Technation - June 2016

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EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

JUNE 2016

Succession For HTM Departments

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VOL. 7

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Company Showcase USOC Bio-Medical

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Company Showcase Elite Biomedical Solutions

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Roundtable Nuclear Medicine

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Scrapbook MD Expo Dallas

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TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

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THE ROUNDTABLE : NUCLEAR MEDICINE Advances in nuclear medicine continue to extend the uses for this imaging modality.

TechNation reached out to industry experts for the latest on nuclear medicine, including what to look for when purchasing a system or selecting service options.

Next month’s Roundtable article: Ultrasound Systems

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SUCCESSION PLANNING Succession planning in the HTM department seeks a smooth transition with minimal disruption. For leadership, it includes identifying and developing replacement managers. The process also seeks to replace retiring HTM staff in an efficient manner without disrupting internal resources. TechNation talks with experts to find out how departments can plan for the future.

Next month’s Feature article: TJC: Requirements for Diagnositc Imaging Equipment

TechNation (Vol. 7, Issue #6) June 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.

JUNE 2016

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INSIDE

Departments PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Warren Kaufman Jayme McKelvey Chandin Kinkade

ART DEPARTMENT

Jonathan Riley Jessica Laurain Kara Pelley

EDITOR

John Wallace

EDITORIAL CONTRIBUTORS

Roger Bowles K. Richard Douglas John Noblitt Todd Rogers Manny Roman David Scott Cindy Stephens Karen Waninger Steven Yelton Alan Moretti Jeff Kabachinski

WEB DEPARTMENT

Betsy Popinga Taylor Martin Adam Pickney

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

P.12 SPOTLIGHT p.12 p.16 p.18 p.22

Company Showcase: USOC Bio-Medical Professional of the Month: Mike Lane Biomed Adventures: A Fish Tale Department of the Month: Texas Children’s Hospital Biomedical Engineering Department p.24 Company Showcase: Elite Biomedical Solutions

P.28 INDUSTRY UPDATES

p.28 MD Expo Dallas p.32 News and Notes: Updates from the HTM Industry p.36 ECRI Institute Update p.38 AAMI Update p.40 NCBA

P.42 THE BENCH p.42 p.44 p.46 p.48

Biomed 101 Tools of the Trade Shop Talk Webinar Wednesday

P.68 EXPERT ADVICE

p.68 Career Center p.71 Ultrasound Tech Expert Sponsored by Conquest Imaging p.72 The Future p.74 Karen Waninger p.76 Thought Leader p.78 Tech Savvy p.80 Roman Review

P.82 BREAKROOM p.82 p.84 p.86 p.88

Did You Know?

The Vault What’s on Your Bench?

MD Expo Dallas Scrapbook

Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer

p.93 Index Like us on Facebook, www.facebook.com/TechNationMag MD Publishing / TechNation Magazine 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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We Stay Up So You’re Never Down!

Some things you just can’t plan for. Like wrecking your car at 2 AM, or uncontrollable pain well after doctors’ hours. In your job, you do plan to be able to help your patients 24/7. And that means having a trusted team you can call any hour of the day or night to keep your ultrasound equipment up and running.

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COMPANY SHOWCASE

USOC Bio-Medical Services

U

SOC Bio-Medical Services is a leader in the medical device industry determined to know its customers, provide high-quality services, build solid customer rela-

tionships and maintain vendor neutrality. The company’s core values, as stated in its mission statement, are quality, integrity, innovation, accountability, collaboration and leadership.

Ali Youssef founded USOC Bio-Medical Services in 2009 to offer “simple solutions for complex devices” – namely, biomedical, respiratory, and durable medical equipment. His goal to create an efficient and reliable repair company that focused on biomeds continues to motivate the entire team at USOC Bio-Medical Services.

Today, USOC employs 75 people who provide biomedical equipment repair solutions to health care facilities, clinics and medical companies of all types and sizes. The company’s commitment to providing high-quality, cost-effective equipment and services is reflected in its ISO 9001:2008 certification. The company is currently working toward ISO 13485 certification.

USOC, located in Irvine, California, has a proven approach designed to keep medical equipment running in peak condition at a guaranteed cost savings.

The company is used as a reference by

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AUGUST JUNE 2016 2014

the market for patient monitoring equipment repair and for refurbished devices. Additionally, the USOC team strives to help biomeds who may not specialize in specific types of equipment when faced with the daunting task of maintaining patient monitoring devices and every type of hospital equipment. The company partners with the BMET community and is present at biomed tradeshows throughout the United States.

For more about USOC, we asked them to share their insider knowledge about the company’s services, goals and customer service.

Q:

Please share a little bit about your company’s history and how you achieved success.

USOC: One of the keys to USOC’s success lies in our commitment to understanding not just the equipment, but each

customer’s unique situation, level of expertise and needs. The company has achieved success by understanding the pressures today’s health care professionals face. Its innovative practices and expert engineers have allowed USOC to reduce the price of patient monitoring service without sacrificing quality.

Q:

What are some advantages that your company has over the competition?

USOC: Our added value is our value proposition, especially compared to the competition. We are more than a repair facility for our biomeds, we act as a partner to help facilitate the repair process. We create a partnership with biomeds and support them. We are the biomed shop for our biomeds and provide technical support 24 hours a day, seven days a week. We understand more than anyone else the biomed’s needs as our CEO is a biomed and serves as our lead technician and head engineer.

We have leveraged our experience to create a unique repair facility that meets the quality standards and turn times of each valued customers. Our quality is the reason we have the confidence to offer a 12-month warranty for each repair. We facilitate our biomeds’ daily tasks through a customer portal (USOC e-link) that is used not only for repairs but support and guidance. We also have

an emergency kit for our biomeds. The emergency kit consists of the most popular items that break down and can be used as an exchange program when devices break down.

Q:

Please explain your company’s core competencies and unique selling points.

USOC: USOC provides biomedical equipment repair solutions to health care facilities, clinics and medical companies in the USA and Canada.

Here’s how it works: The hospital calls for troubleshooting and, if necessary, sends equipment in to us. We test, diagnose and repair it at our facility and then send it back to them. We offer a warranty that allows the biomed shop to send the equipment back free of charge if there is ever a problem. We also offer continuing troubleshooting over the phone. If the equipment needs to be sent in for repair, USOC Bio-Medical Services will program a loaner based on the

hospital’s data and expedite shipping to the facility.

Q:

What product or service that your company offers are you most excited about right now?

USOC: We are excited about patient monitoring and development of costeffective ways to perform repairs on products. We are also excited about the implementation of software that enriches and eases the customer experience.

Q:

What is on the horizon for your company? How will it evolve in the coming years?

USOC: Hopefully, continued growth as well as the addition of new product lines and services are on the horizon. We are also spearheading new ways of doing things and performing repairs while developing relationships and partnering with market-leading companies to advance our services and offerings.

Q:

What is your company’s mission statement, or if you don’t have a specific one, what is most important to you about the way you do business?

USOC: Our vision is empowering better patient health with technical insights. Our three goals are to promote a healthier world, build value and create an inspiring workplace. Our five-point strategy to achieve our goals are innovative growth, drive operational excellence, simplify the organization, focus on technical information services and deliver great products and services. An important part of the USOC Bio-Medical Services environment are our behaviors, which are customer focused, performance oriented, united as one team, transparent and agile. The core values at USOC Bio-Medical Services are quality, integrity, innovation, accountability, collaboration and leadership.

FOR MORE about USOC Bio-Medical Services, visit them online at www.usocmedical.com.

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April 2016

PROFESSIONAL OF THE MONTH Mike Lane, CBET

By K. Richard Douglas

A

sense of humor can go a long way; just ask Mike Lane, CBET, who is the supervisor of Clinical Engineering at the University Medical Center of Southern Nevada. Lane works at the facility for Aramark. He says that TechNation readers should get to know him in person. “I should be on everybody’s bucket list for a meet and greet,” Lane says.

“Like so many biomeds, Lane found the HTM field because it was cooler than what he was used to.“It was purely by accident,” Lane explains. “I was an electrician by trade, working at my fi rst hospital when, one day after running conduit in a very hot attic, my boss asked me if I wanted to apply for a position in the biomed department. I did not know what all was entailed, but I will tell you when I walked into that nicely air conditioned shop, with some great blues coming over the excellent sound system, met the manager who was a cool guy, I immediately signed up. The rest is history,” he says.

Lane’s formal training included a stint that offered the opportunity to dodge bullets. He was a member of the U.S. Navy at the time.

“I was enrolled in the U.S. Navy Nuclear Program as a power plant operator, but after one year of brutal intensive electrical/mechanical training, with an additional six-year commitment to the service, I backed out and they rewarded me with a one-year tour working on riverboats in Vietnam,” he says. “They showed me.”

Lane handled the electrical repairs for the boats.

“After fi nishing that tour, I was sent

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to electrical ‘B’ school and then a motor rewind school. It was all rewarding,” he adds.

USING AVAILABLE RESOURCES After being discharged from the Navy, Lane got a heating and air conditioning contractor’s license in California and ran a small business for five years before succumbing to some tough economic times. He then found a more stable line of work.

“Since then I have had a working relationship with my current employer (Aramark) for a good part of 25 years as a technician and supervisor,” he says.

While living in Big Bear Lake, California, Lane’s home was heavily damaged in an earthquake. That was just enough motivation to move out of the region and he relocated to Las Vegas.

Aramark has had the contract with University Medical Center of Southern Nevada for 20 years and Lane has enjoyed working with his competent team of biomeds there. Like so many hospitals today, Lane’s facility has the same budgetary challenges, but his Aramark team works efficiently to keep the equipment up to snuff just the same. Even though some equipment is becoming a little older, Lane points out

MIKE LANE, CBET

Supervisor of Clinical Engineering University Medical Center of Southern Nevada that the hospital performs great and that “our cardiology and pathology departments are nationally recognized.”

Lane says that the department is so integrated into the hospital that some colleagues, in other departments, are surprised to hear that they work for a third-party service provider.

Lane’s department does a great job of maintaining some equipment that hasn’t yet been replaced. They updated

It helps to have a sense of humor in the HTM profession and apparently it has helped him during a dedicated career.

16 rooms of surgical lights working at night so as not to disrupt any scheduled surgeries. They knocked off the project in a week. They also updated a central station and formatted new hard drives, working on a weekend, which saved the hospital money.

“Our department has become specialists in keeping older, but critical operating systems running, much to the amazement of vendors and hospital management,” Lane says. “Sometimes, I even amaze myself.”

OUTSIDE OF WORK Lane is active in the HTM community.

He helped launch the Nevada Healthcare Technology Association in 2012. Several individuals in his department are active in the association, including in leadership positions. The association seeks to bring together the different groups of biomeds in Nevada. Lane says that vendors have been really supportive.

Away from work, the golf course, a group of friends and an occasional stogie make for just the right combination for relaxation.

“I’m an avid golfer and take advantage of the wonderful music scene that Las Vegas has to offer,” he says. “I have lived here for 20 years and never regretted it. I also collect antiques and enjoy a great cigar now and then.”

“I’ve been with my wonderful wife Patricia for almost 35 years, raised two boys, Sean and Chris, and have a cool dog — a Papillion — named

Mike Lane is seen in front of his 100-year-old Japanese ivory and jade silkscreen, holding his favorite Padron stogie and TaylorMade driver.

Patches. My mom, Jeanne, is 87 and is still very active and I have two brothers who aren’t as handsome as I am,” Lane adds.

Personal recognition is always appreciated and Lane was recently praised by his employer.

“I was just selected by Aramark, along with 199 others out of 270,000 employees, as a ‘Ring of Stars’ and they rewarded me with an all-expenses paid vacation for me and my wife to a resort in Scottsdale, Arizona,” he says.

“It was an event to remember, as we were coddled for five days, and I got to meet all the hierarchy of Aramark and all the selectees of this hugely diversified corporation.”

Aramark just launched the Ring of Stars program last year. It is meant “to honor those who deliver outstanding service” to the company’s clients.

Lane says it helps to have a sense of humor in the HTM profession and apparently it has helped him during a dedicated career.

FAVORITE BOOK:

Anything by Clive Cussler

FAVORITE MOVIE: All Bourne flicks

FAVORITE FOOD:

Mexican and a prime cut “Tomahawk Steak” from Del Frisco’s

HIDDEN TALENT:

”I am the ‘Most Interesting Biomed in the World,’ and my charm, so I’ve heard.”

FAVORITE PART OF BEING A BIOMED:

“Working with our younger techs and watching them grow, and behold the technical advancements being made in our profession.”

WHAT’S ON MY BENCH

”Working with my super sweet H/P TouchSmart PC, staring at my anatomically correct glass head, listening to my iPod on my Bose docking station, munching on my Wasabi coated peas, and reading my latest TechNation magazine.”

SPOTLIGHT SPOTLIGHT

BIOMED ADVENTURES

By K. Richard Douglas

F

ew pastimes offer the tranquility of fishing.

Staring out at the water, whether it is a lake, the ocean or a river, can calm the nerves as time passes and the anticipation of the next bite on the line awaits. Many a fish tale has emerged from these tranquil or exciting fishing forays; about the big one that got away or the battle that was eventually won by the person holding the fishing pole.

Jessica Wilkolak, CBET, who works for Fitzsimmons Hospital Services in its Cleveland Division has spent a fair amount of time challenging fish to take the bait. She has enjoyed the pastime since she was a child.

“I fi rst became interesting in fishing when I was little. My uncle – on my dad’s side – had a boat and would take us out on Lake Erie to fish for perch,” Wilkolak remembers.

“We would fish here and there during summers, but it has only been recently, in the past two years, that I took up steelhead fishing. I was online looking for fishing reports for Lake Erie, but came across a local Cleveland Metroparks fishing report, that talked about inland lakes and river fishing. I saw some of the pictures of huge steelhead fish that people had caught in the nearby Rocky River and I was like ‘You can catch huge fish like that in the river?’ I knew I had to try to catch one. I was hooked,” Wilkolak jokes.

Since that epiphany, Wilkolak and her dad go out fishing whenever the opportunity presents itself. It might be every weekend if the weather cooperates.

If the river is in good condition, those outings can even happen after work for an hour or two. Because northern Ohio can mean a long winter, the pair has even tried their hand at ice fishing, without a whole lot of luck.

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tough to find a spot to yourself – where the fish are – during steelhead season though,” she adds. “There’s always lots of people out.”

Once in awhile, those steelhead will end up on a dinner plate. Wilkolak has filleted them herself, but finds the process a little distasteful. She admits, when cooked right, they are delicious though.

THE ONE THAT GOT AWAY Jessica Wilkolak is seen with a trout she caught at a local inland lake.

Jessica Wilkolak Certified Biomedical Equipment Technician

A SEAT BY THE RIVER The river has turned out to be Wilkolak’s preferred destination for locating the perfect fishing spot.

“Mostly, I like to fish for steelhead in the Rocky River,” she says. “I like catching them because they’re the biggest.

During fall and spring are the best times to catch steelhead. In the winter, we go ice fishing on smaller inland lakes for stocked trout. Summers are usually spent fishing for bass or perch out on Lake Erie.

Trolling for walleye is next on my list.”

“I’ve spent lots of time scoping out various spots along the river where I think the fish may be holding. It can be

Those who fish often have tales of woe, tales of challenges and tales of triumph.

Wilkolak is no different.

It comes with the pastime.

“My favorite fish story was the first time I caught a steelhead. My dad and I had been trying for weeks to catch one,” she says.

“After I read about these fish online and how you could catch them in the river, I became obsessed. I tried all different types of bait; all different types of lures. Lost tons of hooks on snags at the bottom of the river, and no matter how much I tried, I couldn’t catch one.”

But then one day she knew she had snagged something.

“I was so excited I started yelling ‘fish, fish,’ ” Wilkolak recalls. “My dad ran into the water with the net as I got it closer to shore and got him. I was so excited. I was jumping up and down yelling, and high fiving my dad.”

Above: Jessica Wilkolak says fishing in February is worth it when you catch fish this size!

Right Top: Jessica Wilkolak is seen perch fishing on lake Erie

“Some other fishermen walked by and just gave us this weird glance like ‘Oookay.’ I think they were just jealous,” Wilkolak muses. “It was the biggest fish I had ever caught; 24 inches.”

But just as often as those who fish recount the successes, there are always the stories about the monster that got away.

“Recently, I was out fishing and was having a great day,” Wilkolak says “I was able to land seven fish, but at one point I had an eighth one on the line. I was trying to pull it closer to shore and my dad was trying to get it in the net; but it was too big to fit in the net.”

“Now, I’ll tell you there is a website I visit called TheRockyRiver.com and they have something called the 30/10 club,” Wilkolak explains. “If you catch a steelhead that is 30 inches or longer, or 10 pounds or more, send them the picture; you can be in the club. That fish may have qualified, but I lost it before we could get it in the net. But you bet I’ll get one someday.”

Fishing is just a pastime though.

Wilkolak trained and works as a biomed, repairing and maintaining equipment.

“I got my associate degree back in 2005 and was able to fi nd a job working for a local hospital equipment rental company — Fitzsimmons Hospital

Services,” she says “I will have been working there for 10 years this summer. I got my CBET certification about three years ago. I’m the only biomed that works in our Cleveland office. When equipment comes back from a rental, it can be pretty beat up and dirty. I clean the equipment as well

“That fish may have qualified, but I lost it before we could get it in the net. But you bet I’ll get one someday.” as check the functionality of it before it goes back out for another rental,” Wilkolak explains.

