A panel discussion hosted by the ISSA Healthcare Surfaces Institute offered a timely preview of topics set for the Healthcare Surfaces Summit, May 5-6 in Chicago, where clinicians, manufacturers, and facility professionals will come together to address the evolving challenge of surface-related infection risk.

Moderated by Linda Lybert, executive director of HSI, the conversation featured Barbara Strain, principal at Barbara Strain Consulting and a veteran value analysis professional with more than four decades in healthcare; Sarah Wilkerson, System Executive Director of Infection Prevention at Providence Health and Services; and Zeynep “Z” Ekemen, inventor and founder of Silver Defender.

What is surface intelligence—and why does it matter?

Strain opened the discussion by grounding surface intelligence in a concept most people encounter without recognizing it. Every surface in a healthcare environment—bed rails, doorknobs, monitors, even the couch visible in the background of a video call—is made of a material with specific chemical properties. When that material is paired with the wrong disinfectant, the result is invisible damage: micro-fissures and surface degradation that create the ideal conditions for microbial colonization and biofilm formation.

“Microbes are always inherently looking for a way to attach to a surface material,” Lybert noted, pointing to ongoing work by HSI over the past 12 years to address disinfectant-surface incompatibility. “When they’re not compatible, it creates damage or little fissures, and you may not necessarily see it initially.”

She added that a growing number of hospitals are running internal testing to validate that the surface materials on a given product—which may include multiple material types—are compatible with the disinfectants used in their facilities.

Navigating the EPA registration gap

One of the panel’s most substantive exchanges centered on regulatory compliance for antimicrobial surface products. Ekemen described the rigorous path Silver Defender took when developing its antimicrobial film technology, which uses pure silver as its active ingredient.

After investing roughly a year and seven figures into working with a top EPA consulting firm—including former EPA officials—and specialized legal counsel, the company discovered that EPA’s testing pathways are designed for liquid products such as sanitizers and disinfectants, not for solid antimicrobial films.

“Because of this, we fall under the regulatory framework of EPA’s treated articles exemption, and our main active ingredient is EPA registered,” Ekemen said. “This is the same framework that global leaders like Microban also use.”

She was direct about what the product is and is not: “We’re not a disinfectant. We are not claiming to replace cleaning protocols. We’re providing an essential antimicrobial shield to be used in between cleaning cycles.”

The film is installed annually, requires no changes to existing cleaning workflows, and has demonstrated 99.9999% microbial reduction in controlled testing. The company has conducted toxicity testing showing 86.9% cell viability, as well as leachability testing confirming no health hazards from continuous human contact.

Lybert and Strain both noted that EPA’s regulatory framework has not kept pace with the pace of surface technology innovation—a gap that HSI’s testing and validation task force is actively working to address, along with a proposed advocacy task force to help manufacturers navigate the federal process.

How clinicians evaluate new surface products

Wilkerson outlined the framework Providence uses when evaluating new surface technologies. Evidence, workflow fit, and total cost of ownership are the three primary lenses—and all three have to align before a product moves forward.

“We want evidence that it works,” she said. “We want to understand where it fits in our workflow and whether it’s really worth the cost.” That includes confirming regulatory status, reviewing peer-reviewed literature, checking for FDA adverse event reports, and understanding what training and maintenance requirements come with the product.

She also raised a critical point about cost calculations: initial price is rarely the full picture. Ongoing supply costs, training, competency assessments, and additional cleaning products required for the device all factor into actual cost of ownership.

The ‘self-cleaning surface’ misconception

A pointed exchange emerged around a firsthand account Lybert shared from a hospital visit, where an EVS professional had skipped cleaning a surface equipped with antimicrobial technology, believing it to be self-cleaning.

“There’s no such thing as a self-cleaning surface,” Lybert said. “It creates a false sense of security.”

The panel agreed that training must address the “why” behind continued cleaning protocols, not just the “what.” Ekemen described Silver Defender’s practice of recommending that hospitals issue facility-wide memoranda to EVS, nursing, and clinical staff before installation, clarifying exactly what the product does—and that standard cleaning protocols must continue unchanged.

From infection control to infection prevention

Wilkerson touched on a profession-wide tension: infection prevention teams are often forced into reactive mode by the volume of competing priorities, even as the field has formally shifted its identity from “infection control” toward true prevention.

“If we spend that time on the preventative side, really put the energy and the effort into the prevention, we’ll have less that we have to do on the control side,” she said—while acknowledging that communicating that investment case to hospital administration remains an ongoing challenge.

Strain echoed the point, noting that the surveillance infrastructure and communication tools available today give healthcare facilities a genuine opportunity to get ahead of problems they once could only respond to.

The panel closed with a call to register for the Healthcare Surfaces Summit, May 5-6 in Chicago, where these topics will be explored in greater depth alongside a manufacturer-clinician panel examining the divide between product innovation and testing and validation standards.

Register today for the ISSA Healthcare Surfaces Summit; seats are limited!