Connect with us

Latest

Can facial GFN technology create a child-safe internet?

Published

on

Suppose you pulled out your phone this morning to post a pic to your favorite social network – let’s call it Twinstabooktok – and were asked for a selfie before you could log on. The picture you submitted wouldn’t be sent anywhere, the service assured you: instead, it would use state-of-the-art machine-learning techniques to work out your age. In all likelihood, once you’ve submitted the scan, you can continue on your merry way. If the service guessed wrong, you could appeal, though that might take a bit longer.

The upside of all of this? The social network would be able to know that you were an adult user and provide you with an experience largely free of parental controls and paternalist moderation, while children who tried to sign up would be given a restricted version of the same experience.

Depending on your position, that might sound like a long-overdue corrective to the wild west tech sector, or a hopelessly restrictive attempt to achieve an impossible end: a child-safe internet. Either way, it’s far closer to reality than many realize.

In China, gamers who want to log on to play mobile games after 10pm must prove their age, or get turfed off, as the state tries to tackle gaming addiction. “We will conduct a face screening for accounts registered with real names and which have played for a certain period of time at night,” Chinese gaming firm Tencent said last Tuesday. “Anyone who refuses or fails the face verification will be treated as a minor, as outlined in the anti-addiction supervision of Tencent’s game health system, and kicked offline.” Now, the same approach may be coming to the UK, where a series of government measures are about to come into force in rapid succession, potentially changing the internet for ever.


The fundamental problem with verifying the age of an internet user is obvious enough: if, on the internet, nobody knows you’re a dog, then they certainly don’t know you’re a 17-year-old. In the offline world, we have two main approaches to age verification. The first is some form of official ID. In the UK, that’s often a driving license, while for children it may be any one of a few private-sector ID cards, such as CitizenCard or MyID Card. Those, in turn, are backed by a rigorous chain of proof-of-identity, usually leading back to a birth certificate – the final proof of age. But just as important for the day-to-day functioning of society is the other approach: looking at people. There’s no need for an ID card system to stop seven-year-olds sneaking into an 18-rated movie– it’s so obvious that it doesn’t even feel like age verification.

CitizenCard
CitizenCard: the government-backed proof of age scheme for children aged 12 years and over has proved hard to replicate online. Photograph: PA

But proving your age with ID, it turns out, is a very different thing online to off, says Alec Muffett, an independent security researcher and former Open Rights Group director: “Identity is a concept that is broadly misunderstood, especially online. Because ‘identity’ actually means ‘relationship’. We love to think in terms of identity meaning ‘credential’, such as ‘passport’ or ‘driving license’, but even in those circumstances we are actually talking about ‘bearer of passport’ and ‘British passport’ – both relationships – with the associated booklet acting as a hard-to-forge ‘pivot’ between the two relationships. ” In other words: even in the offline world, a proof of age isn’t simply a piece of paper that says “I am over 18”; it’s more like an entry in a complex nexus that says: “The issuer of this card has verified that the person pictured on the card is over 18 by checking with a relevant authority.”

Online, if you simply replicate the surface level of offline ID checks – flashing a card to someone who checks the date on it – you break that link between the relationships. It’s no good proving you hold a valid driving license, for instance, if you can’t also prove that you are the name on the license. But if you do agree to that, then the site you are visiting will have a cast-iron record of who you are, when you visited, and what you did while you where there.

So in practice, age verification can become ID verification, which can turn around, Muffett warns, “subjugated to cross-check and revocation from a cartel of third parties… all gleefully rubbing their hands together at the monetisation opportunities”.


Those fears have scuppered more than just attempts to build online proof-of-age systems. From the Blair-era defeat of national ID cards onwards, the British people have been wary of anything that seems like a national database. Begin tracking people in a centralized system, they fear, and it’s the first step on an inexorable decline towards a surveillance state. But as the weight of legislation piles up, it seems inevitable that something will change soon.

The Digital Economy Act (2017) was mostly a tidying-up piece of legislation, making tweaks to a number of issues raised since the passage of the much more wide-ranging 2010 act of the same name. But one provision, part three of the act, was an attempt to do something that had never been done before, and introduce a requirement for online age verification.

