TechNation - March 2015 by MD Publishing

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VOL.3

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

MARCH 2015

5 Tricks Ever y HTM Professional Should Know Advice from Experienced Ind

ustry Professionals

Biomed Adventures Grappling and Teaching

The Roundtable CMMS Software

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5 Tricks Every HTM Professional Should Know Advice from Experie

36 44

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TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

THE ROUNDTABLE - MANAGEMENT SOFTWARE CMMS software is a valuable tool for biomeds. It does more than just schedule PMs. We asked a panel of experts what to look for when it comes to CMMS and how to get the most out of the system to perform regular maintenance, show cost savings and more.

5 TRICKS EVERY HTM PROFESSIONAL SHOULD KNOW – ADVICE FROM EXPERIENCED INDUSTRY PROFESSIONALS TechNation reaches out to experts in the HTM community to share the top tips every clinical engineer should know whether they are a rookie or an experienced veteran. We quizzed them all to find out the top five things every biomed should know.

Next month’s Feature article: Big Data & Alarm Management

Next month’s Roundtable article: Patient Monitors

TechNation (Vol. 6, Issue #3) March 2015 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.

MARCH 2015

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INSIDE

Departments PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Sharon Farley Warren Kaufman Jayme McKelvey Andrew Parker

ART DEPARTMENT

Jonathan Riley Jessica Laurain

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

P.12 SPOTLIGHT p.12

p.14 p.18

Department Profile: SSM Health Clinical Engineering Services Department Professional of the Month: Carlos Villafane, CBET, CET Biomed Adventures: Grappling and Teaching

P.23 THE BENCH p.23 p.24 p.27 p.28 p.31 p.32 p.34

Editor’s Insights ECRI Institute Update Tools of the Trade AAMI Update Webinar Wednesday Biomed 101 Shop Talk

P.52 EXPERT ADVICE

p.52 Career Center p.54 Ultrasound Tech Expert Sponsored by Conquest Imaging p.57 The Future p.59 Patrick Lynch p.60 Roman Review

P.62 BREAKROOM

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.62 p.63 p.64 p.66 p.70

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p.69 Index Like us on Facebook, www.facebook.com/TechNationMag

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DEPARTMENT PROFILE SSM Health Clinical Engineering Services Department By K. Richard Douglas

aintaining 75,000 assets isn’t easy; it takes a whole bunch of technicians, imaging engineers, administrative help and leadership. With facilities in four states and 7,000 medical staff, SSM Health is a big system for its Clinical Engineering Service (CES) department to get its figurative arms around. The department, staffed with a contingent of 113 members, does an admirable job of keeping up with the demands of such a large health care system. Overall, SSM Health has 30,000 employees in 19 hospitals, nursing homes, hospice, physician offices, a pharmacy benefit company and even an insurance company. Headed by Vice President Heidi Horn, the senior leadership team includes Regional Manager of Missouri and Illinois Bob Jakubczak, Director for Wisconsin Jim Anderson and Director for Oklahoma Bobby Thompson. The large staff includes professionals supporting medical equipment, imaging, procurement, maintenance software and data analysis. The team includes three BMET Is, 39 BMET IIs, 10 BMET III specialists and 15 BMET III leads. Those equipment technicians are supplemented by 15 senior diagnostic imaging engineers for high-end imaging and nine diagnostic imaging engineers. The team is also supported by a director of clinical equipment planning and support, a CES analyst, 11 managers, a CMMS product specialist and three administrative assistants. The department uses a system-wide team approach to accomplish large projects and to keep everyone on the same page. The department spends several hundred

1TECHNATION.COM

MARCH 2015

thousand dollars annually on training. This reduces expenditures on service contracts. The team attempts to keep as much maintenance and repair work in-house. “It is our practice to avoid service contracts as much as possible,” Horn says. “We budget $400,000-$600,000 annually for service training and have documented that by investing in our CES staff, we can save approximately 50 percent in annual clinical equipment maintenance expenses compared to a full service contract — inclusive of the training costs.” Horn says her team has demonstrated they are just as skilled on most device types as the vendors, but because they’re already on site, can respond faster. “And there is a sense of ownership that the CES team has regarding ‘their’ equipment, and they take care of it knowing that someday they or a family member or friend might be in need of it,” she says. The department has a comprehensive laundry list of reports available to it, and to other stakeholders, that provide an assessment of everything the team touches. Reports that show medical device inventory and purchase price, cost of

Members of the SSM Health Clinical Engineering Services Department include Dave Martin, BMET III; Ryan Harden, BMET III-Lead Tech; Dustin French, BMET III-Lead Tech; Rob Hoene, BMET II; Heidi Horn, VP; Bill Buckles, BMET II and Brian Hill, CES Operations Manager.

maintenance by device/department/entity, service contract listing and expiration dates, information systems data on devices, clinical device replacement recommendations and cost, repair histories, alert work orders and a CES colleague satisfaction survey result report are among them. Creative use of their databases offers the department the opportunity to help reduce capital costs and provide rock-solid replacement information. “One problem that had a big impact on the system, as a whole, was the inability to prioritize clinical equipment replacement projects,” Horn relates. “In the past, capital was given to the clinical department that complained the loudest and not based on those with the biggest need. CES developed the Clinical Equipment Replacement Prioritization List, which is available upon request and sent out annually to all capital decision makers around budgeting time.”

Clay Ainsworth, BMET III, at St. Clare Health Center in St. Louis, Missouri, works on a patient monitor.

Steve Bischoff, BMET II, at DePaul Health Center in St. Louis, Missouri, works on medical equipment.

Dave Hanus, BMET II, at St. Anthony Hospital in Oklahoma City, Oklahoma, repairs a piece of medical equipment.

Horn says that the department uses their CMMS to produce the list, using objective criteria such as age of device compared to AHA expected life guidelines; cost of maintenance; mean time between failure and cost to replace, along with subjective criteria based on CES’s and the clinical department’s feedback. “The Clinical Equipment Replacement Prioritization List has now become one of the most used tools in the capital review process, and it’s not uncommon to hear executives ask someone requesting clinical device replacement capital if it’s ‘on the CES list.’ If it’s not, it most likely won’t be approved,” she says.

manager and a CareFusion project manager to coordinate the implementation efforts of nursing, pharmacy, EMR team, IT, clinical engineering service and supply chain,” she says. The department has also been active on the team that is selecting system-wide vendors for OR integration with the health care system’s EMR. Jim Anderson has taken the lead on this project. They have also been working with their IS department creating policies and practices for storing images and video taken in the OR during surgery and retrieving them for training, clinical review and other purposes. For training purposes, those images must be HIPPA compliant. Along with a team made up of physicians and clinical leaders, patient safety and nursing, the clinical engineering team is also leading the SSM system-wide Alarm Management Team to ensure SSM Health is compliant with The Joint Commission’s National Patient Safety Goal on Alarm Safety, including identifying how best to decrease alarm fatigue and improve alarm response time, says Horn. The corporate structure at SSM Health integrates the department with IT. “CES is a department within SSM’s Integrated Health Technologies (IHT) division, which is led by the system CIO/

senior vice president,” Horn says. “The CES VP — who reports to the CIO — sits on the IHT Administrative Council with the Regional CIOs and other IT VPs. In this respect, CES and IT are very integrated. There are many projects that CES and IT must work very closely together.” The department has been under this reporting structure since 2007. This puts the department’s vice president only two steps away from the health system’s CEO. Away from work, many of the department’s techs are involved in local biomed societies. Horn is active on the Executive Committee of AAMI’s Technology Management Council, on an AAMI task force and other AAMI committees. Horn says that while some HTM departments may feel a lack of appreciation, that is not the case with their department. “We know our SSM colleagues appreciate the multitude of problems we solve,” she says. “The SSM Clinical Engineering Service team takes great pride in our ability to help our SSM colleagues and provide them with the medical equipment technology expertise they need to provide exceptional patient care.” You can’t ask for, or offer, anything more than that.

PROJECTS AND DECISIONS Big departments are capable of taking on big projects and the team at SSM Health does not disappoint. The department is “leading the system-wide implementation of approximately 8,000 CareFusion Alaris PCUs and large volume pumps systemwide,” Horn explains. “This is a very rapid deployment, converting our entire existing large volume infusion pump inventory to Alaris in a two-month time frame. I am the executive champion overseeing the project, and am working closely with an IHT project

SPOTLIGHT

PROFESSIONAL OF THE MONTH

Carlos Villafane, CBET, CET By K. Richard Douglas

ometimes the biggest challenge in starting a HTM career has nothing to do with comprehending electronics training or memorizing anatomy.

“My biggest challenge was when I was a student, all of my technology books were in English. So, I needed to improve my English in order to learn electronics and biomed,” says Carlos Villafane, CBET, CET, who works as a BMET III in the Clinical Engineering Services Department at St. Anthony’s Hospital in St. Petersburg, Florida. “That motivated me to write a biomed book in Spanish, directed to biomed students in 2008,” he says. Villafane had studied English in school in Puerto Rico, where English instruction starts in the first grade and continues through high school. The problem was that there weren’t any native English speakers around to practice his conversational English with, so pronunciation was always in question. When he worked for Panasonic in Puerto Rico, the company’s tech support was in New Jersey. That’s when he started to go deeper into English. “I completed an associate degree in electronics in the early ’90s, and became

1TECHNATION.COM

MARCH 2015

an electronics technician. After five to six years in the field, I started noticing that the consumer electronic devices started to become ‘disposable’ because it was not cost-effective to repair,” Villafane says. “I started looking for similar alternatives in my field and I found biomed. With my strong electronics background, it was an easy transition for me, and it positively changed my life.” Villafane started taking biomed classes after work and completed an associate degree in biomedical engineering. He holds two associate degrees and a bachelor’s degree. “The courses helped me to learn about physiology and other important information,” he says. “I did a field practice in a hospital for about six months before graduation, and that gave me a good idea of what the biomed field entails.” Today, Villafane is a general biomed, taking care of the surgery department. Years ago, while working for GE Healthcare, he took care of phaco machines and pulmonary function machines. Whatever type of equipment he works on, it’s OK with him because he says that he loves technology. Those early language challenges certainly didn’t slow Villafane down. He has been very active in the HTM profession outside his duties at work with positions that require a lot of speaking. He has been president of the Bay

Calors Villafane loves working on the latest technology.

Area Association of Medical Instrumentation since 2012 and has been a member since 2005. He was one of the association’s original members. Starting January 1, 2015, he also took over the duties of president of the Florida Biomedical Society. He will hold that position for a year. “As I mentioned before, I started as an electronics technician, but during all these years I’ve had the opportunity of learning and doing a lot of different things. I acquired all the commercial FCC Licenses in 1998 and for some time I gave reviews for the FCC exams in

Carlos Villafane works on a device at St. Anthony’s Hospital in St. Peteresburg, Florida.

Puerto Rico,” Villafane says. “I also worked as a computer repair technician, as a sales manager for an electronics store, as a technical trainer for Panasonic and AIWA and as an electronics teacher in various institutions in Puerto Rico.” The Commercial Radio Operator License Program awards a license to those who pass the qualifying exam, in order to perform transmitter operation, maintenance and repair duties, according to the FCC. Villafane says that this would include equipment calibration also. “When I moved to Florida in 2003, I returned to Biomed, acquired my CBET certification, and got really involved in the biomed field,” Villafane says. “I had the opportunity of working as a system analyst, team lead and BMET III in various companies. Last year, I started as an adjunct Instructor for the St. Petersburg College’s Biomedical Technology course. Right now, I’ve been the president for our local biomed association (BAAMI.org) and this year I have the privilege of being the president for the Florida Biomedical Society (www.FBSonline.net ).”

FAMILY AND PASSTIMES Villafane sometimes can’t leave his work behind at the end of the day, but that’s OK with him. Knowing how to fix things has its benefits.

Carlos Villafane repairs guitars and Puerto Rican Cuatros in his spare time.

