TechNation - December 2014 by MD Publishing

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vol.12

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

DECEMBER 2014

BEST OF THE

BEST A Look At The Top Biomeds, Departments And Issues From 2014

Biomed Adventures A Golden Oppurtunity

The Roundtable Test Equipment

What's on Your Bench? Highlighting the workbenches of HTM Professionals

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BEST OF THE

BEST A Look At The Top Biomeds, Departments And Issues From 2014

34 42

TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

THE ROUNDTABLE - TEST EQUIPMENT Test equipment is vital for the HTM community. Rarely does a day go by where they don’t have to test something as part of a repair process. TechNation asked a group of experts in the field about the latest in test equipment and more. Next month’s Roundtable article: RTLS

TECHNATION’S BEST OF THE BEST It was a busy year for HTM professionals. We take a look back at the top professionals and departments in the industry as well as some of the top news items from 2014.

Next month’s Feature article: When Disaster Strikes — Dealing with Natural Disasters

TechNation (Vol. 5, Issue #12) December 2014 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

DECEMBER 2014

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INSIDE

Departments PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Sharon Farley Warren Kaufman Jayme McKelvey Andrew Parker

p.12 Professional of the Month: Gina Contreras p.14 Biomed Adventures: Golden Opportunity p.17 FBS: Southeastern Biomedical Wins Award p.18 Department Profile: Grande Ronde Hospital Clinical Engineering Department

ART DEPARTMENT

Jonathan Riley Jessica Laurain

P.22 THE BENCH

EDITOR

John Wallace

EDITORIAL CONTRIBUTORS

Roger Bowles K. Richard Douglas Myron Hartman Patrick K. Lynch Todd Rogers Manny Roman Cindy Stephens Matt Tomory Karen Waninger

CIRCULATION

Bethany Williams

WEB DEPARTMENT

Betsy Popinga Taylor Martin

ACCOUNTING

Sue Cinq-Mars

EDITORIAL BOARD

Manny Roman: manny.roman@me.com Patrick Lynch: Biomed Support Specialist at Global Medical Imaging, patrick@plynch.us Karen Waninger: Director of Clinical Engineering at Community Health Network in Indianapolis KWaninger@ecommunity.com Eddie Acosta: A Clinical Systems Engineer at Kaiser Permanente, Northern California, Fastedy99@yahoo.com John Noblitt: Program Director at Caldwell Community College & Technical Institute in North Carolina jnoblitt@cccti.edu

P.12 SPOTLIGHT

p.22 p.24 p.27 p.28 p.31 p.32

ECRI Institute Update AAMI Update Tools of the Trade Biomed 101 Webinar Wednesday: Myth Buster Webinar Shop Talk

P.50 EXPERT ADVICE

p.50 Career Center p.52 Ultrasound Tech Expert Sponsored by Conquest Imaging p.54 The Future p.56 Patrick Lynch p.58 Karen Waninger p.60 Beyond Certification p.62 Roman Review

P.64 BREAKROOM p.64 p.66 p.68 p.70 p.74

Did You Know? The Vault Scrapbook What’s on Your Bench? Parting Shot

p.73 Index Like us on Facebook, www.facebook.com/TechNationMag

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PROFESSIONAL OF THE MONTH Gina Contreras, BS, CBET By K. Richard Douglas

ometimes your spouse is right and you should pay attention. Some people actually heed their spouse’s suggestions and that was the case with one HTM professional in Dallas.

“I was 18 years old when I became a medical assistant and worked for an internist who would have a cardiologist, podiatrist, and general surgeons rounding in our Las Colinas office,” says Gina Contreras, BS, CBET, clinical engineer in Clinical Technology, part of Biomedical Technology Services at Baylor Scott and White Health. “I was exposed to a myriad of opportunities to continue my education and was unsure of the direction in which to go,” she recalls. “ I knew I wanted to study medicine, but because I had small children at home, I knew I had to decide quickly. When my husband suggested I study biomedical engineering, I thought he was insane. I thought there was no way I could commit to something I knew nothing about.” It didn’t take long for Contreras to realize that she loved the idea of designing machines to improve someone’s quality of life. She received a Bachelor of Science degree in biomedical engineering technology from DeVry. Her fourth year really launched her career. “Our senior project took countless days and evenings to achieve the best senior project of my class. It was a device that was geared toward quadriplegic patients; comprised of sensors, amplifiers to increase the signals, software, and finally AC receptacles for outputs.,” Contreras says.

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“Our goal was to give patients the power to operate on/off switches by capturing movement from the patient’s forehead to operate anything that would plug into our AC plugs,” she explains. “Ultimately, we got the attention of the judges who hired me at Baylor Health Care System. Here I am five and a half years later.” Her education was supplemented by what she describes as “ad hoc training;” learning from veteran biomeds in her department. Her on-the-job training came from specialists in the ED and OR. “I attended a couple formal courses for nurse call training and GE patient monitoring,” she adds. Contreras started out at Baylor as a BMET in March of 2009. “In July of 2013, I was promoted to clinical engineer because of my involvement with several in-house projects,” she says. “One of which included the improvement of nurse to patient response time by communicating with clinicians the services available to them they didn’t know they had. We pulled data from reporting servers to determine what configurations could be made.” That promotion changed the characteristics of her job fairly substantially. She was used to handling the day-to-day functions of a biomed technician. Her new job resulted from her increasing involvement in replacing equipment, attending meetings

DECEMBER 2014

Gina Contreras serves an important role at Baylor Scott and White Health

and communicating with suppliers related to network integration. She gained knowledge on how to manage projects and how to work with networks. Her current boss, Richard Swim, was looking for someone with networking experience and Contreras also had project management experience. “When I interviewed for the clinical equipment management position, that’s exactly what my new manager was looking for,” she explains. “Now it’s a totally different spectrum of knowledge; going from opening and closing devices to now we’re setting up equipment on networks. Whether it’s hard-wired or wireless, to communicate with the rest of the hospital. It’s completely different.” Her position requires more collaboration with IT than before.

Gina, far right, attends a career fair at a local school.

“I have to make sure that the equipment we set up on our hospital network is secure and that we set up our switches and our ports and all of our equipment with the correct configurations,” she says. “If we don’t, we could shut down the system or mess up whatever other devices are on the Baylor network.” “Gina is a true inspiration,” says Carol Wyatt, MPA, CBET, manager of biomedical engineering at Baylor. “She started with Baylor as a biomed tech and did an outstanding job. She moved into a clinical engineer role a little over a year ago. Besides managing medical equipment applications such as MedNet, she manages projects for the entire Northern Baylor Scott and White’s 14 hospitals.” Wyatt points to one example where Contreras’s skill set was of great benefit to her employer. “One of our hospitals experienced interference between the WOWs and the infusion pumps. It was a frequency conflict. Due to lack of on-site resources, Gina volunteered to resolve the issue by changing the frequency protocols, which required touching 160 infusion pumps,” Wyatt says.

FAMILY Away from work, her kids are a big priority. “My hobbies are spending my every waking moment to raise my children and all

Gina programs a Dräger monitor.

other children spiritually with love and confidence in Him. My husband and I coach for U15 girls with a team of 19. They are my Alpha Phi United girls,” she says. “We also enjoy hiking, biking, and anything else that pushes us out of our own element — kind of like being a biomed.” A true believer in the ability of girls to set goals for their futures, Contreras encourages the girls to pursue their dreams. She is more than willing to be a helpful mentor. Contreras and her husband met in high school and have been together for more than 19 years. “We have three beautiful blessings; Jasmine, 18, Isaiah, 16, and Abigail, 14,” she says. “My daughter will begin college this fall to pursue a career as a physician’s assistant, my son has ambitions to become a cardiac surgeon, and Abi would like to be a professional soccer athlete or go into marketing for FIFA.” Her kids have the same spirit of unlimited possibilities that Contreras believes in based on her journey. “I have been blessed to have been surrounded by amazing leaders. Even when I didn’t have faith in myself, I’ve always had someone to encourage me to go beyond my own understanding. Recently, I had a manager tell me, ‘Never be afraid of a job description, if it’s something you want,’ ” she says.

FAVORITE BOOK: “Forbidden Love”

FAVORITE MOVIE: “The Story of Us”

FAVORITE FOOD: Italian or pan dulce (look it up)

HIDDEN TALENT: I love to sing!

FAVORITE PART OF BEING A BIOMED: “Patient/Customer satisfaction! I love knowing that I was able to resolve an issue with little or no interruption.”

FAVORITE MUSIC: Richard Meyer/ Andrea Bocelli

FAVORITE DRINK: Water

FAVORITE SNACK: Apple

WHAT’S ON MY BENCH? My laptop; a DELL Latitude E6520 My Daily Promise

SPOTLIGHT

BIOMED ADVENTURES A Golden Opportunity By K. Richard Douglas

“G

o west young man” paraphrased the words of newspaper editor Horace Greeley from a biography about him in an issue of the New Yorker newspaper from 1838. The quote was later thought to be Greeley’s endorsement of the 1849 gold rush. He had visited Colorado and tried panning for gold himself. It’s thought that some locals planted some gold dust, in order to fool him, and when he returned to New York, he wrote of the gold to be found out west.

Even with our advanced technology, there are still those who enjoy the adventure and excitement of panning for gold the old-fashioned way. “I had just had knee surgery and was going on medical leave for about two months. I was watching the Discovery Channel about the gold rush in 1849, and they showed how the prospector looked for gold,” recalls Terry Wells, CBET, biomedical tech specialist with Mercy Southwest Hospital in Bakersfield, Calif. “One of my old high school buddies told me he had got into prospecting and I should give it a try.” “I would say the old adage, ‘Go West,’ still holds true today, with the drought we’ve had in California; you can get to some places to find gold that would otherwise be under water,” Wells says.

THAR’S GOLD IN THEM THAR HILLS Wells started his research on the Internet, watching YouTube videos, learning about what equipment was needed and reading books about making equipment for prospecting. The Bureau of Mines says that prospective gold miners should know where “placer deposits are located and [the miner] must have the technical knowledge to extract the gold.” Early mining in the U.S. occurred in the southern Appalachian region during the late 18th and early 19th centuries. When the richer deposits were exhausted,

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attention turned to the western part of the country. A major impetus that turned enthusiasts’ attention toward California was the discovery, by James Marshall in 1848, of a major deposit on the American River in Coloma, Calif. His find started the first of the early gold rushes. Placer or alluvial deposits of gold are those deposited by rivers or streams. Gold is heavier than other things found in water and will sink to the bottom of a collection device. “I’ve been pretty good at building things in the past, and thought I could build everything they [gold prospectors] use. So I took other people’s ideas, and with a few scraps of things I had around the house, [and] a Home Depot right down the street from my house, [was] off to building the things I would need,” Wells says. “I borrowed some equipment from family and friends to draw my own plans and build my own equipment. I had some old batteries and some solar panels for charging them, for my power source,” he adds. “First I built a dry washer for separating heavy materials, like gold, from the lighter materials. Then I built a sluice box, [in] which water flows down this tray with matting in it to catch the gold and black sands,” Wells says. “Then, I pan out the gold from the black sands and dry the gold and put it in a glass bottle. I don’t sell my gold.” “A dry washer is something you put dirt in, and this thing will use air pressure and

DECEMBER 2014

Terry Wells, CBET, biomedical tech specialist with Mercy Southwest Hospital likes to prospect for gold in his spare time.

gravity to separate light material and the heavy material; the heavy material being gold,” he says. “It’s got a motor. It uses a bellows underneath and you put your material in the top and it uses a bellows to kick the light material out and it uses an offset motor to vibrate and the heavy material is caught in a trap at the bottom.” Wells did his research and learned, to his good luck, that one of the biggest areas for placer gold was nearly in his backyard; the Kern River Valley. “I purchased some books from the 1960s that had old maps of the area where gold mines and gold bearing areas were located in Kern county. With these maps and Google Earth, [I] found areas that gold was found in times past,” he says.