“If anything is broken, I order the parts that are needed and make the repairs. Our company rents out all sorts of stuff from ventilators, bipaps, infusion pumps, wound pumps, and bariatric beds and wheelchairs, to name a few. I like having the variety of

Read this article on 1Technation.com to view this video of Jessica Wilkolak chasing a storm!

equipment to work on. It helps keep things interesting,” she says.

HOBBIES Although fishing may be her main pastime, it is by no means Wilkolak’s only hobby.

“I like to tie my own fishing lures, so fly tying (is a hobby). I also enjoy doing some computer gaming. When the weather is lousy and I’m not fishing I can usually be found playing Diablo 3,” she says.

In addition to some gaming and creating fishing lures, Wilkolak loves travel.

“I try to go somewhere new every year or so,” she says. “Some of the places I have visited and experienced are: doing the wild cave tour at Mammoth cave (National Park) in Kentucky, snorkeling and deep sea fishing in Aruba, visiting the Mojave Desert in California, [and] storm chasing.”

That last pursuit nearly put an end to Wilkolak’s fishing days. Her experience as a storm chaser was intense, as seen in the video on 1TechNation.com.

“And, this year I’m planning to visit the Redwood National Forest in California and next year finding a spot to view the solar eclipse in totality,” she says.

From the shores of the Rocky River to adventures elsewhere, this biomed has plenty of stories to tell.

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DEPARTMENT PROFILE Texas Children’s Hospital Biomedical Engineering Department

By K. Richard Douglas

H

ospitals who serve the health needs of children are a special breed.

In Texas, the seeds were planted back in the 1940s for one of these valuable institutions. With the charter of the Texas Medical Center in Houston, along with the establishment of the Texas Children’s Foundation and the securing of six acres of property, the plans were laid for the new Texas Children’s Hospital.

Ground was broken in the spring of 1951 and two years later a 106-bed pediatric hospital was dedicated. The first patient was admitted early the following year. In the decades to come, the hospital would expand and gain a lot of positive publicity.

Today, Texas Children’s Hospital is a large not-for-profit 650-bed tertiary care hospital with its main campus located within the Texas Medical Center.

“The main campus is comprised of seven buildings designed for providing patient care, clinics, and research. Outside of the medical center, Texas Children’s locations include two community hospitals, two centers for women and children, six health centers, four maternal

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fetal medicine clinics, a radiology center and 52 pediatric practices around the Houston area,” says John Weimert, director of biomedical engineering for the large institution.

Weimert’s department is up to the task of handling the facilities approximately 36,000 devices. The department includes 73 staff members presently, with plans to add two leaders later this year, and next year, to add five new technical positions; bringing the total to 80 by the end of 2017.

In addition to Weimert, the department includes Assistant Director Ron Robb, Managers Randy Taylor, Roy Stuedemann, Ralph McCall and Jeffrey Wessels. There is currently one vacant manager position.

There are six equipment planners, one computer programmer, one contracts coordinator, three secretary/call center dispatchers and several employees serving in technical positions. There are three levels within the technician category: BMET, Senior BMET and Specialist, according to Weimert.

The department’s equipment planners plan medical equipment for all projects.

This work includes collaboration with contractors, architects and clinical end users to plan equipment and infrastructure as care areas are remodeled, or as new spaces and buildings are constructed, Weimert says.

The group’s contract coordinator handles service contracts.

“We currently manage about 220 contracts (about $7M in annual contract cost). The contract coordinator meets regularly with department managers to review contract status, renewal dates and to assist with negotiating contract

revisions, including conversion to in-house service and contract cancelation,” Weimert explains.

“Contracts are then forwarded to Supply Chain for final processing.

Department managers coordinate with clinical end users when making significant decisions regarding service contracts,” he says.

While not a part of IS, the team has a number of areas where cooperation exists.

“Biomed operates separately from the IS department, but coordinates closely with EPIC integration, physiologic monitoring networks, nurse call systems, infusion pump networks, neurophysiologic monitoring networks and regarding other issues where networks are involved. Biomed coordinates with IS on all projects as well,” Weimert says.

Biomed provides the hospital with the full gamut of services, from pre-purchase evaluations, planning and installation, to clinician training and rapid response.

“This large and diverse in-house servicing group provides coverage from 6 a.m. to 11 p.m. weekdays. The off peak hours are covered using technicians on call,” Weimert adds.

The department employs the Infor EAMS database for data collection.

“Each piece of durable medical equipment is assigned a unique asset tag number as the equipment is received,” Weimert says. “The equipment history reflecting every service intervention is documented against that unique asset tag.

The Infor database runs specific reports on a weekly and on a monthly basis. Report analysis is performed weekly by department leadership and reporting out to committees is done on a monthly basis.”

The members of the Texas Children’s Hospital Biomedical Engineering Department are (front row from left) Manager RalphMcCall, Manager, Assistant Director Ron Robb, Director John Weimert, (back row) Manager Roy Stuedemann, Manager Jeffrey Wessels and Manager Randy Taylor.

“We currently manage about 220 contracts (about $7M in annual contract cost).”

RECOGNITION FOR INNOVATION Special projects come with expansion and the department has been fully involved.

“Projects include building renovations, new construction and growth into the community. During these projects, Biomed is involved in the RFP process, equipment evaluation and selection, and performs equipment planning, equipment initial inspection, equipment acceptance testing and installation,” Weimert says.

Some of the current projects the department is involved in include the CareFirst Tower, a new 21-floor expansion to the existing women’s pavilion building.

This is a pediatric tower that will house a heart center, CVOR, cath labs, PICU, additional operating room space and expansion space for other care areas.

There is also the Woodlands Hospital, a new 100-bed community hospital with operating rooms, ER, PICU and an adjacent medical office building.

“Many other projects are in play, such as new care areas, remodeling of clinics and physician practices, growth and expansion of other care areas,” Weimert adds.

“Biomed receives new equipment, unpacks, inspects and prepares for first patient use. Project go-live activities include carefully coordinated communication for equipment rollouts such as preparing 1,700 new syringe pumps, or new ultrasound machines to be set up on a network, or new anesthesia machines requiring connectivity to the EMR,” he says.

The department received some well-deserved attention recently when it was awarded for its pioneering work in the often troublesome area of clinical alarms.

“To address the problem of improving the management of clinical alarms, Biomed partnered with clinicians to dig

deep and discover a better way to manage alarms at the bedside,” Weimert says.

“Multidisciplinary Teams were formed to study alarm settings, environmental factors, work flows and we also partnered with a third-party vendor to develop a dashboard for bringing alarm management into bedside care. This project was submitted to the ECRI Institute as a best practice for clinical alarm management and bedside care.

The ECRI awarded Texas Children’s with the Devices Achievement Award in March 2016,” Weimert adds.

In addition to the work that gained ECRI recognition, the department is involved with AAMI, IEEE, ACCE, NFPA, ASHE, RSNA and others.

While Texas Children’s Hospital is one of a special breed, its biomedical engineering department deserves that classification as well.

SPOTLIGHT

ELITE BIOMEDICAL SOLUTIONS

NOBODY DOES IT BETTER

E

lite Biomedical Solutions supports hospital biomed departments with new replacement parts, recertified parts, on-site service and repairs that keep clinical equipment performing at optimal levels.

“No other supplier does it better,” according to the company’s website.

The ambition to be the best dates back to the company’s beginnings and continues to be a driving force with every employee from upper management to the most recent hire.

Elite Biomedical Solutions is almost four years old and the majority of its employees were already in the health care industry when Nate Smith and Jeff Smith started the business.

“The owners/employees brought great relationships with suppliers, customers, and the expertise to run the business with them when they created/joined Elite Biomedical Solutions,” Nate Smith said. “We’ve also surrounded ourselves with great business partners who have been there to help guide us as we grow the business.”

The business was launched to meet a need and continues to serve the health care industry and, just as importantly, the communities they call home.

“We believe there is a huge void that needs to be filled in this area. In four

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years, we have grown from nine employees to 18, from 1,000 square feet to 10,000 square feet and have acquired a large portfolio of infusion pump

A scanner we’ve implemented to help with our internal Reverse Engineering Process.

parts,” Nate Smith explained. “We’re positioned to continue to grow our pipeline of new replacement parts. We

are here to raise the bar in healthcare.

Our company has been built on our Christian faith, which has blessed and given us this opportunity. We recognize how fortunate we are at Elite Biomedical Solutions and strive to make a difference each and every day to our employees, customers, business partners, and communities.”

Being a young and rapidly growing business comes with challenges. Elite Biomedical Solutions has had challenges and has met them head on.

“We went through a voluntary recall on one of our products last year. This is a major cause of concern for any company and this could have been devastating. However, instead of running from the issue, we effectively implemented a well thought out strategy.

Our goal was simple. We wanted to ensure patient safety, by working closely with the FDA as well as communicating any and all updates to our customers,” Nate Smith said. “When faced with adversity, your true character is seen by those around you. We now do all reverse engineering and precision measuring

“Our purpose statement is Improving the lives of our employees, customers, business partners, and communities one day at a time.”

Elite Biomedical Solutions utilizes 3D printing technology in-house, which enhances our delivery time to customers.

in-house with our new design team, to ensure our Quality meets the customer and OEM standards.”

“In addition to this, we have worked diligently to reach a goal of achieving Elite’s ISO certifications,” Nate Smith adds. “Jeff and I made the decision to become dual certified and in March we achieved both ISO 13485:2003 and 9001:2008!”

The growth continues and the future looks bright as Elite Biomedical Solutions gears up for expansion.

“New parts for other medical equipment modalities are coming in 2016,” Nate Smith said. “We have developed a pipeline of new products that will take us into 2018. We are excited to broaden our horizons outside of just I.V. pumps and continue to brand our company as the new replacement parts provider in health care.”

“We can fully service the majority of all large volume, syringe, PCA OEM infusion pumps within the industry, including Hospira, Baxter, CareFusion and B. Braun,” he added.

The success of the company adds to

the growth of the Elite “Gives Back” Foundation that supports causes in the Cincinnati area and beyond.

“Elite is proud to highlight charities and causes that we as a company value,” Nate Smith said.

One area of importance for the Elite “Gives Back” Foundation is pancreatic cancer research.

“It is near and dear to our hearts here at Elite,” Nate Smith said. “Don Swett who was one of the initial investors, a step-father, and step-grandfather of multiple employees at Elite Biomedical Solutions, lost his battle to pancreatic cancer November 18, 2014. In honor of him, Elite Biomedical Solutions will be doing its part in advancing the fight against pancreatic cancer.”

The Price of Life is another cause the company supports. Price of Life is a week-long campaign fueled by faith and the idea that one of the best ways to eradicate human trafficking is through mobilizing college students.

“We are partnering with over 70 organizations (from Circle K to the UM Law School) to put on 30+ events the

week of October 19-24. It is our goal to educate 30,000 people about human trafficking and mobilize 5,000 people to engage in the fight to end modernday slavery,” according to the company’s website.

The company also supports the TriMedx Foundation and the international need for medical equipment repair and support.

The mission of Elite Biomedical Solutions is to provide the medical community cost-effective solutions for their clinical needs by collaborating with hospital biomed departments to identify key replacement parts and, in turn, engineer a higher-quality and less-expensive alternative.

The company also has a defi ned purpose.

“Our purpose statement is: Improving the lives of our employees, customers, business partners, and communities one day at a time,” Nate Smith said.

FOR MORE INFORMATION: visit www.elitebiomedicalsolutions.com

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MD EXPO

Dallas • April 21-23, 2016

Dallas Crushes Attendance Record

T

Staff Reports

exas is known for cowboys and barbecue. The state also has an unofficial motto in “Everything is bigger in Texas.” The saying proved true in April with the biggest MD Expo ever.

A partnership with HTMA-Texas garnered local support and intensified interest in the Lone Star State. Attendee registration eclipsed the all-time high weeks before the biannual conference and a large number of walk-up attendees equated to a packed exhibit hall. Booths sold out early with more than 100 medical equipment and service providers exhibiting at the conference.

The industry-leading conference was bigger and better than ever with new features, including the Leadership Summit and Reverse Expo. These new additions kicked off the MD Expo with executive-level hospital personnel and medical equipment and service professionals.

MD Publishing President and Founder John Krieg said the idea was to create a community and encourage the sharing of ideas.

“Despite being leaders in their field, these professionals face the same issue and obstacles as everyone else, so the goal was to get them together so that they could share ideas and best practices,” Krieg explained.

Ray Laxton, Administrative Director at Sutter Health, attended the Leadership Summit and the Reverse Expo. He admitted to being a little skeptical going in, but said he was blown away by the experience.

“The Leadership Summit was excellent,” Laxton said. “I hope they carry on with that (tradition). The content was great and the flow of the Q&A was excellent.”

“The Reverse Expo was absolutely a great experience, and that surprised me,” he added.

Laxton said what he “loved” about the Reverse Expo is that he was “forced, and I don’t mean that in a bad way, to talk with people.” He said the five-minute intervals were ideal.

“You had to get to the point and create interest,”Laxton explained. “I found some vendors that do different things that I didn’t know they did. I discovered some things that could help me.”

“I will absolutely do it again if given an opportunity,” he said.

“I also came out and told other vendors that they need to do it.”

The first day was capped off with the Poolside Welcome

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A sold out exhibit hall showcased the latest technology in medical devices.

Reception sponsored by Modern Biomedical & Imaging Inc. The weather was perfect as vendors and attendees enjoyed great food, cold beverages and unlimited networking opportunities in a casual setting.

Ozark Biomedical sponsored the Continental Breakfast the next morning as everybody geared up for the top-notch educational sessions. The first morning of the MD Expo also featured a special panel discussion on the new FDA Docket “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed

by Third-Party Entities and Original Equipment Manufacturers; Request for Comments.”

Experts from throughout the industry shared their insights.

It was an educational and thought-provoking event. Attendees were reminded to submit their comments by the FDA deadline, which has since been extended to June 3. The comment period was extended “due to the unanticipated high level of interest from interested persons,” according to a notice posted in the Federal Register. The “high level of interest” was evident at the MD Expo.

The Exhibit Hall was open from 1-4 p.m. the first day followed by the Networking Happy Hour sponsored by AIV. Sodexo sponsored a special career insights panel discussion and reception later in the evening.

Atlantic Health System Biomed Informatics Specialist Benjamin Larson praised the conference.

“The Expo was great. It was good to see a lot people attending. I was able to meet some new people and discuss how they are handling some of the same issues I am facing,” Larson said. “I also got to meet some new vendors and saw some products and services I want to take back to my department to

Attendees and vendors enjoy refreshments at the Poolside Welcome Reception.

The Leadership Summit was kicked off with 20+ thought leaders from the HTM Community.

Dan Vick and Nat Drowne attend the Happy Hour sponsored by AIV

The first annual Reverse Expo featuring hospital personnel was a success.

FBS president Bill Hascup networks with Brandon Karas & Ben Pridgeon from Intermed.

Attendees kicked up their heels line dancing at the MD Expo Dallas Hoedown, sponsored by Sodexo.

discuss the possibility of using.”

“My favorite part of the Expo was the educational seminars. I picked up some great tips from some leaders in the field,” he added.

The second day of the MD Expo started with a continental breakfast, educational seminars and a keynote address by John Maurer from The Joint Commission. The exhibit hall opened at 12:30 p.m. with the Door Prize Extravaganza at 3:15 p.m. followed by a future of the industry panel discussion at 3:30 p.m.

Laxton said MD Expo stands out because of the great networking opportunities and the “intimate” setting that allows HTM professional and medical device and service providers to exchange ideas at scheduled conference events as well as at casual interaction.

“It was a great conference and all the feedback I got (from others in attendance) was about how great it was,” Laxton said. “I had some meaningful conversations with people.”

“There was a real camaraderie feeling,” he added. “The content of the session were really good, too. There was a good mix of exhibit hall and classes.”

Laxton said he plans to attend future MD Expos.

“I highly recommend it,” he said when asked what he would tell somebody considering attending the next MD Expo at Mohegan Sun Casino Resort in Connecticut on October 4-6.

To conclude the event was the Dallas Hoedown, sponsored by Sodexo, that Saturday evening with delicious Texas barbecue, line dancing and refreshing drinks. It was the perfect ending to a

busy, educational and fun MD Expo.

Sponsors played a big part in the successful Conference. The sponsors included Sodexo, Modern Biomedical Imaging Inc., USOC Bio-Medical Services, SPBS Clinical Equipment Service, AIV, Pacific Medical, Direct Med Parts & Service, MW Imaging, Select Biomedical, RPI, Ozark Biomedical, GMI, Technical Prospects, Southwestern Biomedical Electronics, Imaging Conference & Expo, MedWrench and Alpha Source Inc. Without their support, the MD Expo would not be possible.

TO VIEW MORE PHOTOS or watch the educational presentations, see page 88 and visit www.mdexposhow.com/dallas.

INDUSTRY UPDATES

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Now that’s refreshing!

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It is not a parts company that offers training. Ask us about the difference!

VISIT WWW.TRIIMAGING.COM OR CALL 855.401.4888

NEWS & NOTES

Updates from the HTM Industry BC GROUP RELEASES NEW SAFETY ANALYZER BC Group International has released its newest model of safety analyzer, the SA-2500. The SA-2500 was created to fill the need for an advanced safety analyzer with AC + DC measurement. The new analyzer is a portable, durable instrument with advanced testing abilities.

