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YOUR TECHNOLOGY PARTNER FOR INNOVATIVE IMAGING COMPONENTS Varian Imaging Components has a 50+ year history of dedication to the imaging industry. We are uniquely able to build on decades of technology experience and expertise to offer state-of-the-art imaging components for medical applications to customers worldwide. We equip the world with best in class tools for taking X-ray images. We have a reputation of making high-quality, long lasting products. Our dedicated teams of engineers and scientists continually work to enhance the longevity and performance of imaging components, finding new ways of developing X-ray technology that yields superior image quality that is safe, efficient, quiet, long-lasting, and cost-effective. With each new innovation, our customers gain new capabilities and technology takes another step forward. To learn more, visit our website at varian.com VARIAN IMAGING COMPONENTS tel: 801.972.5000 fax: 801.973.5050 e-mail: info.xray@varian.com © 2014 Varian Medical Systems, Inc. Varian and Varian Medical Systems are registered trademarks. All rights reserved.
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“I like to help people in general and I like to go on missions, but now that I am going to my own country, I feel indescribable. I want to go every year.” “In order to do a good analysis, you’ve got to have good data, we’re trying to get organizations to collect good data and code in a way that is meaningful.”
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CONTENTS_Features 44 COVER STORY
In the health care world, it is important that facilities are evaluated on the strength of their compliance with standards designed to uphold and improve patient safety. Two of the biggest standards changes of the past calendar year, in regards to the maintenance of medical devices, involved relocatable power taps as well as the outline of an Alternative Equipment Maintenance. The thrust of the changes are meant to usher in greater compliance with established standards that help ensure patient safety, which is the ultimate goal.
61 PAY IT FORWARD
Volunteers from Joe DiMaggio Children’s Hospital in Hollywood, Florida, reach out to the Napoleon Franco Pareja La Casa del Nino Children’s Hospital in Cartagena, Columbia, with medical supplies and educational information for the members of the staff. The group of volunteers plan to return to Columbia with more supplies later this year.
Medical Dealer (Vol. 19, Issue #4) April 2015 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to Medical Dealer at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. For subscription information visit www.medicaldealer.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2015
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INDUSTRY UPDATE 15 News & Notes 18 Block Imaging MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 (800) 906-3373 Fax: (770) 632-9090 Publisher
John M. Krieg john@mdpublishing.com
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Art Department Jonathan Riley Jessica Laurain
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Contributors
Jim Fedele Matthew N. Skoufalos Dan Bobinski
Accounting Sue Cinq-Mars
Circulation
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20 OEM Updates
MARKET ANALYSIS Radiology:CT 25 Market Analysis 26 Product Showroom 29 Preferred Listings Med/Surg: Anesthesia 35 Market Analysis 36 Product Showroom 40 Preferred Listings
SLICE OF LIFE 54 The Other Side 58 Dan Bobinski 61 Pay It Forward 67 Off the Clock 72 Marketplace 76 Categorical Index 75 Alphabetical Index
Web Department Betsy Popinga Taylor Martin
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MEDICAL EQUIPMENT, PARTS & SERVICE
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INDUSTRY UPDATE_News and Notes
VARIAN MEDICAL SYSTEMS TO EXPAND OPERATIONS IN ATLANTA Varian Medical Systems has announced that it will expand its operations in Fulton County, Georgia. Company officials anticipate that this expansion will enable it to better serve its East Coast customers and accommodate anticipated growth that will create up to 100 new highpaying technical jobs over the next five years. Varian has a long history in the Atlanta area, with an office in Marietta for over 30 years. In 2012, Varian supported establishment of a clinical linear accelerator laboratory at the George W. Woodruff School of Mechanical Engineering at Georgia Tech University, for medical physics students to get hands-on experience with state-of-the-art radiation therapy equipment. Varian’s operations in Georgia recently expanded with the acquisition of Velocity Medical Solutions, an Atlantabased developer of specialized software for cancer clinics that was incubated at Emory University. Velocity was supported, in its early stages, by the Georgia Research Alliance, a nonprofit organization aligned with Georgia’s Department of Economic Development, working to expand research and commercialization capacity in Georgia’s universities to launch new companies, create high-value jobs, and transform lives. “We anticipate that there will be significant worldwide growth in demand for technology and software that clinicians can use to improve outcomes when treating cancer,” said Kolleen Kennedy, president of Varian’s Oncology Systems business. “Our acquisition of the Velocity group was part of a larger strategy to produce more tools and software that support our clinical customers. The new facility in Atlanta will enable us to foster greater collaboration across our teams and make sure that we have the space to accommodate future growth. We sincerely appreciate the support we have received for this project from Georgia state officials.” According to Kennedy, the new Atlanta center will operate as an East Coast hub for Varian. “It will include a state-of-the-art customer visit facility so that customers in the Eastern part of the U.S. and in Europe do not need to come all the way to California to meet with us, see our products, and talk with us about their future technology needs,” she said. Varian anticipates that the new center, which is located at 3290 Northside Parkway, will be ready for occupancy in November of this year. • WWW.MEDICALDEALER.COM
Staff Reports
HITACHI ALOKA MEDICAL AMERICA EXPANDS SALES FORCE TO ADDRESS CARDIOVASCULAR Hitachi Aloka Medical America Inc. continues the expansion of its sales organization with the announcement of a new dedicated sales force targeting cardiovascular ultrasound opportunities in physician’s offices and hospitals. The move from distribution to a direct sales force will help the company expand its brand in the cardiovascular market and grow revenues, according to President and General Manager David Famiglietti. “Over the past several years, we have used distribution to promote the Hitachi Aloka products in the cardiovascular market,” Famiglietti said. “This new sales force will give us a team that is dedicated and exclusively focused on the cardiovascular market and enable Hitachi Aloka to become a recognized leader.” The company has tapped Tom Wolk to lead the new dedicated cardiovascular sales force. “Tom is an industry veteran and brings a wealth of knowledge and experience to Hitachi Aloka in the cardiovascular market,” said Randy Baraso, national cardiovascular business manager. “Hitachi Aloka is very fortunate to have Tom leading our new cardiovascular team.” This growth in sales capacity is the latest in a series of similar moves by the company, which has seen its sales teams more than triple through acquisitions and new hiring in the past three and a half years. • MEDICALDEALER 15
INDUSTRY UPDATE_News and Notes
ENMET LLC ANNOUNCES NEW PRESIDENT ENMET LLC has appointed Norman Davis Jr. president. He succeeds Verne Brown who served as the company leader for 43 years until his passing. Davis brings a wealth of knowledge to the position with a background in executive management and business development with a focus in the safety and instrument sensor technology market. He has held a variety of positions and is the former president of Microsensor Systems, which was acquired by MSA (Mine Safety Appliances) in 2005. His education is in chemistry, environmental science and industrial hygiene. Founded in 1970, ENMET is a manufacturer of hazardous gas detection equipment for health, safety and medical applications. Products range from compressed air line monitors to portable detectors and continuous multi-channel fixed systems which address a variety of hazardous gas conditions. ENMET also designs custom engineered gas and vapor detection systems for a range of applications. •
Because Quality Matters.
Staff Reports
Norman Davis Jr.
CONQUEST IMAGING EARNS ISO 9001:2008 Conquest Imaging has received ISO 9001:2008 certification, an internationally recognized standard issued to organizations with a quality management system. The certification was authorized by TÜVRheinland, a global provider of independent testing and certification services with 15 locations throughout North America. ISO 9001:2008 provides a set of requirements that must be in place to have a quality management system, regardless of the organization’s size, product or service line, or public or private status. Certification to the standard is voluntary, and organizations must complete a rigorous auditing process by a third-party registrar. “Conquest Imaging has always had a reputation for quality above and beyond our competitors in a very crowded market,” said Matt Tomory, Vice President of Sales at Conquest Imaging. “This industry is self-regulated which allows for a huge disparity in quality; with ISO certification we stand out even more in our market. Partnering with TÜVRheinland for the certification and continuing audits will ensure our Continuous Quality Improvement program will only make us more efficient and remain in front of the rest of the industry.” Founded in 2000 by Jean and Mark Conrad, Conquest Imaging has more than 50 employees throughout the USA and provides ultrasound products, support and services across the country and around the world. • For more information, visit www.conquestimaging.com.
16 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
_News and Notes
PACIFIC MEDICAL DEBUTS NEW TELEMETRY BUILDING Pacific Medical LLC has announced its expansion with a new telemetry building to meet the demand of customer repairs and critical turn times. The new building was acquired as a solution to support the surge of Pacific Medical’s telemetry business and to provide for future growth. The telemetry department offers dedicated repair areas for the different types of telemetry devices, including a separate room for testing and quality control. Telemetry is the wireless monitoring of cardiac rhythms transmitted to a central location where they are recorded and analyzed. Pacific Medical focuses on three main parameters for patient monitoring in the hospital room. Pacific Medical’s systems are classified into the following categories: transmitters, equipment and parts. The company offers the assurance that the work completed is backed by dual ISO certifications and strict standards of quality with the work completed by OEM-trained technical teams. Pacific Medical understands the critical nature of timely telemetry repairs and the industry demand for increased efficiency and streamlined repair processes. “We created the new building to address the needs of our customers while meeting the increased volume in our telemetry business. We experienced a significant influx of repair volume from our customers and we needed to provide a solution to keep up with the demand. The new building allows us to decrease turn times, increase efficiency and overall customer satisfaction. We also now have the extra space for the assembly of complete transmitter units on the shelf for purchase,” Pacific Medical President and CEO Andy Bonin said. Pacific Medical takes pride in continuing to increase cost efficiency and volume while adhering to its strict ISO processes. Pacific Medical’s telemetry repair department capacity has quadrupled since the new building opened, expanding from four workstations to 10. Pacific Medical now completes an entire telemetry repair process within 48 hours. •
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INDUSTRY UPDATE_Block Imaging
By Gabe Viscomi
HOW TO CHOOSE THE BEST CT SCANNER SERVICE PROVIDER
C
T service providers come in a lot of varieties; OEM or independent, national or regional, contract-only or time and materials. Having so many options is both good and exasperating for anyone trying to make the best decision for their CT equipment service needs. The following are a few factors that will help narrow the field of players and simplify your service decision.
