Medical Dealer - October 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

OCTOBER 2014 | WWW.MEDICALDEALER.COM

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Excellence in Imaging Equipment Service and Support

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THE INFRASTRUCTURE IMPACT OF MOBILE DEVICES on the delivery of healthcare …

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OPERATING TABLES

TEE Bayer HealthCare Multi Vendor Service will repair your probe with the same precision and care you provide to your patients.

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Bayer, the Bayer Cross and Multi Vendor Service are trademarks of the Bayer group of companies.

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Crothall Healthcare Technology Solutions has grown 215% in just two years because we do more than just repair and manage your equipment. We are the only equipment service provider that’s focused on patient and nurse satisfaction. We have a response team that maintains the equipment patients use every day. We provide better access and use of medical equipment for nurses through Clear Connect. And, because we’re not tied to specific manufacturers, we give you best-in-class service and solutions.

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NATIONWIDE SALES. LOCAL SERVICE.

YOUR BEST DECISION FOR ULTRASOUND SERVICE EXPERTS Meet 2 of our engineers

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MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

“Our customer Crucial Care was struggling to find service companies that would actually care about them and give them the service they deserved.

“There are a lot of behavioral changes that are

When they were told about our

occurring, and the mobile technologies are

company we quickly came in and

helping with a lot of that. We are in the midst

56

of the cultural change for healthcare.”

set the standard for service.”

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CONTENTS_Features 56 MOBILIZED

Mobile devices continue to evolve in the healthcare setting.

We look at some of the new devices and ask experts about the infrastructure needed to support the latest high-tech gadgets becoming more and more common in healthcare facilities.

66 CORPORATE PROFILE

Medical Imaging Technologies Inc. prides itself on its quality work and outstanding customer service. For more than a quarter of a century, owner Rick Player and the highly skilled individuals at M.I.T. have monitored the pulse of the medical imaging industry to ensure the company’s ability to meet the needs of their customers.

Medical Dealer (Vol. 18, Issue #10) October 2014 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 302691530. POSTMASTER: Send address changes to Medical Dealer at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.medicaldealer.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2014

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MEDICALDEALER 11

CONTENTS_Departments

MEDICALDEALER | OCTOBER 2014

INDUSTRY UPDATE 17 News & Notes MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 (800) 906-3373 Fax: (770) 632-9090 Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

24 OEM Updates 28 Block Imaging

MARKET ANALYSIS Radiology: CT 33 Market Analysis 34 Product Showroom 40 Preferred Listings

Editor

John Wallace jwallace@mdpublishing.com

Art Department Jonathan Riley Yareia Frazier Jessica Laurain

Med/Surg: OR Tables 47 Market Analysis 48 Product Showroom 51 Preferred Listings

Account Executives Sharon Farley Warren Kaufman Jayme McKelvey

Contributors

Jim Fedele Myron Hartman Matthew N. Skoufalos Dan Bobinski

SLICE OF LIFE 72 The Other Side 74 Pay It Forward 81 Success Story 86 Dan Bobinski

Accounting Sue Cinq-Mars

Circulation

Bethany Williams bethany@mdpublishing.com

92 Categorical Index 94 Alphabetical Index

Web Department Betsy Popinga Taylor Martin

Proud supporters of Like us on Facebook! www.facebook.com/MedicalDealer

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MEDICAL EQUIPMENT, PARTS & SERVICE

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INDUSTRY UPDATE_News and Notes

Staff Reports

JUSTICE NAMED NEW CUSTOMER RELATIONS MANAGER

Trisonics recently announced Danielle Justice will fill the new role of Customer Relations Manager. The Customer Relations Manager role was created to be a resource for the engineers and to expand the reach of Trisonics to new areas. This role will ensure Trisonics is doing everything possible for customers.

Justice says her focus is to reach out into areas where potential customers could benefit from cost savings and premium service that Trisonics has to offer. “The engineers and I work as a team to best reach out to and serve our customers. I’m making this role my own by becoming a partner with the customer to understand their goals,” says Justice. “I believe this position is successful explicitly by personally taking the time to get to know our customers’ needs and working to create a plan to reach their goals,” Justice concluded.

Justice understands that Trisonics values relationships, and she will work to embody that value in every step of her role.

“It became clear to me the large potential to reach out into small offices who could largely benefit with lower costs,” explained Justice. “I’ve made it my goal for the next few months to lead such offices into cost-savings relationships through my position at Trisonics.” •

ADVANCED MOBILITY MANUFACTURES NEW MOBILE SIEMENS BIOGRAPH TRUEPOINT PET-CT FOR ALLIANCE-HNI

Advanced Mobility and Specialty Vehicles has announced the delivery of a new Siemens Biograph TruePoint PETCT Trailer to AllianceHNI. Alliance-HNI awarded a contract to Siemens Healthcare for the Biograph TruePoint PET-CT system WWW.MEDICALDEALER.COM

contingent on Advanced Mobility completing the process of validation by Siemens as an approved manufacturer of the PET-CT trailer.

“The Siemens Biograph TruePoint PET-CT is a high-powered medical imaging platform with a whole

new set of requirements to ensure its reliability and durability, allowing the PET-CT system to be transported and function safely inside a trailer,” said Gregg Hedegore, President, Alliance-HNI. The proposal process commenced in March of 2014. By April, the bid was awarded and Advanced Mobility had the new chassis delivered to start the new build.

“This is the first newbuild Siemens Biograph TruePoint PET-CT for Advanced Mobility. They were able take the system requirements and turn them into a high-quality,

mobile specification that has resulted in a first-class mobile image unit for Alliance-HNI,” said David Jolly, Siemens Healthcare Sales Manager at Delta Medical.

Advanced Mobility worked closely with Siemens to accommodate the specifications.

The Advanced Mobility team built and delivered the new Siemens Biograph TruePoint PET-CT Trailer to the Alliance-HNI in early August, in a build-time of less than four months. • FOR MORE INFORMATION visit www.amstcorp.com.

MEDICALDEALER 17

INDUSTRY UPDATE_News and Notes

CERNER TO ACQUIRE SIEMENS HEALTH SERVICES FOR $1.3 BILLION Cerner Corp. and Siemens AG have associates in more than 30 countries, announced a definitive agreement 18,000 client facilities, including some for Cerner to acquire the assets of of the largest healthcare organizaSiemens’ health information techtions in their respective countries, $4.5 nology business unit, Siemens Health billion of annual revenue and $650 Services, for $1.3 billion in cash. By million of annual research and develcombining investments in research opment investment. and development, knowledgeable Following the acquisition, support resources, and complementary client for Siemens Health Services core platbases, the acquisition creates scale for forms will remain in place. Current future innovation. implementations will continue, and As part of the agreement, Cerner Cerner plans to support and advance and Siemens will form a strategic allithe Soarian platform for at least the ance to bring new solutions to market next decade. Cerner will work with all that combine Cerner’s health IT leadclients to support their short-term and ership and Siemens’ strengths in long-term business needs. medical devices and imaging.

Cerner and Siemens will create “We believe this is an all-win a strategic alliance to jointly invest situation for the clients of both orgain innovative projects that integrate nizations and all of our associates health IT with medical technoloand shareholders,” said Neal Patgies for the purpose of enhancing terson, Cerner chairman, CEO and workflows and improving clinical outco-founder. “Through more than $4 comes. Each company will contribute billion of cumulative investments in up to $50 million to fund projects of R&D, Cerner has established a strong shared importance to both companies market standing and is positioned for and their clients. continued growth. Siemens’ healthThe alliance has a three-year initial care IT assets provide additional scale, term. Advanced workflows along with R&D, an impressive client base, and medical images and their unique role knowledgeable and experienced assoin diagnostic and therapeutic deciciates who will help Cerner achieve sion-making, will be an early focus of our plans for the next decade. In addithe joint work. tion, the alliance we’re creating will Cerner intends to finance the drive the next generation of innovaacquisition with cash on hand. The tions that embed information from the acquisition is expected to close in the EMR inside advanced diagnostic and first quarter of 2015, subject to regutherapeutic technologies, benefiting latory approval and other customary our shared clients.” conditions. The transaction has been Based on 2014 estimates, Cerner approved by the boards of Cerner and and Siemens Health Services have Siemens. • combined totals of more than 20,000 18 MEDICALDEALER | OCTOBER 2014

Staff Reports

MEDICAL PARTS FINANCE PROGRAM LAUNCHED BY CAPMED+ CapMed+ is excited to announce the launch of its patented Medical Parts Finance Program. The program provides an alternative to paying cash upfront for high-dollar value parts. This program can be used by hospitals, imaging centers, ISOs and dealers.

“We can provide rapid funding up to $250,000 which can be approved and funded in less than 4 hours. This program is designed for high-dollar value parts such as tubes, detectors, imaging intensifiers, etc.,” says Ric Arcadi with CapMed+. “We consider this an industry game changer and the response from industry leaders we have presented this to has been excitement and eye-opening for them.”

“We are breaking new ground with the creation of our Medical Parts Finance Program which will revolutionize the process of buying, using and owning CT and X-ray tubes as well as other high-dollar replacement parts,” Arcadi adds. • FOR MORE INFORMATION, visit www.capmedplus.com.

MEDICAL EQUIPMENT, PARTS & SERVICE

_News and Notes

ACERTARA ACOUSTIC LABORATORIES R&D TEAM RECEIVES U.S. PATENT Acertara Acoustic Laboratories has announced that its research and development team was recently awarded United States patent No. 8,803,532 related to a new system for testing diagnostic ultrasound probes.

“This patent represents the 15th patent our team has been awarded relative to diagnostic ultrasound system and probe testing devices,” said G. Wayne Moore, President and CEO of Acertara. “Our engineering team first developed the modern ultrasound probe testing paradigm more than 13 years ago when we introduced FirstCall at Sonora Medical Systems. It is our passion to once again redesign the probe testing market by creating disruptive technologies that match the very complex and sophisticated ultrasound probes being used today, including 2D matrix arrays. Our team is excited by the challenge of taking our test equipment product development legacy to the next level, and creating products that insure the safety and efficacy of ultrasound probes and systems. We have already made significant strides in that area by our introduction of the AureonT and Active-Z devices, both of which have multiple patents pending.”

The research and development team at Acertara Acoustic Laboratories has been awarded more than 40 United States and international patents ranging from 3D ultrasound devices to devices that deliver super-saturated levels of oxygen to myocardial tissue of heart attack patients.

Acertara Acoustic Laboratories is an independent ISO/IEC 17025:2005 accredited medical ultrasound acoustic measurement, testing, and calibration laboratory. It is a ISO13485:2003 certified probe repair and new product development facility. • FOR ADDITIONAL INFORMATION, visit www.acertaralabs.com.

SONO-WIPES DISINFECT ULTRASOUND EQUIPMENT Advanced Ultrasound Electronics has announced the availability of Sono-Wipes, a one-step disinfectant deodorizer wipe specifically made for ultrasound equipment.

The wipes are designed to be used for transducer and cable infection control and cleansing. They are safe for touch screen cleaning and sanitizing all ultrasound systems. The wipes are used without gloves and are proven effective against 47 pathogens, including MRSA, HIV and Staph.

Infection control is becoming the single most important regulation to hit the medical industry.

Most disinfectant wipes used in hospitals, clinics, and imaging centers can cause damage to ultrasound equipment, which cannot be cleaned in the same ways as X-ray machines, CT and MRI units. SonoWipes provide an option for safe infection control on ultrasound equipment.

Sono-Wipes come in 50-count packs of non-abrasive, non-damaging large (7” x 11”) moist wipes. The packs have ultra-stick technology to keep them fixed to equipment for convenient use. The wipes keep equipment looking new and sanitized. • FOR MORE INFORMATION or to place an order, visit www.auetulsa.com.

WWW.MEDICALDEALER.COM

AADCO IMAGING INTRODUCES NEW PRODUCT LINES AADCO Imaging LLC of Georgetown, Texas, is pleased to announce that it continues to retain the exclusive right to distribute all Comed/GEMSS products in the United States and Canada. The company’s master distributorship agreement with Comed/GEMSS expires in 2018.

The agreement includes all Comed/ GEMSS products that are FDA approved and offered for sale in the U.S., as well as all products approved for sale in Canada. To date, the only Comed/GEMSS product that is FDA approved is the KMC-950 C-arm.

AADCO has a running inventory of KMC-950 C-arms on hand that are ready for immediate delivery to authorized dealers.

At RSNA 2014, AADCO introduced a number of new product lines, including high-powered Monoblock C-arms, an innovative Mini C-arm, a small bore MRI Scanner and a small bore CT Scanner as well as its line of Esaote Ultrasound Equipment and other products under exclusive agreement. •

MEDICALDEALER 19

INDUSTRY UPDATE_News and Notes

VARIAN EXPANDING IN UTAH Varian Medical Systems recently broke ground on new construction that will expand its Salt Lake City manufacturing facility and allow for the consolidation of operations currently underway outside of Utah to ultimately create 1,000 new full-time jobs in the state over the next 20 years.

