The measurement of ECG-derived heart rate variability (HRV) provides early diagnosis and prevention of cardiac events such as coronary artery disease (CAD) and myocardial infarction (MI). The disease severity causes ECG shape deformation, leading to difficulty in R-wave detection required for heart rate variability (HRV) analysis. Therefore, the study aimed to optimize R-wave threshold filters at 50%, 60%, 70%, and 80% within the framework of HRV analysis for better diagnosis of MI and CAD. Lead-II ECG was recorded from CAD (n=15), MI (n=15), and Control (n=10) group participants using an MP45 amplifier (Biopac Systems Inc., USA). The ECG morphologic features were extracted to analyze the change in R-wave amplitude. The R-R interval time series was extracted at different threshold filters (50%, 60%, 70%, and 80%) and used for heart rate variability (HRV) analysis. The HRV features extracted using Kubios V2.0 in time, frequency, and nonlinear domains at different threshold filters were compared. The obtained findings revealed that R-wave amplitude was suppressed under the CAD and MI groups in comparison to the control subjects. The observed results also suggested 70% threshold filters for optimum detection of R-wave under CAD and MI. Further, the time and frequency domains presented the best result in comparison to the nonlinear HRV domain. The present study suggested that HRV analysis may be made more predictive for various cardiac diseases by optimizing R-wave threshold filters.

During the COVID-19 pandemic, the Biomedical Engineering team at the University of Ottawa Heart Institute (UOHI) faced challenges coordinating with external medical equipment vendors’ service experts due to travel restrictions. Although the UOHI BME team is highly skilled and capable of addressing many equipment issues in-house, certain specialized or vendor-specific interventions still require external input. With most vendors and their support teams located outside Ottawa, UOHI Biomed explored alternative solutions during the pandemic to ensure timely remote service support, minimize delays, reduce equipment downtime, and control costs. This paper outlines an attempt by the Biomedical Engineering department at UOHI to explore a Remote Service Support Program (RSSP) aimed at improving the process of obtaining assistance from vendors by enabling remote connections between Biomedical Engineering Technologists (BMETs) and medical equipment service experts through live, real-time calls. Although the program offered features such as hands-free maintenance support and the ability for remote experts to share documents or screenshots, it ultimately did not integrate well with the department’s established workflows. Furthermore, although several manufacturers had existing remote support platforms, in practice, BMETs continued to rely on familiar tools such as video calls, phone calls, or general-purpose communication platforms when needed. As a result, the Remote Service Support program was not adopted for sustained use.

This study investigates the evolving landscape of innovations in hospital management, highlighting their essential impact on the present and future of healthcare. It examines the importance of advancements such as technology integration, human resource management, and improvements in patient care, along with challenges such as big data transfer between hospitals and insurance companies. By reviewing 20 scientific articles on hospital management, medical coding, and Odoo, this research underscores the need for a collaborative, innovative approach to help hospitals address these challenges and move toward enhanced patient care, operational efficiency, and technological progress.

On September 24, 2023, the US Food and Drug Administration (FDA) and other stakeholders marked the 10-year anniversary of the publication of the FDA Unique Device Identifier (UDI) Final Rule. The infrastructure for the UDI system is in place—UDI is on the label of medical devices for which UDI requirements apply, unless an exception or alternative applies, and key device identification information, including the device identifier portion of the UDI, is available in the Global Unique Device Identification Database. The focus now is on adoption and implementation of UDI throughout the healthcare ecosystem to realize the intent of the UDI Rule, which is to enhance patient safety through accurate device identification. To that end, this article provides an example of the utility of the UDI for evaluating device performance as a device evolves over time. The example demonstrates that UDI can facilitate identification of the specific version or model of a device that has malfunctioned and/or contributed to an adverse event by enabling more accurate data aggregation compared with other identifying information, potentially leading to key safety insights.

The first article of this series demonstrated that some medical equipment exhibits clear, progressive deterioration with age, whereas some others do not. The second article showed that although most equipment remains safely and reliably deployed well over its respective depreciation period and the end-of-life or end-of-support dates declared by the respective manufacturers, some equipment needs to be replaced sooner. Because it is not practical to wait for the collection and analysis of large amounts of data to better plan for maintenance and replacement, a simple, quantitative model for equipment aging is introduced in this article to help improve both types of planning. The model was tested on professionals not directly involved in its formulation and applied to 34 equipment types. The results show this aging model can be used by professionals experienced in medical equipment maintenance and management, with only some basic instructions. Furthermore, it can be used to update the traditional “risk-based criteria” for planned maintenance and turning it into a risk management method fully compliant with the ISO 14971 standard.

As the healthcare environment becomes increasingly digitally connected and cyber threats to healthcare technologies evolve, cybersecurity controls are necessary to ensure the safety and effectiveness of medical devices. Digital certificates are one such security control commonly utilized to secure various technologies and systems including medical devices. However, few academic resources describe the use of digital certificates in the unique context of medical devices. Additionally, digital certificate issues have the potential to impact the safety and effectiveness of medical devices and to negatively hinder the delivery of patient care. This article provides an introduction on the role of digital certificates to secure and manage access to medical devices, including potential issues and digital certificate management considerations.

Corresponding author: Ode R. Keil, MS, MBA, CCE, President, The Ode Keil Consulting Group, Inc, 20947 Weatherstone Rd, Kildeer, IL 600047 ([email protected]). The author declares no conflicts of interest.