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VOL. 7

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

MARCH 2016

Company Showcase Maull Biomedical Training

The Roundtable CMMS

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42 50

TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

THE ROUNDTABLE – CMMS A Computerized Maintenance Management System (CMMS) is a valuable tool for HTM professionals. As technology advances, CMMS is becoming even more important for HTM professionals as they strive to maintain medical devices in health care facilities. TechNation magazine reached out to companies and professionals in the HTM community to find out the latest on CMMS.

GET SMART: AVENUES FOR CAREER ADVANCEMENT For healthcare technology management professionals, one of the quickest ways to get ahead is to add knowledge through education, training or certification. These things create additional value to an employer, more knowledge and greater competency. We examine some options for career advancement for HTM professionals. Next month’s Feature article: Stay Alert: Tips to navigate ECRI’s latest list of technologyrelated issues

Next month’s Roundtable article: Test Equipment (Imaging) TechNation (Vol. 7, Issue #3) March 2016 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

MARCH 2016

1TECHNATION.COM

INSIDE

Departments PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Warren Kaufman Jayme McKelvey Andrew Parker

ART DEPARTMENT

Jonathan Riley Jessica Laurain Kara Pelley

EDITOR

John Wallace

EDITORIAL CONTRIBUTORS

Roger Bowles K. Richard Douglas Patrick K. Lynch John Noblitt Todd Rogers Manny Roman David Scott Cindy Stephens Karen Waninger Steven Yelton

WEB DEPARTMENT

Betsy Popinga Taylor Martin

ACCOUNTING

Kim Callahan

CIRCULATION

Lisa Cover Laura Mullen

EDITORIAL BOARD

Eddie Acosta, Clinical Systems Engineer at Kaiser Permanente Manny Roman, CRES, Founding Member of I.C.E. Karen Waninger, MBA, CBET Robert Preston, CBET, A+, 2014 Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System James R. Fedele, Director, Biomedical Engineering Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer

P.12 SPOTLIGHT

p.12 Professional of the Month: Jennifer DeFrancesco, MS, CCE, CHTM p.14 Company Showcase: Maull Biomedical p.18 Department of the Month: Erlanger Health System Clinical Engineering Department p. 20 Biomed Adventures: Journey Down Under

P.24 INDUSTRY UPDATES

p.24 News and Notes: Updates from the HTM Industry p.30 ECRI Institute Update p.32 AAMI Update

P.34 THE BENCH p.34 p.36 p.38 p.40

Tools of the Trade Webinar Wednesday Biomed 101 Shop Talk

P.58 EXPERT ADVICE

p.58 Career Center p.60 Ultrasound Tech Expert Sponsored by Conquest Imaging p.62 The Future p.64 Patrick Lynch p.66 Roman Review

P.68 BREAKROOM

p.68 Did You Know? p.70 The Vault p.72 MedWrench Bulletin Board p.74 Index Like us on Facebook, www.facebook.com/TechNationMag

MD Publishing / TechNation Magazine 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 â&#x20AC;˘ Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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MARCH 2016

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PROFESSIONAL OF THE MONTH

Jennifer DeFrancesco, MS, CCE, CHTM By K. Richard Douglas

ennifer DeFrancesco, MS, CCE, CHTM, who is Chief of Biomedical Engineering at the Indianapolis VA Medical Center (Richard L. Roudebush VA Medical Center) and the Veterans Integrated Service Network (VISN) 11, recently won the VA’s Chief Biomedical Engineer of the Year Award. That award encompasses the entire VA system. For somebody who has excelled in the HTM profession, it isn’t necessarily the career field that DeFrancesco fi rst considered. “I interned with Carnegie Mellon University’s Green Institute in high school and was introduced to engineering. I was able to tour their biomedical engineering labs and was hooked from there,” she says. “I learned about hospital-based biomedical engineering professionals through a happenstance meeting with BMETs at the Miami VA while I was a graduate student doing research there.” That new interest in biomed led DeFrancesco to the Technical Career Field (TCF) Program with the VA, which is very successful at training hospital based biomedical engineers and BMETs, she says. “I was privileged to work under the tutelage of Mike McDonald (now the Chief of Biomedical Engineering at Puget Sound VA) for two years. The program focuses on on-the-job training and funds training for further professional advancements,” DeFrancesco recounts. “The curriculum has some mandatory training and learning programs and

1TECHNATION.COM

MARCH 2016

some flexibility in specializing with specific training opportunities based upon your interests,” she adds. “There isn’t a better program out there right now training entry-level biomedical engineering professionals and it definitely set me on the right path in my career.” DeFrancesco started her career where she works now at the Richard L. Roudebush VA Medical Center as a TCF Biomedical Engineer. She later became the Chief of Biomedical Engineering at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. “A little over two years ago, I returned to the Richard L. Roudebush VAMC and have a dual role with our VISN which supports medical centers and Veterans in three states (Michigan, Indiana and Illinois),” she says. In the challenges department, DeFrancesco says that being pulled in a few different directions, at the same time, can test one’s abilities. “The past two years, in my current position, really pushed me professionally. In February of 2014, I was appointed to roll out a Clinical Information System and Anesthesia Record Keeping System for six ORs,

Jennifer DeFrancesco checks the interventional radiology room prior to a procedure.

four ICUs and six PACU/ Outpatient areas,” she says. “While I had encountered dynamic challenges in my previous tenures, my time management and coping skills were really tested with this addition of a third role. Interfacing with a different group of stakeholders at each facility (clinical, biomedical engineering, information technology, etcetera) posed its unique challenges.” DeFrancesco points out that it takes good human resources to get things accomplished. “Like all good engineers, I was resourceful and developed a very strong working relationship with our VISN (region) Clinical Applications Coordinator Katherine VanDenburgh, which helped ease some of the responsibilities on both of us,” DeFrancesco says. “My Assistant Chief of Biomedical Engineering at the Indianapolis VAMC, Jordan Keebaugh, and her expert knowledge, also was a

FAVORITE MOVIE:

“National Lampoon’s Christmas Vacation”

FAVORITE BOOK: “Born to Run”

FAVORITE FOOD:

Grilled chicken Parmesan and caprice salad

HIDDEN TALENT:

Ability to make others laugh with my surprisingly loud and unique laugh. (My retirement career is going to be as an audience laugher.)

FAVORITE PART OF BEING A BIOMED:

“No two days are ever the same. Because I work at a teaching hospital, we have a wide range of students from various training programs and academic affiliates – it keeps me on my toes because I want to make sure they have a great experience and grow to love this profession like I do.”

WHAT’S ON MY BENCH

• Coffee – an Americano to be exact. View from the control room in interventional radiology.

huge component of being able to take on the expanded responsibilities.” DeFrancesco also worked with the VA’s National Information Technology Workforce Development Team and created a fi rst of its kind pilot program in the VA for enhanced IT training. The program trained 20 people from seven facilities in three different courses: A+, Net+ and Sec+ and provided certification opportunity. “The biggest challenge moving forward in this profession is the continued education and relevance to the growing need and demand,” she says.

BEING INVOLVED AND KEEPING BUSY DeFrancesco will be a presenter at the MD Expo in Dallas next month. She is also a member of AAMI’s Technology Management Council (TMC). She was a member of the ACCE 2015 Class of Certified Clinical Engineers and contributes her time to the organization. “I co-chair the ACCE Education Committee and am a member of AAMI’s TMC. I am a VHA certified mentor and also recently became a

Certified Clinical Engineer (CCE) and Certified Healthcare Technology Manager (CHTM) and fi nished my doctorate in health administration,” she explains. She is a graduate of the VA’s Healthcare Leadership Development Program (HCLDP), which prepares individuals to become hospital executives. DeFrancesco also enjoys writing articles and speaking about matters pertinent to Healthcare Technology Management at various conferences. Away from work, travel gets the nod as one of DeFrancesco’s favorite pastimes. “I run — slowly — and am going to do my fourth half marathon this year. I also love to travel. I went to Macedonia with Habitat for Humanity and worked to build an apartment complex for 12 families. This June, I’m going to do the Incan Trail trek to Machu Picchu in Peru,” she says. DeFrancesco feels very fortunate to have ended up working in the HTM field. “I am so appreciative of the global

• Portfolio/notebook – I am really big on being prepared and following up on items. • Binders – Call me old school, but I really believe in binders • Picture of my Godson – He is two and adorable and provides some much needed motivation on especially difficult days. • Flats, these are under my desk along with some extra suit coats

(just in case.)

ethos that is Healthcare Technology Management. Six years ago, I started my career and I can’t imagine another technology-based career field with so many people so ready and willing to teach, mentor and open doors for you,” she says. “I’m always amazed when looking at recruitment and retention at the diversity of our field relative to other engineering disciplines. This is a true testament to the importance that HTM professionals put on mentorship, continuing education, diversity, research, and information sharing. I hope to continue to pay it forward throughout the rest of my career,” she adds.

SPOTLIGHT

COMPANY SHOWCASE Maull Biomedical Training

he evolution of contrast injector training for HTM/ clinical engineering professionals mirrors the growth of Maull Biomedical Training LLC. “In 2008, I was doing some industry research into what clinical engineering training was in demand but not being met,” said Stephen Maull, founder and owner of Maull Biomedical Training LLC. “That’s when I came to realize that the contrast injector industry was completely unrepresented in the training sector. I thought it was odd because I had worked on contrast injectors in the military.” Maull served in the United States Air Force as a BMET and BMET Instructor for 11 years. He realized his expert military training could benefit others and have a positive impact on patient outcomes throughout the nation. “Nobody, and I mean nobody, was providing training on these devices,” Maull said. Maull thought it over at length before jumping in with both feet. “After a couple of months of thinking and wondering and fretting about it I finally thought, ‘Screw it, I’m doing it.’ I’ve always been a leap before I look type, and I’ve also always believed we regret what we didn’t do more than what we did do,” Maull explained. “So, in the summer of 2008 I started Maull Biomedical Training and had a stomachache for a year.” “Eight years later, we’re still going strong and growing,” he added. A reason for the company’s success is that it is on the same page as health care providers when it comes to cutting costs

1TECHNATION.COM

MARCH 2016

STEPHEN MAULL Founder and Owner of Maull Biomedical Training LLC

“ I’ve always been a leap before I look type, and I’ve also always believed we regret what we didn’t do more than what we did do.” - Stephen Maull

and providing cost savings. He also provides a unique service. “We don’t really have a direct competitor as there are no other companies that do injector training from custom written manuals,” Maull said. “The OEMs offer training on some of their injectors, but they are much more expensive than we are. Plus, if you go to the OEM for training you only get trained on their equipment whereas our training encompasses the injector models of multiple manufacturers.” Maull Biomedical is able to provide very in-depth training on various product lines. “We train BMETs on the principles of contrast injection (what it is, what it’s used for, and so forth) and then we teach them how to operate, PM, calibrate and repair the contrast injectors,” Maull said. “Nearly all of our training is hands on; we have about a two-hour lecture on the first day of class where we talk about medical imaging and contrast injectors in general. Once that lecture is finished, the students get on actual working contrast injectors where they learn to operate it, they perform a full PM using our custom written training manuals and PM check sheets as well as a calibration or calibration verification. We also go over the most common malfunctions with each model and the most likely fix. We currently have seven different models of injectors we provide training on, but we will be adding more injectors later this year.” Maull’s idea to provide in-depth, high-level training online is the latest of his keen business ideas. “We have taken our training to a place no other comprehensive BMET training has ever gone; completely online and computer based. If you go to our website and register (www.maullbiomedical.com) you can see the ‘Introduction to Contrast Injectors’ and operational training videos for all the models we provide training on,”

he explained. “The first step is to watch the ‘Introduction to Contrast Injectors’ videos and take the in-video quizzes. Once they pass all the quizzes, they receive a training certificate stating they have successfully passed the Introduction to Contrast Injectors Training Course. Then, they can take the Operational Training Courses (online videos) for any particular model they wish. All of this training is free to anyone who registers on our website. Then, they can purchase the PM training software for each model they wish.” “The PM software is best described as a comprehensive computerized PM check sheet with how-to videos for each PM step.

We actually have a free demo version online that anyone can download,” Maull said. “After they have finished performing their first successful PM on that particular model they email Maull Biomedical a copy of the PM report that gets generated. Then, they get another training certificate stating they have been successfully trained on the PM and calibration/verification procedures for that particular model.” Maull’s genius idea makes training convenient for everybody. “What this allows is for you to get your contrast injector training when you need it and where you need it. No more travel and being away from your hospital and home for days,” Maull said. “The BMET can download this software and learn at their own pace anytime, anywhere. This is truly the best computer-based modality and model-specific BMET training in the world. If a BMET still wants a classroom setting for the training, we can still arrange that as well.”

A new website forum is another free tool Maull Biomedical offers. “We have a very comprehensive troubleshooting and tech support section on our website that is model specific. If you are getting an error with a particular model injector you can search the tech support area for that particular model and error code to see what the most likely solution is,” Maull said. “Plus, any BMETs registered with the site are invited to contribute to the tech support forum based on the model and error code and what they did to correct the issue. As the years go on, our tech support and troubleshooting forums will become more and more comprehensive.” Maull’s decision to provide training in 2008 has proven to be the right call for him and HTM professionals. The results speak for themselves. FOR ADDITIONAL INFORMATION about Maull Biomedical, visit wwwMaullBiomedical.com.

SPECIAL ADVERTISING SECTION

SPOTLIGHT

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DEPARTMENT PROFILE Erlanger Health System Clinical Engineering Department By John Wallace, Editor

“

For more than a century, Erlanger has been central to the lives of generations of Chattanooga families,” according to the Erlanger website. “Erlanger was founded through the generosity of a French nobleman in 1889.”

Today, Erlanger encompasses five campuses – North, East/Women’s East, Bledsoe and the Baroness campus in downtown Chattanooga that includes the campus of Children’s Hospital. The system runs two community health centers, Southside and Dodson Avenue. The downtown Erlanger campus was re-dedicated in 2002 as the Baroness Campus. Sights are set on the 21st century and a continued commitment to healing, teaching and leading. This commitment includes plans for a $35 million, 90,000 total square foot expansion of Women’s and Children’s services, to include a new Children’s hospital and outpatient clinic. The Erlanger Clinical Engineering department plays a huge role in the hospital’s success. The CE department has a stellar reputation and continues to strive for excellence amid personnel changes, including changes in leadership positions. The CE staff has easily transitioned along with these changes and continues to provide exemplary service. The CE department maintains more than 27,000 active medical devices, Clinical Engineering Supervisor David Townson said. Members of this top-fl ight HTM department boast various degrees and certifications. The team members working alongside Townson are Kirk Schemerhorn, Imaging Specialist III; Roger Trochelman, Imaging Specialist III; Ron Hart, Imaging Specialist III; Mark Walker, Imaging Specialist II;

1TECHNATION.COM

MARCH 2016

Members of the Erlanger Health System Biomedical Engineering Department are, from left to right, Joe Watson, Rob Herrington, David Townson, Kyle Fitzgerrel, Paul Wertanen, Kirk Schermerhorn, Ron Hart, Mark Walker, Crystal Everest, Terry Dodson, James Roberts, Kenny Lee, Mary Laband, Tom Dwelley, Hector Acosta and Gail Maynor.

