Rural hospitals face equipment uptime challenges—here's how to overcome them
Keeping critical medical equipment up and running is a persistent challenge for rural hospitals, where geographic isolation, limited budgets and staffing constraints can lead to prolonged downtime and disruptions in patient care. From MRI scanners and CT systems to patient monitors and infusion pumps, delays in repairs can trigger canceled procedures, patient transfers and significant financial losses.
Chris Espinosa, CBET, a biomedical engineer and regional service manager at InterMed, said geography is often the single biggest hurdle rural facilities face when it comes to equipment maintenance and repair.
“Geography is going to be the biggest barrier that we have when it comes to rural facilities,” Espinosa said. “A lot of these facilities, they could be 200 to 300 miles away from a major metropolitan area.”
As a result, many rural hospitals rely on a very small in-house biomedical engineering staff.
“So typically with a facility like that, you might have one or two in-house biomeds,” he explained. “But sometimes a good biomed is the jack of all trades but master of none. So sometimes they just need a little extra help that comes from the outside.”
Espinosa noted that original equipment manufacturers (OEMs) service priorities often favor large urban health systems: "[In] most of the major metropolitan areas, that's where the most of their business is going to be at,” he said. “The way a lot of our OEM counterparts operate is if you have a contract with them, you're first priority.”
Many rural hospitals, however, may not have those contracts because of cost constraints.
“What we found is that a lot of our rural customers typically, because of budget constraints, they won't have a contract with the OEM,” Espinosa added.
In Espinosa’s experience, equipment downtime in rural hospitals is not an isolated issue. “It's actually a pretty common issue is what I've seen a lot of our rural facilities,” he said. He added that many rural hospitals operate with minimal redundancy: “They'll be lucky they have one and they might be the only one that has one for the whole county or maybe for a hundred some miles away.”
When a key system goes down, the consequences ripple through the entire facility and impact patient care. “If you have one piece of equipment that stops that chain of events, whether it's an anesthesia unit, a RAD room, an MRI, CT, that patient's care at that facility stops,” Espinosa said. “So that patient traditionally, or more than likely, is going to go get transported to another facility.”
Those transfers can be costly for hospitals and burdensome for patients and families. “The hospital, now that rural hospital's going to lose tens of thousands, if not hundreds of thousands of dollars in revenue,” he said. “And then of course, you got to think about the patient themselves and their family. They're now being transported hundreds of miles away.”
Preventive maintenance can play a significant role in minimizing downtime, but Espinosa said completion rates vary widely depending on the service model. “So what we've seen is when it comes to maintenance of their equipment, if you're relying on just the OEM, we've seen anywhere from a 70-80% completion rate,” he said. “However, if we take over the equipment, we've always been over 90% completion rate with other preventive maintenance.”
Slow response time leads to downtime
Response time is critical in rural settings, where facilities may be hundreds of miles away from service hubs. Espinosa said regional and mobile service teams help reduce delays. “It could be anywhere from same day to 24 hours to 72 hours, just depending on what is down, what technician is available, and of course how far the facility is,” he said.
He also described a recent case that highlights the challenges of aging equipment in rural hospitals. An instrument washer failed due to a circulation pump issue, and the OEM told the hospital the unit was no longer supported and that the part was no longer manufactured. “Their only answer was, you got to buy a new one,” Espinosa said. Instead, technicians sourced a pump and restored the system quickly. “They were able to go out and find the pump from a third party and then get the customer back up and running within about two days,” he said.
Due to budget constraints, rural hospitals often have older or used equipment, which OEM vendors often cannot service because of the lack of parts or they no longer provide support for the older technologies.
“As parts get older, as units get older, we're seeing that sometimes OEMs won't even offer you the ability to get a contract with them or they won't be able to sell you the parts,” he said. “Even tech support sometimes will tell you, ‘Yes, we've worked on that for 10 years, but it's now beyond life expectancy, so we're not even going to talk to you about it.’”
For rural hospitals already operating on thin margins, those realities make equipment uptime a critical issue with direct implications for access to care in underserved communities.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]