AAMI Publication Highlights Similarities, Differences in Healthcare and Nuclear Industries

What can the nuclear power and healthcare industries learn from one another? That question is the focus of a new Association for the Advancement of Medical Instrumentation (AAMI) monograph, "Risk and Reliability in Healthcare and Nuclear Power: Learning from Each Other," the result of a two-day workshop held in San Diego last July to promote shared learning and promote gains in risk management and reliability.

The 120-page monograph was edited by AAMI president Mary Logan, Bruce Hallbert, PhD, director of nuclear science enabling technologies at the Idaho National Laboratory (INL), and Matthew Weinger, MD, professor of anesthesiology, biomedical informatics, and medical education for Vanderbilt University. It features eight chapters written by industry experts, who review the similarities and differences between the fields in four topic areas:
- Dependability of safety-critical software
- Diagnostic and prognostic technologies
- Human factors
- Event analysis and corrective action

While nuclear power and healthcare might not necessarily appear to be complementary industries, they both are complex, tightly coupled, high-hazard sociotechnical systems that serve a public good. Furthermore, they both rely on highly trained and skilled professionals working in interdisciplinary teams, according to the monograph.

In terms of regulatory oversight and organizational structure, however, there are a number of differences, as detailed by David Gaba, MD, professor of anesthesia and associate dean for Immersive and Simulation-based Learning at the Stanford School of Medicine, in a chapter titled Thorniest Issues in Healthcare. There are about 100 nuclear power reactors owned by 30 to 40 firms in the United States, and they face significant scrutiny by the U.S. Nuclear Regulatory Commission. By contrast, there are 4,000 to 6,000 hospitals, owned by between 1,000 and 2,000 firms, as well as a large number of standalone surgical centers and physicians offices. Yet, unlike with the nuclear power industry, there is no single regulatory entity for healthcare. Oversight is spread across state and federal bodies.

It is true that healthcare cannot strive for the same level of standardization within a facility, or especially between facilities having the same basic technology, as is achieved in nuclear power or the aviation industry, Gaba wrote. However, as for many things in healthcare, the pendulum is currently too far to the side of insufficient standardization.

As a result of last years meeting, experts in the two industries now hope to work together on research projects, workshops, and position papers.

The workshop was a first step at making the advancements in two safety critical fields available to one another, Logan says. The invited attendees started with curiosity about what healthcare could learn from nuclear power and vice versa. By the end of the first morning, the curiosity had turned to excitement, as these individuals realized they were sitting in the same room with giants well known in the other field. By the end of their two days together, it was obvious that we were onto something important.

Logan adds that the monograph captures the essence of that shared learning among some of the best and the brightest people in their respective disciplines. It is a way of extending the workshop learning out further into the community. If it sparks an idea, connects people, and deepens conversations about what we can learn from experts in other fields, then it was a worthwhile endeavor.

The monograph is available for sale at the AAMI Marketplace (www.aami.org) in hard copy and PDF formats. The list price for the hard copy is $60, but it is available to AAMI members for $35.  The PDF version is free to AAMI members; nonmembers pay $60.