“There is a quote attributed to Confucius that says ‘Choose a job you love, and you will never have to work a day in your life.’ And I believe that is my case. I love repairing stuff. Most of my hobbies involve repairing something; a computer, my car or something in the house,” he explains. “I also love electric guitars. I never learned how to play well, but I learned to repair and modify guitars. In 1996, I took a continuing education course at the University of Puerto Rico, where I learned how to build the ‘Cuatro Puertorriqueño’ from scratch. The Puerto Rican cuatro is the national instrument of Puerto Rico. It has 10 strings, and looks like a small guitar. With this experience, and my electronics background, I can make any repair or guitar modifications.” With 10 electric guitars in his collection, the interest in the instrument is a serious one. He repairs electric guitars as a hobby. “My other hobby is traveling around the world. Every year I try to visit some interesting place,” Villafane says. “I’ve been married to my childhood sweetheart for 18 years. I have no kids. I have a very energetic Papillon dog named Addy.” Some of Villafane’s travel experiences, with his wife Demi, include trips to India in 2010, Hawaii several years ago and

Alaska in 2014. Those two weeks every year are something he looks forward to. Not a bad set of accomplishments for someone who was first challenged with a second language.

FAVORITE BOOK: Any book from Edgar Allan Poe or Horacio Quiroga. Both had similar writing styles.

FAVORITE MOVIE: “The Matrix”

FAVORITE FOOD: Hispanic, Thai and Indian food

HIDDEN TALENT: I like to play the guitar. I would like to have more time to practice.

FAVORITE PART OF BEING A BIOMED: There’s something new and interesting every day!

WHAT’S ON MY BENCH? I have funny quotes posted around my workbench, some pictures, a calendar, my tools and my favorite network test device: a Fluke LinkRunner.

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BIOMED ADVENTURES Grappling and Teaching By K. Richard Douglas

f you’ve ever watched a UFC or MMA fight or an octagon match, you are familiar with the term “ground and pound” or the importance of the “ground game.” The ability to grapple, to take an opponent to the canvas, and the strategy to get them to a point of submission, comes from very specialized training. One of the most important ways that fighters can cut their teeth to realize success with grappling is to learn Brazilian Jiu Jitsu. The martial art teaches adherents the techniques of grappling, positioning, and in the case of MMA fighting; how to mitigate strikes and gain dominant position for striking. It also builds core strength. The art of Jiu Jitsu grew out of Judo originally. Just after the turn of the 20th century, one of the first American Judo teachers traveled to Brazil to teach the art of Judo there. Called Jiu Jitsu, the technique was picked up by an early student in Brazil named Carlos Gracie. Gracie would popularize the current incarnation of Jiu Jitsu for self-defense, sport grappling and MMA competition.

SCIENCE OF THE GROUND GAME There is one student of Jiu Jitsu who is also an HTM professional. Roy Sida, clinical engineer at Franciscan St. James Hospital in Olympia Fields, Illinois, also teaches the programming language C++ at Purdue Calumet as a graduate aid. “I was actually introduced to Jiu Jitsu while at my university’s fitness center. I saw some guys training and thought, ‘I want to be a part of this,’ ” Sida recalls. “I was always sort of interested in the idea of learning martial arts, but schools were

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MARCH 2015

very expensive and it was also a bit intimidating, since I am a smaller guy and didn’t know what to expect.” Sida learned that the guys training in the fitness center had formed a club for those interested in martial arts. The idea was that those who had learned different disciplines could share their knowledge with other members. He joined and began training. “They started with Jiu Jitsu and Aikido when the club formed, and although I did like both, I think Jiu Jitsu stuck because it was a martial art you can jump into sparring from day one. There is no striking so you can also go 100 percent when training unlike other martial arts. It’s something that you kind of learn by doing instead of having to practice forms for a while before using them,” he says. Sida says that Brazilian Jiu Jitsu was adapted from Japanese Jiu Jitsu to rely less on strength. He says that the techniques should allow a fighter to make use of them on someone bigger and stronger. That appealed to him. “It is also a great form of control, where you can use it in a self defense situation to control your attacker, or even

Roy Sida, right, is seen here with Sensei Bravilo.

put them to sleep without having to hurt them,” Sida says. “But, what probably got me the most interested, was watching all the old videos with members of the Gracie family going around to different dojos (schools) and challenging their best fighter and defeating all of them with Brazilian Jiu Jitsu,” he adds. “Even at the start of mixed martial arts, fighters quickly caught on to the importance of knowing how to fight on the ground,” Sida says. “The Gracies defeated a lot of very good fighters because, as soon as the fight went to the floor as most fights do, the other fighter did not know what to do.” Because it had few members and people’s schedules changed, the club did not last very long. Sida happened to meet

Roy Sida, Second from left, enjoys learning Jiu Jitsu and teaching computer programming.

someone who trained at Corral Martial Arts and began training there. “I actually revived the club with a few friends and still run it today at Purdue Calumet. I introduce others to martial arts the same as I got into it and practice with a few people who are in a position where training out of an academy is just out of their budget. I collaborate with my academy and every now and then bring in members from my club during their open mat nights so they get to train with all the fighters there,” he says. Sida is only able to train two times a week because of his busy schedule. His schedule can get hectic. He has tried his hand at a couple of tournaments and is training for a third.

TEACHING A PROGRAMMING LANGUAGE As if Jiu Jitsu training wasn’t enough to occupy Sida’s off hours, he can be found at the head of the classroom as well. “I am teaching C++ at Purdue Calumet as a graduate aid; I’m not

actually a professor,” he says. “So I applied for grad school right after getting my bachelor’s and about three weeks before classes started, I was informed that a professor had recommended me for the position, and if I would be interested in teaching C++.” Purdue Calumet is in Hammond, Indiana, about 25 miles from Chicago. It is a regional university and is part of the Purdue University system. “Talk about a late notice, but I was interested and agreed to it. Both lab and lecture were left up to me, so aside from helping me with the curriculum, the professor did not have much involvement,” Sida says. “Although that was a bit stressful at times, I feel like it made me grow a lot professionally and really reinforced my knowledge in C++,” he adds. “I felt like I had a rough start, but I feel like I have a good relationship with my students and have had many compliments. I am currently having them work on their final

Roy Sida battles during a match.

projects and I am very excited to see what they produce. This project not only allows me to evaluate what they have learned, but evaluate myself.” On the job, Sida services clinics owned by The Specialty Physicians of Illinois and the Franciscan Physician Network, located in the area around the two Franciscan hospitals in Chicago Heights and Olympia Fields. “In Olympia Fields, I work with our telemetry system, a lot of general equipment and occasionally assist our imaging specialist,” he explains. “At Chicago Heights, aside from the general stuff, I also assist the work in surgery.” From working on medical equipment to standing in front of a class to grappling with an opponent, this HTM professional gives new meaning to the term modern Renaissance man.

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EDITOR’S INSIGHTS

Biomeds Have One of The Best Jobs People Don’t Know About By John Wallace, Editor

very year as I am making my New Year resolution to live a healthier lifestyle I start to see countless Top 10 lists of the greatest stories from the previous year or the exciting things to look for in the upcoming year.

I began 2015 less focused on new year resolutions. I am old enough to know better than to spend a ton of time and energy on something that won’t last. Instead, I am going to focus on small measures and see if I can maintain that objective over the course of a year. The number of articles, blogs and websites with Top 10 lists, however, seems to have increased this year. There are more than ever and some of them include great news for the readers of TechNation. According to an article on the Money magazine website, a publication of Time magazine, “The 5 Best Jobs You’ve Never Heard Of” includes three jobs that we know well. The first in their list of jobs is “Nuclear Medicine Technologist.” Yep, we’ve all heard of this job. However, just to recap, this job requires a degree from an accredited program but it does not require medical school training. This is the person in the hospital or health care facility who operates the special medical imaging equipment to do CT scans, MRIs and other tests that are used to make a diagnosis and plan treatments. The reason this is a great job in 2015 is the pay with a reported salary of about $71,000 and because jobs are developing fast where health care and technology intersect. You guessed it. The intersection of health care and technology is a reason the next job is No. 2 on Money’s list. “Medical Equipment Repairer” a.k.a. Biomed or HTM professional is the second best job we’ve never heard of as we enter 2015. This career usually requires a two-year

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degree in biomedical equipment technology or engineering and produces an average salary of about $44,000, according to Money magazine. The No. 3 job on this list is a Digital Risk Officer. Money describes this job as somebody who prevents data breaches. This is becoming an important job at many health care facilities with more and more emphasis being placed on cybersecurity. The education requirement for this career is a two- or four-year degree in IT and digital analytics certification. The average salary for a chief risk officer is a whopping $153,602, according to the article. Another list that caught my attention as we welcomed the new year is ECRI Institute’s Top 10 Health Technology Hazards for 2015. There are some familiar items on this list starting with the No. 1 hazard for 2015 – alarm hazards. Data integrity is second on the list followed by mix-up of IV lines and the inadequate reprocessing of endoscopes and surgical instruments. Ventilator disconnections not caught because of mis-set or missed alarms rounds out the Top 5. The complete list can be viewed by downloading a free white paper at https://www.ecri.org/Pages/2015Hazards.aspx. ECRI Institute also produced the Top 10 Hospital C-Suite Watch List for 2015. “ECRI Institute’s 2015 Top 10 Hospital C-Suite Watch List discusses a blend of novel, new, and emerging technologies that will demand attention and planning over the next 12 to 18 months, plus important issues and programs affecting care processes and delivery in 2015 and

JOHN WALLACE Editor of MD Publishing

beyond,” according to the white paper that contains the list. “We used our Institute’s intellectual capital across our 450 interdisciplinary staff to identify these new and emerging technologies and care delivery issues. Our mission is to help decision makers understand the hype versus the evidence and the important issues to consider when deciding whether to be early adopters, middle adopters, or no-adopters.” Disinfection robots leads this list followed by 3-D printing with middleware completing the top three. Postdischarge clinics and Google Glass round out the top five items on this ECRI list. The complete list is available online at https://www.ecri. org/Pages/ECRI-Institute-2015-Top-10Hospital-C-Suite-Watch-List.aspx. So, as you can see, 2015 is going to be an exciting year. I can’t wait to see all the latest technology and solutions at MD Expo Nashville in late March. I hope to see you there as well. Be sure to register at MDExpoShow.com

MARCH 2015

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COTS EQUIPMENT

Does One Size Fit All for Off-the-Shelf Computer Equipment?

any hospitals use commercial off-the-shelf (COTS) computer equipment rather than components specifically designed for the health care setting. Some of these facilities allow COTS computer components to be used anywhere in the facility, including patient care areas. For example, such equipment may be placed in patient rooms as part of a hospital information system installation. But does the use of COTS equipment near the patient create concerns about touch current or other safety issues that should prohibit its use? ECRI Institute doesn’t think so, if the proper precautions are taken. For COTS computers and monitors used within the patient care vicinity — that is, the area extending 6 feet beyond the normal location of the bed or other patient support, and vertically 7 feet 6 inches above the floor — there are reasonable steps that can be taken to verify the equipment’s quality and safety so that it can be used without worry. For equipment that will not be used within the patient care vicinity, fewer precautions are required.

WHAT RELEVANT CODES AND AUTHORITIES SAY Compliance with codes and the expectations of authorities could be an issue when deciding whether to allow COTS equipment in the patient care vicinity. Many hospitals look to agencies such as the Joint Commission or the National Fire Protection Association (NFPA) for guidance. Unfortunately,

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neither of these organizations nor any other certifying organizations or prevailing standards offer detailed recommendations on the use of COTS computer equipment.

such as UL 60601-1, the facility should verify that the device has a UL or similar listing or mark that is appropriate for the general category of equipment.