Terry Wells built many of the tools he uses when prospecting for gold. Pictured from the top, gold is seen in a pan and on the bottom, a drywasher that Wells uses to separate free particles of placer gold from dry sediments.

“In February 2014, I joined the Gold Prospector Association of America to gain more access to gold bearing areas near Bakersfield,” Wells says. “Kern County has had a rich gold history, according to the old books I’ve come across. So every couple of weeks, I go to the Kern River and take a couple of test pans to see if it’s worth it, then take some pay dirt I’ve processed home and pan it down and collect my gold. I’ve been pretty successful so far; but not rich.”

CASTING A LINE “I’m a trout fisherman when time permits. I’ve been going to the Owens River Valley area for the past 40 years,

thanks to my dad. He took me to the Bishop area when I was young and have been going back for a long time. I would like to become a trout guide in that area when I decide to retire,” Wells says. “My largest trout to date is about 7 pounds.” Wells also plays darts and even became a franchisee for the American Darter’s Association out of St. Louis for about six years and ran a 30-member league at five locations. “There were only two dart leagues in Bakersfield at that time,” he remembers. “We took several members to the national finals in Las Vegas. I, myself, finished in the top five to seven in the nation on several different trips there. Those were good times.” An HTM professional for 34 years, Wells started the apprenticeship program for the VA in Kern County in 1980. “I got certification in 1985. I was number 2,224 in the field of CBETs. Lots more have come and gone since I started,” he says. Wells says that he has trained, or helped train, about eight other biomeds. “We work on just about everything here except MRIs,” he says. “No contracts on equipment here either. We fix it or call in for assistance on repairs. I have served as the interim manager for about six years before TriMedx came on board back in August 2012.” When retirement arrives, he will be found shaking a pan or casting a line.

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SOUTHEASTERN BIOMEDICAL Receives FBS’s President’s Award

he Florida Biomedical Society presented awards at MD Expo Orlando in October. The association recognized a vendor of the year, a professional of the year and presented several scholarships. Southeastern Biomedical Associates Inc. was presented the President’s Award.

“They have provided to FBS and its chapters education and material support as well as support to the HTM committee at large,” according to an email from Fred McMurtrie. “The founders Greg Johnson, CBET, CHFM, and Boyd Campbell, CBET, CRES, are active members of the North Carolina Biomedical Association in addition to helping other biomedical societies. Boyd has also assisted numerous biomedical organizations by providing training and education not only in the United States but also abroad in conjunction with such organizations as the World Health Organization.” “Over the years, Boyd has been published

and been featured in many industry magazines and newsletters on topics from education to recognition of his contributions to the biomedical field,” McMurtrie added. “In addition, he has assisted hospitals by traveling to India and Africa on multiple occasions to perform biomedical duties in underprivileged countries.” “Greg has served the NCBA on the board as a directors for over 10 years and is a past-president, a two-term treasurer, hotel coordinator for multiple years and has held other board-appointed positions,” he wrote. “Embracing the spirit of giving back to those in need, Greg has travelled to Europe on four occasions, volunteering biomedical expertise

to multiple hospitals and clinics in Pristina and surrounding cities within Kosovo.”” “Ashley Miceli a member of Southeastern Biomedical Associates’ sales team has severed as the FBS Vendor Ambassador for the past two years with dedication and distinction during her tenure. The Florida Biomedical Society takes great pride in recognizing their outstanding leadership in our profession,” according to McMurtrie. The FBS BMET of the Year was awarded to Steve Slichter. TO LEARN MORE about Southeastern Biomedical visit www.sebiomedical.com

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DEPARTMENT PROFILE Grande Ronde Hospital Clinical Engineering Department By K. Richard Douglas

here is only one hospital in Union County, Oregon; a county that covers 2,038 square miles and has more than 25,000 residents. The county’s main economic driver is farming and it offers hunting, fishing and camping for leisure. The hospital that serves the residents of the county is Grande Ronde Hospital (GRH). The hospital’s doors were opened for the first time in 1908. A new facility replaced the aging one in 1966. Additional construction in 1982 and 1992 extended the hospital’s footprint and offerings. A small group of HTM professionals oversees the maintenance and repair of the hospital’s medical equipment. “Our department consists of a combined clinical and facilities engineering group of 18 people,” says J. Michael Shepherd, BS, CBET, Biomedical Equipment Technician II. “Of that group, there are three biomeds; myself, Leroy Shelman, and Stephen Jeffery. Our department manager, Elaine La Rochelle, is the Director of Facilities here at GRH and is a Certified Healthcare Facilities Manager,” Shepherd explains. The department is responsible for equipment at the main campus and several satellite locations. “In addition to the main hospital, we also provide service for our affiliated clinics,” Shepherd says. “These clinics include our regional medical clinic, regional medical plaza, children’s clinic, women’s clinic, sleep clinic, and hospice.” As a smaller group of HTM professionals, circumstances require that the group be generalists and very flexible. The biomeds who make up the small contingent do have their areas of expertise. “Being a small critical access hospital, we cannot afford to specialize too strictly,” Shepherd offers. “The needs of the job requires us to be able to overlap each other in most areas. That being said, there are some things that primarily go to one or another of us due to greater

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familiarity or training.” “Leroy focuses on ECG, lab, and radiology. Steve focuses on anesthesia, thermometry and patient monitoring. My focus areas are patient monitoring/telemetry, ventilation and infusion,” Shepherd says. The biomeds try as much as possible to provide in-house service on equipment for the convenience of the clinical staff. “When an OEM or third-party service contract is required, it is normally the responsibility of the department to renew,” Shepherd says. “We provide oversight and coordination for service scheduling, however, in order to minimize impact on clinical care.” Shepherd says that all three of the department’s biomeds are members of the Oregon Biomedical Association. Because of a reciprocation agreement, they are also considered members of the Washington Biomedical Association. “In addition, I am also a member of the Intermountain Clinical Instrumentation Society as well as AAMI,” he says.

BEYOND THE ROUTINE The department has been involved in some special projects, both related to medical equipment and representing the HTM profession itself. “Most recently, we were involved in the implementation of the Philips IntelliBridge Enterprise, allowing data from our vital signs

DECEMBER 2014

Stephen Jeffery, Leroy Shelman, and Michael Shepherd are the three biomeds at Grande Rpnde Hospital.

monitors to be integrated into the EMR system,” Shepherd says. “Prior to that, we moved to an enterprise server for our infusion system.” With the ever-evolving relationship and handoffs between CE and IT, the team at Grande Ronde has it figured out. “We are separate departments, but have a fairly good working relationship with IT. Given the network intensive nature of modern medical systems means that collaboration is necessary from planning, through implementation, and finally to active use,” Shepherd says. “There were two issues that we have had to address recently; both are incidences

Grande Ronde Hospital serves a rural area of Oregon.

the world of the clinical and the networking world let us see the problem with more detachment to let us find the message formatting issue that was preventing successful communications.” Also, Shepherd has represented his team as he has become very involved with the alarm management task force at Grande Ronde. The task force was created in response to the Joint Commission National Patient Safety Goal of reducing alarm fatigue. “HTM was considered a vital member of the team as we have the greatest knowledge as to the types of alarms that can be produced by different systems, which alarms are configurable, and the degree to which they can be configured,” he says. “I have been working with the nursing managers to identify the largest sources of alarm fatigue in each care unit so that we can address response.”

HTM AMBASSADOR

Leroy Shelman works on a device.

where the worlds of HTM and Information Technology interface,” he explains. “The first was a problem with placeholder SSN issues,” Shepherd says. “When a patient, without a Social Security number is admitted, a placeholder of all zeroes is entered, as our ADT system requires SSNs. Our OB TraceVue system does not require Social Security numbers however, and when a patient is imported into the system, the all zero number is seen as a conflict, since it had been attached to the first patient to use the number.” “With IT we stripped the SSN off of the ADT data on import into the OB system,

Michael Shepherd works on a Puritan Bennett Model 840 ventilator.

then reattached the number on export to the medical records system with discharge of the patient.” The team at Grande Ronde also used its problem-solving skills to solve another technology conundrum. “Another issue was working between IT and Philips medical with regards to interfacing our vital signs monitors to the EMR,” Shepherd recalls. “The data moved between the two systems by way of the Clinical Data Interface, and had a great deal of issues getting the data across. Both sides were convinced that the problem was on the other side, and our unique position between

In a variety of ways, HTM professionals across the country have found ways to let the next generation of biomeds know about the profession. Many have found ways to bring about more public awareness of what biomeds do. “This [past] spring was the first year that clinical engineering was asked to present at our hospital’s annual community health fair,” Shepherd says. He ran a booth for the day, demonstrating a small selection of equipment to raise awareness about the HTM profession. “I had a patient monitor, an oscilloscope, and a therapeutic ultrasound,” he says. “I used water on the ultrasound head to show the energy output. Kids especially found that cool, but most people seem to like an active display. It allowed me to explain the principles of ultrasound and the differences between therapeutic and diagnostic ultrasound, as well as how we troubleshoot and repair them. A large number of people were interested in how to enter the profession.”

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IN DEPTH

Low-Acuity Continuous Monitoring

ow-acuity continuous monitors offer the constant vital signs monitoring that spot-check monitors lack, but without the high cost of higher-acuity, ECG-equipped physiologic monitors.

Low-acuity continuous monitors are designed to take continuous measurements of one or more of the basic vital signs that have traditionally been acquired intermittently during nurse spot checks, such as pulse rate, noninvasive blood pressure (NIBP), arterial blood oxygen saturation (SpO2), and respiration rate. They do not display ECG waveforms. This relatively new class of devices is becoming increasingly popular, and it fills a niche in low-acuity areas because of two key advantages over other types of monitoring devices: • Unlike spot-check monitors, low-acuity continuous monitors provide constant, automatic monitoring of patients. • At an implementation cost of $4,000 to $6,500 per bed, they are less expensive than ECG-equipped physiologic monitoring devices — the other alternative for providing continuous patient monitoring on lower-acuity med/surgical floors — which can cost anywhere from $8,000 to $40,000 per bed. In addition, low-acuity continuous monitors commonly allow centralstation and remote monitoring and include capabilities such as connectivity with electronic medical records (EMRs), admit/discharge/transfer systems, and ancillary alarm notification systems.

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THE NEED FOR LOW-ACUITY CONTINUOUS MONITORING A limitation of vital signs spot checks is that several hours may pass from one check to the next. Nighttime checks may be particularly infrequent, since checking vitals during sleeping hours can result in an increase in patient blood pressure and delirium. During the gap between these spot checks, the patient may experience warning signs that precede critical events such as cardiopulmonary and respiratory arrests, and the patient’s health may begin to decline. These changes may go undetected until the next spot check. The sooner changes in vital signs can be identified, the sooner clinicians can alert the rapid response team (RRT) — a group of specially trained staff ready to treat patients whose health is in rapid decline, with the goal of minimizing or preventing an impending critical event. Studies show that having an RRT intervene during ominous vital signs changes can significantly reduce occurrences of critical events, unplanned transfers to the ICU, and mortality rates. Automated, continuous vital signs monitoring for low-acuity patients is one way to help meet this need, and is specifically recommended in certain instances by the Anesthesia Patient Safety Foundation and the Joint Commission.