The SA-2500 includes all the usual features of a standard safety analyzer, including line voltage measurement, earth/ ground lead resistance/leakage current, point-to-point testing, enclosure/chassis leakage current, external resistance and external leakage current. The SA-2500 has a universal power supply compatible with line voltages from 90-240 VAC with load currents up to 16 amps. All measurements are true RMS readings.

The SA-2500 includes a variety of other features. With microprocessor-based technology, the SA-2500 is able to separate

and measure the AC and DC signals. The SA-2500 also has the ability to measure the quality of insulation of a product’s power wiring. This feature ensures that the insulation of internal wiring is intact and ensures a safe resistance between the power wiring and any exposed metal parts.

The SA-2500 can be controlled remotely from a PC or laptop, which allows users to control measurements and test sequences. Through remote operation, users are also able to produce reports and print results from a computer. The remote control software allows the user to generate automated test sequences, providing for repeatable and consistent test procedures that can be shared or sent to technicians as needed.

FDA EXTENDS DEADLINE FOR COMMENT The deadline has been extended for comments on the FDA docket “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed by Third-Party Entities and Original Equipment Manufacturers; Request for Comments.”

Experts from throughout the industry shared their insights during a panel discussion at MD Expo Dallas regarding the FDA docket and encouraged HTM professionals to take time to submit comments.

The FDA has extended the deadline to June 3 “due to the unanticipated high level of interest from interested persons,” according to a notice posted in the Federal Register.

For more information visit https://www.federalregister.gov/ articles/2016/04/25/2016-09443/ refurbishing-reconditioning-rebuildingremarketing-remanufacturing-and-servicingof-medical-devices.

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Find more information about the SA-2500, visit the online store at www.BCGroupStore.com or speak to a sales representative at 314-638-3800.

ACCRUENT ACQUIRES MAINSPRING HEALTHCARE SOLUTIONS Accruent has announced the acquisition of Mainspring Healthcare Solutions.

“We are excited to welcome Mainspring’s customers as part of the Accruent family,” said Mark Friedman, chief executive officer, Accruent. “Within the health care industry, we’ve experienced significant growth in the past 18 months. We look forward to driving even more value for our customers with the addition of Mainspring’s services-oriented platform to further meet the unique needs of health care organizations.”

In addition to its computerized maintenance management solution (CMMS), Mainspring offers technology to address operational challenges across the hospital. With its suite of mobile solutions – iNeedIt, iGotIt and iTrackit – Mainspring focuses beyond clinical engineering and facility management, where Accruent traditionally specializes.

“Our health care system is under a tremendous amount of pressure to improve patient care and reduce costs,” said Jason Beem, general manager of healthcare, Accruent. “Mainspring’s unique suite of workflow automation solutions complement Accruent’s existing health care solutions and will give our health care customers the technology they need to adapt to today’s market dynamics.”

Mainspring, which has served the health care market for nearly 25 years, will extend Accruent’s suite of purpose-built health care solutions into hospital service departments to drive efficiencies in operations. With the addition of Mainspring, the company’s solutions are now used by more than 55 percent of U.S. hospitals.

Integration of Mainspring Healthcare Solutions into Accruent is expected to be completed in mid-2016. Customers will see no interruption of support and services, and will be invited to attend a series of webinars that provide an introduction to Accruent and learn about expanded solution options available to them.

TRIPP LITE OFFERS NEW HOSPITALGRADE POWER CORDS

ELITE BIOMEDICAL SOLUTIONS ACHIEVES ISO CERTIFICATIONS Elite Biomedical Solutions is proud to announce that it has obtained ISO 13485:2003 and ISO 9001:2008 certifications. The ISO 9001 certifies the Quality Management System for Design and Assembly of Electromechanical Products and Components. ISO 13485 certifies the Quality Management System for Medical Devices which includes Design and Assembly of Components to be used in various active, nonimplantable medical products, recertification of OEM components, and service of active, non-implantable devices. The mission of Elite Biomedical Solutions is to provide the medical community cost-effective solutions for their clinical needs by collaborating with hospital biomed departments to identify key replacement parts and, in turn, engineer a higher-quality and lessexpensive alternative.

“Obtaining both ISO 13485:2003 and ISO 9001:2008 shows the dedication and the commitment of the Elite Biomedical Solutions team. It is a true testament to the devotion and team work that radiates throughout all areas of the company. This achievement affirms the company’s attention to the quality management system, consistency, and customer satisfaction,” Elite Biomedical Solutions Co-Owner/Vice President Nate Smith says.

Elite Biomedical Solutions received its ISO 13485:2003 and ISO 9001:2008 certifications from Eagle Certification Group, an ANAB-accredited company.

Elite Biomedical Solutions supports hospital biomedical departments with new infusion pump replacement parts, re-certified parts, on-site services and repairs. Currently, its focus is infusion pumps, but it is quickly evolving to include patient monitoring and other modalities based on customer needs.

For more information about Elite Biomedical Solutions, visit elitebiomedicalsolutions.com/.

Tripp Lite, a manufacturer of power protection and connectivity solutions, has added a new series of hospitalgrade power cords to its line of solutions addressing the unique needs of the health care field, including power strips, surge protectors, uninterruptible power supply systems and isolation transformers.

The new hospital-grade power cords are designed specifically for connecting medical equipment, computers and accessories to grounded hospital-grade AC outlets in a health care setting. The cords themselves have hospitalgrade plugs and meet standards for use in medical facilities to help protect patients and staff from shock hazards.

The cords come in a variety of lengths and are available with ratings of 10A, 13A and 15A to accommodate devices with a three-pin C14 port, including computers, printers, scanners and monitors. The line also includes cords with clear plugs for users who need or want to be able to inspect the integrity of the connections.

Each cord features a C13 female connector on one end and a NEMA 5-15P-HG plug on the other and are available in lengths from 3 to 25 feet, including a model with an 8-foot coiled cord that resists tangles and knots.

Find more information at www.tripplite.com.

PHILIPS ULTRASOUND VALIDATES LEAKAGE TESTER AND PROBE ADAPTER The BC Biomedical ULT-2020 Current Leakage Tester with the ULT-PA-19 Adapter has been validated by Philips Ultrasound for use with the X7-2t, S7-3t, and S8-3t compact connector TEE transducers, according to a news release.

The testing includes the proper fit of the compact connector TEE transducers into the ULT-PA-19 adapter, the testing function and limits used in the ULT-2020 Leakage Tester.

BC Group’s ULT product line complies with the new IAC Standard.

For information about the ULT-2020 and ULT-PA-19, call 800-242-8428 or email sales@bcgroupintl.com. For information about BC Biomedical products, visit www.

BCGroupStore.com.

INDUSTRY UPDATES

ALL NEW MEDICALDEALER.COM The new MedicalDealer.com website delivers the industry’s best online medical equipment marketplace for vendors and buyers. Designed specifically for the health care industry, the website delivers a one-stop shop to list equipment, buy medical devices and find/post vendor reviews.

“Medical Dealer provides more than 16,000 medical equipment purchasers with comprehensive information about new and pre-owned medical equipment, parts and service, including in-depth coverage of timely issues, industry and regulatory updates, new product news and profiles of people in the industry,” according to the website. “Readers include radiology administrators, department managers, purchasing officers, materials managers, clinical engineers, C-level executives, OR supervisors and others involved in equipment purchasing at hospitals and medical facilities.”

Market demand sparked the decision to launch the new MedicalDealer.com.

Parent company MD Publishing stays abreast of the health care industry via three trade publications including Medical Dealer magazine, TechNation magazine and OR Today magazine. The magazine’s websites, online communities and MD Publishing’s signature conferences combine to provide in-depth knowledge regarding industry trends.

“For over 20 years, MD Publishing has set the standard for medical equipment industry news,” President and Founder John Krieg says “Today, a broad demographic of national readers recognize MD Publishing’s industryleading magazines and events as critical tools for their success. That’s because our brands break the news and set the trends. Whether in print or digital media, conferences, or contract design and web services – you’ll hear about it first at MD Publishing.”

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“With three award-winning magazines serving niche audiences, an annual medical equipment buyers guide, and our ever-expanding conferences – the MD Expo, the Imaging Conference & Expo (ICE), and OR Today Live!

Surgical Conference – MD Publishing continues to innovate. We are changing the way medical equipment professionals get information and do business – for the better of the industry,” he adds.

The new MedicalDealer.com website offers a free trial period for vendors to list medical equipment. This service is combined with trusted customer reviews of the vendors to empower those seeking to purchase medical equipment with confidence that they will receive quality at every turn.

The site is already a destination for vendors and buyers.

Med-E-Quip Locators Inc. President/ CEO Bob Caples has equipment listed on the new website and has high expectations based on the company’s previous experiences with MD Publishing.

“There are a lot of people out there who have sites, but they are not as well known as Medical Dealer,” Caples said. “Medical Dealer magazine has been out there for 20 years. It will take a little while to get the word out about the new website, but I think it will be successful.”

Many vendors have already received reviews on MedicalDealer.com.

Industry experience and dedicated support from a proven industry leader will power the website to success.

“After 20 years of building loyal and dedicated readers, we felt the time was right,” Krieg says about launching the new website. “There aren’t many viable options for third-party vendors and hospitals to buy and sell equipment that are affordable.”

“This is an opportunity to provide a needed service,” Krieg adds.

MedicalDealer.com is a commission-free service where vendors pay to list for as little as $5 or $10 per item for a month.

“We know we are the not the first to do this, but our technology and experience will lead us to be the best,” Krieg says.

RIGEL MEDICAL TO LAUNCH NEW PRODUCT AT AAMI Rigel Medical will showcase its biomedical test instrumentation at Booth 510 at the AAMI 2016 Expo on June 3-6 in Tampa, Florida, including important new additions to the range.

“The AAMI show is one of the main platforms for us to launch new products – and we’ll be doing so again this year, so we will be welcoming all visitors to our booth to see the latest introduction to our test range,” Jack Barrett, national business development manager at Rigel Medical USA says. “Our new addition will continue what has been an incredible year with the introduction of the SafeTest 50 safety analyzer, the VenTest 800 ventilator tester and the low-cost patient simulator, the UNI-SIM Lite.”

The SafeTest 50 is a rugged electrical safety tester for testing basic medical and hospital equipment such as medical beds and chairs, operating tables, hoists, infusion pumps, CPAPs, centrifuges and other similar equipment that does not require patient lead testing.

Also on display will be the new VenTest 800 ventilator tester and gas flow analyzer and the UniSim Lite entry level vital signs simulator that also includes an SpO2 test capability.

Visitors to this year’s AAMI show can also see the UniTherm, Rigel’s leading electrosurgical analyzer in full operation. Approved and used by the world’s leading ESU manufacturers, the Uni-Therm offers current and power measurements with an ergonomic design. It is a valuable tool for bench and field applications.

When accuracy and speed of testing of infusion devices is paramount, Rigel recommends AAMI attendees come and see the Multi-Flo infusion pump analyzer in action. This single to multi-channel configuration analyzer has been accepted by leading manufacturers and hospitals in the nation.

For more information,visit www.seaward-groupusa.com.

INDUSTRY UPDATES

ECRI UPDATE

Miniature Leadless Pacemakers: Will Potential Benefits Make a Difference?

N

ext-generation pacemakers in development are less than 10% the size of conventional pacemakers, leadless, and do not require surgery to implant. These self-contained devices house a battery, electronics, and electrodes. They are able to sense and pace in only one heart chamber, so they are considered appropriate for only about 15% of patients requiring a pacemaker. Nonetheless, the hope is that this new generation of pacemakers will improve safety, comfort, and quality of life for some patients compared to existing devices.

Two companies are in the race to the U.S. market with a leadless pacemaker: St. Jude Medical, Inc. (St. Paul, MN, USA) makes the Nanostim Leadless Pacemaker, and Medtronic, plc (Dublin, Ireland) makes the Micra Transcatheter Pacing System (TPS).

Both devices have received the CE mark within the past two years and are commercially available in Europe, but not in the United States, where latephase clinical trials are ongoing to generate data for premarket approval submissions to FDA. Nearly 3 million U.S. patients had a pacemaker implanted between 1993 and 2009, with overall pacemaker use increasing by 56% during that period.

Although pacemaker use in most patients is uneventful, about 4% of patients encounter device-related complications, including lead migration, other lead failure, or implant-related infection, typically in the subcutaneous pocket housing the pacemaker. Also, implanting the pulse generator subcutaneously in the chest can cause a visible lump or scar and somewhat reduce arm mobility.

The leadless single-chamber cardiac pacing devices are implanted directly into the right ventricle via a transcatheter approach. Possible candidates for the devices include patients with permanent atrial

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fibrillation with bradycardia who meet standard pacemaker indications, patients with sinus rhythm with a low level of physical activity or short expected lifespan, and patients with sinus bradycardia with infrequent prolonged pauses or unexplained syncope.

PROCEDURE To implant a leadless pacemaker, an interventional cardiologist, typically an electrophysiologist, inserts the steerable delivery catheter at the femoral vein in the groin or jugular vein and advances it to the apex of the right ventricle under fluoroscopic guidance. The device does not have a separate pulse generator and requires no surgical pocket, like a standard pacemaker. The procedure takes about 30% to 60% of the time required for a conventional pacemaker implantation. The pacemaker is attached using a fixation mechanism, and the pacing and sensing system are tested with the device still connected to the catheter. Once deployed and detached from the catheter, the leadless pacemaker can be repositioned or retrieved if necessary.

Generally, the patient is observed for 24 hours before discharge. The battery reportedly lasts from about 9.5 years up to 15 years, depending on pacing parameters.

WHAT TO DO IF YOU ARE CONSIDERING THIS TECHNOLOGY • Meet with the interventional cardiovascular team about whether to be an early adopter.

• Monitor FDA regulatory decisions expected in 2016.

• Monitor results of ongoing pivotal trials for both devices.

• I f adopting, plan sufficiently for necessary staff training time.

• B e alert to individual product warnings regarding patient selection, device repositioning after fixation, and long-term safety.

• Verify reimbursement status with payers in your geographic area.

COST EQUATION According to ECRI Institute’s PriceGuide database, the average price paid for the Nanostim leadless pacemaker, as reported by member hospitals, was $9,000, and the average price for the Micra TPS was $9,500. A recent review article estimated additional procedure implantation costs of about $4,000/case. In Australia, the Health Policy Advisory Committee on Technology in a July 2015 report on leadless pacemakers indicated that costs were nearly three times higher than for conventional pacemakers.

A 2014 article by two cardiologists reported that lack of billing codes specific

to leadless pacemakers caused many centers participating in U.S. clinical trials to perform procedures at a financial loss. Trial sites reported difficulty securing adequate reimbursement to cover the costs for leadless pacemaker implantation from local Medicare contractors, with many cases reimbursed under a code designated for a conventional single-chamber pacemaker with lead implantation.

However, in January 2015, the American Medical Association established specific temporary Current Procedural Terminology (CPT) codes that describe transcatheter insertion or replacement of a leadless pacemaker, transcatheter removal of a leadless pacemaker, and in-person programming and interrogation evaluations. These temporary codes facilitate data collection and set the stage for introduction of permanent codes to facilitate reimbursement if FDA approves leadless pacemakers.

Stay tuned! In future issues of TechNation, we’ll take a deeper dive into more of the topics featured on ECRI Institute’s 2016 Top 10 Hospital C-Suite Watch List.

This article is excerpted from ECRI Institute’s 2016 Top 10 Hospital C-Suite Watch List. The full report contains an in-depth miniature leadless pacemaker evidence story. To download the full report, visit www.ecri.org/2016watchlist. For more information on ECRI Institute’s evidence-based health technology assessment or consulting services, contact communications@ ecri.org, or call (610) 825-6000, ext. 5889.

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INDUSTRY UPDATES

AAMI UPDATE

In Repair Debate, Industry and HTM Agree Competency is Key

I

n high-reliability industries such as health care, the quality of a device’s service and repair can literally mean the difference between life and death. With the need to assure patient safety, members of AAMI’s Supportability Task Force – which includes representatives from original equipment manufacturers (OEMs) and healthcare technology management (HTM) professionals – are focusing on developing competency guidelines for servicing and maintaining medical equipment.

“The serviceability and supportability of medical devices have been tricky issues for both HTM professionals and OEMs for years,” said Patrick Bernat, AAMI’s director of HTM. “During last November’s AAMI Forum on the Supportability of Healthcare Technology, participants agreed that competency verification could go a long way toward tearing down the walls that have separated the two sides. They felt that developing mutually agreed upon criteria to evaluate and measure competency for working on various types of equipment could be the key to establishing the trust and confidence needed to move the conversation forward.”

This effort comes at a time when the Food and Drug Administration (FDA) is asking questions about the third-party service and repair of medical devices, due in part to OEM fears that repairs by

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unqualified personnel are putting patient safety at risk.

Many working in hospitals see a bias on the part of OEMs against hospital HTM departments, but these professionals agree that the two sides can find common ground by talking about competencies.

“The only way to alleviate perceptions on the part of vendors that parties other than the OEM may not be qualified to safely and effectively service and maintain their products is to look at how HTM professionals and OEMs can come to terms on competencies and expectations,” said Mike Capuano, manager of the biomedical technology department at Hamilton Health Sciences in Ontario, Canada.

The task force is not looking to build these competencies from the ground up, but instead leverage an existing or modified certification process.

“It’s important that OEMs, especially those not involved with the task force, have something universal to recognize,” Capuano said. “When health care organizations purchase equipment, having these credentials up front will hasten the process and provide more success in acquiring the support needed to repair devices in-house. This will allow health care institutions to maintain the highest level of patient safety and capitalize on the cost-effectiveness HTM professionals can bring to the bedside.”

The group is also working to create a template for service-level agreements and developing data points that will eventually be included in a dashboard for the C-suite.

AAMI’S ESUBSCRIPTION SERVICE EXPANDS In the fast-paced world of technology, it seems like almost everything is available at your fingertips – the latest news, television shows, music, and even transportation. To keep up with what healthcare technology professionals and the medical device industry need to ensure conformity and compliance in this on-demand world, AAMI moved its complete collection of standards to a web-based platform last fall.

In addition, this service now includes specialized subsets, such as standards collections focusing on sterilization, dialysis, or human factors, instead of providing them on a CD. AAMI is also preparing to offer some individual

“The only way to alleviate perceptions on the part of vendors that parties other than the OEM may not be qualified to safely and effectively service and maintain their products is to look at how HTM professionals and OEMs can come to terms on competencies and expectations.”

standards via the eSubscription service.

One of the main benefits of the eSubscription service, according to Sonia Dorfman, a librarian at NeuroPace Inc. – an implantable device company in Mountain View, California – is the search function. Using a keyword search of the title or full text, you can much more easily find the exact standard and page you need.

“The CD-Complete Collection used to be so difficult to search,” Dorfman said.

“But with the online version, people can more easily find what they are looking for. When people ask me for a standard, I just have to point them to the platform, and they are able to get what they need.”

For organizations such as NeuroPace that have acquired a multiuser license, it is also more convenient for employees to access standards. Instead of passing around a hard copy or a CD, staff members are able to get what they need, when they need it, wherever they are.

“The access is so much easier,” Dorfman said. “As many people who need to look at a standard are able to, even if they are not at their desks.”

Joseph Bremner, AAMI’s director of marketing, said the move to the eSubscription service was driven by AAMI’s commitment to offer the best experience possible for professionals who purchase and use its standards.

TO LEARN MORE ABOUT AAMI’S ESUBSCRIPTION SERVICE or to view a

demonstration, visit www.aami.org/ esubscription.

JUST TWO CHANCES LEFT TO GET ACI CERTIFIED IN 2016 A central concern for many hospitals and companies is having a workforce that’s both knowledgeable and skilled in the safe application of biomedical equipment.

Certification demonstrates that successful applicants have the knowledge to ensure a safe and reliable health care environment.

It also demonstrates to employers a significant commitment to career and competence.

AAMI’s Credentials Institute (ACI) maintains certification programs for biomedical equipment technicians (CBET), laboratory equipment specialists (CLES), radiology equipment specialists (CRES), healthcare technology managers (CHTM), and quality system managers (CQSM).

With more than 4,000 people certified worldwide, the ACI seal of approval has become a commanding credential in the healthcare technology field.

There are two exam windows left in 2016: Sept. 9-17 (registration due by Aug. 9; late registration by Aug. 23) and Dec. 2-10 (registration due by Nov. 4; late registration by Nov. 18).

FOR MORE INFORMATION, about the exams and eligibility requirements, visit www.aami.org/certification or reach out to an ACI representative with questions at aci@aami.org.

INDUSTRY UPDATES

410002 INTERNATIONAL MEDICAL TechNation AD 09102015.indd 9/10/15 1 4:08 PM

NCBA

Symposium Returns to Pinehurst

T

By W. Glenn Scales, CBET-E, President of NCBA

he North Carolina Biomedical Association (NCBA) will be hosting its 38th annual Symposium and Expo August 23-26 at the worldfamous Pinehurst Hotel and Resort. Yes, that Pinehurst, which has hosted the U.S. Open multiple times. And of course, the event starts with a golf tournament on Tuesday, August 23 on Pinehurst Course Number One. While golf is a great way to start the Symposium, the real focus is on education, leadership development, collaboration, and the opportunity to see old friends and renew relationships.

The 2015 NCBA Board of Directors is excited about the return to Pinehurst

The education is divided into six tracks that allow us to focus our programs into a comprehensive series of sessions that enhance the educational efforts. The six tracks are Biomed Track I, Biomed Track II, Imaging, Information Technology, Leadership Development and Safety.

Some of our confirmed speakers include John Maurer with The Joint Commission, John Noblitt with Caldwell Community College, Corinne Hoisington with Central Virginia Community College and Jenifer Brown

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with Health Tech Talent Management.

The five half-day educational sessions are spread out over three days and cover the six educational tracks for a total of 30 educational programs.

The NCBA Board of Directors has been planning for over six months to provide specific and targeted programs that are of practical value for our attendees. Prices for the symposium are $150, $200 and $250 respectively for one-, two- and three-day attendance.

Students enrolled in a BMET or HTM curriculum only pay $75, regardless of

W. GLENN SCALES, CBET-E

NCBA President

how many days they attend.

Some of the educational sessions include a full-day CRES Review class, a full-day networking fundamentals class, and Bill Franklin with MindSet LLC speaking on “The Leadership Secrets of a Technical Expert.” In addition to the CRES Review, RSTI will present “Diagnosing Problems in a PACS Network Using Software Emulators” and experts from Southeastern Biomedical teach a MAC 5500 troubleshooting and repair class.

Another highlight is the “Alcon Infiniti Overview, Anatomy and Troubleshooting” full-day class on Wednesday. Pat Lynch, CCE, the first president of the NCBA will present two classes, “FDA Updates” and “Building Relationships with the C-Suite, and Growing a Positive Department Image.”

One of the highlights of the symposium is the expo and product fair. We are on track to fill the vendor exhibit hall. It opens Wednesday at 4:30 p.m. for a two-hour welcome reception. The exhibition is open from 9:30 a.m. to noon on Thursday.

NCBA will award two scholarships

Your Patient Monitoring Experts to students enrolled in their final year of an accredited BMET two-year degree programs in North Carolina. The Norman Reeves Scholarship and the Eddy Whisnant Scholarship each award a plaque and a payment of $2,000.

In addition, the W. Glenn Scales Scholarship awards a $5,000 scholarship and plaque to a working BMET (must be an NCBA member) who is pursuing an advanced degree beyond their initial educational degree. Drager has graciously donated to fund the scholarship this year.

Contact us for Details offer good thru end of July

ADDITIONAL INFORMATION about the NCBA Symposium and scholarship programs is available at www.ncbiomedassoc.com.

VIEW MORE PHOTOS of the 2015 NCBA Symposium and Expo online at www.1technation.com/ncba

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BIOMED 101

A Guide to Surviving Your First Year as a Clinical Engineer

By Connor Walsh

M

erriam-Webster defines the word ambition as “a strong desire to achieve something, typically requiring determination and hard work.” This definition is pinpoint accurate when describing what is required in the world of clinical engineering. When looking at the big picture, it is very overwhelming to think about the extensive work involved in maintaining a hospital’s entire inventory of medical equipment and technology. However, with the right mindset from the get-go, it is very possible to grasp and manage this process over time.

The most important resources that you have as a clinical engineer are your technicians. They are the experts on the equipment and how it operates. It is imperative that you spend time early on building a relationship with them. They are the foundation of any successful clinical engineering department, and ensuring that they receive adequate training goes a long way. Communicate with them, see what concerns or issues they have, and create an understanding that they are able to come to you for anything that they may need. Without them, a department cannot function, and showing them respect and generating a healthy working environment facilitates growth within.

Clinical engineering is unique in the fact that many college courses cannot teach you everything you must know to be successful, and grasping this knowledge early in your career is extremely important. In most hospitals, distinguishing between an Information Technology (IT) device and medical device is becoming more difficult. As a result, we as clinical engineers are absorbing more IT

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responsibilities, and the knowledge of how these types of systems work can go a long way. Use the first year to dive into conferences or training that will help you better understand this side of clinical engineering. Whether it’s a CompTIA certification, a PACS administration course, or any of the many other options, understanding a basic knowledge of IT/ clinical devices is an excellent idea to pursue in your first year.

Within my first year of clinical engineering at the Veterans Affairs (VA), I have been able to see the tremendous benefits that can come with networking.

There is no need to re-create the wheel.

Reach out to other clinical engineers when you are trying to implement a new process in your facility to see if there might be a similar idea already in place. In addition to the other 151 clinical engineering departments in the VA that we can contact, we have developed a relationship with the clinical engineering staff at the private hospital located near us and also have affiliate agreements in place with local colleges to provide additional opportunities for co-ops, interns and

CONNOR WALSH

Biomedical Engineer

volunteers. Step out of your comfort zone and think outside the box at how and to whom you can develop a connection with.

The resources that can be gained by networking with individuals in your field can be very beneficial, and it is important to set the groundwork for these relationships in your first year.

Clinical engineering is an exciting, growing field and the opportunities that lie within are vast. Starting your career down the right path can shape the kind of experiences you face, and making sure to take advantage of these opportunities early on is essential. Build a relationship with your technicians, pursue various training options, and build a network of clinical engineers that you can rely on to help ensure the success of your department.

Utilize the first year to its full potential and never lose the ambitious trait that all clinical engineers should have.

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1TECHNATION.COM

45

SHOP TALK

Conversations from the TechNation ListServ Q:

Some have said that HTM is the greatest job nobody knows about.

Why do you love your career choice?

Would you suggest it to a friend?

A:

I enjoy my job for the fact that no two days are the same. I also enjoy the “Yes” feeling you get when you solve an issue and make someone’s day. As far as suggesting it to a friend; yes, I would, to the right friend. The fact that a good biomed must have a good grounding in mechanics, electrics, electronics, pneumatics, hydraulics, computers, etc., leaves out quite a few people who may have an interest but none of the ability. I’ve seen people who looked great on paper come into the field only to find out that they didn’t know which end of a screwdriver not to stick in a light socket.

I’ve seen others who couldn’t translate what they read in a manual into the actions on the piece of equipment they were working on. I am not saying that these people are stupid or ignorant. There is a set of skills that a good biomed needs, and there are people who will never have those skills. I would make a terrible banker, stockbroker, insurance agent, etc. I don’t have (or want) the skill set required to be successful at them.

A:

I enjoy HTM since it is genuinely about always learning and sharing what you’ve learned with your colleagues. And, most importantly, helping doctors and nurses in making people get well! As far as encouraging others, that depends on the person as others have already suggested.

A:

The excitement of the job from a technical perspective would be enough but I really love this career for the places it has taken me. As a small town Alaska boy, I never dreamed of half the

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places I’d travel as a BMET/Imaging Tech.

I’ve walked through Times Square, toured the nation’s Capitol, I’ve worked on Maui, wept at the Civil Rights Museum in Birmingham, watched the sun rise at Myrtle Beach, enjoyed 4th of July fireworks in Charleston, listened to Jazz on Beale Street in Memphis, had my Rocky moment in Philly, jogged the magnificent mile in Chicago, sipped wine in Napa Valley, and visited many National Parks just to name a few! I love to creatively make the most of my work travels.

Someday, when my kids are grown maybe I’ll volunteer for an Antarctic tour! Hey, why not!?! I’m truly humbled and blessed by the opportunities that this career has and continues to offer.

P.S. I do actually fix a few things every now and then!

A:

Yep, this is a great career and I have been doing this for 45 years. I really enjoy working as a biomed and I have taught a number of students during their clinical training and started a few biomedical shops. True, this is a job that few people know about and the pay is good. In my early years as a biomedical technician a lot of the hospitals did not know about the profession. I started in Biomed working for Bendix Field Engineering on the East Coast and everyone dressed professional. I remember the Corbin Farnsworth service people wore dark green pants, light green shirts, dark green ties, and black dress shoes.

Corbin Farnsworth made patient monitors and they were cutting edge at the time. On one of my first service calls, I talked to a guy leaving the hospital that had been on a service call. He asked me if I was the guy that was going to service the patient monitors, and I said yes. He informed me that he had been servicing the monitors until the company I worked for got the

contract. He said he was glad we got a contract to service the equipment and wished me well. Come to find out he owned the local TV repair company and was in over his head on the monitors. This type of story happened a number of times in the early days of biomed. This is a career that is always advancing in technology, so you are always learning something new. I feel that I made one of the best career choices many years ago.

A:

Yikes, I just did the math and I have been in the Biomed world for 41 years. I love working on machines and troubleshooting to figure out why it is not doing what it should be doing. I love solving real-world problems that make a difference, this could be why I never got into online gaming, too unreal.

This career has sent me all over the world from China to Italy to Denmark to just about every European country and as of two years ago, every state in the USA including Alaska, Hawaii and Puerto Rico. I now own my own company and create opportunities for interested souls to explore this career. It has given me the opportunity to explore many avenues of expression from doing to creativity to teaching. Looking back, this path has been a blast. Looking forward, I am just beginning.

Q:

We have an intermittent problem where the E9 reboots itself, sometimes during procedures. How do I access the service logs to see what errors are popping up? The users have not been taking good notes to give any insight to the problem.

A:

Verify the filters are clean and remove the dust/lint from the fan assy. System is probably experiencing an overheating problem.

A:

We’ve already done this two weeks ago (after experiencing the same issue), all fans and filters are clean as a whistle. Could there have been damage done if the overheating was over an extended period of time?

A:

There are two ways to get to the Common Service Desktop: Click on “Utility” and then “Service” or click on the phone icon at the lower left of the display. Then, select “Service Desktop.”

Login as External Service, password is gogems. Click on the “Utilities” tab, then select the “Common Utilities” folder to find the “Event Log Viewer.” I would suspect the BEP Power Supply or the BEP itself. Be sure to disconnect the EPS battery at J3 on a GFI system or J2 on a MRX system to keep from accidentally damaging something while working in the BEP. Also check the EPS battery; it should have 24V PROOF APPROVED CHANGES NEEDED of charge on it. For further help or to get a quote for parts, pleaseCLIENT call AUE at SIGN–OFF: 918-628-2831.

PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT PHONE NUMBER WEBSITE ADDRESS BEP power supply board or ILOGO have

A:

had loose prongs on power cords many times. Try swapping both for known good ones.

PROOF S

SPELLING

GRAMMAR

TRIM 4.5”

A:

I also vacuum the very large dust bunnies under the heatsink on the motherboard occasionally.

A:

TRIM 4.5”

The Pulser voltage TXPS1 varies between 0 and 140V depending on the probe and preset selected, and the acoustic output setting. The system log may show some errors, however when it is the BEP or BEP power supply causing the problem, the error does not get logged. I forgot to mention one of the basic and common causes of this problem on GE systems. Check the power cord where it goes into the system to make sure the clip is holding it as tightly as possible, and look for signs of corrosion at that connection.

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.

FOR 2016

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Wednesday

WEBINAR WEDNESDAY Session Examines Risk Assessment Staff Reports

T

he 2016 Webinar Wednesday series continues to draw large crowds and impart valuable knowledge.

“The theme of the webinar was compelling, but the fact that it was

Pat Lynch, CHTM, CBET, CCE, CPHIMS, CHTS-PW, fACCE, presented the AlphaSource sponsored webinar “Risky Business: How to Assess Your Financial Risk Without a Service Contract” to 193 attendees on April 13.

Lynch’s presentation informed attendees how to share the results of a new study on the economic value analysis of service contracts with supervisors and C-suite level executives.

Lynch used a step-by-step guide to help biomeds make informed decisions on service options for their imaging equipment. The webinar built on the information that Lynch shared during a February 24 session that was also sponsored by AlphaSource. Both webinars can be watched online at 1TechNation. com/Webinars.

Lynch pointed out analytic tools HTM managers can use to evaluate their imaging maintenance program scope, size and other factors to estimate their likelihood of saving money by opting for at-risk equipment maintenance.

The goal is cost savings and Lynch shared his insights after more than 40 years of service in the biomed realm as

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combined with TechNation as a reliable and reputable source for information made it worthy of the time on my calendar.”

- Robin B. well as new information from the recent whitepaper “Economic Value Analysis (EVA) on the Total Cost of Ownership of GE Healthcare Logiq 9 Ultrasound Imaging Equipment.”

Lynch also discussed several factors to consider, including employee turnover, retiring employees, proximity of backup service, geography of hospital service, age

of imaging equipment and the availability of parts.

The session concluded with a Q&A session in which Lynch answered questions submitted by attendees.

Attendees reviewed the webinar in a survey and reported a positive experience.

“The theme of the webinar was compelling, but the fact that it was combined with TechNation as a reliable and reputable source for information made it worthy of the time on my calendar,” Robin B. wrote.

“Excellent breakdown for making decisions regarding your service contract needs,” Franklin C. shared.

“Pat's webinar was excellent. He made a very clear explanation of the various options as pertaining to the service of our high-end medical equipment,” John H. wrote.

“Presenters like Pat bring a great deal of experience and great guidance to our HTM career field,” Doug S. wrote. “Great presentation!”

FOR INFORMATION about Webinar Wednesday and upcoming presentations, visit 1TechNation.com/Webinars.

TECHNATION WEBINAR WEDNESDAY would like to thank our sponsor AlphaSource. Learn more about this company by visiting www.alphasource.com.

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51

ROUNDTABLE Nuclear Medicine

52

1TECHNATION.

NOVEMBER JUNE 2016 2014

A

dvances in nuclear medicine continue to extend the uses for this imaging modality.

TechNation reached out to industry experts for the latest on nuclear medicine, including what to look for when purchasing a system or selecting service options. The panel of experts includes: Craig Diener, Senior Product Manager, Universal Medical Resources Inc.; Michael Eaton, Field Service Engineer at Southeast Nuclear Electronics; Jonathan Frey, Vice President of Product Management, Siemens Molecular Imaging; Kirill Shalyaev, Ph.D., Vice President and General Manager, Advanced Molecular Imaging, Philips; and Northeast Electronics Inc. CEO John Shaw.

Q:

WHAT ARE THE LATEST ADVANCES IN NUCLEAR MEDICINE?

Diener: The clinical utility of SPECT, SPECT/CT, PET/CT and general nuclear medicine remains a viable mainstay in assisting physicians and health care facilities with the care of their patients.

Technical advances for nuclear medicine systems remain relatively the same. PET/ MR is being investigated for clinical utility but is an expensive modality. Also, fusion imaging with SPECT/MR is being investigated. A primary advance for nuclear medicine lies with the development and implementation of radiopharmaceuticals that not only target specific diseases for diagnosis but also impact treatment of diseases, particularly cancer. The Accountable Care Act (ACA) has impacted nuclear medicine and the entire health care delivery systems. One of its directives transitions from a “fee for scan” to “value and patient focus” type reimbursement environment. This has stimulated nuclear medicine to be proactive in adapting to these forthcoming changes. One of these proactive adaptions is implementing Appropriate Use Criteria (AUC) that provides the right procedure for the right patient at the right time. Software advances that utilize existing nuclear medicine systems are being implemented to provide improved diagnostic information, reduced imaging times, and reduced radiation dose to the patient.

Eaton: There’s been a lot of buzz lately regarding solid state gamma detection.

While computing and radio pharmaceuticals have advanced

the introduction of solid state technologies, but they are principally for research purposes and have fairly narrow applications at present, for example organ imaging and specific tracers. On the PET side, we see new acquisition techniques that include continuous bed motion, which enables personalized acquisition and allows routine incorporation of respiratory motion correction. Another PET advance is the increasing adoption of large bore PET, approaching 80 cm. Those large-bore systems are being used for radiation therapy planning, which is becoming an increasing application for PET.

CRAIG DIENER

Senior Product Manager, Universal Medical Resources, Inc.

considerably over the years, gamma scintillation technology has remained mostly idle. Solid state detection is a significant technological leap, touting shorter acquisition times and better energy/spacial resolution. The downside is cost. The price point for solid state will render it out of reach for all but those departments with big budgets.

Frey: The adoption of SPECT/CT for clinical reasons and its replacement in the install base is a major recent development.

Another SPECT/CT advance is quantification and the adoption of quantification for oncology and the growing application of radionuclide therapy. We’re also seeing new SPECT/CT visualization techniques such as for bone imaging. One final SPECT/CT advance is

Shalyaev: As personalized medicine continues to influence how we deliver care, advances in nuclear medicine and molecular imaging technologies are making it more critical in the care continuum. First off, new radioisotope tracers represent a major development that will take nuclear medicine beyond the standard FDG (fluorodeoxyglucose), which will enable greater specificity to target individual tumors or disease processes. Second, advances in imaging equipment in digital technology such as digital PET/CT have demonstrated that they can provide approximately twice the volumetric resolution, sensitivity gain and quantitative accuracy when compared to analog systems. Finally, in order for physicians to deliver personalized treatment, they need quantitative data and advances in nuclear medicine have given providers more access to actionable information and analytics.

Shaw: Nuclear medicine has seen some updates including SPECT/CT and the trend to PET and PET/CT.

THE ROUNDTABLE

Q:

Q:

HOW ARE REIMBURSEMENT TRENDS IMPACTING NUCLEAR MEDICINE PURCHASE DECISIONS?

SHOULD A HEALTH CARE FACILITY FOCUS ON PET/CT OR SHOULD IT CONSIDER OTHER NUCLEAR MEDICINE OPTIONS LIKE SPECT, SPECT/CT, PET/MR? WHAT ARE THE ADVANTAGES OF EACH?

Diener: Lower reimbursement is making nuclear medicine purchase decisions very difficult these days, which means advancing the quality of medical imaging services and care extremely challenging.

Purchasers are looking toward reconditioned nuclear imaging systems more and more as the cost of new equipment isn’t going down and service agreements are not free either.

Eaton: Since attenuation correction reimbursements have ceased, the source rods are mostly unused and in the way.

To be effective, source rods must be replaced every couple years. Given the high cost of doing so, we’re beginning to see this option phased out with the absence of reimbursement.

Frey: Reimbursement trends are driving purchasers to focus on clinical, operational and financial efficiencies.

They aren’t looking for “gee-whiz” features. Instead, they want to know how they can make a clinical, operational or financial difference. So they ask the question, “How can this product provide the same performance in less time with less total cost of ownership?” For instance, can features such as continuous bed motion for PET offer a significantly improved clinical workflow, increase efficiency and provide more data in less time? With reimbursement declining, purchasers need more clinical, operational and financial bang for their buck.

Shalyaev: Despite some slowdown in overall imaging volume due to the changing reimbursement landscape, advanced imaging modalities (CT, MRI and PET) will show significant growth.

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Diener: Health care facilities should definitely consider more options other than PET/CT. SPECT systems are much more cost-effective than PET/CT. SPECT gamma cameras cost a fraction of what PET/CT scanners do – $400,000 to $600,000 versus upwards of $2 million.

SPECT radio tracers also last much longer and are much more inexpensive – ultimately increasing throughput.

MICHAEL EATON

Field Service Engineer at Southeast Nuclear Electronics

There are ongoing studies and data that demonstrate the value of nuclear medicine solutions in both traditional and new use cases. Today, the value in these innovations and the added confidence they provide in informing better patient care is more widely recognized. As a result, PET volume is expected to rise steadily over the next 10 years, driven by new indications, novel tracers and expanded insurance coverage.

Shaw: In the past seven years, we have seen the private cardiology doctors either dropping nuclear cardiology or selling the practice to the hospitals due to the decrease in reimbursements. Since the Supreme Court made its decision two years ago, the physicians have learned how to make a profit and offer nuclear cardiology again. Hospital scan numbers are down all around, most departments have forced the employees to go part time or they send people home if there is not enough work. Equipment sales are down to private practices and hospitals because of the decrease in reimbursements.

NOVEMBER JUNE 2016 2014

Eaton: That all depends on the facility, the budget and the need. While PET is excellent for detecting abnormalities, combining it with CT greatly assists physicians in determining if a treatment or course of action is effective. The initial investment is astronomical, as is the operation and maintenance. I’d say much the same for PET/MR. SPECT is still the only modality that illustrates function, and not just structure.

Additionally, SPECT tracers have a half life of around 6 hours, allowing ample scan time. Comparatively PET tracers have a half life closer to 75 seconds.

SPECT tracers are also more widely available and less expensive.

Frey: Health care facilities should focus first on the clinical needs that they are trying to address. Then, you worry about the technology. For example, if the facility needs cardiology and general oncology, like thyroid and bone and organ function, SPECT/CT is probably best. If the facility is focusing strictly on cardiology, a dedicated SPECT system is likely the best choice. If, on the other hand, the facility wants to support radiation therapy and management of lung, lymphoma, breast,

head and neck cancer, PET/CT is probably the way to go.

Shalyaev: With health care facilities seeking new, better ways to enhance diagnostic confidence, we’re seeing a growing demand for technologies that enhance image quantification. In looking at the options outlined above, they each have unique benefits and functions.

SPECT is an established and widely-used modality, but it involves long scan times and low resolution images. SPECT/CT brings in CT imaging that can sharpen the image, providing attenuation corrected data and anatomical information for diagnostic purposes. PET/ CT has become part of the standard of care for oncology, adding a layer of diagnostic confidence to disease staging and localization by combining PET’s ability to determine metabolic activity of tissues and CT’s high-resolution anatomic information for an integrated rich, actionable data set. PET/MR combines the power of PET with MR’s advanced soft tissue contrast, diffusion-weighted imaging and dynamic contrast-enhanced imaging, making it conducive for robust imaging evaluation in certain clinical settings that are disease or organ specific.

Shaw: In more rural hospitals the PET/ CT market doesn’t seem to be a big seller. Most small hospitals hire a truck to come in once a week and they end up doing 2 or 3 scans all day. Big city hospitals will often have multiple PET/ CT scanners. The nuclear medicine departments offering SPECT and planar imaging are steady, but the scan numbers are down from eight years ago.

Insurance policies require a high co-pay and that seems push people to decline the scan even though a doctor has ordered it. Other forms of hybrid imaging don’t seem to be discussed at all in the smaller rural hospitals.

best. Third-party service and equipment providers do not have the luxury of assumed superiority in quality like the OEM. Take the time and do the research, you’ll be glad you did.

Frey: Consult with someone who has purchased from the company and determine whether that entity will service the equipment. I wouldn’t recommend purchasing equipment from a third-party or eBay type of vendor because you don’t know what you will get. Will they service what they sell – and if they do, what is the geography of their service area? Is it California? Is it global?

JONATHAN FREY

Vice President of Product Management, Siemens Molecular Imaging

Q:

WHAT SHOULD TECHNATION READERS CONSIDER WHEN LOOKING TO PURCHASE NUCLEAR MEDICINE EQUIPMENT FROM AN OEM OR THIRD-PARTY PROVIDER? Diener: When looking to purchase a piece of nuclear medicine equipment, buyers need to understand that it is all about their clinical and financial needs – nothing else. There are many things to think about. Look at the region you would be drawing scans from, what is the demand like? What’s the potential for reimbursement for a scan? Does the provider’s installation schedule make sense for your facility? Make sure the system fits your specifications, not the vendors. Does it fall within your budget?

Eaton: Purchasing a system is a sizable investment and should never be done hastily. Don’t refrain from asking questions, researching the company and checking references. Another trap to avoid is the mind set that the OEM is the

Shalyaev: When looking to invest in new technology from a vendor, it is important to choose the right equipment for your organization, which will meet the needs of the technicians, environment and patients. In working through contracts with an OEM, your readers will want to take usage and the end users into account – looking at the skill level and training along with how often the equipment will be used, etc. It is worth noting to your readers that the most common platform, hybrid PET/CT, offers the convenience of a single exam with both functional and anatomic data.

Shaw: Equipment purchasing is largely based on quality of the equipment and the reputation of the company and their service organization. The user needs to make sure the system they are looking at will do all the studies that their department is asked to do. Overbuying because it is the greatest unit available will turn into a higher cost in purchase and service when they don’t need all the bells and whistles. Purchasing what is necessary, and not more, and the reputation of the service department would be first on my list.

THE ROUNDTABLE

Q:

WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN CONSIDERING SERVICE OPTIONS FOR NUCLEAR MEDICINE DEVICES? Diener: Just like purchasing a piece of equipment, there is much to consider when selecting service. Obviously there is cost, but there are many other factors as well. Does that independent service provider have field-service engineers specifically trained in nuclear medicine?

Are they qualified to service this particular system? You’ll also want to know if they know the normal maintenance schedule. What is the average time-frame between putting in a call and someone arriving to perform service? Without answering these questions, you’ll likely be over-paying for services that you don’t need or won’t get the preventive maintenance required to maximize uptime.

Eaton: The first attribute that comes to mind when choosing a service company is experience. Aside from being complex and delicate, nuclear medicine systems can be very dissimilar from one another, even within the same OEM. Second is inventory. You’ll want to avoid downtime due to shipping, and the potential of costly restocking fees. For these reasons, having immediate access to parts is crucial. Third is response time, take measures to assure you’re not being over promised when it comes to response time.

Whoever you decide to use should have a local presence.

Frey: Consider three key points. Number one: Do they offer both remote and on-site service plus backup? (The geography question comes into play there, too.) Number two: Do they offer updates to performance and new safety standards? I would add cybersecurity to that, as well as upgrade options for the

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both in the delivery of service and that they can adjust the program to fit the end user’s needs. The reputation of the service organization is most important.

The purchaser should call around to other users and get their opinion of the service provider. Asking for a reference list from the service provider is one way, but you can be sure you will get the customers who like the service provider best. You would be best to call around to other departments.

Q:

HOW CAN PURCHASERS ENSURE THEY WILL HAVE ACCESS TO PARTS AND SERVICE OPTIONS FOR NUCLEAR MEDICINE DEVICES?

JOHN SHAW

President and CEO, Northeast Electronics, Inc.

latest innovations. And finally: Do they have a proactive monitoring system or remote diagnostic, predictive failure detection?

Shalyaev: In addition to the capital investment for the devices, your readers should consider their facility needs, operating costs and annual service options. In the case of service options, annual service contracts generally run around 8-12 percent of the purchase price. Also, some referring physicians may still be unfamiliar with PET utilization for these new devices, so it is also important to develop an active education and outreach program to communicate the new device’s availability and value can build confidence in the reports being provided.

Shaw: There are many service organizations available. OEMs obviously support their systems but don’t always take care of the needs of the individual customer. ISO groups usually have an easier path to take care of the customer

NOVEMBER JUNE 2016 2014

Diener: The process of ensuring access to viable parts and service should take into consideration the provider’s ability to provide both excellent, cost-effective service as well as quality parts that are tested on operating camera systems to assure that parts are viable and will be able to get your camera system operational in a timely manner. Purchasers should take time to qualify and confirm that a service and parts provider will meet the demands and needs of their nuclear medicine services offering.

Eaton: Again, this is where research and legwork pay off. Don’t be afraid to ask direct questions about specific concerns. A reputable company should have a list of customer references.

Frey: Work with established vendors – it’s that simple. Siemens, for example, plans to support our products for 10 years after the shipment of the last system. So if our company introduced a system in 1995 and ended its run time in 2005, it would support that system for another 10 years after that end date. And that’s the policy of any established vendor in this market that plans to be around a long time.

Shalyaev: As nuclear medicine and imaging technology is constantly evolving, it is also important to understand what technical support and system updates are often bundled in the terms and conditions with the purchase of a service contract, as well as availability of parts for repair. For purchasing organizations still building expertise, it is important to look at training options in the form of fellowship programs, vendor-supported programs and use of overreading services that can help to provide the highest standards of quality in exam interpretation.

Shaw: Usually purchasing departments never ask these questions. Many smaller hospitals do not have a biomed department or the purchasing department knows nothing about the nuclear medicine equipment so these questions are not asked. Again the OEMs are pretty much stuck with one plan fits all where the ISO can be creative and work with the department and offer plans that might fit the hospital’s needs better. We are often asked about the biomed doing a first look and that idea has worked very well if the biomed is willing to actually take the time to learn the system. Some ISOs will offer training for biomed engineers as part of the service agreement. Parts are usually readily available for systems older than five years for ISO groups.

OEMs will end of life systems and they will stop stocking parts for the older cameras. Many ISO companies will work together to help each other with parts and technical support which will benefit both the hospital and the ISO.

Q:

WHAT ELSE DO YOU THINK BIOMEDS NEED TO KNOW ABOUT NUCLEAR MEDICINE DEVICES? Diener: Nuclear medicine devices/ systems add to the portfolio of imaging

been avoided by something as simple as clearing dust from cooling fans.

Frey: What is the platform history of the product being purchased? Has it been upgraded? Can people who bought this platform 10 years ago fully upgrade it? And is it a forklift, or have features been added? At Siemens, we pride ourselves on being able to take the product from serial number 1 to look as good as the latest factory shipment, so there are a series of upgrades. Also, what is the status of that vendor on cybersecurity? No one really discusses this topic, which is an important and growing area of concern for health care in general and for imaging in particular.

KRIRILL SHALYAEV, PH. D.

Present and General Manager, Advanced Molecular Imaging, Philips

systems that biomeds/clinical engineers are now becoming responsible to maintain. The responsibility to maintain a variety of imaging devices within the health care facility is daunting to say the least. However, by developing a mutually beneficial relationship with an independent service provider this responsibility can be shared. In addition to a collaborative relationship with a quality independent service provider that can provide support, parts, and escalated service offerings, the clinical engineering department should research the independent service provider’s ability to provide training programs.

Eaton: Listen to your technologist! These men and women spend more time with the systems than anyone. Too often service and maintenance requests are downplayed or ignored and this can prove to be a costly mistake. I’ve also noticed a trend in biannual PMs morphing into annual PMs and then progressing to calling when it breaks.

Many expensive replacements could have

Shalyaev: With access to more data, biomedical professionals are looking for ways to customize treatment for patients, based on their anatomy and specific molecular and cellular patterns of disease. They should understand that nuclear medicine and molecular imaging provides the most detailed view of how disease functions in the body, combining data with digitally advanced imaging tools to help make faster and more confident diagnosis and treatment decisions. Molecular imaging has also shown to be helpful in improving the drug discovery process by giving a clear and detailed picture of how the drug is interacting with a target.

Shaw: Each individual biomed department would have to decide how involved they want to be in the actual servicing of the equipment. Many ISOs will offer on-site or off-site training.

Learning the function and some minor repairs of the system might save the department some downtime. Some biomed departments are so busy that to learn the nuclear systems is not cost effective.

THE ROUNDTABLE

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"Succession planning has to ďŹ rst begin with committed and dependable associates. I have to be certain the successor is here for the long haul."

- Roger Kyrouac, Advocate Eureka Hospital

Succession for HTM Departments

By K. Richard Douglas

A

sk any financial advisor to give you a rundown of the areas they cover with their clients. Most people think of savings and investing as the primary focus, and those are certainly two that are important. But, there are several others that are just as important, like tax planning, insurance and estate planning. That last one seeks to leave things to the client’s heirs in the most advantageous, tax-efficient and low-cost way. It is succession planning in the purest sense.

The process is designed to cause minimal disruption to the estate and minimal disruption to those receiving the proceeds. It seeks to pass the baton without dropping it.

Succession planning in the biomedical or clinical engineering department seeks a smooth transition also with minimal disruption to the operation of a hospital or health system. For leadership, it includes identifying and developing replacement managers. The process also seeks to replace retiring HTM staff in an efficient manner without disrupting internal resources.

A Numbers Game The line at the exit is longer than the line at the entrance. This is a big problem when you look at the dilemma facing the HTM profession in the years ahead.

There are 76.4 million baby boomers in America and they started reaching retirement age in 2011. From the first day of that year, and for every day for the following 19 years, 10,000 baby boomers will turn 65. There is a point in most people’s careers where they decide to enter retirement. The HTM profession will not be spared from this certainty.

Concurrently, that same aging baby boom generation puts more pressure on the country’s health care system, with larger numbers of potential admittances for age-related conditions.

Strategic succession planning is not only a fact of life in the financial planning profession, but is a stark reality in HTM, which faces a daunting challenge in maintaining staffing in departments across the country. The senior members of HTM departments are collecting their gold needle nose pliers and heading for the exit.

With their exit comes the departure of years of experience, training and maturity.

Planning for their replacement, and the training of each department’s next generation of experts, along with replacing managers, requires forward thinking.

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“We have learned that succession planning cannot be a one-time process without follow through and staff development,” says Walter Barrionuevo, director of Clinical Engineering Services at BayCare Health System in Clearwater, Florida.

“It requires continual attention to ensure our profession and industry are served for the many years to come,” he says.

That opinion is shared by F. Mike Busdicker, MBA, CHTM, system director of Clinical Engineering at Intermountain Support Services/Supply Chain in Midvale, Utah. Busdicker believes it is not only good policy, but incumbent on managers to plan ahead for their own replacements.

“In my opinion, the development and career succession planning for HTM departments includes personnel at all levels within an organization and the industry,” Busdicker says.

He adds that good leaders do not sit back and enjoy their status until the day comes for them to retire. This type of attitude does a disservice to the organization they serve and to the industry. He says that current department and industry leaders should be proactive in developing their replacements and the leaders of the future.

“Recently I had a mentor relay a message that has stuck with me. He said ‘We should not be concerned about our legacy, but should be more concerned with the handprint we leave on the organization and health care as a whole.’ This statement really hit home with me and provides an example of a leader looking beyond their specific accomplishments,” Busdicker says.

“I would suggest that organizational leaders need to look within their individual departments and understand the desire and talent of current personnel,” he adds.

“Once this information is understood, and documented, it becomes part of the leader’s responsibility to help create opportunities for growth and development.”

Not only are Busdicker’s suggestions

relevant for future planning, but for many in HTM leadership, they are a reality that is hitting home as the profession waves good-bye to the baby boomers within its ranks.

“This is real and I am living it,” says Douglas Dreps, MBA, director of Regional Clinical Engineering for Mercy Health in St. Louis. “I am just starting to put a plan together as I will have four to six senior biomed and imaging technicians planning to retire over the next five years, starting early 2017. This is a huge issue in our industry.”

RAMPING UP THE ROOKIES Finding new staff, to replace those retiring, would seem to be an easy task. It’s not as if the HTM field is not attractive. There is plenty of incentive for a young person, planning their future, to choose HTM. The projected growth for CEs is particularly strong, and even the growth for BMETs beats many professions.

U.S. News and World Report ranked “medical equipment repairer” in the number one spot among maintenance and repair jobs. Their assessment included a projection of an expected six percent growth rate between 2014 and 2024.

Using statistics from the Bureau of Labor Statistics, the publication estimated that there should be “2,900 new positions created by 2024.”

These figures may be conservative.

Anecdotal evidence appears to suggest that the need will be far greater.

The medical equipment repairer position also made U.S. News and World Reports “100 Best Jobs” list for 2016, coming in at 96.

That publicity should have created an avalanche of new entrants into the profession, but the reality is that the line at the entrance is not long enough and there is no way to acquire instant experience.

The new generation of biomeds may have more exposure to the networking and security components that are now an

“In my opinion, the development and career succession planning for HTM departments includes personnel at all levels within an organization and the industry.”

MIKE BUSDICKER, MBA, CHTM System Director of Clinical Engineering, Intermountain Support Services/Supply Chain

essential component in the field, but they haven’t had the opportunity to learn from those vexing challenges that molded the accumulated experience of the veterans.

“Succession planning has always been a top priority for our leadership,” Barrionuevo says. “We are committed to both developing the competencies of our leaders and providing the tools to develop our technical team members.”

He says that technical development utilizes formal assessment and development plans that address individual competency needs. His department utilizes several processes to develop their technical staff. The plan includes providing technical training to staff for all new equipment purchases to keep them competent.

Barrionuevo’s department also created an in-house CBET training program for all entry-level team members to ensure they are all at the same technical level and to promote the HTM industry by partnering with local educational sources, including St. Petersburg College, to ensure future candidates meet the needs of the HTM field.

He says his department’s technical training includes providing networking/IS information since HTM is becoming more IS centric. They have also taken steps through the “creation of a DI Associate position which helps bridge the gap between clinical engineering service and field service diagnostic imaging service,” he says.

CAREER PROGRESSION Big systems have an equally bigger challenge when career progression, recruitment and staffing are considered across a vast number of facilities. Some have employed a well-thought-out strategy for managing career transitions so that management positions are not left empty.

“This is definitely a challenging issue and we have experienced what happens when we don’t take the opportunity to work through robust succession planning,” says Perry Kirwan, MSE, CCE, vice president of Technology Management at Banner Health.

“We have since put in a talent management review process to try and identify both talent and likely successors to advanced positions in Banner, whether they be technical/specialists positions, or management ones,” he says.

Kirwan says that each employee not only receives an annual review, but is also asked to identify career aspirations.

Employees are then mapped relative to their current capabilities for their aspiring positions. He says that career development plans are built to help each employee reach the required steps to achieve their goal.

“The goal is to identify two to three people for each position higher than the one that they are in so that we always have a pipeline for advancement,” he adds. “These plans are reviewed twice a year so that they stay current and can be refreshed accordingly if the organization

should experience turnover or other mitigating factors.”

“Career development plans consist of mentoring with a more senior employee to learn both technical and managerial skills, taking on stretch assignments designed to grow employee skills, interim leader assignments – for managerial track employees – and taking educational courses, both within the hospital systems, and through formal education to prepare the employee,” Kirwan says.

In addition to developing internal resources, his department spends time working with community colleges and for-profit educational institutions, like DeVry, as well as state colleges and universities “in an advisory capacity to try and win both interns and new talent into the organization,” he says.

“We also have a few staff members that speak at local middle and high schools through the state AHA chapters to build enthusiasm for HTM and biomedical/ clinical engineering,” Kirwan adds.

He says local trade organizations can help with recruiting talent as well.

“AzMIA (Arizona Medical Instrumentation Association) is just beginning to tap that process by sponsoring community activities that help prospective students get exposure to hospital-based technology management professions. This is a new area for this chapter, so there is not so much to report,” he says.

SUCCESSION PLANNING

While experienced biomeds can fill the manager ranks, there has to be a process to get the rookies ramped up. A team from GE Healthcare will be presenting “Leveraging Learning Technologies: Tools to Address an Impending Workforce Shortage and to Train a New Generation” at the 2016 AAMI Conference & Expo.

“A phased approach, or a training continuum, is recommended to provide incremental learning for developing a technical workforce. Entry-level workers should be provided competencies – aggregates of knowledge, skills, abilities and tools – to understand equipment operations, participate in basic maintenance tasks and assist in minor repairs,” says Art Larson, general manager Global Services Training at GE Healthcare.

Larson says that new biomeds can then engage in follow-up training that may include visits to equipment manufacturer’s institutions, online training modules, on-the-job training, simulation and/or other learning experiences. He points out that a flexible model, with multi-faceted learning delivery methods, should include opportunities to apply learning before additional training is required, allowing for discussion with peers in the field and real-life experience which will enhance future training, understanding and retention.

Ahead of training those new recruits is finding qualified candidates in the first place.

“I have built up relationships with several schools in my area. I have affiliation agreements for intern and externships with three of them,” Dreps says. “The past seven years, I have hired many of the interns or externs that were at one of our hospitals. Training is another area that I have already started on to boost others’ knowledge, so they can fill in for those that plan to retire.”

MAPPING IT ALL OUT It’s been said that writing down a goal brings you half way to achieving it. With the projections of a retiring workforce, the

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“A phased approach, or a training continuum, is recommended to provide incremental learning for developing a technical workforce.

Entry-level workers should be provided competencies – aggregates of knowledge, skills, abilities and tools – to understand equipment operations, participate in basic maintenance tasks and assist in minor repairs.”

ART LARSON General Manager Global Service Training at GE Healthcare

best approach is to face that fact and develop a succession plan. It’s all about mapping out known future events and being prepared.

“Back in 2012, I developed a comprehensive succession plan for our entire division, and identified the following major concerns,” says Dave Dickey, CHE, CCE, corporate director of Clinical Engineering for McLaren Health Care in Flint, Michigan.

Dickey began by charting the estimated

retirement target dates of his staff at the time. The breakdown included 12 MCES staff members who would be retiring within five years, 20 who would be retiring within 10 years, 10 others who would be retiring within 15 years and 20 who still had 15 or more years to work before retirement.

The resulting fact was that half of his staff would be retiring within 10 years. As a director, Dickey saw that he had four time periods of concern which needed to be “properly planned for and managed.”

At the time, he captured the relevant data to formulate a plan.

“In 2015, the CE lead tech (supervisor) at one of our sites will be retiring. Also, during this same year, two of the senior biomed staff at one of our other hospitals will be retiring (representing 33 percent of the total biomed tech staff),” he explains.

For this year, and next, he found that two of his current call center/admin staff (FTEs) would also be retiring.

“Both of these individuals share phone (call center) duties. One has primary responsibility for invoice management for all locations, and also serves in the role as office coordinator; the other is responsible for customer service report generation and distribution,” he says.

For 2019 and 2020, Dickey is faced with his own retirement and about half the corporate program managers. In 2022, “36 percent of the service specialist staff will be retiring, along with 18 percent of the biomed tech staff,” Dickey adds. “In total, 13 individuals will be retiring at this time. At our Lansing site, three (42 percent) of the biomed tech staff will be retiring.”

Put in context, and with 2022 not that far off, the need for succession planning is front and center. In defining the challenge, a manager should consider timelines and resources. The solution for staff replacement, skill set consideration, sourcing and timing, according to Dickey, looks like this:.

“Ideally, hospital CE programs should have, as a goal, to have 10-30 percent of its staffing being entry-level technicians, with zero to five years of experience.”

DAVE DICKEY, CHE CCE Corporate Director of Clinical Engineering, McLaren Health Care

“According to a Deliott Best practice leadership survey report, the best method to prepare new leaders incorporates a 70:20:10 ratio, of 70 percent on the job experience in various progressive leadership roles, 20 percent one-on-one mentoring with coaching and performance management, and 10 percent classroom instruction, training, reading, and seminars,” he says.

He points out that typically, clinical engineering professionals obtain their experience in different ways.

For technicians, Dickey points to internship programs, followed by entrylevel employment within hospitals or external service organizations.

“Ideally, hospital CE programs should have, as a goal, to have 10-30 percent of its staffing being entry-level technicians, with zero to five years of experience. What has happened, historically, is that due to the low turnover of staff within properly managed CE departments, most of the biomedical technician staff are all extremely experienced, with little to no entry level staff available that have upward career mobility,” he adds.

“This situation leads to loss of new, young talent, as they pursue new career opportunities within five years of employment at their first job out of school.

This can be averted by having a structured career advancement program, whereby an entry-level technician can gain promotion to a Level 2, then Level 3 technician, based upon experience and obtainment of CBET certification,” Dickey adds.

The real challenge he cites, is that there is currently “only one local technical college in Michigan offering a structured AA degree in biomedical equipment service, that being Schoolcraft College in Livonia, Michigan.”

He says that in preparation for the need for new BMETs, it is recommended that MCES explore a formal internship program with them as a means to generate a source of replacement BMETs as the existing workforce enters retirement.

The challenge faced by this one HTM department supports the perception that the turnover in HTM staff, in the coming years, will reflect the percentage of baby boomers in the workforce.

TRANSITIONING LEADERSHIP As stated earlier, good leaders begin working on the process of filling their own shoes ahead of their own retirement. For some, this process is well planned and considers a number of factors.

“Succession planning has to first begin with committed and dependable associates.

I have to be certain the successor is here for the long haul,” says Roger Kyrouac, clinical engineering site manager for Advocate Eureka Hospital in Normal, Illinois.

“My succession plan began four years ago, when I hired a new biomed with bachelor degrees in both business administration and clinical engineering; he also aced the interview. I was 58 years old at the time and saw the opportunity to groom my replacement,” he says.

“The plan was and is simple,” he says.

“I have always been rather aggressive bringing talent up to speed.”

His planned successor is currently a Biomed II doing Biomed III work.

Kyrouac says that during annual evaluations, and periodically throughout the year, he has had conversations with that candidate about this plan.

“He is committed to this area and is excited about this plan,” Kyrouac adds.

As his retirement nears, Kyrouac will periodically expose his replacement to more leadership opportunities: “joining me for physical environment and leadership meetings and filling in for me on occasion; putting him in charge of higher end projects; spending more time coaching him as a leader rather than a biomed.”

“The year that I plan to retire will ramp up his exposure to those activities while I personally back fill some of his biomed responsibilities. The end game is to spend my last month as a biomed while he assumes the role of manager, which will ease me into retirement while getting him acclimated with me nearby for support,” Kyrouac says.

Beyond the planning for leadership succession, Kyrouac also has staff retirement challenges to contemplate. His imaging tech has been very successful at keeping imaging costs low, but he is two years older than Kyrouac. The challenge is that there is not a viable replacement in-house and his system’s policy will “only allow a max of three-month overlap of FTEs which is not satisfactory to replace the imaging tech. This will require a new

SUCCESSION PLANNING

“This is real and I am living it. I am just starting to put a plan together as i will have four to six senior biomed & imaging technicans planning to retire over the next five years starting early 2017. This is a huge issue in our industry.”

DOUGLAS DREPS, MBA Director of Regional Clinical Engineering, Mercy Health

position,” Kyrouac says.

The plan to justify an additional position is to use “recent major cost savings in imaging, overtime, contract and outside service reduction for the entire shop (all data driven with no imaginary numbers); I was able to document $120K against $65K (salary and benefits) for another FTE for a savings of $55K annually.”

With this in mind, and the additional benefit of increased “associate satisfaction,” he would submit a request for another Biomed II (hybrid) “with imaging experience or imaging training or imaging skill sets and interest,” Kyrouac says.

“Once on board, the focus would be to fully orient as a biomed II and enter the on-call schedule within six months.

Followed by a realignment of PM assignments and mentoring by my Rad II. Ongoing responsibilities will be balanced between biomed and imaging,” he adds.

The upside is that the new position has the support of Kyrouac’s director and vice president, as well as the vice president of finance.

HIRING POTENTIAL MANAGERS In the quest to develop the next generation of leaders within a health system, Busdicker suggests that there are certain important building blocks.

“Teach them, and help them understand, the importance of building relationships with the organization and the industry,” he says. “Provide them with the tools and training necessary to develop natural and learned leadership

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abilities and competencies.”

Busdicker also suggests that they be allowed to manage some projects and functions that will provide valuable experience and learning opportunities. He says that leadership should also be mentors and/or provide them with an opportunity to interact with other leaders within the industry.

“Help them learn through your experience and provide them opportunities to learn through individual experience,” he says.

Busdicker says that HTM personnel, who have management aspirations, should make it clear that this is a career path choice.

“It is just as important for them to be proactive in their own careers and let others know of their desires. Over the past few years, I have had the opportunity to conduct a number of interviews,” he says.

“One of the questions I have asked is ‘Where do you see yourself in five years?’

There have been a couple of occasions when the response has been: ‘I would like to have your job or something similar to it.’ In my opinion, this is a great response and demonstrates an individual’s desire to develop professionally and become a difference maker within the industry.”

“Leadership development provides competency training through classroom instruction, individual and team coaching,” Barrionuevo says. “Using our organization’s succession planning process, we identify exceptional team members who demonstrate leadership potential and provide additional training opportunities such as Aspiring Leaders Track, Emerging Leaders Track and

Experienced Leaders Track.”

“Through these efforts combined and due to the continued growth of our department, we have successfully promoted 18 team members in the past six months,” he adds.

That same type of in-house leadership preparation process is playing out at McLaren Health.

“As internal candidates are identified as potential replacements to move into CE management within MCES, it is recommended that they be assigned to attend the MHC Leadership Academy Core I classes, at least one year in advance,” Dickey says. “If no internal candidates are available or meet job requirements, I recommend that an employment announcement be placed in the AAMI careers website.”

“Ideally, I would like to identify a qualified successor at least three months before I retire – in about 3 years – for cross training,” Dickey adds.

While many HTM leaders have developed their own approach to meeting these challenges, AAMI has also published several online resources to aid in the planning and implementation process.

Those resources include: The AAMI Career Planning Handbook, the AAMI Leadership Development Guide and the AAMI Mentorship Program.

With preparation and forethought, the metamorphosis of the HTM profession, post baby boomer, will present less disruption and result in a transition that replenishes every department with minimal downtime.

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CAREER CENTER

Limited Pool Causes Hiring Challenges

By Cindy Stephens

H

ealthcare Technology Management (HTM) hiring authorities and human resource professionals are finding that there are not many technically qualified and experienced biomedical equipment technicians (BMETs) and imaging service technicians available to fill the many vacant positions throughout the U.S. Healthcare employers are struggling to keep up with the demand for these specialized service individuals.

CINDY STEPHENS Stephens International Recruiting Inc.

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We have seen a significant economic impact on health care organizations nationwide due to the decline of available qualified talent. As the aging “baby boomers� retire, the labor shortage for quality healthcare technical professionals will continue to challenge health care organizations more than ever before.

The use of increasingly complex medical equipment drives the demand for professionally trained and experienced service professionals. To add to this problem, there seems to be fewer students graduating from professional biomedical equipment training programs, nor enough BMETs exiting the military to help fill the gap in the available talent pool. This is creating a major shift in hiring trends nationwide.

We have seen some health care organizations and ISOs hiring basic electronics technicians and performing on-the-job training to repair clinical equipment. These organizations soon realized that most of these basic electronic technicians could not replace the services of the professionally trained BMET because they lacked the training and qualifications to repair complex clinical equipment. Additionally, most of these electronic technicians lacked the

understanding or knowledge of the health care structure and the impact on patient care.

Another challenge for hiring officials is recognizing professionally trained BMETs and imaging service technicians with appropriate compensation as a crucial part of the successful hiring and retention equation. While historically not at the top of the pay range for technical positions, salaries have increased for professionally trained BMETs over the past few years due to the classic economic law of supply and demand. The demand for experienced BMETS and imaging service technicians is significantly increasing, and wages continue to rise due to the labor pool shortage. Employers need to continually evaluate the market trends and keep up with the appropriate pay and benefits to retain qualified staff.

Hiring authorities can ease their recruiting burdens by utilizing appropriate resources that are available. We suggest using local biomedical equipment associations and trade publications.

As a result of the shortage of talent, we are experiencing an increase in need for our services to locate top healthcare technology talent for health care organizations and service support firms.

As recruiters, we screen our candidates carefully, and dedicate our time to find qualified candidates who are ready to accept a new opportunity.

Professional recruiting agencies can save time in screening and qualifying candidates for these very technical specialty positions, saving time and money for employers in the end. Fees are reasonable and worth the investment, relieving the burden for managers and HR professionals.

Recruiters may be found from a variety of resources; however, you want to focus on using a firm that specializes in this career field as they have the experience and resources to find the required talent to fill these positions.

Another challenge is that candidates are moving on to other opportunities because of the slow process. When employers finally find qualified talent and go to hire permanent employees, hiring authorities are taking much longer to bring an employee on board. In the

temp-to-perm alternatives to lock in a prospective candidate.

We, along with several other recruitment and staffing agencies, provide contract staffing. They are a reliable single source for the hiring organization’s staffing needs (to include direct hire, contract staffing, contract-to-direct conversions or temp-toperm conversions, payroll services, as well as retiree re-staffing).

Why contract staffing?

Contract staffing enables companies to bring in workers on a temporary basis to fill the demand and eliminates the fear of having to lay-off a direct-hire since it is easy to end a contractor’s assignment.

Contract staffing services allow organizations to reduce their overall staffing costs and increase their staffing flexibility without the time-consuming administrative and financial responsibilities associated with engaging contractors or employing personnel themselves.

done on any contractor provided, as well.

Now companies and hiring managers have an alternative to handling the stress of staffing shortage and increased workloads by using contract staffing. This major shift in hiring trends is an excellent alternative in meeting the employment challenges of today.

However, there is one thing I would like to address as a concern that has come up in our business. The hiring organization needs to ensure they are working with a reputable company who has contract staffing experience and meets the legal and IRS requirements. An experienced contract staffing firm actually brings on a contractor as their employee, as the legal W-2 employer of record for contractors.

There are a few temporary staffing agencies using BMET contractors as 1099 employees rather than a W-2 employee. If a contractor is hired as a 1099 employee for an organization, it can result in

“The demand for experienced BMETS and imaging service technicians is significantly increasing, and wages continue to rise due to the labor pool shortage.” process, the candidate may become very discouraged and may move on to another opportunity. So both the employer and the candidate lose out due to the delayed hiring process which is not good considering the shortage of available and qualified talent.

On a positive note, this very tenuous and uncertain economic period has created a shift in hiring trends that helps employers and candidates. To meet the staffing demands and deal with the economic insecurity, employers are turning to recruitment and staffing companies for temporary and contract staffing as an alternative to the economic risks of hiring permanent employees. The delay in hiring is also causing many employers to consider

Contract staffing services provide hiring organizations temporary employees to fill in for staff shortages due to extended sick leave, equipment inventory and PM requirements for Joint Commission inspections, temp-to-perm hires, and special project initiatives. It also allows the employer to evaluate a potential employee for a future permanent position.

A contract staffing firm will handle all the employer headaches on behalf of the hiring organization. They handle all the payroll and employment issues, and provide an added layer of insurance protection for the hiring organization. The contract staffing company ensures a criminal background and drug screening is

significant fines and penalties, even for the organization using a temporary staffing service. The government continues to crackdown on companies who mistakenly hire or classify a worker as a 1099 independent contractor versus a W-2 employee.

Don’t get frustrated with the challenges of today’s recruitment process, whether you are an employer, HR professional, or a candidate. In this tight labor market, recruitment and retention of professionally trained biomedical equipment technicians and imaging service technicians can be painless and successful by utilizing the right resources and providing incentives to prospective employees.

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Making a Difference

By Matt Tomory

A

s we finish celebrating Healthcare Technology Management Week and all that biomedical equipment technicians (BMETs), clinical engineers and the rest of the Healthcare Technology Management (HTM) members contribute to patient care, I pondered the evolution of biomedical/clinical engineering over the 30 years I have been in the industry.

MATT TOMORY VP of Marketing & Sales, Conquest Imaging

EXPERT ADVICE

What we have witnessed is truly astonishing when looking at the development of the HTM field and the professionals who now are the backbone of hospitals, medical centers and clinics.

“Making a Difference” is an appropriate title for what the HTM profession does today and this article will explore the traits modern, successful BMETs possess to make a difference when it comes to ultrasound (or other device) support.

Having the pleasure of partnering with hundreds of BMETs from across the country and around the world with in-house ultrasound support programs, I have noticed that all progressive/ successful ones have several things in common with the first being a strong sense of curiosity. How does this work?

Why do we do things a certain way?

What if we tried doing this instead?

Being a non-linear thinker is a major asset in the HTM field when it comes to repairs, processes and new modalities to take in-house. Complementing this is a willingness to take calculated risks when something new can be done, something can be done better or differently, or an old way of doing something can be discarded.

The best BMETs also have a high Emotional Quotient (EQ) or Emotional Intelligence (EI) which is the combination of personality traits, social graces, communication skills, language, personal habits, interpersonal skills and the ability to manage up, down and laterally. This includes interrelating with fellow team members, management, clinical department staff and even hospital administration. These soft skills complement the strong technical skills typically associated with BMETs and are equally important, if not more so, in my opinion.

Going the extra mile is also readily apparent in today’s successful BMETs. Having been in field service for 25 years, I learned the day is not over until customers are satisfied or, at the very least, all options have been exhausted for the day. This mindset is something I see every day in the HTM profession and separates a good engineer from a great one.

The HTM field has changed dramatically over the last 30 years and I am continually amazed to see what it has become today. Thank you to all of you for what you do and who you have become.

JUNE 2016

1TECHNATION.COM

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THE FUTURE

Feast or Famine?

By John Noblitt

O

ne month the PMs are due on the infusion pumps in your facility and you have way too many PMs to perform. The next month your PM list is extremely short in comparison. When this happens you have a feast or famine PM scenario.

Depending on how you look at it, you would have a famine in your time to do other things besides searching for infusion pumps in the first month and a feast in the second month for completing other duties. Some consider this to be the ebb and flow of your work cycle. One month you feast and the next you have a famine. This month you have a decrease in your work load followed by an increase in your work load and the cycle continues throughout the year.

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

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This feast or famine or ebb and flow in work load is seen in many different industries. A great example may be a CPA each April when tax filing deadlines are fast approaching. Higher education also has its workflow follow these patterns of feast or famine as it pertains to student enrollment.

I have written fairly extensively about several issues related to the HTM career field and education. I’ve discussed how you may better prepare yourself or someone you know about seeking an outlet for educational services. I hope you have found the information useful.

This article is about how you can help, but first a little background on higher education’s feast and famine.

Currently, in the community college system, we are experiencing a little bit of a famine when it comes to student enrollment. This is a natural feast or famine cycle experienced in higher education and is directly tied to the economy. Student enrollment in the community college system has an inverse relationship with the economy.

When the economy is doing well potential students usually do not have time or a desire to enhance their job skills as they are too busy working. On the other hand, when the economy is

not doing well and the job market is really tight, many folks find this to be a great time to return to school to enhance job skills and better prepare themselves for the limited number of jobs available.

The feast or famine analogy is applicable in regards to student enrollment, but with a sadistic twist.

It has been my experience in 25 years of teaching in the community college system that when I have full enrollment there are a limited number of entry-level job openings. However, when enrollment is down there seems to be much better entry-level job availability. To illustrate this point, one major health care provider in my state has seven entry-level positions currently open. I can’t remember a time when one hospital system had that many entry-level positions ready for new graduates. However, this year we will only graduate 10 students.

Unlike eight years ago when I had three times this many students but only knew of two entry-level positions in the state. So, we continue to feast on students when job availability is short and when the jobs are plentiful we endure a famine in regards to the availability of quality students.

P h a n t o m s U l t r a s o u n d

This is where everyone in the HTM field can help. Steer that bright young kid into the HTM field. You know the kid I’m talking about, he or she was on your child’s baseball team or went to church with your family. Or how about the well-spoken young kid you see all the time when you are checking out at the grocery store. Odds are most of these kids have never heard about this career field. What better way to ensure the next leaders of the HTM field are of the caliber you would be proud to work with?

No one knows what it takes to be successful in this career better than each person reading this. When you see someone with the potential to be successful in this field, please take a moment to reach out. Inform them about this wonderful career field and all the wonderful opportunities that await them. Share with this person how you make a difference in the patient outcomes with your job performance and how they can experience that same type of satisfaction in their career. Please be proactive in helping choose tomorrow’s leaders of the HTM community so we can ensure a quality health care feast for all.

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KAREN WANINGER Is Failure the New Success?

F

By Karen Waninger

rom comics to television commercials to advice from a financial advisor, it is common to hear or see the phrase “70 is the new 50.” My interpretation: people are in denial about the fact that they are getting older, so industries have figured out how to take full advantage of that. When you consider that more than 14 percent of the current population in the United States is over age 65, the intensity of the way pharmaceutical and skin care companies are targeting that audience makes sense.

It goes far beyond those companies, though. Look at the commercials for new cars, luxury vacations, and even online dating services. Much of the marketing focus is clearly directed toward people over age 65 who are looking for new experiences, bucket-list or otherwise, and who have the financial resources to support their interests.

KAREN WANINGER, MBA, CBET

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While the early baby boomers are enjoying the benefits of their guaranteed pensions and savings from all those years with a lower cost of daily living, the rest of us are typically more cautious about letting go of any extra cash on hand. The consumer products industry is continually searching for better ways to get that money, though.

It’s all cyclical and somewhat predictable, unless something happens to disrupt the normal course of events.

The same applies to health care organizations. Historically, equipment was put on some schedule for replacement at intervals of every five to 10 years. With that knowledge, the equipment manufacturers were able to plan their design and production cycle, with somewhat predictable cost and revenue streams. The different manufacturers would leap-frog ahead of each other with market share as their newest products would be released to market. Occasionally, something really different would be developed. When that happened, the manufacturers were confident the physicians would be impressed enough to pressure the hospitals to buy the new toys, even if

“Poor quality products would have guaranteed failure for a company in years past. Apparently now, it has become the new corporate strategy for success.”

outside of a typical replacement cycle.

Those types of devices are referred to as disruptive technology, meaning they are products that simply create a whole new set of consumers.

That is one strategy for increasing revenue. There is also another one that we should be watching more closely. It doesn’t seem nearly as obvious when it happens, but potentially has an even more significant long-term financial impact. Have you noticed that the typical life cycle is getting shorter for many of the things we consumers use on a daily basis?

Let’s look at three specific examples, a

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coffee pot, a hair dryer, and a washing machine. My father had one coffee pot from the time he married my mother in 1944 until he decided he wanted to get one of the “new style” automatic drip coffee makers in the early 1970s. The hair dryer I bought in college lasted more than 15 years, now the motors burn up about every eighteen months. My eight-year-old washing machine finally died completely last week. When I called the appliance repair guy to discuss whether it was worth repairing or not, he informed me that new ones of the same model, marketed as high-capacity and highefficiency, are lasting about two years.

That convinced me to go get the 15-yearold one that he had just rebuilt, sight unseen.

Who came up with the definition of high-efficiency? We are expected to think those washing machines use less detergent, less water, and are good for even our most delicate fabrics. Wrong!

The reviews I saw when I was shopping, before I called my repair guy, were all about how the clothes didn’t get as clean with the new washer and the spin cycle was wearing the fabric out after only a few washes. With that information, it sounds like these washers are only highly efficient for the manufacturers. It’s also no wonder they are proudly promoted by the garment industry.

Poor quality products would have guaranteed failure for a company in years past. Apparently now, it has become the new corporate strategy for success: more frequent repeat buyers. I don’t think the Healthcare Technology Management profession in general has shifted to that kind of philosophy yet. We are still struggling, too often, with the concept of adopting a run to fail service strategy on devices that do not show any increased

safety or longevity as a result of periodic inspections. Maybe we just need to follow the lead of all those companies that have been driven to change under the external pressures of the economy. If we recognize those same pressures are shaping the Advanced lmage Diagnostics long-term strategies of our employers, it Light Measurement Internal optics should become easier to realize that we Wireless Documentation & More! need to shift our way of thinking, too.

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Medical Device “Drones” Are On The Way – Part III

By Alan Moretti

W

ith the April 2016 awarded patent to Google for its “dispatching” drone technology that is enabled through an “emergency intercom” type mechanism, these “angels of medical device transport” will now swoop down from above on demand with critically needed medical devices.

ALAN MORETTI Healthcare Technology Management Executive

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You may recall my writing on this visionary concept about 18 months ago and I believe it deserves a follow-up column, as this emerging visibility of “drone” presence in our society and environment is clearly here to stay!

The use of drone technology, which has revolutionized military operations and warfare, has now clearly established itself in the civilian world.

Thinking in a futuristic mindset we will see the sky full of drones delivering merchandise to doorsteps.

Amazon thinks so, and most likely once the FAA and other federal agencies can be convinced that this “Jetsons” style mode of services is safe then perhaps a new definition regarding mobile medical devices will begin to emerge. Let your imagination wander as defibrillators, pumps of all types, non-invasive BP and whatever other device you can think of comes cruising in for a patient care landing.

A recent Federal Aviation Administration (FAA) report on the

drone population in the continental United States estimates that by the end of 2016 over 2.5 million will be flying the skies above and will blossom in 2020 to over 7 million! The FAA is expected by mid-summer of 2016 to issue final regulations on the use of both private and commercial drones.

So as you think about this futuristic “medical device drone concept” as HTM service professionals, here’s a few questions to noodle on. How would you see yourself performing scheduled medical device drone PMs? Responding to that medical device drone service call that just came in from dispatch? Exciting stuff and again another reason why this profession is so stimulating to those who can see and be the future.

Some may have said I was pipe dreaming again – maybe so but please note you heard it here first! This puts a new spin on the old saying, “I’ll take care of that service call on the fly.”

EXPERT ADVICE

TECH SAVVY

The DICOM Association Process

T

By Jeff Kabachinski

his issue of Tech Savvy explores the DICOM association process. DICOM is the universal communication standard that imaging devices use in a PACS (Picture Archive Computer System). It allows cross-vendor communication of things like diagnostic images, ECG waveforms, diagnostic reports and workflows.

However, none of this can happen without two Application Entities (AEs what DICOM calls DICOM compliant devices or network nodes) first recognizing a connection.

Jeff Kabachinski Senior Director of Technical Development

An association process sets in place all the details required to ensure proper connection and interoperability between devices from varying vendors. Since DICOM intends to be as diverse as possible to enable connection with “anyone“ the standard can be complex in all the various types of encoding. In other words, because DICOM attempts to include all connection nuances from all manufacturers the standard becomes large and complex but accommodating. This is why the DICOM association is detailed but vitally important.