ECRI Institute Recommendations

BE WARY OF RELYING ON MEDICAL/ HOSPITAL-GRADE LABELING

VERIFY UL LISTING, AT MINIMUM Even for computers and monitors that will be used in the patient care vicinity, a facility need not limit its selections to equipment that complies with a medical device standard such as Underwriters Laboratories’ UL 60601-1 (Medical Electrical Equipment—Part 1: General Requirements for Safety) if not required to do so by local regulations. Most COTS computer equipment is UL listed, not to the medical device requirements of UL 60601-1, but to other relevant UL standards (e.g., those covering IT or office equipment). While the latter standards may not be as rigorous as those for medical devices, they still provide some assurance of safety. If a COTS device being considered is not listed to a medical device standard

When selecting computer monitors and some other nonmedical devices, a hospital does not need to limit its selections to products designated as “medical grade” or “hospital grade.” No universal meaning exists for these terms, and neither term is defined in the 60601-1 standards or in NFPA 99. NFPA 99 does not require hospitals to use hospital-grade or medical-grade equipment, even for patient care. Precisely what is meant by “medical grade” or “hospital grade” varies among suppliers. With some devices, the medicalgrade or hospital-grade designation is used to indicate that the device addresses concerns covered by 60601-1 standards. But with other devices, these designations are not related to equipment safety but instead describe, for example, inclusion of performance features that the supplier considers appropriate for medical

2. Addressing Touch Current

All COTS computers or monitors being considered for use in the patient care vicinity should be verified to be electrically safe. Further, such equipment should be assessed for other considerations that might be relevant in a medical environment. applications. As a result, a computer or monitor with such a designation may not necessarily offer any safety advantages over a commercial device. A facility that does decide it prefers computer equipment with a medical-grade or hospital-grade designation should contact the supplier to verify whether the designation relates to the device’s safety.

VERIFY EQUIPMENT SAFETY All COTS computers or monitors being considered for use in the patient care vicinity should be verified to be electrically safe. Further, such equipment should be assessed for other considerations that might be relevant in a medical environment, such as fluid resistance and instructions for cleaning and disinfection. More specific recommendations include: 1. Examining the Equipment Have health technology management personnel examine the equipment for overall quality and electrical safety.

Several hospitals have expressed concern to ECRI Institute that COTS computer equipment may exceed the touch (leakage) current limits they apply to their medical devices, since COTS devices are subject to less stringent regulations than devices designed for medical use. ECRI believes that COTS equipment exceeding a facility’s maximum touch current can be used safely in the patient care vicinity, provided that the appropriate steps are taken and that precautions are applied when called for. The first step is to measure the device’s touch current. This measurement should be made before any redundant grounds are installed. If equipment touch current is 500 μA or less, the device meets international and U.S. standards and no measures to address touch current are needed. THIS ARTICLE is based on an article that was posted on ECRI Institute’s membership website on December 24, 2014. The full article features additional ECRI perspectives and recommendations, more background and details on relevant standards, and more detailed guidance on addressing touch currents. The article is available on ECRI’s Health Devices System, Health Devices Gold, and SELECTplus member websites. To learn more about these programs or any other ECRI Institute service, visit www.ecri. org or call (610) 825-6000, ext. 5891.

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TOOLS OF THE TRADE SCOTTeVEST

COTTeVEST is well known for incorporating gadget friendly pockets into their clothing line. The company has a strong following with doctors and medical professionals. SCOTTeVESTâ&#x20AC;&#x2122;s multi-pocket, gadget-oriented engineering philosophy has been applied to redesign the lab coat, with the incorporation of 16 purposeful pockets. The lab coats are great for HTM professionals. The 16 pockets include two handwarmer pockets for easy access to small items and two pen pockets, suitable for pens and penlights. There are two exterior drop-in welt pockets for notepads and tools. There are also two interior cellphone pockets to protect phones from exposure to external contamination. These are also great for portable testing devices. Four interior chest pockets and one ID badge friendly exterior chest pocket are also included in the design. There are two tablet pockets sized to hold an iPad and log books. The coatâ&#x20AC;&#x2122;s integrated weight management system distributes the weight evenly to prevent a pull to one side. And there is one long ruler pocket intended to hold slender instruments upright. FIND OUT MORE ABOUT THE SCOTTEVEST LAB COATS at www.scottevest.com.

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MARCH 2015

1TECHNATION.COM

AAMI UPDATE

Joint Communication Addresses Humidity Levels in the OR

ow should health care delivery organizations tackle the complex challenge of setting appropriate relative humidity (RH) levels in the operating room (OR)? A group of professional health care and sterilization organizations has studied this question and has recommendations on how to assess the risks associated with this question, especially as it relates to the impact on sterile supplies and electro-medical equipment. “Health care facility leaders should think about whether lower humidity levels are desirable and appropriate in their facility — and the answer may vary depending on the climate where the facility is located, the services offered, and the products and equipment used in their location,” the organizations said in a joint communication released last month. Concerns in the field about appropriate humidity levels in the OR, equipment, and regulations related to them prompted a meeting this past fall at AAMI headquarters in Arlington, Virginia, involving multiple stakeholders. The joint statement was developed in the wake of that meeting. Its goals are to ensure that patients are protected through the safe use of equipment and that resources for installation, energy and ongoing maintenance are used efficiently. “Many health care delivery organizations are choosing to lower their humidity levels,” said AAMI President Mary Logan. “Doing so can affect the shelf life and integrity of sterile supplies. This document provides points facilities should keep in mind as they think about lowering humidity levels.” The communication provides background on the issue and explains

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why some medical supplies cannot tolerate the lower RH levels. Manufacturers of these supplies want to support the HDOs in expanding the RH range, but they cannot change their products overnight, according to the statement. “It will take some time for manufacturers to modify products and/ or packaging to accommodate or verify the lower minimum RH, complete testing requirements for these typically regulated products, and have those products available for HDOs,” according to the communication. It advises HDOs to follow the product’s instructions for use or contact the manufacturer if they cannot find an answer to their question. The communication, which is available at www.aami.org/news/2015/ Humidity_in_OR_Joint_ Communication_to_HDOs_ January_2015.pdf, includes considerations for preparing for lower humidity levels, including whether checking the IFU for existing inventory of supplies used in the OR and what level of humidity the heating, ventilating, and air conditioning system can maintain.

AAMI SCHOLARSHIP MEETS ITS FUNDRAISING GOAL In 2009, AAMI embarked on an ambitious goal to raise $500,000 for a scholarship fund to help students interested in a healthcare technology management (HTM) career. Now, thanks to a number of generous donations, the fund has reached that mark, enabling AAMI to expand the program. Named in honor of former AAMI President Michael J. Miller, the scholarships, which are awarded by the AAMI Foundation, go to students aspiring to become biomedical equipment technicians (BMETs) or clinical engineers. Ten students — five aspiring BMETs and five clinical engineers — have received the honor. Bob Stiefel, a retired clinical engineer (CE) and former consultant, gave the initial donation, as well as the one that pushed the fund over its target. As a lecturer at courses for biomedical equipment technicians from the 1970s through the ’90s, Stiefel appreciates the work HTM professionals do. “I had graduates of these and other BMET programs as interns and employees in my CE departments at the University of Rochester-Strong Memorial Hospital and at Johns Hopkins Hospital. I also established a joint Johns Hopkins Hospital-Howard Community College scholarship program for BMET students,” he said. “Obviously, I value the educational opportunities available in BMET programs. I know from personal experience that scholarships help some of the best future BMETs.” Steve Campbell, AAMI’s chief operating officer, said the organization is determining how best to move the program forward.

“We are in the process of developing some recommendations to the AAMI Foundation Board on the expansion of the scholarship program,” he said. “I can’t thank our financial supporters enough — from AAMI’s corporate members and our exhibitors to AAMI leaders and members. Every bit has helped and made a difference.” Students helped by the scholarship have diverse backgrounds, and many already have thriving HTM careers. In fact, several have landed high-profile positions. “The scholarship helped motivate me to continue my passion within the HTM field and pursue my doctoral degree as a full-time student,” said 2012 winner Avinash Konkani. “Now, I work as a clinical engineer at University of Virginia Health System, having graduated with a PhD in systems engineering from Oakland University in Rochester, Michigan.” He credited the scholarship for giving him not only the financial support he needed, but also exposure to experts in the field. To donate or learn more about the program, visit www.aami.org/ foundation/scholarship.

GUIDE AIMS TO IMPROVE INSTRUCTIONS FOR PROCESSING EQUIPMENT Human factors engineering principles play a huge role in the proper processing of medical devices. To help in the development of clear and consistent instructions for use (IFU) and education and training guides for processing equipment, AAMI has unveiled a new technical information report. Intended for medical device manufacturers, the document is

called “AAMI TIR55: Human factors engineering for processing medical devices.” “Medical device processing is performed by and is dependent on humans, and therefore human factors engineering needs to be considered in the design of the various elements of processing,” according to the document. In the section dealing with IFU, the document recommends using text and images in close proximity to improve comprehension. Also, instructions should be in a text that is easy to read and simplifies jargon. In addition, the document recommends starting sentences with action verbs when describing steps, breaking down each into separate bullet points. “TIR55 provides information not available in other AAMI documents and will assist the medical device manufacturer in designing a device, creating IFU, and providing education, training, and competency assessment tools so sterile processing can more effectively and efficiently clean and sterilize medical devices,” said Martha Young, president at Martha L. Young, LLC, who provides sterilization solutions for health care.

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WEBINAR WEDNESDAY Off to a Fast Start in 2015 By John Wallace, Editor

ore than 200 people registered for the first Webinar Wednesday session of 2015 and those in attendance learned how to be a biomed superstar! MD Publishing President and Founder John Krieg presented “5 Ways MD Expo Can Help You be a Bigger Superstar in Your Profession” to kick off the second year of the popular TechNation webinar series. The informative session was well received with a 4.6 rating on a 5-point scale. Attendees shared their thoughts on the webinar and the Webinar Wednesday series. “This being my first TechNation webinar, I was most impressed by the smooth delivery and flow of the presentation,” said Jeff W. “(The webinar was) very helpful, especially if your hospital has a tight budget. I look forward to the webinars because the experts are doing the presentations,” Maximilian G. said. Krieg discussed the history of MD Publishing and its signature event, including the first-ever MD Expo held 13 years ago at Callaway Gardens in Pine Mountain, Georgia. He said the MD Expo continues to “inspire, educate and empower” biomeds with a laid back and intimate environment as it supports and promotes the HTM community. Krieg’s five bullet points on how MD

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Expo can empower biomeds and help them advance in their career included networking, exhibit hall/vendor relationships, workshops/product demos, how to seek administrative approval/ support and education/CE credits. A recording of the webinar is available online at IAmTechNation.com. MD Expo’s new features, especially the VIP Passes and the Attendee Toolkit, were hot topics during the Q&A session of the webinar. Individuals can attend the MD Expo free by contacting one of more than 100 exhibitors to request a VIP Pass. A list of exhibitors with VIP Passes can be found in the Pre-Show Planner available online at MDExpoShow.com. The new VIP Pass option allows for complimentary admission for hospital employees, students and members of the military. The cost of registration without a VIP Pass is $100 for hospital employees, students and members of the military. Registration is $200 for non-hospital personnel. The Attendee Toolkit includes a sample letter that biomeds can use to prepare a letter to their supervisor requesting permission and funding to attend the MD Expo. It outlines the many benefits of the MD Expo and can be found online at MDExpoShow.com. The Attendee Toolkit also has a sample Trip Report that HTM professionals can use as a template to record the educational sessions, networking and other experiences at MD Expo. It can be used to prepare a report for a supervisor after the event.

JOHN KRIEG President of MD Publishing

The Webinar Wednesday series continues on March 25 with “Outlet Strips and Extension Cords – Meeting the CMS Requirements Simply, Easily and Cheaply” presented by Pat Lynch. Webinar attendees earn 0.1 credits for ICC certification. Register for the webinar at www. IAmTechNation.com. FOR MORE INFORMATION about upcoming webinars visit IAmTechNation. com and click on the “Upcoming Webinars” tab at the top of the page. For sponsorship opportunities, email webinar@ mdpublishing.com or call 800-906-3373.

MARCH 2015

1TECHNATION.COM

BIOMED 101

Power Strip Safety and Regulatory Compliance By Jim Folk

he convenience of power strips is undeniable, but the hazards they present in hospitals and other health care facilities are less well-known. Because misused power strips can endanger patients and staff, strict regulations govern how and where they are used. Failure to follow regulations can lead to code violations, citations, fines and accreditation issues. Even more important, violating regulations can also increase the risk of inflicting injury upon patients, staff and visitors. By understanding the basics of health care power strip technology and the various codes and standards that govern power strips in health care environments, you can benefit from their cost-effective convenience while encouraging optimal safety and regulatory compliance. S–T–R–I–P METHOD Following the five-step S-T-R-I-P method will put you on the right path to better promote safety and compliance for your health care facility. Your policy-making Strategy will be informed by understanding the Technology available, understanding the Regulations that apply to power strips and your facility, understanding the proper Installation of power strips, and understanding the correct Purpose (i.e. application) for each type of strip.