DECEMBER 2014

SYSTEM COMPONENTS Low-acuity continuous monitors — like most other continuous monitoring solutions — utilize the following components: • Sensor device(s). One or more types of devices that detect patient vital signs information. They are typically attached to the patient (such as with an upper-arm NIBP cuff or an SpO2 sensor). • Display unit. A device located near the patient that receives input from sensors and displays the vital signs information. It may be a tabletop unit, a wallmounted display, or a lightweight module worn by the patient. Alarms are a common feature of these devices, and are typically designed to sound when a vital signs measurement deviates outside a certain range or when an early warning scoring system indicates the need for an alert. In order to support continuous monitoring of multiple patients, display units send physiologic and alarm data to a central station.

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• Central station. Technology that facilitates the monitoring of multiple patients at a single location, typically at a central nurses’ station. The connection between the monitoring device and the central station may be wired (via a LAN) or wireless (via the hospital’s network or a proprietary network). Central stations often have alarm features that alert clinicians to changes or deterioration in patient vital signs, and may include alerts to mobile devices via ancillary alarm notification solutions.

AVAILABLE TYPES OF SYSTEMS Low-acuity continuous monitoring devices can be grouped into three general categories: • Bedside monitors. Sensors attached to the patient (e.g., NIBP cuff, SpO2 sensor) are physically connected via cables/leads to a display unit situated near the patient’s bed. Vital signs data can be viewed on these display units or at a central station or on a remote display. • Wearable monitors. Sensors attached to the patient are connected to small, lightweight display units also attached to or worn by the patient. These monitors can display vital signs data on their small screens as well as wirelessly transmit the data to a central station. The absence of a

connected bedside unit allows the patient to move more freely. • Noncontact (or “unconnected”) monitors. These devices are able to monitor certain vital signs (e.g., heart rate and respiratory rate) without any physical connection to the patient. As long as the patient is in bed (or, in some cases, a chair), the device — typically a sensor placed beneath the bedsheets or mattress — can monitor vital signs and display the data on a unit situated near the patient’s bed and/or at a central station. The patient is not required to be in direct contact with the sensor; however, if the patient leaves the bed, vital signs monitoring will cease until the patient returns. THIS ARTICLE is an excerpt from a Health Devices article posted on ECRI Institute’s membership websites on September 10, 2014. The full article includes more guidance on purchase considerations. For help in evaluating low-acuity continuous monitors, to purchase the full article, or to learn more about membership programs, visit www. ecri.org, contact clientservices@ecri.org, or call (610) 825-6000, ext. 5891.

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AAMI UPDATE

Top 10 Medical Device Challenges

ealthcare technology management (HTM) professionals face a number of challenges as they make sure the equipment they maintain provides safe and effective care.

A recent survey, which includes responses from 195 hospitals across the United States, reveals what problems keep them up at night. Ensuring that networked devices and systems work properly topped the list of medical device-related challenges, according to the results of a survey commissioned by AAMI. The survey, the results of which appear in the September/October issue of AAMI’s BI&T (Biomedical Instrumentation & Technology) journal, found that 62 percent of those surveyed rate the networking issue as “challenging” or “extremely challenging.” Meanwhile, 52 percent name integrating data into electronic health records as their top concern. Maintaining infusion pump systems (44 percent) came in at number three. The results reflect those seen in previous AAMI-commissioned surveys, indicating that there are no easy solutions for these ongoing complex problems. Other challenges making the list are cybersecurity, device incident reporting, recalls, spectrum and wireless management, battery management, endoscope management, and nonhospital devices being brought in by patients.

AAMI INTRODUCES FREE SERIES OF PODCASTS Seeking to connect with healthcare technology professionals in new and creative ways, AAMI has launched a series of podcasts that will focus attention on some of the hottest issues in the field. The podcasts, developed in partnership with Healthcare Tech Talk, will cover a range of

1TECHNATION.COM

DECEMBER 2014

topics, including tubing misconnections, the operation of healthcare technology management (HTM) departments, and ventilator technology. The series kicked off with an interview with AAMI President Mary Logan. “Earlier this year, I sat down with the hosts of Healthcare Tech Talk, and the idea to collaborate on this series was born,” said Logan. “We’re excited to work with the hosts of the show, Terry Baker and Kelley Hill, and welcome suggestions or interview subjects for future shows.” To Logan, the addition of the podcasts was a natural progression for AAMI. “We have great publications; we have great educational sessions; and we have great content,” she said. “However, people are different in terms of how they want to receive information. We weren’t maximizing all of the opportunities to disseminate content on subjects people are passionate about. These podcasts are yet another way to help our audience learn more about pressing healthcare technology challenges and patient safety issues.” All AAMI podcasts will be available on a new page on the AAMI website: www. aami.org/news/podcast.html. Additionally, the podcasts can be accessed through three major podcast distributors: iTunes, TuneIn, and Stitcher.

UPDATED GUIDE PROVIDES ANSWERS TO WATER QUALITY QUESTIONS Water is a critical component in the various stages of medical device reprocessing. How can those in charge of reprocessing devices ensure they are using water of the proper quality? A revised technical information report

(TIR) from AAMI can help. TIR34:2014, Water for the reprocessing of medical devices, addresses water treatment equipment, water distribution and storage, quality control procedures for monitoring quality, strategies for bacterial control, and environmental and personnel considerations. Intended for personnel who reprocess medical devices and those who maintain the water treatment system, the document revises the 2007 version. “The biggest change in this TIR is that we now have two categories of water quality: critical and utility,” said Emily Mitzel, laboratory manager at Nelson Laboratories and co-chair of AAMI’s Water Quality for Medical Device Reprocessing Working Group, which developed the TIR. “The definitions of these and how they are utilized are explained very well in the document.” The document defines utility water as coming from the tap and usually in need of no further treatment. It is primarily used for flushing, washing, and rinsing. Critical water is treated extensively to ensure that microorganisms and inorganic and organic material are removed. It typically is used for either the final rinse or steam generation. While the main text covers information for those involved in reprocessing, annexes provide technical information for water maintenance personnel. “An informative annex addresses poor water quality and the impact on medical device reprocessing with pictorial examples, along with recommendations for investigation and correction,” added Jackie Daley, corporate director at LifeBridge Health in Baltimore, Md., and co-chair of the working group. “An extensive reference list is provided for further reading. Therefore, if water quality is important to you, then this TIR is a must-have reference.”

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BIOMED 101

Using Disk Management For A Safer Clinical Environment By David Shane

n the 20th century when one bought a PC in a store someone would load the operating system and applications from portable disks like CDs or floppy diskettes. This process took a great deal of time. As operating systems got more complex the process took more and more time. Toward the end of the last century, manufacturers began using image files that store the entire contents of a system hard drive or volume. Using these files to replicate the operating system, basic applications and the default factory settings saved time and money. They also reduced the number of mistakes. These image files would be applied to the hard drives using a method called disk management. Large corporate enterprise system planners quickly followed suit and started using the same technology to package a homogenous suite of applications and, just as important, security settings to protect the hard work of the system engineers. And, to protect the hard work of the business partners, the system planners often mandated that the data produced by the business partners be kept on servers that could be backed up. The concept of disk management entails being able to isolate the system hard drive or boot drive of the PC while it is running. The goal is to make a perfect copy of all of the data, bit by bit, on the system drive. This cannot be done while the PC is running as files are locked during operation. For this reason something called a Pre OS is used to boot the computer. A Pre OS can be a version of Windows or Linux or even an old version of DOS. WinPE, an acronym for Windows Pre-Environment, is a Pre OS that uses a Windows kernel to power the processor and is the most popular Pre OS. In the pre-environment, the operating system is loaded on the PC without using the hard drive. The Pre OS loads from another

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medium such as a portable disk or a USB thumb drive or even from a network source. The PC will run while the hard drive is isolated. In this state, an image file can be created from the drive or be applied to the drive. Clinical workstations present a special kind of challenge when trying to apply this kind of methodology. Often the sheer amount of data being crunched by a clinical PC requires the database and data to be hosted on the PC itself. The delicate nature of the applications might not mix well with a homogenous security scheme. Often with clinical workstations electronic patient health information, or ePHI, is kept on a single hard drive in a database. And while the enterprise security settings are usually tested on the homogenous business PCs to insure stability, due to the time and cost to produce, it is often impractical to test these settings on a clinical PC that was built by the manufacturer or a custom PC built by a clinical engineer or technician. Clinical PCs can often cost thousands or even tens of thousands of dollars. Custom builds can take days of effort just to load the applications and patches from disk and then properly configure. These challenges invite new questions. How can the method of disk management be used to reduce the cost of deploying and supporting the clinical environment? Can these methods also be used to create a

DECEMBER 2014

DAVID SHANE Clinical System Intergration Engineer

safer clinical environment? Using a Pre OS to connect the PC to a network source allows the use of network resources. The image files can be downloaded from the storage server. The operator could then choose from a selection of image files. Using a server to â&#x20AC;&#x153;pushâ&#x20AC;? a Pre OS to the clinical PC over the network allows one to automate these processes. Pushing the Pre OS from a server would also allow one to back up an entire clinical PC, system, data, and

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application settings all into one image file. Every last physical bit of data can backed up. When a hard drive crashes one needs only to replace the download and reload the most recent image file. How do we use disk management to deploy and support the environment? The three things a clinical desktop management system needs to be able to do is deploy, backup and restore the workstation. By storing the image files on a server the technician restoring the PC can choose which specialized image should be applied to the workstation. When using disk management methods one creates the clinical work station once. Once the image file is created it can be easily replicated across the enterprise. It’s easy to build one perfect workstation in a test environment. It’s not as easy to build 10 or 100 perfect PCs in a production environment. One can almost be assured a percentage of the PCs will have mistakes in them. This makes disk management a better solution for patient safety. When the PC hardware needs to be upgraded it can be as simple as adding new drivers for the new hardware. When the hard drive crashes the image file can be loaded quickly without error. When a new system is deployed the image file can be used again and again to load multiple PCs. Clinical system manufacturers can list the PC hardware on an 510k certificate from the federal Food and Drug Administration. This certificate then becomes the legal standard for the clinical application, system and hardware. When this happens, the PC hardware cannot be changed without going through the extra

steps required to become a medical equipment manufacturer. When the PC hardware is listed on the FDA 510k certificate the restrictions for disk management can be a bit more challenging. The manufacturer will need to approve the method of disk management that is used. They may even have their own method. They may have listed the PC hardware on the 510k certificate in order to avoid conflicts with a Pre OS. Application licensing can also present a challenge for disk management. There are third-party utilities for this. They vary in concept, cost and time required to process. Working with manufacturers to develop a scheme for clinical application licensing is something that may cut the time and costs required. Using site licenses with a vendor approved audit utility might be the simplest method. In the context of existing enterprise disk management tools, a business system simply needs to be able to deploy the image files to PCs. In contrast, disk management for the clinical environment needs to be able to deploy, backup and restore. The contribution to system availability that disk management represents is easily quantified by means of accounting for the time required to restore a clinical system. The less time it takes to restore a clinical system, the more available the system is. The contribution to patient safety is harder to quantify. But it is as simple as understanding that a running system is keeping people safe. A system that is under repair is not available therefore it is not keeping patients safe.

