Across-the-board reimbursement cuts, the pressure to improve the quality of the patient experience, and a slew of regulations regarding equipment maintenance have providers reeling. Many are turning to the OEMs they do business with to share their pain and be part of the solution. Parts and service costs are definitely among the the expenses hospitals are scrutinizing for potential cost saving.

But working with the equipment manufacturers has been complicated by the fact that they are feeling the pinch too – new equipment sales have been taking a hit for several years now. The OEMs, in response to that, have moved beyond their primary role as purveyors of new equipment and are aggressively expanding their role as service providers, serving not only their own products but that of their competitors by building new service arms or through the acquisition of established service companies.

In the following responses to HCBN’s questions, you’ll see how the OEMs use their unique access to proprietary parts and technology to make their case as the preferred service provider -- you can compare their arguments side-by-side. If you’re looking for a new or extended service contract this is required reading.

No one ever got fired for buying . . .
If you’ve been in the health care field for any length of time, you’ve likely heard the old adage, “No one ever got fired for buying GE. ”While it’s impossible to confirm the veracity of the statement and any number of OEMs could fill in that blank in place of GE, the general sentiment holds true. That is, there’s less risk going with the company that manufactured the machine when making a purchase or entering into a service relationship.

In that, the OEMs have a decided leg-up on ISOs. But they’re backing that name recognition and brand loyalty with increased and expanded service options in order to keep existing customers and bring on new ones.

Bud DeGraff, general manager of diagnostic and clinical services at GE Healthcare probably appreciates the sentiment behind the statement. While he wasn’t asked the question directly, he did point to GE’s reputation as something that he thinks sets the company ahead of the competition. He addressed the company’s insights, experience, data and tools that help hospitals to improve their business, bottom line and the ever-critical patient outcome and experience.

“Clearly, it’s not business as usual,” DeGraff says. “That’s true for GE and the hospitals we serve. In the past, we’ve focused on helping to increase the reliable uptime performance of advanced medical technologies. We’ll continue to provide that support in a costefficient manner. But we know that in today’s environment, our customers need more. They need sustainable improvements in performance that will help them meet business objectives over the long term.”

DeGraff went on to explain that when GE partners with hospitals, the answer for improving performance rests in three key operational areas; managing assets, improving patient workflow and workforce utilization. “In this ‘not business as usual’ environment, we are focused on helping our customers improve the financial and operation health of their enterprise,” he says.

And in a turnaround from the direction many hospitals are going— taking more responsibilities in-house — DeGraff says that by enabling facilities to outsource maintenance and management of their clinical engineering services, the company can help to reduce the operating costs associated with clinical assets by 15 to 20 percent.

GE, like most OEMs offering service in today’s highly competitive health care environ, has taken steps to provide parts and service beyond their brand. Although they have a large number of service techs dedicated to servicing GE products, there are also techs covering competitors’ equipment. “GE has more than 1,000 service engineers, trained to work on non-GE equipment,” says DeGraff.

GE maintains a Multi-Vendor Services Center of Excellence in Arlington, Texas that serves as a training facility for those techs. There, techs train on nearly 50 different pieces of equipment installed in the facility, according to DeGraff. “This is in addition to field-based training programs that include many more non-GE systems,” says DeGraff. “The TCOE is also home to a parts repair operation that handles more than 700 repairs each year.”

The techs servicing non-GE imaging equipment have on average more than 20 years of experience on other OEM products and receive an additional 15,000 hours of training annually on non-GE systems. Those techs are well-stocked with parts from GE’s $30 million supply consisting of more than 74,000 unique parts numbers from more than 200 suppliers, stocked in 59 warehouses across the country according to DeGraff.

Yet, it’s not always a question of getting a part to fix a problem. Remote diagnosis of issues along with the possibility for remote repair also factors in or should factor in to the decision a hospital makes about who will service their equipment. According to DeGraff, GE online engineers utilize more than 40,000 broadband connections for more than 50,000 connected systems that ultimately resolve 40 percent of the issues that arise in less than 30 minutes.

GE is also leveraging technology to prevent problems before they occur. The company offers iCenter, a web-based application that provides information on maintenance history and asset utilization by consolidating inventory, planned maintenance compliance and performance comparisons, according to DeGraff. Complimenting that system is On- Watch which monitors and analyzes device performance to help identify any possible red flags before a problem escalates.

