it is, so that you can have this I guess, standard architecture, clean architecture, remediated architecture, so that you can deploy the medical devices and connected devices in a safe way.
Chyrill Sandrini 07:19
I mean, you’ve looked at the connectivity over the past even, I would say, five years, it has changed dramatically. You know, when it used to be in a totally different part of the building, and they had nothing to do with with biomed. Right, and you have to work cohesively now, with that being said, how is that working across your enterprise with the communication between IT, and…
Steve Ellithorpe 07:52
Wow, that’s a big one. That’s a big one. And and we’ve spent a lot of time on this. And I think bringing those teams together, first is a big step. And within our organization, some of the work that we’re doing is actually doing a level of, I’ll call it cross-training. But the intent of the cross training isn’t necessarily to immediately immediately deploy these hybrid, it clinical engineering type technicians. What it is, is bringing information and education across our teams. So we understand when we’re talking about infrastructure, or connection points, or encryption types or language across the internet, or, you know, all of these different kinds of elements. We’re talking the same language, and it changes the conversation, when you can sit down, and you’ve identified terms, you’re talking the same language. And you can really inform and educate across our teams better that way. I think that’s something that I think if I were to go back and rewind the tape a little bit, we’d probably spend more time on that first, before we started, you know, some of the other activities. But what we’re finding is that this is a, it’s an onion, and you’ve heard this analogy many times. And you know, there’s a lot of things that you’re seeing on the surface of the onion, and you’re saying, Well, what can we do to address that, you start addressing it and realize, well, we need to go a little bit deeper. And as soon as you pull back that first layer, you’ve basically peeled back to a completely new level of challenges. And, you know, and opportunities and you work through those things. And, and, you know, I don’t think when we started this journey 12 or 15 years ago, when we were implementing medical devices that we could have put our finger on exactly what the core was, and started there and worked out. But I think that what we’ve been able to do is we’re able to identify the challenges faster, we’re able to escalate Those challenges faster in anyone speaking the same language and helps us not only as we’re planning, but with cybersecurity when you do have an event, and most organizations probably will have an event. It’s in how do you respond to that, and understanding common language common terms, common devices helps get us remediated faster.
Chyrill Sandrini 10:21
Yeah, the cybersecurity threats are just becoming more and more prevalent, and you’re hearing more about them every day. And I really fear for, you know, some hospitals that aren’t of the enterprise that you are, and maybe they’re outsourcing a lot of their services. And that communication gap can be a struggle for those…
Steve Ellithorpe 10:43
That, we’ve got, you know, sure, that’s a great point, too, because we’ve we’ve we had some of those challenges as well. I mean, whether it’s working with a vendor, or working with a third party service provider, you know, I think one of the things going back to the core is that we know more today than we did then. So then when we sit down, we can have those conversations about as we’re doing a level of work, or as we’re contracting for a level of work, help us gather these elements of data that maybe we didn’t have. Or how do we partner with them to get the information we need about connected devices. You know, and part of this is, you know, I’ll just tell you, there’s a struggle part of the chaos is to is it we’re in the now with, with, wanting to advance and wanting to accelerate to our not yet, and there is so much in the rearview mirror right now, you know, with with technical debt, Legacy infrastructures, legacy devices, Legacy OS, you know, systems, all of those things, it’s, you know, how do we, how do we make those right decisions along the way between the now and the not yet, but then also, as we’re planning for the future state and where technology is going, as we’re making decisions? Do we have the right people in the room, that then we can make those right decisions and make the right steps to get where we want to be? And we know that where we want to be as a is a moving target, but at least directionally how do we accommodate that? And, you know, we’ve we’ve learned a lot, there’s, there’s been a lot of painful conversations over the last two or three years, you know, in this space, but we are, we’re getting better, we’re getting better.
Chyrill Sandrini 12:27
And, you know, you saying like, not then not now, when AI is another one that’s coming up that, when did you think of IT, that’s just throw that ball, you know, toss it in there, right?
Steve Ellithorpe 12:41
You’re and that’s really, that’s two sides of of one coin, there’s there’s much good that we can can get from AI in our space. And I think that’s going to develop over time, it’ll probably help us with greater service analytics, it will help us automate, you know, error management, you know, as we’re monitoring devices, and things like that, it will help us on the clinical side, right, as as clinicians can see information and almost like peer review in near real time, you know, with with informed AI. The other side of that, though, is that the AI side and sophistication to develop phishing and cyber attacks is becoming more prolific as well. And, you know, I know that that is accelerating, when when you can start through AI, sending out phishing attacks, and cleaning up all the the bad grammar and the bad sentences and all of those things that you can identify the phishing emails very easily. When that starts looking, you know, like, the real thing, and those start getting cleaned up. That’s going to be a problem.