Experience Obviously, “experience” is tied to the number of years an engineer has been working on CT scanners, and this is certainly an important and desirable trait for a service provider to have, but it is equally important to learn a provider’s specific manufacturer and model experience. It should not be assumed, for example, that a seasoned Siemens CT veteran is also a good choice to work on a Toshiba CT. Likewise, it’s a poor assumption that an engineer welltrained on GE’s LightSpeed series will automatically be a good candidate for their BrightSpeed CTs. Customer Service This aspect of service is surprisingly easy to overlook when faced with a 18 MEDICALDEALER | APRIL 2015
well-rounded technical resume and/ or a reasonable price quote. However, a service provider may have a stable of fully-trained, veteran engineers but lack severely in the administrative infrastructure to make them effective. Try asking these customer service questions: • What is your average closing time on a service call? • Do you take after-hours or weekend service calls? • How does your company resolve an X-ray tube failure? • How far away is your engineer from my site? A company might have the world’s best CT engineer on their staff, but that doesn’t matter if poor customer service blocks your access to them. Parts Availability In the event of a CT breakdown there’s always the chance that the solution will require replacement parts. Choosing a service provider that stocks their own inventory of parts gives your site some great advantages. These parts generally cost far less than ordering them from an OEM. The ordering and shipping processes are also often faster. Best of all, after their engineer gets to know your system, he can bring
Gabe Viscomi
many of these parts with him at the outset of the repair and save you significant downtime. The Takeaway The most important thing for a CT service buyer to take away from these tips is this: Ask a lot of questions! Only by learning exactly what a service provider’s capabilities are can you make an informed service purchasing decision. GABE VISCOMI is the Vice President of Service at Block Imaging. His goal is to provide imaging equipment users with outstanding service by leading, refining, and equipping an outstanding Block Imaging service team. MEDICAL EQUIPMENT, PARTS & SERVICE
INDUSTRY UPDATE_OEM Updates
ESAOTE LAUNCHES EVOLUTION’15 AT ECR 2015 • increased signal homogeneity and At ECR 2015, Esaote introduced EvoSNR as a result of multichannel lution’15 (EVO’15) as the latest upgrade lumbar and cervical spine coils. in its dedicated MRI Evolution program. EVO’15 combines software updates By combining patented Speed-Up and new hardware features to provide superb image quality and increases protechnology with GPU-based image ductivity by almost 50 percent. reconstruction, the EVO’15 upgrade for Esaote’s G-scan Brio, enables a very fast Powered by eXP technology, EVO’15 acquisition protocol for evaluation of reflects the continual collaboration spine morphology in the weight-bearing between Esaote’s research and development team and clinicians that ensures position, for the first time ever – in under its dedicated MRI offering remains at 10 minutes. With its new eXP technology, Esaote the cutting edge. Evolution’15 is available across Esaote’s entire MRI portfolio and has achieved a reduction in scan time provides the following benefits: of up to 50 percent. This enables a significant increase in patient throughput, • increased image quality for betimproving system economics for a maxiter diagnostic accuracy, due to a mum return on investment. combination of sophisticated soft“The eXP technology developed ware algorithms (eXP technology), for the Evolution’15 upgrade has been graphic processing unit (GPU) and X-MAR (Metal Artefact Reducengineered to achieve the ‘seemingly tion) which reduces inhomogeneity, impossible’: improve image quality, yet allowing for a better evaluation of reduce scan time,” says Eugenio Biglieri, the prosthesis; MRI global marketing director at Esaote. • reduced image acquisition and The EVO’15 upgrade has been designed to meet increased demand reconstruction times by as much as 50 percent, thanks to Speed-Up Pro, from physicians and clinics wishing to offer high-quality, on-site dedicated helping to increase throughput and MRI services: minimize patient discomfort; and 20 MEDICALDEALER | APRIL 2015
Staff Reports
• EVO 3D: isotropic 3D sequences reduce voxel size, enabling high-resolution Multi-Planar Reconstruction. Used in conjunction with Speed-Up Pro, scan times are reduced by almost 50 percent. • X-MAR: uses new imaging sequences that increase signal to noise ratio, yet also reduce scan time. Visualization is improved using enhanced image contrast and metallic artifact reduction to reduce in-plane metal distortions (ideal for evaluating prosthesis instabilities and for post-operative patients). • e-Spine: optimized spine protocols and examination management for image clarity, plus improved patient comfort and operator usability. • Speed-Up Pro: enables superior image quality in reduced scan time, due to enhanced acquisition and reconstruction methods. EVO’15 is available across Esaote’s dedicated MRI product range, including the O-scan, S-scan and G-scan Brio. •
MEDICAL EQUIPMENT, PARTS & SERVICE
_OEM Updates
FUJIFILM RECEIVES ONC HIT 2014 EDITION COMPLETE EHR CERTIFICATION FOR SYNAPSE RIS Fujifilm Medical Systems U.S.A. Inc. has received ONC HIT 2014 Edition Complete EHR certification for Synapse RIS Version 6.3.3., which designates that the software is capable of supporting eligible professionals with meeting the Stage 1 and Stage 2 Meaningful Use measures required to qualify for funding under the American Recovery and Reinvestment Act (ARRA). Synapse RIS Version 6.3.3., was certified by ICSA Labs, an Office of the National Coordinator-Authorized Certification Body (ONC-ACB); and is compliant in accordance with applicable criteria adopted by the Secretary of Health and Human Services (HHS). Fujifilm received certification in December 2014. “As Meaningful Use continues to grow and evolve, Fujifilm remains committed to providing our customers with the most up-to-date information,” said Jim Morgan, vice president of Medical Informatics, Fujifilm Medical Systems U.S.A. Inc. “Synapse RIS has integrated EHR into a powerful radiology management tool that can enhance workflow and help increase the productivity of radiology practices.” ICSA Labs, an independent division of Verizon, offers vendor-neutral testing and certification. ONC HIT2014 Edition Certification is granted to those technologies that are capable of meeting the more rigorous testing criteria developed to support providers and hospitals who wish to demonstrate Stage 2 meaningful use, which focuses on the capability of health IT to deliver higher quality patient care and exchange clinical information securely. Synapse MU, v 6.3.3’s certification number is 140243R00. ONC HIT certification conferred by ICSA Labs does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services. The clinical quality measures to which Synapse MU, v 6.3.3 has been certified include: CMS 69, CMS 117, CMS 125, CMS126, CMS 134, CMS 138, CMS 139, CMS 146, CMS 155, CMS 165 and CMS 166. •
TOSHIBA NAMES DIRECTORS FOR MR AND X-RAY VASCULAR BUSINESS UNITS Toshiba America Medical Systems expertise in the MR market make him tute in Buffalo, New York. Inc. has named Guy Poloni as director, the perfect leader of the MR business Newsom also comes from within MR business unit, and Bill Newsom as unit,” said Calum Cunningham, vice Toshiba, having been with the company director, X-ray vascular business unit. president, marketing and strategic busisince 2003. He has held several senior They will be responsible for impleness development, Toshiba. roles in the X-ray vascular business unit, menting strategic marketing plans that Poloni was Toshiba’s 3T product having served most recently as the west drive growth and profitability for their manager from 2011 to 2014 and most zone business manager. respective product lines. They will also recently served as deputy director of MR “Bill’s extensive knowledge of the interface with the global business units at Toshiba Medical Research Institute. X-ray vascular market and our products, at Toshiba Medical Systems Corp. to Prior to joining Toshiba, Poloni worked and his dedication to giving customers a communicate the needs and requireas the sequence development unit direc- voice, will help drive sales for our indusments of the U.S. market. tor at Buffalo Neuroimaging Analysis try-leading products in this segment,” “Guy’s proven track record and Center at the Jacobs Neurological InstiCunningham said. •
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MEDICALDEALER 21
INDUSTRY UPDATE_OEM Updates
Staff Reports
SAMSUNG UNVEILS WS80A WITH ELITE PERFORMANCE PACKAGE Samsung Electronics America Inc. has introduced the Samsung WS80A with Elite performance package, its flagship ultrasound product for women’s health care designed to streamline exam workflows and deliver exceptional image clarity. This high-resolution premium system offers enhanced diagnostic capabilities and expanded 5D features – including a new 5D heart application – building on Samsung’s WS80A platform. “The Samsung WS80A with Elite performance package incorporates Samsung’s latest innovations, including an expanded set of 5D workflow applications, to continue our promise of delivering fast, easy and accurate diagnosis for health care providers and their patients,” said Doug Ryan, group vice president for health and medical equipment at Samsung Electronics America. The screening and diagnosis of congenital heart disease remains an important challenge for sonographers and physicians. The Samsung WS80A with Elite’s 5D heart tool generates nine standard fetal cardiac views simultaneously in a single template, offering an intuitive workflow that can simplify examination of the fetal heart and improve reproducibility. The 5D workflow refers to semi-automated identification of specific diagnostic image planes and measurements from a volume data set. The Samsung WS80A with Elite performance package also features improved image quality through S-Vue transducer technology offering broader bandwidth and higher sensitivity. The convex 3D S-Vue transducer offers higher performance, in a smaller, lighter and more comfortable design for imaging sonologists. The system incorporates a 23-inch wide LED screen to provide vibrant color representation and enhanced viewing of ultrasound images. The Samsung WS80A with Elite performance package system has received 510(k) clearance and is now available. •
22 MEDICALDEALER | APRIL 2015
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MEDICAL EQUIPMENT, PARTS & SERVICE
PRODUCT FOCUS_Radiology_Market Analysis
Staff Reports
GLOBAL COMPUTED TOMOGRAPHY MARKET TO REACH $5.9 BILLION BY 2019
C
omputed Tomography is a valuable tool that assists health care professionals deliver quality care to patients around the globe. “Computed tomography (CT), sometimes called ‘computerized tomography’ or ‘computed axial tomography’ (CAT), is a noninvasive medical examination or procedure that uses specialized X-ray equipment to produce cross-sectional images of the body,” according to the U.S. Food and Drug Administration. “Each cross-sectional image represents a ‘slice’ of the person being imaged, like the slices in a loaf of bread. These cross-sectional images are used for a variety of diagnostic and therapeutic purposes.” “CT scans can be performed on every region of the body for a variety of reasons (e.g., diagnostic, treatment planning, interventional, or screening). Most CT scans are performed as outpatient procedures,” according to the FDA. CT can be used to treat cancer and other diseases. “In addition to its use in cancer, CT is widely used to help diagnose circulatory (blood) system diseases and conditions, such as coronary artery disease (atherosclerosis), blood vessel aneurysms, and blood clots; spinal conditions; kidney and bladder stones; abscesses; inflammatory diseases, such as ulcerative colitis and sinusitis; and injuries to the head, skeletal system, and internal organs,” according to the WWW.MEDICALDEALER.COM
National Cancer Institute. “CT can be a life-saving tool for diagnosing illness and injury in both children and adults.” The global Computed Tomography (CT) market is forecast to reach $5.9 billion by 2019, according to a report from GBI Research. “Driven by supply-side initiatives to improve workflow, enhance image quality and reduce patient discomfort, the global computed tomography (CT) market is expected to increase from $3.8 billion in 2012 to $5.9 billion by 2019, at a Compound Annual Growth Rate (CAGR) of 7 percent,” according to business intelligence provider GBI Research. The report states that four companies combined to account for more than 75 percent of the CT market in 2012. The four Original Equipment Manufacturers (OEMs) that shared the majority of the market were GE Healthcare (22.5 percent share), Siemens Healthcare (22.1 percent), Toshiba Medical Systems Corp. (17.9 percent) and Philips Healthcare (13 percent). The market leaders are poised to advance their offerings and business operations in developing countries, especially in Asia. “These top firms are focusing on expanding their manufacturing facilities into developing countries such as India and China in order to increase revenue,” according to GBI Research. “Companies such as Siemens Healthcare and GE Healthcare have set up manufacturing facilities not only to meet domestic demand, but also to export CT equipment to developed
countries. This move is expected to significantly reduce the operating costs of these firms, which will have a cascading effect on improving profit margins,” says Rashmi Nishtala, GBI Resarch’s Analyst covering Medical Devices,. Another factor expected to impact the CT market are new advances in technology. Features dealing with reduced imaging time and radiation dose are also expected to increase growth in the CT market. “New technology, such as dynamic volume CT, significantly reduces image acquisition time, which enables imaging centers to handle higher volumes of procedures, as well as reducing radiation doses by up to 80 percent,” Nishtala says. However, cost-cutting measures and limited reimbursement rates are expected to create some difficulty for the CT market. Health care reforms in the U.S. are impacting reimbursement rates and thus affecting the CT market. Reimbursement is also substantially lower across Europe, with varying rules applying to different countries in the region. “This situation is not limited to the developed countries, but is also characteristic of developing nations, where the lack of adequate reimbursement is a major market deterrent, as patient access to compensation or health insurance is limited. Sadly, the majority of high-end screening techniques, including CT scanning, have to be paid for out-of-pocket,” Nishtala concludes.
MEDICALDEALER 25
PRODUCT FOCUS_Radiology_Product Showroom
Staff Reports
MARCH PRODUCTS : This month, Medical Dealer explores Computed Tomography.