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WEBINAR WEDNESDAY

Continues To Educate And Impress Attendees By John Wallace, Editor

iomeds from around the country enjoyed two free webinars during October thanks to the TechNation Webinar Wednesday series and sponsors Advanced Ultrasound Electronics (AUE) and MedEquip Biomedical. Jim Carr of Advanced Ultrasound Electronics (AUE) provided an in-depth look at 2014 ACR ultrasound and breast ultrasound accreditation programs on Oct. 22. The 75-minute webinar examined ACR accreditation requirements. Carr touched on the basics and more as he shared the reasons for ACR accreditation, reviewed quality control measures, provided a list of recommended assurance tasks and shared 12 recommended activities for a quality control plan. He also reviewed important tools and procedures for PMs and ACR testing. Attendees praised the webinar in a post-webinar survey. “This webinar covered questions and issues I have been interested in for some time. Mr. Carr did an excellent job! Please continue this series. I wish I could attend more of the series, but usually I am working. I viewed this one on my day off,” Kelly W. wrote. “I always learn something new, so I look forward to each webinar. You choose excellent speakers that are well informed and present information clearly,” Chad J. said in his survey. Medical Dealer Lifetime Achievement award winner Frank Magnarelli presented the webinar “How to Enlist the Support of Administrators and Department Heads to Reduce Your Hospital’s Dependence On Maintenance Agreements” on Oct. 29. This was a popular webinar with more than 150 people signing up. He discussed the impact of technology on healthcare and hospital operations with insightful examples from the automotive industry. Magnarelli also touched on maintenance agreement pricing and how to move away from the standard “10 to 15 percent of device replacement costs” for a maintenance contract. He discussed avenues for change including self insurance, a gradual implementation of programs and annual reports. Magnarelli also answered questions throughout his presentation and says he is available to answer questions or discuss the topic further via email at Frank39@gmail.com.

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“I think Frank is awesome and I am glad he shares his knowledge accumulated over years of experience. When he talks I listen! I always have time to listen to Frank,” David S. wrote in his post-webinar survey. “Frank is a veteran and long time clinical engineer with great ideas for saving money. Downtime is an extremely valuable tool as it is usually not deferred revenue but rather lost revenue. If a CT is down and the patient goes to hospital X for that service the surgery will probably be lost as well ... along with follow up. It’s exponential,” Frank N. wrote in his survey. A recording of the October webinars and information about upcoming webinars is available online at IAmTechNation. com/webinars/. FOR MORE INFORMATION about Webinar Wednesday, visit www.IAmTechNation.com.

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Wednesday

1TECHNATION.COM

SHOP TALK

Equipment Inventories Q:

I keep running into hospitals that have their equipment inventories only partially setup. By this, I mean they are missing some of the following: 1. Imaging Equipment – they only inventory the stuff that they personally maintain. 2. Department accounting number – they are not able to identify which departments are their biggest customers, nor are they able to run department-specific reports. 3. Work order data – technicians do not log their time accurately. 4. Parts costs – Technicians do not log the cost of parts to specific assets in the inventory. 5. Hourly cost in the CMMS – I have seen departments that set the CMMS chargeback rate anywhere from $15 to $350 per hour. What other inventory and CMMS data omissions do you see? Could the industry be ready for a basic inventory management class? Why are the CMMS vendors not teaching these things?

Some other traditional ones that are often missed are lab equipment, endoscopes, scope washers and sterilizers. Some new ones that are often missed are IP address, anti-virus software version, PHI identification (Does it store PHI?) and PHI protection (How are you protecting against PHI – physical security, encryption, etc.?)

1TECHNATION.COM

Inventories should include: operating system and patches applied, applications revisions, network information (to include but not limited to IP address, MAC IDs, LAN, primary and backup networks, etc.), serial numbers, model numbers, and manufacturing dates of certain parts of the system such as X-ray tubes, collimators, detectors and equipment license information such as systems that require a license to operate in your state such as CT or sterilizers.

What are your favorite pieces of test equipment? And, why? I am interested to find out what tools are good for a Biomed starting to fill up his first toolbox.

air leaks, it is unaffected by ambient noise. I first encountered this tester working in a pharmaceutical manufacturing plant.

Fluke Impulse 7000. It is a defibrillator/AED/pacer analyzer. No test loads needed, they are built in and it is very light!

A quarter-inch SAE and metric socket set, butane soldering iron, zipties (new age duct tape) and a nice LED penlight are always handy.

The Fluke Pro Sim 8. You can complete a patient monitor PM with ease in just five minutes. It’s pretty compact, has built in leak testing functionality, and can check all parameters including cardiac output, invasive pressures, NIBP, temperature, ECG, and SP02. It also has a long battery life.

My favorite tool is a de-soldering iron from RadioShack. It is a simplified version of a de-soldering station. It has an integrated squeeze bulb on a soldering iron with a hollow tip. All you have to do is compress the bulb with your thumb, put the component lead into the tip of the iron, wait for the solder to melt and release the bulb. I paid about 12 bucks for mine and use it all the time. For board level replacement of ICs, it is the best! Now, I don’t have to wish I had a third hand every time I de-solder.

Pronk’s toolkit is my favorite. NIBP, pulse ox, ECG and cardiac output in a handy self contained carry around. My Pronk Slim-Sim SL-8. It’s great for rapid troubleshooting of EKG issues and it never needs charging. My most non-traditional piece of test equipment is an ultrasonic leak detector. I have an Inficon “whisper.” It is great to check for pneumatic leaks that are very small or in noisy environments. Since it detects ultrasonic disturbances caused by

DECEMBER 2014

What is the benefit of getting a certification? Is it worth the time for a HTM professional just starting out? I feel that the effort taken to obtain certification shows a commitment to the occupation. If I was looking at two candidates of equal experience, but only one had certification, I would give preference to the certified individual. While this is generally not a requirement for employment, most employers prefer certified applicants.

FAST, PRECISE AND DEDICATED

Many years ago having a certification got you a hiring bonus at some places. One hospital in our city requires certification to get promoted to a Tech 3 position. I’ll agree it is a huge advantage in the hiring process. But, unfortunately, I’ve been hearing that a low salary seems to be more of a priority these days over experience and certification to some employers.

A: A:

It also sets the bar for a minimum standard. I agree 100 percent. The effort to get certified shows commitment and dedication. We can teach the rest!

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THESE POSTS are from TechNation’s ListServ. Go to www.1TechNation.com to find out how you can join and be part of the discussion.

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ROUNDTABLE Test Equipment

est equipment is vital for the HTM community. Biomeds rely on these hightech devices to perform many tasks to help them maintain medical devices. Rarely does a day go by where they donâ&#x20AC;&#x2122;t have to test something as part of a repair process. What are the latest advances in test equipment from the leading manufacturers? Is it possible to keep up with the latest test equipment technology without buying brand new?

1TECHNATION.COM

DECEMBER 2014

TechNation asked a group of experts in the field of test equipment these questions and more. These experts agreed to share their insights with readers. The members of the expert panel are Greg Alkire, Vice President of Sales and Marketing, Pronk Technologies Inc.; Jack Barrett, National Business Development Manager, Rigel Medical; Michael T. Bayliss, Global Sales Manager, Datrend Systems Inc.; Ken O’Day, Vice President of Sales and Marketing, BC Group International Inc.; Patrick Pyers, Vice President of Sales, Marketing & Business Development, Radcal Corp.; and Jerry Zion, Global Training Manager, Fluke Biomedical. The answers provided by these individuals are the opinions of the submitters and not necessarily the opinions of the company that employs them.

WHAT ARE THE LATEST ADVANCES OR SIGNIFICANT CHANGES IN TEST EQUIPMENT IN THE PAST YEAR? ALKIRE: The Healthcare Technology Management (HTM) test equipment market continued to migrate toward more portable devices with more flexibility in the past year. There is a concerted effort to reduce the footprint of existing technologies in order to adapt to the more mobile biomed of today. Manufacturers that are able to leap ahead of legacy technologies with advanced features that include a more intuitive user interface, improved accuracy and speed are seeing success in the market today. I see this as a tremendous benefit to assist the biomeds in saving time and cost for maintaining the medical devices. BARRETT: Last year, I commented on the growing importance on test automation and data traceability. This continues to grow in importance. BAYLISS: The use of wireless connectivity is probably the biggest change recently. Almost everyone uses a smartphone or tablet and would like to see the same capabilities with their test equipment.

ZION: The most notable advances in the past year include wireless connectivity functionality, software developments to interface with a broader range of technology (think tablets, notebooks, etc.) and innovative ways to turn data into real-time insights. All of which have improved the way measurements (and ultimately decisions) are made.

HOW WILL THOSE CHANGES IMPACT THE TEST EQUIPMENT MARKET IN THE FUTURE?

JACK BARRETT

National Business Development Manager, Rigel Medical

For example, using the tablet as both the user interface and the wireless communication link. O’DAY: In order for the test equipment to keep up with new medical devices, they need to be faster, more comprehensive, software driven and upgradeable. Smaller is another trend, but being able to hold something in your hand while you test doesn’t always give you the best results. Sometimes functionality is more important than size. PYERS: Test equipment is a very broad arena of products used today. It is comprised of many different testing instruments from electrical safety analyzers to sophisticated diagnostic X-ray test meters. The use of new displays utilizing the latest in touchscreen technology is more prevalent today than in the past. With the emphasis on time savings, touchscreens speed up the testing setup procedures and analyzing the results obtained from the measurement. Laptops, tablets and smartphone technology of today provide the platforms of some of the new technology seen this past year and will play an even more important role in test equipment to come in the near future.

ALKIRE: Smaller and more flexible solutions will allow users to be more efficient and flexible in their work environment. For example, rather than removing a medical device from a patient room on the fourth floor and dragging it down to their shop, they can now do all the testing needed right in the patient areas without pushing a cart full of equipment through the hospital. One impact of more portable test equipment on the market, which may not be a coincidence, is an increase in the number of biomed shops taking on the maintenance work of smaller remote facilities. Historically, engineers would have to push an equipment cart across the parking lots and load/unload larger equipment in and out of a vehicle. Newer, smaller devices fitting into a small carrying case that can be thrown over a shoulder or even into a shirt pocket significantly increase the viability and efficiency of managing those remote clinics. BARRETT: Better and easier accessibility to test data along with porting data into CMMS via direct links or as attachments. BAYLISS: By using a wireless communication system, a user will not have to carry a tester, laptop, and multiple service manuals in order to perform tests. Tests can be initiated on the tablet/smartphone by a user, or through a CMMS system, performed with a high degree of automation, with records wirelessly communicated and stored.

THE ROUNDTABLE

O’DAY: In order to compete, we will need to continue to use the latest technology to design products with the future in mind. Continued support and “future proofing” our products is our way of being a good corporate citizen in this ever-changing field. We want the end user to be a long-time partner and not just someone to purchase the latest item on the market.

should investigate all test instruments available today and be sure that they are purchasing the right tool for the right job. Work with your vendor. Most vendors have programs to help you fit your budget to the right tool to meet your requirements. Test equipment where options can be added on as money becomes available would be the most desirable.

PYERS: With the new technology incorporated in the instruments of today, faster processors with more capabilities of storing and analyzing more information will be seen in future test tools. The consolidation of several test instruments into a single device could be seen to provide the user with a time-saving and productive testing tool.

ZION: Consider how you can use the least amount of equipment possible. Look at comprehensive analyzers to test all parameters you need in a single tool. It’s also important to consider the expected life of the test equipment. Durable, reliable test equipment is always worth the investment.

ZION: The future is smaller, more portable and more efficient. Expect technology advances to improve productivity and mitigate risk. Form follows function, and that will be what drives innovation in test equipment.

WHAT TECHNOLOGIES AND TEST EQUIPMENT ARE WORTHY OF THE INITIAL INVESTMENT? HOW CAN A FACILITY WITH A LIMITED BUDGET MEET THE TEST EQUIPMENT NEEDS OF TODAY?

