How InterMed and TidalHealth Maintained HTM Consistency Across Multi-Site Expansion
infusion pump preventive maintenance now takes two weeks. It used to take all of February.
telemetry transmitters lost since tagging began. Before, about a dozen were lost every year.
cost of each telemetry transmitter that used to go missing.
TidalHealth is a nonprofit health system that has grown from one hospital in Salisbury, Maryland, to a network of hospitals, outpatient sites, and physician practices throughout the Delmarva Peninsula. As it expanded, the teams responsible for clinical equipment had to support a wider range of devices.
Clinical equipment inventories grow predictably when health systems add facilities, but the operating model often does not. Preventive maintenance (PM) schedules must stay consistent, vendor relationships expand, and compliance requirements change. The result is a more fragmented equipment environment across the system.
The Problem
TidalHealth’s expansion created challenges that a traditional healthcare technology management (HTM) contract couldn’t absorb. Sites used equipment from a wide mix of vendors under varied service agreements that were managed by multiple departments with separate budgets. As the company expanded across the region, maintaining consistent enterprise-wide visibility into equipment and service coverage became increasingly complex.
Infusion pumps and other high-use equipment often moved between departments and were not always able to be accounted for, making preventative maintenance harder to execute. Telemetry transmitters and other devices were not being used as efficiently as they could have been. These visibility problems affected operational efficiency, equipment availability and cost control simultaneously.
Service contracts presented a different kind of complexity. Departments negotiated their own agreements with original equipment manufacturers (OEMs) and third-party providers. This made budgeting difficult, as no one had a complete picture of what was under contract or what needed to be purchased. TidalHealth also wanted to reduce its dependence on OEMs’ expensive, inflexible full-service contracts for maintaining imaging equipment.
It sought a partner that could help overcome these challenges. Rather than introduce new vendors, TidalHealth turned to InterMed, an independent service organization (ISO) that had reliably managed the company’s core HTM program for years, to see whether the partnership could expand beyond its traditional scope into a hybrid model that would extend internal capabilities without surrendering oversight.
The Solution
InterMed’s approach focused on building systems that could scale alongside TidalHealth’s growth rather than solving isolated problems.
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Centralizing service contract management
Service contract spending was fragmented across departments with no central oversight. InterMed took on centralized coordination of all medical equipment service agreements and established a framework that routed every contract through a single point of oversight that gave TidalHealth greater visibility into system-wide service spending.
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Building asset visibility with RTLS
During a fleet replacement project, InterMed identified that nursing’s request for additional infusion pumps stemmed from a visibility problem, not a capacity shortage. InterMed proposed implementing a real-time locating system (RTLS) instead, with the savings from purchasing fewer pumps funding the tracking infrastructure. InterMed acquired the technology, installed tracking tags on devices, and set up monitoring infrastructure, including alarms at loading and linen docks, to prevent equipment from leaving the facility.
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Absorbing adjacent responsibilities
TidalHealth faced another challenge related to its infusion pumps. The devices weren’t being cleaned consistently or redistributed efficiently, so some floors ran short while others had excess inventory. While historically outside its purview, InterMed proposed adding a dedicated pump management role that would round twice daily to redistribute equipment between units, monitor cleaning compliance, and educate staff members on proper protocols. Implementation is underway.
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Structuring flexible OEM partnerships
OEMs’ insistence on full-service contracts when selling imaging equipment locked TidalHealth into expensive, inflated PM or repair agreements. InterMed addressed this by making vendor cooperation part of the purchasing criteria and negotiating contracts that preserved flexibility. For the campus in Millsboro, Delaware, InterMed negotiated a 10+1 contract with an OEM that allows TidalHealth to step down from full service during the term once InterMed’s technicians gain proficiency and parts become available.
The Results
Over time, the partnership has delivered outcomes that directly address the pressures created by TidalHealth’s growth.
Operational efficiency improved measurably. Before the RTLS, conducting preventative maintenance on the infusion pump fleet took all of February, the annual compliance month, and still only reached 90% of devices. The missing 10% weren’t necessarily broken — they were just lost somewhere in the building. After implementation, the team now completes preventative maintenance in two weeks because the equipment that used to require a systemwide search now takes minutes to locate. Additionally, the promise of the pump management role has led TidalHealth to evaluate a similar approach for beds and stretchers.
Asset losses dropped to near zero. TidalHealth lost roughly a dozen telemetry transmitters annually at a cost of $3,000 each before the RTLS was installed. Any tagged device passing through the trash and loading docks triggers a 100-decibel alarm and a flashing blue light. TidalHealth has since lost fewer than five transmitters, and RTLS tracking has been applied to other high-value equipment. In one case, it prevented an employee from discarding two $2,500 HoverMatt devices that needed cleaning.
Cost predictability increased. Centralizing contract management gave TidalHealth a complete view of system-wide service spending for the first time. InterMed built and maintained a consolidated budget that finance uses to project costs as new facilities and technologies come online.
Vendor relationships became strategic. The 10+1 contract structure established that OEM relationships don’t have to be all or nothing. By factoring training access and service flexibility into purchasing decisions, TidalHealth gained immediate coverage while preserving the option to bring work in-house as capabilities grew.
Expansion proceeded without disruption. TidalHealth has added facilities, increased outpatient services, opened new imaging centers, and introduced advanced modalities while maintaining the same HTM relationship that existed when it was a single hospital in Salisbury. InterMed’s ability to take on additional responsibilities means TidalHealth doesn’t need to turn to new vendors every time operational needs change.
Conclusion
Poor equipment visibility, decentralized oversight of service contracts, and inflexible vendor relationships threatened to undermine TidalHealth’s expansion. InterMed addressed these challenges by stepping beyond its traditional role and consolidating clinical technology management so TidalHealth could focus on patient care and strategic growth.
As TidalHealth continues to expand and clinical technology grows more complex, the partnership with InterMed is structured to adapt as challenges evolve.