PHILIPS IQon Spectral CT
P
hilips IQon Spectral CT adds a new dimension to Computed Tomography (CT) imaging, delivering anatomical information and offering the ability to characterize structures based on their material content within a single scan. The enhanced image quality may help improve confidence in diagnoses and deliver operational efficiency. IQon was developed in close collaboration with clinicians and is designed to overcome some of their most immediate challenges, including workflow and image management issues. Through the Spectral CT scan, clinicians can access the conventional gray-scale anatomical images, along with the spectral information within the same scan. As a result, Philips IQon Spectral CT enables real-time, retrospective data analysis, without disrupting a clinician’s workflow and takes the guesswork out of multi-energy acquisitions, making it easy to use and allowing for routine spectral use. •
26 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
CT_Product Showroom
SIEMENS HEALTHCARE SOMATOM Scope
T
he SOMATOM Scope 16-slice CT system from Siemens Healthcare delivers the image quality, dose reduction and workflow-enhancing benefits long associated with the SOMATOM family of CT scanners at a price point that enables facilities to extend routine diagnostic imaging services to more patients and in more specialty settings. The SOMATOM Scope includes eCockpit technology that extends the scanner’s operational lifetime by minimizing wear and tear on its most vital components. Designed for private radiology practices, community hospitals, critical access hospitals, specialty practices such as orthopedics and urology, and veterinary medicine, the SOMATOM Scope is available in two configurations – Scope and Scope Power. •
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MEDICALDEALER 27
PRODUCT FOCUS_Radiology_Product Showroom
Staff Reports
TOSHIBA Aquilion ONE
T
he AquilionTM ONE Family is the industry’s only scalable premium CT solution featuring, the Aquilion ONE 320, Aquilion ONE 640 and Aquilion ONE ViSION Edition. All three systems feature a CT detector with up to 16 cm’s of coverage every rotation, the industry’s thinnest slices of 0.5 mm, a large 78 cm bore and a 660-pound capacity couch for bariatric imaging. To ensure dose and safety is not a choice customers or patients have to make, all Aquilion ONE Family systems come standard with Toshiba’s complete suite of dose reduction technology. This includes Toshiba’s SUREExposure 3D AIDR 3D, PUREViSION CT Detector (pending 510(k) clearance), and SUREkV (pending 510(k) clearance). •
28 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
PRODUCT FOCUS_Radiology_Preferred Vendors
Staff Reports
PREFERRED VENDORS
CT
AllParts Medical, LLC 400 Brick Church Park Drive Nashville, TN 37207 Toll-Free: 866-507-4793 Phone: 615-690-5050 Fax: 615-690-5055 Email: apmsales@philips.com Website: www.allpartsmedical.com
SEE OUR AD ON PAGE 33
AllParts Medical is dedicated to servicing the needs of imaging service teams. AllParts provides OEM replacement, Dunlee and Philips parts from its 80,000 square foot facility in Nashville, TN. In addition to parts, AllParts provides: training, technical support, equipment disposition, equipment sales and software (Parts Wizard Customer Portal). Supporting multiple manufacturers (GE, Siemens, Toshiba, Philips) and multiple modalities (CT, MRI, CV / R&F, General Rad, Portable/C-Arm, Ultrasound) AllParts helps imaging teams do more of the work themselves.
BC Technical 7172 S. Airport Rd. W. Jordan, UT 84084 Toll-Free: 888-228-3241 Phone: 801-280-2900 Fax: 801-280-3900 Email: sales@bctechnical.com Website: www.bctechnical.com
SEE OUR AD ON PAGE 7
BC Technical is the largest non-OEM provider of medical imaging solutions. Our ISO 13485 certification and FDA registration ensure medical device standards are met with refurbished systems, parts and service. BC Technical provides the best refurbished SPECT, SPECT/CT, PET, PET/ CT, CT and MR systems from all major OEMs, nationwide on-site service in all 50 states and personal technical/clinical support.
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Consensys Imaging Service, Inc. 615 Industrial Dr. Cary, IL 60013 Phone: 866-310-0071 Fax: 847-462-2198 Email: support@consensysimaging.com Website: www.consensysimaging.com
SEE OUR AD ON PAGE 32
Consensys® is a Galen Partners portfolio company specializing in FDA-compliant and ACR certified diagnostic imaging equipment service nationwide. Consensys® quality management system is certified to both ISO 9001:2008 and ISO 13485:2003 (medical device specific) international quality standards. We deliver world-class equipment relocations and remedial maintenance services for MRI, CT, Mammography and Ultrasound devices.
Ed Sloan & Associates 508 Kasper Way Goodlettsville, TN 37072 Toll-free: 888-652-5974 Phone: 615-448-6095 Fax: 615-448-6099 Email: sales@ed-sloanassociates.com Website: www.edsloanassociates.com
SEE OUR AD ON PAGE 32
Over 25 years of experience and a staff of industry professionals allows Ed Sloan & Associates to offer unparalleled service in the area of GE CT and MRI systems, parts and service. • Quality tested parts • 48,000 square foot facility • MRI and CT QA Bays • CT and MRI Systems • Service on and T&M or Contract Basis MEDICALDEALER 29
PRODUCT FOCUS_Radiology_Preferred Vendors
Staff Reports
PREFERRED VENDORS
CT
SEE OUR AD ON PAGE 63
Injector Support & Service 322 E. Central Blvd., Unit 1911 Orlando, FL 32801 Phone: 888-667-1062 Fax: 888-667-1062 Email: ryan@injectorsupport.com Website: www.injectorsupport.com ISS serves the biomed community by proving professional, timely and superior support and service for medical contrast injectors. We offer telephone technical support, parts identification and sales, loaner systems, and both depot and field service programs. ISS is dedicated to providing the very best in contrast injector support and service.
SEE OUR AD ON PAGE 50
J & M Trading, Inc. 409 Space Park North Goodlettsville, TN 37072 Toll-Free: 866-568-7234 Phone: 615-851-4229 Fax: 615-851-1842 Email: SmartMedSolutions@gmail.com Website: www.jandmtrading.com 35,000 square feet of quality tested parts, tubes, systems and ideas for diagnostic imaging, including but not limited to: X-ray, CT, MRI and NucMed. We provide repairs and deinstallations, and tube reprocessing. Continuous 24x7/365 customer service. All parts warrantied and ready to ship same day. Competitive pricing and discounts throughout the year.
30 MEDICALDEALER | APRIL 2015
SEE OUR AD ON PAGE 33
KEI Medical Imaging Services Hutto, Texas 78634 Phone: 512-477-1500 Fax: 512-853-7090 Email: info@KEImedicalimaging.com Website: www.KEImedicalimaging.com KEI is a MRI and CT service company built on Knowledge, Experience, and Integrity. The President of KEI and Certified Engineers are known for customer commitment and identifying the root of problems to minimize down time and cost. KEI is a company you can trust for service, moves, and capital purchases.
M.I.T. / Medical Imaging Technologies 261 Quality Drive Thomson, GA 30824 SEE OUR AD ON Phone: 800-729-4776 PAGE 56 Fax: 706-843-9638 Website: www.mit-tech.com M.I.T. has been providing top quality products and service for over 25 years. We sell and service all diagnostic imaging equipment. We can provide full service on your equipment. We pride ourselves on doing whatever it takes to get your equipment fixed as soon as possible.
Metropolis International LLC 21-11 44th Avenue, 3rd Floor SEE OUR AD ON Long Island City, NY 11101 PAGE 55 Phone: 718-371-6026 Fax: 718-371-6032 Email: info@metropolismedical.com Website: www.metropolismedical.com Metropolis International LLC is one of the largest stocking dealers of all types of quality pre-owned diagnostic imaging equipment. With over 45 years of combined industry experience, we work with all X-ray, C-arms, CT, Mammography, DEXA, MRI, Ultrasound systems. Located in New York, in a large warehouse, we provide Vendors, Dealers and End-Users, with equipment and services that are second to none!
SouthWest Medical Resources SEE OUR AD ON 1290 E Elm Street, Ste. B PAGE 24 Ontario, California 91761 Toll-Free: 877-873-7967 Fax: 951-735-3373 Email: sales@swmedicalresources.com Website: swmedicalresources.com SouthWest Medical Resources sets the standard for excellence in the area of GE MRi, CT & Pet/CT Service, Parts, Sales & Leasing. Experience the difference by choosing one of our customized solutions for your imaging system investment. Contract or hourly repair services, Preventive Maintenance, Cryogens and an Extensive Parts Inventory are at your fingertips when you partner with us today!
MEDICAL EQUIPMENT, PARTS & SERVICE
TRIM 2.25”
CT_Preferred Vendors
TRIM 2.25”
20 YEARS
SPECIALIZING in Siemens X-Ray & CT Parts
TECHNICAL
PROSPECTS
Experts in Siemens Medical Imaging
Technical Prospects, LLC 1000 South County Road CB Appleton, WI 54914 Toll-Free: 877-604-6583 SEE OUR AD ON Phone: 920-757-6583 PAGE 2 Fax: 920-757-6591 Email: sales@technicalprospects.com Website: www.technicalprospects.com
Quality Injector Syringes & Disposables Never Looked So Good!
TRIM 9.75”
Compatibility Syringes that are fully compatible with your injector system. No injector modifications required.
Reliability Proven product performance in over 14 years of patient use. SEE OUR AD ON PAGE 5
Tri-Imaging Solutions 756 Hickory Industrial Drive Old Hickory, TN 37138 Toll-Free: 855-401-4888 Email: sales@triimaging.com Website: www.triimaging.com Tri-Imaging Solutions is a replacement parts, equipment, service support, and technical training company. We provide quality tested imaging parts – and can even help to install, we buy-sell-move equipment, and provide technical support. All replacement parts come with a 90-day warranty. Available 24/7/365. WWW.MEDICALDEALER.COM
Affordability Priced to significantly lower your syringe supply cost.
Flexibility
German Electronics SIEMENS X-RAY & CT PARTS
www.GermanElectronics.com
888.428.9729
Custom kits that meet your needs while lowering operating costs.
Call us and we will be happy to provide you with a cost savings quotation or product information.
www.misisyringes.com 800-603-6501 support@misisyringes.com MEDICALDEALER 31
TRIM 9.75”
Your clear and affordable choice for contrast media injector syringe kits, disposables, injectors and injector service. Reliable and high quality syringe kits across all injector systems used in CT, MR, angiography, and heart catheterization procedures.
Technical Prospects is the largest provider of pre-owned tested and refurbished Siemens medical imaging replacement parts. We also offer OEM CT brushes, proactive maintenance components, and new and used tubes with installation. Our OEM trained engineers provide 24-hour technical support and our training center provides quality hands-on training opportunities.
We are never too far away
Our 24/7/365 support, teamed with our nation-wide reach, makes us the perfect choice to keep your equipment running. Consensys Imaging Service specializes in: • FDA-compliant and ACR certified diagnostic imaging equipment service nationwide. • Certified to both ISO 9001:2008 and ISO 13485:2003 (medical device specific) international quality standards. • World-class equipment relocation, emergency repair, Consensys Certified™ FirstLook™ training for your in-house engineer. • Full-service maintenance solutions through our team of local Field Service Engineers.
© 2015 Consensys Imaging Service, Inc.
866.310.0071 www.consensysimaging.com
ED SLOAN & ASSOCIATES
&
PRACTICED PERFECTED At Ed Sloan, our 25 years of experience is reflected in the science and fine art of selling imaging parts.
32 MEDICALDEALER | APRIL 2015
• 48,000 sq. ft. facility
• 4 CT & MRI test bays
• De-installs and installs
• Customer parts repairs
• Service on a contract or T&M basis • Remote magnet monitoring services for GE MRIs
• Warehouse storage and mobile bays with electrical hookup
GE MRI & CT PARTS ARE OUR SPECIALTY! Email: sales@ed-sloanassociates.com Web: www. edsloanassociates.com Phone: 888-652-5974 Fax: 615.448.6099
MEDICAL EQUIPMENT, PARTS & SERVICE
The power of two
working for you Now that Dunlee and AllParts Medical are united, one call or click to a single sales team gives you fast access to Philips, Dunlee, and OEM replacement parts, training, technical support, and equipment.
