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Thanks for joining us. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a channel dedicated to keeping health it staff current and engaged. Welcome to our device security briefing. This is such a gnarly problem for healthcare leaders, and I'm excited to get into this topic today.

We're joined today by Samuel Hill director for healthcare for Medigate by Claroty. This podcast series is gonna culminate in an excellent webinar on September 8th at one o'clock Eastern time, we're gonna have two experts from leading healthcare systems. We're gonna have Intermountain and children's of LA Eric Decker is gonna join us and Andrew Sutherland.

And they're gonna talk about the challenges and solutions to unmanaged devices. In healthcare, check out more for more information, just check out the description box flow and the registration link. You could also just go to our website this week. health.com in the upper right hand corner. We will have a link to this upcoming webinar.

Love to have you join us. We wanna thank Medigate for giving us some time with Samuel today and for making this content possible. Now onto 📍 the show.

alright. Today we're joined by Samuel Hill director for healthcare, for Medicaid by clarity before working in technology, he spent seven years as an emergency room tech for two different health systems and lived through an EHR transition. Both times. Samuel is a husband to one father to four and lives on a rural island off the coast of Seattle, Washington, Samuel. Welcome to the show.

Wow, it's good to be here, bill. Thank you again for having me

seven years in the emergency room. Did that prepare you for a life in technology?

I think it probably prepared me for parenthood more than a life in technology the, the, on your feet thinking and rapid adjustment to new plans. And there were nights when I'd walk into the ER and you never knew what you were going to expect or what would come in. It was always dealers choice, if you will. So similar to, to life as a parent, I imagine.

Yeah. I, talked to Lee Milligan about cuz he was in the emergency department as well.

And he said it was a great training ground for triaging problems and determining risk very rapidly and whatnot. We've been talking a lot about risk. And identifying the risk that medical devices pose within your health system is the fourth of a five part series. First one. And you can go back and listen to any of these first one.

We talked about the value of a foundation for zero trust of visibility and transparency and knowing what you have. Next, we talked about holistic assessments, how important it is to tie all this together, and really not only look at the devices and the technology, but also the processes and the methods, and as well as the staff and the skills.

And then last time we got together, we talked about M and a in the uniqueness of an M and a event. And why it's important to know what your Connecting to and what's there. And what risk is associated with that not only from a risk standpoint and a security standpoint, but also from an optimization of the integration standpoint today, we're gonna go into device effectiveness and I've told you this story a couple of times there's there's problems and not knowing where your devices are.

And when I was at St. Joe's, I remember we had a problem at one of our hospitals that our devices started showing up on EBIT. And and no one really knew until they started showing up on eBay, that our devices were walking out the door and being sold. And I mean, that might be an extreme use case, but health systems in general don't know where all their devices are. Do they,

well, it's really hard to track 'em. I mean, that's, it's one of the, I think one of the more difficult things to do inside of hospitals I, whenever I've talked about this topic, Both groups of people I'll, I'll ask, especially if they're practitioners I'll ask 'em where's the weirdest place that you found like an IV pump, for instance, and you know what the weirdest place that I've heard, I've heard this consistently bill, they'll say the ceiling tiles.

So not just eBay, but like these devices are ending up in weird random places that they just really shouldn't. But you gotta look at what's driving that behavior, obviously getting it on EB that's, that's a different set of drivers, but ceiling tiles locked closets CA linen cabinets, wherever it is that these devices are hiding. They're being hidden there for a reason. And it's not because the medical staff hates the biomed team. It's just because they want that device to be available to them when they need it to deliver patient care later.

Interesting. It's almost a hoarding thing. It's like, I got, I got the device. I'm gonna make sure I get the device tomorrow when I come back into work.

Absolutely. Yeah. And it's, and then my favorite was the whenever a device would break in the unit, we needed it to get fixed. And I would just take one of those little paper napkins out of the hand washing station and put a piece of tape and just write the word broke and tape it to that device. And so the biomed teams always loved that because they would get this device that just says broke.

They're like, what's broken, why they needed way more detail about it. But I'm like, I was just warning all the other people on the unit. Don't try and grab this device. It's not going to work for you. You need to find another

so let me ask you this. Yeah, I can imagine the problems that this causes it, it causes Significant under utilization of the devices that you have, which I assume would lead us to replace devices. We don't need to replace when we have devices just down the hall. So what kind of problems does this create for health systems? And does it create as I would think it would a significant budget pressure because you're buying devices that potentially you don't need.

I think it's it's yes, it does create that budget pressure. The frontline units are always asking for more devices and without the accurate data, to be able to say how often the devices they already have, are being used, or do they actually have inside their unit, the number of devices that they have allocated if they're supposed to have a hundred IV pumps in med surge, do they have a hundred or do they only have 50?

Those are things that without real good data about where devices are located, it's hard to really put to make good decisions about them in a lot of ways. And so, yeah, hospitals spend millions of dollars every year. Buying and replacing medical devices that they may not need to. Now, there's obviously growth.

We've got a life cycle. We have to replace those that are end of life or whatever, for whatever reason. But if we're just buying more devices, cuz the frontline teams say that they need them that could potentially be budget that we're using. We may not need to.

So talk to me about, you've probably seen this play out a couple times now. Do you have any examples of the ROI that's as for an organization that does identify other devices? What does the ROI look like on that?