ALKIRE: Test devices that can save time and space (portability) are a wise investment, especially if they are affordable enough for each technician to have their own rather than sharing. Also, take into consideration the cost of ownership on calibrations and purchase units with warranties covering more than just the first or second year. Work with test equipment vendors that offer flexibility in buying options like offering individual testers or pieces of a more complete test system. This lowers initial investment and provides the flexibility to still take advantage of cost savings if a complete system is purchased over time. BARRETT: Ever tightening budgets, at a time when aging test equipment is reaching end-of-life, is a challenge for every healthcare facility. I think the

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GREG ALKIRE

Vice President of Sales and Marketing, Pronk Technologies Inc.

answer as to which equipment is worthy of investment begins with understanding the limitations of the current equipment versus what manufacturers specify is needed for PMs. If a PM cannot be completed per specification, it is time to upgrade. BAYLISS: I would suggest that test equipment with a high use of automation technology will result in the biggest impact. Facilities are looking for large savings in time, costs and manpower. Automation helps achieve these goals. O’DAY: Choosing equipment that is cost effective, but feature rich is a good start. Having the ability to choose from a family of products, allows the facility to get into the basic testing. Having an upgrade path or “Future Proofing” to allow the same instrument to perform on a higher level is the best way to protect your investment. PYERS: For a department that enters into a new modality such as X-ray machine testing and analysis, the most advanced test equipment is required to accurately measure on the more complex X-ray machines manufactured today. This holds true for all areas utilizing diagnostic test equipment. A facility needing these instruments

DECEMBER 2014

WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND MAINTAINING TEST EQUIPMENT?

ALKIRE: An important aspect that should always be considered is selecting test equipment that exceeds the accuracy specification of the medical devices being tested. Selecting test equipment that has an accuracy ratio of 4:1 where the test device should be four times more accurate then the device being tested will ensure the medical device being tested is indeed passing its specifications. BARRETT: Time savings associated with test automation increases the biomed’s bandwidth. Minimizing test equipment downtime is important as well. Rigel Medical has several leading calibration houses now authorized to accomplish on-site calibration. BAYLISS: The big consideration within facilities is time and manpower. Sometimes less expensive equipment involves less automation and ultimately costs more (to the facility) over the life of the test equipment. Other important purchasing factors to consider are length of warranty, access to service and calibration, and certainly ease-ofuse. O’DAY: Purchasing from a company who listens to the users and

considering the suitability of the technologies available from the test equipment provider, the next most important thing to look for would be the standard warranty that is included with their products. Purchasing devices that carry three or more years of warranty should be considered as a minimum standard as it is a great indicator of the reliability and durability of the product, as well as guarantees lower cost of ownership.

KEN O’DAY

Vice President of Sales and Marketing, BC Group International, Inc.

incorporates those conversations in the product is invaluable. Our products are designed, manufactured, maintained and redesigned in the U.S. Our engineering staff works with OEMs to incorporate test procedures and specifications to match what they require. If new specifications are introduced, our test equipment will be there for you. PYERS: When purchasing new test equipment, consider the features of each system and compare them against your needs. Do not base your decision solely on price, but think how the new tool will benefit you the most. Consider all the options for purchasing your new test instrument to meet your budget constraints. Purchasing equipment that is advanced today will allow for updating in the future to insure many more years of use. ZION: It comes down to portability, reliability, accuracy, ease-of-use and being there for the customer before and after the sale. Innovation defines the future, but only if it’s delivered in the right context.

WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR IN A REPUTABLE TEST EQUIPMENT PROVIDER?

ALKIRE: I would say that after

BARRETT: Do they provide full, self-contained functionality to meet PM and data requirements? Is there overhead in product specification to help address future product development from the OEM? Do service and support levels meet the biomed department’s expectations? BAYLISS: Look for a provider who has the technical knowledge of the test equipment and how it is used. The provider should be responsive to your needs in a timely manner, flexible and willing to work with you if a problem arises. O’DAY: Partnering with a test equipment company who has your best interest as their best interest is probably the best advice. Find a company who will be there for the long haul and support your product for years to come and not drop the previous product because there is something new. PYERS: The most important factors to look for in a reputable vendor are quality and longevity. The stability of a company does say a lot about the company. Being in business for many years shows commitment to the industry and most importantly the ability to support and service their products. ZION: The most reputable test equipment providers in the industry are companies that have gained their leadership positions by engineering the most reliable quality-assurance solutions for regulatory compliance. Look for a company with a reputation

MICHAEL T. BAYLISS

Global Sales Manager, Datrend Systems, Inc.

for exceeding customer’s expectations in quality, durability and accuracy.

IS IT POSSIBLE TO KEEP UP WITH THE LATEST TEST EQUIPMENT TECHNOLOGY WITHOUT BUYING BRAND NEW?

ALKIRE: It can be. It depends on the device in question. The most common approach would be to contact the test equipment company and determine if there is an upgrade path for the equipment in question. Our philosophy is that the first customer that bought the very first product we ever produced is as important, if not more, than a customer considering purchasing our devices for the first time. Therefore, we offer upgrade paths for all users even if their device is 10 years old. BARRETT: I would look at this a little differently. If the latest technology does not provide measured value for the biomed department, then it isn’t needed. Scarce budget dollars can then be directed to technology that fills a void in test capabilities. BAYLISS: Attempting to save a few dollars by purchasing used equipment may, at first, seem like a good plan. But when compared to the huge savings in time and manpower afforded by maximizing automation in a test device, those savings are negated, particularly when factored over the lifetime of the test equipment.

THE ROUNDTABLE

HOW CAN PURCHASERS ENSURE THEY ARE MAKING A WISE INVESTMENT IN TEST EQUIPMENT?

PATRICK PYERS

Vice President of Sales, Marketing & Business Development, Radcal Corporation

O’DAY: Whenever possible, BC Group attempts to “Future Proof” your purchases. BC Group introduced the ESU-2400 in 2008. There have been many changes over the last six years, but because we have the ability to flash updates at no charge, the shop that purchased the first ESU-2400 has a version identical to the production line version shipping today. The new ESU2400H is our latest model. However, the first ESU-2400 can be upgraded to all the features of the ESU-2400H for a small upgrade price. No need to buy new. PYERS: Although there are many older instruments out there that can do “most” of the job you need to do, newer technology far exceeds the capacity and ability of the older tools. You might get the job done, but the accuracy and time savings are not there. The manufacturers of the device you need to test are pushing the limits of test equipment each day as new machines are released. In order to get the job done right, you need the latest tools. Buy the most current tool while looking toward the future for new developments. ZION: Yes. Demo equipment purchases and taking advantage of volume-purchase agreements and promotions is the best way to get the latest test equipment technology for less than list price.

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ALKIRE: I think one of the best resources of information in our market is both the TechNation ListServe and the ECRI Institute’s Biomed Talk, where user facilities from all over the country (and elsewhere) are able to post questions and get answers directly from their peers regarding not only the user interface, features, accuracy and technology available in a specific product but they can also get a real sense of the manufacturer’s quality and support of the products. Both are free as far as I know. ECRI’s site is https://www.ecri.org/biomedtalk/Pages/ default.aspx and TechNation’s can be found at http://1TechNation.com/listserv/. BARRETT: Explore the options based on your requirements. Evaluate best-inclass solutions. Select the best total cost solution that aligns with the strategic direction of the department. Look at price versus performance juxtapositioned against requirement. BAYLISS: Investment decisions should involve reducing time costs and manpower through the use of automation as much as possible. Users should also consider maximizing their options by choosing scalable equipment to account for future capabilities and by ensuring equipment will communicate with devices from different manufacturers. O’DAY: When evaluating your test equipment needs, determine what you really need and don’t purchase features you do not need. Purchasing an item that will do 12 things when you only need to do three is not always the best bargain. Sometimes packaging items together make it look like a good idea, but if you don’t really need the features you might be wasting your money. PYERS: Purchasers should do their homework and compare all test equipment that they are searching for. Brand name equipment usually represents quality and long life. Most facilities need to realize that it is an

DECEMBER 2014

JERRY ZION

Global Training Manager, Fluke Biomedical

investment in purchasing a test tool and not just “another tool” that the department is asking for. An investment should not always be based upon the lowest price, but on the tool that will provide an increase in productivity. In the X-ray testing meter side, if the tool can prevent the X-ray machine from going down for a day or two, it more than pays for itself. Buy wisely. ZION: Wise investments are made beyond test equipment. Wise investments are made in a company. Whether it’s additional product training, or technical support you need, invest in a company that is committed to your success before and after the sale.

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BEST OF THE

BEST

A Look At The Top Biomeds, Departments And Issues From 2014 By: K. Richard Douglas

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DECEMBER 2014

hroughout the year, TechNation shines a spotlight on the good work that is done by HTM professionals and their departments. To wrap up the year, TechNation takes a look back at some of those individuals and departments who were featured throughout the year. In the year ahead, TechNation will shine the spotlight of recognition on many more HTM professionals and departments as they contribute to patient safety and patient recovery and are at the core of the nation’s healthcare system.

TechNation will also hit on some of the highlights of the year that affect HTM professionals. In some studies of employees, it is the more intangible rewards that motivate people and make them enjoy their work. The HTM profession is not excluded from this reality. Without HTM professionals, medical technology would be useless. There could not be healing without the contributions of HTM professionals. Recognizing and spotlighting the important work of biomeds and clinical engineers ensures that those professionals get the attention they deserve. In addition to the positive impact of HTM professionals during 2014, there were other events, products and regulations worth mentioning. Safer connectors, cybersecurity and a ruling on power strips were all big news items for HTM professionals and healthcare providers. Also during the year, AAMI continued

to work on its Career Ladder project. And, the TechNation Webinar Wednesday program saw real success. The MD Expo Orlando broke attendance records and an exchange for imaging professionals was launched at the first-ever Imaging Expo.

RECOGNITION In an article called “The Ten Ironies of Motivation,” from 1999, author Bob Nelson stated; “Study after study has shown that praise and recognition motivates employees to put forth their best efforts and to perform at higher levels.” Many studies support this contention and point out that recognition and praise are very

important to employees. While people expect to be compensated for the work they do, it is recognition for that work, and achievements on the job, that are truly meaningful to every working person. People want to be noticed for doing good work. While hospitals and healthcare systems have found ways to recognize the achievements of their employees, publications can carry that appreciation to a national audience of the employee’s peers. Often, it is the HTM professional who takes on a special project or gets additional certifications or skills, who might stand out. Sometimes, it’s the biomed who volunteers, using his or her skill set to help others. Other times, it’s the clinical engineer who spends extra time helping out their colleagues. In some cases, it may be an HTM professional who has also served our country. There are many reasons why individual HTM professionals are featured in TechNation.

BEST OF THE BEST

DEPARTMENT OF THE YEAR

Award winners at the MD Expo Orlando include, from left, TechNation Department of the Year ProHealth Care represented by Rob Bundick, Medical Dealer Lifetime Achievement award winner Frank Magnarelli, Medical Dealer Humanitarian of the Year Lynda Hammond and TechNation Professional of the Year Robert Preston.

PROFESSIONAL OF THE YEAR Robert Preston, CBET, A+, lead technician at St. Anthony Hospital, was featured as a Professional of the Month in TechNation. Preston is a good example of the people nominated by their peers; a biomed who has met challenges, a former officer in his biomed association and a former U.S. Army biomed who also volunteers his time to help others. One of the early graduates of triservice biomed training at Sheppard Air Force Base, Preston benefited from the program’s intense curriculum. Preston’s colleagues and fellow association members describe him as “committed,” “passionate,”

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“dependable” and “dedicated.” Like many of his HTM colleagues around the country, Preston had the experience of setting up a new hospital. He helped his department parse the difficult task of determining vendors for equipment. Also, as a former vice president and secretary for the Colorado Association of Biomedical Equipment Technicians (CABMET), Preston was the go-to guy for the group’s annual symposium. A fellow CABMET member, Dave Scott, said; “He helped make the CABMET Symposium what it is today. He would always say, ‘Next year is going to be even better.’ ” Preston was also featured in March 2014 for his volunteer work in Vietnam that included setting up medical equipment at Bach Mai Hospital in Saigon and coordinating a symposium to train biomeds in Vietnam. At the fall MD Expo in Orlando, Fla., Preston was presented with the TechNation Professional of the Year award.