“Utah is home to hardworking people with immense engineering and technical talent, many of whom can be credited with Varian’s success in the manufacturing of our state-of-the-art X-ray technology,” said Dow Wilson, CEO of Varian Medical Systems. “Today we celebrate more than 45 years of Varian’s economic partnership with Utah which continues to be a sound investment for the future of our company, the state of Utah and Utah’s citizens.”

Salt Lake City serves as the headquarters for manufacturing Varian’s X-ray products and the additional space will allow for Varian’s flat panel image detector and X-ray tube product lines as well as cleanrooms, research and development laboratories, expanded manufacturing space and administrative offices.

Currently, approximately 70 percent of the orders for X-ray products come from customers outside the U.S., making Varian Medical Systems one of Utah’s largest exporters.

Currently, Varian employs 860 people in Utah. The expansion effort will add 135,000-square-feet to the existing 341,000 square foot building and is expected to generate more than $400 million in new state wages. • FOR MORE INFORMATION on Varian Medical Systems, go to www.varian.com.

Staff Reports

MEDICAL RADIOISOTOPE FACILITY COMING TO FLORIDA Coquí RadioPharmaceuticals has announced plans to build a $250 million medical radioisotope production facility in Alachua, Fla. The company expects to employ 164 people at the facility.

The 100,000-square-foot facility will stand on 25 acres of land owned by the University of Florida Foundation near Progress Park.

The facility will make nuclear radioisotopes used in medical diagnoses and treatments for diseases such as cancer, Alzheimer’s, renal disease and bone traumas.

Intermed Nuclear Medicine Owner, President and CEO Rick Staab is excited about the addition of Coquí to the Alachua, Fla., medical community.

“It will have a nuclear reactor so a lot of people want to keep it low profile, but it should be international news,” Staab says. “It will be the only place in the U.S. that does this and there are only a select few around the world and they are older and have to be shut down.”

“This is going to be a huge boost to healthcare and the U.S. and our community,” he adds.

Coquí aims to produce Mo-99, a medical isotope used in a wide variety of medical tests, including cardiology stress tests and cancer screening diagnostic treatment. These procedures require a reliable supply of Mo-99, a challenge due to its half-life of only 66 hours.

“Among the aspiring medical isotope production companies looking to build facilities in the U.S., Coquí Pharma is the only one using a design and production method already proven in the commercial markets. We know that the Coquí’s facility will bring a reliable domestic production source of these life-saving medical isotopes to the United States,” Carmen Bigles, CEO of Coquí, stated.

InterMed will benefit from being neighbors with Coquí.

“Just by it being so close to us and because we work with isotopes everyday it will be an advantage to us,” Staab says. “It will provide education and we will also have direct access to isotopes that we didn’t have before. It will increase the ability to run isotope tests around the country and that will increase business.”

The announcement also means good news for a cause close to Staab’s heart.

“They have partnered with Tyler’s Hope. They have an international reach that will be a big boost to our foundation. They are onboard with us until we find a cure (for Dystonia),” Staab says.

Dystonia is a neurological movement disorder characterized by involuntary muscle contractions, which force certain parts of the body into abnormal, sometimes painful, movements or postures.

Dystonia can affect any part of the body including the arms and legs, trunk, neck, eyelids, face or vocal cords.

Tyler’s Hope is a nonprofit organization on a mission to find a cure for Dystonia.

FIND OUT MORE at www.tylershope.org.

20 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

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MEDICALDEALER 21

SURGICAL TABLES

Go Green

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22 MEDICALDEALER | OCTOBER 2014

9/5/2014 8:50:49 AM

MEDICAL EQUIPMENT, PARTS & SERVICE

Sentinel Imaging offers a full range of new and pre-owned ultrasound imaging equipment and repair services. Our staff has over 40 years combined experience in the industry. Our professionally refurbished and reconditioned ultrasound equipment, parts and transducers enable healthcare providers to save thousands of dollars without sacrificing image quality, performance or reliability. As one of the nation’s fastest growing ultrasound refurb companies, we service all products we sell, as well as our customer’s existing equipment at a fraction of the Manufacturer’s costs.

CALL 888-838-7488 TO SAVE YOUR PRACTICE THOUSANDS OF DOLLARS ON PREMIUM IMAGING EQUIPMENT AND SERVICE! Introducing our newest facility the Sentinel West Coast Division, located in Chandler Arizona. Focusing on buying and selling refurbished Transducers by name brands like GE, Philips, Hitachi and Siemens.

Thousands of items in-stock all backed by our Iron Clad, Full Service Warranty and ready for overnight shipment. Call 480-303-0026 for a no hassle quote.

Sentinel is one of the only independent groups in the industry that specializes in the refurbishing and repair of BK Urology and Surgical Transducers.

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INDUSTRY UPDATE_OEM Updates

Staff Reports

CARESTREAM ANNOUNCES CEILING-MOUNTED TUBE OPTION FOR IMAGING SYSTEM Carestream has added a ceiling-mounted tube option for its DRX-Ascend System to provide versatile positioning for a variety of imaging exams. The system also offers a floor-mounted tube stand, wall stand and a choice of an elevating float-top table or non-elevating table.

“The DRX-Ascend delivers cost-effective, fully featured imaging that allows hospitals, imaging centers, orthopaedic practices and urgent care clinics to select a configuration that satisfies their imaging workflow and budget,” said Heidi McIntosh, Global Marketing Manager for X-ray Solutions. “DRX-Ascend users and other healthcare providers are interested in a ceiling-mounted tube because it can deliver flexible patient positioning that helps technologists perform imaging exams in less time, which can lead to greater productivity.”

The system can be configured with DRX-1 and DRX-1C detectors. Both detectors fit into the

standard Bucky used in X-ray wall stands and tables. In addition, Carestream’s small-format 25 x 30 cm detector, the DRX 2530C, can be used for orthopaedic and tabletop exams.

Customers can also opt to install a fixed 43 x 43 cm detector for the wall stand.

The multi-color touch panel screen mounted at the tube stand gives technologists remote generator control, displays image previews and allows review of previous images for the current patient. The DRX-Ascend system offers several detector holders to help technologists perform cross-table lateral exams as well as other specialty views. Facilities can use a single DRX detector with the system or opt for two or more detectors to maximize productivity and efficiency.

The DRX-Ascend offers users the benefits of image processing software and a consistent user interface across Carestream’s computed radiography (CR) and digital radiography (DR) systems. •

FDA CLEARS FIREFLY FLUORESCENCE IMAGING FOR THE DA VINCI XI SURGICAL SYSTEM Intuitive Surgical Inc. has announced ket advanced technologies for vessel uses the Firefly System in conjunction the FDA clearance of Firefly Fluosealing and stapling for use with the da with an injectable fluorescent dye, tisrescence Imaging for the da Vinci Xi Vinci Xi System. All three technologies sue with blood flow is highlighted in a Surgical System, which provides surwere previously cleared for use with green color and tissue without blood geons with enhanced visualization the da Vinci Si System. flow appears gray in the surgeon’s view. during minimally invasive surgical The Firefly Imaging System enables The Firefly System is intended to be procedures. Firefly Imaging has been real-time visual assessment of vessels, used for biliary duct visualization in available since 2011 as an optional blood flow and related tissue perfusion. conjunction with standard, visible light feature for the da Vinci Si System, It also enables assessment of the major in bile-duct imaging and where indiand this clearance means that Fireducts that connect to the gallbladder for cated, X-ray examination of the bile fly Imaging will now ship with all da transport of bile, a digestive fluid. This ducts during surgery. • Vinci Xi Systems. assessment is helpful during surgical This marks the third significant U.S. removal of the gallbladder. The FireFOR MORE INFORMATION about Firefly FDA clearance for products supportfly System enables surgeons to switch Fluorescence Imaging and the da Vinci Xi ing the da Vinci Xi System since its U.S. between standard, visible light and Surgical System, visit intuitivesurgical.com. launch in April. The first and second near-infrared imaging during minimally clearances allow the company to marinvasive procedures. When a surgeon

24 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Updates

PHILIPS RECEIVES FDA 510(K) CLEARANCE FOR TAVI PRECISION TREATMENT PLANNING APPLICATION

TOSHIBA MEETS DEPARTMENT OF DEFENSE NETWORK SECURITY GUIDELINES

Toshiba America Medical Systems Inc.’s MR systems have received approval to operate (ATO) with the U.S. Air Force. This makes Toshiba the only manufacturer to have fully certified MR systems (Vantage Titan 1.5T and Vantage Titan 3T) for use on the Air Force Network. This follows the recent Air Force ATO for Toshiba’s CT systems.

By achieving ATO status, Toshiba met the Air Force and Defense Health Agency’s Platform Information Technology guidelines for ensuring protection of Patient Health Information and guarding against malware, viruses and malicious attacks. To meet these requirements, Toshiba enhanced its MR platform to include Microsoft Windows 7 and application whitelisting software to proactively identify and prevent viruses and malicious solicitations.

“Toshiba understands its customers’ business and makes data security one of its highest priorities,” said Beverly Plost, director, MR Business Unit, Toshiba. “This approval is proof that when a customer partners with Toshiba, they are getting the same protection and security expected by our nation’s armed forces.” • WWW.MEDICALDEALER.COM

Royal Philips has announced that it has received 510(k) clearance from the U.S. Food and Drug Administration to market its precision planning application for Transcatheter Aortic-Valve Implantation (TAVI) treatments. Through 3D imaging, the Philips TAVI application provides interventionalists with pre-procedural, high-precision positioning to treat aortic stenosis ailments.

The Philips TAVI planning application is available as part of Philips IntelliSpace Portal 6 – the company’s advanced visualization and analysis solution that allows clinicians to access and analyze patient imaging and data virtually anywhere, at any time. The application features a comprehensive measurement package to accommodate virtually all types of TAVI devices.

“As our population ages, minimally invasive TAVI procedures are becoming increasingly popular in the United States, since they provide a non-surgical option for those patients who might have once been considered too high-risk for heart surgery,” said Gene Saragnese, CEO, Imaging Systems, Philips Healthcare. “Treating cardiac conditions requires intense precision and our TAVI planning application delivers a solution for aortic device placement to help improve patient care.”

Through advanced computed tomography imaging, the TAVI planning application provides planes and panel measurements for precisely placing TAVI devices to manage the risk of under- or oversizing of a TAVI device. It renders images into a 3D heart model to allow interventionalists to orient the device and address less-than-optimal patient cases.

FOR MORE INFORMATION on Philips IntelliSpace Portal 6 with TAVI application, visit www.usa.philips.com/healthcare.

MEDICALDEALER 25

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MEDICALDEALER 27

INDUSTRY UPDATE_Block Imaging

By David Harns

AEC SYSTEMS FOR GE CT SCANNERS: AutomA VS. SmartmA

Y

ou probably already know that automatic exposure control (AEC) is an excellent way to help reduce the radiation dose to the patients you scan with your CT scanner. What may still be confusing you are all the different names for AEC systems.

In the case of GE CT scanners, the AECs are called AutomA and SmartmA. Cool names, huh?

Everyone loves it when something is done for them AutomA-tically, and if SmartmA is half as smart as your smartphone, it's gotta be awesome too, right? Of course. But high-tech sounding proprietary names won't tell us how these controls work and what makes them different from one another. So, let's break it down.

AutomA VS. SmartmA AutomA and SmartmA are essentially two sides of the same radiation dose-reducing coin. Both controls adjust mA up or down over the course of a scan to optimize dose on a patient-by-patient basis. The biggest difference is what triggers adjustment from each of them.

AutomA AutomA changes dose based on the radiation attenuation of tis28 MEDICALDEALER | OCTOBER 2014

of softer tissues, AutomA will turn the mA down. This results in a significantly lower overall radiation dose than leaving the mA at "bone level" for the entire scan.

SmartmA SmartmA does very much the same thing – adjusting dose up or down to the optimum level for any given point in a scan. However, instead of responding to attenuation, SmartmA changes dose based on variations of the position of the X-ray tube relative to the patient within each gantry rotation (X and Y axes). If the tube is closer to the patient, the dose turns down. If it's further, it turns up to compensate for the distance.

David Harns is a CT Product Specialist for Block Imaging

sues along the length of the patient's body (Z axis). For example, bony areas, like the upper chest or around the hips and pelvis, will need a higher mA to get a clear image. AutomA will increase the mA in those areas. In areas like the abdomen, which are comprised

PREREQUISITES Another notable difference is that you can't have SmartmA without AutomA. In fact, a GE CT system will only allow SmartmA to be activated after AutomA has already been activated. This is because SmartmA is informed in part by the information gathered

by AutomA. A tube's proximity to the patient is only part of the picture.

Consider this as an example: the MEDICAL EQUIPMENT, PARTS & SERVICE

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stomach of an obese patient will be closer to the tube at the apex of a rotation than the stomach of a thinner patient.