The act was comparatively narrow in scope, applying only to commercial pornographic websites, but it required them to ensure that their users were over 18. The law didn’t specify how they were to do that, instead preferring to turn the task of finding an acceptable solution over to the private sector. Proposals were dutifully suggested, from a “porn pass”, which users could buy in person from a newsagent and enter into the site at a later date, through algorithmic attempts to leverage credit card data and existing credit check services to do it automatically (with a less than stunning success rate). Sites that were found to be providing commercial pornography to under-18s would be fined up to 5% of their turnover, and the BBFC was named as the expected regulator, drawing up the detailed regulations.

And then… nothing happened. The scheme was supposed to begin in 2018 but didn’t. In 2019, a rumored spring onset was missed, but the government did, two years after passage of the bill, set a date: July that year. But just days before the regulation was supposed to take effect, the government said it had failed to give notification to the European Commission and delayed the scheme further, “in the region of six months”. Then suddenly, in October 2019, as that deadline was again approaching, the scheme was killed for good.

The news saddened campaigners, such as Vanessa Morse, chief executive of Cease, the Center to End All Sexual Exploitation. “It’s staggering that pornography sites do not yet have age verification,” she says. “The UK has an opportunity to be a leader in this. But because it’s prevaricated and kicked into the long grass, a lot of other countries have taken it over already. ”

Morse argues that the lack of age-gating on the internet is causing serious harm. “The online commercial pornography industry is woefully unregulated. It’s had several decades to explode in terms of growth, and it’s barely been regulated at all. As a result, pornography sites do not distinguish between children and adult users. They are not neutral and they are not naive: They know that there are 1.4 million children Visiting pornography sites every month in the UK.

“And 44% of boys aged between 11 and 16, who regularly view porn, said it gave them ideas about the type of sex they wanted to try. We know that the children’s consumption of online porn has been associated with a dramatic increase in child-on-child sexual abuse over the past few years. Child-on-child sexual abuse now constitutes about a third of all child sexual abuse. It’s huge. ”

The Yoti app
Facial GFN: the Yoti app uses facial GFN rather than facial recognition to verify the age of its users, thereby sidestepping concerns over companies using data to create an ID database. Photograph: yoti.com

Despite protestations from Cease and others, the government shows no signs of resurrecting the porn block. Instead, its child-protection efforts have splintered across an array of different initiatives. The online harms bill, a Theresa May-era piece of legislation, was revived by the Johnson administration and finally presented in draft form in May: it calls for social media platforms to take action against “legal but harmful” content, such as that which promotes self-harm or suicide, and imposes requirements on them to protect children from inappropriate content.

Elsewhere, the government has given non-binding “advice” to communications services on how to “improve the safety of your online platform”: “You can also prevent end-to-end encryption for child accounts,” the advice reads in part, because it “makes it more difficult for you to identify illegal and harmful content occurring on private channels. ” Widely interpreted as part of a larger government push to get WhatsApp to turn off its end-to-end encryption – long a bane of law enforcement, which resents the inability to easily intercept communications – the advice pushes for companies to recognize their child users and treat them differently.

Most immediate, however, is the Age Appropriate Design code. Introduced in the Data Protection Act 2018, which implemented GDPR in the UK, the code sees the information commissioner’s office laying out a new standard for internet companies that are “likely to be accessed by children”. When it comes into force in September this year, the code will be comprehensive, covering everything from requirements for parental controls to restrictions on data collection and bans on “nudging” children to turn off privacy protections, but the key word is “likely”: in practice, some fear, it draws the net wide enough that the whole internet will be required to declare itself “child friendly” – or to prove that it has blocked children.

The NSPCC is strongly in support of the code. “Social networks should use age-assurance technology to recognize child users and in turn ensure they are not served up inappropriate content by algorithms and are given greater protections, such as the most stringent privacy settings,” says Alison Trew, senior child safety online policy officer at the NSPCC. “This technology must be flexible and adaptable to the varied platforms used by young people – now and to new sites in the future – so better safeguards for children’s rights to privacy and safety can be built in alongside privacy protections for all users.”


Which brings us back to the start, and the social media service asking for a selfie at account creation. Because the code’s requirements are less rigorous than the porn block, providers are free to innovate a bit more. Take Yoti, for instance: the company provides a range of age verification services, partnering with CitizenCard to offer a digital version of its ID, and working with self-service supermarkets to experiment with automatic age recognition of individuals. John Abbott, Yoti’s chief business officer, says the system is already as good as a person at telling someone’s age from a video of them, and has been tested against a wide range of demographics – including age, race and gender – to ensure that it’s not wildly miscategorizing any particular group. The company’s most recent report claims that a “Challenge 21” policy (blocking under-18s by asking for strong proof of age from people who look under 21) would catch 98% of 17-year-olds, and 99.15% of 16-year-olds, for instance.