DECEMBER 2014

It takes a group of HTM professionals to make a department. Sometimes, there will be some ancillary people to help with administration. Departments have been nominated for a number of reasons; they have great protocols and procedures, have tackled some big projects successfully or find ways to serve their customers in an exemplarily fashion. Many are innovation leaders as well. It may be the leadership or the experience, or even participation on committees that can make an exceptional biomed or clinical engineering department. The one department that made the cut and received department of the year honors is ProHealth Care, a biomedical engineering department originally profiled in August of 2011. The department went through a big transition in 2007, merging biomed groups from two hospitals and trying to make it all work right. Colleagues and clinicians say that the department is collaborative and provides good coverage. They are seen as a key part of the organization and deserving of recognition. The department’s manager, Rob Bundick, more recently helped out with a TechNation cover story about asset tracking in which he shared his department’s experiences. The members of the department were recognized at the MD Expo Orlando in front of their peers as the TechNation Department of the Year.

IMPORTANT EVENTS IN 2014 For those working with imaging modalities, there was the introduction of

the Imaging Community Exchange (ICE) at the first-ever MD Imaging Expo in Indianapolis this past summer. The Imaging Community Exchange, a web portal that brings together imaging professionals, provides a community exchange. It offers useful information, industry news, a community forum and career advice. The many benefits of sharing knowledge and networking, a service that the Internet performs so well, can be fully utilized through the website www. ImagingIgloo.com. The exchange can also pair prospective job seekers with openings in healthcare systems across the country. The MD Imaging Expo exceeded expectations with stellar reviews from industry leaders and a strong showing from throughout the United States. More than 200 attendees registered for the inaugural event held at the JW Marriott in Indianapolis. The Imaging Expo was created in response to a demand for a specialized conference on medical imaging. Attendees were treated to world-class speakers and exhibitors. The inaugural Imaging Expo featured 46 booths and sold out more than a month before the summer showcase. Hundreds of attendees benefitted from educational

opportunities with a variety of ASRTcertified classes. MD Publishing President John Krieg announced earlier this year that the second annual Imaging Expo is set for July 22-24, 2015, at the JW Marriott in downtown Indianapolis. The MD Expo spring show was held in Las Vegas in April 2014 and crushed attendance records. There were more than 350 attendees and more than 100 vendors with 275 exhibitor personnel. The three-day event combined work and educational sessions with social networking opportunities. The 2014 MD Expo Orlando was a runaway success with a record number of attendees. With 118 companies exhibiting and 468 registered attendees, the show broke previous records. The opportunities to learn and earn credit for continuing education reflected the professionalism of those in the HTM community. In partnership with the Florida Biomedical Society, the show’s number of vendors also reflected their commitment and respect for the profession. In addition to the recognition for the professional and department of the year honorees, the event honored the recipients of the Medical Dealer Humanitarian of the

The first-ever MD Imaging Expo was a huge success with hundreds of attendees and a sold out exhibit space. The Imaging Expo is returning to the JW Marriott in Indianapolis in July 2015.

JAYME LYNN MCKELVEY Webinar Wednesday Coordinator and MD Publishing’s Sales Expert

Year and Medical Dealer Lifetime Achievement awards. Lynda A. Hammond from ATS Laboratories was presented with the humanitarian award. Frank Magnarelli received the lifetime achievement award. Another successful TechNation undertaking in 2014 is the Webinar Wednesday series. Enthusiasm for the sponsored learning tool took off and participation grew. “We kicked off our Webinar Wednesday series in January with Trisonics Inc. sponsoring Hobie Sears’ presentation of ‘Troubleshooting Ultrasound Imaging Quality Concerns,’ ” says Jayme Lynn McKelvey, the coordinator of the series. “We sought ASRT certification for the webinars to help HTM professionals with their continuing education requirements. Our plan was to have one webinar a month, but by April, the events had become so popular with the TechNation community and advertisers that we grew the schedule to include two to three webinars monthly,” she says. McKelvey says that through the first three weeks of October, the webinar series has seen 1,932 attendees, or an average attendance of 138 per webinar. “Overall, TechNation’s free, ASRTcertified, monthly Webinar Wednesday series has far exceeded my expectations,” McKelvey adds. “Due to its success, we started a similar series for our OR Today community in September, and we are already scheduling webinars for 2015 with leading companies in the medical equipment industry. I am truly excited to see what 2015 has in store for Webinar Wednesday.”

BEST OF THE BEST

TOP HEADLINES Major news items from 2014 included AAMI’s Career Ladder, a focus on cybersecurity, power strips and more. These will continue to be important topics in 2015 and beyond. AAMI’s Career Ladder provides guidance for HTM professionals. The organization has developed a framework that spells out the

those newer to the HTM profession, specifically those with less than six years of experience. It is the Certified Associate in Healthcare Information and Management Systems (CAHIMS) and clearly reinforces the direction the field is headed. The certification “demonstrates knowledge of health IT and management systems,” according to HIMSS. It can act as a pathway to the CPHIMS credential for those seeking this certification. The CPHIMS certification provides an international standard for professionals in healthcare information and management systems. Both certifications require passing an exam. HTM professionals, like their clinical

“Our plan was to have one webinar a month, but by April, the events had become so popular with the TechNation community and advertisers that we grew the schedule to include two to three webinars monthly.” -Jayme Lynn McKelvey

“knowledge, skills and experience needed for BMETs and clinical engineers.” The career development program will create career ladders that will aid HTM professionals in acquiring the right education and experience. Guidebooks will outline the roadmap needed by HTM professionals to “grow their skills and advance their careers,” according to AAMI News. A guide for HTM leadership is also in the works. HIMSS introduced a new certificate program for HTM professionals during 2014. The certification is designed for

1TechNation.COM 1TECHNATION.COM

counterparts, are forever focused on the acronym HIPAA. The 1996 law laid out a framework for information privacy in healthcare. By extending protections for patients’ in the form of restricted access to their health information, HIPAA spelled out several safeguards that must be followed. During 2014, we were reminded that administering the requirements would be extra challenging in the face of several highly publicized security breaches at major retail and banking institutions. Cybersecurity has become a battle

DECEMBER 2014

between cybersecurity experts and cyber criminals, with consumers and patients as unwitting victims. Reported breaches at J.P. Morgan Chase, Wal-Mart, Target, Apple and Home Depot made national news and affected millions of people. The infrastructure of networks, and the securing of data in medical devices, has been a major focus in the HTM community in light of these threats. EMRs must be protected. Complying with HIPAA to prevent medical identity theft benefits patients and healthcare institutions. A major health system and the government’s own HealthCare.gov website were both breached during the year, serving as a reminder that the healthcare sector is a target. Some clarification and leeway was provided by CMS with regard to power strips in September. The use of relocatable power taps (RPTs), or power strips, in patient areas, as defined in the National Fire Protection Association (NFPA) 101 Life Safety Code (LSC) in 2000, could create unreasonable hardship according to CMS. A waiver allows for liberal use of power strips as long as they meet code, are regularly maintained and that they be used only for medical devices. Certain requirements related to ampacity are also noted in the waiver. There will be big changes in 2015 that relate to connectors. Accidental misconnections of enteral feeding and other tubing to intravenous systems have had catastrophic results and have led to numerous deaths. The FDA notes that the prevalence of this problem is most likely underreported. As a result, AAMI, the International Organization for Standardization and other groups have worked on “a suite of tubing connector standards.” According to AAMI, standards for enteral connectors will be rolled out first in early 2015.

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CAREER CENTER

The Importance of Progess Reports By Todd Rogers

light bulb recently turned on in my head and it relates to processes and progress.

TODD ROGERS Talent Acquisition specialist for TriMedx, Axess Ultrasound, eProtex and TriMedx Foundation

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People find it reassuring when they are informed that there is progress happening in pretty much anything that they are involved in. But, some parties to a process are more deserving of progress reports. Additionally, the act of sending an unsolicited update can have different effects on the recipients, depending on the roles and circumstances of the stakeholders. As a career-minded person, you should pay special attention to the importance of progress reports. Here are some dots that I’ve connected with respect to doing my job that might hopefully be of use to others. In almost any arrangement, the person who’s holding the capital (i.e. the guy with the money) is most deserving and most appreciative of regular and unsolicited progress updates. In our civilization, the guy with the money is usually the same guy who’s got the most power among a group of stakeholders. Consider the following example. Your car breaks down, you take it to the shop, they examine it and then they tell you what is most likely wrong, you agree to let them service it. You sit there reading yesterday’s newspaper while sipping on cheap coffee. You are pretty much wondering one thing and one thing only: how much is this

DECEMBER 2014

going to cost me? Now, imagine that at unpredictable intervals, someone comes over and gives you an unsolicited update. Even if those updates were complete fiction, you’d probably not feel so sickened by the thought of the invoice that you know is soon to be handed to you. But, you’re the guy with the money and you probably could’ve taken your car to any number of places. The fact that an employee came to you with periodic updates is soothing enough to probably bring you back the next time you have service needs. If you just sat there and no one said a word to you until it was time for the bill, the loitering anticipation of the amount, coupled with not having any idea about anything that was going on would, justifiably, make you really unhappy. The sting of paying the bill would be that much more unpleasant. And you would likely find another vendor the next time your car broke down. After all: you’re the guy with the money. In your working arrangement, your boss is the guy with the money. You’re the guy with the labor. The boss wants updates and the boss, being the guy with the money, is fully entitled to them. Most bosses expect to be provided with updates and progress reports. And they don’t want to have to track you down to get them. I suggest that you go back and re-read the previous sentence – maybe read it out-loud two or three times. The boss wants updates and the boss wants those updates brought to him, not the other way around. Here’s the magic-moment of this

paragraph: your boss’s boss is also the guy with the money and he is asking your boss for updates that are dependent upon you supplying your boss with updates. Don’t ever let your boss be in a situation where he (or she) doesn’t have enough updates for the next higher guy with the money. When your boss is caught off guard because he or she wasn’t updated by you, you will always lose, always. If it happens too frequently, you will lose something big: you will lose your job. The conclusion is, every now and then, stop working and provide an unsolicited update. Along with updates, there is something that people also like, when it comes to progress. People like knowing that when a problem occurs (or is identified) that someone will come up with a way to make the problem go away. Be careful with this one, though. Sometimes people don’t want a solution. Sometimes people just want to let others know about the problem; they want to vent. If you try to make someone else’s problem go away when they were just coming to you to vent, you’re probably making the problem worse. But, if during the course of venting, you ask, “So, what do you plan on doing about it?” the other person shows a look of panic, then it is time to offer up the possibility that you can assist with the solution. You absolutely must wait for the other person to accept your offer of assistance. Without acceptance, you’re just forcing yourself on to the other person and that is bad. Once you volunteer to assist, it can be with just the

planning phase or it can be with the execution phase. Situationally, you aren’t under any obligation to provide updates. But, by agreeing to assist, you probably should provide updates. Also, you should go and ask for updates on how that person is doing with solving the problem. Just asking how it’s coming along will be unimaginably valuable. Technically, you’re not asking for an update. The act of just asking is an extension of empathy, which seems like a request for an update but it isn’t the same. It signals, “Hey, I know that is really unpleasant and I’ve thought about it and I’m thinking about you.” The central idea is, people like progress. Exchanges of updates are foundational to progress. Without other involved parties being regularly apprised of progress, it’s as if the undertaking didn’t really matter in the first place. In closing, as you’re doing your job, keep in mind that the performance of the actual work is only part of the job. Part of your job is to keep the boss informed. When I finish this very column and send it in, I will cc my boss, because she wants and deserves to know that I’ve done what I committed to do. I don’t expect even so much as a “thanks” in response. I just hope that when I start my car to go home, there aren’t any “check engine” lights on my dashboard … otherwise I will be the one looking for updates – updates that I don’t want any part of.