Chyrill Sandrini 13:58
I agree. I agree
Steve Ellithorpe 14:01
and the other piece of that is, you know, as more and more devices are connected to the internet more, more, more, you know, the IOMT, right internet of medical technologies, and more of those kinds of wearable devices and things that are getting more access more, it’s, it’s just going to become more and more targets for security as well. Oh,
Chyrill Sandrini 14:21
I mean, there’s an app for it, right?
Steve Ellithorpe 14:24
Yeah. Cyber attack app. Yes.
Chyrill Sandrini 14:27
So let’s, let’s switch gears a little bit, because this is something that I think is causing chaos, that maybe you can impart what you’re doing at Providence, but the age of retirement, and the attrition rate in the clinical engineering space is prevalent. And we’re not even though we’ve got great schools out there and there’s more schools that are coming back online and they’re teaching and I’ve, I get to talk to those people. It’s amazing what people out there doing. Even with five or six students at a time. But Steve, that number is leaving. And that number that’s coming in with, with not to experience. That’s part of the chaos that we’re experiencing. Right?
Steve Ellithorpe 15:12
Yes, yeah. And it’s, and it’s happening at a very fast rate COVID accelerated it, there were a number of retirements, you know, in during COVID, as well, which, you know, that also added to it. But the the other piece, though, is that is is trying to catch up, it’s almost like, you know, what’s the right analogy here is, you know, you talk about book knowledge, or, you know, you just have local knowledge, right tribal knowledge, all of those things. You know, I remember when I worked in, in hospitals, and, you know, you knew where specific devices were, and you knew where this awkward connection was, and you knew where that closet was that you could go and do the work that you needed to do. And you knew the right resources to connect with, when that tribal knowledge and that local knowledge leaves, there’s, there’s no school that can connect that gap. And so these are individuals that are highly skilled, been in the field been in location for a long time. So it isn’t just the technical skills that you lose, it’s those other pieces. And so, I mean, in this space, one of the things that, you know, we want to do, you know, within Providence is how do we retain our teams? How do we invest in our teams? How do we continue to redevelop that information, and share the technical information across our teams and across our enterprise, and that is new for us, you know, bringing that all together under one umbrella, we’re only about two and a half years into that journey. But but investing in our teams, seeing where we can grow our teams, and then work with local colleges, and we do in a number of our states work with local colleges with, with internships, you know, and try to place students, you know, so they can complete those internships and give us visibility to them. And we’re also working with other organizations, even, you know, veteran’s organizations, so individuals that are retiring from the military, you know, or have been in the military for a few years and have training, there might be a pipeline into our organization, but it’s, it’s really us having to reevaluate what is the skill set we need for these roles, how has it changed? And then trying to identify folks that, you know, can, can come in can be taught, and, and can grow their skills or want to grow their skills in specific areas. But this is something we’re chasing a little bit, I wish we were way ahead of it and just had, you know, technicians on the bench just waiting, you know, to come in. It just isn’t like that. And so some of this we’re catching up to,
Chyrill Sandrini 17:54
Yeah, I mean, you’re not the only one either. problems that don’t feel bad. But…
Steve Ellithorpe 18:00
We’ve had a number of our team members, you know, recruited, you know, by other organizations and and vendors, and and, you know, it is just a really difficult space right now.
Chyrill Sandrini 18:11
So, along those lines, we are saying investing. That’s training. Right, training, It takes again, money?
Steve Ellithorpe 18:25
Yeah. You know, I think one of the pieces that we are really investing, the resource of time into right now is really looking full field. Across our, our, you know, the organization and our teams looking at what are not just the skill sets we need today, but how is this emerging for something we might need in a few years? And so, again, this is almost like the technology now, and not yet, where we are, we’re identifying those things, whether we’re contracting it today, and where can we invest in our teams? Where can we buy technology differently? Right, and, and, and change the way we service our medical devices? But then with that, identify where are the schools? Or what are the schools locally? That can get us to the not yet? Are there things that we can be working with local colleges to build skill sets, that those students going through the programs right now would be prepared in two years for that? The not yet and so we’re, you know, it’s a balancing act as as we’re trying to do this. And, you know, we’ve talked to a number of local colleges and universities about this and they are all interested in this conversation. It’s just how do we get more structure to it so that it’s something that they can train to and deploy to and we can actually, you know, be investing in with our teams. Yeah,
Chyrill Sandrini 19:58
And fill that immediate need. Yes, you’re right. And that’s that’s a difficult part. And I think, fortunately, I think the industry’s changed around social media. We have some great allies now, like with AAMI with Daniel McGarry and hg box. And there’s other podcasts besides HTM Insider, we’re getting it out there. So when someone Google’s What is a BMET? What is HTM? They’re finding the answers, right? If we all read it, we’re able to affect, you know, the incoming students to look at the healthcare technology field as a career.