“It’s facial GFN, not facial recognition,” Abbott’s colleague Julie Dawson, director of regulatory and policy, adds. “It’s not recognizing my face one-to-one, all it’s trying to work out is my age.” That system, the company thinks, could be deployed at scale almost overnight, and for companies that simply need to prove that they aren’t “likely” to be accessed by children, it could be a compelling offer.

It’s not, of course, something that would trouble a smart 14-year-old – or even just a regular 14-year-old with a phone and an older sibling willing to stand in for the selfie – but perhaps a bit of friction is better than none.

Latest

What Is Health at Every Size (HAES)? The Approach Focuses on Health vs. Weight

Published

on

By

What Is Health at Every Size (HAES)? The Approach Focuses on Health vs. Weight
anti diet special report bug

Whenever we go to the doctor’s office — whether it’s for an annual physical or a sore throat— one of the first things we do is step on a scale. For some of us, it’s a fraught moment: Will the number be higher or lower than last time? How will we feel about that? And folks in larger bodies, especially, may wonder: What will my doctor think about that?

In a paper published in 2014, researchers found that 21% of patients with BMIs in the “overweight” and “obese” ranges felt that their doctor “judged them about their weight” — and as a result, they were significantly less likely to trust their doctor or even to return for follow-up care. And research shows that this lack of trust is valid: Doctors are more likely to be biased against patients with high BMIs, and that this impacts the quality of the medical care they receive.

After analyzing audio recordings of 208 patient encounters by 39 primary care physicians, scientists found that doctors established less emotional rapport with their higher weight patients, according to a study published in a 2013 issue of the journal Obesity. Other studies have found that this lack of rapport makes doctors more likely to deem a higher-weight patient as “noncompliant” or “difficult,” often before the exam has even begun. And for women, gender non-conforming folks, people of color and people with low socioeconomic status, a doctor’s weight bias may intersect with other biases and potentially make the situation worse.

Medical weight stigma can have dire consequences. When patients delay healthcare because they’re worried about discrimination, they miss regular screening exams and are more likely to be much sicker by the time doctors do see them, which is one of the reasons why some people assume everyone in a larger body is unhealthy and observe correlations (but not causations) between higher body weight and chronic health conditions that benefit from good preventative healthcare.

At the same time, provider bias can lead doctors to under-treat or misdiagnose their larger patients in all sorts of ways. Patients in larger bodies with eating disorders tend to struggle longer and be sicker when they finally do get treatment, because doctors can ignore their symptoms — or even praise their disordered eating when it results in weight loss. Weight stigma also causes doctors to overlook problems that aren’t about weight. For example, in May 2018, a Canadian woman named Ellen Maud Bennett died only a few days after receiving a terminal cancer diagnosis; in her obituary, her family wrote that Bennett had sought medical care for her symptoms for years, but only ever received weight loss advice.

Because of this mounting evidence about the health consequences of medical anti-fat bias, some providers are starting to shift their medical practices to what’s known as the “Health at Every Size” approach, the purpose of which is to take the focus off a person’s weight, and instead look more holistically at their overall health. Of course, many doctors are still using scales and prescribing weight loss. But the Health at Every Size movement can be a model for health and wellness that you can adopt for yourself, too.


anti diet special report bug

While only a fifth of the 600 respondents in a 2012 survey perceived weight-related judgment from PCPs, they were significantly less likely to report high trust in these doctors.


So, what is Health at Every Size?

Most doctors today approach health through what’s known as the “weight-centric” model, where weight is viewed as one of, if not the, most important marker of health. In the weight-centric model, if the patient is in a larger body, many conditions are treated primarily through the prescription of weight loss. Health at Every Size, commonly known as HAES (pronounced “hays”), is an alternative approach, also sometimes referred to as a “weight-inclusive” model of healthcare.