“

We track our savings and make certain that the C-suite sees the resources we provide to the organization and the community as a whole. We have moved a large variety of medical devices to an in-house service model.” - David Townson, Clinical Engineering Supervisor

Paul Wertanen, BMET III; Joe Watson, BMET Specialist; Kenny Lee, BMET III; Hector Acosta, BMET III, CBET; Tom Dwelley, BMET II; Kyle Fitzgerrel, BMET II; Crystal Everett, BMET II; James Roberts, BMET II; Terry Dodson, BMET II; Simon Myers, BMET I; Rob Herrington, BMET I; Gail Maynor, Director of Nursing Informatics and former acting Clinical Engineering Director; Mary Laband, Administrative Assistance; Lori

Hansel, Parts and Logistic Support; and David Peterson, CIO. The latest additions to the Erlanger CE team include, Richard Peterson, BMET III; Richard Brannon, BMET II; Bill Canfield, BMET III; and Jim Caporali, Director of Clinical Engineering. The team works wonders and has recently completed some important projects for Erlanger. “We are finishing up the installation of GE B-Series bedside monitors in all ICUs

Erlanger has a long history of serving East Tennessee.

and ancillary campuses, including all of the East campus,” Townson explained. “We began replacing the Philips CMS and Intellivue bedsides with the Solar 8000 series in 2008. Now we are replacing the Solar series with the B-Series (B450, B650 & B850). The Solar monitor has been bulletproof, but the B-Series has many advantages that anesthesia preferred.” Erlanger has a number of needs to match its huge footprint in Tennessee. One important project included addressing the National Patient Safety Goal regarding alarm fatigue and alarm management. “We installed the Excel Medical Alarm Navigator system and have tracked alarm trends since April 2015,” Townson said. “We have identified opportunities to decrease the number of non-actionable alarms significantly. SPO2-Low alarm was the first such opportunity. We saw that SPO2-Low accounted for 33 percent of total alarms logged. We reduced the Spo2-Low default low limit and saw an immediate improvement.” The department has also been handson during Erlanger’s growth. “We opened the Sequatchie Valley Emergency Department July 2014,” Townson added. “We opened the 22,000-square-foot Erlanger East

Emergency Department in March of 2013.” Townson was quick to point out that everybody in the CE department stresses patient safety and quality outcomes. They also understand the value that comes with being able to procure cost savings for the health system. “Whenever possible we seek factory training for our in-house biomeds and imaging techs. Our rapid response times reduce room downtime and increase patient flow,” Townson said when asked about examples of cost savings. “The nursing staff’s work day lengths have decreased as our equipment expertise has increased. Service contracts have declined as our technicians have embraced the ever-changing health care fi nancial challenges and see their worth to the health system and overall value to the institution.” “We track our savings and make certain that the C-suite sees the resources we provide to the organization and the community as a whole,” he added. “We have moved a large variety of medical devices to an in-house service model. These devices include anesthesia, linear accelerators, dialysis and surgical lasers. We are always challenging ourselves to provide our hospital with high-value services. Administration recognizes this and provides us with the support we

need. We have a great group.” Townson said the team extends its expertise to assist with IT and networking projects. “Biomed has the responsibility for integrating, maintaining and updating all of Erlanger’s PC-based medical devices, including prototype devices brought in from various vendors,” he explained. “The main responsibility of installing, tracking and maintaining a medical device is changing with the integration of PCs in the medical industry. We not only have a responsibility to get the device tagged or tracked in our maintenance system, but we also have to get the system set up for secure communication.” “Additionally, software updates, vendor-approved patches as well as hospital-approved virus software, and operating system hot fixes have to be maintained. This requires multiple people – not only in the biomed department but also in the IT department,” he added. “Without this open line of communication, the simple task of software updates becomes impossible.” The department has faced some challenges, but continues to receive accolades. Clinical Engineering, like Erlanger Health System, provides world-class service that makes a world of difference in East Tennessee.

SPOTLIGHT

BIOMED ADVENTURES Journey Down Under

By K. Richard Douglas

uring the 1980s, the term “throw another shrimp on the barbie,” became a part of the American lexicon. Americans were exposed to some of the jargon that is common in the land down under; or so they thought. The phrase was originally made popular by Australian actor Paul Hogan for an Australian tourism board commercial that ran in the U.S. The irony is that Australians don’t use the term “shrimp,” but instead “prawns,” which would single out any American visiting the island nation who was trying to sound Australian. Despite the misinterpretation of facts, the country of Australia has often been a fascination for many Americans. Visions of kangaroos, koalas, white sand beaches and a famous opera house are all images that Americans associate with the country. Not exactly a hop, skip and a jump from Australia, but in the same part of the South Pacific, are the Fiji Islands; a mere 2,200 miles away. Made up of over 300 islands, one Fiji island was the setting for the 1980 movie “The Blue Lagoon.” Both locations are exciting destinations for travelers. Kevin Davis, who owns Equipment Repair & Diagnostics in Carson City, Nevada, hadn’t taken a vacation in several years. Typical of many business owners, the workload often precludes much opportunity for time away. Davis had been on location for a project in San Francisco and became fascinated by the variety of people and their travel experiences. This glimpse into other cultures caused him to ponder some exotic travel. “Moving to San Francisco motivated me to make the trip. I took on a short-term work project in San Francisco and left my home in Carson City, Nevada, to live in the city while the project took place. I am born and raised in Carson City, Nevada, and although I have traveled across the United States, I had never left North America,” Davis explains. “I experienced the multi-cultured city of San Francisco and heard many amazing stories of foreign people and

1TECHNATION.COM

MARCH 2016

VISITING SYDNEY AND NADI

places,” he adds. “After hearing multiple stories of positive experiences, I wanted to see for myself and decided to start in the South Pacific.” Traveling to the South Pacific from California is a challenge for anybody who gets restless on a plane trip. Davis stopped at the main airport in Fiji first, making the first leg of his journey an 11-hour trip. One reality made the trip a little more uncomfortable than it might be for many other people, but Davis had tools to improve his situation. “Thankfully both flights to and from Sydney were broken up by stops in Nadi, Fiji. The longest legs of my journey were only 11 hours,” Davis says. “But I am six foot six and not used to being contained in a small airplane seat for that long. During both long flights, I found myself performing aisle yoga and conversing with flight attendants and other travelers in the rear galley.”

With its distinctive harbor front Opera House, Sydney is the most populous city in Australia. Davis was impressed that downtown Sydney was both quiet and clean. A real feat for a city of four and a half million people. Davis stayed in the downtown area. Because he isn’t a big fan of crowded cities, he spent time exploring outside the city. He describes his experience with the restaurants there as “interesting.” “I spent most of my time in the city and its surrounding beaches,” he says. “My best memory is hiking five kilometers along the coast from Bondi Beach to Coogee. I enjoyed exploring and photographing the city while travelling by mass transportation.” “I quickly left the Sofitel Hotel after talking to the locals and went straight to Natadola reefs. Free diving there was incredible, I was able to swim with some of the most extraordinary fish species in the world near an incredible reef break,” he says. “The most enlightening part of my stay there was discovering how happy and thankful most of the people I encountered were.” Davis says that the accommodations at the Sofitel Hotel were “incredible,” but again, he spent most of his time there exploring the countryside. “I tried some delicious local food, the fresh fruit and fish was a nice break from American fare,” he says.

WIDTH 3.25”

CAN YOU SPOT THE DIFFERENCE?

The Sydney Opera House is a performing arts center in Sydney, Australia, identified as one of the 20th century’s most distinctive buildings.

FIRST IMPRESSIONS

TO VIEW MORE photos of Kevin Davsis’ trip, visit www.1technation.com/journey-down-under.

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Surprisingly, it was not something about Sydney or the Fiji Islands themselves that held the most surprise for Davis; it was other travelers. “What surprised me the most is the number of people who actively travel and take vacations, as a balance between work and pleasure,” Davis says. “I, myself, get very consumed in work and often don’t take the time to appreciate the most important things in life. I had anticipated travelers who were getting away from winter to enjoy summer, but was blown away at the amount of young people who were extremely well traveled, spoke multiple languages, and had done it all before. It was very cool to see.” There’s a good reason Davis has become consumed in work. Like many entrepreneurs, the workday can easily exceed the hours of a regular shift. Davis opened for business three years ago. As an ISO, the company serves as a cost-savings alternative to the OEM, according to Davis. “I am lucky enough to own and operate my own company,” Davis says. “My team and I specialize in on-site surgical equipment installation and repairs. We also have a 5,000 square foot shop (research and development lab) where we explore innovative repair and testing processes for the latest healthcare technology.” The business is comprised of technicians and engineers. “We work hard for our clients determining what their needs are and how we can help them achieve their goals. We provide well-designed, cost-effective service on sterilizers, washers, tables and endoscopic video systems. Although we are a small shop now, we are steadily growing through word of mouth and reputation,” Davis says. Staring at a white sandy beach and aqua waters may be the perfect retreat for a biomed who has spent too much time staring at medical devices. The South Pacific calls.

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NEWS & NOTES

Updates from the HTM Industry

TECHNATION 20 LEADERSHIP SUMMIT AT MD EXPO DALLAS The MD Expo Dallas will feature a new unique event for HTM professionals at the Fairmont Hotel in downtown Dallas on April 20-21. The TechNation 20 Leadership Summit is a group of 20-plus thought leaders from the nation’s HTM industry (CE, Healthcare Technology Management, Imaging, Supply Chain and Procurement) who will meet to network, learn and share innovative and creative ideas to help attendees advance personally and professionally. There will be several exciting networking events, including the “TechNation 20 Talks” where attendees can learn and share innovative and creative ideas. The event’s grand finale will have attendees take part in the first-ever MD Expo Reverse Expo, which provides brief one-on-one introductions with vendors who will share product information that will assist with equipment and service needs. The TechNation 20 will begin Wednesday, April 20 with the Eat & Greet at 6 p.m. Networking is the theme of the day on Thursday starting with a Networking Breakfast at 8 a.m. followed by the TechNation 20 Talks from 9-11:45 a.m. A nutritious lunch will be served from 11:45 a.m. to 1 p.m. to provide energy for the Reverse Expo, which is being held from 1-4 p.m. The MD Expo will kick off after the Reserve Expo with a Welcome Reception at 5 p.m. To learn more, visit http://mdexposhow.com/dallas/

leadership-summit/ or call 800-906-3373 for details.

1TECHNATION.COM

MARCH 2016

Because Quality Matters.

CONQUEST IMAGING ANNOUNCES GSA SCHEDULE 65IIA CONTRACT AWARD Conquest Imaging, a supplier of Philips, Siemens, Toshiba and GE ultrasound equipment, has announced that it has been awarded a Federal Supply Schedule 65IIA contract by the VA National Acquisition Center. Under delegated authority by GSA, the VA manages multiple award contracts for medical equipment, supply, pharmaceutical, and service Schedule programs. With over $10 billion in sales, the VA FSS Service supports the health care requirements of the VA and other federal government agencies by providing federal customers with access to over one million state-of-the-art commercial products and services. The five-year contract allows for federal health care facilities to efficiently purchase a wide-range of ultrasound equipment, services, and training products. Matt Tomory, Conquest’s Executive Vice President of Sales, stated, “We are pleased to expand our long-standing relationship with our government customers, and proud to provide assistance to the VA in their mission to care for America’s veterans.”

BETA BIOMED SERVICES CELEBRATES 20TH ANNIVERSARY Beta Biomed Services Inc. was established in 1996 by George Worley. He spent over 50 years in the electronic/medical field as an engineer and sales associate. Worley was involved in the early pioneering days of biomedical technology, assisting in the design of the first DC defibrillator, cardiac monitor, cardioverter and macro oximeter. He served on numerous new product committees that have brought about the development of such products as: demand pacemaker, micro oximeter, invivo oximeter, heart lung oxygenator, portable defibrillator, fiber optic diagnostic instruments, diagnostic cardiac catheters and cardiac output computer. It was his understanding of these and other medical devices that led him into the new field of pulse oximetry in the early 1980s. He has a number of patents on emerging technology in pulse oximetry. Beta Biomed Services’. design skills and attention to engineering details are what make its SPO2 sensor cables among the best replacements on the market. Worley’s innovations and commitment to the betterment of biomedical technology is one of the core strengths that has kept BETA Biomed Services at the forefront of the industry. BETA Biomed Services is committed to producing quality rather than quantity. To accomplish this objective, the company adheres to a preventative quality system, which focuses on the identification and solution of problems at the point of occurrence thereby eliminating them from the final product. BETA Biomed Services will continue to expand its design horizons to bring the best and most innovative products to the medical field, according to a press release. Learn more about Beta Biomed Services Inc. online at www.betabiomed.com.

NEW RIGEL 62353 PLUS MEETS MEDICAL DEVICE TEST NEEDS Rigel Medical has introduced an upgraded version of its dedicated tester for the in-service and post-repair safety testing of medical electronic devices in line with the standards required by IEC 62353. In line with changes in test requirements from manufacturers of 24V DC and 48V DC operated medical equipment such as operating tables and portable lighting installations, the new Rigel 62353 Plus tester is equipped with an extended range of insulation test voltages between 50V DC to 500V DC. As a result, four separate insulation test voltages are now provided at 50V DC, 100V DC, 250V DC and 500V DC to give the latest tester even more flexibility in meeting the routine safety testing needs of medical devices in line with the internationally recognized in-service test standard. Other design features include an earth bond “zap” circuit that makes use of preconditioning the contact resistance by using a high-current, low-energy pre-pulse. In addition, the new tester can measure and warn of secondary earth paths which are common in hospitals and which may seriously affect the validity of leakage measurements if undetected, potentially leading to false positives and passing medical equipment as electrically safe when in fact they are not. Improved battery power reduces the downtime between testing and other features include an easy-to-use facility for testing up to two individual applied parts from different modules or classes e.g. BF and CF class, in either fully automatic, semi-automatic or manual test modes. The comprehensive testing capability of the safety tester is supported by a large internal memory for the storage of test results, with stored test data being transferred to PC-based asset management and test records databases for maximum traceability. The new Rigel 62353 Plus analyzer tests in full compliance with IEC 62353 and NFPA 99 or AS/NZ3551 respective local versions. For full details, visit www.seaward-groupusa.com/unisim-lite.