STRATEGY Combine your knowledge and resources to develop a policy that makes sense for your facility and the regulators involved (such as The Joint Commission, OSHA, CMS, and federal, state and local authorities having jurisdiction). It is up to you to conduct a risk assessment and develop an appropriate policy. Get to know the surveyors who make regular appearances at your facility. Ultimately,

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the interpretation of code is up to them. Understanding their interpretations will help you tremendously when developing your policy.

TECHNOLOGY There is a big difference between the technology used in a generic power strip from the local big box store and specialized power strips with fault protection that are designed for health care applications. Generic power strips consist of several components, such as multiple electrical receptacles, an on/off switch, a circuit breaker, a power cord and a grounded plug. UL refers to these power strips as “Relocatable Power Taps (RPT),” defined and listed in UL 1363. In 1990, manufacturers introduced RPTs with “hospital-grade” plugs and receptacles that have additional features and performance requirements for improved grounding reliability, assembly integrity, strength and durability. Around 2000, UL introduced new labeling and

JIM FOLK Executive Vice President of Tripp Lite

marketing requirements for hospitalgrade strips. Under the new guidelines, power strips needed to meet the medical electrical equipment requirements. In 2010, UL adopted UL 1363A, a new standard for “Special Purpose Relocatable Power Taps,” power strips permanently attached to medical equipment assemblies. As a result, power strips used in patient care areas must be tested to UL standard UL 1363A or UL 60601-1.

REGULATIONS Regulations, standards and codes are not laws, but rather, criteria that certifying bodies such as CMS and The Joint Commission use to benchmark electrical safety for patients and staff. Understanding regulations, and especially how regulations are interpreted and applied, is a complex

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and confusing task for anyone who is not experienced in dealing with them. The first step in understanding and successfully interpreting the regulations is familiarizing yourself with the relevant codes and standards applicable to your requirements. Ultimately, you need to make sure you follow the code. Once you become familiar with the code, you can work with regulators and experienced partners to ensure your compliance strategy is successful.

INSTALLATION Many regulatory violations are for improper installation of approved power strips, even when the right kind of strip is being used in the right location for the right application. Improper installation will render all your other efforts useless, so it is crucial to make installation part of your power strip policy and to understand what regulators are looking for when they inspect your facility. OSHA requires that “listed or labeled equipment shall be installed and used in accordance with any instructions included in the listing or labeling.”

1. Medical-Grade Power Strips (UL 60601-1) 2. Medical-Grade Power Strips for Mobile Applications (UL 1363A) 3. Power Strips for Administrative Areas and Operating Rooms with Isolation (UL 1363) 4. Surge Protectors for Administrative Areas (UL 1449) Medical-grade power strips meet the requirements of medical equipment (UL 60601-1 or UL 1363A) and they can be used in the “Patient Care Vicinity.” Power strips that do not meet UL 606011 or UL 1363A cannot be used in the Patient Care Vicinity.

CONCLUSION

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Whether you consider power strips indispensable cost-saving devices or a necessary nuisance, it is all but certain that they are or will be used within your health care facility. By designing and implementing a power strip policy, the need for accessible power can be achieved without losing sight of a health care administration’s mission to protect patients.

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It is important to understand that there is not a single type of health care power strip that is suitable for every application in your facility. Each category of health care power strip has a specific purpose and should not be used for a different purpose that it is not designed and approved for. Health care power strips (including surge protectors) can be divided into four primary application groups that use different technologies and meet varying UL standards:

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SHOP TALK Q

I was asked by administration to reach out and see how other institutions handle off-hours coverage or do you run two or three shifts of support? Any information or opinions are appreciated.

A A

We rotate on-call one week at a time.

Most of our hospitals run a day shift. My one large hospital has a second shift, we cover until 10:30 p.m. We do not have everyone come in and leave at the same time during the day, i.e. day shift might cover from 6:30 a.m. to 5:30 p.m. (on-call technician covers until 5:30 p.m. for sites that do not have a second shift.) Technicians also change hours to get PMs completed before or after normal working hours or on weekends. We do have technicians on-call for after hours and weekends.

On-call coverage for all off hours. On-call compensation is $4 per hour with a minimum 4-hours pay if called in.

We have a technician on call after hours and weekends (6 p.m. to 6:30 a.m. weekdays and 24 x 2 hours for the weekend). They are paid $1.50 per hour to be on call. If they are called in they are paid for two hours minimum. My folks take call a week at a time.

I worked as a BMET at a large hospital in northern Virginia and we always rotated pager on call.

We’re in a smaller facility than you are, but our on-site coverage is 7 a.m. to 4 p.m. Monday through Friday. For off-hours coverage I carry a pager and our cellphones are also posted

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internally. If I am on vacation, my tech carries a pager. Since I am on salary, if I get called in it’s just a part of the job. If my tech gets called in, he is guaranteed a two-hour minimum even if he has the issue fixed in 15 minutes. This has worked well. We’ve only had a few calls in the last year that required one of us coming in. The last call we had concerned a nurse in our nursing home who ran the battery down in a lifter until it wouldn’t work at all. She wanted one of us to come in and make it charge faster. That didn’t happen, and the nursing supervisor there received a call from us on Monday morning. All of the batteries in their lifters had been replaced within the last 6 weeks, and all of the chargers were checked out at the same time. The nurse’s issue was due to staff (her included) not plugging the equipment in when not in use. We get to be the final judge of whether or not the issue warrants one of us coming in. We had an issue over Memorial Day where they couldn’t get an ECG trace on a defibrillator. The facility’s spare crash cart had been locked up in a portable CT scanner we were using while our new CT was being installed. I came in and checked the defib out; no problems found. The nurse admitted while I was there that she may not have had the electrodes quite right. Having a crash-cart without a defib that could cardiovert was definitely cause to come in while a dead battery in a patient lifter (when there were at least three others in that wing) was not. This approach won’t work unless your facility trusts your department to be able to make that call. My attitude is that if they don’t, how can they trust you to maintain the equipment.

We have day shift 6:30 a.m. to 3 p.m. at one campus, and 7:30 a.m. to 3:30 p.m. at the other. A swing-shift tech works 1:30 p.m. to 10 p.m. Standby/on-call is from 10 p.m. to 6:30 a.m. (unless the swing-shift tech is gone, leaves early, etc). Call is rotated weekly between five technicians. It begins at 10 p.m. on Monday, and runs until 6:30 a.m. the following Monday. We get $3.50/hour for standby (on-call) pay. If we get called in, we get three hours minimum. It used to be four hours minimum, but we are (unfortunately) union, and our union is notorious for giving away our money, as long as they keep getting their monthly extortion dues payments. We’re also in the same union/group as facilities/maintenance, and there are 30 of them and five of us biomeds, so our needs are consistently ignored.

How is everyone classifying infant incubators? Are they life support or critical/high risk?

A A

They are critical/high risk.

It depends on the manufacturer. Following the manufacturer’s recommendation can’t steer you wrong. GE/Datex-Ohmeda recommends an annual inspection of the “Giraffe Omnibed.”

A A

We consider them critical/high risk.

With TJC there will be no distinction between the two. Critical/high risk, which would contain all life support, would be scored as an A standard, which require 100 percent PM completion.

Be aware, CMS wants a separate listing of “critical” equipment. TJC decided to use the term “high risk.” AOA/HFAP has their own requirement, for “life support” equipment. Not all critical equipment is life support. Critical equipment can be any device or system which is essential to taking care of the patient, revenue generating, or required for a test that must be done before you can discharge a patient. Someday, I would hope that all three agencies can agree on terminology. 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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ROUNDTACMMS Software

echNation reached out to industry leaders for their insights regarding CMMS, how it can help clinical engineering departments and what to expect in the future. The panel for this roundtable includes: Greg Doherty, Executive Director of Clinical Asset Management for UnityPoint Health; Phil Englert, BA, National Director Technology Operations, Clinical Engineering for Catholic Health Initiatives; Alan Gresch, Vice President of Client Success at Mainspring Healthcare Solutions; Dale Hockel, Senior Vice President, Operations for TriMedx; Bhaskar Iduri, Manager, Clinical Engineering & QA for Renovo Solutions LLC; Robert Maliff, Director, Applied Solutions Group, ECRI Institute; and Eric Sacks, Director, Healthcare Product Alerts, Health Devices Alerts, ECRI Institute. 36

1TECHNATION.

NOVEMBER MARCH 2015 2014

WHAT SHOULD HTM PROFESSIONALS LOOK FOR WHEN PURCHASING CMMS SOFTWARE?

DOHERTY: Aside from a system that meets the existing business needs it is important to have flexibility, integration with IT and ERP systems, and growth capability that aligns with the organization’s strategic goals and regulatory agency compliance. ENGLERT: There are so many important features in current CMMS. When considering the features of a CMMS, the organization should first look for features that can be linked to meeting the strategic goals of the organization. If a strategic goal is to improve the patient experience, look for features that can be linked to equipment availability and reliability. If a strategic goal is to reduce expenses, look for features that identify how resources are expended. Look for the system that fits the way your group does business without a lot of work-arounds. The CMMS should accommodate your organization’s business processes with ease and grace rather than require a shoehorn. GRESCH: Scalability and the ability to support where the department is going to be 10 years down the road, as it may be that long before you look at replacing the system again. As Gretzky cited, “Skate to where the puck is going to be.” Great HTM departments need to think beyond just the PM/break-fix function (any CMMS can do that) and determine what other ways they can bring value to their organization. Can their CMMS help take them to that next level? Can they provide mechanisms to

reduce expenses, increase staff efficiencies, and improve customer service like parts management, dispatch functions and customer surveying capability? Does it have an extremely robust reporting tool to create good management dashboards, provide for internal and external benchmarking, and support optimum compliance with TJC and CMS regulations? Does it have auditing capabilities to insure ongoing data integrity? With all the hospital consolidation and acquisitions, can it support a true enterprise application? HOCKEL: CMMS should provide regulatory readiness and expertise to ensure compliance with all regulatory agencies. It should track all medical device performance records, preventive maintenance schedules, safety issues, equipment recalls and manufacturer recommendations to ensure the highest level of patient safety related to potential device malfunctions and lowest level of risk related to compliance. IDURI: It has to be a web-based application. It should be user friendly (easy to operate and train). The response time should be instantaneous when accessing the information. It should have the ability to customize reports. It should be flexible to be customized to meet future demands and standards. MALIFF: Flexibility with reporting – how easy is it to create customized reports and how easy is it to establish a dashboard of metrics? Also, how might it integrate with financial/materials management systems like the hospital asset database, service contract database and C-level dashboards? Look for demonstrated/proven

THE ROUNDTABLE

purchasing and supply chain analytics are the most popular. Many systems now either integrate with Enterprise Resource Planning (ERP) or can be used to schedule, staff and manage HR functions within HTM. ENGLERT: Advanced features include integration with testing equipment, mobile platforms enabling service recording at any location, clinical user service request system, ad-hoc report generation and interfacing with organization’s requisition, ordering and accounting systems.

PHIL EGLERT

GREG DOHERTY

National Director Technology Operations, Clinical Engineering for Catholic Health Initiatives

Executive Director of Clinical Asset Management for UnityPoint Health

installation sites.

WHAT ARE SOME OF THE BASIC USES OF CMMS FOR HTM PROFESSIONALS?

DOHERTY: Tracking, analyzing and reporting on inventory, preventive maintenance (PM), break downs, work orders, equipment maintenance, performance, regulatory compliance and productivity (equipment and employee). ENGLERT: The primary purpose is to document service events on regulated medical devices. The ability to reconstruct a device’s lifecycle is a CMS and JCAHO requirement. Additionally, the CMMS should be able to schedule and record periodic inspections and service activities as well as “on-demand” service events. GRESCH: Any CMMS must be able to schedule maintenance work (preventive and corrective) and adequately capture all the relevant information about every device the department maintains.

1TECHNATION.