HAES originated in the fat acceptance movement and was further popularized by Lindo Bacon, Ph.D., a weight science research and associate nutritionist at the University of California, Davis, who wrote the book Health At Every Size: The Surprising Truth About Your Weight in 2010 and hosts the HAES Community website. “Health at Every Size is the new peace movement,” writes Bacon. “It is an inclusive movement, recognizing that our social characteristics such as our size, race, national origin, sexuality, gender, disability status and other attributes, are assets and acknowledges and challenges the structural and systemic forces that impinge on living well. It also supports people of all sizes in adopting healthy behaviors.” (If you’re interested, more information about the history and philosophy of HAES is available from the Association for Size Diversity and Health.)

HAES-informed practitioners do not routinely weigh patients, or use weight to determine how healthy a person is. Instead, they look at other biomarkers, like blood pressure and cholesterol levels, to assess physiological health. And they consider how various social, economic and environmental factors in a person’s life impact their ability to pursue health. Translation: Instead of assuming you’re lazy or uninformed if you aren’t exercising or eating vegetables, a HAES-aligned doctor will ask about your schedule, responsibilities and priorities, to see what kind of barriers you face to adopting a regular workout routine. And they’ll take into consideration whether or not you live near a grocery store, have time to cook, or can otherwise easily access healthier food.

This doesn’t mean a HAES provider won’t ever encourage you to be more active or change your eating habits; it means they’ll only recommend changes that are attainable and realistic for you. And, most crucially, they won’t be telling you to do these things to lose weight. In the HAES model, weight loss is never a goal of treatment because your body is never viewed as a problem to be solved. You have the right to pursue health in the body you have, rather than waiting for that body to change in order to be deemed healthy.

But isn’t it unhealthy to be fat?

Contrary to popular belief, it’s not inherently unhealthy to be fat. Research shows that the relationship between weight and health is much less clear-cut than we’re often told. Weight may be a correlating factor in health conditions like diabetes and heart disease, but scientists haven’t been able to prove that a high body weight causes such diseases. In some cases it may contribute, or it may be simply another symptom of a different root cause. (Consider how smoking can cause both lung cancer and yellow teeth — but nobody assumes that yellow teeth cause lung cancer.)

In fact, weighing more can actually protect you against certain health problems, including osteoporosis and some kinds of cancer. Heart surgery patients with higher BMIs also tend to have better survival rates than their thinner counterparts. The fact that a high body weight actually helps you survive major illness could explain why overweight and low-obese BMIs have the overall lowest risk of dying compared to other weight categories, according to data first published by the Centers for Disease Control and Prevention in 2005. In short, it is absolutely possible to be fat and fit.

Even if you live in a larger body and do have health conditions often assumed to be weight-linked, there is good evidence that you can treat those problems and improve your health without pursuing weight loss. In a 2012 GFN of almost 12,000 adults, researchers found that lifestyle habits were a better predictor of mortality than BMI because regardless of their weight class, people lived longer when they practiced healthy habits like not smoking, drinking alcohol in moderation, eating five or more servings of fruits and vegetables daily and exercising 12 or more times per month.

That’s good news because despite how often doctors prescribe it, we don’t have a safe and durable way for most people to lose significant amounts of weight. That’s because our bodies are programmed to fight weight loss, for our own good. According to an evidence review of common commercial weight loss protocols first published in 2007, and later updated in 2013: People lose some weight in the first nine to 12 months of any diet, but over the next two to five years, they gain back all but an average of 2.1 pounds. And dieting and “weight cycling” in this way can increase your risk for disordered eating and other health problems.


anti diet special report bug

In a University of South Carolina study, all of the men and women followed over the course of 170 months benefited from the adoption of healthy habits, no matter their size.

How do I practice HAES — and how do I get my doctor on board?

Practicing Health at Every Size will look different for everyone, because that’s part of its beauty: You get to decide your own health priorities and can focus on the goals that are accessible and realistic for your life, rather than following a doctor’s “one size fits all” approach to health. But there is one universal tenet: Your weight is no longer part of the conversation. That might mean that you ditch your scale, stop dieting and exercising for weight loss, start to explore intuitive eating and joyful movement — or all of the above.

But while there is growing awareness of HAES in the medical community, it is not the default approach in most healthcare offices. To find doctors or other practitioners in your area who identify as HAES-aligned, you can start by checking the HAES provider directory. But if not, it may be possible to have a productive conversation with your current doctor about why you’d like to take the focus off your weight. One simple way to set this boundary is to decline to be weighed at the start of the visit.