Relying on professionals for ProCare

According to Alisandra Rizzolo, vice president general manager of customer care for Stryker Corporation’s instruments division, while it’s very hard to predict when a piece of equipment will fail, by partnering with a quality service, hospitals can better manage costs since repairing an item is usually less expensive than replacing it.

Even better than repairing a piece of equipment is preventing its failure in the first place, thereby saving money on parts and eliminating unplanned downtime. Rizzolo identifies Stryker ProCare as a service the company offers to help do just that. “Stryker ProCare’s preventative maintenance services help hospitals take control of their costs by maximizing the equipment’s life-cycle,” she says. “Our highly-trained service team provides on-site equipment testing and works with hospitals to evaluate how equipment is being cleaned and stored to identify solutions to ensure the total cost of ownership is optimized.”

When even preventative maintenance can’t fend off an unforeseen system failure, the service also offers equipment repair options, onsite support and loaner equipment as well as a troubleshooting helpline for service- related questions, according to Rizzolo.

Rizzolo says the ProCare service team undergoes a rigorous training program in order to be ready to repair equipment according to OEM standards. “For all medical equipment, but especially those used in direct patient care, it is important that the devices being repaired are working in compliance with the highest OEM standards,” she says. “Stryker ProCare service providers are specially trained and certified to handle and repair parts according to the manufacturer’s instructions. They also have access to OEM original parts and the tools specifically designed to repair that equipment, which can elevate health care provider’s confidence in the repair and reduce the risk of malfunction or the need for additional repairs and services.”

Rizzolo says it’s common for hospitals to make the mistake of thinking that all service contracts provide them with the full line of services they need. That’s not necessarily the case, she says. “Hospitals should first evaluate their equipment service needs before selecting a service provider. Once a hospital has identified the breadth, volume and criticality of supplies in their facility, they can make an informed decision regarding what level of service they require and which provider can best match their needs.”

During the negotiating process, it’s also important for decision makers to ask questions about the level of experience the service techs will bring to the table as well as finding out what certifications they hold and how accessible they are. After all, even the most experienced and knowledgeable technician is of little use if they can’t be reached in a timely manner.

In the future, Rizzolo expects to see more hospitals partnering with quality service providers and service providers working hard to keep staff abreast of the latest in medical equipment updates as the equipment continues to evolve at a rapid pace. She believes the relationship will only grow deeper between hospitals and service providers as the need to provide better care at a reduced cost becomes even more of a priority.

The role of Bayer’s arms
Bayer Healthcare has two distinct service arms that deliver support to customers. The first, Bayer HealthCare service strictly focuses on providing preventive maintenance and repair for Bayer radiology and interventional equipment. Anne Osbourn, U.S. service marketing at Bayer, says it’s important to note that service on those products is not limited to the U.S., with service on devices in other parts of the world supported through Bayer Medical Care’s hub in Maastricht in the Netherlands and through a large network of distributors.

Meanwhile, Bayer Multi Vendor Service offers maintenance and repair capabilities on all major brands of radiology coils, probes and imagers used in the U.S., according to Bill Kollitz, head of Bayer Multi Vendor Service. “These products are serviced in the field by our field service engineers, at our facility in Pittsburgh, and our remote facility in Tulsa, Oklahoma,” Kollitz says. However, the MVS division does not service equipment that directly competes with Bayer products, according to Kollitz.

As for getting field service engineers involved with equipment issues, Shawn Kimmel, head of U.S. Service says Bayer field service engineers respond within 30 minutes to requests in order to determine if the problem can be addressed remotely or if onsite service is necessary. When onsite service is called for, service engineers usually arrive same-day or early the following morning.

For multi-vendor service dealing with CR and dry film printer service, technical support is just a phone call away, with Bayer offering free phone-based support to anyone needing it. “If a service call by an engineer is required, that engineer will be onsite within eight business hours of receiving the call for a contracted customer,” says Kollitz. “Calls are acknowledged within 15 to 30 minutes after the service request is placed with our call center. For depot based repairs, Multi Vendor Service can respond to requests for probe and coil repair with a no charge loaner shipped overnight for first priority delivery, and completes most repairs within a few days of receiving the customer’s product in house,” he says.

Bayer is able to provide such prompt service to customers in part because its Health-Care Service team specializes in servicing the company’s product portfolio of power injectors, according to Osbourn. And most parts are near at hand. “These field service engineers carry sufficient ‘trunk stock’ to have the products on hand,” says Osbourn.