Without the attenuation analysis of AutomA, SmartmA would turn the dose down over the stomach and the mA would not be high enough to penetrate the thicker layer of fat tissue.

With AutomA and SmartmA working together, the system is fully informed and able to lower doses while maintaining consistent image quality across all portions of a scan.

Both AutomA and SmartmA are available on GE's Lightspeed, Brightspeed, and VCT product lines. CT scanners from other manufacturers have these same functions, but they are known by other sets of proprietary names. Hopefully, for those of you considering a GE CT scanner, this explanation has lent some clarity to your pursuit of radiation dose reduction. AECs are only a piece of the puzzle, but a crucial one.

DAVID HARNS is a CT Product Specialist for Block Imaging.

WWW.MEDICALDEALER.COM

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MEDICAL EQUIPMENT, PARTS & SERVICE

Is this the only thing preventing your equipment from failing?

Have your CT volumes dropped, and now you need a cost-effective service alternative?

Consensys Imaging Service, Inc. specializes in FDA-compliant diagnostic imaging equipment service nationwide. Our quality management system is certified to both ISO 9001:2008 and ISO 13485:2003 (medical device specific) international quality standards. With our robust Radiation Safety and proprietary Power Quality programs, you can rest easy knowing that your CT meets all the regulatory requirements. Call today to learn how we can help you save money, without compromising quality service.

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PRODUCT FOCUS_Radiology_Market Analysis

Staff Reports

CT MARKET TO EXCEED $5 BILLION

A

CT scan, or computerized tomography scan, is a detailed X-ray used to produce three-dimensional images of the body, according to the Mayo Clinic Health System. This type of medical imaging allows doctors to peek inside the body without having to perform surgery.

CT scans are used for many diagnoses, including internal injuries from a car wreck or another type of trauma. CT machines can be used to make images of all body parts making them a valuable healthcare tool.

The total CT market was estimated to be about $4.05 billion in 2010 and is expected to grow at a compound annual growth rate of 4.48 percent through 2016, according to MarketsandMarkets.com. The growth is expected to power the CT market to $5.25 billion by 2016.

Derek Stovesand with International Medical Equipment and Service expects a shift in the CT market.

“It will be interesting to see how the global market changes given that some aspects of the technology have slowed down, like slice platforms and image reconstruction, but low-dose capability and connectivity are certainly the drivers of any innovation in the near future,” Stovesand said. “Some of this technology may be able to be retrofitted to existing systems, which can change how we procure equipment as well as our customers’ demands.”

However, he expects an increase in demand for CT devices to fuel WWW.MEDICALDEALER.COM

the U.S. market in the near future.

“We’ve seen a lot of healthcare providers cinch their belts over the last five years, so there is surely pent up demand that will drive the market in the coming years as clarity comes to some of the regulations and reimbursements,” Stovesand said. “The unknowns about the economy and ACA legislation made a lot of purchasing choices especially difficult, often paralyzing a hospital or at least delaying fiscal decisions. As the market slowed, reliability and quality in an equipment provider became even more crucial. I believe that no matter how the market recovers and grows from here, those will continue to be the chief considerations in the purchasing process.”

Yet, Stovesand said strict budget restrictions are not going away.

“It’s difficult to say exactly what the effects (of ACA) have been in reality. Ostensibly, everyone needed to watch their budgets and look for ways to save costs in capital equipment purchases and service solutions because the fiscal and administrative pain was imminent,” he said. “Whether the reality bore

out that way, or if the collective apprehension was a self-fulfilling prophecy, it really doesn’t matter: tighter budgets are here to stay.”

The CT market makes up a portion of the overall diagnostic imaging market that is expected to grow at a steady rate through 2018, according to a separate MarketsandMarkets.com report. The overall diagnostic imaging market is forecast to grow at a CAGR of 4.7 percent from 2013 to 2018.

Driven by supply-side initiatives to improve workflow, enhance image quality and reduce patient discomfort, the global CT market is expected to increase to $5.9 billion by 2019, according to a press release from GBI Research.

The GBI report “CT Systems Market to 2019 – Lower Radiation Dose and Improved Workflow in Advanced CT Systems to Increase Adoption Rates” states that four companies combined to account for more than 75 percent of the CT market in 2012. These were GE Healthcare, Siemens Healthcare, Toshiba Medical Systems Corp. and Philips Healthcare.

The big four highlighted in the GBI report appear to be focused on expanding their manufacturing facilities into developing countries such as India and China in order to increase revenue.

MEDICALDEALER 33

PRODUCT FOCUS_Radiology_Product Showroom

Staff Reports

OCTOBER PRODUCTS : This month, Medical Dealer explores current trends in CT.

GE REVOLUTION CT

R

evolution CT was designed from the ground up, providing uncompromised image quality and clinical capabilities across all clinical areas through the convergence of whole organ coverage, speed and image quality, all in one CT system. Traditionally, there have been trade-offs in the industry where all three were not achieved in one system. •

34 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

CT_Product Showroom

SIEMENS HEALTHCARE SOMATOM PERSPECTIVE

T

he single-source SOMATOM Perspective CT system – available in 16-, 32-, 64- and 128-slice configurations – is designed to drive efficiency and reduce costs for community hospitals, critical access hospitals and outpatient centers, enabling them to extend the range of available examinations at reduced radiation dose. The SOMATOM Perspective covers all clinical fields, including cardiac imaging with iTRIM (Iterative Temporal Resolution Improvement Method) technology that increases temporal resolution to 192 ms. The system’s new 16-slice configuration is ideal for facilities that conduct high-volume routine scanning. The new 32-slice configuration is designed to provide more detailed imaging for bone fractures, inner ear examinations and vascular applications. •

WWW.MEDICALDEALER.COM

MEDICALDEALER 35

PRODUCT FOCUS_Radiology_Product Showroom

Staff Reports

PHILIPS HEALTHCARE INGENUITY ELITE WITH IMR

P

hilips Healthcare’s Ingenuity Elite with IMR integrates high performance imaging technology with the ability to customize patient care. With the only performance CT scanner configurations with access to model-based iterative reconstruction techniques, the Ingenuity Elite with IMR enables radiologists to deliver low-contrast resolution with IMR, personalized image quality and dose with SyncRight and improved visualization in the presence of large metal orthopedic implants. Philips’ patient-focused advanced imaging technology enables customization now with the flexibility to transform in the future. •

36 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

CT_Product Showroom

TOSHIBA AQUILION ONE FAMILY

T

he Aquilion™ ONE Family systems match current clinical needs with a field-upgradable path for the future. The Aquilion ONE 320 – 8 cm, single rotation scan at 0.35 second rotation speed allows for optimal speed and efficiency.

The Aquilion ONE 640 – Single 640-slice rotation covers 16 cm, allowing full-organ imaging in a comprehensive CT scan. The Aquilion ONE ViSION – Combines the capabilities of the Aquilion ONE 640 with higher volume capabilities, delivering matchless functionality. •

WWW.MEDICALDEALER.COM

MEDICALDEALER 37

VENDOR Q & A_Med/Surg_CT

Staff Reports

VENDOR Q&A: CT M

edical Dealer keeps you updated on the latest in medical devices and equipment. This month, Consensys Imaging® President and CEO Jim Spearman shares his expert knowledge on CT and what healthcare facilities should look for when they are in the market for an upgrade or a service provider.

What are the most important things to look for when seeking service for a CT system?

CT is a critical care modality and thus comes with critical criteria for proper maintenance and emergency service requirements. CT makes ionizing radiation and thus requires compliance with state regulations for X-ray certified service. The service engineer must be registered with the state in which service is being performed.

Another important element is the quality of replacement parts. Should the CT unit ever be involved in an adverse patient event, the formal investigation will include checking the maintenance records as well as the part replacement history. Most replacement parts, even those supplied by the OEM, are often repaired to original specifications multiple times before the part is finally retired and taken out of service circulation.

It will be critical that the service provider can demonstrate definitively what the test results were for the last repair of all parts installed in the unit by their engineer(s).

Clearly, with CT being a critical modality, it’s very important that the service provider has a positive track record of high-quality service. One way to investigate this is to look at the details of the service report, does it clearly explain what was done to effect the repair and what parts were replaced during the service event?

38 MEDICALDEALER | OCTOBER 2014

The final area to investigate is the training documentation of the service engineer.

Has the engineer been formally trained and certified to work on the exact CT platform for which you’re seeking service. If not, you could open your organization to unnecessary legal liability.

Is it possible to keep up with the latest CT technology without buying brand new?

This is an interesting question because it’s more a factor of what clinical setting the unit will be deployed versus just outright advancements in technology. For example, consider radiation oncology. Historically, CT sim or SPECT/CT was the leading technology standard. There is a current trend towards deploying diagnostic CTs instead of CT sim units for use in the radiation oncology space in order to utilize the unit for other studies and improve the ROI of the investment. A well cared-for, secondhand 16-slice CT unit from any of the major manufactures will perform very well in this role. Thus, there is no need to buy brand-new to meet the needs of this clinical setting. An older unit will give added capability compared to the typical four and eight-slice units, historically deployed in this care area.

For more high patient volume, diagnostic clinical settings, platforms launched within the last five or so years also perform very well since the major

Jim Spearman

OEMs have improved image quality while significantly lowering dose. Now that the “Slice Wars” are over, much of the technology deployed on 64-slice units in the past few years is more than adequate for the majority of diagnostic clinical settings. There are also software upgrades available from the OEM for specific clinical needs that are typically compatible with these older units. Again, a well-maintained 64-slice unit from a major manufacturer is a great platform to consider versus buying brand-new.

Describe your CT service offerings.

Consensys Imaging Service Inc.® is a high-quality alternative to OEM CT equipment service and maintenance with a national footprint. Our service offerings are similar to what you would typically see from your favorite OEM. They range from “Planned Maintenance-Only” up to and including “Full Service” with unlimited tube coverage. One of our core strengths is a vast database of intellectual property in all four of the modalities we service and CT is no exception. Because we service units from the major manufacturers in hospitals and other high-use settings, we have developed a knowledge database of failures that even the OEMs may not be aware of and we make that information available to all of our engineers.

MEDICAL EQUIPMENT, PARTS & SERVICE

CT _Vendor Q & A

As soon as a problem is identified on any platform, our entire team knows about it immediately and we often notify the OEM as well if there are patient safety implications.

All of our engineers are Consensys CertifiedTM and must maintain that certification over the entire time they are assigned to care for your CT unit. Even if our engineer was initially trained by the OEM, he or she must re-certify at regular intervals depending on how their initial certification was obtained.

Consensys® also holds both ISO 9001:2008 and ISO 13485:2003 quality certificates. This means our entire operation, including part supply, operates like an OEM and is in full compliance with all state and federal medical device regulations, including all FDA requirements. All of these elements enable Consensys® to deliver OEM-level service support without the OEM price-tag.

Finally, experience has taught us that the quality of the power to the CT can be a major culprit of extended down-time, intermittent problems and/or frequent system failures. As a result, we developed a proprietary “Power-Quality” program that comes standard with all of our full-service contracts. The program is so sophisticated that a power company in Pennsylvania conducted side-by-side testing at a hospital with us and opted to discard their test data and use ours as our program properly identified the source of the problem at the root-cause.

What kind of custom options do you offer?

Our business philosophy is to be a trusted partner in everything we do with our customers. Due to the tough economic challenges everyone has faced over the past several years, we’ve been extremely collaborative and flexible in our service offerings. CT tubes are one of the most significant expenses in keeping a CT running well. We’ve created offerings where customers can take some calculated risks in order to save on contract cost by limiting the number of tubes we cover over the life of the contract. We’ve also trained in-house engineers per our FirstLookTM WWW.MEDICALDEALER.COM

All of our engineers are Consensys CertifiedTM and must maintain that certification over the entire time they are assigned to care for your CT unit. Even if our engineer was initially trained by the OEM, he or she must re-certify at regular intervals depending on how their initial certification was obtained. service offering where we still provide back-up on-site support, telephone tech support and all parts including tubes for the life of the contract term.

Flexibility of service offerings have been cited by many of our customers as the reason they renew their contracts for longer terms and add other assets to expand the partnership. Consensys® has demonstrated that it has truly been a trusted partner for many years with large IDNs as well as independent imaging centers nationwide.

How do you convince dept. directors that a reputable, independent service company could provide the same level of service as the OEM? There is never a substitute for experience and Consensys’ customers are our best advertisement in response to this concern. Any service provider can make claims, but the proof is in the delivery and ultimately the customer’s direct experience. We strongly encourage any prospective customers to investigate our references, many of whom are very large and nationally recognized healthcare institutions including several of the “Top 100 Hospitals” as published annually.

Customer satisfaction is an internal metric we monitor at Consensys® and while we believed we were doing a good job for our customers, we launched a customer survey program earlier this year to know for sure.

What we found through 1,178 surveys confirmed that we were not only doing a good job, we were doing a great job because we only received two complaints.