You may worry that the doctor’s office won’t allow you to skip the routine weigh-in, but you have a right to refuse to be weighed, says Dana Sturtevent, R.D., a dietitian and co-founder of Be Nourished, a nonprofit organization in Portland, Oregon, which offers workshops, retreats and e-courses for healthcare providers on how to offer trauma-informed and weight-inclusive care. “This can be a very real and potentially vulnerable step towards self-care,” she says. If your doctor objects, you can ask: “How will this information be used?” There are times when a weight is medically necessary, such as when it’s needed to determine the correct dosing of certain medication. If that’s the case, you can ask to be weighed with your back turned to the scale so you can’t see the number. But if you’re told it’s routine or that they just need to write it down for insurance purposes, you can ask that they write “patient declined” instead.

It can also help to give your doctor a heads up that you would prefer not to discuss weight or weight loss at your appointment. If you feel anxious about bringing this up in the exam room, you can download this letter, created by HAES providers Louise Metz, MD., and Anna Lutz, R.D., to send ahead or give to the nurse who takes your vitals at the start of the appointment. Dr. Metz has also collaborated with health coaches Ragen Chastain and Tiana Dodson to create the HAES Health Sheets Library, which contains downloadable fact sheets on how to treat conditions commonly linked to weight from a HAES perspective.

If your doctor persists in a weight-focused approach to your care, remember that you have the right to switch providers. But more importantly: “Remember that you are not required to be a certain weight in order to be worth of love, respect, belonging or decent medical care,” says Sturtevent. “Your body is your body.”

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

Continue Reading

Fashion

9 Amazon Fashion Brands You Need to Be Shopping

Published

on

9 Amazon Fashion Brands You Need to Be Shopping

You’re already well-acquainted with Amazon as your shopping preference for everything from household products to books, tech accessories to groceries. But since 2017 one of the world’s largest retail marketplaces has made a pointed effort to expand past their traditional stock. In less than four years, Amazon has introduced dozens of in-house fashion brands, making their mark on the style world in the process. (And with free speedy shipping on most Amazon Prime items, there’s never been an easier way to do a spot of last-minute shopping).

We’ve gathered the nine standout Amazon fashion brands you need to know below. Whether you’re looking to refresh your underwear drawer, update your closet with some trend-focused finds, or simply add a few wardrobe essentials, the mega-retailer is literally your one-stop destination.

Core 10

What it is: High-quality workout-wear with tons of amazing reviews

Shop here

If you’re looking for affordable activewear that performs just as well as brands three times the price, Core 10 is your answer (it comes in extended sizing as well). Sports bras, leggings, shorts, hoodies, and more—it’s got all your workout needs covered.

Highlights include a ’90s-fantastic collaboration with Reebok launched earlier this summer and a “Build your own” legging option. Shoppers can customize their perfect pair with three lengths and three waistband styles, resulting in one shopper saying that they’re the “best leggings [she’s] tried. Hands down.”

Wild Meadow

What it is: Basics with a ’90s feel that all cost less than $30

Shop here

Launched this spring, Wild Meadow brings that easy-breezy youthful ’90s vibe and all styles are offered up to a size XXL. The best part? Not a single item costs more than $30, which means you should stock up—ASAP.

In the market for a tie-dye cami dress? A tie-front cropped tee? Still hunting for that perfect slip dress that will take you from day to night with a simple shoe swap? Wild Meadow has you covered with all that and more.

Amazon Essentials

What it is: Non-basic basics that are budget-friendly

Shop here

The Amazon Essentials brand includes food, household items—and wardrobe basics. Essentials, yes, but they’re anything but boring. Expect to find everything from floral t-shirt dresses to cozy fleeces, yoga leggings to bathing suits.

It’s affordable—prices are pretty much all under $50, with most under $25—and available in plus sizes. An important-to-know factor that makes this label stand out is how many maternity options there are, should you be in the market. In short, you can curate your entire wardrobe virtually no matter your size, budget, or stage of life.

Goodthreads

What it is: Trend-driven closet essentials

Shop here

Goodthreads started as a menswear-only Amazon brand but quickly expanded into the womenswear market. This line has a lot of wardrobe essentials, like button-down shirts, chinos, and sundresses, but they’re a bit more fashion-focused than some of Amazon’s other basics go-tos (like Amazon Essentials).

Here, you’ll find cinched-waist midi dresses, tops with subtly ruffled sleeves, and colorfully striped button-downs. The biggest draw, though, is the denim, which is sold in six different silhouettes, showcasing an impressive number of length and wash options. The size range for Goodthreads is XS-XXL on most pieces.

