Sound Troubleshooting Steps and a Solid Relationship with IT: Essential Components in Solving Telemetry Issues


By: Becky Crossley

July 20, 2021

Categories: AAMI News, HTM Professionals

TROUBLESHOOT IT

A patient monitoring system in a hospital.

We frequently receive work requests for our telemetry boxes going “offline” or losing connectivity to the network in one form or another. Do you have suggestions for resolving this issue?

First, it’s important to note that telemetry systems can transmit in a variety of ways. For simplicity in this article, I am going to assume we are talking about the system working over a hospital-based wireless network.

Loss of connectivity of telemetry systems is something we struggle with at my facility as well. Today’s network systems are very diverse and complex. We all are aware of how many things are “running” on a network. Putting telemetry on the network only adds to the complexity. This is another reason clinical engineering needs to have a good working relationship with network information technology (IT).

As with all our work as clinical engineers and biomedical equipment technicians (BMETs), we need to work the troubleshooting steps. These steps are identifying the problem, determining the cause, testing the theory of the cause, developing a curse of action to solve the problem, and verifying whether the problem is solved. As always, start with basic and move toward increasingly complex potential causes.

Also, at the same time, seek out obvious causes but don’t allow your search for the obvious to cloud your vision and overcomplicate the problem. Remember that many users are on the network. Having many users translates to many potential problem sources. Stay strong in your troubleshooting process—because the process never fails.

I like to start where the telemetry pack is being monitored. I would make sure that the device is properly admitted. By checking that all steps that the manufacturer has laid out were followed properly, the cause of lack of connectivity may be discovered. Next, observe the telemetry pack for when the error occurs, and when it does, make note of where the patient is, what the patient is doing, and what is being done to the patient.

Then, I would get another telemetry pack and have it admitted. I mainly do this because I don’t like to constantly bother a patient. If I have the telemetry pack in hand, I can eliminate the problem as being patient related, which has the added benefit of determining that the telemetry pack admitting process is not the culprit. It also eliminates the chance that the telemetry pack is not properly connected to the patient. It is amazing how performing simple actions such as this can resolve issues and help facilitate the overall troubleshooting process.

Remember that communication is the most important factor in troubleshooting. For example, the person who reported an issue with a medical device or system may not necessarily be the person who had or saw the issue. We have all witnessed the “game of telephone,” where a message is relayed to several people, and most often the message is not the same at the end of the relay. This happens a lot to those of us who repair equipment.

Silhouetted faces and speech bubbles overlap.Everyone in healthcare technology management has experienced the “game of telephone,” where a message regarding a problematic medical device or system is relayed to several people, and when the message gets to you, it’s not the same as the original. Effective communication therefore is vital to any troubleshooting process.


If the telemetry pack is still going offline, I would walk it around and see if I can find a place where it comes back online. Sometimes you will get lucky and be able to identify an area where the telemetry pack doesn’t work, while in other instances you will have a big area where the pack is offline. Then, retrace your steps and verify that you can duplicate the issue again. Once you have done this, stay confident in your findings. Don’t allow yourself to believe it can’t be possible to have just one spot where it goes offline or that you have found a huge area where the telemetry pack doesn’t work. I have seen both of these as being valid problems.

After you have verified the problem and you know where the problem is occurring, involve your network/wireless IT department. They will be able to verify functionality of, for example, the access point, router, repeater, switch, or server. We have experienced failures of most of these IT devices and were able to work with IT and get the problem solved quickly.

However, sometimes the problem is much more complex and doesn’t involve a physical device/issue, such as an access point or switch. At times, it may involve what I like to call the “magic” of wireless. This would be concerns related to, for example, degradation of signal, interference of signal, failure in signal program, or problems with signal packets. These are more in-depth issues that leave most of us BMETs scratching our heads. In these cases, IT staff from the manufacturer and your facility might have to work together more closely to determine and fix the issue.

Good troubleshooting steps and a working relationship with your IT department are essential components in solving issues such as those related to telemetry. By working the steps of the troubleshooting process and having confidence in yourself and the process, you can easily work your way through these types of problems.


Becky Crossley, CBET, is a BMET specialist in the Biomedical Engineering Department at the University of Pittsburgh Medical Center Susquehanna-Williamsport in Williamsport, PA. Email: crossleyrk@upmc.edu