This means there’s no delay waiting for a part to arrive. Bayer also offers Virtual Care which allows for remote diagnosis to help identify and possibly resolve errors remotely. All of this is backed by a 24/7 technical assistance center, she says.

As a group, they believe as imaging technology continues to advance, software will play a growing role in its operation and by extension, remote service and monitoring will become a more important service and should be a welcome one for cost-conscious hospitals.

Another tip they offer for cost-conscious hospitals, or really any facility that isn’t looking to throw out money is to be sure of what’s being included when it comes to negotiating a service contract. They suggest hospitals look at the details of the individual proposals to ensure an “apples to apples” comparison. What may seem like a deal can ultimately cost more than another offer once all aspects of a contract are considered.

Keeping true to the source

“When preventative maintenance, repair or repair replacement is completed through KARL STORZ, or any OEM, the product warranty is assured and, in some cases, the warranty clock restarts to ensure maximum protection for your repaired devices,” says Jeffrey Yates, group marketing manager, Protection1 for KARL STORZ.

According to Yates, only KARL STORZ technicians can restore the company’s products to their original factory specifications, thus ensuring optimal performance according to the instructions for use (IFU) that are supplied with the devices when they are new.

Yates warns that repair of those products by an ISO may void indemnification by STORZ, or at least limit any guarantees previously in effect, depending on what repairs or modifications were done. “More importantly however, is that the IFU provided with the device is no longer valid,” Yates says.

He suggests that any facility utilizing third party repair options get validation in writing that states the devices repaired can be cleaned and sterilized using the reprocessing instructions they provide and will perform according to the specifications of a new device.

The company has field service technicians available throughout most of the country to carry out minor repairs, exchange rigid and flexible endoscopes, provide preventative maintenance service and conduct in-service education programs for staff. Onsite technicians are another option. The obvious benefit they deliver is the immediacy of support.

The company also offers customizable service and no-fault service plans and asset management programs. Yates acknowledges that the impact of the Affordable Care Act on hospital spending has still yet to be fully realized, but capped operating budgets and tight restriction on capital dollars will likely be with us well into the future.

Therefore, while tempting, Yates believes it is critical for hospitals to weigh the balance between short-term savings through independent repair services versus long-term savings that can be realized through a comprehensive service and repair contract. That decision can also have repercussions for patient care. Yates cites ECRI Institute’s top ten patient safety concerns for 2014 as proof of the risk, with inadequate reprocessing of endoscopes and surgical instruments making that list.

When a facility is considering repair options by non-OEM service providers, Yates suggests they ask the service organization these questions:

1. What impact will repairs by your company have on the OEM warranty?

2. How does your repair warranty compare to the original manufacturer’s warranty?

3. For devices that must be reprocessed and/or sterilized, can you provide me with documentation that the repaired devices are validated for sterilization?

4. Because the KARL STORZ IFU are invalid upon third-party repair, it will require new instructions for use from your company in order to maintain compliance. Will your company provide new IFU for repaired devices?

“A better solution is to carefully consider the total cost of ownership at the time the capital decision is made, and then hold the endoscope and equipment supplier strictly responsible for their devices’ performance and cost over their expected lifetime,” he says.

To illustrate his point, Yates offered an example of a situation where a hospital did take the long-term approach. “The surgery program manager at a hospital named a 100 Top Hospital for 11 years, recently prepared a report on that facility’s experiences and achievement from implementing Protection1 solutions. In addition to eliminating 95 percent of all issues that previously posed ongoing daily challenges (issues relating to quality, safety and cost effectiveness), equipment repair turnaround time was reduced from three weeks to 24 hours, and surgeon complaints decreased from 40 per month to none at all.”

Knowing what you want and getting what you know
For hospitals utilizing in-house staff for preventative maintenance and repairs, there are a few things they need to know in order to control and predict parts costs, according to Mike Schwarzwalder, director of service marketing for STERIS.

First, the total cost of the required part needs to be determined. That includes acquisition, any carrying, obsolescence cost and down time for equipment. The need to know doesn’t end there. It’s also necessary to know the right parts to inventory in order to get things up and running with the first call. OEMs should have data available that will allow them to help in the process, says Schwarzwalder.

Those same manufacturers may have auto-ship programs for PM parts. That option helps reduce in-house storage needs, while providing a physical and timely reminder of the need for a PM.