Quality and competence of service are the additional critical factors to consider when looking for an alternative to an OEM service contract. Think about what could go wrong and how the service provider can support you when it does. Can your service partner provide FDA-compliant records and documentation for their service engineers’ training on your exact CT, maintenance records of the unit to OEM specifications and traceability of every part that was installed? Joint Commission inspections will require most of what the FDA will require in an adverse patient event scenario, so these are critical points to investigate. Is the engineer servicing your unit nearby and can they respond in a timely manner?

Consensys® is an approved supplier to four of the major OEMs and we deliver warranty service nationwide for one of them on their brand-new devices. If you’ve purchased any of their units, you may already be receiving Consensys® service during your warranty period! Needless to say, there are truly high-quality alternatives available to OEM service contracts, Consensys Imaging Service® is one of them.

MEDICALDEALER 39

PRODUCT FOCUS_Radiology_Preferred Vendors

Staff Reports

PREFERRED VENDORS

CT

Consensys Imaging Service, Inc.® 615 Industrial Dr. Cary, IL 60013 Phone: 847-462-2030 Fax: 847-462-2198 Email: support@consensysimaging.com Website: www.consensysimaging.com

Injector Support & Service, LLC Office/Fax: 888-667-1062 Cell: 407-312-2253 Email: Ryan@injectorsupport.com Website: www.injectorsupport.com

Consensys Imaging Service, Inc.® is a Galen Partners portfolio company specializing in diagnostic imaging equipment service, with a national foot-print. Utilizing proprietary tools, technology and extensive experience, we deliver world-class equipment relocation, emergency repair and maintenance services for MRI, CatScan, Mammography and Ultrasound devices. Consensys is an FDA-compliant, long-term service partner with hospitals, imaging centers, veterinary clinics, OEMs and imaging service providers nationwide.

Ed Sloan & Associates 508 Kasper Way Goodlettsville, TN 37072 Toll-free: 888-652-5974 Phone: 615-448-6095 Fax: 615-448-6099 Email: sales@ed-sloanassociates.com Website: www.edsloanassociates.com

Injector Support & Service serves its’ customer base by providing professional, timely and superior support and service for medical contrast injectors for CT and MRI equipment. From biomedical technical support with parts identification and sales to preventative maintenance with calibration verifications, ISS is dedicated to providing only the very best in contrast injector support and service.

Intermed 13351 Progress Blvd.

Alachua, FL 32615 Phone: 800-768-8622 Fax: 386-462-5330 Email: sales@intermed1.com Website: www.intermed1.com SEE OUR AD ON PAGE 54

Over 25 years of experience and a staff of industry professionals allows Ed Sloan & Associates to offer unparalleled service in the area of GE CT and MRI systems, parts and service.

• Quality tested parts • 48,000 square foot facility • MRI and CT QA Bays • CT and MRI Systems • Service on and T&M or Contract Basis

40 MEDICALDEALER | OCTOBER 2014

SEE OUR AD ON PAGE 42

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MEDICAL EQUIPMENT, PARTS & SERVICE

CT_Preferred Vendors

International Medical EQUIPMENT & SERVICE

Hometown Feel, Global Reach

International Medical Equipment & Service, Inc. 8190 Regent Parkway Fort Mill, SC 29715 Phone: 704-739-3597 Fax: 704-259-4008 Email: Info@IMESimaging.com Website: www.IMESimaging.com

SEE OUR AD ON PAGE 43

IMES provides reliable, cost-saving solutions for all of your diagnostic imaging systems and parts needs. Inside our 24,000 sqft warehouse, we stock and test parts from all OEMs and modalities. IMES is an unmatched source of quality, inventory availability, and hands-on service training—all backed by 24/7 technical support and customer service.

J & M Trading, Inc. SEE OUR 409 Space Park North AD ON PAGE 71 Goodlettsville, TN 37072 Toll-Free: 866-568-7234 Phone: 615-851-4229 Fax: 615-851-1842 Email: SmartMedSolutions@gmail.com Website: www.jandmtrading.com

J & M Trading offers over 35,000 square feet of quality tested parts, tubes, systems and ideas for diagnostic imaging, including but not limited to: X-ray, CT, MRI and NucMed. We provide repairs and deinstallations, and tube reprocessing. Continuous 24x7/365 customer service. All parts warrantied and ready to ship same day. Competitive pricing and discounts throughout the year.

WWW.MEDICALDEALER.COM

Metropolis International LLC 21-11 44th Avenue, 3rd Floor Long Island City, NY 11101 Phone: 718-371-6026 Fax: 718-371-6032 Email: info@metropolismedical.com Website: www.metropolismedical.com

SEE OUR AD ON PAGE 43

Metropolis International LLC is one of the largest stocking dealers of all types of quality pre-owned diagnostic imaging equipment. With over 45 years of combined industry experience, we work with all X-ray, C-arms, CT, mammography, DEXA, MRI, ultrasound systems. Located in New York, in a large warehouse, we provide vendors, dealers and end-users, with equipment and services that are second to none!

M.I.T. / Medical Imaging Technologies 261 Quality Drive Thomson, GA 30824 Phone: 800-729-4776 Fax: 706-843-9638 Website: www.mit-tech.com

SEE OUR ADS ON PAGES 29 & 69

M.I.T. has been providing top quality products and service for over 25 years. We sell and service all diagnostic imaging equipment. We can provide full service on your equipment.

We pride ourselves on doing whatever it takes to get your equipment fixed as soon as possible.

MEDICALDEALER 41

PRODUCT FOCUS_Radiology_Preferred Vendors

TECHNICAL

Staff Reports

PROSPECTS

Experts in Siemens Medical Imaging

Technical Prospects, LLC 1000 South County Road CB Appleton, WI 54914 Toll-Free: 877-604-6583 Phone: 920-757-6583 Fax: 920-757-6591 Email: sales@technicalprospects.com Website: www.technicalprospects.com

SEE OUR AD ON PAGE 65

At Technical Prospects, we are experts in Siemens Medical Imaging because Siemens is all we do. We offer training, technical support, preventative maintenance, and high quality replacement parts. We also buy your used Siemens equipment. We have moved way beyond a parts company. Technical Prospects is a Siemens Imaging Solutions Center.

SEE OUR AD ON PAGE 31

Tri-Imaging Solutions 756 Hickory Industrial Drive Old Hickory, TN 37138 Toll-free: 855-401-4888 Email: sales@triimaging.com Tri-Imaging Solutions is a replacement parts, equipment, and technical support company. We provide quality tested CT & X-ray parts, buy and sell equipment, and provide technical support. All replacement parts come with a 90-day warranty.

Available 24/7/365.

Injector Support & Service Providing professional, timely and superior support and service for medical contrast injectors. injectorsupport.com 888.667.1062

42 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

BEST CHOICE IN IMAGING SYSTEMS

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MEDICALDEALER 43

WE PUT THE "WE" IN WEALTH

We’d like to say we put the “we” in wisdom... but there’s no darn “e” in there!

Wisdom like: knowing we’re in this together. It saves to update your used devices. Classic can earn you thousands by closing your downtime window. In fact, we supply free technical support and Parts ID on most OEM products. Whether it is a part from stock, a refurbished component, Biomedical device support, or a complete system refurb – it all adds up to wealth for you.

ASK US ABOUT CLASSIC KNOWHOW THAT SAVES. FACEBOOK: SEARCH FOR CLASSIC IMAGING TWITTER: FOLLOW @CLASSICIMAGING REMADE IN AMERICA

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Highly tested…always trusted medical imaging parts 800.726.2314 www.troffmedical.com

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MEDICAL EQUIPMENT, PARTS & SERVICE

Repairable 9800/9900 HV Cable Cores Call or email us the condition of the cable(s) and we will submit an offer to purchase the part. We will then inspect and test the part to see if it can be repaired. If it is deemed repairable, we will process the transaction and mail you a check the next day.

Email photos and requests to: info@eng-services.com 330.425.9279 X.11 Kenneth C. Saltrick www.eng-services.com

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PRODUCT FOCUS_Med/Surg_Market Analysis

Staff Reports

SPECIALTY OPERATING TABLES TO FUEL MARKET GROWTH

S

urgical suites and operating rooms are high-tech areas where life-saving surgeries occur on a daily basis. The advances in tools include robots that perform surgeries with the assistance of a human surgeon, the latest in lighting technology and high-definition monitors that exceed anything one might find in an electronics store.

It is understandable that with all of the high-tech equipment and devices needed to perform surgery that the most fundamental tool – the operating table – is often overlooked or taken for granted. Yet, the market for operating tables is expected to grow over the next five years fueled by competition, new advances and an aging population.

As the U.S. population ages, particularly baby boomers, more and more surgeries are being performed in hospitals and in surgical centers. The increase in surgeries is a cause for the growth of the operating room equipment market that includes surgical booms, lighting systems, surgical imaging displays, OR integration systems and operating tables.

A report from Transparency Market Research indicates that the operating table market can be divided into two areas – operating tables and specialty operating tables.

The operating tables segment was the largest segment in 2012 accounting for almost 31 percent of the market. However, the demand for WWW.MEDICALDEALER.COM

specialty tables is expected to drive the market in coming years.

“During the forecast period 2013 to 2019, the demand for general operating tables is expected to be stagnant or very slow and the overall growth will be offset by the increasing demand of specialty surgery tables,” according to the report.

Advances, including the demand for hybrid operating rooms, are expected to promote growth in the overall market.

“Some of the major factors expected to drive growth of the OR equipment market during the forecast period include increasing numbers of ambulatory surgical centers across the globe, rising demand for a wide range of modern operating room equipment and a growing trend for adopting hybrid operating rooms,” according to Transparency Market Research.

A report by CompaniesAndMarkets.com predicts the global market for operating tables will reach $866.7 million by 2020.

“Global market for operating tables is witnessing steady

growth buoyed by rising incidence of ailments that require surgery, increasing demand for innovative, state-of-the-art operating tables, increase in the number of hospitals with next generation healthcare infrastructure, and growing number of Ambulatory Surgery Centers,” according to CompaniesAndMarkets.com. “Currently, demands for ergonomic and versatile operating tables featuring a range of patient positioning accessories are gaining in popularity. While increasing population drives growth in developing countries, the expanding base of an aging population in developed markets offers robust opportunities since advancing age increases the prevalence of health ailments.”

An increase in the number of obese patients is also impacting the market as specialty tables are needed that can accommodate heavier patients. Tables that can be used for more than one type of procedure are also impacting the market.

“Against a backdrop of increased emphasis in cost savings and enhanced productivity, there is a clear trend toward operating tables that can be configured easily to suit various surgical disciplines,” according to CompaniesAndMarkets.com.

MEDICALDEALER 47

PRODUCT FOCUS_Med/Surg_Product Showroom

Staff Reports

OCTOBER PRODUCTS : This month, Medical Dealer explores current trends in Operating Tables.

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MEDICALDEALER 49

PRODUCT FOCUS_Med/Surg_Product Showroom

Staff Reports

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he OPERON D860 offers exceptional lift capacity and height adjustment to accommodate almost any working level, allowing for gentle patient positioning and safety no matter the surgical discipline or body type. Some key benefits of the D860 are an industry-leading patient weight capacity of 1,250 pounds and a vertical range of a 22.6-inch minimum height to a 46.4-inch maximum height. The table features a lateral imaging window of 18.3 inches. Other features include a carbon fiber table surface construction, multiple therapeutic surface options and InstaDrive increases mobility and maneuverability. •

50 MEDICALDEALER | OCTOBER 2014

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MOBILIZED THE INFRASTRUCTURE IMPACT OF MOBILE DEVICES on the delivery of healthcare …

By Matthew N. Skoufalos

I

n Burgama, Turkey, on a visit to the Asklepion, the premier hospital of the ancient world, the notion crystallized for Thomas Martin.

Amid the historic ruins of one of the most famous landmarks of medicine, a place where the ailing and their caregivers drank from healing springs, bathed in mineral spas, prayed for divine intervention, and interpreted dreams, Martin took the measure of the mood, and noted that it was, foremost, a meeting place.

“Healthcare has always been about having a conversation,” Martin said. “Sitting there among the ruins of what was formerly a hospital two or three thousand years ago, it became clear to me that, at the fundamental level of healthcare, we’re having conversations.”

MOBILIZED

ways in which providers are engaging in the mobile space is with their personal devices.

Martin is the Director of Health Information Systems for the Chicago-based Healthcare Information and Management Systems Society (HIMSS), a nonprofit policy group dedicated to health IT. What he realized in Turkey is that the most prominent way in which those conversations have changed since the

}

One of the most common

95% 95% 70-80%

that analyzes trends in mobile healthcare technology and offers guidance on its implementation, sees that beyond just connecting doctors and patients for consultations or transmission of prescriptions, mobile healthcare is about, systems access, patient monitoring and geriatric care.

of providers have a smartphone Are using a tablet of sorts, if not in a clinical setting

simplicity in mobile devices that you don’t necessarily have in a desktop architecture.”