• One point of contact • Extended warranty • Free training and tech support
• No restocking fee for AllParts • Reduced shipping fees • Discounted labor
Contact apmsales@philips.com or call 866-507-4793 to learn more.
Two powerful brands, one smart choice. AllParts Medical is a Philips company.
Power of Two-half_Final.indd 1
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3/9/15 3:11 PM
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New & Refurbished Anesthesia Equipment
Video Stylet Only $499 each
Refurbished GE S/5 Aestiva
Refurbished Cardiocap/5
Refurbished Mindray Spectrum
Refurbished Draeger Medical Fabius GS
SimpleBlend O2 & Air Mixer
Refurbished GE S/5 Avance
Refurbished Zoll Defibrillators New&Refurbished Paragon/Penlon $8,900-$16,900
Refurbished GE Aespire/7900
800-448-0814
www.ParagonService.com
tgreen@paragonservice.com
PRODUCT FOCUS_Med/Surg_Market Analysis
Staff Reports
NEW TECHNOLOGY FUELS GLOBAL ANESTHESIA MARKET
A
nesthesia is an important part of delivering health care, especially when treatment calls for surgery.
“Anesthesia refers to a loss of sensation with or without loss of consciousness that is typically used to allow patients to comfortably undergo surgery. There are four main types of anesthesia,” according to the Baylor College of Medicine. The four types of anesthesia include general anesthesia, regional anesthesia, local anesthesia, and monitored anesthesia care (MAC) anesthesia. The global market for anesthetic and respiratory devices is expected to approach $20 billion in 2018. “The global market for anesthetic and respiratory devices reached $11.1 billion in 2012. This market is expected to grow to $12.4 billion in 2013 and $19.6 billion in 2018 with a compound annual growth rate (CAGR) of 9.5 percent for the five-year period, 2013 to 2018,” according to a press release from PRNewsire. A report by Industry Experts forecasts the U.S. market will surpass $11 billion by 2020. “Anesthesia device product segments analyzed in this study include delivery machines, disposables, accessories, monitors and information systems. The global market for anesthesia devices is estimated at $7.4 WWW.MEDICALDEALER.COM
billion in 2013 and forecast to be $8.1 billion in 2014. Maintaining a CAGR of about 7.5 percent between 2010 and 2020, anesthesia devices market worldwide is further projected to reach $11.8 billion by 2020,” according to Industry Experts research. An aging population and technological advances in anesthesia devices is helping to fuel the market. “The evolution of anesthesia machines has encompassed the journey from being standalone non-networked systems to networked anesthesia workstations that comprise anesthesia monitors and anesthesia information systems (AIMS),” according to Industry Experts. “The last decade has witnessed manufacturers introducing anesthesia machines with features, such as advanced ventilators, additional and new modes of ventilation, graphical screens, and loops that offer a clearer picture of the patient, with a major proportion of the ventilators being electronic and driven by software. The buyer now has several advanced ventilation options to choose from, such as synchronized intermittent mandatory ventilation (SIMV), pressure support ventilation (PSV) and pressure controlled ventilation-volume guaranteed (PCV-VG), with the additional alternative of either updating them or purchasing them on a prioritized basis.” Portable devices are becoming more popular and are expected to trigger future growth An increase in respiratory illness in the U.S. and
new technology are also significant in regards to this market. “Increased health care expenditure has shifted the preferences of patients from hospital care to home care. Therefore, the demand for portable devices for better health care monitoring is rising,” according to Reports and Intelligence. “Potential drivers that are responsible for generating the high demand for anesthesia and respiratory devices include high frequency of respiratory illness that occurs in the form of COPD (Chronic Obstructive Pulmonary Diseases) and OSA (Obstructive Sleep Apnea). The factors responsible for these two conditions are primarily, ageing and rising levels of air pollution. There has also been a considerable mount in number of operative conditions (surgeries) globally, which provides a key opportunity for anesthesia devices market to grow. Technological advancement in devices is another driving force for the growth of global anesthesia and respiratory devices market. However, the tax reforms and critical regulatory compliance procedures restrain the growth of this market in developed economies. Thus, these two factors have opened the avenues of emerging economies such as India, Brazil and China.” Some key leaders for anesthesia and respiratory devices market include GE Healthcare, Covidien, Getinge Group, Draegerwerk AG, Fischer & Paykel, ResMed, Teleflex Inc. and Philips Healthcare.
MEDICALDEALER 35
PRODUCT FOCUS_Med/Surg_Product Showroom
Staff Reports
APRIL PRODUCTS : This month, Medical Dealer explores current trends in Anesthesia.
DRÄGER PERSEUS A500 ANESTHESIA WORKSTATION
T
he Dräger Perseus A500 anesthesia workstation is one of the largest development projects ever from Dräger. This innovative device offers unprecedented configurability, high-performance ventilation, enhanced ergonomics, and automation to support the workflow of the operating room. More than 100 different versions of the anesthesia workstation can be created to match the needs of hospitals by combining various hardware options, shelf arrangements, and storage areas. In addition, various software options – such as ventilation and monitoring modes – increase the number of possible configurations. To learn more about the Perseus A500 or interactively configure an anesthesia workstation, visit www.draeger.com/perseusA500. •
36 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
Med/Surg_Product Showroom
GE AISYS CS² WITH ECOFLOW
M
odular and upgradeable, with Aisys CS² you’re planning for the future while protecting your investment. Electronic agent control allows you to capture set agent concentrations and precisely measures agent usage. The 15 inch touchscreen ventilator display and ecoFLOW option displays oxygen flow alongside pre-set targets while calculating anesthetic agent cost and usage in real-time. Clinicians can use this to adjust oxygen flow to help avoid unnecessarily high fresh gas flow rates. •
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MEDICALDEALER 37
PRODUCT FOCUS_Med/Surg_Product Showroom
Staff Reports
MINDRAY A7 ANESTHESIA WORKSTATION
T
he new A7 Anesthesia Workstation takes the popular A-Series to a higher level. The feature-rich A7 combines traditional bellows driven ventilation with electronic fresh gas technology, to provide effective care across a wide range of patients. Electronic gas control ensures precise gas flow dynamics with accurate and responsive support for both clinical and cost-saving requirements, including low-flow anesthesia delivery. Gas analysis with agent usage calculation, advanced ventilation modes, integrated suction, auxiliary common gas outlet, and a convenient pull out table, provide the necessary tools for today’s clinical and cost-saving requirements. With HL7 connectivity to AIMS and EMR systems, the A7 functions as a truly comprehensive workstation that saves time, space and cost •
38 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
Med/Surg_Product Showroom
MINDRAY ANESTHESIA CONSUMABLES
D
eliver perioperative care with Mindray’s quality and economical anesthesia consumables. Breathing circuits offer 90-inch expandable hoses and are available in adult and pediatric sizes. Anesthesia facemasks are cushioned and designed with a teardrop shape. Laryngeal airway masks are available is seven sizes with flexible tubing and a soft, flexible cushion. The high-quality breathing circuits, facemasks, filters and laryngeal airway masks complement your anesthesia systems, offering one solution in the operating room. •
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MEDICALDEALER 39
PRODUCT FOCUS_Med/Surg_Preferred Vendors
PREFERRED VENDORS
ANESTHESIA
ONE SOLUTION FOR ALL YOUR PATIENT MONITORING NEEDS
Government Liquidation 15051 N Kierland Blvd #300 Scottsdale, AZ 85254 Phone: 480-367-1300 Email: info@govliquidation.com Website: www.govliquidation.com
SEE OUR AD ON PAGE 78
Government Liquidation (GL) is your direct source for U.S. Government surplus. Sales are conducted via our online auction platform through internet auctions. GL invites you to purchase medical, dental and test equipment in a convenient environment at: www.govliquidation.com. Search our inventory as new items are added daily.
SEE OUR
AD ON InterMed Biomedical Services, Inc. PAGE 66 13351 Progress Blvd. Alachua, FL 32615 Toll-Free: 800-768-8622 Phone: 386-462-5220 Fax: 386-462-5330 Email: sales@intermed1.com Website: www.intermed1.com • Full range of service from general biomed, to anesthesia, to sterilizers • Services including full coverage, preventative maintenance or time and materials • Biomedical Jump Teams • New, used and reconditioned biomedical equipment from all manufacturers • Tailored Strategic Asset Management Programs designed to meet your needs • Life cycle analysis on inventory • Superior management staff teamed with well trained service engineers • DNV and Joint Commission Consulting and reviews
40 MEDICALDEALER | APRIL 2015
Pacific Medical Repairs & Equipment 32981 Calle Perfecto San Juan Capistrano, CA 92675 Phone: 800-449-5328 Fax: 800-449-5328 Email: info@pacificmedicalsupply.com Website: www.pacificmedicalsupply.com
SEE OUR AD ON PAGE 14
Experience our quality on all purchase and repairs: • Monitors • Modules • Telemetry • Patient Cables • Fetal Transducers • Infusion Pumps • Endoscopes • O2 Blenders & • Gas Analyzers • Suction Regulators From a wide variety of OEMs: Philips, GE, Datex Ohmeda, Datascope and more. Call for OEM quality without the cost.
Paragon Service 204 West Bennett Street Saline, MI 48176 Toll-Free: 800-448-0814 Phone: 734-429-5958 Fax: 734-429-3197 Website: www.paragonservice.com
SEE OUR AD ON PAGE 34
Paragon Service is the premier refurbisher of anesthesia systems in the United States for over 23 years. Paragon Service is an anesthesia specialist which sells new and refurbished anesthesia systems, new and refurbished patient monitors, defibrillators and anesthesia accessories. Regional biomedical service and depot repair services are also available. We are your anesthesia specialty company.
MEDICAL EQUIPMENT, PARTS & SERVICE
Med/Surg_Preferred Vendors
USOC Medical 14 Hughes St. Irvine, CA 92618 Phone: 949-243-9109 Email: cusotmerservice@usocmedical.com Website: www.usocmedical.com
SEE OUR AD ON PAGE 41
USOC Medical provides worldwide biomedical equipment repair/sales solutions to health care facilities, clinics and medical companies of all types and sizes.
Soma Technology, Inc. 166 Highland Park Drive Bloomfield, CT 06002 Toll-Free: 800-GET-SOMA Phone: 860-218-2575 Fax: 860-218-2565 Email: soma@somatechnology.com Website: www.somatechnology.com
SEE OUR AD ON PAGE 60
Soma Technology is the industry leader of refurbished medical equipment, and is capable of outfitting entire healthcare facilities from the initial stages to expansion. Our certified engineers and sales representatives provide high quality products and services at the most affordable prices. Our large inventory allows for prompt delivery and guaranteed satisfaction.
SIMPLE SOLUTIONS for COMPLEX DEVICES SERVICE & SALES + Bedside Modules / MMS + Patient Monitors + Telemetry & Telemetry Stations + Fetal Transducer Systems + Infusion Pumps + AGMS / Anesthesia + Regulators + Oxygen / Air Blenders + Patient Cables
+ 12 Month Warranty + 2-4 Day Turn Times + Free Shipping + Price Beat Guarantee + 25 Years Experience + Component Level Repairs
WWW.MEDICALDEALER.COM
855.888.8762 www.usocmedical.com MEDICALDEALER 41
42 MEDICALDEALER | APRIL 2015
MEDICAL EQUIPMENT, PARTS & SERVICE
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MEDICALDEALER 43
THE KEY TO COMPLIANCE
44 MEDICALDEALER | APRIL MARCH 2015 2014
MEDICAL EQUIPMENT, PARTS & SERVICE
THE KEY TO COMPLIANCE CMS/TJC GUIDELINES COMBINE TO PROMOTE PATIENT SAFETY By Matt Skoufalos
In the health care world, the final word on accreditation always belongs to The Joint Commission. On its say-so, facilities are evaluated on the strength of their compliance with standards designed to uphold and improve patient safety. In turn, these standards and National Patient Safety Goals evolve “if they relate to patient safety or quality of care, have a positive impact on health outcomes, meet or surpass law and regulation, and can be accurately and readily measured,” the agency states on its website. Two of the biggest standards changes of the past calendar year, in regards to the maintenance of medical devices, involved the definition of a categorical waiver for the use of power strips (or “relocatable power taps”) in health care facilities as well as the outline of an Alternative Equipment Maintenance (AEM) routine designed to cut back on health care spending in the biomedical field.
