In May 2018, St. Luke's Medical Center in the Philippines (Quezon City, Metro Manila) was named a finalist for ECRI Institute's 12th Health Devices Achievement Award for its clinical engineering department's "Third Comes First" medical equipment accessories management program. Developed in response to product shortages, delivery delays, and high costs associated with obtaining original equipment manufacturer (OEM) supplies in the Philippines, this program sought to (1) identify appropriate third-party alternatives for medical equipment accessories that require frequent replacement and (2) assess the quality and performance of those products.
The Health Devices Achievement Award recognizes innovative and effective initiatives undertaken by member healthcare institutions to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology. For details about the winning submission and other finalists, see The Health Devices Achievement Award: Recognizing Exceptional Health Technology Management.
ECRI Institute congratulates the project team members: Robert D. Camacho and Chiqui Anne A. Rebultan.
The Challenge
To identify functionally equivalent, alternative medical equipment accessories to help a hospital address obstacles associated with obtaining OEM supplies in the Philippines—obstacles that include delivery delays and product shortages, along with the high prices sometimes charged for OEM supplies.
The Landscape
1. Staff members at St. Luke's Medical Center describe some of the challenges they face in obtaining reliable replacement parts and medical equipment accessories in the Philippines.
a) OEMs tend to dominate the market, but their distribution channels in the region may not be extensive enough, or the OEM product supplies in the region may not be large enough, to meet demand.
b) This can lead to delivery delays of up to a few months for OEM supplies. OEM supplies also can be expensive.
c) While some products can be obtained more quickly from third-party suppliers, concerns exist about whether such products will be of sufficient quality.
d) Without confidence that the third-party product will perform comparably to an OEM one, healthcare facilities may decide they have no choice but to wait for OEM products to become available.
2. Rather than accepting that the healthcare facility would have to cope with supply shortages while waiting for OEM products to be delivered—and that it would be compelled to pay the high costs of such products—the St. Luke's clinical engineering team instituted a process to:
a) Identify third-party alternatives for medical equipment accessories that require frequent replacement
b) Evaluate the quality of such products to determine whether they can be considered an appropriate alternative to an OEM product
The Process
1. The clinical engineering team implemented a medical equipment accessories management program focusing on a small group of supplies that frequently require replacement due to wear and tear.
a) The project was initiated for three types of supplies: ECG cables, pulse oximetry (SpO2) sensors, and blood pressure accessories.
b) The project was later expanded to include light-source bulbs, batteries, hoses, printers, ECG grabber sets (e.g., ECG alligator clips), and mechanical parts for patient beds.
2. For each device type, the team sought to:
a) Identify an alternative brand of medical equipment accessory that had equivalent specifications and met similar quality standards to the OEM brand (e.g., TUV/ISO accreditation)
b) Test the alternative product to verify that it performs as desired
3. Factors that the team considers during its analysis include:
a) Compatibility with the original brand of medical equipment—assessed, for example, by connecting test samples of the accessories to the medical device
b) Compliance with an international quality standard (e.g., CE marked, FDA approved, EN 60601-1:1990 compliant)
c) The results of its product testing—for example, physically examining the product and testing it using a patient simulator to assess the accuracy of the output
d) Life span
e) Availability—for instance, a third-party accessory might be available for delivery within three days, compared with two to three months for the OEM accessory
f) Cost
The Results
1. The program was implemented in 2014 for just a few products, with the goal of identifying third-party alternatives that could be considered functionally equivalent to the original brand, but at a more competitive price.
2. Initial success quickly prompted the expansion of the program to include nine product types, as noted above.
3. Over four years, the program achieved savings of more than PHP8,348,350 (US$160,000).
Key Takeaways
1. This project illustrates one of the many ways that a clinical engineering department can offer value to the healthcare organization above and beyond its role in maintaining medical equipment.
2. The St. Luke's clinical engineering team notes that a good program requires good data. It cites cooperation with other groups within the organization as being vital to conducting accurate analyses.
3. The quality of a product is not defined by its cost. Less-expensive alternatives can be equally effective.