HOCKEL: CMMS should maintain service records and provide routine schedules and reports. Such reports should document life-cycle maintenance costs, monitor equipment performance and track inventory. By having this holistic equipment life cycle view, you can optimize and extend the use of equipment. IDURI: It should function as a central repository to store and access data related to medical equipment maintenance activities and to run reports and the ability to perform equipment life-cycle planning. SACKS: Basic uses include: maintain a complete inventory of capital and durable medical devices; quickly identify and locate devices that are the subject of a recall, field correction, or other alert; and schedule and manage routine maintenance and repairs.

WHAT ARE SOME MORE ADVANCED USES OF CMMS SOFTWARE?

DOHERTY: Key Performance Indicator (KPI) reporting, project management,

NOVEMBER MARCH 2015 2014

GRESCH: Some advanced uses of CMMS software include: parts management (ordering connectivity to materials management information system, automated part cost capture on work order, ability to tie PM kit ordering to PM schedules and initiate automatic ordering); dispatch and response capture to be able to determine response time, turnaround time, and equipment uptime; and advanced reporting tools. HOCKEL: Advanced software can report on performance trends, safety concerns and training needs. Some of those trends include: uptime; service response; PM; customer satisfaction; significant events; capital planning and budgeting; and equipment utilization. This type of data provides true business intelligence and analytics to support the entire system’s needs today and in the future. IDURI: Some advanced uses include real-time tracking of the assets, automated login/logoff for users, monitoring/reporting the resources utilized like parts cost, labor hours, travel time, etc., against the equipment, project management and advanced reporting features like YTD spend, downtime, life-cycle planning and compliance reports. SACKS: Advanced uses include: monitor device performance; uptime, frequency of repairs, repair costs; plan for medical device purchases based on age and performance of existing inventory; look for opportunities to

standardize both to maximize negotiating leverage when purchasing and to provide staff with consistent user interfaces; and monitor staff productivity: device inspections and repairs, etc.

HOW CAN HTM DEPARTMENTS GET THE MOST OUT OF ITS CMMS SOFTWARE?

DOHERTY: Quite simply – by investing effort equal to or greater than the desired output. Other than acquiring the correct software it is important to develop standards and spend time caring and feeding the system on a continual basis. CMMS software is an important tool to the success of any HTM professional. AL GRESCH

ENGLERT: Identify key business rules and processes before shopping for a CMMS system and then set up the CMMS system to drive process integrity within your organization. Inconsistent and incomplete data lead to unreliable decision making. The data recorded for similar functions must be consistent and complete. CMMS systems allow for a great deal of process variation to accommodate different customer needs. Turn off the features you aren’t ready to implement or utilize. GRESCH: Put a significant emphasis on data integrity. Create rules around data entry, with drop-down selections as much as possible. Create a mechanism for ongoing auditing of data. In order to provide a good foundation for capital planning, and to do any meaningful benchmarking, you must have clean data. HOCKEL: Using CMMS to capture specific data to help manage networked devices and align device security/ compliance will ensure you’re getting the most out of the software. However, collaboration between clinical engineering and IT is paramount in delivering programs that meet patient satisfaction and organizational strategies.

DALE HOCKEL

Vice President of Client Success at Mainspring Healthcare Solutions

Dale Hockel, Senior Vice President, Operations for TriMedx

IDURI: By implementing it, I should be able to effectively manage service, financial and reporting areas in my department.

effective data controls five or more years ago, you may still have “dirty data” in the records of devices that were commissioned earlier. And in today’s world of health care system consolidations, merging inventory databases from multiple facilities presents an overwhelming challenge. That is why ECRI Institute has developed the ECRI Product Catalog that establishes a standard naming and categorization for thousands of medical devices.

SACKS: A big change over the years has been the way CMMS systems allow the clinical engineer to control data to ensure consistency in a system used by multiple staff members. For example, in the past, the entry of new asset records was pretty informal. So you might end up with the same model of device spelled multiple different ways (abbreviations and misspellings) and categorized under multiple device type descriptions. Today’s CMMSs support creation of model profiles so that each time an additional unit is commissioned, it is set up using the model profile as a template. Different users are provided different levels of permissions based on their role in maintaining the database: setting up new model profiles, entering individual new assets, completing maintenance and repair work orders. Establishing such consistency within an individual hospital is a big effort. Many medical devices remain in service for more than 10 years. So even if you implemented

HOW CAN PURCHASERS ENSURE THEY ARE MAKING A WISE INVESTMENT IN CMMS? WHAT ARE THE MOST IMPORTANT FEATURES TO LOOK FOR WHEN IT COMES TO CMMS SOFTWARE?

DOHERTY: Performing an internal gap analysis prior to conducting an RFP or search for a new or replacement system is important. Aligning the gaps and business strategy with the ability of the CMMS to meet or address existing and future needs. It will also be important to test systems during the evaluation process to ensure they will meet business needs upon purchase rather

THE ROUNDTABLE

BHASKAR IDURI Manager, Clinical Engineering & QA for Renovo Solutions LLC

than just meet needs defined on paper. ENGLERT: Identify what problems you want the CMMS to solve for you and then look for the system with features that solve those problems. Avoid looking at CMMS systems without knowing what features are important to you to avoid buying features you don’t really need. Today’s complex CMMS systems come with a broad spectrum of features. They all do the basics fairly well. Choose the program that best fits your most basic needs within the business processes of your organization. It will have the features to grow with you. GRESCH: First, as previously mentioned, make sure the CMMS will support you in the future and not just where you are today. Ideally, it will help take you to another level. Second, make sure you are going to get substantial ongoing training and support. HOCKEL: Always partner with an organization whose mission and vision align with your strategic goals. Be sure the software not only comes with adequate training, but also has proven and detailed

1TECHNATION.

ROBERT MALIFF Director, Applied Solutions Group, ECRI Institute

performance metrics of medical devices over the years. CMMS should have a comprehensive inventory; inclusive of service history data, device alerts/recalls, operations benchmark metrics, and documentation of all service costs during the life of the asset. These will ensure appropriate maintenance is performed, equipment is accounted for, and devices are safe for use in patient care, per regulatory and accreditation standards. IDURI: Software should be able to meet your requirements and should be flexible enough to be able to be customized as per the department needs. It should be a real-time application. It needs to follow nomenclature in accordance with the standards of accreditation agencies. It should track the status of the open services/ repairs, order. It should have the ability to run the reports by modality like biomed, imaging, laboratory, etc., by risk levels. SACKS: Bring in multiple vendors to showcase their products. Look carefully at reporting features to ensure that they meet your needs. Carefully assess each vendor’s

NOVEMBER MARCH 2015 2014

ERIC SACKS Director, Healthcare Product Alerts, Health Devices Alerts, ECRI Institute

commitment to servicing your account and get references from similar sized health care provider organizations in your region.

WHAT ARE THE MAIN BENEFITS OF IMPLEMENTING A CMMS PROGRAM?

DOHERTY: CMMS programs allow for the implementation of best practices and standards. Examples are: regulatory compliance, improved information, control of inventory and service activity, planning and scheduling, and reporting. Additionally, CMMS reports allow HTM departments to report on successes and performance that contributes to the goals of their organization. ENGLERT: A well implemented CMMS system can teach you about your program and that information can be used to make more informed decisions about equipment support, service quality, staff effectiveness, and service delivery efficiency so that the value of your HTM group can be maximized. GRESCH: There is an old adage that you

BECOME A can’t improve what you can’t measure. Implementing a good CMMS will provide the basis for capturing all the relevant data around service and support of your medical equipment. Once you have good data, you can determine ways to improve service, increase productivity and reduce cost. The data will also be a good way to protect you from arbitrary staff reductions. HOCKEL: CMMS provides valuable information regarding inventory, downtime, productivity needs and regulatory issues. It can also be used for capital planning and budgeting, to consolidate contracts, to better manage the lifecycle of equipment, and possibly bring some services in-house in the future. IDURI: Some important benefits include accurate inventory, consistent nomenclature of the devices, ease of workload distribution, effectively manage the department under budget allocated, effective replacement planning.

WHAT ELSE WOULD YOU LIKE TO ADD OR DO YOU THINK IS IMPORTANT FOR BIOMEDS TO KNOW ABOUT CMMS AND ITS USES?

DOHERTY: Be an active participant in the development and growth of your CMMS. Data entry is merely the entry point. Provide active feedback as users to your support and leadership teams that allow for adequate adjustments. Leaders need to know how changes in the CMMS affect daily activities. As leaders, it is also important to engage technicians prior to change implementation and to clearly explain why changes or measures are being implemented. This impacts the data and the results any CMMS can produce. ENGLERT: Don’t try to drain the ocean. I recommend turning off features until the basic cost-saving and quality processes are ingrained into the HTM organizations DNA. Then, periodically evaluate additional features that either further

support the organization’s strategic goals or enable the next level of service delivery based on customer needs. Lastly, each data element has a cost; a cost to enter, a cost to maintain, a cost to analyze and a cost to report. Choose data elements sparingly and wisely. Choose them because they provide a “need to know” and have a return on investment and rather than a “nice to have.” GRESCH: Understand what your department needs now and down the road and don’t settle for less. Often, a CMMS acquisition can involve multiple departments like HTM, facilities engineering, IT and EVS. Don’t settle for something that may be easy to use for one of these other departments, but doesn’t provide the critical data and data analysis you need to optimize your department and its value to your organization. HOCKEL: CMMS is the most effective way to organize data. CMMS can help track several key factors – all of which help the management team make informed decisions and accurately forecast. CMMS is critical to success in a hospital system. IDURI: Biomeds needs to know that the CMMS software should meet their daily needs like the ability to track the location of the equipment, monitor the order status, view open task orders assigned, enter amount of hours spent and run monthly PM reports, etc. MALIFF: Think more broadly about how the system ties into other IT management systems.

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1TECHNATION.COM 1TECHNATION.COM

MARCH 2015

5 Tric HTM ks Eve Profe r y Shou ssion ld Kn al ow Advic

e from

Expe

rienc

ed In

dustr

y Pro

fessio

nals

BY K. RICHARD DOUGLAS

ow many times have you heard somebody lament; “I wish I knew then what I know now”? Benjamin Franklin may have said it best when he said; “Life’s tragedy is that we get old too soon and wise too late.”

What if you could have the benefit of that wisdom earlier in your career? What if some sage advice just happened to fall out of the sky? Well, your day has come. We sought out the wisdom of many veteran and mid-career HTM professionals to glean a little wisdom for the benefit of the rookies out there and anyone who just wants to learn, or be reminded, of a few truths. Some of the best advice helps to establish an HTM professional’s role in the health care schematic. Not just as the person who performs repairs and maintenance; but as a customer service professional, number cruncher, communicator and problem solver. What are five things that every HTM professional should know? Keep reading for some collective wisdom. You may find that five is just the starting point.

5 THINGS TO KNOW

DEALING WITH PEOPLE Those who have been in the field for any length of time can tell you that the most important things to know may not have anything to do with a particular piece of equipment. It may have nothing to do with knowing anatomy and electronics; although those things are certainly prerequisites for the profession. The important things are often intangibles; knowing about managing priorities and people skills. As a practical matter, what you may find in a psychology book or in an article about human interactions may outweigh what you find in an electronics textbook. Among the many pearls of wisdom are suggestions to improve listening skills, nurturing an image as the person who is always up for a challenge and knowing when to say, “I don’t know.”

“Try to occasionally leave your technical ‘comfort zone’ and explore and seek to understand some of the basic concepts surrounding organizational psychology, culture, politics, and the often seemingly bizarre nuances of human behavior in general and within your own organization in particular,” suggests Larry Fennigkoh, Ph.D., P.E., professor of Biomedical Engineering at the Milwaukee School of Engineering. With a dose of humor, Fennigkoh lays out one of those intangible qualities that the HTM professional needs to figure out. “The goal here is to not try and change your basic personality, but rather recognize and simply be sensitive to differences in individual values and what motivates some and not others,” he explains. “Such an awareness not only helps you get along with others of differing backgrounds, but also can help keep your sanity when confronted by a seemingly insane customer.” This idea of leaving your comfort zone and thinking outside the box finds its way into another suggestion for modifying your behavior to become an exceptional HTM pro. The people skill angle is echoed by Glenn Scales, CBET-E, past-president of

“The goal here is to not try and change your basic personality, but rather recognize and simply be sensitive to differences in individual values and what motivates some and not others...” -Larry Fennigkoh

“You have to have lots of patience, excellent customer service skills, the drive to want to learn, acceptance that you are not always going to be right and be able to work under pressure,” says Jesse Rodriguez, AAS, biomedical equipment technician with Baylor Medical Center in Carrollton, Texas.