INDUSTRY UPDATES

FLUKE BIOMEDICAL INTRODUCES THE INCU II An infant’s first days can be their most critical, which is why Fluke Biomedical developed the INCU II Incubator/Radiant Warmer Analyzer to provide the functionality biomedical technicians need to test and verify the performance and safety of infant incubators, transport incubators and radiant warmers. “At-risk infants can’t communicate that they’re uncomfortable – too hot or cold. That’s why it’s essential to verify infant incubators are performing according to manufacturers and industry standards,” explains Eric Conley, General Manager for Fluke Biomedical. “The INCU II is an all-in-one analyzer that supports IEC standards to accurately assess the environmental parameters of infant incubators and radiant warmers.”

Weighing just three pounds, the compact INCU II can simultaneously measure relative humidity, airflow, sound and six independent temperature points. Its color-coded probes make it easy to switch between the sensors for testing temperature in an incubator or the five pucks for verifying the environment of a radiant warmer. The large LCD screen of the INCU II displays real-time test results, along with pass/ fail indicators. Once an incubator reaches a steady temperature, it takes just 15 minutes to conduct a sequence of tests, which can be customized and stored in the analyzer. Test data can then be sent and monitored from a computer, using a USB cable or the INCU II wirelessly. (Wireless capabilities became available worldwide on Jan. 26, 2016.)

“The INCU II offers the portability and intuitive interface biomedical technicians’ desire with the advanced technologies to accurately test commonly available incubators and radiant warmers,” explains Ashton Solecki, INCU II Product Manager. “In addition, the INCU II comes with a placement pad that

DA-2006-VL RECEIVES FDA 510(K) CLEARANCE The DA-2006-VL Variable Load Box is the newest accessory for the BC Biomedical line of defibrillator analyzers and has received FDA 510(k) clearance. It works in conjunction with the DA-2006 and DA-2006P Defibrillator Analyzer as an external load bank. If you already own a DA2006 or DA-2006P you can update your software for free to be compatible with the DA-2006-VL. The DA-2006-VL is used when testing defibrillators to ensure the proper electrical current is delivered to the heart, per AAMI DF80 and IEC 606012-4 standards. Both AAMI and IEC require defibrillator analyzers to test a variety of impedances, to simulate a wide range of patients. With the DA-2006-VL, the DA-2006/P has test loads from 25-200 ohms and can be measured in 25 ohm increments. With the DA-2006-VL’s advanced technology, it is automatically recognized by the DA-2006 Series, leaving no settings to change or configure. No other defibrillator analyzer load bank offers this feature. The DA-2006-VL is only compatible with the BC Biomedical line of defibrillator analyzers.

1TECHNATION.COM

MARCH 2016

helps technicians learn how to correctly place the temperature sensors and pucks.” Along with complying with the latest global industry standards, including IEC 60601-2-19 (incubator), IEC 60601-2-20 (transport incubator), and IEC 60601-221 (radiant warmer), the INCU II supports China sound standards (Class II).

THE INTERMED GROUP TAKES SHAPE InterMed Biomedical, InterMed Ultrasound, InterMed Nuclear Medicine, and InterMed X-ray have joined forces with financial player Wafra Partners LLC to form The InterMed Group. This restructuring positions The InterMed Group to become a thirdparty provider of medical equipment management and service solutions in the U.S., and opens avenues to new opportunities to provide the solutions and customer service for which the InterMed name has long been known. Rick Staab, CEO of the newly combined entity, says, “The InterMed Group is uniquely positioned to capitalize on several avenues for enhancing its service proposition as an integrated, broad organization with diversified equipment management and service offerings. Combining the modalities into a single company and streamlining services positions us for significant growth. The entire team is excited about this momentum.” Staab will be joined by long-term industry leaders Dave Bauerle, Don Fletcher and Shawn Chatfield in key management roles. Michael Goodman, Managing Director of Wafra Partners adds, “Wafra believes that InterMed is an excellent platform in this highly fragmented sector. Rick Staab and his management team have earned a reputation for delivering superior and consistent services in each modality, and we look forward to supporting their growth initiatives and momentum.”

HTMA-GA OFFERS FREE TECHNICAL CLASS HTMA-GA is excited to offer a technical class on the AMX-4 Portable X-ray System. In this class, attendees will learn how to perform preventive maintenance and get troubleshooting tips for common symptoms, corrective actions, and parts ordered for the AMX-4. The class is free and will be held at 5 p.m. on Wednesday, March 9. The class is scheduled to last about 90 minutes. The class will be held at Piedmont Atlanta, Building 77, 1968 Peachtree Road NW, Atlanta, on the sixth floor, in Classroom 7. Interested parties can call Steve Kelly for directions or more information at 404-2743243 or register online at http://htma-ga.org.

VERSUS ANNOUNCES WI-FI REAL-TIME LOCATING PLATFORM AND ASSET TAG Versus Technology Inc. has released its new Wi-Fi locating platform and asset tag which, combined with its existing precision locating systems, creates an effective and scalable RTLS for health systems. “With the addition of our V-Net real-time locating system platform and Asset Net Tag, health care facilities no longer have to choose between Wi-Fi RTLS and the precision locating Versus is known for,” says HT Snowday, Versus President. “The combination of precision infrared with the ubiquity of Wi-Fi are now available in one tag, leveraging the benefits of both options — benefits that are vital to deliver operational efficiency.” With lower reimbursements and higher operational costs, health systems need solutions to optimize

operations. Administrators require systems that can leverage existing infrastructure, yet still solve urgent issues such as increasing capacity through improved workflow, or enhancing patient and staff safety. As a Cisco Solution Partner, Versus now offers hospitals the ability to leverage their existing Cisco infrastructure to track assets across entire buildings and the entire health system for enterprise-wide fleet visibility. When the hospital is ready to grow into advanced clinical applications that require precise locating, they simply add small, discrete wired or wireless infrared (IR) sensors where necessary. This highly scalable, building block approach offers a wide range of proven RTLS solutions, including enterprise-level fleet visibility,

par-level asset management, nurse workflow, and patient flow process improvement in the ED, OR, and hospital-wide. Versus clients have experienced multi-million dollar savings while also increasing patient safety and satisfaction through its location-based solutions. The V-Net Wi-Fi platform works in combination with Versus’ wireless and wired RTLS options. V-Link offers battery-powered IR sensors for quick and easy implementations, and V-Direct features 11th-generation wired IR sensors for a maintenancefree network. A dual Wi-Fi and IR option for staff and patients, the Clearview Net badge, will be released in early 2016, extending the benefits of Wi-Fi RTLS to staff locating and patient flow.

INDUSTRY UPDATES

DIMPLEX THERMAL SOLUTIONS OFFERING GLOBAL PROCESS COOLING SOLUTIONS Dimplex Thermal Solutions, the North American chiller manufacturer of Koolant Koolers, has a strategic partnership with Glen Dimplex Deutschland, the German manufacturer of Riedel process cooling equipment to offer global distribution of both product lines. Dimplex Thermal Solutions and Glen Dimplex Deutschland are both owned by the Glen Dimplex Group, of Ireland. Both manufacture similar products for industrial process cooling, but now the two brands will be aligned together through the DTS sales network to offer the customer the best possible cooling solution for the application, coupled with the confidence of global service and support. Combined together, Riedel and Koolant Koolers have more than 100 years of experience designing and manufacturing auxiliary equipment (also known as chillers) to remove heat from medical equipment, such as MRI, CT and Linear Accelerators. For every application that needs heat removed, customers will now have two engineering design teams who can offer the best solution for the application requirements. “Offering both brands to customers will allow the two engineering teams to design the best solution with the best delivery, best pricing and best features for their application,” said Tim True, Director of Sales, Service and Marketing for Dimplex Thermal Solutions.

ENTECH NOW AUTHORIZED SERVICE PROVIDER FOR MIDMARK ENTECH Clinical Equipment Services has been named an authorized service provider for Midmark products. Midmark offers a wide range of medical and health care products, including power procedure tables and chairs, exam tables, lights, workstations and more. ENTECH’s service agreement extends to Ritter products as well and its line of automatic sterilizers. Midmark utilizes authorized service providers across the nation and internationally. With ENTECH added to its exclusive list of service providers, hospitals and health care facilities can be assured that scheduled maintenance and repairs to Midmark medical equipment will be handled professionally by Midmark-trained ENTECH technicians. ENTECH is Midmark’s primary authorized service provider for all hospitals and health care facilities in the Tucson, Arizona area. In order to be considered an authorized service provider for Midmark, a company’s technicians must complete an intensive training program at Midmark’s Ohio facility. This includes a combination of classroom instruction as well as hands-on training on all Midmark and Ritter products, from procedure and exam tables to specialty stools, equipment carts and sterilizers. For warranty repairs on Midmark products, customers should contact Midmark and they will then be directed to the nearest service provider. For ENTECH customers in Arizona requiring Midmark service, click on Service Request at ENTECH’s website www.entechbiomedical.com or call the main dispatch/service line at 800-451-0591.

1TECHNATION.COM

MARCH 2016

INDUSTRY UPDATES

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1TECHNATION.COM

ECRI UPDATE

A Fresh Look into the #1 Issue on ECRI Institute’s Top 10 Health Technology Hazards for 2016

he failure to adequately reprocess contaminated instruments – that is, to clean and disinfect or sterilize them – before using them on subsequent patients can lead to the spread of deadly pathogens. ECRI Institute has included this topic multiple times on its annual list of the Top 10 Health Technology Hazards. However, a series of fatal infections attributed to the use of contaminated endoscopes, combined with ECRI Institute’s own investigations into poor endoscope cleaning and disinfection practices, prompted the organization to elevate flexible endoscope reprocessing to the top of its 2016 list. PROBLEM

BACKGROUND

A key aspect of effective reprocessing is cleaning biologic debris and other foreign material from instruments before the disinfection or sterilization step. This entails initial cleaning of the instrument at the site of use, as soon as possible after the procedure, combined with more thorough cleaning at the reprocessing site. If this precleaning is not carried out properly, the disinfection or sterilization step may not be effective. Flexible endoscopes in general, and duodenoscopes in particular, are of specific concern because their complex design and long, narrow channels can make effective cleaning difficult. A series of fatal carbapenem-resistant Enterobacteriaceae (CRE) infections that attracted a lot of attention in 2014 and 2015 illustrates this concern: The deaths were associated with the use of duodenoscopes that had not been successfully disinfected between uses. Facilities need to emphasize to their reprocessing staff that inattention to the cleaning steps within the reprocessing protocol can lead to deadly infections.

Cross-contamination of patients due to ineffective reprocessing of reusable medical devices is a recognized source of infection. For endoscopes, effective reprocessing requires careful adherence to a multistep protocol, typically encompassing the following: • Precleaning in the room where the procedure was performed • Transport to the reprocessing room • Leak testing • Manual cleaning • Sterilization or high-level disinfection • Rinsing and drying (often, the channels are also flushed with alcohol) • Storage and handling

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MARCH 2016

The cleaning stages are mostly manual processes; thus, it’s possible that staff will not perform the required steps consistently. Concern also exists that staff will target these stages for shortcuts if they feel pressured to complete the reprocessing process quickly, as can occur if the demand for instruments is high.

Failure to preclean and keep instruments moist at the point of use before they are transported to the reprocessing area can result in the formation of biofilms that are exceedingly difficult to remove once they have been allowed to dry. In addition, bioburden and residual soil on the interior or exterior surfaces of the instrument can shield microbes from disinfection or sterilization. A key factor in the case of duodenoscope CRE infections is that the instrument’s complex design contributes to inadequate cleaning. Our investigations have also shown that poor communication between reprocessing staff and clinical personnel can adversely affect the reprocessing function. For instance: An environment in which the needs of reprocessing staff are not considered can lead to unreasonable expectations and, ultimately, ineffective reprocessing. Health care facilities should instead promote a culture of teamwork between reprocessing and clinical staff, rather than allowing an “us and them” mentality to persist.

e. Time constraints, which can lead to demand-driven reprocessing shortcuts f. Instrument designs that make cleaning difficult.

ECRI INSTITUTE RECOMMENDATIONS Clinical managers should take the following steps:

Emphasize to all personnel involved in the reprocessing (cleaning and disinfection or sterilization) of reusable medical devices that inattention to the cleaning steps within the reprocessing protocol can lead to deadly infections.

Assess your reprocessing program to identify and rectify factors that could contribute to poor instrument cleaning. Such factors include: a. Missing, incomplete, or inaccessible reprocessing instructions. b. Inadequate training. c. Inconsistent cleaning practices, possibly resulting from an underappreciation of the importance of these steps. d. Insufficient work space, equipment, or supplies to perform the task effectively.

Verify that reprocessing procedures are: a. Clearly documented (i.e., available in print or electronic form.) b. Comprehensive, covering all steps including precleaning at the site of use. c. Model-specific â&#x20AC;&#x201C; reprocessing instructions can vary from one model of endoscope to another. d. Readily accessible for review by personnel with reprocessing responsibility. e. Up to date, reflecting the equipment, cleaning agents, and processes that are currently in use.

4 5

Review procedures periodically to confirm that they meet the above criteria.

Train appropriate personnel in the correct reprocessing methods. This should be done: a. When individuals are first given reprocessing responsibility (e.g., when hired) b. Before they are asked to reprocess any new device c. When any changes are made to the process

Disease Control and Prevention (CDC) recommends that training be provided at least once a year (For details, see: http://emergency.cdc. gov/han/han00382.asp). Monitor adherence to protocols and the quality of instrument cleaning.

Additional steps are described in the complete ECRI Institute report. Visit www.ecri.org/hazardsolutions to learn more.

NEED HELP? CHECK OUT OUR SOLUTIONS KIT Awareness of critical health technology hazards is a key first step. The next steps involve taking action to prevent the problems from occurring. ECRI Institute now offers a 2016 Top 10 Health Technology Hazards Solutions Kit with comprehensive discussion of each topic, actionable recommendations for minimizing the risks of harm, and lists of useful resources for more information about each topic. For questions about the technology hazards or to purchase the comprehensive Solutions Kit, visit www.ecri.org/ hazardsolutions, or contact ECRI Institute by telephone at 610-825-6000, ext. 5891, or by email at clientservices@ ecri.org.