Steve Ellithorpe 20:36
But yeah, yeah, let me add to that one of the things we’re also trying to do through local biomedical associations, and I know the CMIA, you know, you know, they have multiple chapters across California and are trying to make those local connections as much as they can, and, and getting information on their websites. If you’re, you know, if you’re someone that has a job, a vendor that has a job, you know, they can be posted, if you’re someone looking for a job, you know, you can, you can post that and make connections, and through our Northwest organizations, and I’m actually located up in the Pacific Northwest, is that through the Washington State Biomedical Association, the Oregon Biomedical Association, I know the Alaska teams are have started an association here just within recent months. And so we’re trying to make those connections to local schools as well. So they’re, they’re not having to do just connect with hospitals. But we’re also connecting vendors, we’re connecting ISOs, and the schools, all of those things together. We’re also finding wherever we can, how do we take it one step further and connect with high schoolers, right? Career days with high schoolers, something to get that word out there that this is a career field, there is opportunity in healthcare in technology. And and there’s lots of opportunity for it today, especially with the gaps we have with our staffing needs.
Chyrill Sandrini 22:05
Yeah, I agree. 100%. So when we’re talking about chaos in the hospital. You’re talking, there’s so many different moving components that need to work together. So when you have nursing, you have physicians, you have equipment, you have everything from ER to ICU, right? How are you navigating that, as a leader at Providence for your biome is to understand it might seem chaotic, but let’s just ride this out. We’re gonna get there.
Steve Ellithorpe 22:42
Yeah, okay. Yeah, that’s a tough one. And, and there’s, there’s elements of that, that, you know, that I would say, are cultural, you know, I mean, being a be met. That’s how I started my career, I spent 11 years as a biomed technician and a specialist and, and then I’ve, you know, managing teams, and one of the things that is very cultural to biomedical technicians is that when there’s a problem, that caregiver can get a hold of a biomed technician immediately, well, when you’re an enterprise, those, those kinds of things can create unwanted variance. And, you know, it’s difficult to transition clinicians across you know, different regions and, and have different methods of contacting biomed. And so, one of the pieces that we have just stood up within our enterprise is, is an Ask CE helpline. And so, now we have one, one way across our enterprise, whether you’re a clinic or you’re a hospital, there is an Ask CE number that our clinical caregivers can call. And we have worked with our with that help desk to really create diagnostic questions and help streamline processes so that if it’s urgent, we can get connected to a technician directly. If it’s non urgent, you know, there’s a way to submit those service requests and get routed to the right teams. And, and if there’s a truly an emergency, such as a, a, you know, a cyber event, you know, or a, it’s a recall, that is a, you know, class one, something’s got to happen right now, across the enterprise. We can also leverage technology to then inform and gather our teams very quickly, and bring them together to resolve an issue. And so this is something that’s still developing, but it is, it is chaotic for the caregivers in the beginning because this isn’t what I used to do. And this isn’t, you know, the processes I used to have to go through. Once they make that connection. If it’s a connected device. You mentioned this before Chyrill, is that, you know, if there’s infrastructure and architecture and this device and that device and those things is, if there is a problem with data, right to the medical record or something, then how do we diagnose that question to get it directed to the right team. And, you know, this is this still is a work in progress, we’ve made great strides to make this smoother and cleaner and more efficient. But there are just so many moving parts and so many different things that can can be wrong, right? From from data to medical record, to the device to infrastructure, so many different things. But, man, I tell you, I’m grateful to have just great people I’m working with that are they’re fully engaged, and they want this to be a better experience for our clinical caregivers. Because ultimately, again, we need to provide care, and we need to do it in a safe and efficient way. And so still still road to travel here, but very pleased with our journey so far.
Chyrill Sandrini 26:02
How does that come down to your teams having a 52 hospital system? You know, that communication? And so you’re managing the same? So it’s across the board? How difficult is that?
