by K. Richard Douglas
It took a 19th-century Scottish philosopher to put the importance of tools into the right light. “Man is a tool-using animal. Without tools he is nothing, with tools he is all.” Thomas Carlyle had it right. Among mechanics and carpenters, and yes, biomeds, these words ring true. For the guys and the gals who work on medical equipment, you can’t do the job without the right tools.
What tool collection would be complete without test equipment? From ECG simulators to AC receptacle testers, light meters to volt meters, the scope of test equipment is broad and all-encompassing. Checking the safety and accuracy of equipment and regulatory compliance make test equipment invaluable. It’s all about size, portability, multiple functions and speed these days.
The role of technology will continue to impact the design of test equipment and determine the trends to follow.
“Test instruments are getting smaller, lighter and easier to operate,” says Jerry Zion, M.S., Fluke Biomedical’s global training manager. “They are beginning to use local wireless transfer of measured data and configuration, and break the tether between the display unit and the measurement unit.”
Zion see’s an evolution that has flourished outside of the hospital also.
“Increased use of tablets as application software platforms is certainly on the horizon, as is the use of daylight visible displays. Backlit LEDs and LCDs will be a thing of the past,” Zion says. “Additionally, I believe we will see more cloud-based applications and databases.”
Fluke covers the whole gamut of biomedical test and simulation products and software. From the feature-rich ProSim 3 and 2 vital signs simulators to the 190M medical ScopeMeter portable oscilloscope, their test product portfolio keeps expanding.
“With the daily release of new computers or inexpensive androids, there is almost a new cutting edge product released weekly. From ultrasound to cardiac to radiology, new products are being developed utilizing the new tablets and interfacing to iPads,” says Pat Pyers, vice president of sales, marketing and business development for Radcal Corporation.
“Without being too biased, the new Accu-Gold+ non-invasive diagnostic test instrument made by Radcal offers the most when it comes to X-ray output testing,” Pyers says. “Utilizing both solid state sensors and Gold Standard Ion chambers in one meter gives the user the choice of which method to accurately test the X-ray machine”.
“The Accu-Gold+ also can be used with previously purchased Radcal ion chambers forgiving the user the cost of new sensors,” he adds. “The Accu-Gold+ Software which is provided with the AccuGold+ Digitizer, offers a very flexible and user-friendly program to capture entire waveforms and user selected output values. Utilizing the power of the laptop or android makes the Accu-Gold+ the most powerful system available today.”
Pyers see’s the effect of technology’s ability to downsize instruments as a continuing trend.
GOOD THINGS COME IN SMALL PACKAGES
On Star Trek, Dr. McCoy could pass an analyzer over a patient and instantly know that patient’s condition. The analyzer covered every system, from cardiac to nervous to autoimmune. An all encompassing analyzer might be just as desirable for a biomed.
“Small, compact, easy-to-use computer-based instruments are fast becoming the trend in test equipment. Over the years, techs have used large heavy scopes and test devices, sometimes needing a cart to move them from room to room. Now that time is short to analyze an instrument or machine, a test device that is powerful, easy to set up and use and easy to transport is very important to the tech,” Pyers says.
“In radiology departments, it is critical to get a machine up and running without the loss of too much time and expense to the facility,” he adds. “Having a test instrument that allows one to obtain fast analysis data of the problem helps the tech perform their job expeditiously and accurately.”
Those insights are reflected by Ken O’Day, vice president of sales and marketing for BC Group International, Inc.
“From the feedback we receive, it is any device that helps them (biomeds) perform their daily duties that is reliable, easy to use and cost effective. Smaller, easy to transport and multi-function would always be a plus,” O’Day says. “The answer to this question is also dependent on the level of the technician. A technician who provides general biomedical service will rely on a completely different set of test devices than a technician who specializes in a particular modality, like anesthesia, respiratory or imaging.”
“I think you’re seeing customers that are looking for devices that are accurate and test according to manufacturer’s suggested test procedures,” says Joe Rebot, president of Clinical Dynamics. “The day of test equipment that is ‘in the ballpark’ for testing accuracy is long gone in many medical service professionals’ eyes. It is critical to accurately test patient monitors and other medical devices correctly and accurately utilizing test equipment that works.”
“Our line of AccuPulse, SmartSat and AccuSim Total Patient Simulators were developed with, and approved by, the world’s leading medical device manufacturers. Our testers are also written into many manufacturers test procedures,” Rebot says.
“We pride ourselves at Clinical Dynamics on working with patient monitoring manufacturers and other medical device manufacturers so that our test equipment tests those devices accurately. There shouldn’t be guesswork in testing medical devices that are relied upon to take care of our patients.”
Rebot echoes the compactness theme as a clear trend.
“The trend is going towards providing medical devices in more home and portable locations. In the patient monitoring area, companies are coming out with portable patient monitors that can be used in many locations other than the hospital,” he says.