Institute a method for assessing competency on an ongoing basis, and provide refresher training at regular intervals to help staff sustain competency. The U.S. Centers for

INDUSTRY UPDATES

AAMI UPDATE

AAMI’s Supportability Task Force Creates Checklists

o help prevent adverse events related to the improper use of replacement parts in healthcare technology, AAMI’s Supportability Task Force has compiled two checklists regarding the proper development, selection, and use of replacement parts. One checklist is geared toward healthcare technology management (HTM) professionals, while the other is aimed at manufacturers. Replacement Parts Checklist — HTM • Is the part an exact replacement from the manufacturer of the device, or from the manufacturer of the part? • If it is not, are the specifications identical? • Does the part affect the accuracy of the device? • Does the parts provider offer a warranty at least equal to the manufacturer? • Does the parts provider fully test each part before making it available? • Does the parts provider have ISO or another type of quality certification? • If the parts provider isn’t the manufacturer, does the provider have a relationship with the manufacturer? • Is the parts provider financially sound and likely to be around for a while? • If you send a device out for repair, how do you verify the quality of the repair when it comes back? • Does the parts provider offer a wide selection of quality parts or is it a niche provider? • If you have used third-party parts and require manufacturer assistance, will the manufacturer require you to replace those parts with its parts before doing any work?

1TECHNATION.COM

MARCH 2016

When a device is returned for repair, inspect it to determine if unauthorized repairs were made. For example, does the batch/ lot number of a critical part match the DMR record of when it was originally assembled? Replacement Parts Checklist — Manufacturer • Are there restrictions on what cannot be serviced by the customer? • Are those restrictions clear? • For items that cannot be serviced by the customer, is there an explanation as to why? For example, is a special calibration fixture or test setup required? Without an explanation, the repair personnel cannot defend to management why OEMs must make certain repairs when, at first glance, those repairs appear to be able to be

performed in-house or by a third party. • Consider providing drawings that indicate what components/ subassemblies are and are not user-replaceable. • For restricted components/ subassemblies that are likely to be serviced, consider labeling them as “not user replaceable” and providing an explanation in the service manual. • Consider tamper-evident seals for access to restricted components. • When a device is returned for repair, inspect it to determine if unauthorized repairs were made. For example, does the batch/lot number of a critical part match the DMR record of when it was originally assembled? Are the calibration parameters the same as they were originally? If not, these are signs that the device might have had unauthorized work performed.

POST-SUMMIT REPORT AIMS TO MAKE RISK MANAGEMENT EVERYBODY’S BUSINESS There is wide recognition that caring for patients can be a risky business. Currently, the compelling need for greater responsibility and accountability in managing risk does not match the reality in health care delivery. A postsummit report from AAMI and the U.S. Food and Drug Administration (FDA) aims to identify the barriers and priority actions for strengthening the discipline and practice of risk management for healthcare technology. The report, “Making Risk Management Everybody’s Business: Priority Issues from the 2015 AAMI/ FDA Risk Management Summit,” includes broad, multidisciplinary perspectives from device manufacturers;

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health care delivery organizations; regulators; standards development organizations; patient safety organizations; clinicians; safety, risk, and quality management professionals; healthcare technology management professionals; and systems engineers who attended the summit this past September. Their discussions yielded the following clarion themes: 1. Recognize that everyone in health care is a risk manager. 2. Develop shared understanding of the risks — and benefits — of healthcare technology. 3. Adapt systems engineering principles, practices, and tools for risk management. 4. Engage in a total life cycle approach to risk management, which is required to effectively manage risk. 5. Create new practical tools to continue advancing the field of risk management for healthcare technology. To download the complimentary report, visit www.aami.org/risk_ management_summit_report.

FOUNDATION REPORT MAKES CASE FOR CONTINUOUS MONITORING OF PATIENTS RECEIVING OPIOIDS The AAMI Foundation has released a compendium that describes the serious risks faced by patients receiving opioids and the potentially life-saving benefits of continuous electronic monitoring (CEM). The report, “Opioid Safety & Patient Monitoring: Conference Compendium,” includes diverse perspectives from stakeholders who attended the kick-off meeting for the National Coalition to Promote Continuous Monitoring of Patients on Opioids.

Continuous respiratory data and other vital sign information from electronic monitors can identify subtle changes in respiration, detect trends, and provide clinicians with actionable information that is not readily apparent from a two- or four-hour spot check of vital signs. “CEM isn’t the only answer, but it’s a fundamental part of any meaningful solution,” said Marilyn Neder Flack, senior vice president of patient safety initiatives at AAMI and executive director of the AAMI Foundation. “Many hospitals are saving lives by integrating technology as a tool to support the work of clinicians.” In addition to issuing a call to action, the compendium outlines the strategies eight hospitals have used to make the business case for and implement continuous patient monitoring, as well as provides insights from experts at the Westchester Medical Center in New York, the ECRI Institute, and the San Diego Patient Safety Council in California.

NEW PODCAST COVERS CULTURE OF SAFETY What does it take to develop and support a culture of safety in hospitals and other health care facilities? A complimentary new podcast from AAMI answers that question with insights from experts who stress that changing a culture starts with changing behaviors. “Safety is not automatic in health care,” one guest notes. This AAMI podcast, along with more than a dozen others, is available at www. aami.org/newsviews/podcasts. FOR MORE INFORMATION, please visit www.aami.org.

Dallas • Spring 2016 Empowering the Biomedical/ CE Professional

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INDUSTRY UPDATES

TOOLS OF THE TRADE The R7000

ational Safety Technologies offers one simple device for testing all of your electrical receptacles. The R7000 Electrical Receptacle Analyzer performs up to 12 standard NFPA 99 tests and automatically generates reports that are recognized by The Joint Commission. In addition, the R7000 has several convenient features, including a touch screen, optional reference cord, preloading capabilities, advanced reporting features and ample memory and storage capacity. Automated testing reduces the likelihood of errors. To that end, the R7000 Electrical Receptacle Analyzer performs the following tests: • Ground to ground voltage • Phase relationship between • Standard “OKX” test, to check • Ground to ground resistance receptacles receptacle wiring polarity • Contact tension (gripping force) of • Neutral to ground voltage • Isolated power wiring hot, neutral and ground prongs • Neutral to ground resistance • Line voltage Each R7000 analyzer is calibrated to NIST traceable standards and NST offers a one-year warranty on all parts and labor. Annual calibrations are required by NFPA 99 Code 6.3.3.1.5. FOR INFORMATION VISIT WWW.NST-USA.COM.

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MARCH 2016

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WEBINAR WEDNESDAY Pronk Kicks Off the 2016 Series Staff Reports

ntering its third year, the TechNation Webinar Wednesday series has added new features that were unveiled during the first webinar of 2016. The webinar “Is the Medical Device Really Ready to go Back to the Clinical Department?” sponsored by Pronk Technologies included prizes presented by TechNation, including free lunch and TechNation T-shirts for one lucky winner’s entire department. Rich Sable of St. Francis Medical Center in New Jersey won a TechNation pullover for correctly answering a question about the upcoming MD Expos. The question was asked during the introduction of the speaker. Jessica Wilkolak of Fitzsimmons Hospital Services in Ohio won lunch for her department as well as TechNation T-shirts for her social media post about the webinar. Attendance was high as 321 people tuned in for Greg Alkire’s informative presentation. The webinar gave attendees a chance to better understand test equipment specifications that are used for maintaining and calibrating medical devices. Alkire reviewed examples of actual device manufacturer testing requirements and compared them to specifications of commonly used test equipment. Through this comparison attendees learned how to determine if an analyzer or meter actually meets the manufacturer’s requirements, and if not, how much error could be introduced into the testing. The webinar also examined common test equipment set-up errors using infusion pump testing as an example. The webinar is available online, along with all previous Webinar Wednesday presentations, at 1TechNation.com/webinars.

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MARCH 2016

Alkire, who has more than 20 years of experience in the medical device industry in a wide range of roles, is currently responsible for worldwide sales and marketing for all Pronk Technologies products. He also has an active role in the research and development of new products. Visit http://www.pronktech. com/ to learn more about this company’s products and services. The webinar received positive reviews from attendees in a post-webinar survey. Comments included positive feedback for Alkire’s presentation as well as the TechNation Webinar Wednesday series as a whole. “I encourage all biomedical technician, managers, and directors to include TechNation’s free monthly series, ‘Webinar Wednesday’ into their training programs,” attendee Kip S. wrote. “They’re free and worth your training time. I listened to an excellent seminar today hosted by Greg Alkire who presented a relevant topic; ‘Is the Medical Device Really Ready to go Back to the Clinical Department?’ I would guess most everyone took away something from the webinar. I sure did and I’ve been in the field for over 30 years.” “The webinar series is a great asset to small business/third-party repair for maintaining CBET license. It keeps me up to date with current technologies,”

“I encourage all biomedical technician, managers, and directors to include TechNation’s free monthly series, ‘Webinar Wednesday’ into their training programs. They’re free and worth your training time.” - Kip S.

Michael M. wrote. “I’m currently a student and these webinars are a great training tool. I plan on watching them for the rest of my career,” attendee Ben N. shared in his survey. FOR INFORMATION about the TechNation Webinar Wednesday series, including recorded presentations and a calendar with upcoming webinars, visit www.1TechNation.com/webinars. PRONK TECHNOLOGIES would like to thank all attendees for participating in the webinar. Please visit www.pronktech.com to learn more about this company’s products and services.

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MARCH 2016

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BIOMED 101

Nurse Call Systems and Quick Tips for Troubleshooting By Jesse Bernstein, BMET II

hat is a nurse call system? Nurse call is exactly what it sounds like, it is a system designed to allow a patient to call or contact their nurse or the nurse’s station. It is the quick and easy communication between the patient and the nurse. And it can be the lifeline for the patient. Things can be integrated with the nurse call system such as bed exit alarms and TV control. The main components of the nurse call system are the pillow speaker also known as a call light, a wall station, the bed cable, desk console, and code blue. The pillow speaker allows the patient to contact the nurse, control the TV and control overbed lights. Alternate breathe calls for patients with limited movement or paralysis can be plugged into the wall station allowing the patient to contact the nurse by inhaling or exhaling into a tube. The wall station actually contains the microphone and speaker for communication between nurse and patient. It is also the receptacle for the pillow speaker and houses the code blue button. A great feature of modern nurse call systems is the ability to connect medical equipment such as IV pumps or ventilators to the nurse call system through the wall station. This allows for alerts at the nurse’s station when connected medical equipment goes into alarm. The benefit is notifying the nurse sooner to address the alarm thus decreasing noise. The patient bed can also be connected to the wall station by a bed cable allowing the clinical staff to know if the patient is trying to exit the bed and shouldn’t, as long as the bed exit alarm is set. If the patient bed is

1TECHNATION.COM

MARCH 2016

equipped it also allows for the patient to call the nurse’s station from the button on the bed rail. The desk console acts like a telephone and in many ways looks like a telephone. It allows the unit secretary or nurse to answer calls from the patient. The unit secretary or nurse can also call into a room if needed.

JESSE BERNSTEIN, BMET II

Baylor Scott & White at Garland

“ Pressing a code blue button sets up a string of audio and visual alerts inside the room, outside the room, at the nurse’s station and anywhere else the nurse call system is configured to alert. Periodic testing of code blue is highly recommended.” And of course code blue. Code blue signifies a patient needs immediate help. Pressing a code blue button sets up a string of audio and visual alerts inside the room, outside the room, at the nurse’s station and anywhere else the nurse call system is configured to alert. Periodic testing of code blue is highly recommended. Troubleshooting these devices can be fairly simple for the most common complaints.

The patient cannot hear or control their TV? The first thing to start with is the pillow speaker. Replace the pillow speaker with a new pillow speaker. This will resolve a majority of your calls. If replacing the pillow speaker does not resolve the problem, check the volume on the TV. If the volume is turned down or off, the patient won’t hear anything through the pillow speaker. Next check the cabling for the TV to the nurse call system. The cables can sometimes work themselves

TRIM 4.5”

loose with constant moving of the TV. If the cables check out OK, check the TV programing in the service mode. If all these things are correct and you still have no sound or control of the TV then you probably have an issue with the wiring in the wall between your wall station and TV.

TRIM 4.5”

Patient can’t call using buttons on the bed? What if the clinical staff informs you that the patient presses the nurse call button on the bed but nothing happens? First assure the bed cable is securely connected to the wall station and to the bed. Check the bed cable pins. One bent pin can cause one or 10 problems. The bed exit alarm is not working. The troubleshooting is the same as for the patient can’t call using the buttons of the bed. Check the bed cable. Next check to assure the bed exit alarm is set. This a very common cause when the bed exit alarm is not working. This is a great opportunity to in-service the clinical staff on how to set a bed exit alarm. Can’t hear the patient or volume is too loud. Check the volume of the pillow speaker and replace if needed. Also, check the volume of the desk console. The unit secretary or nurses can increase or PUBLICATION decrease the volume as needed. Many MEDICALthe DEALER times at night they will decrease volume to keep the noiseBUYERS down. GUIDE This is another great opportunity to in-service MONTH the clinical staff. User error. This is alsoJ a great F M A M J opportunity to conduct in-services for DESIGNER: your patient transport team and JL housekeeping. Many times they just don’t know that the bed cable needs to be connected. An in-service can help them understand how important something as simple as a bed cable can be. The best thing you can do to support a nurse call system is learn as much about the system as possible. Learn what each component does, the wiring and the topography. Become familiar with the manufacturer’s service manual. Check YouTube for nurse call system tips. And if all troubleshooting techniques have been exhausted, contact the manufacturer for support.

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SHOP TALK

Conversations from the TechNation ListServ Q A

What are your recommendations for study material for the CBET?

There is a CBET Review course at the MD Expo this April in Dallas. You can find it at www.mdexposhow.com/ dallas/schedule/.

otherwise, then there is likely an issue with the plunger tip sensor (the springy tip at the top of the injector ram). It likely must be replaced – not a job I would typically recommend be done in the field. I would recommend it be sent to our depot center for repair (we do have loaner injectors available in the interim if required).

A A

I found the CABMET study group to be the most helpful resource when I did my own certification testing (http:// www.cabmet.org/study-group/). They provided good review presentations that were very focused on the certification exam. A good book for the shop is: GE Healthcare – Affinity Reference Guide for Biomedical Technicians, 2010 Edition (may have a newer edition not sure) http://www3.gehealthcare.com/en/ education/education_store/affinity_guide. To purchase: Email geeducation@ge.com. Minimum Order: $99. Preferred payment: P.O. or check.

The CBET Review course offered at MD Expo is by the leader of the CABMET Study Group.

For the MedRad Stellant D, I’m getting a “syringe not docked” on the A side, sometimes I have to reset the syringe 3 or 4 times in order to clear it. Any suggestions?

There is probably contrast in the loading area. There is a block of optical sensors on the side of both the A and B syringe wells, clean or replace.

To be certain – the last action, which must be done prior to arming the injector, is to advance the syringe 3-5mL to ensure it is properly seated/docked. If this step is not done, the error will occur. If

1TECHNATION.COM

MARCH 2016

Has anyone been inspected since the new CMS guidelines for relocatable power taps? How did it go? See Categorical Waver issued by CMS.