“In Windows, there’s three different ways to do one task,” he said. “Mobile has simplified the approach; if an app serves a purpose for [users], they’re going to continue to use it.”

Providers have gotten really advanced in terms of selectivity of mobile applications and what works for them. There’s an opportunity to have a larger conversation.

— Thomas Martin, Director of Health Information Systems, Healthcare Information and Management Systems Society (HIMSS)

age of Galen is that they’ve become more sophisticated, numerous, and, with the infusion of mobile devices, more clear overall.

“Technology has come a long way from simple tracking applications to things that are far more sophisticated,” Martin said.

The HIMSS mHealth Roadmap, a 2013 best practices document 58 MEDICALDEALER | OCTOBER 2014

According to the Roadmap, the World Health Organization reported 83 percent of its member nations offered at least one such mHealth service in 2011, with many providing “four to six specific mHealth initiatives” on a nationwide scale.

That owes, at least in part, Martin said, to the “real focus on

“The really interesting question with mobile is how do we grow an evidence base that supports it,” Martin said, “and how do we provide adequate time and money so that patients can be monitored more broadly?”

Martin believes one of the key areas into which mobile healthcare should push in the immediate MEDICAL EQUIPMENT, PARTS & SERVICE

future is population health management. In terms of the use of administrative resources, he said, developers are out to prove that a mobile approach can deliver better health outcomes, even in the absence of “clear-cut reimbursements.”

“It’s an opportunity to rethink some of these population management tools as mechanisms that provide updates,” he said.

One of the most common ways in which providers are engaging in the mobile space, Martin said, is with their personal devices (i.e., tablets and smartphones). About 95 percent of providers have a smartphone; another 70 to 80 percent are using “a tablet of sorts, if not in a clinical setting.”

Rough estimates taken from a sample of about 500 physicians and nurses showed that they downloaded five medical applications to their devices on average. Martin WWW.MEDICALDEALER.COM

further observed “a fairly high willingness to pay” a price of around $30 for software “that really meets all of their criteria.”

“I think your home screen is increasingly becoming a very valuable piece of real estate,” Martin said, adding that applications offering “contextual information that’s relevant at the right time” have an advantage over non-mobile delivery systems.

That means developers playing in that space have a chance to make some money, he said, but there’s very little room for error.

Products have to be “focused on one specific workflow or item and do that well.”

“Providers have gotten really advanced in terms of selectivity of mobile applications and what works for them,” Martin said.

“There’s an opportunity to have a larger conversation.”

Bakul Patel, Senior Policy Advisor at the FDA Center for Devices and Radiological Health, agreed that part of the reason for the rise in mobile healthcare technology is owed to the ubiquity and power of computing technologies in handheld devices that can be harnessed for various applications.

As computing has gone mobile, Patel said, so has workflow.

Because consumers now have access to more healthcare information from their phones, providers have to be savvy with and accessible by email, text message, even multimedia chat, all of which “has opened up a different type of care in the clinical setting.”

“There’s a whole bunch of things from the consumer side that remind them to be preventative,” Patel said. “There are a lot of behavioral changes that are occurring, and the mobile technologies MEDICALDEALER 59

MOBILIZED

“Once upon a time, an EKG machine used to be the size of a small room.

People have made attachments to smartphones that can do the same thing. We want people to come up with better and more efficient medical device technology.”

— Bakul Patel,

Senior Policy Advisor, FDA Center for Devices and Radiological Health

60 MEDICALDEALER | OCTOBER 2014

are helping with a lot of that. We are in the midst of the cultural change for healthcare.”

By placing the clinical functionality of maintenance issues like glucose metering and blood pressure tracking — both of which can be coordinated via iPhone-ready peripheral devices— in the hands of patients, “we think these things are helping the healthcare process to get people to manage their conditions,” he said.

Advancements in the miniaturization of healthcare technology do not only extend to home healthcare for the management of chronic conditions.

There are ultrasound viewers, spirometers, microscopes, otoscopes, even electrocardiograms that are smartphone-powered, and additional technologies are always on the way.

“Once upon a time, an EKG machine used to be the size of a small room,” Patel said. “People have made attachments to smartphones that can do the same thing. We want people to come up with better and more efficient medical device technology.”

At the same time, he said, the FDA reminds developers that, whatever device they’re manufacturing, patient safety is a primary concern. From one perspective, making an EKG device that fits on a mobile platform means exposing it to all the drawbacks of operating on a mobile platform, including concerns about battery life, screen resolution, or even the possibility of conflicts with other applications.

“The primary purpose of a mobile phone is to make phone calls,” Patel said. “What happens when it’s carrying all the computing resources that you’re relying on?

“When you’re taking an ultrasound or doing an EKG, you don’t want something that can mess up the results of the ultrasound or of the EKG,” he said.

“You need to be able to do something technically that will manage those risks.”

Many companies are creative in doing so, Patel pointed out. In the case of MIM Software, which released a mobile application for viewing diagnostic medical images from a tablet or smartphone, one of the concerns the company had to resolve was creating a display that would be medically useful outside of a radiology darkroom.

Taking the display out of the controlled environment raised obvious questions about managing contrast, calibration and other variables. MIM’s answer was to build in a light verification check, which, unless it is satisfied, doesn’t allow the user to observe and analyze the images.

“There’s a lot of innovation and we support all of that,” Patel said. “We’re very excited that people are coming up with some very clever techniques to bring devices to market.”

What FDA does not take a hand in regulating, Patel said, are those technologies that do not necessarily qualify exclusively as medical devices. The number of medical educational devices — MEDICAL EQUIPMENT, PARTS & SERVICE

things like textbooks, flashcards, video conferencing technologies — that are not necessarily intended for medical purposes, are exempt from its oversight.

“Things we have previously regulated and are coming into a mobile environment, we would continue to regulate,” Patel said. “On the other hand, a phone in the doctor’s office, that’s a phone in a doctor’s office.

It’s not a medical device.”

Neither does the FDA take responsibility for managing patient WWW.MEDICALDEALER.COM

privacy or data security; those are the purview of the Department of Health and Human Services.

“It’s a cross-cutting thing; not necessarily because it’s mobile,” Patel said. “People can use off-theshelf Dell laptops, but when they change that technology or change those features in the functionality that they’re providing, they need to manage those risks.”

It’s “unavoidable” that physicians from outside the hospital are always going to bring their own

devices to their practices, said Paul Czerwinski, Director of Healthcare for Motorola North America. Czerwinski is, however, less bullish on the idea that healthcare-specific peripherals — like handheld EKGs or ultrasound displays — will necessarily be part of the equation.

“I think it’s interesting to see what consumer devices are coming out with,” he said. “I think there’s a long time before a hospital will move their trust over to something that’s consumer-grade.”

MEDICALDEALER 61

MOBILIZED

“With the constant change in these devices, extra accessories are difficult,” Czerwinski said. “Not necessarily is our focus on plugging in a blood pressure cuff; our focus is more centralized in terms of making a clinician faster and smarter at what they’re doing.”

In the case of Motorola, which recently sold off its consumer products division to focus on creating mobile devices for enterprise, government, and health systems, mobile healthcare technologies are designed to stay within the hospital when their users, such as nurses, respiratory 62 MEDICALDEALER | OCTOBER 2014

therapists, and patient escorts, are done with their shifts.

Such products are intended for “the clinician who comes in and works a shift, and then when they come home, they’re not taking their work home with them,” he said.

“There’s certainly a place for a physician who takes their Apple or Android device with them,” Czerwinski said, “but when the enterprise is providing those devices to their clinicians and they want to make sure that they’re secure within their four walls, that’s where we feel we play best.”

Traditional communication means, such as pagers and paper charts, “has been very clunky,” he said. Instead, the company is rolling out smartphone-sized devices intended for hospital use. They’re disinfectant-ready with an interchangeable, 12-hour battery, and offer secure data access, texting and calling.

For inventory management, the Motorola devices contain integrated bar code scanners. For clarity of communication in the hospital without signal interference, it runs on voice-quality WLAN versus cellular phone WAN technology.

MEDICAL EQUIPMENT, PARTS & SERVICE

“Our focus is in improving overall operational efficiency,” Czerwinski said. “We feel we offer a platform for developers that could operate voice,

onboard battery to function, allows professionals to identify the whereabouts of a device, staff member or patient anywhere in the hospital.

Such technologies take the opposite approach of adapting traditional consumer devices for the mobile health market, Czerwinski

“I think there’s a long time before a hospital will move their trust over to something that’s consumer-grade.”

— Paul Czerwinski,

Director of Healthcare for Motorola North America

text, a clinician dictionary; a variety of applications in the hospital.”

In the process of driving such applications, device-makers must be cognizant of the tasks that their products will be asked to execute by developers. Security is “number one top of mind,” Czerwinski said, and thus means sometimes truncating the original functions of the developers’ operating systems.

“We lock out the Google Play store,” he said. “HIPAA violations occur with that.”

Beyond handheld communications, Czerwinski said that Motorola also sees opportunities in mobile healthcare applications like real-time-locating systems, or RTLS. Passive RFID tracking technology, which doesn’t need an WWW.MEDICALDEALER.COM

“What hospitals are recognizing is that they’ve got a lot of very high-cost assets, especially in locations like the operating room or ICU,” Czerwinski said. “A lot of times they’re small and very difficult to find.”

“There’s a little more investment up-front, but after the infrastructure’s deployed, the assets that a hospital is able to track are scalable. Beds, oxygen tanks, wheelchairs; the hospital will be able to know at every moment where everything is.”

In addition to locating devices, the passive RFIDs are rewriteable, Czerwinski said, “so it has a memory to it” that allows maintenance staff to document the last time it was serviced, for example.

said, but demonstrate the other opportunities for device-makers in the space.

“I think there’s a benefit to knowing what you’re good at, and right now, we’re really good at communication and allowing knowledgable workers to access information, and allowing them to use their judgment,” he said.

MEDICALDEALER MEDICAL DEALER 63

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CORPORATE PROFILE

MEDICAL IMAGING

TECHNOLOGIES INC.

M

edical Imaging Technologies Inc. (M.I.T.) in Thomson, Ga., prides itself on its quality work and outstanding customer service. For more

than a quarter of a century, owner Rick Player and the highly skilled individuals at M.I.T. monitor the pulse of the medical imaging industry to ensure the company’s ability to provide the services customers need.

“I started this company in 1987 with my business partner Roger Stephens.

At that time we serviced Phillips CT mostly. Later, we had to change and evolve into doing GE because they started to take over a lot of the CT market,” Player says. “Today, CT is still the majority of our business, but we started doing a few other things to keep our customers happy. I attribute my success to staying current with how the market for different brands is changing and being able to evolve so the company doesn’t fall behind.”

Staying abreast of the latest technologies is important, but it is not the only aspect of M.I.T.’s business.

66 MEDICALDEALER | OCTOBER 2014

“We are also successful because we do whatever it takes to get the customer up and running and to make them happy,” Player says.

The people at M.I.T. don’t just say they are concerned about the needs of their customers. Everybody from the top down places an emphasis on customer satisfaction.

“The advantage we have over some companies is that we really care about our customers,” Players stresses. “We create relationships by visiting them frequently – even when their equipment is running fine. When equipment does go down, an engineer leaves right away to get MEDICAL EQUIPMENT, PARTS & SERVICE

SPECIAL ADVERTISING SECTION

to the site ASAP. We do not leave them waiting.”

The goal is top-quality, sameday service.

“Ninety-nine percent of the time we have the equipment up and running the same day, but there are a few cases where something takes a little bit longer,” Player explains. “When that happens, I always visit the site personally. It brings ease to them because they know we care and we are actually doing everything possible.”

“Also, we work overnight to fix things with no extra charge, so that way the customer can finish out the day and does not have to be down during business hours,” Player says.

He says one example of the type of service and positive relationship M.I.T. strives to have with all its customers is best illustrated by examples of the work it does for current clients.

WWW.MEDICALDEALER.COM

“Our customer Crucial Care was struggling to find service companies that would actually care about them and give them the service they deserved. When they were told about our company we quickly came in and set the standard for service,” Player 3. recalls. “They were so happy that we actually cared about their business that we quickly became good friends.”

In fact, when Crucial Care of Jacksonville, Fla., was later looking to expand its operations it turned to M.I.T. The first call Debbie Willis, executive vice president of operations for Crucial Care, made was to Player at M.I.T. Going back several years, Willis says she’s never used another vendor to supply any of the medical equipment that M.I.T. can provide. Even though M.I.T. is located several hun-

dred miles away. Willis and the rest of the C-Suite at Crucial Care have such affection for Player and the staff at M.I.T. that they consider the company an extension of their own.

“They’re just not located in our office and they don’t work under our name, but they’re under our umbrella,” Willis says.

In Willis’s words, the customer experience provided by M.I.T. has colored the very perception of contract shopping at Crucial Care to the point that “every vendor that we associate ourselves with are referred to as Rick Player-like vendors.”