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DECEMBER 2014

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THE FUTURE

A Snapshot of Beginning Biomedical Equipment Technology Students By Roger A. Bowles

e have an average-sized incoming group of new students in our program this fall. Since they are about eight weeks into their first semester of the program, I thought it would be fun to get a snapshot of who they are and what they know about the career field. I made up a short (and rudimentary) survey and the results from the 46 students who took it should not be taken as scientific fact. There are definitely limitations and delimitations to this short study (which I will not get into as to not bore you) and the results should just be taken at face value. Hopefully, it will provide some interesting reading.

Roger A. Bowles MS, EdD, CBET

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Of the 46 students present the day I gave the survey, 37 are male (roughly 80 percent) and nine are female. This is about average for an incoming group in our program. Ages can be seen in the chart on page 55. There were 22 students ages 18-20; 10 students ages 21-25; 5 students ages 26-30; 1 student ages 31-40; 5 students ages 41-50; and 3 students over the age of 50. The average was 24.89 years of age. This is definitely a younger group than we have seen in previous years as our overall student age has averaged 28 years. The educational levels of these students can be seen in the next chart . Of the 46 students, 2 had some high school, 18 were high school grads, 20 had attended some college before attending our program (college transfer), 2 had associate degrees prior to enrolling in our program, 3 had a bachelor’s degree before enrolling and 1 had a graduate degree in science. Seven of the 46 students had previously served in the military and either were high school graduates and/or had some college before enrolling. One question in the survey asked, “How did you hear about the Biomedical Equipment Technology career field?” Results can be found in the chart labeled Method of Influence.

DECEMBER 2014

As you can see, the overwhelming majority of students still find out about us through word of mouth. More disturbing to me (and an area where I need to redouble my efforts) is that only a few heard about the career field through their high school counselors and/or teachers. Three is better than none, but more teachers and counselors need to be introduced to Biomedical Equipment Technology. I also asked in the survey, “From what you know so far about the career field, for what type of employer do you see yourself working when you graduate?” Yes, this is a long-shot question for beginning students but I threw it in anyway. And some clearly stated a particular type of employer even at this early stage. I thought these results were interesting even if they might have been influenced by family members or friends already in the field. The next question asked, “From what you know so far about the career field, do you intend to pursue a four-year degree and/or certification while working?” Since a few of the students already have degrees, the chart isn’t spot on but you get the idea. I was happy to see that most, if not all, students realize the importance of continuing education and/or certification.

AGE

GRAPHS ARE BASED ON A SURVEY OF 46 INCOMING BIOMEDICAL STUDENTS. METHOD OF INFLUENCE

TYPE OF EMPLOYER

FUTURE GOALS

3 3 24

2 4

The survey also asked whether or not you are ﬂexible to relocate for the right job opportunity. No need for a chart here. Most of the students (34) are willing and able to relocate. Six listed “maybe” as an answer and six stated “no.” Just a quick note here, all students are told prior to enrolling about the need to be flexible about relocation. The survey also asked some questions that required a written response from the students instead of just a box to check. For example, “From what you know about the career field so far, what do you think is the most important characteristic for a Biomedical Equipment Technician to possess to be successful?” A variety of answers made for some interesting reading. Here are a few of them: “a strong desire to succeed,” “customer service skills,” “prior experience in electronics,” “good problem solving ability,” “willingness to adapt to a variety of situations,” “being a fast learner,” “being task-oriented,” “thinking clearly under pressure,” “ability to communicate with people,” “patience,”

“being detail oriented,” “professionalism,” “integrity,” “having the right attitude,” “being a team player,” “being a life-long learner,” “common sense,” “a mechanical and electrical aptitude,” and “troubleshooting skills.” I also asked, “What employer/job characteristics are most important to you? In other words, what will be most important to you when looking for a potential employer?” Here are a few of the answers: “fair salary,” “good work environment,” “location,” “growth potential,” “stability,” “personal challenge,” “advancement opportunities,” “organization that shows it cares about its employees,” “provides guidance and training/education opportunities,” “good leadership,” “cares about work/life balance,” “good health benefits,” “how they treat their customers,” and “good retirement benefits.” Another question was, “What excites you about this career field?” The most common answers were: “helping people,” “job security,” “variety of career options,”

“love of technology,” “working environment,” and “making money.” Several mentioned that this career field allowed them to make a difference in healthcare without direct patient contact. And the final question asked, “Do you have any concerns about this career field?” Lots of interesting responses but here are a few: “job location,” “finding the right job,” “workplace safety hazards,” “relocation expenses,” “concerned about BMET surveys in magazines saying BMETs not enjoying their jobs,” “age being a factor,” “the overwhelming variety of equipment,” “the effect of Obamacare,” “the job bubble for BMETs bursting,” and of course, “Ebola.” As I mentioned at the beginning, this survey and its results were only meant to be informational and perhaps entertaining. It does give us as faculty several things to discuss with our students. And perhaps you the reader would be interested in visiting as a guest speaker to discuss some of these topics. Let me know!

EXPERT ADVICE

PATRICK LYNCH

The Sign of a Good Manager By Patrick Lynch

here are lots of HTM managers today who should never be managers. Many of them grew up (professionally) doing things other than working in HTM. Others could barely manage themselves when they were technicians. There are probably a host of other reasons for these “not-so-good” managers being in the roles they are today. But the consequences for the working biomed can be disasterous. Let me explain.

PATRICK K. LYNCH, CBET, CCE Biomedical Support Specialist for GMI

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When you have the job of managing an HTM (or biomedical) program, there are very specific ways to set up your shop, craft your inventory, manage your work orders, and counsel your workers on the proper use of the system. It is only from a well-designed, fully implemented, and rigorously used system that the data and information can be collected to effectively manage an in-house program and stave off the outsiders who want to take over your program. A good program starts with an inventory. It is the inventory that defines the services, flows from the MEMP and identifies the items to be maintained. The inventory should be ultra-complete, with all medical equipment in the hospital/ system contained in it. This is especially necessary for the equipment that the HTM department does not maintain, because it is this equipment that can most easily fall through the cracks. This non-in-housemaintained equipment is the basis for future program expansion. The inventory must contain a lot of data. It should serve as a look-up for information such as owner department, PM frequency, and PM procedures. It also must contain information about connectivity, such as IP address, software level, and anything else that would help a service person diagnose or correct a problem. In addition to the inventory, there must be a means for the biomeds to enter their time spent engaged in activities that may not be able to be tied to a specific asset number. This includes system installations,

DECEMBER 2014

multi-item troubleshooting, IT related issues, meetings, etc. It also should be used for work performed on small equipment that may not have an individual asset number. This may include suction regulators, oxygen flowmeters, thermometers, rental equipment, or anything else that, for whatever reason, does not have hospital asset numbers attached to them. A good manager will design a system to create “buckets” for biomeds to be able to document every small piece of their workday. A good mananger has worked as a BMET sometime in his/her career. They can help their employees be successful by sharing strategies that work. They can help them plan a way to overcome the obstacles to good documentation and other workflow-related issues which can make the biomed look bad. I hear managers who complain that their technicians do not document as fully as they would like, but they do not know how to create the infrastructure to facilitate good documentation. Chances are that they have never had to set up such a complex system before, or been required to use one. They just tell their technicians to “document more time.” And often quote a goal, such as 85 percent of the paid hours. If their manager cannot tell them how to increase their documentation, the biomeds are left to try and figure it out. And because the working biomeds do not know what the manager or administration is looking for, they have great difficulty in deciding how to comply with their manager’s

demand to â&#x20AC;&#x153;document more time.â&#x20AC;? The technicians often resort to padding all of their work time to give the boss what they are asking for. But the times are inaccurate and lead to problems in the future. Managing people is much more than just setting goals and forcing the employees to meet them. It is often coaching, counseling, discussing and explaining to the employee why a certain goal is important and how the information will be used and useful to the organization. It should always be coupled with some self-serving motive, like why it is important to the biomeds themselves to comply with the goal. Here is a perfect instance where a biomed manages biomeds better than a business manager can. Someone who has walked the walk and dealt with the difficulties and demands of administration is much better at forming a team than a prescriptive manager who can just give orders. We need experienced biomeds to lead the HTM shops of U.S. hospitals.

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KAREN WANINGER Staying Afloat By Karen Waninger

icture yourself in a boat on the river. Oh, wait, that has probably already created an incorrect vision for many of you. This is not going to be a tribute to The Beetles, and there will be no discussion of tangerine trees and marmalade skies. For those of you who have no clue what I am talking about, go find someone who likes classic rock and ask about “Lucy in the Sky with Diamonds.”

KAREN WANINGER Director of Clinical Engineering for Community Health Network

1TECHNATION.COM

So let’s try this again, back to my boat on the river … No, that won’t work either. Those were the lyrics to a song by Styx, on their Cornerstone album, although it wasn’t as popular as the aforementioned Beetles song, and similarly should not be confused with “Sail Away.” Maybe there is a way to calibrate your image processing a bit, so we all start to see the same thing. Let go of those rock-n-roll images. Shift your thoughts to something more like Tom Sawyer and Huckleberry Finn, and picture yourself on a raft on the river. I grew up along the river, and know first-hand that floating along peacefully on a warm, sunny afternoon can be a very pleasant experience. Like life or work, though, the river is not always calm and predictable, and things around you don’t always stay balanced along the journey. The important thing to understand is how to manage the disturbances and still get to the destination. In my world, the new senior leadership team heard (and believed) there may be an opportunity to significantly reduce costs, so he decided we should explore other service delivery options. Of course he made that decision without really understanding anything about technology management. He did not know what would be required to do a comprehensive evaluation and comparison of the programs, however he did trust us to figure that out. This most recent series of events and disruptions at work have somehow reminded me of what it must have been like for some of our early

DECEMBER 2014

settlers, using flat rafts to travel the maze of rivers that crisscrossed the country. In the world of the early settlers, a family may have heard stories about more fertile farm land a few states away. Based only on that information, they decided to file for a homestead claim and relocate. They would probably have started by looking at different ways of getting to the new place, while retaining as many of their valuable belongings as possible. After all, if they had already invested in livestock, farm implements and household goods, it would make sense to have those to start with in the new location. They could make their own raft by cutting trees, tying the logs together with homemade ropes to form a flat raft large enough to hold them and everything they owned. Then it would just float freely down the river and deposit them safely and gently at the desired destination, right? Just like we will magically be able to step out of the office one day under our current program, and step in the next day under some new program, any new program, without any perceivable disruption of any kind. Well, not exactly. As the belongings are loaded on the raft to begin with, everything is neatly stacked and balanced, secured into its own specific location. The livestock, farm implements, household belongings, pets and family members are all aboard and the mooring lines are pulled in. A push pole and a couple of oars are probably important accessories, and if the raft was designed with a built-in rudder,