We were recently inspected from a state level and had to remove/ exchange some power strips. Remember this is a nationwide OSHA project. CMS enforces what is written but it is a federal guideline for all hospitals. They (the state) also checked areas outside of patient care for space heaters. Space heaters are not allowed in a hospital, any part of a hospital, unless a patient has a written doctor’s order. That doesn’t happen much because the doctor takes responsibility for any incidents with the heater. There are only two approved UL listings for hospital power strips, one for patient care and one for non-patient care. It’s a huge project for most hospitals to become compliant. I think inspections are fairly light right now, but you can pretty much guarantee by 2017 that they will be in full force mode. Prices for compliant power strips have come way down in the last year. I think we are paying $72 per strip now. If anybody has a good resource at a cheaper price than that, pass it along!

We had the same issue from a recent survey, we were able to get a bulk discount from CDWG of $54.60 each. Be advised, since the fire marshall has turned

over LSC inspections to CMS, they have increased their budget and will really be looking for violations.

I have a HDI3500 ultrasound that after turning on gives a white screen and nothing more. The LEDs on board are on and then on PCB (rear) are run as everything is OK.

Software or CPU problem. First you must try to start the machine with the backup MO disk. You can find the MO normaly on the right side. Push the disk in and switch on the device. The system starts now from the disk – if this works the problem is the hard disk or the SW on the HD – if not your CPU board is causing the problem.

As the backup disk does not exist, do you know if I could order it through the Internet? Secondly, I have the service manual of HDI3000. Do you know the differences between it and the HDI3500 that my customer has?

The MO disk is hidden on the right side behind the flap. There are some differences between 3000 and 3500 (power supply, front end) you always need the backup MO disk (options!). Anyway, the CPU board might be bad. If you have a second HDI you can try to swap the CPU board. It is important that you do not swap the B1 chip (looks like a battery). THESE POSTS are from TechNation’s ListServ and MedWrench.com. Go to www.1TechNation.com/Listserv or www. MedWrench.com/?community.threads to find out how you can join and be part of the discussion.

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Ask us how to meet XR-29 standards!

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ROUNDTABLE

Computerized Maintenance Management System

1TECHNATION.COM 1TECHNATION.COM

NOVEMBER MARCH 2016 2014

Computerized Maintenance Management System (CMMS), sometimes referred to as a Computerized Maintenance Management Information System (CMMIS), is a valuable tool for HTM professionals. As technology advances, CMMS is becoming even more important for HTM professionals as they strive to maintain medical devices in health care facilities. TechNation magazine reached out to companies and professionals in the HTM community to find out the latest on CMMS. We asked them to share their insights with readers. Participating in this roundtable article are Sandra Calderon, Senior Systems Analyst at INOVA Health Systems, Falls Church, Virginia, and Senior Consultant at FBC-Tesseract Solution Provider, (SME-Clinical Engineering); Jesse Happ, Eastern Region Director of Imaging Services, Renovo Solutions; Tommy Lee, Chief Technology Officer, Connectiv; Vishal Malhotra, Chief Technology Officer, EQ2; and Ben Mannisto, President and CEO, Phoenix Data Systems.

HOW DOES A CMMS BENEFIT HEALTHCARE TECHNOLOGY MANAGEMENT (HTM) DEPARTMENTS? Calderon: Healthcare Technology Management departments can greatly benefit from implementing a CMMS system in their organization. A CMMS system is a powerful tool that can keep track of all of the organization’s assets, track work orders, maintain asset history, schedule tasks, manage contract administration, and customized reporting. It can also help with regulatory compliance with full audit trails. Happ: A robust CMMS system is the engine for an HTM department. A single solution that can be used by everyone from the customer and the service engineer to

the department to manage regulatory compliance with ease. Mannisto: A CMMS can be a powerful management tool when properly and fully implemented. The CMMS will provide management with a means to achieve regulatory compliance while identifying where remediation is required. Through dashboards and reporting, the CMMS provides managers with information regarding department PM and CM completion, departmental costs, vendor provided services and more.

WHAT ARE THE MOST IMPORTANT FUNCTIONS AND FEATURES TO KEEP IN MIND WHEN PURCHASING A CMMS SYSTEM FOR A HTM DEPARTMENT?

SANDRA CALDERON Senior Systems Analyst at INOVA Health Systems Falls Church, Virginia, and Senior Consultant at FBC-Tesseract Solution Provider

those at the executive level. It is essential. Each area will have its role in the service process. CMMS systems that have the ability to provide online or phone service request/tracking, documentation of the services performed, and financial and regulatory management in a single solution will benefit a HTM department. Lee: Modern CMMS solutions should go well beyond the traditional bounds of just “managing maintenance” and be strategic solutions that improve efficiency and increase visibility at all levels intradepartmentally, inter-departmentally, and enterprise-wide from technicians to operation managers to buyers to executives. Malhotra: The HTM department is the only department in the hospital that has all the critical information required for effective life cycle management of medical devices. With the solid design and architecture of a good CMMS application and the HTM department’s business processes, the HTM department can be one of the key players in the hospital to help reduce the cost of ownership of medical devices and to make a safer environment of care for patients and clinicians. The right CMMS should help bring visibility of the HTM department to the C-suite. It benefits

Calderon: The ability to keep up with the professional’s expectations as they continue to evolve. As well as staying abreast with the new advances in technology. Happ: All of the CMMS systems do the basics. What’s more important to me is technician workflow steps, and the tools to harvest the data. I would also expect my CMMS product to constantly evolve as technology advances. If a product has not had a major advancement within the last two years I would question the product and its future use within my organization. Lee: The most important functions and features are: Reporting/Dashboards – The ease and speed at which users of all roles and responsibilities can get decision data out of their CMMS system is key. Due to variability of reporting requirements, the quantity of canned reports a CMMS system ships with should no longer be the measure of quality for reporting. Instead, HTM departments should evaluate the ease at which users can create reports and dashboards within the CMMS systems they are evaluating. Flexibility/Agility – No two HTM departments run exactly the same way. As such, beyond core CMMS capabilities, HTM departments should evaluate the flexibility of CMMS systems

THE ROUNDTABLE

auto identifying life support, critical – non life support and low-risk devices. It should also have the ability to document tester information along with the tester’s history. A CMMS application should have the capability for two way communication with automatic electrical safety analyzers, electronic recalls/alert integration, managing and tracking Service Level Agreement (SLA), stock management with semi-auto reordering ability, powerful multiple frequency PM scheduling with parts, configurable call escalation based on the hospital’s corporate policy and electronic library support. The support for smartphones and tablets is also critical.

JESSE HAPP

Eastern Region Director of Imaging Services, Renovo Solutions

on the market. Modern CMMS systems need to be malleable enough to meet evolving customer-specific business processes and regulatory requirements without impacting downstream upgrades. Consolidation – With acquisitions of health systems still occurring at a rapid pace, having a modern CMMS system that can quickly onboard new users, assets, locations, etc. is critical. Additionally, modern CMMS systems should be architected with centralized HTM operations in mind. Meaning, data and process should be easily divisible and securable (e.g. by site, by region), as defined by the unique requirements of HTM departments, but also have the ability to quickly provide holistic visibility. Malhotra: A CMMS should provide built-in intelligence for regulatory compliance, like the ability to classify AEM,

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Mannisto: It is important to ensure the quality of user data. Valid data entry is the cornerstone to accurate and required reporting. Additionally, the system should be intuitive and easy to use, offering drop down, valid entry pick lists enabling the user to quickly enter data. The ability to make global changes to large groups of equipment, vendors, work orders and more is a valuable feature that can save time versus hours of manual data entry.

HOW CAN HTM PROFESSIONALS BE CERTAIN TO PURCHASE A CMMS THAT WILL MEET THEIR NEEDS?

Calderon: The CMMS vendor should be able to provide a demo customized to the customer’s needs and wants. By having this demo, you will be able to get the feel of the system and have the ability to tailor it in a way that will be best utilized by your organization. Happ: You have to know your needs first as a department and organization. Identifying a wish list that has input from the clinical staff, risk management,

NOVEMBER MARCH 2016 2014

TOMMY LEE

Chief Technology Oﬃcer, Connectiv

accounting, executive leadership and clinical engineering will help guide the vetting process. Lee: In addition to developing the “here and now” internal business requirements for an evaluation, the answer is community and partnerships. HTM professionals should continue to get to know what their peers are doing in the industry. Also, don’t underestimate the value of vendors that treat the customer-vendor relationship as a mutually beneficial partnership in which they take time to truly understand their customers’ needs, share their knowledge/experience from other customers, and adapt their solution to a customer’s processes instead of a department’s processes and potential being dictated by the tool. Malhotra: HTM professionals should translate their goals into measureable metrics with milestones for short-term and

modern CMMS solutions’ ability to interface with IT in processes where necessary. For example, when a backend change is being proposed to EMR infrastructure, there should be visibility to which devices may be impacted and the process should include the HTM decision makers’ input and approval around factors such as the ideal time for the change to be made.

long-term goals. Then, they should assure that these are achievable by the CMMS application that they are considering. HTM professionals must verify the technological strength of the vendor. One way to verify is to see if they are certified by companies like Microsoft or Oracle (based on the technology the vendor uses for the development). It is also critical to check the customer satisfaction level of the vendor’s current customers (by references and/or by studies published by independent bodies). Finally, make sure that your future vision matches the vendor’s future vision. Mannisto: When purchasing a CMMS, it is important to choose a vendor that offers scalability with respect to users, components and, especially, new technology. Your CMMS should be able to meet your current needs while offering the ability to add to your system as needs increase. The CMMS should include reports that meet your current needs, while consistently providing new reports as regulatory requirements change. Implementing a new CMMS can be an expensive endeavor, so it is important to look at vendor longevity and examine the reasons behind that longevity. Your CMMS should be user-driven to enhance and bring the software forward to meet your needs, rather than the needs of the vendor.

Malhotra: Data inconsistency is a common problem with many CMMS applications as they do not have built-in business intelligence to automate the processes. This limitation of a CMMS application leads to more dependency on technicians for consistent data entry every time, which is difficult if not impossible. A CMMS should have configurable exception reporting tools to help HTM professionals review any inconsistency in data entry, based on the department’s business processes. The HTM department should have a policy to review this exception report on a fixed interval. No reporting tool can provide reliable business metrics with inconsistent data.

VISHAL MALHOTRA

Chief Technology Oﬃcer, EQ2

reducing data entry errors, the mobile solution is proven to enhance performance and improve productivity. In the long run, the system will pay for itself.

WHAT ARE SOME COMMON CMMS CHALLENGES AND HOW CAN HTM PROFESSIONALS OVERCOME THEM?

Happ: A common CMMS problem I run into when consulting with prospective clients is the lack of a standard models database that uses industry standard naming conventions. Too often we run across like model devices input with different model names and device descriptions ex. AMX 4 Plus and AMX 4+. When vetting a new CMMS system I would make sure a model’s database is included and a simple way to input new entries with some kind of validation process.

Calderon: The challenges of wireless devices to access the CMMS system when you’re on the go. The cost, security, and coverage can impact the decision to add mobile/ handheld devices to the workflow. But considering the many benefits, for example, improving efficiency, saving time and

Lee: In addition to challenges around reporting, flexibility/agility, and ease of consolidation addressed earlier, healthcare technology is becoming increasingly dependent on the data network which requires greater collaboration with IT. HTM professionals should evaluate

Mannisto: One of the biggest challenges for department managers is having the appropriate information at exactly the time it is needed. Staying on top of emergency situations – such as all three of your CT machines are down for repair – can be difficult, if not impossible, unless the CMMS has a mechanism to notify managers of those types of situations. Managing labor costs, part costs and contracted service costs are likewise challenging. It is important to be able to justify necessary staffing levels to the C-suite. Implementing best practices can seem like a daunting task, but if your CMMS vendor provides services to implement best practices, operations can be streamlined and more efficient.

THE ROUNDTABLE

HOW HAS THE GROWTH OF MOBILE/HANDHELD DEVICES IMPACTED CMMS?

requests, and the ability for technicians to go paperless. Mobile devices should be able to go offline with no data loss. The use of a mobile device can increase a technicians’ efficiency more than 30 minutes each day by eliminating the need for the tech to return to a workstation to enter data, or to a printer to retrieve new work orders.

Calderon: With the heightened interest of mobile/handheld devices many are seeing the benefits it can bring. Therefore, many CMMS systems have invested in this technology and now offer the option of a mobile solution. Happ: Due to newer mobile technology solutions like tablets, smartphones, and hybrid touch screen laptops with different operating systems, CMMS providers have been challenged to create solutions that are compatible across the board. Also not all service engineers have the same documentation processes. Some technicians like to document on the fly while others will return to their workspace and complete documentation. With that in mind, CMMS providers will need to have a flexible solution that can quickly adapt to the various technologies and work habits. Lee: From my perspective, the effect of handheld devices has not been as dramatic as was once envisioned. While the size profile of smartphones offers a level of convenience, developing flexible user interfaces that can precisely match the experience from desktop to smartphone has been a challenge in the software industry overall. Tablets are also a tempting form factor, but with the evolution of laptops (e.g. Surface Pro, Macbook) that are lightweight, have fantastic battery life, and include a physical keyboard, it’s difficult for tablets to match a laptop’s productivity. However, an area where there has been benefit is in the area of barcode scanning where a smartphone’s camera can be utilized for actions such as asset inventory scans.

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MARCH 2016

WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING A CMMS?

BEN MANNISTO

President and CEO, Phoenix Data Systems

Malhotra: CMMS applications have adopted to the latest technological development of handheld devices like smartphones and tablets and with this capability, the right CMMS now provides real-time, easy-to-use applications that have reduced time for documentation with more consistency in data entry. This has helped in effectively managing the call escalation process along with increased ability to provide real-time reporting and feedback to managers and customers. It also has provided the capability for the technicians to have access to the electronic library (technical manuals, drawings, plans) right in the field. With this advancement, technicians now have all of the information regarding equipment history, parts suppliers, contracts, etc. at their fingertips. Mannisto: Mobile devices have quickly become the current technology, and are a must for any CMMS. Mobile devices meet many needs including real-time notification of newly added work

Calderon: Before purchasing a CMMS system, consider selecting a vendor that has prior experience with the medical field and can provide consistent service and support during all phases of the buying process. Happ: Sometimes the more features that are available doesn’t always mean it’s a superior product. However, with increased medical device integration to IT networks and the introduction of IEC 80001 risk guidelines, I feel it is essential for a CMMS system to play a role in the identification, tracking and risk mitigation of these networked medical devices. Lee: For a variety of reasons, HTM departments are required to be less and less siloed. Therefore, purchasing a modern CMMS is not only for the benefit of the HTM department, but also for the strategic benefit of the organization overall. Your CMMS should be powerful enough to meet your requirements without compromise while, at the same time, being able to provide C-level executives the visibility needed to support and evolve the business. Malhotra: Proactive maintenance is not a dream anymore. The ability of a 21st

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EQ2 HEMS: CMMS For Biomed and Facilities Looking for a CMMS?