“They have to meet that standard he has set and maintained in the past six years, or else we don’t associate with them,” she says.

M.I.T. is an expert source when it comes to GE CT equipment, but the company also recently began working on X-ray equipment.

MEDICALDEALER 67

CORPORATE PROFILE SPECIAL ADVERTISING SECTION

Technicians attend training sessions on a regular basis build on their expertise.

“What we have been doing the longest, and know the most, is GE CT. We have multiple highly trained service engineers for GE CT,” Player says. “We started servicing X-ray equipment last year.

We mostly service control-X and GE rad rooms and fluoroscopy rooms. We also service GE portable X-ray units.”

Training allows M.I.T. to meet the needs of its customers and expand the amount of service the company can provide. If a CT customer wants M.I.T. to service their X-ray equipment, Player says technicians will attend training sessions on the customers’ X-ray devices so they are able to “to learn everything about that piece of equipment.”

“In the future, we will keep rolling with the punches and continue picking up new and different things,” Player says.

“In the very near future we are sending some engineers to school for Toshiba CT. We will 68 MEDICALDEALER | OCTOBER 2014

have that service to offer in the coming years.”

Great employees are another very important part of M.I.T. “All of our engineers do a great job and they are very knowledgeable,” Player says.

“Senior Service Engineer Frank Watts is very good at teaching the other engineers everything he knows. He is not scared to take on anything. I know I can rely on him to learn something new very quickly. Like the X-ray equipment, he jumped right in to researching and learning about the systems. He becomes an expert at everything we decide to service.”

Growth is inevitable when a company has existed for more than 25 years and M.I.T has expanded over the years and continues to increase its market area.

“We are very excited about our expansion in Florida and New Jersey,” Player says. “We look forward to bringing the service excellence to those customers that our current customers already experience.”

“We have a 10,000 square foot warehouse where we stage CTs for training our engineers and we refurbish the CTs for customers,” Player adds. “We have a painting station to paint the covers so the refurbished CTs not only run like new, but look like new as well.”

Exceptional service and outstanding customer relations are expected at M.I.T. – it’s just the way they do business.

“The most important thing about the way we do business is that I want to lay down at night and know I was honest, did not take advantage of anyone, that my customer is up and running and that we have a good relationship,” Player says. “Also, our mission statement is, ‘Do whatever it takes to get the job done.’ ” “I want people to know that we are good honest people that care about our customers and that we have very qualified engineers,” he adds.

TO LEARN MORE ABOUT M.I.T . please visit www.mit-tech.com.

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MEDICALDEALER 71

SLICE OF LIFE_The Other Side

By Jim Fedele

THE ‘THIRD-PARTY HARDWARE’ BLUES

R

eporting to the CIO has given me a bird’s eye view of all the systems and programs that are being implemented and planned for on a daily basis. As I look at the list it is breathtaking to see so many things going on. Many of the projects have a common purpose, to make us more efficient. As I think about these items and the projects my team has completed lately, I am not so sure that the “efficiencies” ever actually exist.

The majority of the new medical equipment systems we have installed have been a mix of networking and computer hardware provided by the OEM. Because the systems are built to run and act like a normal network the hardware included with some of the systems are what the OEM is calling “third-party hardware.” This is significant because now when there are problems with the systems, third-party hardware may be to blame.

My first experience with thirdparty hardware issues occurred a few years back after we installed a new cath lab. The installation included a robust PA system that allows the techs in the control room to speak to the people in the procedure room. This system was purchased 72 MEDICALDEALER | OCTOBER 2014

and installed by the OEM without anyone from the Biomedical Engineering Department being involved.

Because we had purchased a full-service agreement from the OEM for the system. It was about two years after the installation that we discovered the PA system and realized it was broken. A technician called me and asked if I knew anything about the system, I told him it was covered by a full-service agreement and then asked him why he was working on it.

He explained that when he called the OEM they said they do not cover the PA as it is “third-party hardware.”

I immediately called the service manager and asked him about the situation, he confirmed the policy and basically said, “Sorry.” I became very frustrated, because we were now responsible for a system we did not select, install or get trained on.

I continued to protest to the service manager, but he did not move from his position. Luckily, I had a technician with PA system experience and we were able to fix it. However, it took a long time for us to figure it out and it frustrated the doctor enough that he confronted the salesperson about the issue. The salesperson apologized and promised to involve us in the future.

My latest experience with “thirdparty hardware” has been with our monitoring system. We recently installed a new system for our ICU. It is an elaborate system that allows the nurse to use the patient monitor as a workstation in the room and have access to the system from multiple nurse stations and touchdown points. The system was built based on the OEM’s experience with previous installs and their recommended workflow analysis. The system is a complex network with remote KVMs (keyboard, video and mouse) and KVM extenders that distribute control over multiple computers to multiple locations. When the system works, it is quite impressive.

Nurses can access a central station computer from down the hall, eliminating the need to walk to a main station to input data or run reports.

However, when it doesn’t work it is a very difficult problem to troubleshoot. The system has been plagued with intermittent problems that lock up the keyboard and mouse control. The main problem we are having is it is never the same set of steps to fix it.

The issue is incredibly frustrating for me, my techs and the OEM because there is not a way to isolate MEDICAL EQUIPMENT, PARTS & SERVICE

_The Other Side

The OEM of the monitoring system is stating that their equipment is working and the vendor of the “third-party hardware” does not know how to solve our problem. the failing component. The OEM has been trying to help and they have randomly (affectionately known as shotgunning) replaced some components. However the problem is with the “third-party hardware” and they are reluctant to change out the hardware. My opinion is that the company who built the KVM is not as committed to solving the problem as we are. They keep pointing to settings and user problems. They have not offered any way to troubleshoot the problem, nor are they motivated to come to our facility to help. During our last call, they started hinting that we could have wiring issues, even though the wires were just installed and certified specifically for the project.

At this point, we are squarely stuck in the middle. The OEM of the monitoring system is stating that their equipment is working and the vendor of the third-party hardware does not know how to solve our problem. During my last call with the OEM, I explained that although I understand they did not make the third-party hardware they purchased and designed the system around it and it is their problem to solve. The vendor of the hardware WWW.MEDICALDEALER.COM

does not have an incentive to help me out because I did not give them a dime for their product. As I write this, we are still stuck trying to figure out what the problem is with all sides stating it is not their problem.

Luckily, we have another monitoring project coming up that I will use as leverage to get this resolved one way or another.

As technology continues to advance and more devices are put on “the network” the use of thirdparty hardware will grow. This will create issues when problems occur because people often find it easier to blame the problem on someone else than to own it and try to solve it. I have now added questions about the use of third-party hardware and who is responsible for repairs to the questions I ask when we consider the installation of new equipment. I am hopeful that this activity will mitigate some of these issues in the future.

JIM FEDELE, CBET, has been with Medical Dealer magazine for more than 12 years.

He is currently the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments by email at info@mdpublishing.com.

MEDICALDEALER 73

SLICE OF LIFE_Pay It Forward

By Matthew N. Skoufalos

STANDING WITH HOPE

T

he idea for Standing With Hope came to Grace Rosenberger the day she had her second leg amputated.

Her husband, Peter, recalls that his wife had been lying in bed, fatigued from the exertion of walking on her prosthesis, and watching television. She flipped to a documentary about Princess Diana working with victims of land mines in Southeast Asia, and said, “That’s what I’m going to do.”

It was not the plan that the two may have mapped out for their lives, but it was the one they have embraced.

In 1983, Grace Rosenberger was involved in a serious car accident that eventually claimed both of her legs. For 28 of the years that followed, Peter has been her caretaker.

She’s had 78 surgeries, 60 doctors, been in 12 hospitals, and amassed $9 million in medical bills.

Peter Rosenberger is a piano player; Grace, a world-class singer, who once performed at the request of Barbara Bush at the Republican National Convention in Madison Square Garden. Today, they are parents to two boys, Parker and Grayson, who have “literally carried their mother on their back at times,” Peter said, and they operate a nonprofit organization that is powered almost entirely by preowned medical equipment.

74 MEDICALDEALER | OCTOBER 2014

Standing With Hope Prosthetist Randy Roberson ​works with Ghana Health Services Prosthetist Peter Nartey.

The Rosenbergers’ Standing With Hope foundation collects used prosthetic limbs from donors nationwide, and ships them to Ghana, where they find second lives.

Along the way, they pass through the hands of inmates in a Tennessee state prison, customs agents on two sides of an ocean, and medical professionals in west Africa.

But eventually, and thousands of miles away from their initial homes, they are recirculated into use.

“There’s a lot of amputees in a country the size of America, and we’re not running out of prosthetics,” Peter Rosenberger said. “Mostly they come from individuals; a family member passed away, and they don’t know what to do with the leg. You don’t want to throw these things in the trash.”

Finding a second user for a prosthetic limb is tricky, he said, because they’re custom fitted to the unique physiology of the wearer, and a secMEDICAL EQUIPMENT, PARTS & SERVICE

_Pay It Forward

The new book for caregivers by Peter Rosenberger. Available wherever books are sold.

ondary user can end up hurting themselves by wearing a prosthesis that wasn’t intended for them.

But without access to the affordable option of pre-owned medical equipment, Standing With Hope would have a much harder time fulfilling its mission.

A brand new prosthesis is expensive, costing an average of $7,000, Peter Rosenberger said. The devices themselves are exceptionally durable, however. Moreover, many families of prosthetic patients would rather not see such a personal and sentimental artifact discarded after its owner has outgrown it or passed on. To do so not only closes the door on the difference they can make to the life of a non-ambulatory person — especially when there are so many such people in need the world over — but also misses out on the opportunity to recoup the significant investment it takes to construct and fit a prosthesis.

“If I had to buy everything new, there’s no way we could do it,” Peter Rosenberger said. “Instead of trying to come up with a cheap foot and a cheap knee, we came up with the best America has to offer.”

Before they reach their destination in Ghana, where Standing With Hope has a memorandum of understanding with the state Ministry of Health, the limbs are processed and disassembled WWW.MEDICALDEALER.COM

​New​and​recycled​prosthetic f​ ​eet ​wait to be c​ategorized, sized and added to a ​ c​ ustom​-​fitted limb.

by inmates at the Metro-Davidson County Detention Facility. Participation in the program is voluntary, Peter Rosenberger said, and he’s “never had anything but positive feedback.”

“One said, ‘I’ve never done anything positive with my hands before, let alone help the disabled,’ ” he said.

The sockets of the prosthesis are custom-fitted to their patients, and therefore is not reusable, Peter Rosenberger said; these are recycled. But the other components — connectors, adaptors, pylons, feet, and knees — may all be reused.

Once they’re all stripped down, the parts are shipped to Ghana, where the prosthetics are cast, molded, modified and reused.

To aid in the process, the Rosenbergers receive donations of raw materials as well as of the prosthetics themselves. A New Hampshire airplane wing manufacturer supplies cast-off,

custom fiber that can be laminated into the socket to create a lightweight connection that is “virtually unbreakable,” Peter Rosenberger said.

“Nobody’s doing carbon fiber sockets over there except us,” he said.

Standing With Hope also fundraises to ship materials, such as acrylic resin and an accompanying catalyst to aid in the fabrication of sockets, to Ghana every three years. At $7,500 per 55 gallons, Peter Rosenberger calls it “a big-ticket item for us,” but the organization is concerned with producing high-quality results.

“My wife’s policy is, ‘I’m not going to put a leg on somebody that I’m not willing to wear,’ ” Peter Rosenberger said, adding that Grace Rosenberger has donated some of her own prosthetic feet to the cause.

“If the socket doesn’t fit, that’s where you run into problems,” he MEDICALDEALER 75

SLICE OF LIFE_Pay It Forward

“PullQuote” — xx

​Standing With Hope P ​ ​resident​​Peter Rosenberger ​watches as Ghana Health Services​worker​James Annang fits a patient with a new limb.

said. “It’s got to be custom-fit.”

After the prostheses are provided and the sockets fitted, however, there’s still more work to be done in building a sustainable infrastructure that supports the patient after he or she receives the device. Providing a leg to a patient is “a lifetime commitment,” Peter Rosenberger said, particularly to pediatric patients, who will require adjustments to their prostheses as they grow and develop.

“If you can’t create a sustainable infrastructure, there’s no point in going over there,” he said. “You can’t show up and put a leg on somebody and say, ‘God bless you, live a good life.’ If something happens and there’s nobody there to repair it, that’s almost cruel.”

The Ghanaian Ministry of Health was already providing prosthetics 76 MEDICALDEALER | OCTOBER 2014

before Standing With Hope set out to work in the country, but some were so rudimentary as to be carved wooden legs, Peter Rosenberger said. Rather than “reinvent[ing] the wheel,” he said, Standing With Hope inked a memorandum of understanding with the ministry, which has enabled the organization to be far more effective, legitimate and streamlined.

“We’ve got to work with a partner that can have a facility there, staff members there, somebody to help us get stuff through customs, and somebody to be on point to help us do the work,” Peter Rosenberger said.