Occasionally, a sudden thunderstorm rolls in with strong winds and a drenching rain, ruining a few more of the valuables. That is exactly how it feels as we are running from one issue to the next in the daily work activities, while trying to avoid the obvious pitfalls in some of the proposed options. all the better to get out to the strong current and start the journey. Similarly for our team, everything seemed to be going well at first, as we started exploring with a sense of excitement about possible new opportunities. Then, about the time the raft gets up to speed in the middle of the river, the family dog sees a deer on the bank and starts barking. That startles the cattle and they all run to the opposite side of the raft. One family member grabs the dog to silence it, another goes to herd the cattle back toward the center of the raft, while everyone else instinctively runs to the opposite corner to counteract the shifting weight before the raft capsizes. Tragedy averted, only a few of the belongings got wet, and the raft continues floating along. In the context of our evaluation of service strategies, one vendor who wasn’t competitive to begin with went barking at the door of the president’s office with the promise of a better option. Thankfully, that was silenced as they were redirected to go through the proper channels. In the meantime, the members of my team are

continuing to tackle the daily calls as they come in, cranking through the scheduled inspections, and continuing the planning efforts for the various projects that are underway. On top of all that, we are gathering the information required to further validate the theory that it may make sense to implement some changes in our program. Throughout their journey, the family on the raft is busy running here and there as someone catches a glimpse of jagged rocks or an uprooted tree that must be avoided. Occasionally, a sudden thunderstorm rolls in with strong winds and a drenching rain, ruining a few more of the valuables. That is exactly how it feels as we are running from one issue to the next in the daily work activities, while trying to avoid the obvious pitfalls in some of the proposed options. We are just trying to stay afloat until we get to some kind of designated landing point. Every new day brings a glimpse of hope, sometimes followed by a sense of frustration, which is disheartening for the members of our service team. Thankfully, we have a strong team with a sense of commitment to sticking together and making the trip a success for all involved. We are all starting to ask, though, “Are we there yet?” Throughout all of this, we continue to be reminded of the importance of purposefully regrouping and collectively recovering after every unexpected disruption. Sharing information openly, and giving people the opportunity to be involved in decisions and actions that affect their future will help assure we are staying afloat. As far as that initial mental image of picturing yourself in a boat on the river, don’t completely give up on that. A day at the river can be a very relaxing and rejuvenating experience. However, if your journey is anything like the one we have experienced, you may want to consider something other than the raft. If we don’t get to a decision and destination soon, it will be time to upgrade to something more like a submarine, and I don’t care if it is yellow or some other color. We will continue to ride it out, trying to keep everything balanced between the service needs, the financial expectations, and the individual impact to each party. I hope to share more in a future issue regarding what we have learned on our journey.

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EXPERT ADVICE

BEYOND CERTIFICATION Webinars Are Great For Certification Renewal By David Scott

n past articles of Beyond Certification we have looked at the best ways to get points toward certification renewal. We have discussed other certifications and further educations. I talk to a lot of people who have earned their certification and they seem to have a common question. “How do I get points towards certification renewal? I live in a rural area or my work doesn’t send many people to training.” Everyone likes to go to a manufacturer’s training course that pertains to equipment you have in your workplace. It helps you do your job more effectively. But a lot of times they are expensive and only one or two people from a HTM department can attend. Where does that leave the others that can’t attend and get points? They have to find other ways.

DAVID SCOTT Biomedical Technician, Children’s Hospital Colorado; CABMET Study Group Organizer

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My answer for those people is always the same. It is webinars and biomed society participation. This time we are going to discuss webinars. In the continuing education journal there is a category called “Courses.” This category is defined as “Educational activities directly related to the biomedical field that can positively affect you on a professional level may be listed in this category, such as: formal discussion groups, professional sessions, continuing education courses, etc.” When you edit this section you will see under Course Type C “Correspondence course, teleconference, computer-based course, in service, etc.” Teleconference and webinar are one and the same. Webinar has not only the phone portion of a teleconference, but also has some type of program to let everyone attending share the PC screen with the presenter. This allows the audience to see Power Point slides or anything else the presenter is looking at on the PC.

DECEMBER 2014

These webinars or teleconferences count for one point toward renewal if you are a participant. They count for two points if you are the presenter. The courses category has a total of 10 points that you can count toward renewal. If you can get all 10 points in this category over a three-year period that puts you two-thirds of the way toward the 15 renewal points needed. I have noticed lately that there are a lot of webinars available to HTM professionals. TechNation just happens to have what they call “Webinar Wednesdays.” These free webinars are offered at least once a month and some months there are two or three webinars offered. You can start to see that it should be fairly easy to accumulate 10 points in the courses category over a three-year period. If you participate in one webinar every other month you would have six points at the end of a year. Take that over three years and you have maxed out the courses category

without ever leaving your workplace. I always recommend to have more than what is available in a category. So, you should be trying to get more than 10 points. That way if for some reason some of your points arenâ&#x20AC;&#x2122;t counted you will still have some in the bank for reserve. No one should try for only 15 points in a three-year period. I have looked at the TechNation webinar schedule and they have some top name presenters for the webinars. People like Manny Roman, Frank Magnarelli, Karen Waninger and Alan Moretti have presented free webinars for TechNation. When these people talk or have something to say, I listen. There are not very many people in our profession that I hold in higher regard than this group. There are other great presenters that may not be as well known as these people but they cover topics that could be helpful in your workplace. All of the TechNation webinars are free. You can find out more about the webinars at www.IAmTechNation.com/webinars. In addition to TechNation, I have seen several webinars offered by AAMI. Sometimes the AAMI webinars are free and other times there is a fee to participate. So, you have no excuse not to have all 10 points in the courses category. I have attended webinars by both organizations and recommend you do the same to get the most points possible toward certification renewal.

BRINGING POWER TO THE BIOMED COMMUNITY

MAGAZI NE WEBI NARS ONLI NE COMMU NI TY

F O R A FR E E S U BS CRI P T I ON , V I S I T W WW.I A MT E CHN AT I ON . COM

EXPERT ADVICE

THE ROMAN REVIEW

Advice for Your Young Self By Manny Roman

MANNY ROMAN CRES, Founding Member of I.C.E. imagingigloo.com

1TECHNATION.COM

admit it. I read People magazine sometimes. I am amused by some of the articles regarding the antics of the celebrities who are so admired and followed by millions. I wish I was as popular.

In a recent People these celebrities were asked what advice they would give their young selves. Although it was not mentioned specifically, it seemed that most of these people gave advice to their teen selves. Some of the advice is predictable. Among these are: love yourself, respect yourself, hang in there because things will get better, it will all work out in the end, you are beautiful, etc. Then, there were the maybe unexpected tidbits such as, trust in your own self, stop being afraid, more is not what itâ&#x20AC;&#x2122;s about and be willing to fail. One of the celebrities said that she would not give advice to her young self as she wanted to experience things just the way they turned out. This started me thinking about what I would say to myself as a teenager and realized that I am what I am because I did not have this special retro-advice from myself. Had I given myself advice from the future, I would inevitably have taken a variety of alternate paths. These alternate paths may have led to greater wealth, and greater happiness, or greater poverty or great sorrow. Would I have remained in the Army for 20 or 30 years? Would I have ever met my Angel Ruth? Would I have had my children and grandchildren? (I do like my grandchildren; the jury is still out on their parents). Would I have become a member of this great profession and had the opportunity to establish these great relationships and friendships? Would I have felt the elation of owning a business and the sorrow of losing partners?

DECEMBER 2014

Like that celebrity mentioned above, I would not want to give advice to my young, ignorant, unruly, undisciplined, wayward, inconsiderate, foolish, etc. self. (Come to think of it, these adjectives still apply to me although maybe at a less intense level). There are many people that I respect and admire in business and life. Among these are close friends and associates, and even acquaintances. These are people that demonstrate a desire to add value to the lives of others in their thoughts and actions. These are the people that I want to get advice from, however, I want that advice now, not when I was young and stupid. Someone said that youth is wasted on the young. Outside wisdom would likely also be wasted on the young. So what is this all about then? I am suggesting that you not waste time thinking or even lamenting on the advice you wish you had been given when very young. Learn from past mistakes, but donâ&#x20AC;&#x2122;t dwell on them. Seek advice from those whom you most admire and respect. Seek that advice now. Start today. Generate a list of the people you admire, and what it is you admire about them. Then, make a list of the questions you would like to ask of them. Then, ask. Most people will be glad to be singled out for this advice and will provide it readily. Then, act on the advice. First value yourself as you are today and then seek to add value to yourself and others. Leave people better for having known you. As for me, I value who I am even with all my flaws and imperfections of which my Angel Ruth reminds me often.

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DECEMBER 2014

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DID YOU KNOW

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DECEMBER 2014

BREAKROOM

So You’ve Inventoried Devices that Alarm. Now What? It’s time to implement an alarm management safety plan.

But don’t be overwhelmed. ECRI Institute’s alarm management safety experts are here to help. Our on-site consulting team has extensive experience working with world-renowned healthcare facilities and systems to identify their clinical alarm hazards, analyze current practices, and craft proven, practical alarm management strategies. And, we can help you. Together, we’ll review the four pillars of alarm management safety as they pertain to your hospital: 



 Culture: What is your organization’s attitude about alarm safety?

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 Infrastructure: Does the hospital have the optimal layout,

care model, and policies? 

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 Practices: What are you doing now and what should you

be doing differently? 

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 Technology: Does your technology support your clinical needs?

Start making changes to your hospital’s alarm management safety practices today. To learn more about our customized services, call (610) 825-6000, ext. 5655, e-mail consultants@ecri.org, or visit www.ecri.org/alarmsafety.

THE VAULT

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will receive a $5 gift card and will be entered to win a $25 gift card. To submit your answer, visit 1TechNation.com/vault-november-2014. Good luck!

LAST MONTH’S PHOTO ORM-1 aka “Bullet” Operating Room Monitor The photo was submitted by Bob Douglass, Biomedical Engineering Manager at Mount Auburn Hospital. To find out who won a $25 gift card for correctly identifying the medical device visit 1TechNation.com.

SUBMIT A PHOTO Send us a photo of an old medical device to jwallace@mdpublishing.com and you could win lunch for your department courtesy of TechNation!

1TECHNATION.COM

DECEMBER 2014

BREAKROOM

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1TECHNATION.COM

SCRAPBOOK OBA Conference

The Oregon Biomedical Association’s 2014 Statewide Conference and Exhibitor Exposition was a huge success topping the 2013 event. OBA President Russ Magoon said it was “better than last year” with almost 200 people when including exhibitors. The event had 42 booths compared to 34 last year. 1. The Oregon Biomedical Association

presented awards to two of its members. Valdez Bravo, left, was honored for his past service as OBA President, and Steve Reid, right, received the award for OBA Biomed of the Year.

1. 3.

2. Jonathan Payne holds up a copy of TechNation magazine at the MedWrench booth.

3. Pat Lynch of GMI, a veteran of the biomedical equipment field, addresses attendees about the business side of biomed versus the culture of biomed at the 2014 Oregon Biomedical Association Statewide Conference and Exhibitor Explosition.

4. Chris Walton, CBET, MA,

presents his class “Tips & Options for a Successful HTM Career” at the OBA conference.

5. The OBA and Pacific Medical present a check to Portland Community College for a biomedical scholarship.

1TECHNATION.COM

DECEMBER 2014

HTMA-MW Conference 1.

The Healthcare Technology Management Association of the Mid-West’s 2014 Symposium and Vendor Exhibition was one of the best ever for the organization with 27 exhibitor booths and more than 50 registered attendees. Chris C. Coleman, CBET, who serves as the president of HTMA-MW, said the group had to turn away a few companies because the exhibit hall space was sold out. The symposium featured educational sessions and a keynote address on the interconnectivity between IT and biomed departments. 1. Attendees check in at the

registration table to get their class schedules and a map of vendor tables. They could also register or renew memberships and turn in a completed visit card to be entered in the drawing for door prizes.

HTMA-MW President Chris C. Coleman introduces keynote speaker Tim Gee. His presentation “Industry in Transition: Tools for Navigating the Change” was a hit with those in attendance.

Members of the symposium planning committee, from left, are Webmaster Gabe Jamison, Secretary Tyler Tryon, Treasurer Harold Golden, President Chris C. Coleman, Vice President Chris Hawkins, Symposium Committee member Kevin Hashman and Symposium Committee member Tim Cordes.

4. The vendor interaction area was busy throughout the show.

BREAKROOM

WHAT’S ON YOUR BENCH?