Or have one but still face challenges getting actionable data for the following?

• • • •

Preparing for compliance inspections Knowing what equipment to replace and when Managing work orders and parts inventory Reports and Dashboards for proper analysis

Help is available! EQ2 is offering TechNation readers a free CMMS readiness assessment to help you examine your organization’s readiness to meet these types of challenges.

Mannisto: There are five things to consider when purchasing a CMMS: stability and longevity of the vendor; guaranteed software evolution to keep up with changing technology and regulatory agency requirements; superior technical support; quality and integrity of data converted from legacy system; and attentiveness and responsiveness of the CMMS vendor.

Go to : www.eq2llc.com/cmmsready/technation for your free assessment!

888-312-4367 | www.eq2llc.com

PUBLICATION MEDICAL DEALER BUYERS GUIDE

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THE ROUNDTABLE

TRIM 4.5”

century CMMS for interoperability with medical devices, using open standard architecture like IHE PCD (HL7), helps reduce downtime by proactively monitoring medical devices and auto-creating repair work orders for faults/issues before even noticed by clinicians. The technicians are auto-notified for these issues. CMMS applications should also have the capability for RTLS integration. The application should provide tools to quickly review and balance the annual PM load. It should help indicate if you need more FTEs based on corrective and preventive workload projections and have the capability to import inventory from Excel and tracking capability of all updates, additions and deletions.

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THE TRUSTED LEADER I N B I O M E D I CA L D E V I C E R E PA I R S I N C E 1 9 8 9

Expect More with BMES: QUALITY . SPEED . SERVICE

BY K. RICHARD DOUGLAS

Would you like to... earn more money this year than you did last? Is taking the next step up the career ladder one of your goals for this year? Would you instead be happy to just be seen as a more valuable asset by your employer? All of these questions have one common attribute; they are all premised on some action on your part. 50

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MARCH 2016

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THAT HELP HTM PROFESSIONALS GET AHEAD

s in any career field, any profession, the means toward advancement or security is often based on the actions taken by the employee to get better, more knowledgeable or more competent at what they do.

For healthcare technology management professionals, the quickest route to getting ahead, beyond solid job performance, is to beef up your knowledge through education, training or certification. These things all create more value to an employer, more knowledge and greater competency. Through the efforts of AAMI, the many great biomed education programs around the country and specialist recruiters, biomeds new to the field, along with seasoned veterans, can all find resources to advance their careers. It is just a matter of tapping into these resources to get started toward a more rewarding year. Steven J. Yelton, PE, CHTM, professor/professor emeritus at Cincinnati State Technical and Community College, recently provided an overview of AAMI’s educational offerings. “AAMI has developed a vast array of ‘tools’ to help educational programs as well as employers and students, determine strengths and weaknesses. AAMI offers many documents including ‘Core Competencies for the Biomedical Equipment Technician,’ ‘AAMI Career Development Guide’ and the ‘BMET Study Guide.’ In addition, AAMI University offers continuing education, and now BMET program accreditation assistance is offered. AAMI’s board feels that this will help to enhance AAMI’s commitment to biomedical education.”

Yelton teaches biomedical instrumentation courses. He is also a member of AAMI’s Board of Directors, AAMI’s Foundation Board of Directors, Vice Chair of AAMI’s Technology Management Council, Chair of AAMI’s HTAC committee and is a member of the ABET Board of Delegates. In the TechNations “Future” column, Yelton said that the “Core Competencies for the Biomedical Equipment Technician” guide is a great resource for educational institutions, BMETs and employers. A committee of diverse individuals from the HTM field developed this document. The Core Competencies guide will be updated and examined to assure that it contains current information. The guide is complete to the associate degree or entering technician level with plans to expand it in the future,” he says. CERTIFICATION BASICS There are approximately 7,000 biomeds who hold the CBET certification. In 2015, two new certifications were added to the mix of certification exams. AAMI, through the AAMI Credentials Institute (ACI), offers numerous resources to help those investigating certification as a career enhancement option. According to the AAMI ACI Certification Candidate Handbook; “Achieving ACI Certification indicates

that certification candidates have demonstrated a broad knowledge skill-set in the specific certification area, general biomedical technologies, clinical laboratory technologies and medical imaging technologies, including regulatory requirements.” “The ACI certification programs recognize healthcare technology management professionals whose practice reflects a high degree of knowledge about medical devices and clinical practice as well as skill in implementing electro-mechanical talent in the repair and maintenance of devices used in the delivery of health care,” says Sherrie Schulte, CAE, director of certification programs at AAMI. ACI awards certification in five areas: Certified Biomedical Equipment Technician (CBET), Certified Laboratory Equipment Specialist (CLES), Certified Radiology Equipment Specialist (CRES), Certified Healthcare Technology Manager (CHTM) and Certified Quality System Manager (CQSM). Schulte says that “each program requires an application and registration form fee. Candidates must meet the eligibility requirements of the individual certification program. Testing candidates must successfully pass a comprehensive closed-book exam that covers a particular area.” She also points out that once a person has become certified, they must maintain the certification by completing a continuing practice journal every three years to show that they continue to educate themselves and stay up-to-date in current practices within the industry. Three of the exams have become very familiar to most BMETs, as well as to those working with lab equipment and imaging technicians. The CBET, CRES and CLES certifications are geared toward those with a predetermined amount of experience already.

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SHERRIE SCHULTE CAE, director of certiﬁcation programs at AAMI

The ACI certiﬁcation programs recognize healthcare technology management professionals whose practice reﬂects a high degree of knowledge about medical devices and clinical practice as well as skill in implementing electromechanical talent in the repair and maintenance of devices used in the delivery of health care.”

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Those taking the CRES certification test should have experience with “a wide-range of medical imaging modalities.” Likewise, those testing for the CLES certification should have “experience with a wide-range of clinical laboratory devices,” according to AAMI. Training for CBET certification even finds its way into the formal curriculum of degree programs. “From my perspective, my students are really only focused on the generic certification, CBET,” says Barbara Christe, Ph.D., program director for the Healthcare Engineering Technology Management program, and Associate Professor in the Engineering Technology Department at the Purdue School of Engineering and Technology at Indiana University-Purdue University in Indianapolis. “The other options require more specialized training. As a result, we discuss the CBET exclusively. We actually start in the first course in the curriculum and show them the breakdown of topics (anatomy and physiology, safety, electricity, technology [devices], problem solving, and IT),” she says. “We compare our curriculum to these sections to show the students what course content will be critical to save and archive for preparation for the exam,” she says. “This promotes students saving exams and text books. I urge students to take the exam as a candidate as soon as they are eligible — typically November for May grads.” Christe says that by taking the exam right away, the electronics, A+P and other recent preparation is fresh. She says that alums of the program report that the information gets rusty the longer they wait. “In addition, in my experience, students who study/prepare for the exam pass and students (even A stu-

dents) who do not prepare, don’t pass. Reviewing the course materials seems to be a successful tool for my alums,” she says. “In addition, we use the certification sample questions (available for purchase through AAMI) as questions on exams, especially in the last class that focuses on troubleshooting,” Christe says. “This approach offers students the ability to know the knowledge level expected for the exam.” For managers, who are responsible for other HTM professionals who report to them, there is the Certified Healthcare Technology Manager (CHTM) certification. This is one of two newer certifications that were made available last year. The certification covers the management of operations and also of personnel. AAMI says that “the manager is also expected to have the skills and understanding needed to perform strategic, business, and change management as well as employee relations.” Certification shows knowledge in all of these areas or responsibilities. The other new certification now available is the Certified Quality System Manager (CQSM). “The CQSM certification goes beyond assessing knowledge of standards and regulation,” Schulte says. “It is based on a holistic view of the roles and responsibilities of experienced quality system professionals and how they contribute to better, safer products.” AAMI says that “quality system managers oversee all aspects of quality assurance including establishing metrics, applying industry best practices, and developing new tools and processes to ensure that quality goals are met.” What is the cost? “The cost of an AAMI exam ranges from $350-$500 depending on AAMI membership and the individual

RESOURCES

THAT HELP HTM PROFESSIONALS GET AHEAD

exam,” Schulte says. “Once certified, there is a renewal fee due every three years that ranges from $100-$150 for one certification.” THE CLASSROOM “As a college HTM program, we are currently receiving numerous requests for training in the area of CE-IT from both employers and students,” says Yelton. “This is the integration of Clinical Engineering and Information Technology. CE-IT is a very ‘hot’ area in Clinical Engineering/HTM departments.” Yelton says that some of those requests for additional training are in the area of healthcare information technologies. He says that the training explores everything from how medical devices are connected to a network and cybersecurity to how the entire IT infrastructure of the hospital is constructed and how clinical engineering is affected. “This is an area where the senior level personnel may not have training unless they have sought it out recently,” Yelton says. “Some of our recent graduates are trying to attain CE-IT training in order to give them some sought after skills when entering the job market.” “Life-long learning in this profession is perhaps even more important than other engineering disciplines because of the evolving nature of medicine,” Christe says. She says that at the Purdue program, they keep this in mind and “educate students on the opportunities for professional development and lifelong learning, including professional society membership.” “We explore the need to connect with other professionals in the field (especially important in smaller, rural hospitals where staff members are few),” she adds.

STAYING UP TO DATE Getting a formal biomed degree, prior to entering the field, may be only half of the education and training equation. Like any profession, which changes and evolves, the need for continuing education and broader knowledge are realities that keep biomeds on their toes. There are many sources available for keeping HTM skills relevant and updated. AAMI, Fluke Biomedical and TechNation provide access to ongoing training, along with many other educational sources. “Advantage Training from Fluke Biomedical and Unfors RaySafe is designed to ensure a good understanding of medical device quality assurance, the minimum performance and safety standards and other sources of requirements for testing, and expected test results. In addition, it provides why and how testing helps manage risks to patients based on how the medical devices in a medical facility are maintained,” explains Jerry Zion, global training manager/product manager for Fluke Biomedical Education and Training. “In the near future, we will be adding a course in ‘Why Metrology Matters’ in Medical Device Quality Assurance. This knowledge of metrology, and why it matters, helps with risk mitigation and proper up-keep of test instruments and the medical devices themselves,” he says. A certificate of completion is provided for each of the courses offered via Fluke’s Advantage Training Center. Zion says that they teach the “background and the proper use of our test instruments in doing medical device quality assurance testing, and calibration verification. We do not teach specifics of how to repair any particular medical device. That subject matter belongs to the medical device manufacturer.”

STEVEN J. YELTON, PE, CHTM Professor/professor emeritus at Cincinnati State Technical and Community College

As a college HTM program, we are currently receiving numerous requests for training in the area of CE-IT from both employers and students. This is the integration of Clinical Engineering and Information Technology. CE-IT is a very ‘hot’ area in Clinical Engineering/ HTM departments.”

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JAYME McKELVEY Webinar marketing manager at MD Publishing

We are working with biomedical departments in Guyana, St. Lucia, The Philippines and other international locations to provide access to training they would never be able to receive.”

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MARCH 2016

Zion says that mastery of the courses and topics Fluke teaches demonstrates an interest, enthusiasm and commitment to HTM as a career. He points out that an “understanding of medical device quality assurance best practices is transportable from one employer to the next. Wisdom, as to how this understanding is applied, is valuable to any medical facility, medical device manufacturer or third-party service provider,” he adds. The self-served training from the Advantage Training Center is free of charge, Zion says. It just requires registration for access. “We offer longer on-location training, frequently with hands-on, instructorled laboratories, which may be billable (i.e., have a participation price-tag). The self-served and on-location training are currently being evaluated by some of the universities and training schools in ASEAN as add-ins to their current curriculum, and may become accredited to the extent they become part of an accredited program offered by that academic center,” Zion says. “Most people will benefit from self-served training to meet their need. This becomes part of what one invests in acquiring test instruments from Fluke Biomedical and RaySafe,” he adds. Access to the Internet is a conduit to a wealth of information, along with on-location training. “Now in its third year, TechNation’s Webinar Wednesday has quickly established itself as a popular educational resource for HTM professionals,” says Jayme McKelvey, who is the webinar marketing manager at MD Publishing. “Webinar Wednesday is a byproduct of our successful biannual MD Expo. We often asked ourselves how we could provide the same caliber of education

that MD Expo is known for in a format that makes it accessible to the individuals unable to attend our shows. I think we found the best answer by creating the Webinar Wednesday series in 2014.” McKelvey says that she is amazed by the rapid growth in participation of Webinar Wednesdays. Feedback remains very positive as well. “In 2015, we had over 4,200 individuals participate in our webinars, and we provided 2,122 certificates for continuing education,” she says. “We are working with biomedical departments in Guyana, St. Lucia, the Philippines and other international locations to provide access to training they would never be able to receive.” She says that the webinars are creating a valuable library of preventative maintenance, service and product information, that are then provided online for on-demand viewing. “Most of our webinars are eligible for 0.1 CE credit from the ACI and typically run 60 minutes, including live Q&As with our presenters,” McKelvey adds. This year, the number of webinars will increase. There are 20 scheduled, meaning that there are at least 20 opportunities to earn valuable CE credits from the convenience of a computer, laptop or smartphone. GETTING INVOLVED There are HTM associations and societies from coast to coast. There are many benefits to participation and joining a local group can be a great way to further one’s career. Networking is one obvious benefit, but most groups also offer training opportunities, certifications training and presentations by representatives from OEMs. National organizations also present many great opportunities for getting involved.

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“Participation in AAMI, NESCE (New England Society of Clinical Engineering) and CEAI (Clinical Engineering Association of Illinois) have all proven invaluable to my professional development. The networking alone has allowed me to make connections that have helped my career and others in the process,” says Barrett Franklin, MS, CCE, manager, Clinical Engineering Service Line, VA New England Healthcare System (VISN 1) in Bedford, Massachusetts. Franklin says that getting involved with many HTM organizations, like AAMI and NESCE, can also lend a voice to his local counterparts, because his viewpoints and opinions “have been developed through my interactions, experiences and lessons learned from and alongside them.” Franklin is also a member of AAMI’s Technology Management Council. “Being a society leader is challenging, but it has paid back in spades; it’s given me opportunities to work on public speaking, leadership and at times management, often in a forum much less intimidating then in my work environment. If you make a mistake people recognize you’re a volunteer and that you’d welcome their help,” Franklin says. Membership with AAMI allows HTM professionals to have access to high-quality education programs, subscriptions to AAMI publications, access to an online community of experts, industry events, an opportunity to participate on committees that develop standards and posting a resume for free on AAMI’s Career Center. “AAMI membership is an important asset every healthcare technology professional should have at his/her disposal as they chart their career progression,” says Sabrina Reilly, vice president of Membership and Marketing at AAMI.