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MEDICALDEALER 45
THE KEY TO COMPLIANCE
George Mills, Director of the Department of Engineering, The Joint Commission, said the Centers for Medicare and Medicaid Services (CMS) categorical waiver for power taps addresses power management concerns in patient care areas. “The problem is that in an older operating room that is 24 x 24 or a new one that is 30 x 30, [tables] electrical receptacles may be 15 feet away from the wall,” Mills said. “If I decided to go with extension cords, on a temporary basis, either I gang them all together into one big cable and I have a huge trip hazard, or I have a bunch lying on the floor. It’s been a problem for years.” Part of the issue came about in aligning standards for power taps that had been certified by Underwriters Laboratories (UL) with those acknowledged by agencies like CMS and The Joint Commission. “Although not directly cited in our standards,” Mills said. “UL does impact compliance.” The Joint Commission does recognize the National Fire Protection Association (NFPA) as the agency that develops codes and standards for facility safety, however, and its documents include reference to the NFPA 99-1999 Health Care Facilities Code, which set limits on the use of relocatable power taps anywhere medical equipment is used. An acceptable alternative, prior to the waiver, was to wire a ceiling drop from a junction box into which devices may be plugged. In 2014, the Healthcare Interpretations Task Force (HITF) convened to re-evaluate whether a more workable solution could be managed that would benefit health care facilities without compromising patient safety. HITF revisited the standard based on a variety of factors (including the UL 1363A designation) and an updated 46 MEDICALDEALER | APRIL 2015
“In my mind, you start with life support and then you go into the other areas like surgical robots. People say, ‘Is a ventilator high-risk?’ If it’s breathing for you, then yeah. If you’re putting it under your arm when you go to buy groceries, then maybe not. You really need to use some sort of risk criteria [and] your measuring stick is injury, harm, or loss of life.” – George Mills edition (2012) of the NFPA 99 code that Mills described as “a lot more flexible” in allowing permanently affixed power taps. After that review, it was recommended to CMS that they revisit the 2012 edition of NFPA 99, and offer a categorical waiver for facilities seeking to use relocatable power taps “with some provisions,” Mills said. This includes ensuring that the facility fully meets the requirements of the 2012 NFPA 99 standards edition,
George Mills Director of the Department of Engineering, The Joint Commission an internal, documented assessment that a facility is using a categorical waiver, and disclosure to any surveyors at the beginning of a survey that a categorical waiver has been employed. The implication is that facilities might consider the use of the categorical waiver, he said, and when they are used they meet the 2012 NFPA 99 standards, that facilities “can document where they are, they have an inventory of them, and they announce before the survey that they’re using the categorical waiver.” “It’s either you have eight extension cords going to the wall or you have eight medical devices plugged into a power strip,” Mills said. “It just makes sense to bring the power to where you need it. It’s a major safety issue [and] it’s a practical issue as far as consolidating your need to plug in these devices.” The categorical waiver also restricts the use of relocatable power MEDICAL EQUIPMENT, PARTS & SERVICE
taps for powering non-medical equipment “in the patient care vicinity,” Mills said, which prevents the patient from plugging in a personal laptop or cellphone, for instance, into a power strip in areas where patient care is administered. “If a patient brings in their personal laptop, it’s got a current leakage issue, and you plug it into the power strip, you could cause safety problems,” he said. “I think the good news is that we brought the issue to the HITF, CMS reviewed it, and made a good solid decision to allow the categorical waiver. We all benefited from that one,” Mills said. David Stymiest, PE, CHFM, CHSP, FASHE, a senior consultant at the Nashville, Tennessee, engineering firm of Smith Seckman Reid Inc., called the categorical waiver “a huge deal,” albeit a complicated one. “I think a lot of organizations have said, ‘We’re going to invoke this in our facility,’ ” Stymiest said. “I think there are a lot of issues that are going to be confounding issues. “As with any categorical waiver,” he said, “you have to be in compliance with other requirements; typically a newer standard. I don’t know whether all of the organizations that are adopting the waiver have done their homework with respect to the newer requirements.” “To me, a categorical waiver is like many other things: the first page giveth in the fine print, and then the second page taketh away,” he said. ALTERNATIVE EQUIPMENT MANAGEMENT PROCESSES Similar to the categorical waiver on power strips, another critical change in The Joint Commission’s standards in 2014 was the body’s continued allowance of Alternate Equipment Management (AEM) processes for WWW.MEDICALDEALER.COM
David Stymiest PE, CHFM, CHSP, FASHE, a senior consultant at the Nashville, Tennessee, engineering firm of Smith Seckman Reid Inc.
“As with any categorical waiver, you have to be in compliance with other requirements; typically a newer standard. I don’t know whether all of the organizations that are adopting the waiver have done their homework with respect to the newer requirements.” – David Stymiest
facilities that elect to not follow the manufacturer’s recommended guidance for preventive maintenance (PM). To crystallize the need for this approach, Mills offers an example: imagine an engineer tasked with the maintenance of a pair of defibrillators, one designated for ride-alongs with EMTs and another stored in a quiet wing of a hospital facility. The unit that has been through active use in an ambulance reasonably would be maintained to the strictest PM standards, which are typically what is written by the manufacturer — checking the latch, the lids, the plugs, the paddles, etc. That same strategy may not make sense for the unit that sits quietly in the hospital wing because it sees far less use, if any; in turn, a less rigorous PM routine would be sensible in consideration of staff time and resources. That extensive adherence to manufacturer guidance could have cost the health care industry an estimated $4 to $8 billion, based on man-hours and biomedical test equipment, Mills said; moreover, a 2012 Joint Commission survey asking organizations whether revising manufacturer guidance in favor of AEM processes had resulted in any injuries or harm to patients returned a clear answer: “Out of approximately 2,500 respondents, nobody,” had such an event, he said. Some equipment that is AEM-eligible is what hospitals may have a more difficult time defining: those mission-critical devices that require a 100 percent, on-time PM completion rate. The Joint Commission now uses the term “high-risk” to describe such technologies, which replaces the term “life-support devices,” a phrase that dated to 1995. “We had the chance to retire ‘life support’ and use the term ‘high-risk,’” Mills said. “I personally really like it; MEDICALDEALER 47
THE KEY TO COMPLIANCE
‘high-risk’ also includes by default ‘life-support’ devices. A defibrillator is not a ‘life-support device’; when we use it, you’ve already died and we’re using it to bring you back to life. But if you said, ‘How important is it?’ I’d say it’s pretty darn important.” The new, broader definition, Mills said, turns on whether a device were to fail, resulting in “patient risk, harm, or loss of life.” “In my mind, you start with life support and then you go into the other areas like surgical robots,” he said. “People say, ‘Is a ventilator highrisk?’ If it’s breathing for you, then yeah. If you’re putting it under your arm when you go to buy groceries, then maybe not. You really need to use some sort of risk criteria [and] your measuring stick is injury, harm, or loss of life.” “A lot of those recommendations appear to be liability control rather than quality control,” Mills said. “People want flexibility and there’s a reasonableness to [the AEM].” The statute also restricts from AEM eligibility imaging equipment, lasers, and brand-new equipment with which a facility “has no experience with,” Mills said. “Once you have that new device for a period of time and learn its reliability you may be able to deviate [from manufacturer’s requirements],” Mills said. “New equipment that you have no experience with is something you couldn’t change the PMs frequency or activities on. ” Stymiest said that when his clients ask him for advice on determining whether a piece of technology is high-risk, he invites them to contemplate the kinds of questions a surveyor is likely to ask in order to remain in compliance. “Firstly, the hospitals need to understand that the CMS term ‘critical equipment’ is identical to the 48 MEDICALDEALER | APRIL 2015
Joint Commission term ‘high-risk equipment,’ ” he said. “It means the same thing. Hospitals are struggling with thinking beyond something that’s just life support that has that level of importance.” “The new rules are very clear,” Stymiest said. “There’s no longer an inventory that’s selected based on risk. The inventory is now everything. Hospitals need to wrap their heads around the fact that they have to think about all other equipment that’s used as medical equipment that they may not have put in their inventories in the past.” For hospitals that decide to employ an AEM schedule for a device or group of devices, the statute outlines “multiple elements of performance that tell them exactly what elements of risk need to be considered,” Stymiest said. That obligation implies a different risk assessment than what may have previously been followed, which could require rewriting or authoring new policies and procedures. It’s not for everybody, he said. “I’ve heard some say that they’re going to go with manufacturer’s recommendations because they don’t want to deal with the paperwork,” Stymiest said. “I’ve heard some hospitals say that they don’t want to do what the manufacturers say because it makes no sense.” “When I first read the letter, it came out in December 2013, my reaction was, ‘Good, CMS is finally giving the industry what the industry has been looking for, which is some flexibility,’ ” he added. For individuals and organizations who are considering varying from a manufacturer’s recommended maintenance schedules, the AAMI standards committee has developed a pair of guidance documents — EQ56 (Recommended Practice for
Stephen L. Grimes FACCE, FHIMSS, FAIMBE, the CTO of ABM Healthcare Support Services
a Medical Equipment Management Program) and EQ89 (Guidance for the use of Medical Equipment Maintenance Strategies and Procedures) — to help hospital leadership evaluate the requirements, resources, and expertise involved in formulating AEM procedures. “There are a variety of things that you need to consider before attempting to deviate from the manufacturer’s maintenance recommendations,” said Stephen L. Grimes, FACCE, FHIMSS, FAIMBE, the CTO of ABM Healthcare Support Services of Holliston, Massachusetts, and a member of the AAMI standards committee that developed the documents. Grimes said the guidance AAMI offers is intended to assist organizations in identifying and evaluating several factors related to appropriate maintenance, including issues that can be analyzed from device service histories. Effective evaluation of service histories requires that organizations keep meaningful data on MEDICAL EQUIPMENT, PARTS & SERVICE
“In order to do a good analysis, you’ve got to have good data. We’re trying to get organizations to collect good data and code in a way that is meaningful.” – Stephen L. Grimes equipment failures; i.e., which failures are attributable to maintenance issues versus those failures occurring during handling or use error. After analyzing and making changes to maintenance procedures, he said, both the process and result should be fully documented, with periodic follow-up to ensure the intended results are achieved without compromising safety. “In order to do a good analysis, you’ve got to have good data,” Grimes said. “We’re trying to get organizations to collect good data and code in a way that is meaningful.” “We’re attempting to give guidelines that will allow organizations to consider the appropriate factors, collect the right data, consider the environment in which the equipment will be used, and deviate from the manufacturer’s recommendations only where they can demonstrate that they can do it safely,” he said. Grimes said that guidance documents can help institutions make better use of their time, labor, and dollars, redeploying them away from processes “that arguably aren’t making the equipment or the environment safer” and “into some of the areas where we do have real safety issues.” It’s all part of effective use of resources in an age of risk-based maintenance management, he said. “The problems we have today generally aren’t maintenance-related,” Grimes said. “Equipment is considerWWW.MEDICALDEALER.COM
ably more reliable and fails less often due to lack of maintenance. It’s often got built-in diagnostics and the kind of failures that do occur are usually picked up by users before any maintenance procedure could detect them.” “Adopting an AEM approach can be very safe and an effective use of resources, but you should consider it only if you are prepared to demonstrate that you’re doing it properly,” Grimes said. AN ATTITUDE OF COMPLIANCE In addition to giving hospitals some relief in the execution of their responsibilities, Mills said, the thrust of the changes are meant to usher in greater compliance with established standards that help ensure patient safety, which is the ultimate goal. “When I first got into health care back in 1984 … I realized why we were doing this, and it’s all about patient care,” he said. “Joint Commission standards were the road map to help me provide and create an environment that provides patient safety. For the rest of my career everything has been built around working with and creating standards that make things safe for patients, staff and visitors.” Stymiest said his advice to clients is that compliance must be an ongoing attitude and not something they attempt to “ramp up” at certain times. “I really believe that, and I advise my clients of this opinion,” he said. “I really don’t think that’s a practical