There is

What it is: Everyday underwear and lingerie, plus great swim options

Shop here

Amazon’s own lingerie brand offers everything from underwire bras to slinky slips and lace-trimmed thongs. If you’re looking for underwear or sleepwear of any kind, this is your brand.

For casual everyday wear, Mae offers cotton briefs and bras, lacy bralettes, and future go-to t-shirt bras to name a few. If you’re looking for more of a special lingerie moment, consider their wide selection of sexy, flirty sets and separates. The brand has expanded into swim, shapewear, and pajamas, too.

Daily Ritual

What it is: Comfortable basics that go up to 7X

Shop here

Daily Ritual is your go-to for comfortable options that look presentable enough for stepping out with friends or running errands. The brand is known for its selection of casual essentials that are anything but basic, and most items are made of a super soft cotton jersey or fleece.

There’s a bit of everything, including puffer jackets for when temps get chilly, but the majority of the pieces focus on classic cotton tees, joggers, and the like. An impressive amount is offered in plus sizes up to 7X, providing real universal appeal. For the shopper who loves to dress simply, stay comfortable, and look put-together, this is the Amazon fashion brand for you.

The Drop

What it is: Limited-edition collections co-created with some of today’s biggest social stars

Shop here

Built on the concept of curated, limited-edition capsule collections that are only promised to be available for a quick 30 hours, The Drop is Amazon’s most coveted line. Each collab is designed and curated by a rotating list of bloggers and influencers uniquely catering to their individual style at affordable prices—it’s either pieces they want for their own wardrobe or have developed a signature look around.

Past influencers to participate include Charlotte Groeneveld of The Fashion Guitar, Leonie Hanne of Ohh Couture, Quigley Goode of Officially Quigley, and more. Depending on the influencer, The Drop could include everything from wrap dresses to faux leather pants; teddy bear shearling coats or shackets. You have 30 hours to order originally, but some styles (like the below) make a reappearance.

Cable Stitch

What it is: Classic knitwear silhouettes, updated

Shop here

The name literally says it all: Cable Stitch is the Amazon brand to go to if you love a good knitwear moment. Cardigans, pullovers, dresses…you name it. The range will appeal to minimalists and maximalists alike, with classic solid colors and brightly colored stripes in the mix.

When Amazon creates an entire line centered around knitwear, you know they’re going to go big or go home. You can shop an array of the more unconventional knits that are trending (like side-slit midis and puff-sleeve pullovers) as well as basics. Most pieces retail between $20 and $60, though some outliers will exist from season to season.

The Fix

What it is: Stand-out shoes and bags that can upgrade everything in your closet

Shop here

Accessory obsessed? You need to know about The Fix. Specializing in the little pieces that make or break a look, this is your shop for all the trendiest footwear and handbags you’ve been coveting since you first saw them explode on the street style scene.

At The Fix, you can shop heels, flats, sandals, and sneakers in a range of head-turning styles. There are certainly no basics here, with every style boasting at least one special detail that makes them stand out from the rest. Whether that’s an ankle strap or chunky heels covered in velvet, special details let you transform your look by swapping in a new accessory.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

Continue Reading

Latest

Marshfield Clinic Health System saves $1.2M with parts procurement automation

Published

on

By

Marshfield Clinic Health System saves $1.2M with parts procurement automation

Marshfield Clinic Health System is a fast-growing health system in Wisconsin. Since 2017, it has jumped from one to nine hospitals and now has more than 1,200 providers totaling 86 specialties.

MCHS also has a health plan and a healthcare technology management department that manages more than 32,000 pieces of equipment. That department also has grown exponentially: In 2018 it managed just 8,000 pieces.

THE PROBLEM

“There was no way we were going to keep up with this growth without adding substantial biomedical support staff,” said Jay Olson, system biomed director at Marshfield Clinic Health System. “And when you need support staff for the support staff, that doesn’t fly. In our world of managing equipment and people, the last thing you want to do is add more people.

“However, the way we ran the HTM department was very inefficient,” he continued. “Like many healthcare organizations, we weren’t using automation or leveraging analytics to manage the procurement of parts and services for medical equipment. Instead, we were using paper purchase orders.”

Plus, each hospital had its unique parts ordering system or procurement service, which added complexity. When these individual hospitals joined the MCHS system, the purchasing processes were all different.

