Mills Announces Major Changes for HTM Departments

Posted June 2, 2014

George Mills, director of engineering at The Joint Commission (TJC), stood in front of a crowded room at AAMI 2014 on Sunday and made something of a plea: “Don’t kill the messenger.”

With that introduction, Mills then announced several changes that are sure to have an impact on healthcare technology management (HTM) departments across the country.

First aGeorge Millsmong those changes: the introduction of significant restrictions on the use of relocatable power taps, or RPTs, as mandated by the Centers for Medicare & Medicaid Services (CMS). According to Mills, the federal agency now says that “RPTs are not to be used with medical equipment in patient care areas.” That includes operating rooms, patient rooms, and areas devoted to recovery, exams, and diagnostic procedures.  While RPTs could still be used for non-patient care equipment, such as computers and printers, and in areas such as waiting rooms, offices, and nurse stations, the news was clearly frustrating to many attendees. They said the restrictions on the use of RPTs would lead to long extension cords stretching across rooms, creating a tripping hazard.

“Please help me,” urged one audience member who told Mills the change would make some rooms more hazardous.

“I wish I could,” replied Mills, stressing that he does not agree with the rule, but that it is effective immediately.

Another CMS-mandated change that elicited groans from the audience was that all ultrasound devices are considered radiologic equipment and may not be included in any alternate equipment management (AEM) program—something the agency disclosed to TJC last month. In other words, hospitals can’t deviate from manufacturer recommendations at all when it comes to maintenance practices involving such devices.

Mills indicated that he thought the restriction was overly broad. “It’s not the answer we wanted,” he said, referring to communications with CMS. The question of how hospitals maintain their medical equipment—both in terms of activities and the frequency—has been a hotly contested subject in the HTM community. Many clinical engineers and biomedical equipment technicians believe CMS can be too narrow in its approach, failing to recognize that many hospitals have had safe and effective practices in place for years. A CMS memo on the subject in 2011 ignited an uproar, and a subsequent memo this past December cheered many HTM professionals, because it granted some leeway in what hospitals could do.

The restriction on ultrasound equipment announced by Mills on Sunday struck many in the room as a step backwards. Mills seemed to agree, and several times he told attendees that he did not agree with many of the changes coming from CMS.

Effective July 1, 2014, according to Mills, all hospitals that use TJC accreditation must maintain a written inventory of all medical equipment. Hospitals must also now identify “high-risk” medical equipment, a category that includes life-support equipment, but is not restricted to it. Hospitals that use TJC accreditation must also identify medical equipment in their inventory that is included in an AEM program.

Mills promised the audience that additional details about these changes would be released by TJC within the next month.