“They’ve already got staff, they’ve already got facilities, they’ve already got equipment,” he said. “Let’s go ahead and help these folks step into a higher level of treatment.”

Thanks to the support of donors the world over, the ministry is able to charge a nominal $350 for the prosthetics, and if that fee is too great for the patient and his or her family to absorb, Standing With Hope will sponsor the leg, Peter Rosenberger said. Children are priority patients.

“We’ve helped hundreds,” he said. “If we’re doing 50 new patients a year, I’m very pleased.

Prosthetics is a very labor-intensive surgery. They were taking three weeks a leg when we got there, that’s plus maintaining the existing patient load.”

But it’s all worth it, Peter Rosenberger said, to give “the gift that keeps on walking."

“It’s a lot of fun,” he said; “it’s a lot of work, but it’s great work.”

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80 MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

SLICE OF LIFE_Success Story

By Matthew N. Skoufalos

ORTHOPAEDIC AND SPINE CENTER OF THE ROCKIES/GELPRO

A

t the Orthopedic and Spine Center of the Rockies in Fort Collins, Colo., sometimes technicians work a 10-hour shift or longer. The cumulative effect of that time spent standing can mean prolonged wear and tear on the back, strained joints and muscles, and general fatigue.

That’s why, said Barb Hardes, Director-Administrator of Surgical Services at the Center, all staff members undergo ergonomics training that emphasizes proper body mechanics in the workplace.

“We actually check our work area very often” for ergonomics concerns, said certified sterile processing technician Ruth Ann Wofford.

“When we’re hired, we’re taught ergonomics, so when something’s not contingent to us, we just say, ‘It’s not working for us,’ and they make changes,” Wofford said.” All we have to do is speak up, and then they start researching [the circumstances].”

“We have to create a safe workplace environment for staff,” Hardes said. “We need happy staff, and a healthy work environment makes a happy, healthy staff.”

As an outpatient surgery center specializing in orthopedic and spine procedures, the center hosts three operating rooms that run “full speed ahead, Monday through Friday,” WWW.MEDICALDEALER.COM

“It’s soft, where the other mats are harder, and harder on your feet. Since using it, I have a lot less upper back fatigue, and I don’t have as many leg cramps in my calves.”

— Ruth Ann Wofford Hardes said. At an attached convalescent care center, specialists see “all kinds of people with joint and spine [issues] to sports medicine [needs],” she said; “basically anything from the neck down.”

With that specialty in mind, Center operators are keenly aware of how environmental conditions affect different areas of the body, particularly nerve-related impact. As a result, Hardes said, the standard practice is to encourage employees to speak up about any pain or discomfort, and to “try to adjust the workplace to the employee, rather than adjust the employee to the workplace.”

In the case of staff who are on their feet for long hours, adjustment means creating a comfortable and adaptive environment with input from all parties concerned.

“In general, everybody’s pretty persnickety about footwear,” Wof-

ford said. “The staff’s pretty serious about what they wear all day. It’s like underwear; it’s very personal.

They wear everything from running shoes to Danskos to Crocs, as long as they meet safety guidelines for being close-toed and keep liquids out.”

But proper footwear is only half the answer to the problem. In order to help ease the burden of prolonged exposure to pressure from standing, the center invested in a system of anti-fatigue mats that would cushion the floor spaces at which workers perform their daily tasks. For a long time, those mats were constructed of a thick, industrial foam that lent additional support; after a while, however, they wore down, losing their shock absorption to some degree. Wofford said staff would frequently double up the mats to compensate for the effect, or move them from place to place to try to distribute the wear.

MEDICALDEALER 81

SLICE OF LIFE_Success Story

GelPro medical-grade anti-fatigue mats have a gel core that distributes weight evenly to avoid additional pressure to shock-absorbing areas of the body.

82 MEDICALDEALER | OCTOBER 2014

By Matthew N. Skoufalos

One day, however, a visiting vendor left a sample of an alternative gel mat, and the staff almost immediately noticed the difference.

“They left us the mat and said, ‘Go ahead and use it as a trial,’ and we really liked the mat,” Wofford said.

“We did a little bit of digging and found out the same exact mat was offered through a different company for a more reasonable price.”

As such, the Center began a trial with a GelPro medical-grade anti-fatigue mat from Let’s Gel, Inc. of Austin, Texas. Created by an engineer who saw his wife’s legs cramping up during her preparation of Thanksgiving dinner, the mats boast a gel core that distributes weight evenly to avoid putting extraneous pressure on typical shock-absorbing areas of the body, from the joints to the back, feet, and legs.

Its high-traction bottom assures the mat will stay in place once positioned, and the flexibility of the surface means that it provides a conMEDICAL EQUIPMENT, PARTS & SERVICE

_Success Story

sistent experience for users of all heights, weights, and body types, the manufacturer said.

The Center purchased five mats in total after the trial, and has used them for a few months with nothing but positive feedback to offer.

“When we were trialing the mat, I noticed that it does give some,” Wofford said. “It’s soft, where the other mats are harder, and harder on your feet. Since using it, I have a lot less upper back fatigue, and I don’t have as many leg cramps in my calves. It’s a lot softer; a lot more comfortable on your feet."

“We have them not only in our washroom but in our other work

areas where we assemble instruments and wrap,” she said.

In addition to delivering a comfortable experience throughout the work day, the medical-grade mats were designed to keep safety in mind, Wofford noticed.

“One of the things I like about the mat is that they’re bright red,” she said. “As you’re approaching the workstation, it’s bright red, and you know you’re standing on a mat.

It catches the worker’s eyes so you know you’re not going to trip jumping onto a mat."

“I never really thought about it until we put the mats down,” she said. “We’ve had staff members trip

from the old mats that we had.”

Throughout the experience, Wofford said that the decision to replace the mats in her workplace with GelPro mats was a difference-maker, especially so because her bosses had established an environment in which staff are free to create a healthy environment. If there’s a lesson to be learned from the experience, she said, that’s it.

“Management really needs to support the employees with what their workplace needs are,” Wofford said. “If employees are coming to management with suggestions or needs for workplace safety or ergonomics, listen to the employees.”

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MEDICALDEALER 85

SLICE OF LIFE_

By Dan Bobinski

A PRESCRIPTION FOR PERFECTIONISM

P

erfectionism can be a very good thing. It generates self-determination to produce quality work, which then leads to high-quality results.

In many medical procedures, such as blood typing, perfectionism saves lives. However, sometimes people become perfectionistic to an unhealthy degree, driving themselves and others to extreme behaviors that are not really necessary. The ripple-effects of this include unnecessary stress, procrastination, and an unbalanced life, among others.

Thankfully, a little evaluation and a few adjustments to our thinking can turn unhealthy practices into a healthy pursuit of excellence.

The first step may be to realize that many of us practice perfectionism selectively. For example, Joe may be a stickler for proper grammar on every piece of correspondence no matter what, but doesn’t care that his clothes are always mismatched and his hair is unkempt. At the same time, Joe’s co-worker Kevin might consistently dress as if he’s ready for the cover of GQ, but regularly writes long, confusing paragraphs, exhibiting no regard for punctuation.

Another thing to realize is that perfectionism is always a choice. It’s not always a conscious choice, but it’s a choice nonetheless. Some people lean toward perfectionism more easily than 86 MEDICALDEALER | OCTOBER 2014

Dan Bobinski Workplace Consultant

others simply due to the way they are wired, but where they focus their perfectionistic ways emerge as they progress through the circumstances of life.

With those understandings as a foundation, if one wants to engage in self-improvement, one has to determine which perfectionistic tendencies are healthy and which are unhealthy. In other words, which ones create a good return-on-investment, and which ones are liabilities.

Jeff Szymanski, author of The Perfectionist’s Handbook, outlines some signs that are indicative of healthy perfectionism. They include matching our available time, energy, and skills to the tasks before us in a way

that helps us feel fulfilled and without be drained. Another indicator is seeing that the payoffs we receive from our efforts are greater than the time and energy we expend on our tasks.

More indicators exist, but did you notice the themes of “fulfilled” and “energy” in those two examples?

These happen when one is self-aware and setting personal and professional boundaries. A gentleman I know named James has an excellent reputation for delivering high-quality work, but he doesn’t work long hours nor does he get stressed out. James knows his own strengths and weaknesses, and he manages his activities to accommodate deadlines. He’s also a student of his co-workers’ strengths and blind spots.

I know James is a perfectionist, but he’s a healthy perfectionist. He knows his priorities, he matches his time and talents to meet his deadlines and he feels fulfilled in his work.

OK, that sounds good, but what are the symptoms of unhealthy perfectionism? Szymanski lists some of those, too. They include repeatedly setting goals but never achieving them; constantly competing to the be the best at everything; feeling like every mistake we make is catastrophic, and believing that only one strategy will work for us as we ignore other options.

These are symptoms of unhealthy perfectionism, but as any doctor knows, MEDICAL EQUIPMENT, PARTS & SERVICE

treating the symptoms rarely does anything to affect the root cause. So here’s the blunt truth: The primary root of perfectionism is fear. Nobody likes to be told that fears are driving some aspect of their professional or personal life, but it is what it is.

Now that we’ve identified the basic root cause, let’s strive to be more specific about the type of fear that’s giving us trouble. Several decades ago, my mentor taught me that everyone is affected (to one degree or another) by at least five fears. They are fear of criticism, fear of rejection, fear of failure, fear of not getting what we want, and fear of losing what we have.

Can you see how fear of criticism can drive someone toward unhealthy perfectionism? Or how the fear of losing one’s position can cause someone to work at home in the evenings and on weekends?

Hang with me, we’re almost to the prescription phase, but a little more diagnosis is in order. If you believe you might be perfectionistic in an unhealthy way, pinpoint the area. Is it your work or school? Is it the way you organize your house, office or desk? Perhaps it has to do with your personal grooming, or your health or physique? Maybe you’re too perfectionistic in your relationships or communication methods.

WWW.MEDICALDEALER.COM

So here’s the blunt truth: The primary root of perfectionism is fear. Nobody likes to be told that fears are driving some aspect of their professional or personal life, but it is what it is.

Now, assuming you want a more healthy pursuit of excellence, consider the following prescription: 1. Select one life area at a time.

Trying to change multiple areas of unhealthy perfectionism all at once is pretty much a guaranteed failure.

2. Identify which fear(s) are at the root of the unhealthy perfection, and explore the reasons these fears exist, and why you’ve set your standards so high.

3. If you are able, forgive yourself for being human, and look for ways to find peace with actions or results that are “less than perfect.” Hint: A good technique is learning to laugh at our own shortcomings. Find the humor!

4. Create new standards for yourself to accomplish an objective without overtaxing yourself or placing undue burdens on others. This is where self-awareness really helps.

5. Set up a timeframe for assessing your progress. A month or six

weeks is a reasonable window for determining your growth. In other words, don’t give up if it’s been only two weeks and you’ve not seen any growth.

Let me close with this: Wherever you are, your behavioral patterns have developed over dozens of years, so don’t expect things to turn around in a weekend. But if you become more self-aware and become better at managing your talents to meet the deadlines before you, you can eliminate the unhealthy behaviors and turn your world into a healthy, fulfilling quest for excellence.

DAN BOBINSKI is a certified behavioral analyst, author of the best-selling “Creating Passion-Driven Teams” and president of Workplace-Excellence.com. He travels internationally helping organizations of all shapes and sizes. Reach him at 208-375-7606 or dan@workplace-excellence.com.

