The results of the testing process are often understood very well by those who performed the evaluation, but may not be immediately understood by other stakeholders.  Additional steps should be taken to ensure that the data is clearly disseminated to key people involved in the decision-making, purchasing, and implementation processes.

Step 6: Select Device

The testing process should have produced a set of numbers that can be used to make a decision as to which product should be purchased.  Additional feedback from clinicians may have helped provide additional insight as to which device will best fit an organization’s needs, and enough expertise will have been created within the testing team to provide useful information to the decision-making team.

Figure 8. Step 6: Select Device

An overview of the tests, the results, and the thoughts of the testing team can help those making the purchase decision better understand which product should be purchased.  The exact mechanics of this process are likely to vary by organization and by the scope of the project.  Ensuring that all decision-makers understand the process that went into testing can help them better understand why particular recommendations have been made; an overview document or final presentation on the testing team’s findings may be useful.

Information Sharing

When the decision has been made, consider creating a high-level summary document to send to those who will be interested to learn more, such as clinicians who will use the devices, organizations who are partners in the project, and other identified stakeholders.  Gather any feedback from these stakeholders, as they may have insights that may not have been considered by the initial team.

Inform stakeholders of upcoming milestones or deadlines that may impact them, such as plans to ship or deploy equipment, purchasing timelines, and training options that will exist as the implementation process continues.

The information gathered up to this point may be rather extensive.  It is important to make a plan to disseminate relevant decisions and next steps to those who will be impacted by this work of the assessment team.  Allow for feedback from interested parties, and be prepared to answer questions about the process followed, the impact of the decisions, and the plan for moving forward.

Technology Assessment 101 – Deployment and Support

Selecting a technology is only the start of a much larger process that involves purchasing and deploying the devices, then supporting them throughout their lifecycle.

Step 7. Deploy

Purchase

Different factors will impact the steps that are taken when purchasing equipment.  If an organization is only getting one or two pieces of equipment, for example, there may not be a need to establish a robust purchasing plan and deployment strategy.  If, however, an organization is deploying many pieces of equipment to multiple facilities, more work should be done to ensure the success of a deployment.

Regardless of the size of a deployment, several things should be considered when purchasing devices:

• Vendors
  • Which vendors carry the equipment that you need?
  • Will they be able to meet additional orders if your program grows in size?
  • Can they provide any information about potential changes in the product line in the future (some vendors may be able to explain the product lifecycle more clearly than manufacturers, such as when new models will be released)?
• Additional Requirements
  • Are there cables, connectors, or peripherals needed for the deployment?
  • Do new computers or other infrastructure pieces need to be ordered to support the new equipment?
  • Are software packages or operating system upgrades required to support the new equipment?

As the size of a deployment increases, so do the complexities of the purchasing process.  Some considerations need to be made for these larger-scale purchases, due in part to the need to coordinate between multiple partners and the benefits that come from ordering some equipment in larger quantities.

Working with Multiple Partners

Depending on the geographic and political relationships between various partners that may be involved in larger projects, the act of coordinating purchases may be more complex.  If a program is centrally purchasing and managing a deployment, work with vendors to answer some basic questions:

• Do equipment prices go down if bought in larger quantities?
• Will it be possible to negotiate different warranty terms for large quantities of equipment?
  • If a centralized organization is receiving and shipping devices to remote sites over a longer timeframe, is it possible to have the warranty period start at the date the device is distribute to the end site instead of the centralized site?
• Will the model of equipment being purchased be available the following year, should additional partners join the program in the future?

Some deployments may be planned in such a way that individual sites and organizations are responsible for the purchasing of equipment.  If this is the case, it is necessary to consider whether or not organizations will be allowed leeway in purchasing equipment other than that selected in the technology assessment.  If there is no flexibility in which device is to be ordered, ensure that precise ordering information is made available.  The make, model, and any additional options or features should be listed clearly so that the correct equipment is purchased.

If organizations will be allowed to select other equipment, ensure that a clear list of valid purchasing options is made available.  This approach may raise interoperability issues and concerns, and can present possible problems to a deployment.  Minimum requirements should be presented to organizations making their own purchasing decisions to ensure that their purchases will meet the needs of the system.  Also ensure that an ordering list is made that include required supplemental materials, such as cables, connectors, and converters.

Depending on an organization’s relationship with a vendor, it might be possible to negotiate special prices for equipment purchased by multiple organizations if certain bulk-order or quantity requirements are met.  Work with vendors and partner organizations to establish if there are any options for this.

