How TRIMEDX operates a shop from a remote location in Grand Cayman Island
It started as a joint venture with Narayana Health out of India, which is how TRIMEDX began at Health City Cayman Islands. The facility embodies the vision of world-renowned heart surgeon, humanitarian and healthcare visionary, Dr. Devi Prasad Shetty. It brings together all the essential elements to deliver healthcare as it has never been done before, such as:
- Top cardiac surgeons, skilled orthopedic surgeons and dedicated healthcare professionals meeting critical healthcare needs – efficiently, cost-effectively and with deep compassion
- An innovative healthcare model leveraging physicians’ extensive experience, leading-edge technologies, and accountability to effectively streamline processes and costs
- Sustainability practices that further contain costs while protecting our environment
- Premier healthcare institution – Narayana Health – partnering to advance the mission of quality, affordable healthcare for all
Challenges
TRIMEDX does not have any vendors on the island, nor is there access to many parts. Getting a vendor requires approval with immigration each time. And getting parts is also challenging, and it’s important to be sure the correct part is ordered. There is almost no way to order anything overnight like in the U.S. Usually, three days shipping is the best that can be done, but sometimes parts can take up to six months to arrive. A lot of planning is involved to be predictive and proactive. Sending anything to the United States requires many steps and additional paperwork. This includes getting approval from customs, FDA, and FedEx to get anything off the island for repair. The same agencies approve anything coming back after the repair, as well. This can often cause delays.
The people
The site only has one technician for each modality. The imaging tech Arun Gowdhaman takes care of all imaging devices (CT, MRI, NucMed, Ultrasound, X-Ray). That’s almost unheard of in the United States. He gets support from the mainland, but he does a great job on his own. The same is true for the biomed Jake Bennett. He takes care of all biomed devices in the facility. They both share responsibility for lab devices. As a site manager, Robert’s role is much different than what is typically seen at a site in the U.S. Robert is relied on more for capital planning. All department heads are actual doctors, so their admin roles are limited, and Robert helps which gives TRIMEDX an advantage in building trust to provide certain models and brands.
Arun Gowdhaman left family behind for two years while working for TRIMEDX in Cayman Islands, and they just recently joined him on the island.
“Work, life balance and teamwork, along with a control and freedom within my job are reasons why I enjoy working for TRIMEDX,” says Arun. “Robert’s appreciation and recognition of us goes a long way, as he supports us whenever we reach out for guidance and help.”
Jake Bennett is from Honduras, but jobs are scarce there. His mom is from Cayman, which gives him resident status. That made it easier for him to find work and stay on the island without the need for work permits.
“I am so proud and fortunate to be part of this great company,” says Jake. “TRIMEDX gives its employees what we need to do our job the right way. I also really appreciate Robert’s hard work, patience and dedication.”
Making a difference 
Karan Dave, facility director of Health City Cayman Islands, says that TRIMEDX adds a great amount of value-add given its geographic location and the associated challenges in order to run a critical industry such as healthcare. “Robert and his team are very approachable,” says Dave. “Management has to be seen and felt, and he carries both of these qualities and is really available around the clock for inquiries.”
Overcoming daily challenges is a success in itself. The site recently had a failure in the cath lab (note: the only cath lab on the island), due to one of the X-Ray generators going bad. TRIMEDX was able to secure the part and repair it in just a little over 24 hours. That is amazing, considering the location!
“Time is muscle,” says Dave. “Serving a population of 65,000, our hospital is the only facility with a cath lab, and TRIMEDX was able to repair it in about 24 hours for us to continue patience care for critical emergencies.”
This involved going through a third party and getting the part next-day handling shipment and custom clearance. An emergency procedure was performed the same night! From diagnosis, part-ordering, shipping, custom clearance, replacement and adjustments, the TRIMEDX team made it happen.
One of the most challenging situations Jake faced so far was when he received a call on one of the sterilizers: the jacket was taking too long to charge. After troubleshooting, it was discovered the generator heating element needed replaced. In getting his part and tools ready, he received another call about the other sterilizer being down which meant both were down with a full schedule in the operating room. He was able to get one back running in about 30 minutes which allowed time to repair the other.
Improving satisfaction and reducing risk
The Key Performance Indicators for TRIMEDX in the Cayman Islands speak volumes. They are as good as most in the continental United States. And that is not an easy feat given logistical issues.
The metrics are reported to the facility monthly to give them an idea of how we are performing. The performance goal is set to United States capabilities, which have better access to parts and service. Typically, a mission critical turnaround timeframe is 2-3 days each month. Mission-critical turnaround for a recent time period was 9.5, but if you remove one call due to a part delay, it was actually 2.66 days.
A great fit
Karan Dave has been known to say this would be a difficult department to manage without the TRIMEDX partnership. Our expertise and leverage with vendors are a huge part of our success.
With the expertise and dedication of the TRIMEDX team that shows its versatility and commitment to excellence each day, there’s also the benefit of having a complete regulatory team, call center and added benefits which enables them to operate the site on the island with additional resources and a central supply chain team based out of Indianapolis. They are being taken into account, the regulatory team is aware of standards that differ from those in the U.S., and all things considered, TRIMEDX’s model is what makes it a great partnership that allows the health system’s CE to be a success.