Well, I'll tell some stories from what we've seen from some of our customers. one hospital said they do preventative maintenance on all these devices, usually every single year, which may, maybe that's something that could be impacted, but there's always about 10% of the devices.

They said that they can't find every single year when it comes time for the preventative maintenance. And so with tools that actually can help them locate where the devices are or where they were last seen. They took that time of finding that 10%, which they estimated to be about 500 people hours.

They took that down to about five people hours to find the remaining balance of devices that needed preventative maintenance. Another hospital, this was an academic one. They said that they had, they discovered that there were 3000 devices that were just sitting around that had not connected, had not been turned on in over 90 days.

So there's 3000 devices that had not been seen transmitting on the network in over 90 days, which. They can go find them now, get them turned on or reallocate them, redistribute them to meet some of the needs. And so imagine if all of a sudden, instead of having to buy 3000 more devices, you were able to just find 3000 that had not been turned on and then deploy those to the frontline units that are asking for 'em.

That's pretty amazing. why is the device inventory so hard to maintain? It's not hard to get that one time, right? We can all do a, we can do a physical inventory. We can do even electronic inventory, but why is it so hard to maintain.

Well, the part of the difficulty comes from that. They move around so much, like, and they should be in this place. They should

they're they're literally on wheels.

Literally. Yeah. Right. Literally. And with all that movement the dynamic nature of patient care in hospitals that's where it becomes difficult. So without a real dynamic feed of information into your records of truth, it really is a point in time.

It's not gonna help you so great. You gotta, you got a record, you got a whole list of these devices that you just purchased that were now on your loading dock. They've got uploaded into your management system, but then they get deployed in the hospital. And what versions are they running? What software do they have?

What do they need? What preventative maintenance cycle are they on? All of that detail becomes quickly out of date.

And so there's an opportunity here to free up budget. This is a hot topic right now, everybody we're talking about the fact that we're entering sort of a recessionary time. And during recessionary times, it's hard to get replacement budgets and those kind of things. But essentially what we're saying is there's likely in this area of medical devices, there's likely unaccounted four devices in your system that could be redeployed today and relieve some of the budget pressure.

There's some ways of that. Yeah, absolutely. We've seen it where we had a customer that said they request for a new, like, I think it's a CR and an operating room and they were able to avoid that capital expense because they better utilize the ones they already had. And so getting into territory now where we're making it more efficient for the delivery of care in some ways, but also we're meeting the needs of the frontline.

That's really what's important. Alternatively, so if there's a bunch of devices that have not been turned on and are not connected that are not in your system if an IV pump specifically, if that IV pump has not received the latest pharmacy guardrails, that PA that device is really no longer safe for patient care.

We can't use it anymore. We shouldn't be using it. Or if that device was stuck in a ceiling tile, and then the biomed team, wasn't able to find it and get it through its system. So they market it as lost in their management system. But then all of a sudden the device is pulled down from the ceiling.

Talent is now used and hooked up to a patient we're entering unsafe territory. So not only can we better utilize these devices, which then saves us capital, potentially replacing capital expense, but we're also ensuring that the devices we are using are fit for patient care.

All right. I feel like you've you had me at hello here. And the question becomes, you know what's what's next? What do I.

Well, we have a we built a little calculator on our website medigate.io/cde. And it's a, it is a back of napkin math calculator. This is no, no spreadsheet that you're gonna take in for a board conversation, but it might give you a little inkling to the specifics that might apply to your organization.

So if you go T IO slash CDE, CDE, Charlie David echo, you'll find this little calculator that's there and you can input just your number of medical devices that you expect to have in your environment. And hopefully see some back of napkin math that might show some potential capital savings and realize that

that's fantastic. Tell me a little about what Medigate does in this area.

So Medigate provides all of the data about connected devices down to a really accurate profile, including where that device is physically located. And then we use that information to match it against your systems, like your CMMS to track the inventory.

So we see the real time view of the network traffic and can understand what devices are communicating and are out there in the wild and can match that with your CMMS. For the inventory perspective. Again, we track to see where the location is based off of where is this device physically talking to our network.

And then the last thing is we look at the packets, we understand the utilization. So we're seeing when is this device? Transmitting and communicating in the course of doing its job. So when is a CT scan actually scanning a patient and how long interval was the interval between patient scans or how often is an IV pump used or whatever those things are.

So, because the data's embedded in the network traffic and we collect and see that we can bring that value to a single reporting tool so you can make great decisions about your devices.

So even if the device doesn't provide you that kind of stuff, you can get the utilization of the devices from your tool. That's phenomenal, Samuel. I wanna thank you for your time again, and really appreciate our conversations.

Thank you, 📍 bill.

What a great discussion. I wanna thank our sponsor for today. Medigate by Claroty for investing in our mission to develop the next generation of health leaders. Don't forget that this whole series ends culminates with a great webinar that we are going to have, and we have two great healthcare leaders. We're gonna join us. Intermountain, Eric Decker children's of LA Andrew Sutherland. And we are going to talk about the challenges and solutions to unmanaged devices in healthcare. You can check out the description box flow for more information and the registration link. You can also go to our website this week, health.com and look for a link to it in the top right hand corner of the page.

Love to have you join us again September 8th at one o'clock Eastern time. Thanks for listening. That's all for now.