Deploying

As with purchasing, the complexity of a deployment increases with the size of the program and the nature of the organizational relationships.  If organizations are ordering their own equipment, deployment is simplified in that the devices will be received at the end sites.  In this scenario, the two largest issues are ensuring that the devices are properly configured and that they are functioning correctly.  Formal configuration guidelines may assist in ensuring that a set of standard settings and connections are made.  If possible, establish a testing plan once the devices have been received and installed by the end sites.

When centrally receiving, configuring, and shipping the equipment, additional considerations should be made.  If done correctly, a centrally-managed deployment can result in consistently-configured devices, installations that contain all necessary parts for a functioning system, and satisfied end-sites.

As equipment is received by the central organization it is important to ensure that there is a protected location that can store all of the devices.  Storing received materials in random offices, empty closets, and available cupboards can readily result in lost or misplaced equipment and delays in later configuration steps.  At a minimum, this space should be able to contain all of the equipment; the ability to lock the space can be useful to protect against inadvertent loss or damage, while a larger space may allow for the devices to be configured in the same area.

The actual process of configuring the devices will vary based on the technology.  Some equipment may need extensive work to ensure that the settings are correct, while others may not require any changes at all.  Performing the configurations in a centralized location can help cut down on support issues later, should devices be sent to a remote site without those changes applied.

If other equipment or peripherals are to be sent with the device, consider creating a packing list and “kitting” all of the equipment together.  Doing so can reduce the likelihood that equipment reaches the recipient site without all of the pieces that are needed to install and use the device.  A clean working environment with ample room for boxing up equipment can be very useful here.

Coordinate the sending of the materials with the recipient site.  Ensure that there is someone set to receive and install or store the materials; some organizations may not be expecting the equipment without prior warning, resulting in an increased chance that it will be misplaced, unused, or lost.

Establish a set of basic tests of the equipment that can be performed with each installation.  This may be as simple as powering up the devices, using them, then powering them down, or it increase in complexity to include interoperability tests, patient encounters, and data transfer between systems.  Document any problems as they occur.  There is a possibility that the problem will happen in other installations; having a documented solution on hand can drastically reduce the time required to resolve the problem.

Support

Installing any particular technology is only the start of a deployment.  The ongoing use, maintenance, and support of the equipment should also addressed.  Ideally, this process will begin well before any devices are shipped.  A service level agreement, or SLA, can be a useful tool if any centralized organization is to be responsible for the support of the device.  This document should formalize who is responsible for which services, as well as what response times, uptimes, and other measures are expected by each party.

Basic device maintenance can be handled in various ways.  The exact approach to this issue will largely depend on the individual organizations participating in any particular deployment.  Some facilities may choose to perform their own scheduled maintenance or calibration, while others will decide to use a third party.

This topic becomes more complex when devices gradually fail, as they eventually will.  If the equipment is still under warranty, the topic of warranty resolution becomes an issue.  Some things to consider include:

• Are the end sites responsible for following up with the vendor or manufacturer?
• If the devices were centrally ordered and deployed, did all of the necessary warranty information get sent to the receiving sites?
• How will sites function while materials are out for warranty repair or replacement?

Some organizations will find it useful to have a set of replacement of spare devices on hand in the event of equipment failure.  Doing this provides several benefits.  Replacements can be used temporarily, as broken devices are out for repairs.  These spares can also be used in the event that the market no longer carries the original model, as is often the case with consumer products that have shorter lifecycles.

Training

When equipment reaches its point of installation, many people may be unfamiliar with how they are supposed to use the device.  A training program can help ensure that equipment is used rather than winding up in a corner.  The exact size and scope of a training program depends on many variables.  It is important to clarify what training will be offered, and who will be responsible for providing it.

If individual end sites are responsible for providing training, consider pooling resources to develop a standard curriculum.  This can reduce duplicated efforts across a larger installation.  Sharing lessons learned and other relevant usage information can help a program grow and better utilize their equipment.

If the equipment is a replacement for an existing device, there may be minimal needs for new training.  A simple document or short, recorded training that discusses the differences between the devices may be sufficient.  There may also be a need to update any existing training materials to refer to the newer technology.

Entirely new technologies may warrant more formalized training, as can the implementation of new devices that are drastically different from their predecessors.  Again, establish who is responsible for providing training and coordinate efforts to reduce the amount of duplicated work when designing training materials.  Consider incorporating some of the initial device testers into the training process, as they may have a firm understanding of the new equipment due to their experience with evaluating the products on the market.