# Empowering Clinical Engineering and Evidence-Based Maintenance with IoT and Indoor Navigation +
## 5 Discussion  
All identified scenarios that could potentially lead to failures (see Section 1.1) were observed during the testing phase. The OHIO management web application played a crucial role in satisfying the UN 1. It achieved this by proactively notifying healthcare staff responsible for a medical device scheduled for maintenance, prompting them to collect the equipment in the EEH. When a device designated for clinical use was required within the scheduled maintenance period, the OHIO management application promptly reported this information to the CE department well in advance. This preemptive communication enabled a timely rescheduling of the maintenance, avoiding excessive time waste. De  
Figure 11: User satisfaction questionnaire. Responses in a range from 1 (strongly disagree) to 5 (strongly agree) are evaluated as the frequency count and percentage obtained for each question. \begin{table}
\begin{tabular}{c c c c c} \hline \multirow{2}{*}{**Year**} & **KPI 1** & **KPI 2** & **KPI 3** & **KPI 4** & **KPI 5** \\  & **Lag (Avg)** & **Duration (Avg)** & **Downtime (Avg)** & **SM with Failure** & **Devices per Technician** \\ \hline
2021 & 17 days & 01 h 00 m 00 s & 0.0344\% & 11.11\% & 2.67 \\
2022 & 109 days & 00 h 53 m 45 s & 0.0283\% & 35.71\% & 2.20 \\
2023 & \(-\)2 days & 00 h 57 m 30 s & 0.0323\% & 21.43\% & 3.00 \\
2024 & 0 days & 00 h 33 m 55 s & 0.0110\% & 14.29\% & 3.50 \\ \hline \end{tabular}
\end{table} 
Table 4: Values for the proposed KPIs for the years 2021, 2022, 2023 (OHIO not deployed), and 2024 (OHIO deployed and in use). spite the theoretically designated collecting area, HiWay effectively shows the real-time positioning of tagged medical equipment within the hospital. During the initial testing, a technician was able to locate the device effortlessly, even though it had been collected in a different \"filter zone\" due to a prior loan between departments the CE department was unaware of (UN 2). The collection of medical equipment in the designated EEH, their specific position, and the precise information of the day and time of intervention provided to the healthcare personnel by the OHIO management web application allows maintenance operations to remain separate from medical ones (UN 3). Moreover, the indoor navigation capabilities embedded in HiWay empower each technician to access the collecting area without requiring a comprehensive understanding of the hospital layout, thus fulfilling the UN 4. This situation has also already occurred during the tests, and HiWay effectively prevented an issue where a newly hired technician assigned to the SM of a tagged US machine would have struggled to independently reach the device without the assistance of HiWay. Therefore, OHIO successfully mitigated all of the identified UNs. Table 4 highlights that all the KPIs improved after the introduction of OHIO. **KPI 1** (Lag) changed from an average of 41 days over the previous three years to 0 days, meaning that each SM has been performed (on average) on the same days it was initially planned. **KPI 2** (Duration) reduced by approximately half in comparison to the previous three years, reaching a value of 33 min and 55 s on average (the minimum recorded time was 8 min and 32 s). HiWay played a pivotal role in reducing KPIs 1 and 2 because it provided a faster and more certain way to reach the equipment. **KPI 3** (Downtime) for 2024 is about one-third compared to the previous years. In the calculation, the \(RT\) (required time per year) was set to 8760 h/year for the medical equipment in use 24/7 activities (e.g., ICU, ER, and ward), and to 3000 h/year (12 h a day for 250 working days per year) for the others (e.g., outpatient clinics, non-emergency imaging). The certainty of finding the devices in the EEH assured by the OHIO framework (both software and IoT hardware) contributes to reducing both KPIs 2 and 3.