“Having a voice within AAMI’s community of more than 7,000 professionals devoted to advancing the safe and effective use of healthcare technology is crucial for staying on top of emerging trends and leading practices in the field as well as connecting with others,” she adds. Reilly says that AAMI offers members significant discounts on a wide variety of benefits that provide opportunities to boost one’s skill set, enhance their resume and give them visibility among their peers. “Both within AAMI, and outside of AAMI, there are lots of opportunities for HTM professionals to get involved in the greater HTM community,” says Patrick Bernat, director of healthcare technology management at AAMI. “Many of AAMI’s brightest and best volunteers started out by volunteering for, or holding offices, in their local HTM associations. Local associations typically have a leadership structure, and also have ancillary positions such as webmaster or newsletter editor,” Bernat says. Bernat adds that within AAMI, opportunities include mentoring, writing and reviewing articles for AAMI publications, blogging, participating on HTM-related committees, participation in the standards-development process, and joining online discussion groups, just to name a few. He adds that there are also a number of HTM-related humanitarian efforts that do amazing work and that can always use more help. With that said, it’s time to get involved in HTM anywhere you think you can make a difference. And, as a means to get ahead and further your career ambitions, there are plenty of training and continuing education opportunities to meet any goal you may have as an HTM professional.

BARRETT FRANKLIN MS, CCE, manager, Clinical Engineering Service Line, VA New England Healthcare System

Participation in AAMI, NESCE and CEAI have all proven invaluable to my professional development. The networking alone has allowed me to make connections that have helped my career and others in the process.

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CAREER CENTER By Todd Rogers

or a lot of people, the idea of their boss taking another job can be grounds for celebration; the mean old ogre is finally going to live in a new forest. In my case, it’s a different story entirely. Today being Wednesday, my current boss’s two week notice comes to a close the day after tomorrow and I’m a little uneasy about it. Mostly, I’m upset because this is the second time in my life that this person has been my boss and both stops have been both challenging and fulfilling. In total, we’re talking about just a little less than nine years that she and I have worked with one another. I am happy for her and a little sad for me. But alas, the work must continue to get done. Since we’re losing a leader and I am the next most senior person on the team, in a mere 48 hours it will be my job to make sure that the work does in fact continue to get done. For two weeks now, I’ve done quite a bit of thinking about what this means. Here’s a brief set of suggestions that may serve as a survival guide should you unexpectedly find yourself promoted from first mate to captain. TODD ROGERS Talent Acquisition Specialist for TriMedx, Axcess Ultrasound eProtex and TriMedx Foundation

“ Since we’re losing a leader and I am the next most senior person on the team, in a mere 48 hours it will be my job to make sure that the work does in fact continue to get done.” The emotional jolts continue to be daunting at times. But, emotions are temporary. At least they should be for most of us. I didn’t actually learn this life lesson until I was in my 30s and I really wish someone would have taught me that when I was a teenager. Nevertheless, I’ve been visited by fear a few times in the last couple of weeks.

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Other emotions have shown up but fear seems to be the most frequent uninvited guest of all. I can only assume that other people, when put in my circumstances, would also experience fear. Each time I felt that tingle, I let the feeling run its course and then I did some analysis. What was the origin of the fear? I made a list and it is short. What if I mess this up? That was the theme of the things on my list. The translation of the theme is almost silly: I’m going to try to make this work and I’m going to do smart things. What if that isn’t enough? What if I am just not that good? I suppose anyone in my situation could have their own set of thoughts if put in this situation. Mine centered around failure. About an hour later, I found myself thinking about the failure and I made a decision: I would work hard and do smart things unless I could observe that things weren’t going favorably. Then, I would make changes if the situation called for it. It occurred to me that with a productive member of the team now gone, the work remained and someone would need to do it. Not all of it will

get done. The next best thing to results is effort. Effort is easily overlooked when stakeholders are anticipating completion. When effort doesn’t produce desired results, it’s critical that stakeholders be frequently reminded of the efforts. Can’t give them output? Then let them see the input, repeat. Just be sure to limit yourself from accepting

Monday-morning-quarterback advice. You have a job to do and while being under-resourced, transparency is critical. Becoming someone’s errand-boy might seem like a cordial way to earn friends but it’s an invitation to dismissal. Along with judiciously communicating to stakeholders, I also go out of my way to make sure that my interim boss is kept well informed. If stakeholders don’t get what they are expecting and can’t get a remedy, they do what anyone else would do: they escalate the grievance. Don’t let the interim boss be on the receiving end of an escalation and that be the first time the interim boss hears about it. You want your most powerful ally to find out from you. The final tip relates to innovation. Acting as an interim boss also comes with at least a little bit of opportunity. If carefully planned, communicated, and executed, you have a chance to implement something new. If there are processimprovement opportunities, now might be the time to explore one. My only word of caution is, whatever you select that you want to improve, try to keep it on the simple side for your first go-around. I’d also recommend being absolutely certain that you get buy in from others and that you know in advance that it will truly make something good out of something that is currently just OK. Finally, do your best. It is not an easy time and others know that. Teamwork is vital and this is an opportune time to enlist the help of others to distribute the workload. A win benefits everyone. So, there you have a few tips for how to deal with a situation almost everyone will face at some point in their career. I hope it helps.

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ransesophageal Echocardiogram (TEE) probe usage and damage can be the single highest cost associated with ultrasound today. The complexity of the device coupled with the density of components throughout necessitates a very small thus fragile assembly. There are times when TEE transducers do wear out but in the majority of cases, malfunctions and damage are caused by mishandling or not caring for the device properly.

MATT TOMORY EVP of Marketing & Sales, Conquest Imaging

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MARCH 2016

Let’s start with TEE care/usage 101: USE A BITEGUARD! I understand there are many different types of personnel who operate a TEE probe and some of them can be stubborn about being told what/how to do something but using a biteguard is the single, easiest, most cost-effective way to prevent damage. I have been told “the patient is out and cannot bite” but reflexes beg to differ and even dragging a lens, bending rubber or insertion tube over sharp teeth can and will cause damage. TEE probes are typically soaked in a caustic chemical solution for high-level disinfection but ensure the probe is only immersed from the tip to about 1-2 centimeters before the strain relief on the handle. From this point to the connector, only an approved disinfectant spray or wipe should be used. When using a chemical soak, ensure several items: the chemical is approved by the manufacturer of the transducer, appropriate soak times (set by the manufacturer of the disinfectant) are adhered to and the probe is thoroughly rinsed after soaking. Prior to disinfecting, the probe should be inspected from the tip to

the handle for any nicks, cuts or pinholes; these are relatively easy and inexpensive repairs for us. If any defects are found, remove the probe from service immediately for safety and damage mitigation. If a compromised probe is soaked, fluid intrusion will occur and the damage/ cost increases exponentially. Storing TEE probes should also be addressed; probes should be hung vertically in protective tubes with tip guards installed. If a probe is temporarily stored on a flat surface, never coil the insertion tube tighter than 12 to 14-inches in diameter. The Intersocietal Accreditation Commission (IAC) has set new standards for TEE testing as well. As of December 31, 2015, all probes must be tested for electrical safety between each use. Again, thoroughly inspect the probe prior to testing for integrity breaches to avoid possible fluid intrusion. The recommendations presented here are a good start in preventing or limiting TEE damage but the subject goes much deeper than this space permits. If you wish to discuss this further, please contact me at mtomory@conquestimaging.com.

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THE FUTURE

Replenishing the Ranks Continued By John Noblitt

ver the past several years there has been quite a bit of conversation about replenishing the ranks in this career field. Many industry leaders such as AAMI have highlighted this growing concern and AAMI has made YouTube videos highlighting this career field. As many of the early biomed professionals have begun to retire and many planning to retire in the next several years this is a very valid concern for the HTM career field. I have written in the past about the lack of students coming into the field and have asked each of you to help by steering any potential candidates to a reputable school for training. This training of the new ranks, however, will be much different this time around – as it always is.

JOHN NOBLITT MA.Ed., CBET BMET Program Director, Caldwell Community College

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The changes are apparent when you look at the use of technology in the classroom over the last 50-plus years. I look back at how my professor was trained. The technology he used was a slide rule, a Simpson meter and an oscilloscope. About 25 years after him I was trained using calculators, DVMs and a Radio Shack TRS-80 computer. Since then we have had an explosion of technologies that have found their way into the classroom. The biggest technology advancement we have seen in the educational world is the Internet and all the information that can be accessed in the learning environment. This technology was not very easily accessible when we only had a dial-up connection, but Wi-Fi and the ability to stream video means we can use it every day in the classroom. Over the past two years, I have experienced a new trend in education. Educators refer to it as dual enrollment. A dual-enrollment student is a high school junior or senior who takes college courses at the local community college. These students receive credit for their high school requirements and also receive credit toward a college degree. It is a wonderful benefit to these students, but it seems the younger the student the more the Internet comes into play regarding education.

I pride myself in trying to use different technologies in the classroom and really enjoy using YouTube and other resources to enhance the learning experience. I like using the TechNation Webinar Wednesdays series to bring new information to second-year students in the BMET program. I also use other online resources like Fluke training videos found on the company’s website. However, after two years of teaching these younger students it is apparent to me that my use of technology in the classroom must be upgraded. If I want to capture the attention of today’s youth I must integrate their smartphone into the classroom. This is a major change in the world of educators as phones in the classroom has been taboo for many years now. I know of colleagues that have a no cellphone policy in their classrooms, but they always complain about how students are always texting or updating their social website instead to paying attention to the class materials. Over the years, I have seen many instructors struggle with a phone policy. These policies have included everything from turning in cellphones at the beginning of class and picking them back up at the end of class to no use of cellphones in class. Another policy is for students to make sure their phones are silenced

U l t r a s o u n d

P h a n t o m s

during the class and requires students to step out of the room if they must receive or make a call. This spring semester I have begun to integrate smartphone technology in one of my classes and more than likely will expand into other classes. The way I see it, if the students are going to be on their phone anyway I might as well integrate learning materials in that format. With most websites today the display will resize to whatever device you access the site with. So instead of fighting the new wave of technology in the classroom I am going to embrace it. One article I read about ATS exceeds the technical standards smartphone integration into the classroom talked about using required by ACR an app called Remind101. This instructor stated that after using this app homework assignment participation went up dramatically. The instructor said he had always just assumed the students were lazy and didn’t do their homework when in • Multipurpose actuality it appears they just forgot. A reminder on their • Doppler Flow cellphone is all it took to get better participation. An app I • Contrast Detail have started using is polleverywhere. This app allows me to poll a class to get immediate feedback about many classroom • Custom Designed activities which allows me to modify course material for better retention.APPROVED The students seem to CHANGES love it as participation is PROOF NEEDED virtually 100 percent. So, SIGN–OFF: if you take a class or see a class and the instructor ATS Laboratories, Incorporated CLIENT begins class with “Break out your smartphone” don’t be www.atslaboratories-phantoms.com alarmed, it’s just the new slide rule. THE FOLLOWING ARE CORRECT PLEASE CONFIRM THAT atslaboratories@yahoo.com

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The Secrets of a Useful CMMS By Patrick Lynch

find that many departments are not documenting their work very completely these days. There are many tips and tricks to making your CMMS work for you. But it all starts with getting good, consistent information into it. Here is a memo I sent to my staff in January 2004. It was instructing them how to document their time, with documentation goals, and reasons why we need complete history records. The entire memo is just as applicable today as it was 12 years ago. I hope you’ll read it and adopt some of the thoughts in it, if you haven’t already. DOCUMENTATION OF ACTIVITIES AND COSTS IN THE CMMS It is important that all activities concerning patient care equipment be documented in the CMMS. There are several reasons for this among them are: • Risk Management – to document scheduled and unscheduled maintenance activities in the case of an incident; • “Lemons” – to identify equipment that is costing the hospital an unusual amount of money and/or time to keep operational and to identify lemons;

PATRICK K. LYNCH, CBET, CCE

• Financial – to enable accurate costs of operations to be calculated for various departments, programs, hospitals and other ventures of Northside Hospital for purposes of budgeting and/or chargeback; • Human Resources – to prove to administration that staff time is being used wisely, and to provide documentation when additional staff is required; and • Servicing Decisions – to evaluate the effectiveness of outside service versus in-house maintenance of various items. Examples of documentable activities include: • Preventive or Scheduled Maintenance,

1TECHNATION.COM

MARCH 2016

which might consist of electrical safety testing, calibration, performance verification, and output testing; • Repairs which might include adjustment, replacement of broken or damaged parts, calibration, or cleaning. Repair time includes incoming inspection, which may include assembly; in-service; education to staff; and anything else related to equipment, or to the use of your time.

HOW TO DOCUMENT YOUR TIME Time in the CMMS must be documented in the following order, with the first being the most desirable: • Against an ID number which is physically attached to a piece of equipment. This is always best if the activity is related directly to that item. • Project Number – major projects will be assigned a project number beginning with the letters PR. • System Number – All items which are classified as Systems will be assigned a System ID Number. Assign work performed on the ENTIRE system, or work which cannot be accurately assigned to one component. • Against a ZZ number. The ZZ numbers are the “catch-all”

TRIM 2.25”

INJECTOR SUPPORT & SERVICE

• Non-work order number – Assign activities which defy categories A, B or C above. This will be PTO, education, or other non-equipment related work. Timing – All activities for a month must be entered by the 10th of the next month.

GOALS Our goal is to document everything done to equipment. All operator errors. All monies spent. All training we give or receive. All of our hours. People with management responsibilities will be excused from much of the documentation requirements. Speciﬁc goals BMET I – At this level, most work should be equipment related. Typical documentation should be above 80 percent of paid hours. Of this 80 percent, half (or 40 percent of the total) should be direct equipment hours (PM or repair or project). The rest should be parts management, training, PTO, etc. BMET II – This position too is largely task oriented. Documentation should be above 80% of total paid hours. Of this 80 percent, three-fourths (60 percent of the total) should be direct equipment hours (PM or repair or project.) The rest may be training, education, in-service given, or PTO, etc. BMET III – This position involves lots of walking and travel throughout

the facility, and to other sites. Documentation should be above 80 percent of paid hours. Of this 80 percent, three-fourths (60 percent of the total) should be direct equipment hours (PM, repairs, or project). The rest may be training, education, in-service given, or PTO, etc. Specialists (Lab, Anesthesia, Imaging Engineer, Senior Imaging Engineer) – Documentation should be above 80 percent of paid hours. Of this 80 percent, two-thirds (50 percent of the total) should be direct equipment hours (PM, repair or project.). The rest may be training, parts management, in-service, or PTO, etc. Supervisors (Biomedical or Imaging) – Since these positions have significant supervisory and strategic responsibilities, goals for these will be established individually. PUBLICATION Everyone will document all MEDICAL DEALER equipment-related activities. TECHNATION BUYERS GUIDE OTHER

MONTH FINANCIAL No equipment may be moved between facilities J without F M updating A M Jthe JCMMS A S and completing the proper transfer JL formsDESIGNER: for the accounting department. All costs will be collected in the CMMS. This includes in-house labor; parts (from stock or special order); PM kits and parts; service contract labor; fee-for-service PMs; fee-forservice repairs; and costs associated with equipment sent out for repair. Responsibilities for input of costs: Each BMET or Engineer – In-house labor and parts installed by the biomed department, whether in a repair, project or during a PM. Secretary – Service contract costs, FFS PMs, FFS repairs and items sent out for repair (scopes, etc.).