Steve Ellithorpe 26:19
You know, it is we desire for it to be really efficient. But I will tell you across our enterprise, you know, standardization in high level technologies is something we have not attained yet. But we are… that is one of our North Stars is where we can where can we bring standardization so that we can share expertise across the enterprise? Before we’ve done that, you know, through email, or shared drives, or you know, kind of our own internal wiki pages kind of thing. But we really want to accelerate that and optimize it for our teams. We’re also, you know, taking our findings that, you know, uncontrolled variance is chaos for teams at some level. So bringing a level of standardization where we can make sense. And then that begins to make more sense as we integrate it to other platforms, as we’re sharing data, as we’re sharing technical tips and tricks and those things across our enterprise. It just, it makes it more efficient. And, you know, we’ve we’ve we’ve taken some big steps through our procurement processes and, and seeking greater standardization. But I think our next thing that we’re really looking to do is is how do we have more, I guess, robust conversation with vendors to help us accelerate this as well is how do we take our North Star and have these North Star conversations with other vendors? And then begin to see, what other chaos can we carve out of this if we partnered together? Right, it’ll help us be better and partner with the vendors. It’ll help us be better in our hospitals. Yeah,
Chyrill Sandrini 28:02
I think it goes back to a comment you made earlier having the right people in the room. Right, whether it’s whether it’s vendors, with we’re all on the same page, if we can get on that page, or a relatively have a piece of that page, and everyone knows that that Northstar is where we’re headed. I feel like the chaos can dissipate.
Steve Ellithorpe 28:23
Yeah, and a lot of what we do today is I mean, when, again, when I was a technician, many, many, many moons ago, you know, a lot of what it was done, then is still done today. I mean, you know, and there’s there’s the safety and performance and scheduled maintenance events and, and repair and those kinds of things. Some of the techniques and some of the manners in which things are repair have developed over time, you know, modular versus maybe component level, those kinds of things. But it’s in all the connected pieces, you know, whether it’s, you know, access points and, and WiFi, or telemetry, or, you know, all of these other elements and all of the other teams now that are connected, just really makes this a challenge. And, you know, my encouragement is just to, you know, for technicians are out there today. This is our future. Right. So how do we just continue to be informed and be educated? And stay passionate about it? I mean, be be curious about what’s coming, because I think if you are curious, you’ll ask questions that maybe you wouldn’t have yesterday, about tomorrow.
Chyrill Sandrini 29:37
Yes, I like it. Well, I really appreciate you taking time out of your busy schedule to join us on htm insider and I hope listeners that this has helped you feel like you’re not alone. In navigating the chaos that occurs in your system, no matter how slight how how big the size of your enterprise is, or maybe just a hospital by yourself. We all feel that chaos at some point. Trying to keep up with technology, device integration, and just keeping the workflow going with the people on retaining or employment. If I wanted to recap, does that feel like I get everything? Steve?
Steve Ellithorpe 30:10
Yeah, and that’s a lot, right. That’s a lot. You know, I like what you said there Sherelle is, is because whether it is a, you know, a single hospital or a or a health care system, the the challenges I think are the same, the scale might be different, but the challenges are the same.
Chyrill Sandrini 30:34
And, and the number one goal is excellent patient care.
Steve Ellithorpe 30:38
Chyrill Sandrini 30:39
Yeah. That’s what we’re all here for. So, we’ve come to the end of our episode, Steve, and if you’ve watched any of them, or you guys have listened before, we always ask for your WoW. Which is your word, or words, of wisdom to leave with the audience. Steve, what do you have for us today?
Steve Ellithorpe 30:56
Well, I think what I’ve learned over the last two years, and my WoW, or encouragement going forward would would be “Lean in,” engage this fully. Because the more you know, the more you’re a part of coming to a solution locally or within your enterprise. You know, just be curious, lean in and grow with it. I think it’ll serve you well, and it’ll serve the HTM community.
Chyrill Sandrini 31:25
I really like that. And, you know, I think it’s true. You know, we get in silos, and we think it only affects us, but you’re really affecting hundreds and 1000s of lives, weekly, yearly. And you’re an important part of the piece of what we call patient care and patient safety. Thanks again Steve for your time. Thanks for tuning in to htm insider, you know where you can find us, where every place where you get a podcast. Also, we listen to tech nation, you get a CE credit for this episode of TechNationTV. We have a YouTube channel. You can find more information, follow us and again, thanks, Steve, for coming on. Thank you