approach anymore. I think continuous compliance is the only valid approach. And you should be doing the right things for the right reasons, too; there’s an altruistic aspect to it as well as the avoidance of risk.” Mills shares the same perspective. “When I see oscillating compliance, it shows me an attitude that is not consistent with all the things that we try to achieve,” he said. “The highly reliable organizations that I have worked with, when you talk to them, the standards are the guidance to what they want to achieve.” Compliance also has a revenue component, said Robert Grajewski, president of health care incubator Edison Nation Medical. “Right now, from a purchasing perspective, groups that are buying products are looking for things that can deliver care efficiently and economically due to the need for cost reduction,” he said. “The reason why there’s compliance is so that people receive the greatest quality of care and the safest care. Any products that are able to make it easy to be more compliant are things that are seen as a positive because it saves time and energy on the back end,” Grajewski adds. Changes that mandate additional safety requirements can even help to accelerate the development of new technologies, Grajewski said, especially those with a greater focus on safety and process improvement. In conforming with designations of high-risk equipment requirements, for example, he suggested that new products might be modified with high- or low-tech adjustments, such as better alerting systems or different colored components. “By making these changes we can help save time and money, and most importantly help save lives,”Grajewski said. MEDICALDEALER 49
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MEDICALDEALER 53
SLICE OF LIFE_The Other Side
By Jim Fedele
REMEMBERING YOUR ASSISTANT
B
iomedical engineers, almost nationally, complain about the lack of respect and recognition they get from the people they help everyday. However, I would contend that there is another group of people that receives even less recognition than the biomedical technicians. This group works tirelessly doing all the jobs the techs don’t want to do. Their compensation is less than that of technicians, but sometimes their knowledge is more. These people wear many hats and typically receive very little credit. The people I am referring to are the secretarial support people. Given the amount of documentation generated and needed in the biomedical field most departments have some form of secretarial support. They go by many different titles including, secretary, assistant, customer service representative, office support personnel and other titles. But, they all do the same important work of supporting the department. I remember in the old days when generating paper seemed to be more important than actually repairing things. Our secretary would spend half her day filing and sorting the paperwork we generated. Today, with the advances in computer technology and changes in 54 MEDICALDEALER | APRIL 2015
what needs to be documented the generation of paper files has been drastically reduced. The job of filing paper has been replaced with data entry and record/document management. This job falls on the shoulders of the office assistant or secretary. However, as important as the record management is, the office assistant typically performs one of the most important jobs for the department, which is receiving calls from customers. The secretary/ assistant must skillfully interface with all types of customers. Occasionally customers are stressed and are not always friendly or kind. The secretary/assistant must try to be helpful and courteous while trying to get the most information she/ he can from the customer. I think this is probably the most thankless part of their job because customers seldom want to take the time to give them complete information on the problem and device. Sometimes the biomed techs themselves can be indifferent to the secretary/assistant because she/he did not get enough information or they don’t feel like dealing with the situation. The secretary/assistant does other jobs that help the department succeed like generating and writing reports, scheduling meetings, providing written status of work
“We all know how it feels to not be recognized for our efforts; let us not forget one of our own that is always there to help us.” requests and general department organization. A great assistant/ secretary can help prioritize calls, soothe customer complaints and help techs with their parts ordering and tracking. They keep the department running like a well-oiled machine. Sometimes the secretary or assistant knows a lot more about fixing equipment than could be imagined. I met a secretary a few years ago, she had 20 years experience in the biomed department and she knew a lot about repairing equipment. During her years of taking calls and reading work orders she had learned what commonly needed repaired for many problems. She got so good that when the customer would call with a problem MEDICAL EQUIPMENT, PARTS & SERVICE
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she would ask them, when appropriate, if they had changed leads or probes, rebooted the unit or if they checked the battery. Her knowledge improved the image of the department greatly as she helped users get their equipment up and running more quickly and helped eliminate nuisance calls for the techs. It was truly impressive. I know it is easy to take for granted a person who is always giving you more work and then asking you for the follow–up paperwork. But imagine if you had to do all these things yourself. My guess is a lot of the “non-technical” but necessary jobs would not get done. We all know how it feels to not be recognized for our efforts; let us not forget one of our own that is always there to help us. Their work allows us to be free to focus on the work of repairing and not on all that other unpopular stuff that is needed and necessary. So be sure to take time and thank your secretary/assistant. They are part of the team, too. JIM FEDELE, CBET, has been with Medical Dealer magazine for more than 12 years. He is currently the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments by email at info@mdpublishing.com.”
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SLICE OF LIFE_
By Dan Bobinski
YES, THERE’S A PLACE FOR HUMOR AT WORK
E
ven when your work is serious, who says it can’t be fun? Granted, humor’s use has to be balanced, but the benefits of enjoying humor in the workplace are many, so I want to challenge you to weave just an ounce more of fun into your workplace. Let’s start with the possibility of reducing workplace stress. Jeff Justice, a motivational humorist, says the ability to take your job seriously but yourself lightly goes a long way in the battle against stress. It doesn’t mean telling jokes all the time, but rather lightening up. Data shows that sick days and turnover are more common in workplaces that have too much negativity, heavy sarcasm and constant noseto-the-grindstone thinking. So, if you think your workplace could use a lighter tone, consider finding ways to lighten up. Justice says, “A sense of humor can be used for stress reduction, problem solving, team building and improving communications.” Humor has also been shown to increase employee engagement and productivity. Scott Friedman, a popular speaker and author on workplace issues, says “Humor creates an instant bond.” He says humor removes negative, non-productive feelings and creates a fresh new approach to situations. The idea, according to Friedman, is to laugh about a situation while it’s happening, because it keeps oxygen 58 MEDICALDEALER | APRIL 2015
Dan Bobinski Workplace Consultant
flowing to the brain which helps people think more clearly. I happen to agree with Friedman, because humor, even when it’s something I’ve kept to myself, has gotten me through some otherwise stressful situations. With that, I think it wise to think of humor as a type of salt. A little can be good, but too much leaves us with a bad taste in our mouths. And just like some foods benefit from salt and others don’t, the same is true about using humor in workplace situations. In other words, timing is everything, and I think Friedman’s suggestion to laugh about something while it’s happening has its exceptions. For example, it would not be appropriate to offer up a humorous comment while your organization’s president was
announcing layoffs. As the English poet Samuel Butler once said, “It is tact that is golden, not silence.” Butler’s admonition is important, because too much humor becomes a burden. One small business owner I know had an employee who inserted a joke or a pun into every situation. Not only was everything a joke to him, but at times his humor was inappropriate, and co-workers got offended. Eventually his excessive use of humor distracted the other employees from being productive, because all they did was anticipate how this guy was going to make a pun or a wisecrack about every little thing that happened. It was clearly a case of too much of a good thing. Dr. Joni Johnston, the founder and CEO of the consulting firm Work Relationships, offers a few tips for using humor at work: 1. Pay attention to clues about your co-worker’s mood 2. Trust your intuition 3. Take yourself lightly 4. Use humor as the icing, not the cake 5. Avoid playful insults Johnston says that humor has to be used at the right time, in appropriate amounts, and shouldn’t make fun of an individual. The idea is to always make light of the situation – never a person. A good example of using humor to make light of a situation is offered by Jeff Justice. He tells MEDICAL EQUIPMENT, PARTS & SERVICE
_Slice of Life
the story about a female employee who grew tired of her boss continually rejecting her budget – always sending it back and telling her it needed to be smaller. When she finally got her budget down to absolute bare bones, he still rejected it. Knowing that she couldn’t make it any smaller and still do the work required of her, she took her paperwork over to the copy machine and literally reduced her budget to the size of a postage stamp, then she took it back in to the boss. After they both had a good laugh, her boss gave in and approved her budget. Workplaces benefit a lot when managers use humor, because it’s managers and leaders who set the tone for any workplace. In fact, Dwight Eisenhower, the Supreme Allied Commander in World War II and two-term President of the United States once said, “A sense of humor is part of the art of leadership, of getting along with people, of getting things done.” My guess is that if you think back over your career, you probably enjoyed working for managers who employed a light, balanced sense of humor. Humor also has a lot of value in employee training. As a trainer, I know that the very act of laughing is usually a sign of learning. Think about it: We laugh when we “get” a joke – when we are connecting two or more pieces of information in a new, unique way. But once that WWW.MEDICALDEALER.COM
connection is made, we don’t laugh anymore because we’ve already learned – we already “got the joke.” Yet for all of its benefits, it bears repeating that the use of humor must be balanced. And let me add that those in positions of authority must exercise extra caution to avoid offending people. For those who remain skeptical about the value of humor in the workplace, let me close by stating just a few of the workplace benefits that have been validated through research. The use of humor improves decision-making and aids in creative problem-solving. The use of humor reduces absenteeism, increases engagement and improves productivity. The use of humor diffuses conflict, builds trust and strengthens teamwork. So here’s my challenge: Consider any area I’ve just mentioned, and then determine one thing you can do differently to improve that area through an increase in the use of humor. It’s kind of like what Jeff Justice tells us: “He who laughs – lasts!” DAN BOBINSKI is a certified behavioral analyst, author of the best-selling “Creating Passion-Driven Teams” and president of Workplace-Excellence.com. He travels internationally helping organizations of all shapes and sizes. Reach him at dan@workplace-excellence.com or 208-375-7606. .
MEDICALDEALER 59
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SLICE OF LIFE_Pay It Forward
By Matthew N. Skoufalos
NAPOLEON FRANCO PAREJA LA CASA DEL NINO CHILDREN’S HOSPITAL
I
t was on a 2007 vacation to the tropical South American fishing village of Cartagena, Colombia, that Linda Reesor first visited Napoleon Franco Pareja La Casa del Nino Children’s Hospital. Reesor, the director of nursing education at Joe DiMaggio Children’s Hospital in Hollywood, Florida, had taken a much-needed vacation. Encouraged to check out the local pediatric health center while she was there, Reesor came face to face with the disparity between its condition and the facility where she works. Touched by the conditions there, Reesor returned home determined to compile the materials, manpower, and strategy to embark on a medical mission to Cartagena. She enlisted the aid of coworker Luis Molina, pediatric endoscopy nurse and nursing committee co-chair at DiMaggio Children’s Hospital, and the two rallied eight other volunteers to join their cause. They paid for the journey entirely out of pocket, supported by donations raised from bake sales, raffles, and other small-scale fundraisers, and packed their bags with as much relief aid as they could carry. Molina, a native of Medellin, Colombia, had visited Cartagena in his childhood, but the feeling of being able to return, armed with the skills and resources to aid its population, was something else altogether. “I like to help people in general WWW.MEDICALDEALER.COM
and I like to go on missions,” he said. “But now that I am going to my own country, I feel indescribable. I want to go every year.” Molina described Cartagena as “like a little Miami. Situated in the northern coastal region of the country by the shores of the Caribbean, it’s an old, Spanish colonial town surrounded by a big stone wall, much like San Juan, Puerto Rico.” Cartagena is also a modern city, “with big, very safe, very good hotels, and beautiful beaches and islands nearby,” he added. The one-story pediatric hospital building is “beautiful and bigger” than the original infrastructure, he said, which was a tiny mission established by Catholic nuns in the 1940s. Eventually it will house an emergency room, Intensive Care Unit (ICU), consultation room, and cardiovascular surgery unit with the technology, staff and logistics necessary to address congenital heart disorders, as cardiac malformations “are very common in that population,” Molina said. Someday, he said, the hospital envisions adding on a pair of eight-story towers in which to provide pediatric subspecialty care. As small as it is, the 150-bed hospital has local university affiliations and draws patients from throughout the region. Molina said it is “considered a teaching hospital,” offering clinical training to nurses and med-
Two children play in front of a typical big door in Cartagena, Columbia.