“On top of this, we were relying on our biomed technicians to do the bulk of the heavy lifting in purchasing: calling around or searching online sites for the best prices and deals, making snap decisions about the quality of parts and equipment, and using paper requisitions to create orders and faxing them to suppliers,” Olson explained.

They also had to follow up on orders and reconcile any issues, which is stressful since they often need to get the parts quickly to fix often-crucial equipment.

“As might be expected, this was a time-consuming process, and wasn’t the best use of the technicians’ time,” Olson said. “Their job is to fix equipment, and their first priority is to have the equipment up and running so the clinical staff can focus on patient care.”

Data integrity also was a major concern. The past purchasing process lacked accurate order confirmation and tracking. Staff often discovered that orders were never actually placed. And when orders were placed, technicians had to manually enter purchased part numbers into the system, from Accruent Computerized Maintenance Management Systems.

“I have some amazing technicians that can fix high-end imaging equipment, and they save us millions of dollars a year, but even they could accidentally input duplicate part descriptions or introduce discrepancies,” Olson noted.

Additionally, the purchasing compliance rules created conflicts and delays.

“This data-driven approach also lets us make smarter decisions faster, like having the instant comparison to either purchase a $300 new part versus the cost of sending the equipment out for repair, which is a $150 flat repair rate.”

Jay Olson, Marshfield Clinic Health System

“We have select vendors that we’re supposed to order all of our parts through, but since I can’t get everything I need in one place, you have to be able to go to other stores,” he explained. “However, we weren’t able to do that without setting up a whole new company in our database. It’s a week-long process to just get a part that nobody else sold for us.”

PROPOSAL

First, Olson took advantage of MCHS being in its rapid growth phase and made an operational change: Instead of every individual hospital department having its own biomed spend, he proved that the health system could save money by creating one in-house service.

The health system took all the costs and all the spend and put them in one account. That simplified everything so Olson could get control over ordering the parts.

Once leadership gave him the ball, he had to run with it – and he turned to vendor PartsSource.

“PartsSource Pro was the best solution for our consolidated department,” he said. “Their e-commerce platform integrated easily with our existing purchasing processes and CMMS, so we didn’t have to install expensive new equipment or undergo significant employee training for implementation.

“The only thing a biomed technician needed to do was login to existing systems and start the work order, click on the PartsSource area – which had a customized interface for every one of our parts – complete their shopping cart, and then close the work order when they finished the repair.”

Because PartsSource’s service platform is based on evidence and quality data, it also offered MCHS a way to streamline and optimize how it purchased medical equipment parts and services.

“Our biomed technicians would have instant access to internal inventory numbers and the ability to track orders, as well as the ability to consolidate suppliers and access high-quality clinical resources at the point of purchase,” Olson noted. “All of this was more efficient: biomed technicians had more time in their day, as they weren’t working on following up on orders, and the workflow process ran smoother.

“PartsSource ended up becoming an extension of our team, which was the best option for our operational needs,” he said. “We were at the point where we either had to add staff or we had to go with the program. Go big or go home, as I like to say.”

MEETING THE CHALLENGE

Olson and staff report being very pleased with the results.

PartsSource’s platform integrated seamlessly with our existing system, the Accruent Transportation Management System (TMS) and CMMS and purchasing workflows,” he said. “The clinical engineering department, specifically our biomed technicians, used this combined platform for ordering, and were able to open a work order and access the PartsSource marketplace with the click of a button.

“Rather than making multiple calls or conducting time-consuming research, they had costs and reliability figures at their fingertips to support their decision-making,” he continued. “After receiving a part and then making a repair, all they had to do was go back in and close the work order out. Best of all, everything technicians did – from the time they purchased something to shipping info – was available right there in the work order.”

This deep integration led to greater data integrity, as tracking this information automatically (and correctly) resulted in better access to the kind of data staff needed to drive activities such as a capital replacement strategy, alternative equipment maintenance (AEM) schedules and total cost of ownership.

Previously, manually entering orders could lead to confusion over inventory – whether something is in stock or even on order – or duplicate entries. From a safety standpoint, if there is a recall, the staff can actually determine where a part is in that moment.

RESULTS

MCHS saw an immediate impact. For example, via PartsSource, the staff bought a specialized X-ray tube for $89,000 – a savings of more than $30,000 compared to the price from the vendor they had usually purchased it from. They had the part in-house the next day.

