In many low-resource countries, hospitals and health clinics can’t provide sufficient patient care because up to 40% of basic medical equipment is absent or broken, including ventilators, infant incubators, diagnostic equipment like x-ray machines, and more.
Donated equipment often sits idle because there is no supply chain for consumables (i.e. suction cups or plastic tubes). Equipment lifespan is reduced by as much as 80% due to inexperienced operators and a lack of maintenance.
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Despite these dire circumstances – and the poor health outcomes that result – medical equipment data is overlooked. In fact, many low- and middle-income countries (LMICs) do not even have up-to-date digital inventories of the medical equipment they own.
Technologists have focused on developing health information platforms like DHIS2 and commodity logistics platforms like OpenLMIS to further the sustainable development goals. Now is the time to make medical equipment data another well-resourced global health priority, and to develop the digital toolkits countries need to navigate out of the medical equipment breakdown crisis.
Asset Data Improves Equipment Usage
Digital health systems practitioners have identified multiple types of data that an equipment management information system should ingest, including:
- Asset data: What equipment do we have, where is it, and is it functioning?
- Utilization: Is the equipment being used?
- Performance: Is the equipment working the way it is supposed to?
- Maintenance: What’s needed to sustain equipment or get equipment working?
- Impact: Are investments into equipment improving health outcomes?
This data must be made accessible and useful to the frontline health workers who interact with the equipment and the data system, such as maintenance technicians, biomedical engineers, procurement specialists, and care providers. They can then answer key questions, such as:
- What equipment is present in Facility A?
- Which equipment at Facility A is non-functional? Why?
- Does Facility A need that equipment? If not, can we redeploy units to Facility B?
- Which equipment in Region 1 is due for planned preventative maintenance?
- Which equipment in Region 1 needs to be repaired or replaced?
The right equipment data platform would provide visibility into equipment performance across the whole country, thus unlocking a variety of management functions for health systems.
IoT Data Improves Equipment Performance
Internet of Things (IoT)-enabled medical equipment has unique benefits for LMIC health systems, especially where traditionally infrastructure is unreliable. Automated wireless data is accurate, does not rely on consistent grid power, and can be particularly useful when developing machine learning and AI applications.
Several smart equipment types designed for LMICs are already available, including monitoring systems for medical equipment and connected devices from Hadleigh Health and smart vaccine refrigerators with an Equipment Monitoring System (EMS) already onboard from Vestfrost.
However, smart equipment is not a prerequisite for real-time data. Right-sized sensor technology, like Remote Temperature Monitoring (RTM) systems, can operationalize data from analog vaccine refrigerators and transport equipment. At least 7 RTM technologies are currently available to countries through WHO’s Performance, Quality & Safety (PQS) catalog.
Like vaccine refrigerators, patient care equipment can also be instrumented with wireless sensors. Nexleaf Analytics, in partnership with Global Health Labs (GHL) and the Center for Public Health and Development (CPHD) recently prototyped a real-time data dashboard for a variety of patient care equipment, including CPAP machines, infant incubators, and six additional device types, using off-the-shelf monitoring devices like smart plugs and accelerometers.
This project revealed that a real-time-data-centered approach to medical equipment management in LMICs opens the door to a variety of maintenance solutions and new innovations.
Best Practices for Medical Equipment Data
With any data system, questions of security, access, and ownership should be considered early and rigorously. As we devote more resources to building medical equipment data tools for LMICs, several best practices and principles should remain top of mind:
- IoT equipment data belongs to the country. Data capture business models for smart equipment in LMICs don’t serve global goals. Maximizing the utility of equipment data for health systems requires that countries retain control of equipment data.
- Data should communicate with a single platform. Ministries of Health around the world have made it clear that multiple proprietary equipment dashboards and logins do not serve health workers adequately. They need a single, one-stop solution.
- Open-source tools should be prioritized. Budget cycle fluctuations make it difficult for countries to procure SAS and keep software subscriptions current. Countries will only adopt software and data solutions they are sure they will be able to access and use over the long term. A digital public goods (DPG) model can ensure sustainable access to the tool, motivating countries to commit to digital transformation and develop equipment management practices with data at their center.
Following these best practices in choosing the right platform, countries can use data as the foundation for building out necessary functions, including:
- Robust equipment maintenance systems driven by data.
- Responsive funding mechanisms that target money for broken or missing equipment, spare parts, and maintenance capacity-building.
- Interoperable datasets robust enough to enable machine learning and AI.
Let’s End the Medical Equipment Breakdown Crisis
We need to raise awareness of the medical equipment breakdown crisis. This under-resourced problem cuts across essentially all vectors of LMIC health, from neonatal and maternal health to immunization and beyond. Better data systems are required to reveal the path forward.
By getting the right data to the right people at the right time, technologists can help countries ensure functional equipment is available to provide care for more people, so that every health facility stands ready to save lives.
Submitted by Nexleaf Analytics