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MARCH 2015

the North Carolina Biomedical Association and the 2013 Medical Dealer Lifetime Achievement award winner. “The single most important resource you have as a technician, is not technology, but your ‘people skills,’ ” Scales says. “We spend our whole careers working for and with others, plus hiring

GUS SAKIS Vice president of sales for MediMizer Inc.

and managing people. Your staff are critical for your success and the advancement of your goals.” “Learn how to be an effective communicator,” he adds. “Every human interaction involves communication and most people need as much help as they can get. Also, remember that communication involves listening, not just speaking.” “Seek out the ‘go-to’ person you can learn from,” suggests Lawrence Countee, CBET, Healthcare Technology Management Biomed at Olathe Medical Center. Countee adds that it is helpful to learn “nurse speak.” Lifelong learning is an area that can put a rookie biomed on the right course. “My advice to new HTM professionals is to constantly pursue educational opportunities,” says Gus Sakis, vice president of sales for MediMizer Inc. “Seek out all sources of knowledge to increase your understanding of the industry with an emphasis on IT.” “Devot time and effort to promote yourself and your department through excellent customer service. Follow closely the news from regulatory agencies such as The Joint Commission and others,” Sakis adds. “Never say ‘no,’ ” says Pat Lynch, CCE, CBET, fACCE, CHTS-PW, CPHIMS, Chief Do-Gooder for Global Medical Imaging (GMI). Lynch says that there are

LARRY FENNIGKOH

GLENN SCALES

PAT LYNCH

Ph.D., P.E., Professor of Biomedical Engineering at the Milwaukee School of Engineering

CBET-E, Past-President of the North Carolina Biomedical Association

CCE, CBET, faCCE, CHTS-PW, CPHIMS, Global Medical Imaging

several benefits from taking this approach. “First, you will become known as the person who can and will do anything for anybody,” Lynch says. “Whenever anybody doesn’t know who to call, it will be you! Second, by opening yourself up to all sorts of weird and unusual challenges, you will become the most diverse person, capable of approaching and solving the most bizarre problems with ease.” Lynch borrows from the old motto of the Army Corps of Engineers from World War II. “ ‘The difficult, we do immediately, the impossible takes a little longer.’ Prepare yourself to do the impossible by accepting every challenge thrown at you,” he says. He also stresses people skills, taking for granted that a technical mastery of all things electronic is a given in the field. “Mechanical and medical is a job requirement, but it is not as important as your ability to talk to people, explain things on their level, and understand their world,” Lynch says. “Our customers have problems and stresses. Our presence should always make their life better and their stresses less. If you can do this, they will love to have you around.” Another important intangible is keeping the lines of communications open with customers and providing a clear explanation of the service provided.

“The most often complaint of a client is that they don’t know when the repair was completed or what was even done,” says Brian Whelan, inside technical specialist with Remi Inc. His advice is directed at HTM professionals who work for ISO providers, but finds application with in-house biomeds as well. “The client should always know what is going on with their equipment. A simple daily email update or even a phone call to let the client know what is going on. Often I have seen FSEs complete repairs and install parts without consent to install or complete the repairs,” he says. Whelan says that the client will not pay the FSE for their services because they did not authorize the repair and the FSE is left with a large bill. He reasons that if the FSE simply communicated and gave updates to the client, many issues can be avoided. “When the repair is completed, the client should be directly notified and given a completed work order in detail of the services performed. I always find it best to ‘bullet out’ the services performed so that it can be easily read,” Whelan says. “Also if you are unsure of how to go about a repair, or what to do, simply just ask someone. There are many resources on the web and other FSE that are glad to help. There’s no harm in asking and often a lot of people will not ask anyone out of fear of looking bad.

“If you are unsure of how to go about a repair, or what to do, simply just ask someone. There are many resources on the web and other FSE that are glad to help. There’s no harm in asking and often a lot of people will not ask anyone out of fear of looking bad. Asking questions will save you time.” - Brian Whelan

5 THINGS TO KNOW

ARAMARK Healthcare Technologies in Albany, Georgia. “Maintain great work ethics. Don’t become complacent. Always strive to know more and be better.”

BRIAN WHELAN

JOE HOWE Biomedical services manager for Lexington County Health Services District

Inside technical specialist with Remi Inc

“In addition to the technical, IT, financial, management — human and technical — and soft skills [...] I believe that knowledge in the (following) is needed; systems engineering, technology assessment, technology and society and technology transfer.” -Bassam Tabshouri

Asking questions will save you time.” This concept is repeated by Joe Howe, biomedical services manager for Lexington County Health Services District. “Never be afraid or ashamed of asking for help. It is not a sign of weakness; on the contrary, it often takes more courage to ask for help than to stumble through a dilemma on your own,” he says. “Don’t hesitate to say you do not know the answer to a question; you can always find the answer and usually will come out looking more foolish if you guess your way through an answer,” Howe says. Lynch reminds HTM professionals that what goes around comes around. He illustrates this reality with the concept of “gray stamps.” “Whenever you win by power or brute

1TECHNATION.COM

MARCH 2015

force, the losing party remembers. They ‘collect gray stamps,’ ” Lynch explains. “They hold onto these gray stamps — which are similar to the old Green Stamps that you could redeem for gifts. When they have the opportunity to spend their accumulated gray stamps, to make your life difficult, they ‘redeem’ the gray stamps and cause you problems,” Lynch adds. “You will long since (have) forgotten that they were left with a minor little revenge motive, but they will never forget the past,” he adds. “The moral: do not ever make enemies – payback is often served very cold.” “Make rounds. Don’t let the only time nurses, techs and doctors see you is when something is broken,” recommends Jason Misner, CBET, biomedical supervisor for

THINKING ABOUT NUMBERS In an area unrelated directly to repair and maintenance or to people skills, Fennigkoh points out that there is a degree of accounting knowledge that should be a fundamental part of your thinking. Don’t just leave this to the C-suite and business managers. In a cost-conscious environment, the HTM professional who thinks about cost containment offers some additional valued insights. “Learn some fundamental concepts associated with cost accounting and the principles that define and determine what the real, complete costs of your operation is to your employer,” he says. “For example, if you were suddenly given the charge of converting your existing cost-centered HTM operation to a for-profit business, how would you go about determining fixed and variable costs, hourly labor costs, etcetera? Essentially, how would you financially survive if you had to now function as a for-profit business?” “Regardless of where or for whom we work, it’s all business of one kind or another,” Scales says. He says that technicians need to understand how a business operates, how finances are managed and how to establish a budget. He points out a truth that has application in many different fields, but which all HTM professionals could benefit from. “Almost anything you want to accomplish will require you to develop a plan and sell it to someone else,” he says.

“Develop and maintain a strong working knowledge of the principles and practices associated with electrical power distribution systems in hospitals, and especially in any remaining areas that still use isolated power systems,” Fennigkoh says. “Such knowledge will allow you to put electrical safety concerns, the appropriate use of power taps, etcetera in their proper perspective.”

Take that business knowledge and number-crunching expertise and let management know you are in tune with what’s important to them. “Learn how to search, gather and analyze ‘big data.’ Become expert in reporting and presenting your findings to C-level management,” Sakis says.

JASON MISNER CBET, biomedical supervisor for ARAMARK Healthcare Technologies

A FEW TECHNICAL THOUGHTS On the technical side, there are tidbits of wisdom that can solve a perplexing problem, illustrate repairs and focus knowledge. “Never trust the labels on lead wires at the distal end — always follow the lead wire back to its origin,” says Bob Siefers, CBET, who works in the clinical engineering department at Promedica Flower Hospital. “Many lead wires can be removed, and all it takes is two leads to be transposed and the techs or nurses will call with complaints. This holds true for monitoring as well as EKG, etcetera. Rule of thumb — never trust a label. Check it out yourself.” “In addition to the technical, IT, financial, management — human and technical — and soft skills,” says Bassam Tabshouri, MSEE, director of Medical Engineering for American University of Beirut Medical Center in Beirut, Lebanon,. “I believe that knowledge in the (following) is needed; systems engineering, technology assessment, technology and society and technology transfer.” Troubleshooting skills is an important skill for HTM professionals, in order to diagnose equipment effectively. This applies to in-house technicians and field service engineers equally.

Whelan says that HTM professionals “should review the service manuals of various equipment. Often FSEs will overlook the simple causes like a bad power cord, battery, power supply (or) faulty outlet and think that they need to replace an expensive PCB just because the error code suggested that is the best course of action,” he says. “Good troubleshooting skills will save you time and money.” He also points out that not everyone has a photographic memory and that a basic piece of technology, that most people have, can come in real handy. “Take pictures – almost everyone has a smartphone,” Whelan says. “Take a lot of pictures of how you are taking apart the piece of equipment you are servicing. Make sure to take a picture of the serial number and the part number that you are replacing. This will help with documenting the service performed. Also, you will be able to show the client visually what you repaired.” The idea saves a lot of explaining, according to Whelan. He says that there are a lot of free apps that you can download to your phone. “You can actually attach a word bubble to the picture and you can type in a description for the photo,” Whelan says. “PicSay is the best free app that I have used for this.”

WHEN ALL IS SAID AND DONE Scales summarizes what many veteran HTM professionals know. “Your job is not just about the technology. In many respects that is the easy part,” he says. “It is critical that you understand the clinical practice that the technology supports and how to help the clinical practitioners better utilize the technology and solve problems. Our role, as HTM professionals, is to help ensure that the patient has the most effective and safe experience while in our care.” Howe concurs. “Never lose focus on the identity of your true customers; patients,” Howe says. “Some may argue that their customers are the doctors and nurses, who use the equipment, but without the patients, the doctors and nurses would not be needed; nor would the medical technology.” Misner reflects one last bit of wisdom. “Always do the job as if the equipment you are working on may be used on your family,” he says.

5 THINGS TO KNOW

Can you uncover ECRI Instituteâ&#x20AC;&#x2122;s Top 10 Health Technology Hazards for 2015? 1. A_ _rm _az_r_s 2. D_ _t int_ _r_ty 3. M_x up _f _V l_ _es 4. In_d_q_ _te r_ _r_c_s_ing 5. V_ _t_la_or disco_n_cti_ns 6. Pat_e_t han_l_ng de_ice _se e_ _ors 7. D_se cr_ _p 8. R_b_tic s_rg_r_ 9. Cy_e_sec_rity 10. R_c_ll mana_em_nt

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CAREER CEN-

Spring Reflections on Your Career Path By Cindy Stephens

ost of us attempt to start out the New Year with specific resolutions and goals, but often we lose track of time, and what started out to be good intentions falls short of our goals. We always think of spring as the time of year to clean out our closets and de-clutter our life, so that when summer arrives we can relax and enjoy summer activities â&#x20AC;&#x201C; shedding the tensions and stress around us. We live busy lives and most of us have not had time for spring cleaning in our personal or professional lives. Spring is a time for reflection and a time for renewal. Instead of floating through your career, take this time to evaluate your job performance and professional accomplishments, and set goals to recharge your job and career. Even if you are happy with your current position, it is important to set goals. By doing so, you will be able to continue to grow within the organization. Often, technicians and managers become complacent and, as each year passes, they find themselves stuck in the same position and being passed over for other

Cindy Stephens Stephens International Recruiting Inc.

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MARCH 2015

opportunities. By evaluating your job performance and professional accomplishments and setting goals, however, you can build a foundation for future opportunities as they become available. Positioning yourself for internal opportunities can also set the stage for those once-in-a-lifetime opportunities that come along from other organizations. The competition is tough today and job security no longer exists! Even people who love their jobs should be looking at ways to remain relevant. This is not the time to be taking it easy or relaxing. You need to ensure you are meeting the challenges to survive and prevail in todayâ&#x20AC;&#x2122;s economy. Competing today will require higher levels of competence and necessitates looking straight ahead, not constantly glancing in the rearview mirror at what you have achieved in your past. How you are perceived by your bosses, as well as your peers, is often the single greatest factor in career advancement. The good news is that you are in charge of your career and your behavior, and you have the opportunity to impact this perception to your professional advantage. Take this time to review your skills, job performance, and your relationships with your employer and peers. Consider how you are viewed as an individual and as an employee. You need to do what it takes to be valuable to your employer and to set

yourself apart from others! This brief list is designed to provide an opportunity for self-analysis and, hopefully, is a useful tool to see how your boss and others perceive you.