ical students, and also receiving occasional international medical student volunteers. On average, the hospital receives about 100,000 emergency patients annually, and admits about 10 percent of those. Approximately 50,000 outpatient consultations and 1,000 surgeries are performed. “It’s in a poor neighborhood, and they serve that population,” Molina said. “People go there without money and without insurance and they take care of them no matter what. They see patients from fetal or one month MEDICALDEALER 61
_Pay It Forward
“I like to help people in general and I like to go on missions, but now that I am going to my own country, I feel indescribable. I want to go every year.” – Luis Molina Volunteer missioneers Joseph Anzola, Luis Molina, Linda Reesor, Juan Mesa, Katy, Allen Reesor, David Anzola, Mara Cabral, and Astrid Cortes are seen at the community health fair in a poor neighborhood in Cartagena. Photo by volunteer Neyda Anzola.
to 20 years, more or less. They treat everything — respiratory, cardiac, digestive ailments.” While onsite, the visitors led staff education classes, a community health fair, and performed some consultations in a nearby neighborhood. They offered psychological, nutritional and other medical care. They did rounds to see some of the children who were receiving care there. Molina recalls meeting one nineyear-old boy who had been waiting until the visitors arrived for surgery to treat a brain tumor; that moment was especially moving for him. “They have no supplies; no resources,” he said. “He was waiting for surgery that week. We went to see him when he came out. They were very happy that they could help him.” With the funds they had raised stateside, the volunteers were able to bring a small cargo of medical and dental equipment with them — scales, toothbrushes, toothpaste — along with educational manuals such as CPR texts, as well as some toys and clothes for the young patients at the hospital. Really, Molina said, it was “not too much because we couldn’t get any62 MEDICALDEALER | APRIL 2015
The group arrives at Casa del Nino Hospital in Cartagena with medical and dental equipment to be donated to the Napoleon Franco pareja children’s hospital.
thing else,” but the recipients “were happy, and we were so glad that we could help in any way.” After returning from the trip, Molina said the group was re-energized by its adventure. They resolved to “pool all our energy to prepare better for the next time.” It’s difficult when the principal motivators are busy health care workers and their trip is not subsidized by larger corporate or health care sponsors, but the volunteers hope to raise enough money to bring 10 to 20 health care workers along with them on their return visit, which they have scheduled
for June 2015. “We have some people who want to go and do something more,” Molina said. “We are going to get our hospital administrators in contact with the Cartagena hospital administrators.” Although some would-be volunteers had apprehensions about traveling to a country unfortunately associated with cartel violence, Molina said Cartagena is a town working against this reputation. “They need to understand that they should fear nothing,” Molina said. “One year ago when we started talking about this and getting people involved, people said, ‘Oh that’s good, but I’m afraid of going to Colombia.’ I said, ‘Don’t be worried. Cartagena is a tourist city. You are safe and you can help these people in need.’ ” “We are very well known because of the bad news,” he said, “but in Cartagena there is no bad news. People are poor, people are in need, but besides that, people are safe.” If you would like to contribute to the mission work in Cartagena, visit www.gofundme.com/b5goig.
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SLICE OF LIFE_Off the Clock
By Matthew N. Skoufalos
VETERAN BMET STAYS BUSY HELPING OTHERS
F
rank Nickells’ BMET certificate is number 385, which makes him one of the first certified Biomedical Equipment Technicians in the country. An Air Force man who started out in 1969, Nickells was invited to take on a new role in the service when the military started looking for recruits with a background in mathematics and physics.
“They said, ‘Would you be interested in this new program called medical equipment repair?’ ” he recalled. From there, Nickells expanded his knowledge base with time spent around the world in different hospital deployments. Without the kind of advanced testing equipment that’s available today, he and his cohorts had to come up with innovative solutions, and often they did it on the fly. They were among the first groups to write preventive maintenance routines for various technologies, Nickells said, which taught the biomeds how to be both flexible and persistent. “You always learn a lot from on-the-job training,” he said. From there, Nickells was led to a four-decades-long career in healthcare with various agencies, until recently, when his position was eliminated due to a workforce reduction. Now that the veteran technician has WWW.MEDICALDEALER.COM
a wealth of time to go with his wealth of experience, he’s looking to apply his extensive skill set in service of a greater good. “I could consider retirement at this point,” Nickells said. “Health care, just like nursing, is a nurturing job, and you feel like spreading the wealth. That’s pretty much where most of us are, and we’d like to do that.” A former board member of the Colorado, Association of Biomedical Equipment Technicians (CABMET), Nickells has donated his time to Project C.U.R.E. of Centen-
nial, Colorado and has inspired other CABMET members to do the same. Last December, for example, CABMET volunteers spent three hours checking the specs and peripherals on a batch of monitors that was later packed up in a conex container and shipped overseas. “Project C.U.R.E. tries to be a little more sensitive to their needs once they send that equipment over,” Nickells explained. “They are being more proactive on that end of things.” Project C.U.R.E. has one electronic engineer on staff “who volunteers MEDICALDEALER 67
_Off the Clock
“Health care, just like nursing, is a nurturing job, and you feel like spreading the wealth. That’s pretty much where most of us are, and we’d like to do that.” — Frank Nickells
his time and has been learning on his own, to a large extent,” Nickells said. That staffer is tasked with verifying the functionality of donated medical equipment that’s bound for mission work overseas, so with extra hands on deck, the work is made lighter. That’s why Nickells chips in about once a month with Project C.U.R.E., sometimes sorting equipment; sometimes fixing it up. Recently, however, he’s embarked on a project that will facilitate the in-country work of Project C.U.R.E. for long after its medical missions have run their brief courses. Nickells is compiling a three-phase, one-week basic equipment training module that can help make life a lot easier for in-country technicians overseas. Project C.U.R.E. partners with hospitals in the African nations of Uganda and the Democratic Republic of Congo (DRC), and the organization is working to establish on-the-ground programs so technicians there will be able to become self-sufficient after medical missionaries depart. Nickells’ manual will give repair teams more of an idea about what they’re working with and how to troubleshoot breakdowns for people who are “just technicians, or, sometimes, not even quite to that level,” he said. “Technicians vary when you’re in foreign countries,” Nickells said. “They might be engineers. They 68 MEDICALDEALER | APRIL 2015
might be an ambulance driver who fixes cars part-time, and fixes medical machines part-time; I’ve seen that [on a prior medical mission] in Nepal.” To start, the manual will cover procedures for some of the most commonly utilized devices: EKGs, fetal monitors, electrosurgical units, and neonatal equipment, including incubators. Nickells’ workbook will include anatomy and physiology lessons in a pre- and post-test format that will help demonstrate knowledge and student growth before and after the training, as well as lessons on “what the device does, and how to work with it. “Then they can understand how to put that into action to identify a problem, even if they don’t have the equipment, like a simulator,” Nickells said. “Very often these countries don’t have a lot of training sources, so they can get a certificate saying they got through this training.” “Part of what I hope to be able to do, because it will be a project training course, has a lot to do with coordinating them, giving them information where they can get parts, get help, and get together,” Nickells said. He envisions his charges forming an internal group that will allow native biomeds to work among themselves in a more coordinated effort to “find experts among themselves.”
“Right now they’re not doing that type of thing,” he said. “They’re, at best, a very loose organization. A good program really starts with data, and right now I really don’t think they have a database, for instance.” “We’re really trying to develop a program for them so they can have a biomed program in these countries,” he added. Nickells said that about 18 technicians in DRC will be among the initial group to be trained when he travels to the country in September. He’ll do five days there, and another five in Uganda; and if the project takes root, he hopes to return to provide his expertise as the basis for training in other modalities. Nickells’ wife, Brenda, is a nurse and will provide the anatomy and physiology component to the program while Frank handles the equipment training. Future editions of the coursework may cover technologies like anesthesia, ultrasound, and X-ray equipment, if time allows. “You really can’t do those with just five days on the equipment,” Nickells said. But when there’s an opportunity to contribute to the education and training of future biomeds, who in turn can apply those life-saving skills in areas where they’re most needed, there’s no greater feeling in the world, he said. “In Nepal, I did have a patient on a ventilator, and the ventilator wasn’t working, and they needed me in the ICU right away,” Nickells recalled. “I had the feeling that I could be part of a team to do something and make a difference. The patient who had been bagged for 24 hours was now on a ventilator.” “That’s a great feeling and that’s what I want to do,” he said. MEDICAL EQUIPMENT, PARTS & SERVICE
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ALPHABETICAL INDEX
Is your ultrasound in need of
RESCUE? KEI Medical Imaging Services ………………… 33
AllParts Medical ………………………………………… 33
Maull Biomedical Training, LLC ……………… 64
Ampronix …………………………………………………………6
MedEquip Biomedical ……………………………… 69
Asset Management Associates, LLC ……… 50
Medical Imaging Solutions
AXIOMTEK …………………………………………………… 42
International ……………………………………………… 31
Bayer Healthcare Services. ………………… 4, 60
Medical Innovations ………………………………… 73
BC Technical, Inc. ……………………………………………7
Medical Specialties Distributors …………… 53
Bio-Medical Equipment Service Co.………… 42
MedWrench ………………………………………………… 71
BiTech Medical …………………………………………… 66
Metropolis International ………………………… 55
Capital Medical Resources ……………………… 73
MIT/Medical Imaging Technologies ………… 56
Carolina Medical Parts …………………………………8
MTC/Medical Technologies Co. ………………… 66
Classic Diagnostic Imaging ……………………… 52
Multi Diagnostic Imaging Solutions ………BC
Conquest Imaging ……………………………………… 13
MW Imaging ……………………………………………………3
Consensys Imaging Service, Inc. ……………… 32
National Ultrasound ………………………………… 64
Continental Equipment Company ………… 52
Pacific Medical …………………………………………… 14
Cool Pair Plus ……………………………………………… 70
Paragon Service ………………………………………… 34
Diagnostic Solutions ………………………………… 50
PartsSource ………………………………………………… 10
Digirad Corp.. ……………………………………………… 73
Phoenix Data Systems, Inc. ……………………… 23
Digitec Medical Service Corp.…………………… 73
QAL Manufacturing …………………………………… 17
East Coast Medical Systems …………………… 69
Quantum Biomedical ………………………………… 52
Eastern Diagnostic Imaging …………………… 74
Radiology Data …………………………………………… 73
Ed Sloan & Associates ……………………………… 32
Radon Medical …………………………………………… 70
Endoscopy Specialists ……………………………… 72
ReMed Equipment ……………………………………… 64
Field MRI Services ……………………………………… 73
S.H. Medical Corporation ………………… 23, 73
German Electronics …………………………………… 31
Shattuck, LLC ……………………………………………… 17
Global Medical Imaging …………………………… 19
Soma Technology, Inc. ……………………………… 60
Global Risk Services …………………………………… 63
Southestern Biomedical, Inc. …………………… 65
Government Liquidation ………………………… 78
Southwest Medical Resources ………………… 24
HMB Endoscopy Products ………………………… 51
Summit Imaging, Inc. ……………………………… IBC
Holden Battery Services …………………………… 70
Technical Prospects ………………………………………2
IAMERS ………………………………………………………… 57
Tesseract ……………………………………………………… 51
Injector Support and Service, LLC …………… 63
Tri-Imaging ………………………………………………………5
InterMed Ultrasound ………………………………… 56
Trisonics ……………………………………………………… 43
InterMed NucMed ……………………………………… 43
TROFF Medical …………………………………………… 22
InterMed Biomed ……………………………………… 66
Unique Biomedical Services …………………… 72
International Medical
USOC ……………………………………………………………… 41
Equipment & Service ………………………………… 59
Varian Medical Systems ………………………………9
International X-Ray Brokers …………………… 69
AUE is defining the standard as your full service partner in the medical ultrasound industry.
