ECRI Blog

What do you do with a medical device when it reaches the end of its useful life? If the device was used to store, generate, or communicate protected health information (PHI) or other sensitive data, you can't dispose of the device "as is." You'll first need to take steps to minimize security risks. Creating a structured decommissioning process now will help assure that the protections you need are in place when you dispose of medical devices in the future. 

Data security concerns

For any medical device that may contain sensitive data, the decommissioning process needs to account for the proper disposal of that data, regardless of whether the device is to be destroyed, sold, refurbished, reassigned to another location within the facility, or otherwise reused.

NFL football is an American pastime, but fun turned to fear last week as Buffalo Bills safety Damar Hamlin, age 24, collapsed on the field. Cardiac arrest is particularly uncommon for healthy young people. However, athletes may be at greater risk than others when actively competing in sports.

Hamlin is not alone. Every year, about 356,000 people in the US experience cardiac arrest outside of a hospital setting—that’s nearly 1,000 people per day. Sadly, an estimated 90% of these events are fatal.

Despite representing nearly 10% of deaths in the US each year, cardiac arrest is poorly understood by the general public. Unlike a heart attack, in which an artery that provides blood to heart tissue is blocked, cardiac arrest is an electrical issue, and the heart can no longer contract in a coordinated manner. As a result, blood cannot be pumped throughout the body, and heart and brain tissue can begin to die off from a loss of oxygen.

Influenza (flu) is a contagious respiratory illness caused by various viruses. It can cause mild to severe illness, and at times can even lead to death. Flu season started earlier than usual this season, and it has been joined by RSV and ongoing COVID-19 to form the “tridemic.” 

We know that getting the flu vaccine is the best defense against getting the flu; and even if a vaccinated person does contract the flu, the vaccine can significantly reduce symptoms. However not every eligible person is getting vaccinated, especially in communities of color.

The Centers for Disease Control and Prevention (CDC) has reported that inequities in access to the flu vaccine and misinformation about the vaccine can contribute to lower vaccination rates in minority communities.

With a vaccination rate of only 43% during the 2021–2022 flu season, Black, Hispanic, and American Indian/Alaska Native adults were more likely to get the flu and more likely to be hospitalized due to the flu. In fact, when the CDC examined hospitalizations caused by the flu, hospitalization rates were 80 percent higher among Black adults than white adults.

As always, influenza (flu) is in the news this time of year, along with recommendations that all eligible individuals get vaccinated against it. As many as 50% of eligible people typically skip a flu shot, and this year the temptation to skip may be stronger than usual.

After facing COVID-19, some people may be quick to dismiss the relatively much smaller risk posed by the flu, and persisting disinformation around COVID-19 vaccines casts a shadow on other vaccines. Several factors, however, suggest that this year's flu season comes with new risks and the potential for a new public health crisis. 

The tridemic is here—are you ready? By taking steps to understand the tridemic, and the effects it’s having on healthcare, your organization can better prepare for and manage the likely increase in utilization of emergency departments, pediatric practices, and inpatient hospital stays. 

What is the tridemic?

The tridemic is the unofficial name that has been given to the rise in cases of three different illnesses—influenza (the flu), COVID-19, and respiratory syncytial virus (RSV). Flu and RSV cases comprise the majority of circulating illnesses, as COVID numbers have been stable recently.

Alone, each of these illnesses can tax an already strained healthcare system. Together, they have the potential to cripple healthcare infrastructure due to worsening illness severity and sheer number of cases. 

Rising numbers in cases have been reported in Canada and in half of the United States. As the holidays and colder weather quickly approach, and with them a likely increase in indoor celebrations, experts fear that tridemic numbers will continue to rise. 

To make more effective and efficient decisions regarding budgeting and managing medical equipment, it’s essential that healthcare organizations focus on capital budgeting, medical equipment selection, and recall management. 

Capital budgeting is the process of allocating funds for the purchase of long-term assets, such as medical equipment. The goal of capital budgeting is to ensure that a healthcare organization has the funds necessary to purchase needed equipment and can do so while maintaining a balanced budget.  

Equipment selection is an area of critical focus during the process. To select the right equipment, healthcare organizations should understand the benefits and drawbacks of the various different types of medical equipment.  

You’ve heard and followed the familiar adage, “consider the source.” And for good reason, since the adage reminds one to verify the trustworthiness of a source before heeding its content. Perhaps nowhere does the saying ring truer than healthcare, where lives are at stake and resources limited.

For health systems, the acquisition of a new medical device can be fraught with a lot of "noise." As a system works to evaluate the potential of a new technology, subjective factors, personal biases, and marketing hype can influence perceptions at a time when identifying trustworthy sources is critical. A lack of sound evidence can further complicate the process.

However, decisions between supply chain and clinical leaders are still possible even when evidence is not conclusive.

In fact, the value analysis process can provide opportunities to engage and educate physicians about acquisition management and the standards and evaluation criteria that will help health systems obtain products that best meet their needs and provide desired clinical outcomes.

Identify biases

A good starting point is to ask your physicians where they get their information and then discuss those sources, so they, as good stewards of institutional resources, become more aware of common biases such as:

Selecting the appropriate genetic test can be daunting, and busy clinicians can be hard pressed to stay up to date regarding the rapidly-evolving landscape of genomic medicine. They need to know what a test does, what diseases or conditions a test targets, what tests have evidence showing a benefit to patient management, and what tests are covered by payers. ECRI’s Genetic Test Assessment service focuses on assessing clinical evidence on genetic tests and deciphering a test’s intended purpose and methodology.

Below are some frequently asked questions from healthcare professionals who use ECRI to guide utilization of genetic testing. 

In one of the latest challenges for the embattled healthcare supply chain, the U.S. Food & Drug Administration (FDA) reported that there is now a shortage of tracheostomy tubes, especially pediatric tracheostomy tubes.

"This supply chain disruption disproportionally affects the pediatric population due to the already limited number of products available for this patient population and the spike in cases of respiratory illnesses in children," says Jillian Hillman, ECRI's senior manager, Functional Equivalents - Device Evaluation.

To help reduce the burden on healthcare providers and promote patient safety, ECRI has issued this functional equivalents report. ECRI will offer updated guidance as this situation unfolds.

The shortage includes the Bivona® tracheostomy tubes manufactured by ICU Medical. The shortage may be related to difficulties in getting the raw materials needed to make the tracheostomy tubes. 

Healthcare organizations are some of the most complex and critical in the world. Supply chain disruptions in healthcare can have a ripple effect on patients, staff, and the community at large. So, whether you are running a health system, hospital network, aging services facility, or ambulatory care center, supply chain disruptions are crucial to understanding your organization as a whole. 

A supply chain is a complex network of individuals and companies that design, manufacture, distribute, and consume healthcare products. Because supply chains are so complex, it's easy for disruptions to occur. Some disruptions are due to labor strikes, transportation issues such as weather-related traffic jams or port closures, supplier bankruptcies, and product recalls. Other reasons could be that a company is sourcing products from a region that's experiencing political instability or if they rely on a limited number of suppliers. 

This can leave you without the necessary supplies or medications that you need to provide the level of care your patients deserve. That being said, there are ways that providers and healthcare facilities can prepare for these disruptions. If you're looking to navigate supply chain changes more effectively, keep reading for tips on preparedness and management strategies you can employ.