RELIABLE AND DEPENDABLE Do you arrive on time every day? Do you get your work completed on or before deadlines? Following instructions, policies and procedures should be normal for most employees, but you would be surprised to find how many employees have been let go during staff cutbacks due to their lack of respect for following expected work hours and/or lunch and personal breaks.

TECHNICAL SKILLS You must remain valuable to your employer with your knowledge and experience. Update and maintain your technical skills. Stay up-to-date with top industry trends, regulatory issues and your competitors. Network with peers and attend association meetings. Read trade journals and online blogs. Attend conferences, take higher education classes, and get certified. Do not rely on your employer to pay for additional training or certification. Spend time learning new health care technology. Take the initiative and be proactive in your career progression. Never stop learning!

The competition is tough today and job security no longer exists! Even people who love their jobs should be looking at ways to remain relevant. - Cindy Stephens

EXCEED EXPECTATIONS. This quality is one of the highest measurements of achievement. Often, a manager’s perception of success or failure is determined by setting and exceeding your boss’s expectations. Do you do what it takes to get the job done (even when it isn’t “your job”)? Do you go above and beyond what is expected? You should be known as a problem solver, one who takes the initiative. Employers want to hire and retain people who are productive, efficient and who can take care of business.

CUSTOMER SERVICE SKILLS These are more important than ever in today’s economy. If you feel you are lacking in this area, look for books or evening classes to help you improve.

EXCELLENT COMMUNICATION SKILLS Verbal as well as written communications are in great demand today. Many employees have not accomplished the basic written and verbal grammatical skills that are needed for most business communications. Excellent documentation, reports and communication skills can make a difference in your accomplishments and how you are perceived. If you have poor grammar, whether speaking or in writing, it gives the impression that you are lacking basic educational skills. Excellent listening skills fall in this category as well. Pay attention when someone speaks to you directly. Consider enrolling in a community college to polish up your communication skills if you feel you are lacking in this area.

EXCELLENT MANAGER AND LEADER

The ability to manage your own time as well as manage and motivate a team is an important characteristic of a successful leader. Organizational skills and tidiness are important in setting the example for others and in getting the job done well. How well you plan and manage your daily activities provides you the focus that is needed to complete your job requirements on time. You should be seen as flexible, accepting change easily, especially when your plan changes and other requirements take over your day. You should be open-minded to other’s ideas and techniques. Do not be opposed to criticism. Learn from your mistakes.

ENTHUSIASM AND COMMITMENT TO THE ORGANIZATION You should approach your job daily with enthusiasm and a commitment to the organization. Taking the initiative inspires confidence in your ability to assume additional responsibility. Managers want people on their team who eagerly take on challenges and exhibit the kind of energy that inspires others to follow. There is no room for negative attitudes in any organization. Leave your personal problems at home and remain focused on meeting your company’s goals. Your ability to concentrate on your job responsibilities, no matter what is going on, indicates you are able to take on more responsibility and, more importantly, that you are ready for the next level in your career.

PROFESSIONAL APPEARANCE AND MANNERS You are not judged by your performance alone. Carelessness towards your appearance and daily grooming isolates you, regardless of your abilities. People shy away from associating with people who

have sloppy appearance such as unkempt hair, wrinkled or stained clothing, or dirty, raggedy nails despite their expertise. It may not seem fair and it may seem unimportant, but you need to pay attention to this as perception is more important than skills in this area! Just as important is your ability to remain professional at all times in your mannerisms. Avoid gossip and getting involved in office politics. Treat others with respect. Always be seen as the ultimate professional in appearance and manners!

INTEGRITY AND HONESTY You should be seen as the person who is always trusted to do the right thing, always. After taking time to evaluate yourself, it is time to make a plan for achieving your goals. It is easy to get overwhelmed when doing this. Make sure to set realistic goals that are achievable. If completing your bachelor’s degree is a goal, break it down into smaller steps. Instead of looking at the daunting task of going back to school for three years, break it down into taking two classes a quarter. Be sure to set realistic timelines and expectations, and review your accomplishments and shortcomings throughout the year. It is important to prioritize your goals to help focus your attention on the most important ones. Like most things in life, you need a plan or a map to get where you want to be. The more focused you are on achieving your goals, the more likely you are to accomplish them. Reflect now on your career, performance, accomplishments, and goals. Make sure that your skills and personal characteristics set you apart from others. Take the steps needed to keep your career

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ltrasound preventative maintenance sounds like a very basic and somewhat boring topic to cover. However, throughout my career I have seen many PMs performed or examined systems post-PM and have found the service to be inadequate at best. In previous articles, compliance with accreditation organizations and CMS has been discussed regarding PMs, but let’s look at the potential cost savings of a proper PM.

MATT TOMORY Vice President of Sales, Marketing and Training

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MARCH 2015

First, thoroughly clean the system inside and out using an ESD compliant vacuum cleaner. Today’s ultrasound systems are more sensitive to heat than ever before and cleaning filters, intake grills and air passages is critical to preventing future failures. The filters on all contemporary systems should be cleaned on a regular basis with the manufacturer’s recommendations as well as environment dictating the frequency. Now you need to complete a full system backup. Twice. This is a critical step to mitigate downtime in the eventuality the system fails due to software issues. By making two complete backups of presets, network data, options and other user preferences, you can fully restore a system in a couple of hours versus many hours or even days. Leave one with the customer and store the other in a central location accessible to your team. On to the transducers, begin by inspecting the pins on the probe connector. Bent pins can damage the probe connector board on the system which then may damage another probe when it is plugged

into that board. This can have a cascade effect throughout a department as damaged probes are moved around and damaged connector boards continue to bend pins on other probes. Also check the probes for overall integrity and safety; a small repair today can prevent a very costly one down the line. You also want to determine the solution and processes your customer is using to clean and disinfect transducers to ensure they are compatible with the manufacturer’s recommendations and are focused toward safe handling from start to finish. This is not part of standard PMs but over the course of my career in the ultrasound service world, I have performed hundreds of process evaluations and have found areas for improvement in the majority of cases. WANT TO LEARN MORE? Conquest Imaging has developed a comprehensive PM training program to assist you to perform the most thorough, compliant and truly preventative maintenance in the ultrasound industry. Call us at 866-9009404 for more details.

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THE FUTURE

It’s Going to Be a Great Year!

By Roger A. Bowles

fter a long break for the holidays, we are once again in full swing with the start of the spring 2015 semester here at Texas State Technical College Waco. I enjoy the time off, but I’m always eager to return to the classroom. And, it’s an exciting time to be teaching Biomedical Equipment Technology.

Roger A. Bowles MS, EdD, CBET

EXPERT ADVICE

Our new, revised curriculum goes live in the fall. Since the state of Texas decided last year that no associate degree needs more than 60 semester hours, even technical ones (I guess all of those legislators know a lot about technical education), we have had to do a lot of revision and soul searching to ensure that the key elements of the program were left intact … and even improved. Sometimes change can be a good thing, especially when it forces you to go back over things piece by piece. And this is happening at a time when the industry seems to want more stuff included in the curriculum. Also, beginning soon, all of the Texas State Technical College campuses will have aligned curricula as the system becomes one college with many different campuses. The number of new students this spring is slightly lower than normal, but I’m expecting that to change with more recruiting effort on our part and new attention being paid to the career field. I was glad to see the article in Money magazine including Biomedical Equipment Technicians as one of the “Five Best Jobs You’ve Never Heard Of,” although I wish they would have used Biomedical Equipment Technician instead of Medical Equipment Repairer. Hopefully, people will put it together. But it is still good attention and I will take it. The recent downturn in oil prices will surely affect some programs here at TSTC, but I think it will benefit our program on a couple of levels. First, we will gain students. We cannot promise students that they will make $70,000 a year upon graduation like some of the programs that place people in the oil and gas business but our career field, in my opinion, has always had the edge in job satisfaction. And, from what I have been hearing from employers, the demand for our graduates will remain

steady and even grow over the next several years. Second, decreasing gas prices will make it easier on our students, especially as they complete internships. Many of them travel over 80 miles (one way) several times a week to work for free and gain experience. When gas was hovering at almost $4 a gallon it was a huge problem for many of the students. Although they did complete their interships (the motivated ones always do), it created hardships for them. Gas here is averaging around $1.75 at this writing (This of course is not good for my part-time gig as a motorcycle RiderCoach. I guess motorcycle sales are down and the rush for large gas guzzling trucks has resumed … it is Texas after all). On another note, we have been blessed with the donation of a new equipment management software program (along with full technical support and assistance with implementation and use) that will give our students real world experience with the same type of program they will be using when they graduate. And, they will get a chance to use this program with a real world assignment as they will be doing preventive maintenance and documenting it for a real hospital department (it is a smaller hospital) while they are in school with the assistance of our faculty. We are also developing a new partnership with an OEM to provide them with quality interns and future employees. This will be good for recruiting! And finally, speaking of faculty, I have been fortunate to work with a team with recent experience and real motivation for teaching. Slowly, but surely, it feels like I’m working myself out of a job as these folks continue to improve our program and do it without supervision. They are true professionals.

MARCH 2015

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PATRICK LYNCH

Is There a Future for Independent Biomedical Associations? By Patrick K. Lynch

hear more and more requests for a national, chapter-based biomedical association. Many of the local associations are having trouble with participation, membership, attendance and volunteers. It seems as if there are always lots of suggestions about things to do, and always too few volunteers to do them.

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

This is the way it is in almost all associations (biomed and others) who base their activities 100 percent on volunteer effort. Most of us are too busy to do very much other than work and take care of our home life. Let me identify the root problem and propose a solution. Is the real problem that associations don’t have enough volunteers, or could it be that we are trying to do too much with the limited volunteers that they have? We have been trying for years to get more people active. They just don’t want to. So let’s stop beating our heads against the wall and begin working smarter. If we only have a few volunteers, how can they have the greatest impact on the profession and members? Certainly you cannot do everything that is asked of you. So why not specialize? If you focus on a narrower goal, you have a real chance of doing it very well, instead of doing a lot of things poorly. Let me give an example. CABMET (the Colorado association) has chosen to focus most of their limited volunteer effort on creating an excellent BMET Certification review course. In addition to local meetings and an annual Symposium, they offer a high-quality review course to Biomeds all over the country. What if all associations utilized their limited resources of volunteers and chose to do one thing realy well? Let me propose some examples of areas which Biomeds would be better off if they had a good resource to look up important information: PM PROCEDURES – Why create your own? Someone could collect PM procedures from all over the country and make them available via a search and download.

EXPERT ADVICE

MASTER BIOMED ASSOCIATION LIST – Why should every association try to keep current with the contact information for all associations? Somebody could become the master reference. POLICIES AND PROCEDURES – Why doesn’t someone collect them from all over and put them in one location – on their website? END OF LIFE DATABASE AND LETTERS – META used to do this (courtesy Masterplan), but no one is doing it now. We could use a one-stop-shop. CMMS SOFTWARE – evaluations, comments, forums on various programs. REGULATORY INFORMATION – Why doesn’t some association keep data on CMS, JC and other regulatory issues for the industry to read and access? MANUALS, OPERATIONS AND SERVICE – It would be good if a huge repository could be created and links posted to various libraries around the world. BIOMED PROMOTIONAL IDEAS – CMIA has a number of videos, but there are surely more. BMET TRAINING MATERIALS – PowerPoints, books, programs, apps and all sorts of reference material is available, but it takes lots of time to search them out. These are just a few of the dozens of areas of specialization that are needed. If every association in the U.S. took a single, narrowly focused area to be the leader in, then we, as a profession, would have 40 or so high-quality resources that we could go to for information and resources. Let’s each

MARCH 2015

1TECHNATION.COM

THE ROMAN REVIEW

Leadership Courage By Manny Roman

recently read an article by Peter Bregman titled Why So Many Leadership Programs Ultimately Fail. The main point of the article is that “… there is a massive difference between what we know about leadership and what we do as leaders. Most leadership programs teach knowledge.”