TRIM 4.5”

numbers. Each department or cost center had a ZZ number. It is identified in the CMMS as “Department Note.” All activity which is related to a cost center, but maybe not applicable to an item of equipment may be documented against the ZZ number.

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EXPERT ADVICE

THE ROMAN REVIEW The Sentence By Manny Roman

uthor Daniel Pink speaks of an incident that may or may not have occurred in the 1960s in President John F. Kennedy’s oﬃce. Playwright, Congresswoman and Ambassador Clare Booth Luce was concerned that Kennedy was attempting to accomplish too many things so she said, “A great man is a sentence.” The president asked what that meant.

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

1TECHNATION.COM

MARCH 2016

She explained that great leaders did not attempt to do a big number of things. They tried to do one or two big transcendent things. Any great leader that accomplished a worthwhile cause could be described in one sentence. Lincoln: “He preserved the union and freed the slaves.” FDR: “He lifted us out of a depression and helped us win a war.” As I thought about my sentence, I realized a few things. First, when we are very young, our sentence can only describe a dream or an aspiration, a vision. It can’t really describe who we are yet because we are not who we will become. It is said that a vision without a task is a daydream. Therefore, to accomplish our vision, we need to have a plan, a course of action and implement it towards that vision. We are now in the process of building our Sentence. In the middle stages of our life, our Sentence is being modified and sculpted by external and internal forces. If we can maintain our vision and the attendant task we are on track with our Sentence. During this critical phase of our development, we are finely tuning our Sentence. We are working under the constraints and objectives of our employment and other circumstances. In the later years of our life, our Sentence should be pretty well defined.

We may have been able to greatly influence our Sentence. We may have developed the ability to make choices that lead to our desired Sentence. In this case we would feel that we had a rich and rewarding life. Maybe other forces had the greater impact and our Sentence is nothing like we wanted or expected. Our life may prove a disappointment and be a cause of bitterness and anger. A third, and more likely option, is that a combination of the two is true in which case we may have some regrets and some joy. All this assumes that we had a vision to begin with and we attempted to implement actions to arrive at that vision. I suspect that, when young, most of us did not have a clear vision of what we wanted to achieve in life. I don’t mean the vision of becoming “rich and famous.” I am talking about something that includes real achievement; a guiding light for your life. Does anyone really want their defining Sentence to be, “He made a billion dollars?” As for me, I never had a true vision of what I wanted to achieve or be. Through a series of fortunate events, I am relatively comfortable with what I have become. I believe that I have brought value to the lives of others and have left many better for having known me. Maybe that is my Sentence. An interesting thing about the Sentence is that although the achievement is mostly in your control, the actual Sentence can only be deduced and spoken by others. Sometimes the sentence is not clear until you have passed on. I find it interesting that once someone is gone, how others view them softens. I suggest that no matter what age you are, you take a few minutes to describe your present Sentence and determine if you are headed in the desired direction toward your end Sentence.

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RSTI EXCHANGE RR S TS IT IE XE CX H CH A NA N GG EE RR S TS IT IE XE CX H CH A NA N GG EE // Visit RSTI Exchange Online and Shop Our Full Line // //Visit Visit RSTI RSTI Exchange Exchange Online Online andand Shop Shop OurOur FullFull Line Line // //of Visit Visit RSTI RSTI Exchange Exchange Online Online andand Shop Shop OurOur FullFull Line Line Pre-owned Equipment of of Pre-owned Pre-owned Equipment Equipment of of Pre-owned Pre-owned Equipment Equipment // Ask About Our On-Demand Service, Parts // //AskAsk About About OurOur On-Demand On-Demand Service, Service, Parts Parts // //Installations AskAsk About About Our Our On-Demand On-Demand Service, Service, Parts Parts and Tech Support in Conjunction Installations Installations andand Tech Tech Support Support in in Conjunction Conjunction Installations Installations andand Tech Tech Support Support in in Conjunction Conjunction with Parts Purchases with with Parts Parts Purchases Purchases with with Parts Parts Purchases Purchases // Access a Constantly Expanding Inventory of Parts // //Access Access a Constantly a Constantly Expanding Expanding Inventory Inventory of of Parts Parts // //in Access Access Constantly a Constantly Expanding Expanding Inventory Inventory of of Parts Parts Stockafor Most Manufacturers and Modalities in in Stock Stock forfor Most Most Manufacturers Manufacturers andand Modalities Modalities in in Stock Stock forfor Most Most Manufacturers Manufacturers andand Modalities Modalities // Call 440.349.4700 or Email // //Call Call 440.349.4700 440.349.4700 or or Email Email // //Sales@RSTI-Exchange.com Call Call 440.349.4700 440.349.4700 or or Email Email for Full Details Sales@RSTI-Exchange.com Sales@RSTI-Exchange.com forfor FullFull Details Details Sales@RSTI-Exchange.com Sales@RSTI-Exchange.com forfor FullFull Details Details

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1TECHNATION.COM

THE VAULT

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-march-2016. Good luck!

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

LAST MONTH’S PHOTO A LionHeart Physiological Patient Simulator from Bio Tech Instruments submitted by the late Myron Hartman To find out who won a $25 gift card for correctly identifying the medical device, visit www.1TechNation.com.

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MARCH 2016

BREAKROOM

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1TECHNATION.COM

BULLETIN BOARD

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

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MARCH 2016

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BREAKROOM

ALPHABETICAL INDEX Alpha Source ……………………………… 29

Global Medical Imaging …………………… 2

Quantum Biomedical ……………………… 48

Ampronix …………………………………… 6

Gopher Medical …………………………… 61

Rieter Medical Services …………………… 61

ATS Laboratories, Inc.……………………… 63

Health Tech Talent Management, Inc …… 59

RTI Electronics …………………………… 35

BC Group International, Inc. ……………

ICE/Imaging Community Exchange ……… 39

RSTI ………………………………………… 67

BETA Biomed Services, Inc. ……………… 39

iMed Biomedical …………………………… 61

Southeastern Biomedical ………………… 71

BMES/Bio-Medical Equipment Service Co. 49

Injector Support and Service, LLC ………… 65

Southwestern Biomedical Electronics …… 7

Conquest Imaging ………………………… 11

Integrity Biomedical Services, LLC………… 63

Stephens International Recruiting Inc. …… 59

Cool Pair Plus ……………………………… 69

InterMed Group …………………………… 37

Technical Prospects ………………… 17, 35

Doctors Depot

…………………………… 22

J2S Medical………………………………… 29

Tesseract

ECRI Institute …………………………… IBC

KMA Remarketing Corp. …………………… 21

Tri-Imaging Solutions ……………………… 56

………………………………… 48

Ed Sloan & Associates …………………… 69

Maull Biomedical Training LLC …… 14-15, 71

USOC Bio-Medical Services ……………… 16

Elite Biomedical Solutions ………………… 3

Pacific Medical LLC ……………………… 8

TechNation Webinar Wednesday ………… 37

Engineering Services ……………………… 4

Pheonix Data Systems, Inc ………………… 47

Zetta Medical Technologies ………… 23, 41

EQ2, Inc. …………………………………… 47

Pronk Technologies ……………………… 5

ANESTHESIA BC Group International

Ph: 314-638-3800

www.BCGroupStore.com

Doctors Depot

Ph: 800-979-4993

www.doctorsdepot.com

Gopher Medical

Ph: 877-246-7437

www.gophermedical.com

Ph: 800-654-9845

www.alphasource.com

Ph: 817-378-4613

www.imedbiomedical.com/

KMA Remarketing Corp.

Ph: 814-371-5242

www.kmabiomedical.com

Rieter Medical Services

Ph: 800-800-5402

www.rietermedical.com

Ampronix, Inc.

Ph: 800-400-7972

www.ampronix.com

Gopher Medical

Ph: 877-246-7437

www.gophermedical.com

Intermed Group

Ph: 386-462-5220

www.intermed1.com

Quantum Biomedical

Ph: 866-439-2895

quantumbiomedical.com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

Ph: 800-229-7784

www.rsti-training.com

BATTERIES Alpha Source

BIOMEDICAL iMed Biomedical

BEDS / STRETCHERS

CARDIOLOGY

CARDIOVASCULAR RSTI

1TECHNATION.COM

MARCH 2016

g inin Tra

rvi Se

Company Info

Pa rt

Pa ge

SERVICE INDEX

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

EQ2, Inc.

Ph: 888-312-4367

www.eq2llc.com

Phoenix Data Systems

Ph: 800-541-2467

www.goaims.com

Tesseract

Ph: 404 719 5994

www.tesseractusa.com

17, 35

CMMS

COMPUTED TOMOGRAPHY Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

Injector Support & Service

Ph: 888-667-1062

www.injectorsupport.com

RSTI

Ph: 800-229-7784

www.rsti-training.com

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

Zetta Medical Technologies

Ph: 800-991-1021

zettamed.com

17, 35 56 23, 41

CONTRAST MEDIA INJECTORS Injector Support & Service

Ph: 888-667-1062

www.injectorsupport.com

Maull Biomedical

Ph: 440-724-7511

maullbiomedicaltraining.com

Ph: 844-342-5527

www.j2smedical.com

Elite Biomedical Solutions

Ph: 855-291-6701

elitebiomedicalsolutions.com

J2S Medical

Ph: 844-342-5527

www.j2smedical.com

Quantum Biomedical

Ph: 866-439-2895

quantumbiomedical.com

Ph: 800-229-7784

www.rsti-training.com

Ampronix, Inc.

Ph: 800-400-7972

www.ampronix.com

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

Paciﬁc Medical, LLC

Ph: 800-449-5328

pacificmedicalsupply.com

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

Cool Pair Plus

Ph: 800-861-5956

www.coolpair.com

Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

Zetta Medical Technologies

Ph: 800-991-1021

zettamed.com

23, 41

Ph: 800-958-9986

www.gmi3.com

14-15, 71

ENDOSCOPY J2S Medical

INFUSION PUMPS

MAMMOGRAPHY RSTI

MONITORS/CTR’S

MRI

NUCLEAR MEDICINE Global Medical Imaging

INDEX

g nin Tra i

rvi Se

Company Info

Pa rt

Pa ge

SERVICE INDEX

Intermed Group

Ph: 386-462-5220

www.intermed1.com

RSTI

Ph: 800-229-7784

www.rsti-training.com

ICE- Imaging Community Exchange

N/A

www.imagingigloo.com

TechNation Webinar Wednesday

N/A

1TechNation.com/webinars

Ph: 800-229-7784

www.rsti-training.com

BETA Biomedical Services

Ph: 800-315-7551

www.betabiomed.com

Bio-Medical Equipment Services Co.

Ph:800-626-4515

www.bmesco.com

Doctors Depot

Ph: 800-979-4993

www.doctorsdepot.com

Elite Biomedical Solutions

Ph: 855-291-6701

elitebiomedicalsolutions.com

Gopher Medical

Ph: 877-246-7437

www.gophermedical.com

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

J2S Medical

Ph: 844-342-5527

www.j2smedical.com

Paciﬁc Medical, LLC

Ph: 800-449-5328

pacificmedicalsupply.com

Quantum Biomedical

Ph: 866-439-2895

quantumbiomedical.com

Rieter Medical Services

Ph: 800-800-5402

www.rietermedical.com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

Ph: 800-991-1021

zettamed.com

Rieter Medical Services

Ph: 800-800-5402

www.rietermedical.com

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

17, 35

ONLINE RESOURCES

PACS RSTI

PATIENT MONITORING

PET Zetta Medical Technologies

23, 41

RADIOLOGY

RECRUITING/EMPLOYMENT Health Tech Talent Management

Ph: 757-563-0448

www.healthtechtm.com

Stephen’s International Recruiting, Inc.

Ph: 870-431-5485

www.bmets-usa.com

Ph: 800-800-5402

www.rietermedical.com

Ph: 888-312-4367

www.eq2llc.com

RESPIRATORY Rieter Medical Services

SOFTWARE EQ2, Inc.

1TECHNATION.COM

MARCH 2016

g nin Tra i

rvi Se

Company Info

Pa rt

Pa ge

SERVICE INDEX

Phoenix Data Systems

Ph: 800-541-2467

www.goaims.com

Tesseract

Ph: 404 719 5994

www.tesseractusa.com

Bio-Medical Equipment Services Co.

Ph:800-626-4515

www.bmesco.com

Elite Biomedical Solutions

Ph: 855-291-6701

elitebiomedicalsolutions.com

Gopher Medical

Ph: 877-246-7437

www.gophermedical.com

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

PaciďŹ c Medical, LLC

Ph: 800-449-5328

pacificmedicalsupply.com

Quantum Biomedical

Ph: 866-439-2895

quantumbiomedical.com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

BC Group International

Ph: 314-638-3800

www.BCGroupStore.com

Pronk Technologies

Ph: 800-609-9802

www.pronktech.com

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Ph: 855-401-4888

www.triimaging.com

Ph: 800-654-9845

www.alphasource.com

N/A

atslaboratories-phantoms.com

Conquest Imaging

Ph: 866-900-9404

www.conquestimaging.com

Global Medical Imaging

Ph: 800-958-9986

www.gmi3.com

Ampronix, Inc.

Ph: 800-400-7972

www.ampronix.com

Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

Engineering Services

Ph: 888-364-7782x11

www.eng-services.com

TELEMETRY

TEST EQUIPMENT

TUBES/BULBS Tri-Imaging Solutions

ULTRASOUND Alpha Source ATS Laboratories, Inc.

X-RAY

Intermed Group

Ph: 386-462-5220

www.intermed1.com

RSTI

Ph: 800-229-7784

www.rsti-training.com

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

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Company Info

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SERVICE INDEX

1TECHNATION.COM

MARCH 2016

BREAKROOM

10 ways technology hazards harm patients... 1 way to keep patients safe

Top 10 Health Technology Hazards for 2016 Download the Executive Brief for free:

www.ecri.org/2016hazards

C O M P L E T E PAT I E N T S I M U L AT I O N Portable

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✔ Cardiac Output ✔ Fetal Maternal

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NIBP-1020

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NIBP-1030

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Carrying Case Included Internal Rechargeable Battery All models are SpO2 Ready Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited