Hospital celebrates managed equipment contract with GE Healthcare

Clinicians and managers in the medical imaging department at Humber River Hospital in Toronto don’t miss having to compete with everyone else for capital budgets to replace aging equipment. The Managed Equipment Service (MES) contract the hospital signed with GE Healthcare in 2015 put an end to that.

The MES program is a partnership where GE Healthcare assumes responsibility for procurement, financing, maintenance, and replacement of all medical equipment within the scope of the contract, even if some of it is purchased from other vendors. In order to preserve clinical choice of the equipment purchased, Humber River commits to maintaining a predefined threshold of equipment by purchasing some equipment from GE, while the remaining equipment can be purchased from any vendor through a procurement process.

To do this, the hospital pays a monthly fee to GEHC through its operating budget. That’s a major benefit because MRIs, CTs and all other medical equipment required by hospitals is generally paid for out of limited capital funds, much of it raised in the community – often with great difficulty.

As Humber River President and CEO Barb Collins points out, “capital equipment is not paid for by government. You have to raise money locally, so this program ended up saving us $80 million. It’s huge. It’s massive. I don’t know why a hospital wouldn’t do it, quite frankly.”

“It’s not every piece of equipment in the hospital,” said Collins. “You define the equipment you want to put in the scope of the MES and GE is contracted to manage it. We bought our beds ourselves but all our diagnostic imaging equipment, our MRIs, our CTs, all of our cardiac monitors, our anesthetic machines, screens, rotating arms, ECG machines and ultrasounds, among other pieces, are included in the contract, so it’s a lot of equipment.”

Clinicians are still heavily involved but GE writes the RFPs and puts them out to market. As part of the procurement process, site visits are co-ordinated with other hospitals or products are brought to the hospital for clinicians to evaluate and clinical choice remains with the hospital

There was initially some resistance from other vendors about GE buying equipment from them for Humber River and “some people tried to convince us it was a bad idea, but it has worked,” said Collins.

GE Healthcare’s MES program not only provides hospitals with the most current, technologically advanced equipment, but it also plans for its replacement at a specified refresh time.

“Having that refresh through the life of the contract is a benefit to our patients and staff because we can stay innovative and up to date, which is important in healthcare. Just as cell phones change and improve every year, the same thing happens to our equipment,” said Dolores Dimitropoulos, manager of the hospital’s medical imaging department.

For example, seventeen ultrasound machines were recently replaced. As well, there are plans to refresh the hospital’s interventional radiology equipment, CT scanners, general X-ray, nuclear imaging, MRI scanners, mammography equipment, life support and operating room equipment in the next few years.

Shadi Mossaed, who shares medical imaging managerial duties with Dimitropoulos, joined Humber River from another hospital. Previously, she worked in an imaging department that contained equipment of varying ages. “That makes it difficult to set your scanning protocols,” she said. “The patient comes in for a CT scan and gets put on one machine, and then the next time they’re put on an older scanner. Due to this MES agreement, having the same and most up to date equipment ensures consistent, quality imaging, lower radiation exposure, and the same interface for staff,” she added.

There’s also an impact on equipment utilization because staff will naturally gravitate to equipment they like, resulting in one machine that’s overburdened and another one that’s underutilized. In the absence of the MES program, Humber River would likely have ended up with a hodgepodge of equipment from its previous locations.

Both Dimitropoulos and Mossaed remember the battles they had competing with every other department for scarce capital budgets. “The old way of doing things would have been through a capital purchase and you’re competing with everyone else in the hospital,” said Dimitropoulos. “That’s how you end up with 25 to 30-year-old equipment because the other programs would be successful getting a piece of that small capital pie. It was a big battle to get approval for capital previously.”

Finally, there’s the issue of maintenance. As part of the contract, GE maintains the equipment “so I’m not dealing with vendor A for the MRI, vendor B for the cardiac machines and someone else for the OR machines,” said Collins. “I don’t have the manager of diagnostic imaging calling the repair people. We have an on-site GE manager to facilitate whatever needs to be done.”

And all of it comes down to customization. “How we define and structure an MES is quite fluid,” said Matthew Khoory, GE Healthcare’s Director of Partnerships and Digital Solutions. “An MES program can be very flexible with regard to the scope of the equipment, the duration, and the responsibilities covered. It can be all of the equipment in our portfolio and more. Or it could be focused on radiology or just a small fleet of equipment – X-ray and ultrasound, for example. We try to create a model in a way that makes sense for the specific hospital or health system.”