1. STUCK IN THE RUT SYNDROME: HOW TO GET YOUR CE PROGRAM OUT OF THE BOX AND SHINY AGAIN Monday March 30, 2014 | 11:30am – 12:30pm THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015

2. Dave Dickey, MS, CHC, CCE, FACHE, Corporate Director CE McLaren Healthcare Alan Gresch, VP Client Success, MainSpring Healthcare Solutions Doug Dreps, MBA, Director Regional Clinical Engineering, Mercy Health THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015

3. McLaren Health Care Dave Dickey, MS,CHC,CCE, FACHE THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Michigan Based 12 hospitals and growing >100 clinics 70 FTE’s 65,000 devices

4. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 McLaren Health Care#1: Take on support of a new equipment type Automation cabinet support (Omnicell or Pyxis) Asked by our Supply Chain to look into this, ‘cost of support is getting expensive’ Not CE budget, but we’ll take anyone’s money and responsibility if there is an opportunity Push back from the vendor.. ‘you can’t service these, too complex, nobody does this in-house’ Get real..we want a custom program in exchange for all of our business! Improved response time, use existing BMET’s

5. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Last Year (12 months) vs. Previous Contract Cost Annual$/Unit GOLD $429,016 $1,012 CE $154,157 $411 Savings $274,859.00 $600.74 64% ANNUAL SAVINGS

6. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 McLaren Health Care #2: New program for Surgical Instrument Support Historically, we had tried it all, and thought we had it all figured out Stainless steel sharpening and repair (1500 trays, est. 60 instruments per tray) Van based scheduled services Rigid and flex scopes Surgical power equipment (drills and saws) Light cords; shavers; widgets Spent years finding the best in class, lowest cost vendors, many on t&m transactional based service Lot’s of time to manage, find loaners, track PO’s (est 1,450 work orders per year on itemized devices alone!)

7. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Eight Vendors Identified Three selected to present One vendor selected to enter into final negotiations and to do trials About 90% of our identified inventory put onto the program Annual Cost savings: 40+%! Program needs close monitoring and support to the vendor to identify and deal with user induced equipment damages

8. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 McLaren Health Care #3 Annual Executive Report Give them the facts, brag and disclose What’s important to the ‘C’ suite Cost of service ratio trends (if they don’t know what this is, shame on you for not teaching them by now!) The great things you did (as a reminder, more than just fixing broken equipment and doing PM’s on time) The bad news…equipment that needs to be on the radar for planned replacement due to age, clinical risk, no parts, dangerous, etc. Opportunities for further cost savings and program improvements; identified projects, etc.

9. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Key Report Sections Key departmental stats (staffing; turn around time for repairs; life support completion rates, etc.) trended year to year Top 20 departments and equipment types to support, sorted high $ to low Top 10 device types or departments with highest ‘no problem found’ and ‘user error’ equipment issues (education needed) Listing of all service contracts in place, managed by CE Major projects completed during past year Upcoming projects for next year Equipment base inventory value changes, graphed showing growth over past X years

10. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 The most important: COSR (Equip base going up, but COSR coming down) What is your goal, or eventual ‘run rate?’ Varies by hospital, equipment mix IV. Annual cost of service ratio (COSR%) comparisons: NORTHERNFY12$41,819,950.00$3,024,193.337.231% FY13$50,166,373.00$3,043,292.006.070% FY14$59,104,998.00$3,378,198.005.720%

11. Clinical Engineering Program Aurora Health Care Al Gresch Corporate Director Capital Equipment Services Program Alexian Brothers Health System Al Gresch AVP, Capital Equipment Services THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015

12. Technology Assessment/Project Planning fMRI Elekta Neuromag Varian Truebeam Siemens Cath Labs GE 64 Slice CTs

13. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Requirements for Success Competence & Expertise Trust Negotiation Skills Consistent Performance Comprehensive Delivery of Information

14. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Capital Planning Tool Systematic and impartial analysis Long-term capital replacement strategy Facilitating group buy opportunities

15. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Capital Planning Tool Development Pulled historical data Created “Most needed” capital replacements listing Inventory > $250K with upgrade and lease information Capital inventory report generation AHA Useful life by equipment type Number of service events assumptions by manufacturer and model based on global data Service support availability by manufacturer and model based on CE consensus

16. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Asset Optimization Type: Alaris IV Pump – Double Location: Second Floor: East Patient Care Unit: 203 Date/Time: 2009-07-28 16:58:23 PDT Owner: Central Service Type: Alaris IV Pump – Double Location: Second Floor: East Patient Care Unit: 203 Date/Time: 2009-07-28 16:58:23 PDT Owner: Central Service Mobile medical equipment tracking (with procedural workflows) Increased asset utilization Reduced rental costs, excess inventory, planned purchases and equipment losses Optimized workflow, ordering, and cleaning processes

17. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Doug Dreps, MBA Director Regional Clinical Engineering Mercy Clinical Engineering Services 40,000 co-workers in 200 communities across multiple states 35 Hospitals across 4 states, First Stand Alone Virtual Care Center >1,800 Primary and Specialty Care Physicians and growing >MCES 121 FTE’s, > 123, 000 inventory, valued >1 billion COSR < 5%, average 1302 devices per tech

18. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Mercy Health CE-IT Collaboration Understanding IT Structure IT understanding CE structure Building communication Communicating both good and bad outcomes

19. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Mercy Health CE-IT Integration Service Model

20. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Mercy Health Working outside our sandbox Selling unused/replaced medical equipment Trade-in vs. selling Offer letter/Bill of Sale – legal dept. Handing over the check Removing assets from finance books

21. THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015 Mercy Health Getting involved with regional colleges and technical schools Advisory Committee Member Internships – Affiliation agreements, screen candidates Aging industry MD EXPO/AAMI/HIMSS/ Local Societies

22. Thank you! Dave.Dickey@mclaren.org agresch@mainspringhealth.com Douglas.Dreps@mercy.net Dave.Dickey@mclaren.org agresch@mainspringhealth.com Douglas.Dreps@mercy.net THE MEDICAL EQUIPMENT SERVICE AND SALES EXPO NASHVILLE MARCH 29-31, 2015