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

1TECHNATION.COM

MARCH 2015

This hit home pretty hard since I have been in the training and education business for over 33 years. We have always had a quasi joke that said that we are not teachers because teaching implies that learning is taking place, thus we are instructors. Learning, by our definition, is a relatively permanent change in behavior. A behavior is observable and since we rarely had the opportunity to see new, long-term behavior from our students, we could not truly ascertain that they had learned. So the outcome of the training we provided was knowledge. Knowledge by itself is relatively useless. We all know a great deal of stuff. Even a non-swimmer knows what to do to stay afloat. Throw that person in the water and he now has to apply that knowledge. For knowledge to have value, it must be applied and then it becomes an observable behavior. Education and training are also different animals. Education is the type of general stuff we were provided in our early years. Two plus two equals four. This is knowledge. Training provides specific task-based programs where we are taught to apply knowledge to specific situations. When we provide fundamentals of servicing radiology equipment courses, we provide mostly education, even if there are laboratory exercises. When we provide a specific product course on a particular manufacturer’s machine, we are providing mostly training. In one we provide the knowledge necessary to be applied in the other. Back to Bregman’s article regarding leadership training. He is essentially saying that most leadership training is not training at all, by our above definition. We spend a lot of time and effort and money on leadership education. We generate a

great body of knowledgeable, welleducated leaders. We provide that education in a safe, non-threatening environment. The evaluations are anonymous to ensure safety and preclude bruised feeling and egos. His conclusion is that no leaders fail due to lack of knowledge, they own that part. Most failed leadership is the result of lack of what Bregman calls emotional courage.

No leaders fail due to lack of knowledge, they own that part. Most failed leadership is the result of lack of what Bregman calls emotional courage. -Manny Roman He states that what makes leadership difficult is not the theoretical, it is the practical. It’s not about knowing what to say or do. It is the willingness to place yourself in the discomfort, risk and uncertainty of saying it or doing it. It is about doing this without separating yourself from others and remaining strong in the face of uncertainty. It is speaking and doing when others are silent. In the TV show “Game of Thrones,” the son asks his father, “Can a man still be brave if he’s afraid?” The father replies, “That is the only time a man can be brave.”

DON’T GET LEFT OUT IN THE COLD! This means that saying or doing the easy things does not demonstrate emotional courage. Emotional courage can only be demonstrated when it needs to be said or done and you are the only one who will stand up. Doing the right thing when others may get angry, or against a politically correct situation, or a distracted situation, and not becoming defensive yourself, is emotional courage. John Maxwell makes a very clear distinction between managers and leaders: Managers do things right, leaders do the right things. Bregman states that, to be effective, training must be conducted in a real life environment without the safety of a controlled classroom. This is where leaders can be challenged to be courageous in the face of whatever fear they are facing. This is where they can ask themselves, “What will it take for you to speak up?” I have conducted customer relations skills seminars for many years now. I speak on communications, personalities, dissatisfaction, competence and other topics. When I am given additional time, I even conduct role play exercises where we put volunteers into likely circumstances and observe and evaluate their behavior. The attendees leave energized and ready to take on those difficult customers. I do a marvelous job of providing valuable knowledge. I suspect that the knowledge disappears, or at least fades, rather quickly for most and they get squashed like a grape by their irate customers. I have often been accused of being disruptive at meetings because I am willing to say what others don’t want to hear. Sometimes they just don’t want to hear my voice. I now have Bregman’s article and permission to be my normal emotionally courageous and witty self.

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MARCH 2015

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-march-2015. Good luck!

LAST MONTH’S PHOTO

SUBMIT A PHOTO

A Vault Spacelabs 701 Patient Montor

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

The photo was submitted by Greg Goll, CBET, Biomedical Supervisor at Erlanger Health System. To find out who won a $25 gift card for correctly identifying the medical device visit 1TechNation.com.

BREAKROOM

BULLETIN BOARD

new resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.

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CONTINUING EDUCATION

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CMIA Symposium 2015

3. 4.

CMIA recently held its statewide symposium at the Town and Country Resort Hotel in San Diego. The annual show was a big hit with more than 400 people in attendance and 84 exhibit booths. The symposium also catered to biomeds with 36 educational presentations and an awards dinner featuring keynote speaker George Mills from The Joint Commission. Award winners included CMIA Professional of the Year Scot Copeland. James â&#x20AC;&#x153;Jimâ&#x20AC;? Ingwersen was presented with the Frank Yip Memorial Scholarship Award. The Los Angeles Chapter of CMIA was named the Chapter of the Year. Pacific Medical received the Corporate Member of the Year Award. Fred Yoffe was presented with the MVP Award for the most outstanding contribution to CMIA by an individual.

1. Scot Copeland receives the CMIA Professional of the Year Award sponsored by Welch Allyn.

2. More than 400 people attended the CMIA statewide symposium in San Diego.

3. Pacific Medical Sales Director Eric Hatteberg and AUE Outside Sales Director Shawn Bryant network in the exhibit hall during the 2015 CMIA statewide symposium.

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MARCH 2015

The Los Angeles chapter was presented with the Chapter of the Year Award at the CMIA statewide symposium in January.

SCRAPBOOK

IBS Annual Conference 2015

1. 2. 3.

The Indiana Biomedical Society Annual Conference was a big success this year. The event was held at the Sheraton Indianapolis City Centre Hotel and drew a crowd. The exhibit hall and speakers were highlights of the annual conference. Binseng Wang delivered an informative keynote address. The awards were also an exciting part of the event. Betsy Kovacik, who is currently a Patient Care Account Manager for Philips Healthcare, was named the Lifetime Achievement Award recipient. She has been a friend and supporter of IBS since its inception. The Professional of the Year Award was presented to Brad Wiley. IBS also provides $500 student scholarships to IUPUI, Vincennes and Brown Mackie.

1. MD Publishing President John Krieg present Brad Wiley with the IBS Professional of the Year Award.

2. A TechNation reader opens his dress shirt to display his I Am TechNation T-shirt at the Indiana Biomedical Society Annual Conference at the Sheraton Indianapolis City Centre Hotel.

3. Attendees and exhibitors network in the exhibit hall of the IBS Annual Conference.

4. MD Publishing Vice President Kristin Leavoy holds up a foam finger at the TechNation booth.

BREAKROOM

Ensure you KEEP receiving TechNation for another year by confirming your subscription information today! 2 Easy Ways to Renew your Complimentary Subscription! 1. Log onto www.1technation.com/subscribe OR 2. Complete the form below and fax to 770-632-9090 Please Print Clearly Name _______________________________________________ Title _______________________________ Hospital/Company ________________________________________________________________________ Address __________________________________________________________________________________ City _____________________________________________________________________________________ State ______________________ Zip _________________ Country ________________________________ Phone ___________________________________________________________________________________ Fax _____________________________________________________________________________________ Email ____________________________________________________________________________________ Website __________________________________________________________________________________ Signature ___________________________________________________ Date ________________________ 1. What is your primary job title?

(check only one) m Clinical, Biomedical or Radiology Engineer m Biomedical Equipment Technician m Service/Support Manager m IS/Network Manager m Purchasing Manager m Sales/Marketing Manager m Department Administrator/ Director or Manager m Other (please specify) _______________________________________ _________________

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MARCH 2015

2. What is your company’s primary business? (check only one) m Hospital or Clinic m Medical Equipment m Computer/IT Equipment m Dealer or Distributor m Multivendor/Independent Service Organization m Depot Repair m Education/Training m Consulting m Other (please specify) ____________________________ ____________________________

3. Please check the statement that best describes your role in purchasing products/technolgy: (check only one) m Make final decision m Specify/recommend m No part in purchasing

4. Type of facility/business: (check only one) m ISO m OEM m Self Employed m Other (please specify) _________________________ _________________________

SAVE the

INDEX AceVision Inc. …………………………………… 51 Ph: 855.548.4115 • www.acevisioninc.com

International Medical Equipment & Service … 25 Ph: 704.739.3597 • www.IMESImaging.com

AllParts Medical ………………………………… 5 Ph: 866.507.4793 • www.allpartsmedical.com

KEI Med Parts …………………………………… 29 Ph: 512.477.1500 • www.KEIMedPARTS.com

Ampronix ………………………………………… 17 Ph: 888.700.7401 • www.ampronix.com

Maull Biomedical Training ……………………… 35 Ph: 440.724.7511 • www.maullbiomedical.com

BC Group International, Inc. ………………… BC Ph: 888.223.6763 • www.bcgroupintl.com

MedEquip Biomedical ……………………………56 Ph: 811.470.8013 • www.MedEquipBiomedical.com

BETA Biomedical Services ……………………… 35 Ph: 800.315.7551 • www.betabiomed.com

MedWrench …………………………………… IBC Ph: 866.989.7057 • www.medwrench.com/join5

Biomedical Equipment Services Co. LLC ……… 51 Ph: 208.888.6322 biomedicalequipment@yahoo.com

MW Imaging ……………………………………… 6 Ph: 877.889.8223 • www.mwimaging.com

Biomed Ed …………………………………………56 Ph: 412.379.3233 • www.biomed-ed.com BMES/Bio-Medical Equipment Service Co. ……58 Ph: 888.828.2637 • www.bmesco.com Capital Medical Resources LLC ………………… 33 Ph: 614.657.7780 www.info@capitalmedicalresources.com Conquest Imaging ……………………………… 11 Ph: 866.900.9404 • www.conquestimaging.com Cool Pair Plus ……………………………………30 Ph: 800.861.5956 • www.coolpair.com ECRI Institute ……………………………………50 Ph: 610.825.6000 • www.ecri.org/alarmsafety Ed Sloan …………………………………………… 22 Ph: 888.652.5974 • www.edsloanassociates.com Elite Biomedical Solutions ……………………… 26 Ph: 1.855.291.6701 www.elitebiomedicalsolutions.com Engineering Services …………………………… 16 Ph: 330.425.2979 ex:11 • www.eng-services.com Fluke Biomedical ………………………………… 4 Ph: 800.850.4608 • www.flukebiomedical.com Global Medical Imaging ………………………… 2 Ph: 800.958.9986 • www.gmi3.com Government Liquidation ……………………… 3 Ph: 480.367.1300 • www.govliquidation.com InterMed ………………………………………… 20 Ph: 800.768.8622 • www.intermed1.com

INDEX

Pacific Medical LLC ……………………………… 21 Ph: 800.449.5328 www.pacificmedicalsupply.com

DATE! Join your fellow Imaging Professionals at the 2015

IMAGING EXPO

Proudly Supported by:

PartsSource, Inc. ………………………………… 43 Ph: 877.497.6412 • www.partssource.com Philips Healthcare ……………………………… 26 Ph: 800.229.64173 • www.philips.com/mvs Pronk Technologies ……………………………… 8 Ph: 800.609.9802 • www.pronktech.com Radiology Data …………………………………… 29 Ph: 303.941.4457 • www.radilogydata.com RSTI/Radiology Service Training Institute …… 55 Ph: 800.229.7784 • www.RSTI-Training.com RTI Electronics …………………………………… 22 Ph: 800.222.7537 • www.rtielectronics.com Sage Services Group ……………………………30 Ph: 877.281.7243 • www.SageServicesGroup.com Southeastern Biomedical ………………………58 Ph: 888.310.7322 • www.sebiomedical.com

JW MARRIOTT

Stephens International Recruiting Inc. ……… 51 Ph: 888.785.2638 • www.BMETS-USA.com

JULY 22-24

Tesseract ………………………………………… 20 Ph: 703.437.4230 • www.tesseractUSA.com Tri-Imaging Solutions …………………………… 42 Ph: 855.401.4888 • www.triimaging.com USOC Medical ……………………………………… 7 Ph: 855.888.8762 • www.usocmedical.com

Now calling for presenters for more information & to submit your presentation, visit WWW.THEIMAGINGEXPO.COM

MARCH 2015

1TECHNATION.COM

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1TECHNATION.COM

MARCH 2015

BREAKROOM

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BOOTH 219

The Medical Product Support Network.

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