“Home care, use in clinics, doctor’s offices, etcetera; that’s the wave of the future,” Rebot says. “We’ve designed our test equipment to be accurate and portable and go to those locations with medical service professionals. You’re seeing it today with biomeds working in many different locations than just hospitals.”
O’Day explains that the latest and greatest doesn’t necessarily equate to the “cutting-edge” device.
“The test device that is designed with an upgrade path is probably the device that best fits this criteria. For example our ESU-2400 ESU Analyzer has been on the market for only three years. During that time period, new ESU Generators have been introduced that our original ESU-2400 could not test as it was configured,” he says.
“Due to the ability to upgrade the ESU-2400, the person who received the first unit out of production has the same test capability as the units shipping today. This helps the purchasing decisions and eliminates the uncertainty. You no longer have to be concerned that as soon as you buy a tester, it will be obsolete because of something newer being offered or some new parameter that needs to be tested.”
Another technological advantage that exists today is the ability to update devices by connecting to a server and getting the most recent software. Anti-virus product producers make this a daily occurrence in many cases and firmware updates are a part of daily life. This convenience has entered the biomedical test equipment arena.
“One of the cutting edge things we’ve done is our new products can be updated with new features; CalTables or R-Curves in the field which eliminates the need to send back test equipment for upgrades,” Rebot says.
TEST EQUIPMENT WISH LIST
The biomeds in the clinical engineering department at Seattle Children’s Hospital summarized their wish list pick in two words – “something portable.”
“Whether that was an all around device to check monitors on the floor, full patient simulation, or ultrasound/radiology phantoms, portability was the key word,” says Jeff Schweer, CBET.
“Specifically, one of our senior biomeds would like a electrosurgical analyzer that was easy to move around and not manufacturer specific. His only choice right now is over $10,000 and
is only usable with the one company’s devices.
“Our respiratory specialist would like a digital differential pressure manometer (portable, of course),” he adds. “Personally, I would like to have a patient simulator for dialysis machines that allowed a little more realism and actually tested the machine in a more robust fashion. Right now, we have different pieces but no integrated system.”
Sometimes, what we want is what we need for someone else.
Pat Lynch, CCE, CBET, FACCE, at Global Medical Imaging lists one particular piece of test equipment for biomeds in developing countries.
“Infant incubator tester,” Lynch says. “I am training biomeds in Central America and Africa to maintain their equipment. The most critical (and most difficult for them to test) is infant incubators. I would like several Incubator testers, one to distribute to each country (Honduras, Guatemala, Belize, Nicaragua, and Rwanda).”
“A good NIBP simulator is a necessary instrument on my list,” says Samuel Gene Mitchell, D.S.M., CBET, HIT Pro with the Missouri Rehab Hospital. “At the previous hospital I worked for, we had one and it was almost indispensible. Pronk Technology makes a Simcube 5 that sure would make my job a little easier.”
“A second piece of equipment I need is an RF spectrometer,” Mitchell says. “We are constantly having issues with our telemetry and that is one piece of equipment I need to troubleshoot our system. It would be so beneficial to have it as it would save about $400 every time I have to send in a telemetry box to have it calibrated, not to mention the use I would get out of it troubleshooting the antenna, receiver and looking for interference around the ward we use telemetry on.”
Matt Tekker, manager of biomedical engineering at Maniilaq Health Center in Kotzebue, Alaska has the Medtester 5000C at the top of his list.
“Some things at the top of our list are network cable tester, video simulator for digital video (and) light output meter,” says Dave Scott, CBET from Children’s Hospital in Colorado.
WHAT ARE CUSTOMERS SAYING?
Beyond a prized new piece of test equipment, what do the manufacturers and marketers hear from the field?
“From speaking with our customers and people in the industry, they are looking for accurate and portable test equipment to allow them to test their medical devices,” Rebot says.
“They want accurate test equipment that travels with them so they can complete their testing easily and quickly,” Rebot adds. “Is it broken or need to be repaired? Does the patient monitor have a leaky cuff or hose assembly? Is the pulse oximeter probe not working and need to be replaced? These are some of the questions our industry has in working with our customers and medical device manufacturers.”
The ease of use property is echoed by Pyers.
“Any type of analyzer or test instrument that makes the tech’s job easier with accurate results would be most sought after. Since there are many types of analyzers for the different testing protocols I would say that for each modality there is one particular market leader of the most sought after test instrument,” he says.
“As of today, there is not one that will perform on all types of instruments for all types of components being electrical or non-electrical components of the device,” Pyers says. “I think one would get a different answer from whichever tech they asked this question. They all have different needs.”
“In our experience, the most sought-after piece of general test equipment is the digital multimeter,” Zion says. “However, when we think specifically about the needs and ubiquity of medical devices, we think rapid response test tools that are ultra-easy to use and able to connect to patient monitors, infusion devices and defibrillators are at the top of the list.”
While biomeds are tasked with doing more, and hospital budgets shrink, the evolution in more useful test equipment will add some balance to the equation.