Finally, by ordering parts from the OEM, you know you’re getting a part that will precisely fit the same part it’s meant to replace, thereby removing any risk of repair delays due to a non-compatible part. “I travel frequently and it never fails, every time I am out there I hear stories about the wrong part being sent, it was a used part or, a previous generation,” says Schwarzwalder. “While the initial price may attract attention, it is really the long term cost that needs to be considered. Also by using OEM STERIS parts you are assured that it will not void the warranty.”

For facilities tapping STERIS for service, the company technicians start with more than 250 hours of initial training on STERIS exclusive equipment. That’s followed by yearly specialized and new product training, which may equal as much as 80 hours. On average, company techs have been working at STERIS for more than 12 years. Trucks also carry a market specific inventory of replacement parts. The goal is to provide customers with service coverage 24/7, powered by more than 850 field technicians, customer service and training programs, according to the company. This has helped spawn the phrase used by some techs, “call us by lunch and we’ll be there by dinner,” in regard to their response rate.

It’s not just the techs in the field going the extra mile though. STERIS has 20 in-house service engineers who continually evaluate data from field repairs as well as data fed through their ProConnect Response Center which all helps determine if adjustments are needed for the company’s proprietary preventative maintenance check list.

For a hospital’s checklist, at least when it comes to negotiating service contracts, Schwarzwalder cautions against quick comparisons of just labor charges. Instead, make sure to look at the entire picture and all the potential expense that entails. That includes not only labor, but parts costs, response times, travel charges and the timeliness and quality of the service provider’s preventative maintenance program.

Siemens guarantees customers will keep their cool

Siemens Healthcare, like STORZ, has strict requirements when it comes to who can service equipment under warranty, with service by non-Siemens personnel resulting in a voided warranty. But Jon Matthews, senior director of Siemens Healthcare service business management says there’s good reason for that.

Matthews gives the example of a customer with a Siemens MR system. He cites the exorbitant cost of helium and the importance of a well-maintained chiller to prevent issues that could result in helium loss. “Siemens offers a service whereby if our technicians do the maintenance and Siemens parts are used, and for any reason there is a service event due to chiller-related issues, we will not only waive related billable service events including components, but we will also cover any helium lost as a result of the service event,” he says. “Another company could certainly handle the preventive maintenance of the chiller, but in this case, if a service event occurred, the customer would not have the opportunity to have the chiller service that would cover not only the parts but the cost of helium lost as a result.”

According to Matthews, Siemens only supplies genuine Siemens certified OEM parts through the company’s Service by Request program, with parts either new or remanufactured. “Remanufactured spare parts are tested with the same rigor to ensure performance is identical to new spare parts,” Matthews says.

When it comes to advice for purchasing parts, Matthews warns buyers to be cautious. “There are several companies and individuals in the market that hunt for used medical device equipment just to recover ,parts and re-sell them,” he says.

In those cases, it can be difficult to ascertain the provenance of those parts or their life expectancy. “With the pressures on health care providers to ensure patient safety and quality outcomes as conditions for reimbursement, now is not the time to gamble on parts. For confidence and peace of mind, the best option is to obtain parts from the OEM manufacturer,” Matthews says.


As for getting those Siemens certified parts installed, Peter Soltani, senior vice president of Siemens Healthcare customer service touts the company’s Customer Care Center, which is always open. “The Center handles scheduling and implementation of planned maintenance for proactive support, and making remote as well as on-site repairs,” says Soltani.

Siemens has also heavily invested in Customer Service Material Logistics depots across the country. These depots comprise an extensive parts supply system, which enables timely delivery of parts anywhere in the U.S. Meanwhile, via the company’s Integrated Service Management organization, Siemens provides full service solutions for non-Siemens as well as Siemens equipment.

Another option for service needs is Siemens Remote Service, a subscription-based option the company offers. According to Soltani, many customer issues can be resolved with just one phone call without the need for an onsite visit.
Siemens also has the Evolve program. “Evolve enables customers to keep their hardware and software abreast of advances in medical technology with periodic upgrades,” Soltani explains.

While the choices Siemens offers attract quite a few customers, it’s still not for everyone. For those health care professionals, Soltani says they should seek out a strategic partner that will help them to achieve their clinical missions and will be proactive in assisting with the issues regarding patient throughput, safety and satisfaction. Companies doing business strictly on a transactional level might be shortchanging you. “The cost savings you achieve, and the reimbursements you could optimize by finding this type of partner, could yield higher returns than you might expect,” he says.