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CATEGORICAL INDEX ANESTHESIA Paragon Service…………………………………………… 34 Soma Technology, Inc.………………………………… 60 ASSOCIATIONS IAMERS…………………………………………………………… 57 AUCTION/LIQUIDATION Government Liquidation…………………………… 78 Shattuck, LLC………………………………………………… 17 BATTERIES Eastern Diagnostic Imaging……………………… 74 Holden Battery Services……………………………… 70 BIOMEDICAL Bayer Healthcare Services.…………………… 4, 60 Conquest Imaging………………………………………… 13 Global Medical Imaging……………………………… 19 InterMed Biomed………………………………………… 66 Maull Biomedical Training, LLC………………… 64 Medical Specialties Distributors……………… 53 QAL Manufacturing……………………………………… 17 Quantum Biomedical…………………………………… 52 Unique Biomedical Services……………………… 72 CARDIOLOGY J & M Trading…………………………………………………… 50 Southestern Biomedical, Inc.……………………… 65 C-ARMS Eastern Diagnostic Imaging……………………… 74 CARDIOLOGY ReMed Equipment………………………………………… 64 CMMS Phoenix Data Systems, Inc.………………………… 23 COMPUTED TOMOGRAPHY BC Technical, Inc.………………………………………………7 Consensys Imaging Service, Inc.………………… 32 East Coast Medical Systems……………………… 69 Ed Sloan & Associates………………………………… 32 German Electronics……………………………………… 31 J & M Trading…………………………………………………… 50 KEI Medical Imaging Services…………………… 33 International Medical Equipment & Service…………………………………… 59 Medical Imaging Solutions International………………………………………………… 31 Metropolis International…………………………… 55 MIT/Medical Imaging Technologies…………… 56 Technical Prospects…………………………………………2 Tri-Imaging…………………………………………………………5
76 MEDICALDEALER | APRIL 2015
DATA MEDIA Radiology Data……………………………………………… 73
MODULE/TELEMETRY Bio-Medical Equipment Service Co.…………… 42
DIAGNOSTIC IMAGING Digirad Corp..………………………………………………… 73 Eastern Diagnostic Imaging……………………… 74 J & M Trading…………………………………………………… 50 Medical Imaging Solutions International………………………………………………… 31 Multi Diagnostic Imaging Solutions…………BC Radiology Data……………………………………………… 73 TROFF Medical……………………………………………… 22
MONITORS/CRTs Advanced Ultrasound Elec./AUE………………… 75 Ampronix……………………………………………………………6 AXIOMTEK……………………………………………………… 42 Technical Prospects…………………………………………2 TROFF Medical……………………………………………… 22 Soma Technology, Inc.………………………………… 60
ENDOSCOPY Capital Medical Resources………………………… 73 Endoscopy Specialists………………………………… 72 HMB Endoscopy Products…………………………… 51 Medical Innovations…………………………………… 73 S.H. Medical Corporation…………………… 23, 73 GENERAL Eastern Diagnostic Imaging……………………… 74 Global Risk Services……………………………………… 63 Government Liquidation…………………………… 78 PartsSource…………………………………………………… 10 Phoenix Data Systems, Inc.………………………… 23 Shattuck, LLC………………………………………………… 17 INFORMATION TECHNOLOGY Tesseract………………………………………………………… 51 IMAGING/PARTS Ampronix……………………………………………………………6 AXIOMTEK……………………………………………………… 42 BC Technical, Inc.………………………………………………7 Consensys Imaging Service, Inc.………………… 32 Diagnostic Solutions…………………………………… 50 Eastern Diagnostic Imaging……………………… 74 Injector Support and Service, LLC……………… 63 InterMed Ultrasound…………………………………… 56 InterMed NucMed………………………………………… 43 J & M Trading…………………………………………………… 50 PartsSource…………………………………………………… 10 Technical Prospects…………………………………………2 Tri-Imaging…………………………………………………………5 TROFF Medical……………………………………………… 22 INFUSION THERAPY Medical Specialties Distributors……………… 53 LABORATORY MIT/Medical Imaging Technologies…………… 56 Unique Biomedical Services……………………… 72 LASER IMAGERS Multi Diagnostic Imaging Solutions…………BC
MRI BC Technical, Inc.………………………………………………7 Carolina Medical Parts……………………………………8 Consensys Imaging Service, Inc.………………… 32 Cool Pair Plus………………………………………………… 70 East Coast Medical Systems……………………… 69 Ed Sloan & Associates………………………………… 32 Field MRI Services………………………………………… 73 KEI Medical Imaging Services…………………… 33 Medical Imaging Solutions International………………………………………………… 31 MIT/Medical Imaging Technologies…………… 56 Southwest Medical Resources…………………… 24 NUCLEAR MEDICINE BC Technical, Inc.………………………………………………7 Digirad Corp..………………………………………………… 73 Global Medical Imaging……………………………… 19 InterMed NucMed………………………………………… 43 International X-Ray Brokers……………………… 69 J & M Trading…………………………………………………… 50 PATIENT MONITORING Bio-Medical Equipment Service Co.…………… 42 BiTech Medical……………………………………………… 66 MedEquip Biomedical………………………………… 69 Pacific Medical……………………………………………… 14 Quantum Biomedical…………………………………… 52 ReMed Equipment………………………………………… 64 Southestern Biomedical, Inc.……………………… 65 USOC………………………………………………………………… 41 PATIENT TRANSPORT Medical Innovations…………………………………… 73 PROBES/PROBE REPAIR Conquest Imaging………………………………………… 13 Global Medical Imaging……………………………… 19 ONLINE RESOURCES MedWrench…………………………………………………… 71 RADIOLOGY Asset Management Associates, LLC………… 50 Eastern Diagnostic Imaging……………………… 74 MEDICAL EQUIPMENT, PARTS & SERVICE
Categorical Index German Electronics……………………………………… 31 Holden Battery Services……………………………… 70 International X-Ray Brokers……………………… 69 InterMed Ultrasound…………………………………… 56 InterMed NucMed………………………………………… 43 J & M Trading…………………………………………………… 50 Maull Biomedical Training, LLC………………… 64 Metropolis International…………………………… 55 Multi Diagnostic Imaging Solutions…………BC Radon Medical……………………………………………… 70 Southwest Medical Resources…………………… 24 Technical Prospects…………………………………………2 TROFF Medical……………………………………………… 22 Varian Medical Systems…………………………………9 RADIOLOGY PARTS InterMed Ultrasound…………………………………… 56 InterMed NucMed………………………………………… 43 J & M Trading…………………………………………………… 50 TROFF Medical……………………………………………… 22 REPAIR/REFURBISH Advanced Ultrasound Elec./AUE………………… 75 Ampronix……………………………………………………………6 Bio-Medical Equipment Service Co.…………… 42 BiTech Medical……………………………………………… 66 Carolina Medical Parts……………………………………8 Conquest Imaging………………………………………… 13 Continental Equipment Company…………… 52 Digirad Corp..………………………………………………… 73 Eastern Diagnostic Imaging……………………… 74 Ed Sloan & Associates………………………………… 32 Endoscopy Specialists………………………………… 72 Field MRI Services………………………………………… 73 German Electronics……………………………………… 31 Global Medical Imaging……………………………… 19 Injector Support and Service, LLC……………… 63 International Medical Equipment & Service…………………………………… 59 KEI Medical Imaging Services…………………… 33 MedEquip Biomedical………………………………… 69 MIT/Medical Imaging Technologies…………… 56 MTC/Medical Technologies Co.…………………… 66 Multi Diagnostic Imaging Solutions…………BC MW Imaging………………………………………………………3 Pacific Medical……………………………………………… 14 QAL Manufacturing……………………………………… 17 Quantum Biomedical…………………………………… 52 Radon Medical……………………………………………… 70 ReMed Equipment………………………………………… 64 Summit Imaging, Inc.………………………………… IBC TROFF Medical……………………………………………… 22 USOC………………………………………………………………… 41
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REPLACEMENT PARTS Advanced Ultrasound Elec./AUE………………… 75 AllParts Medical…………………………………………… 33 BiTech Medical……………………………………………… 66 Carolina Medical Parts……………………………………8 Classic Diagnostic Imaging………………………… 52 Conquest Imaging………………………………………… 13 Continental Equipment Company…………… 52 Diagnostic Solutions…………………………………… 50 Digirad Corp..………………………………………………… 73 Ed Sloan & Associates………………………………… 32 Global Medical Imaging……………………………… 19 Government Liquidation…………………………… 78 International Medical Equipment & Service…………………………………… 59 J & M Trading…………………………………………………… 50 KEI Medical Imaging Services…………………… 33 MTC/Medical Technologies Co.…………………… 66 Multi Diagnostic Imaging Solutions…………BC National Ultrasound…………………………………… 64 PartsSource…………………………………………………… 10 QAL Manufacturing……………………………………… 17 Radon Medical……………………………………………… 70 Soma Technology, Inc.………………………………… 60 Southwest Medical Resources…………………… 24 Summit Imaging, Inc.………………………………… IBC Technical Prospects…………………………………………2 TROFF Medical……………………………………………… 22 Varian Medical Systems…………………………………9 RESPIRATORY Medical Specialties Distributors……………… 53 SERVICE CONTRACTS Global Risk Services……………………………………… 63 SOFTWARE Radiology Data……………………………………………… 73 Tesseract………………………………………………………… 51 Unique Biomedical Services……………………… 72 STERILIZERS Continental Equipment Company…………… 52 Government Liquidation…………………………… 78 InterMed Biomed………………………………………… 66 SURGICAL Capital Medical Resources………………………… 73 Eastern Diagnostic Imaging……………………… 74 Endoscopy Specialists………………………………… 72 International Medical Equipment & Service…………………………………… 59 S.H. Medical Corporation…………………… 23, 73 Unique Biomedical Services……………………… 72
SURPLUS MEDICAL Government Liquidation…………………………… 78 TUBES/BULBS AllParts Medical…………………………………………… 33 German Electronics……………………………………… 31 International Medical Equipment & Service…………………………………… 59 J & M Trading…………………………………………………… 50 Technical Prospects…………………………………………2 ULTRASOUND Advanced Ultrasound Elec./AUE………………… 75 Bayer Healthcare Services.…………………… 4, 60 Conquest Imaging………………………………………… 13 Diagnostic Solutions…………………………………… 50 Endoscopy Specialists………………………………… 72 InterMed Ultrasound…………………………………… 56 MW Imaging………………………………………………………3 National Ultrasound…………………………………… 64 Summit Imaging, Inc.………………………………… IBC ULTRASOUND PARTS Advanced Ultrasound Elec./AUE………………… 75 Conquest Imaging………………………………………… 13 Global Medical Imaging……………………………… 19 InterMed Ultrasound…………………………………… 56 VCR REPAIR/SERVICES Advanced Ultrasound Elec./AUE………………… 75 Conquest Imaging………………………………………… 13 VENTILATORS Government Liquidation…………………………… 78 VIDEO Endoscopy Specialists………………………………… 72 Multi Diagnostic Imaging Solutions…………BC X-RAY Asset Management Associates, LLC………… 50 Classic Diagnostic Imaging………………………… 52 Diagnostic Solutions…………………………………… 50 Eastern Diagnostic Imaging……………………… 74 German Electronics……………………………………… 31 Government Liquidation…………………………… 78 Holden Battery Services……………………………… 70 MIT/Medical Imaging Technologies…………… 56 Tri-Imaging…………………………………………………………5 X-RAY PARTS J & M Trading…………………………………………………… 50 Technical Prospects…………………………………………2 TROFF Medical……………………………………………… 22
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