Techno-Med
A Special Feature on Medical Equipment Technology

Guidelines to evaluate donated medical equipment

Meeta Ruperal -

Donation of medical equipment and devices is a general trend in any developing country to enhance the healthcare technology in the country. Many a healthcare institutes have a vision to provide state-of-the-art health services, but are laid back due to financial constraints and this is where donations of such a kind can improve the efficiency of health facilities. However if we study the track records of such donations, it is observed through experiences, that equipment donation may cause the recipient more problems than benefits.

Problems like unavailability of complete set of accessories, spares, inability to use the equipment, inadequate knowledge/training for proper applications of the equipment, low acceptance level of the new technology by the end user, etc. Recipient should therefore develop clear policies/ protocols on their equipment requirements. These should be discussed with the donors as well, who in turn are sure to respect such policies and should thereby conform to them. A thorough evaluation of the requirements should be made before a donation agreement is made between the donor and the recipient.

Medical Equipments are donated as a result of:

• A genuine desire to help
• A desire to utilize optimally the equipment not necessarily used by the donor. i.e. to ensure optimal utilization of the functional ability of the equipment.

However complications arise when:

• Hospitals / companies/ other healthcare fraternities donate obsolete, outdated / partially damaged or partially functional equipment as it provides them with tax exemptions or as a means of getting rid of redundant equipment.
• Equipment is donated as a means of promoting and marketing it, which maybe new, but inappropriate for that particular center / recipient.
• The donor of the medical equipment may have inadequate/ no background in health issues, or structure of the type of health services rendered by the recipient and the donor does not recognize the need to seek expert advice for the same.
• Potential donors with patronizing attitudes towards recipients do not feel it necessary to consult the recipient for the requirements assuming them to be desperate for any equipment that is donated. This kind of attitude may result in compounding this problem, wherein a recipient may feel obliged to accept any donation, even though the equipment is unnecessary, or where charges such as import taxes and transport costs, are expensed.

In such situations the donor and the recipient must get together as equal role players to work out the best use of the effort and goodwill involved in making a donation. The right to agree, accept or refuse should be expressed, appreciated and accepted by both the donor and the recipient. The following criteria/ guidelines should be considered for a successful donation.

These guidelines can also be considered for any medical equipment purchase by the purchasing / buyer / procuring committee to help define equipment that is technologically and clinically appropriate to the intended use. Protocols to be considered by the recipient:

1. Prepare an equipment checklist and check whether the equipment to be received conforms to the set checklist. This checklist should be made considering factors such as: name /brand of the equipments, country of origin, company track record, installations if any around, import legalities involved, octroi, sales tax if any applicable, technical specifications, such as humidity, tempt, voltage, frequency, current required, size, weight, etc. Other factors like location, type of special structural changes, ventilations systems, etc, if required.

2. Whether equipment is provided with the required accessories and reasonable quantity of spares & consumables essential for the basic operation of the equipment. This should take into account the “lead period” (i.e. period beteen placing an order and receipt of spare parts)

3. Whether equipment can be fully supported with spares / accessories in the recipient’s country /area.

4. Whether equipment is provided with a complete manual of operations and technical manual, for its use by the end user and the technical team for maintenance. These manuals and other related documents should be easily understandable by the staff and preferably in the local language, if not then should be in English. (A preferably common language followed by all).

5. Availability of the required trained staff (clinical & technical) for the installation, operation and maintenance of the equipment.

6. Ready availability of consumables required regularly (recurrent use).

7. Maintenance costs, import costs, taxes if any, etc. 8. All new equipments must be accompanied by documents of warranty/ guarantee.

9. Cost of training if required for use of the equipment and training the technical staff for maintenance of the equipment.

10. Availability of required space for the equipment, keeping in mind factors such as accessibility, environmental conditions (tempt, humidity, etc), utilities such as required power supply, gas supply, type of water if required, etc.

11. Availability of the support services required for the optimal functioning of the equipment. For e.g.: Many a times an equipment requires expertise in its applications as well as in the analysis of the output. (Expertise in the area of clinical expertise, technical know how, etc)

12. Whether equipment is available locally.

13. Experience of others using similar equipment /brand. 14. Involve technical departments and the end user for the type of equipment required, its use, application, specification, etc.

15. Involve technical departments and the end user for design of the site where the equipment is to be installed and to decide the appropriateness of the equipment in terms of the feasibility of the equipment, running costs, etc. This shall assist in concluding whether a financial contribution would be more appropriate than a donation of equipment.

16. Communicate alternatives in terms of preferences if any for the technical specifications, use of the equipment or maybe a financial contribution would be more easier or cheaper then it should be conveyed immediately to the donor.

Protocols to be considered by the donor:

1. Ensure that the equipment supplied is clinically, technologically, ergonomically and economically appropriate for the recipient.

2. Request for the equipment checklist set by the recipient and verify whether the equipment to be supplied conforms to the same. In case of non-conformance of certain conditions, communicate the same to the recipient immediately. Both the donor and the recipient before the shipping of the equipment should reach an agreement on all conditions.

3. A basic list of all components must be provided and the “life expectancy” of the equipment should be clearly stated.

4. Ensure complete functioning of the equipment. Equipment whether new or refurbished should be tested for its functioning and then shipped.

5. Ensure that the equipment supplied is fully equipped with the required accessories, spares, manuals and other related documents.

6. Supply an initial requirement of essential spares and consumables as requested. Many a times procurement turns out to be a lengthy procedure and such stocks if supplied are of best use for effective functioning of the equipment supplied.

7. Provide the manufacturer’s contact details to ensure easy accessibility by the recipient in case of any queries, requirements (of spares/consumables), etc. 8. Provide the contact details of the authorized distributor / local dealer if any.

9. Ensure proper packaging and provide the complete packaging list to the recipient.

10. Packaging should be strong and sturdy to avoid damage during transportation.

11. Ensure immediate delivery of all the shipping documents to the recipient to avoid delay in receiving the equipment, due to unavailability of essential shipping documents requiredat the recipient end.

12. Understand the import regulations/ liabilities like taxes, import duties, etc and the regulations for donated equipments if any of the recipient’s country. Ensure the ability of the recipient to conform to such liabilities / regulations.

13. Provide the maximum possible technical assistance to the recipient team.

14. Finally keep in mind that if the equipment to be supplied is obsolete or partly functioning and is difficult for the donor to service and use due to unavailability of spares/consumables, equipment is no longer supported by the manufacturer or its authorized dealers, etc, then it will be all the more difficult for the recipient to use such an equipment and would eventually result being as useless an equipment to the recipient as it is for the donor. Please DO NOT SUPPLY such equipments. It is kinder to dispose off such items.

Such above stated guidelines if implemented and followed are sure to assist an effective donation of the medical equipment thereby complying to its basic reason of donation: “Optimal use of Functional ability of the equipment”

Further, if similar guidelines are followed by any purchasing /procuring committee in the event of purchase of an equipment would surely result in an appropriate equipment of high quality, rightly bought for the healthcare center.

(The author can be contacted at meeta@meditecindia.com)