MEDICALDEALER 87

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DIAGNOSTIC IMAGING AMX Solutions.……………………………………………… 16 Brandywine Imaging, Inc.…………………………… 64 Eastern Diagnostic Imaging……………………… 78 J & M Trading…………………………………………………… 71 Multi Imager Service……………………………………BC TROFF Medical……………………………………………… 44

MAMMOGRAPHY Digitec Medical Service Corp.……………………… 64

AUCTION/LIQUIDATION Government Liquidation…………………………… 91 Hilditch Group Ltd………………………………………… 21 MedWrench…………………………………………………… 88 BATTERIES Eastern Diagnostic Imaging……………………… 78 Holden Battery Services……………………………… 64 BIOMEDICAL AMX Solutions.……………………………………………… 16 Bayer Healthcare Services.……………………………2 Conquest Imaging………………………………………… 13 Crothall………………………………………………………………5 Integrity Biomedical Services, LLC.…………… 14 InterMed Biomed………………………………………… 80 Maull Biomedical Training, LLC………………… 30 Medical Specialties Distributors… 27, 53, 77 MedWrench…………………………………………………… 88 TriMedx Foundation…………………………………… 70 Trisonics……………………………………………………………7 CABINETS/CARTS Bryton Corporation……………………………………… 22 CARDIOLOGY J & M Trading…………………………………………………… 71 ReMed Equipment………………………………………… 71 Southeastern Biomedical, Inc.………………………8 C-ARMS Eastern Diagnostic Imaging……………………… 78 Engineering Services…………………………………… 45 COMPUTED TOMOGRAPHY East Coast Medical Systems……………………… 52 Ed Sloan & Associates………………………………… 54 Imaging Affiliates………………………………………… 89 Metropolis International…………………………… 43 MIT/Medical Imaging Technologies…29, 66-69 Tri-Imaging……………………………………………………… 31 CT East Coast Medical Systems……………………… 52 Ed Sloan & Associates………………………………… 54 Imaging Affiliates………………………………………… 89 International Medical Equipment & Service …………………………………… 43 J & M Trading…………………………………………………… 71 92 MEDICALDEALER | OCTOBER 2014

ENDOSCOPY Endoscopy Specialists………………………………… 85 HMB Endoscopy Products…………………………… 79 Mobile Instrument Service & Repair………… 15 S.H. Medical Corporation………………………22, 77 GENERAL Eastern Diagnostic Imaging……………………… 78 Government Liquidation…………………………… 91 MedWrench…………………………………………………… 88 Puma Export, Inc.………………………………………… 90 Remarket Medical………………………………………… 89 The Alternative Source Medical.………………… 29 IMAGING/PARTS Ampronix……………………………………………………………6 AMX Solutions.……………………………………………… 16 BMX-RAY.………………………………………………………… 73 Diagnostic Solutions…………………………………… 89 Eastern Diagnostic Imaging……………………… 78 Engineering Services…………………………………… 45 InterMed Ultrasound…………………………………… 27 InterMed NucMed………………………………………… 54 J & M Trading…………………………………………………… 71 ReMed Equipment………………………………………… 71 Technical Prospects……………………………………… 65 Tri-Imaging……………………………………………………… 31 TROFF Medical……………………………………………… 44 INFUSION THERAPY Medical Specialties Distributors… 27, 53, 77 INFORMATION TECHNOLOGY Tesseract………………………………………………………… 80 INTERNET RESOURCES MedWrench…………………………………………………… 88 LABORATORY MIT/Medical Imaging Technologies…29, 66-69 LASER IMAGERS Multi Imager Service……………………………………BC

MODULE/TELEMETRY Bio-Medical Equipment Service Co.…………… 53 MONITORS/CRTs Advanced Ultrasound Elec./AUE………………… 10 Ampronix……………………………………………………………6 Gopher Medical, Inc.…………………………………… 85 Technical Prospects……………………………………… 65 The Alternative Source Medical.………………… 29 TROFF Medical……………………………………………… 44 MRI Carolina Medical Parts………………………………… 55 East Coast Medical Systems……………………… 52 Ed Sloan & Associates………………………………… 54 Engineering Services…………………………………… 45 KEI Medical Imaging Services…………………… 27 MIT/Medical Imaging Technologies…29, 66-69 ScanMed………………………………………………………… 77 NUCLEAR MEDICINE E.L. Parts………………………………………………………… 79 InterMed NucMed………………………………………… 54 International X-Ray Brokers……………………… 79 J & M Trading…………………………………………………… 71 PATIENT MONITORING Bio-Medical Equipment Service Co.…………… 53 Gopher Medical, Inc.…………………………………… 85 Pacific Medical……………………………………………… 26 ReMed Equipment………………………………………… 71 Rieter Medical Services……………………………… 52 Sage Services Group……………………………………… 30 Southeastern Biomedical, Inc.………………………8 USOC Medical………………………………………………… 70 PROBES/PROBE REPAIR Conquest Imaging………………………………………… 13 Sentinel Imaging Group, Inc.……………………… 23 RADIOLOGY Eastern Diagnostic Imaging……………………… 78 Holden Battery Services……………………………… 64 International X-Ray Brokers……………………… 79 InterMed Ultrasound…………………………………… 27 InterMed NucMed………………………………………… 54 J & M Trading…………………………………………………… 71 Maull Biomedical Training, LLC………………… 30 Metropolis International…………………………… 43 MEDICAL EQUIPMENT, PARTS & SERVICE

Categorical Index

Multi Imager Service……………………………………BC Radon Medical……………………………………………… 89 ScanMed………………………………………………………… 77 Technical Prospects……………………………………… 65 TROFF Medical……………………………………………… 44 Varian Medical Systems…………………………………9 RADIOLOGY PARTS AMX Solutions.……………………………………………… 16 InterMed Ultrasound…………………………………… 27 InterMed NucMed………………………………………… 54 J & M Trading…………………………………………………… 71 TROFF Medical……………………………………………… 44 RECRUITING Adel-Lawrence Associates, Inc.………………… 53 REPAIR/REFURBISH Advanced Ultrasound Elec./AUE………………… 10 Ampronix……………………………………………………………6 AMX Solutions.……………………………………………… 16 Bio-Medical Equipment Service Co.…………… 53 Bryton Corporation……………………………………… 22 Conquest Imaging………………………………………… 13 Continental Equipment Company…………… 71 Crothall………………………………………………………………5 Digitec Medical Service Corp.……………………… 64 Eastern Diagnostic Imaging……………………… 78 Ed Sloan & Associates………………………………… 54 Endoscopy Specialists………………………………… 85 Integrity Biomedical Services, LLC.…………… 14 International Medical Equipment & Service …………………………………… 43 KEI Medical Imaging Services…………………… 27 MedWrench…………………………………………………… 88 MIT/Medical Imaging Technologies…29, 66-69 Mobile Instrument Service & Repair………… 15 Multi Imager Service……………………………………BC Pacific Medical……………………………………………… 26 Radon Medical……………………………………………… 89 Rieter Medical Services……………………………… 52 Sage Services Group……………………………………… 30 Sentinel Imaging Group, Inc.……………………… 23 TROFF Medical……………………………………………… 44 USOC Medical………………………………………………… 70 REPLACEMENT PARTS Advanced Ultrasound Elec./AUE………………… 10 ALCO Sales and Service………………………………… 21 AllParts Medical………………………………………………3 Carolina Medical Parts………………………………… 55 Classic Diagnostic Imaging………………………… 44 Conquest Imaging………………………………………… 13 Continental Equipment Company…………… 71 Diagnostic Solutions…………………………………… 89 WWW.MEDICALDEALER.COM

Digitec Medical Service Corp.……………………… 64 E.L. Parts………………………………………………………… 79 Ed Sloan & Associates………………………………… 54 Government Liquidation…………………………… 91 J & M Trading…………………………………………………… 71 International Medical Equipment & Service …………………………………… 43 KEI Medical Imaging Services…………………… 27 MTC/Medical Technologies Co.…………………… 52 Multi Imager Service……………………………………BC MW Imaging………………………………………………………4 Radon Medical……………………………………………… 89 Technical Prospects……………………………………… 65 TROFF Medical……………………………………………… 44 Varian Medical Systems…………………………………9 RESPIRATORY Medical Specialties Distributors… 27, 53, 77 SOFTWARE Tesseract………………………………………………………… 80 STERILIZERS Continental Equipment Company…………… 71 Government Liquidation…………………………… 91 InterMed Biomed………………………………………… 80 MTC/Medical Technologies Co.…………………… 52 SURGICAL Bryton Corporation……………………………………… 22 Eastern Diagnostic Imaging……………………… 78 Endoscopy Specialists………………………………… 85 International Medical Equipment & Service …………………………………… 43 Mobile Instrument Service & Repair………… 15 S.H. Medical Corporation………………………22, 77 The Alternative Source Medical.………………… 29 SURPLUS MEDICAL Government Liquidation…………………………… 91 Hilditch Group Ltd………………………………………… 21 TABLES Bryton Corporation……………………………………… 22 TUBES/BULBS AllParts Medical………………………………………………3 Imaging Affiliates………………………………………… 89 J & M Trading…………………………………………………… 71 International Medical Equipment & Service …………………………………… 43 Technical Prospects……………………………………… 65

Bayer Healthcare Services.……………………………2 Conquest Imaging………………………………………… 13 Diagnostic Solutions…………………………………… 89 Endoscopy Specialists………………………………… 85 InterMed Ultrasound…………………………………… 27 Medcorp, LLC……………………………………………… IBC Mobile Instrument Service & Repair………… 15 Sentinel Imaging Group, Inc.……………………… 23 Trisonics……………………………………………………………7 ULTRASOUND PARTS Advanced Ultrasound Elec./AUE………………… 10 Conquest Imaging………………………………………… 13 InterMed Ultrasound…………………………………… 27 Medcorp, LLC……………………………………………… IBC Mobile Instrument Service & Repair………… 15 MW Imaging………………………………………………………4 VCR REPAIR/SERVICES Advanced Ultrasound Elec./AUE………………… 10 Conquest Imaging………………………………………… 13 VENTILATORS Government Liquidation…………………………… 91 VIDEO Endoscopy Specialists………………………………… 85 Multi Imager Service……………………………………BC X-RAY BMX-RAY.………………………………………………………… 73 Brandywine Imaging, Inc.…………………………… 64 Classic Diagnostic Imaging………………………… 44 Diagnostic Solutions…………………………………… 89 Eastern Diagnostic Imaging……………………… 78 Government Liquidation…………………………… 91 Holden Battery Services……………………………… 64 Imaging Affiliates………………………………………… 89 MIT/Medical Imaging Technologies…29, 66-69 RTI Electronics……………………………………………… 83 Tri-Imaging……………………………………………………… 31 X-RAY PARTS AMX Solutions.……………………………………………… 16 Imaging Affiliates………………………………………… 89 J & M Trading…………………………………………………… 71 Technical Prospects……………………………………… 65 TROFF Medical……………………………………………… 44

ULTRASOUND Advanced Ultrasound Elec./AUE………………… 10 MEDICALDEALER 93

ALPHABETICAL INDEX Adel-Lawrence Associates, Inc.………………… 53 Advanced Ultrasound Elec./AUE ……………… 10 ALCO Sales and Service ……………………………… 21 AllParts Medical ……………………………………………3 Ampronix …………………………………………………………6 AMX Solutions. …………………………………………… 16 Bayer Healthcare Services. …………………………2 Bio-Medical Equipment Service Co.………… 53 BMX-RAY. ……………………………………………………… 73 Brandywine Imaging, Inc. ………………………… 64 Bryton Corporation …………………………………… 22 Carolina Medical Parts ……………………………… 55 Classic Diagnostic Imaging ……………………… 44 Conquest Imaging ……………………………………… 13 Consensys Imaging Service, Inc. … 32, 38-39 Continental Equipment Company ………… 71 Crothall ……………………………………………………………5 Diagnostic Solutions ………………………………… 89 Digitec Medical Service Corp.…………………… 64 E.L. Parts ……………………………………………………… 79 East Coast Medical Systems …………………… 52 Eastern Diagnostic Imaging …………………… 78 Ed Sloan & Associates ……………………………… 54 Endoscopy Specialists ……………………………… 85 Engineering Services ………………………………… 45

Gopher Medical, Inc. ………………………………… 85 Government Liquidation ………………………… 91 Hilditch Group Ltd ……………………………………… 21 HMB Endoscopy Products ………………………… 79 Holden Battery Services …………………………… 64 IAMERS ………………………………………………………… 84 Imaging Affiliates ……………………………………… 89 Injector Support and Service, LLC …………… 42 Integrity Biomedical Services, LLC. ………… 14 InterMed Ultrasound ………………………………… 27 InterMed NucMed ……………………………………… 54 InterMed Biomed ……………………………………… 80 International Medical Equipment & Service ………………………………… 43 International X-Ray Brokers …………………… 79 J & M Trading………………………………………………… 71 KEI Medical Imaging Services ………………… 27 Maull Biomedical Training, LLC ……………… 30 Medcorp, LLC …………………………………………… IBC Medical Specialties Distributors 27, 53, 77 MedWrench ………………………………………………… 88 Metropolis International ………………………… 43 MIT/Medical Imaging Technologies29, 66-69 Mobile Instrument Service & Repair ……… 15 MTC/Medical Technologies Co. ………………… 52

Multi Imager Service …………………………………BC MW Imaging ……………………………………………………4 Pacific Medical …………………………………………… 26 Paragon Service ………………………………………… 46 Puma Export, Inc. ……………………………………… 90 Radon Medical …………………………………………… 89 Remarket Medical ……………………………………… 89 ReMed Equipment ……………………………………… 71 Rieter Medical Services …………………………… 52 RTI Electronics …………………………………………… 83 S.H. Medical Corporation ……………………22, 77 Sage Services Group…………………………………… 30 ScanMed ……………………………………………………… 77 Sentinel Imaging Group, Inc. …………………… 23 Southeastern Biomedical, Inc. ……………………8 Technical Prospects …………………………………… 65 Tesseract ……………………………………………………… 80 The Alternative Source Medical.……………… 29 Tri-Imaging …………………………………………………… 31 TriMedx Foundation ………………………………… 70 Trisonics …………………………………………………………7 TROFF Medical …………………………………………… 44 USOC Medical ……………………………………………… 70 Varian Medical Systems ………………………………9

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