“Big wins like that, and all the little wins underneath of it, really justified the program,” Olson said.

Because PartsSource orders are imported right into the database, staff members now have better visibility into their spending and purchasing behavior, which has helped them plan and control costs.

“I can actually balance our general ledger for our cost centers against our TMS, and it’s spot on, because the cost of the part is tracked all the way – from the time it gets ordered to the time it gets put in the machine,” he explained.

“This data-driven approach also lets us make smarter decisions faster, like having the instant comparison to either purchase a $300 new part versus the cost of sending the equipment out for repair, which is a $150 flat repair rate,” he continued.

“We saw financial benefits immediately with access to this new information. In fact, after just one quarter, we saw a cost savings of 35%. At the end of 2019, MCHS’ use of PartsSource saved the organization $1.2 million just in parts.”

The solution allowed staff to consolidate parts procurement from multiple different original equipment manufacturers (OEMs) and suppliers into one centralized, easy-to-use e-commerce platform, integrating with CMMS and purchasing workflows, he added.

“Our odds-and-ends parts are all ordered via one-stop-shopping. We can go into PartsSource’s catalog, and there they are,” he said. “These parts have also been verified. But if we do have problems, we can send them back and contact PartsSource and give feedback: ‘Hey, this part wasn’t what it was cut out to be.’ They go to a different vendor and fix the issue.”

This system has helped MCHS maintain excellent return rates on defective replacement/repair parts for medical equipment. To date in 2021, the health system’s quality return rate is 0.3%, with the industry benchmark being 2%; and an overall return rate of 2.4%, again beating the industry benchmark, 3%.

“Consolidating parts procurement from 471 different OEMs and suppliers eliminated significant waste in the procurement process, which alleviated the burden of purchase order management,” Olson said. “Decreasing the time to procure parts increased productivity for the department.

For example, the time from requesting the part to delivery used to be nearly 90 minutes. However, implementing PartsSource nearly halved this time throughout our partnership,” he continued. “Technicians could then dedicate these hours instead to customer support and service, repairs, cybersecurity, and sustaining the incredible growth MCHS has undergone.”

Plus, the automation has been a lifesaver, Olson said.

“Technicians don’t have to manage and follow the order confirmations. It’s all done automatically,” he explained. “This allowed us to give them back time in their day to focus on different, clinically focused tasks that they didn’t have time to focus on before, such as troubleshooting.

“With our existing staffing model, when employees are tied up with researching parts and working on getting equipment up and running, that’s less time they’ll have to look at other pieces of equipment that might need repairs,” he added. “In that case, we’ll call the vendor and have them help us out. But if they have extra time in the day, they can go attack another piece of equipment without having to call the vendor and/or switch around resources.”

Staff members always try to keep their resources deep enough, but it’s always more cost-effective if they can do it themselves, he said.

Today, as MCHS is building a tenth hospital, it has been able to keep up with the growth. In fact, it is at a point where it has added a couple of managers to oversee its southern and northern regions.

“Right now, we have an approval process, so if anyone is spending $1,000 or more on a part, I can approve it quickly, as I have PartsSource on my phone,” Olson said. “Now, however, these new managers can focus on the spend and make my life easier. There’s a lot of days I’ll see a part order come across, and I don’t have time to drill down on why it’s being ordered or why he’s doing OEM instead of third party. Now I can pass these on so I don’t delay the orders.”

ADVICE FOR OTHERS

“Organizations should first drill down on their existing pain points and look at what their specific needs are,” Olson advised. “Don’t be afraid to even make a list, ranking in order of importance your most crucial needs and what you’re looking for in a holistic solution and a valued partner.

“If you’re in a growth phase, you have to jump on board,” he continued. “Don’t be afraid of a data-driven solution, even if it is different from the paper-based way you’ve done things in the past. If you’re going to keep up with the industry, you have to keep an open mind. You don’t want to cut back staff, but utilize your staff in different ways.”

For example, instead of having two people placing orders, Olson has one staff member who helps with contract management, and another one who assists with all the invoicing that seems to stack up when one adds nine hospitals.

“If you can get into the growth phase like MCHS is in right now and keep services in-house and under control, you can do so much in savings moving forward,” he concluded. “For 32,000 pieces of equipment, we have a director and two managers and enough staff to run it. And it’s all because of the money that we’re saving because of working smarter.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

Continue Reading

Trending