Avoiding break-fix solutions

Todd Reinke, director of service marketing for Philips Healthcare Customer Services North America, wasted no time getting to the point. “Our focus is on partnering with the customer for the long-term versus providing ‘break-fix’ only solutions,” he says.

In order to do that, Reinke says Philips employs a national network of more than 2,000 engineers that supports both Philips and non-Philips imaging systems. He also says the company continues to invest in remote services for Philips and non-Philips systems.

According to Reinke, Philips has an industry leading Uptime Service Guarantee of up to 99 percent and offers flexible service plans tailored to full-service requirements as well as support for in-house teams. Philips also offers online and onsite clinical application and training support programs.

“While we are an OEM, we also have developed an extensive service team to support multi-vendor imaging and biomedical service capabilities,” says Reinke. With Dunlee tubes and AllParts Medical providing support, the company’s multi-vendor services provide extensive coverage, according to Reinke.

Philips also offers asset management and system utilization tools to help manage the lifecycle of customers’ overall assets, he says. They also offer programs to support in-house teams via ‘first-look’ and ‘selfservice’ plans for their equipment. “These in-house plans help our customers manage costs by carrying some of the service responsibility themselves and we offer parts on programs for customers that do not want service plans, but want access to certified/ quality parts,” Reinke says.

Customers have told Reinke that they expect to see further consolidation and cost control in the service market. On their wish list, they want service providers that can help them maintain older equipment while also providing service and support to new technology and they want to see investment in new types of service options, like remote service capabilities. Reinke believes we will see service requirements from federal and state levels that will increase administrative burdens. He also believes more value-added service partnerships will crop up across entire hospital networks versus individual service plans for individual pieces of equipment or modalities.

In order to handle all the challenges destined to arise in the future, he believes it’s crucial for hospitals and service companies to work closely together and keep the lines of communication open. “By working closely together during the plan development phase, we are able to successfully support mutual expectations for a long term and very positive service relationship,” he says.


Chris O’Toole, national sales director for AllParts Medical LLC, a division of Philips Healthcare is in a unique position as neither an OEM or aftermarket equipment supplier. Instead, according to O’Toole, the company is a multi-manufacturer, multimodality imaging parts supplier. “We also provide multi-manufacturer, multi-modality training, technical support and asset disposition services. We are not limited in what parts we supply to which systems,” says O’Toole.

O’Toole sees a high demand for CT, Xray and portable parts with GE parts being in highest demand. In the past 12 months however, the company’s fastest growing modality has been ultrasound, with MR parts also bringing in healthy numbers.
AllParts is all-inclusive as a parts provider. “Parts ship with a 90-day warranty irrespective of who performs the repair or what asset the part is installed on,” says O’Toole.

For parts shoppers O’Toole recommends finding a parts supplier that offers technical support, tested parts, a breadth of quality assurance bays to test parts for the manufacturer and modality being serviced and the big one on everyone’s mind these days — competitive pricing.

It’s also a big plus if they can train your technicians in order to enable greater self reliance. Topnotch account managers and customer service representatives will also play a part in making the experience as easy as possible. Finally, program flexibility that can evolve with your needs can also prove beneficial.

Focused training and specialized tools
Joe Graham believes the engineers from his company are the go-to experts in servicing Toshiba equipment. Of course, Graham is the vice president of service sales and marketing at Toshiba, so he’s able to qualify that belief. He further backs the assertion by noting that Toshiba engineers tend to service only or two modalities of equipment and thereby receive more opportunities to gain experience on specific equipment. The company also works to keep its service professionals informed. “Toshiba Service communicates all updates quickly and regularly, keeping our engineers on the leading edge of high-quality service delivery on Toshiba equipment,” Graham says.

While experienced and knowledgeable service engineers will no doubt be in high demand for many years to come, Graham believes the big story will be about the equipment. “I think diagnostic imaging equipment will become even more reliable due to new manufacturing enhancements, installation and warranty efficiencies and more dependable components and subcomponents,” he says.

Graham also believes that system software will become more efficient and improvements in predictive programs that will identify component issues before they become critical will be a boon. He also trusts that enhanced utilization tools will be brought to market which will allow clinicians to realize a higher level of operation performance from equipment while helping to make them deliver a higher financial return. “Ultimately, patient care will benefit most with newer and improved technologies in the short-term future,” Graham says.