The association process has a number of informative precepts to be sure and identify during the association including: • Abstract syntax • Transfer syntax • Protocol data units (PDUs) • Application context • Presentation context • User Information ABSTRACT SYNTAX The abstract syntax identifies the nonnegotiable portion of the impending association and data transfer. It stipulates aspects that cannot be changed. For example, if you’re an MR scanner you’ll be limited to dealing with MR images – not CT, XR or any other modality. The abstract syntax also identifies whether you’re a SCU (Service Class User – like a network client) or a SCP (Service Class Provider – like a network server). Unless I’m a SCP I won’t be able to send or provide anything.

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DICOM STANDARD SECTIONS • DICOM Part 1: Introduction and Overview • DICOM Part 2: Conformance • DICOM Part 3: Information Object Definitions • DICOM Part 4: Service Class Specifications • DICOM Part 5: Data Structures and Encoding • DICOM Part 6: Data Dictionary • DICOM Part 7: Message Exchange • DICOM Part 8: Network Communication Support for Message Exchange • DICOM Part 10: Media Storage and File Format for Media Interchange • DICOM Part 11: Media Storage Application Profiles • DICOM Part 12: Media Formats and Physical Media for Media Interchange • DICOM Part 14: Grayscale Standard Display Function • DICOM Part 15: Security and System Management Profiles • DICOM Part 16: Content Mapping Resource • DICOM Part 17: Explanatory Information • DICOM Part 18: Web Services • DICOM Part 19: Application Hosting • DICOM Part 20: Imaging Reports using HL7 Clinical Document Architecture

TRANSFER SYNTAX Next is the transfer syntax to identify how the data transfer will be encoded – little endian or big endian for example. In hexadecimal byte ordering the most significant byte is left most or comes first in big endian. Little endian is the reverse. For example, A1 in big endian has a decimal value of 161 and a value of 26 in little endian so we better know the format of the data coming across. The transfer syntax also establishes which of the seven data compression formats the AE has in their toolbox.

• A-Release-RQ PDU – requests to terminate the association • A-Release-RP PDU – OK let’s terminate the association • A-Abort PDU – aborts an invalid association

APPLICATION CONTEXT The Application context does not add to the negotiated communication parameters. It defines the context of the application in the requesting AE. For example, if I’m running GE software and the requested AE is also a GE device with the same software, I’d immediately know PDUs that I could use some proprietary data The PDUs in DICOM refer to the transfer scheme. commands themselves including: PROOF APPROVED CHANGES NEEDED • A-Associate-RQ PDU – requests PRESENTATION CONTEXT DICOM association CLIENT SIGN–OFF: The presentation context refers to the • A-Associate-AC PDU – accepts pairing of the abstract syntax and transfer DICOM association PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT syntax that can be used. The abstract • A-Associate-RJ PDU – rejects LOGO PHONE NUMBERsyntax isWEBSITE ADDRESS the subject of the discussion and DICOM association the transfer syntax is the language to be • P-DATA TF PDU – transfers used. An SCP may be able to use several DICOM data

types of data compression, for example, and the SCU chooses which one it prefers from the list.

USER INFORMATION The user in the user information field refers to the requesting AE. This is a list of details important to the data transfer.

Called sub-items these are things like specifying the maximum size of a data block that I can handle.

SUMMARY The idea here was to present a brief overview and demystify the things that occur during a DICOM association while introducing some DICOM-ese. All the grim details can be found in the DICOM standard at dicom.nema.org. The standard has 20 parts as shown in the sidebar. PS3.7 is where you can find the list of user information sub-items, for example. If you SPELLING GRAMMAR have insomnia, reading the DICOM parts could be a good solution for you!

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THE ROMAN REVIEW Your Future Self

By Manny Roman

I

was reading an article by Peter Bregman titled “You Need to Practice Being Your Future Self” that made such a great point that I thought I would share it with you. Of course, I will modify and add stuff to make it appear as though I have additional enlightening input.

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

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The article essentially states that we are all so busy working in the moment and on what is on our minds, that we tend to ignore what and where we want to be. We stay busy all day without really being productive. He states, “It’s the difference between running on a treadmill and running to a destination.”

To be productive we must ask who we want to be and where do we want to go.

These are the questions that determine true growth.

You must spend time on what you want to become. You must spend time getting to where you want to be. You need to spend time on the future even when there are very important things to do in the present. Spend time on your future even when there doesn’t seem to be any return for your efforts. “ … if you want to be productive, you need to spend time doing things that feel ridiculously unproductive.”

You may wind up with emails left to answer, phone calls not returned, grass left uncut and a carried over to-do list, however, you will be closer to who and where you want to be.

I have written before on the value of procrastination. I have stated that procrastination is good because it allows things to get done so we can avoid others. Not just putting things off but delaying them and doing other more pleasant tasks in preparation for the unpleasant ones.

Bregman is not speaking about this

procrastination technique of which I am so fond. He is not speaking about procrastination at all. He is talking about a deliberate and focused approach to becoming your desired future self.

You should have a scheduled, focused, and unwavering commitment to your future self.

I guess that it what Buddha meant when he said something like, “You become what you think about.” I believe this to be true. Most present business gurus say the same thing in their own way. Bregman is stating this in a wonderfully clear way. Spend time thinking about and becoming your future self.

I have been following this advice before it showed up. I want to become a very good poker player. I think about poker strategy all the time. I read articles and books about poker. I play poker almost daily. I let other things go undone to be “my future self as a great poker player” all the time.

I thank Bregman for providing me with a Harvard Business Review article that describes and encourages what I normally do. I now have my justification, reason and excuse for the long undone list that my wife, Ruth, carries around. Remember that he said something about doing things that feel ridiculously unproductive. I have newfound enthusiasm for my poker game. I can ignore that I am not good at poker since I am investing in my future self.

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PUBLICATION MEDICAL DEALER

TECHNATION

BUYERS GUIDE

OTHER

ORTODAY

AD SIZE HALF PAGE HORIZONTAL NOTES

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DID YOU KNOW? Science Matters Solar cells Electric conductor

Smart contact lens inspired by fish’s eye Imagine a contact lens that autofocuses in thousandths of a second. It could be life-changing for older people who have trouble focusing on close objects and in dim light.

Vision as a person ages Cornea

Lens

Lens cannot become rounded enough

Retina

Image does not focus on retina

• Presbyopia is caused by stiffening of the eye's lens as it ages • Degrades close-range vision, especially in dim light • Impairs vision of more than 1 billion people worldwide

Source: Hongrui Jiang of University of Wisconsin, Madison; Proceedings of the National Academy of Sciences Graphic: Helen Lee McComas, Tribune News Service

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Sensor

Shapeadjusting liquid lens

Electronic control circuits 9.5 in.

(24 cm) long

Like a fish retina Elephant nose fish evolved in murky African waters, where it needs to see predators Tiny, reflective pits in its eyes’ retinas help it see in dim light Researchers used that design in light sensor of the experimental contact lens

BREAKROOM

JOIN US IN PINEHURST & REGISTER NOW!

NCBA is pleased to be returning to the Pinehurst

38th Annual Symposium & Expo August 23-26

Resort in Pinehurst, NC! Join us at this year’s symposium for incredible golf, education, exhibit hall and networking opportunities!

Register at www.NCBiomedAssoc.com/Symposium JUNE 2016

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THE VAULT

D

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-june-2016. Good luck!

SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing.com and you could win a $25 Amazon gift card courtesy of TechNation!

LAST MONTH’S PHOTO Siemens Sirecust 404 Patient Monitor. This photo was submitted by Megan Digeon.

To find out who won a $25 gift card for correctly identifying the medical device, visit www.1TechNation.com.

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BREAKROOM

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WHAT’S ON YOUR BENCH?

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echNation wants to know what’s on your bench! We are looking to highlight the workbenches of HTM professionals around the country. Send a highresolution photo along with your name, title and where you work and you could be featured in the What’s On Your Bench? page and win a FREE lunch for your department. To submit your photos email them to info@medwrench.com.

$2 bill weight loss incentive

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T-handle tool holder that I made from real Georgia peach tree wood from my dad’s backyard Command modules for Spacelabs vital signs monitors

SPOTLIGHT ON: See what’s on Professional of the Month Mike Lane’s bench, pg.16

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Danny Gordon University Hospital Augusta, Georgia

Two coffee cups ďŹ lled with pens Instruction card for a piece of GE equipment Various ID badges

Diet Dr Pepper

g, CBET Craig Muehlin Hospital ation Carle Found is Urbana, Illino

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SEND US A PICTURE.

WIN A FREE LUNCH. Email a photo of your bench to info@ MedWrench.com and you could win FREE lunch for your department.

The Pocono Health Sy stem celebrating with a FREE pizza party!

BREAKROOM

SCRAPBOOK MD Expo Dallas

MD Expo was a huge success in Dallas. It included a brand new Leadership Summit and Reverse Expo. A partnership with HTMA-Texas garnered local support and intensified interest in the Lone Star State with record attendance. Also, booths sold out early with more than 300 vendors at the conference.

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1.

2.

4.

3.

5.

6.

1.

Attendees Dennis Callahan, Vishwajit Palsule and Ketan Dighe enjoy refreshments at the Welcome Reception sponsored by Modern Biomedical.

2.

MD Expo’s Welcome Reception was held poolside at The Fairmont Hotel in Dallas, Texas.

3.

Robert Grzeskowak with MW Imaging congratulates their Hot Spot winner with a free iPad.

4.

Eddie Accosta, Rick Walston and Andrew Ulvenes network at the Happy Hour sponsored by AIV.

5.

Kyle Grozelle from Summit Imaging presents his class “Minimizing Transducer Failure Through Proper Care and Early Detection.”

6.

The packed exhibit hall at MD Expo Dallas had more than 300 vendors and 500 attendees; the biggest show to date!

7.

Dale Cover (RSTI) networks with attendees at his booth in the exhibit hall.

7.

8.

10.

9.

11.

8.

Jim Rickner (Conquest Imaging) presents his class on troubleshooting techniques for the new Philips EPIQ 5/7 System.

9.

MD Expo staff pose for a group photo in the famous Venetian Room at the Fairmont Hotel Dallas.

10. Sodexo sponsored the last

event, the Dallas Hoedown, providing fun hats and cups to commemorate the evening.

11. Attendees and vendors enjoyed learning to line dance at the Dallas Hoedown.

BREAKROOM

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Company Info

Pa ge

SERVICE INDEX ANESTHESIA BC Group International, Inc.

Ph: 314-638-3800

www.BCGroupStore.com.

BC

Gopher Medical Imaging

Ph: 844-246-7437

www.gophermedical.com

41

RepairMED

Ph: 855-813-8100

www.reairmed.net

45

Ph: N/A

www.ncbiomedassoc.com

83

iMed

Ph: 817-378-4613

www.imedbiomedical.com

37

Precise Biomedical, Inc

Ph: 866-772-6011

www.precisebiomedical.com

21

RepairMED

Ph: 855-813-8100

www.reairmed.net

45

Ph: 800-729-4776

www.mit-tech.com

81

Ph: 813-886-2775

www.seaward-groupusa.com

43

Ampronix

Ph: 800-400-7972

www.ampronix.com

27

First Call Parts

Ph: 800-782-0003

www.firstcallparts.com

35

Philips HealthCare

Ph: 800-229-6417

www.philips.com/mvs

59

Quantum Biomedical

Ph: 866-439-2895

www.quantumbiomedical.com

81

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

79

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

7

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

31

Ph: 877-604-6583

technicalprospects.com

37

ASSOCIATIONS NCBA

BIOMEDICAL

C-ARM MIT/ Medical Imaging Technologies

CALIBRATION Rigel Medical, Seaward Group

CARDIOLOGY

CARDIOVASCULAR Technical Prospects

COMPUTED TOMOGRAPHY Dunlee

Ph: 800-238-3780

www.dunlee.com

3

Injector Support and Service

Ph: 888-667-1062

www.injectorsupport.com

85

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

39

KEI Medical Parts

Ph: 512 -477 1500

www.keimedparts.com

75

Philips HealthCare

Ph: 800-229-6417

www.philips.com/mvs

59

Precise Biomedical, Inc

Ph: 866-772-6011

www.precisebiomedical.com

21

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

70

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

37

INDEX

JUNE 2016

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CONTRAST MEDIA INJECTORS Injector Support and Service

Ph: 888-667-1062

www.injectorsupport.com

85

Maull Biomedical Training

Ph: 440-724-7511

www.maullbiomedicaltraining.com

45

Precise Biomedical, Inc

Ph: 866-772-6011

www.precisebiomedical.com

21

Capital Medical Resources

Ph: 614-657-7780

www.capitalmedicalresources.com

75

J2S Medical, LLC

Ph: 844-342-5527

www.J2SMedical.com

30

AIV Inc.

Ph: 888-587-6759

www.aiv-inc.com

41

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

J2S Medical, LLC

Ph: 844-342-5527

www.J2SMedical.com

30

Quantum Biomedical

Ph: 866-439-2895

www.quantumbiomedical.com

81

Ph: 800-457-7576

www.ozarkbiomedical.com

49

Ampronix

Ph: 800-400-7972

www.ampronix.com

27

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

77

Tenacore Holding, Inc

Ph: 800-297-2241

www.tenacore.com

26

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

Bayer Healthcare- MSV

Ph: 844-MVS-5100

www.mvs.bayer.com

15

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

39

KEI Medical Parts

Ph: 512 -477 1500

www.keimedparts.com

75

MIT/ Medical Imaging Technologies

Ph: 800-729-4776

www.mit-tech.com

81

Philips HealthCare

Ph: 800-229-6417

www.philips.com/mvs

59

Ph: 800-958-9986

www.gmi3.com

2

MedWrench

Ph: 866-989-7057

www.medwrench.com

97

TechNation Webinar Wednesday

Ph: 800-906-3373

1TechNation.com/webinars

49

Ph: 800-229-7784

www.rsti-training.com

67

Ph: 888-587-6759

www.aiv-inc.com

41

ENDOSCOPY

INFUSION PUMPS

24-25

LABORATORY Ozark Biomedical

MONITORS/CTR’S

12-14

MRI

NUCLEAR MEDICINE GMI/ Global Medical Imaging

ONLINE RESOURCES

PACS RSTI

PATIENT MONITORING AIV Inc.

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Company Info

BETA Biomed Services, Inc

Ph: 800-315-7551

www.betabiomed.com

BMES/Bio-Medical Equipment Service, Co

Ph: 800-626-4515

www.bmesco.com

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

Gopher Medical Imaging

Ph: 844-246-7437

www.gophermedical.com

41

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

77

J2S Medical, LLC

Ph: 844-342-5527

www.J2SMedical.com

30

Pacific Medical

Ph: 800-449-5328

www.pacificmedicalsupply.com

Quantum Biomedical

Ph: 866-439-2895

www.quantumbiomedical.com

81

RepairMED

Ph: 855-813-8100

www.reairmed.net

45

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

79

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

7

Tenacore Holding, Inc

Ph: 800-297-2241

www.tenacore.com

26

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

47 20, IBC 24-25

8

12-14

POWER SYSTEM COMPONENTS Interpower Corporation

Ph: 800-662-2290

www.interpower.com

58

RECRUITING/EMPLOYMENT Health Tech Talent Managment

Ph: 757-563-0448

www.healthtechtm.com

30

Stephen’s International Recruiting, Inc.

Ph: 870-431-5485

www.bmets-usa.com

47

Capital Medical Resources

Ph: 614-657-7780

www.capitalmedicalresources.com

75

Prescott’s

Ph: 800-438-3937

surgicalmicroscopes.com

70

AIV Inc.

Ph: 888-587-6759

41

BMES/Bio-Medical Equipment Service, Co

www.atslaboratories-phantoms.com

Ph: 800-626-4515

www.bmesco.com

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

Gopher Medical Imaging

Ph: 844-246-7437

www.gophermedical.com

41

Integrity Biomedical Services

Ph: 877-789-9903

www.integritybiomed.com

77

Pacific Medical

Ph: 800-449-5328

www.pacificmedicalsupply.com

8

Southwestern Biomedical Electronics

Ph: 800.880.7231

www.swbiomed.com

7

Tenacore Holding, Inc

Ph: 800-297-2241

www.tenacore.com

26

USOC Bio-Medical

Ph: 855-888-8762

www.usocmedical.com

BC Group International, Inc.

Ph: 314-638-3800

www.BCGroupStore.com.

BC

Fluke Biomedical

Ph: 800-850-4608

www.flukebiomedical.com

51

SURGICAL

TELEMETRY

20, IBC 24-25

12-14

TEST EQUIPMENT

INDEX

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Company Info

Pronk Technologies

Ph: 800-609-9802

www.pronktech.com

5

Rigel Medical, Seaward Group

Ph: 813-886-2775

www.seaward-groupusa.com

43

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

70

TRAINING ATS Laboratories

www.atslaboratories-phantoms.com

73

ECRI Institute

Ph: N/A

www.ecri.org

90

Fluke Biomedical

Ph: 800-850-4608

www.flukebiomedical.com

51

Maull Biomedical Training

Ph: 440-724-7511

www.maullbiomedicaltraining.com

45

RSTI

Ph: 800-229-7784

www.rsti-training.com

67

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

79

Technical Prospects

Ph: 877-604-6583

technicalprospects.com

37

Dunlee

Ph: 800-238-3780

www.dunlee.com

3

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

39

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

31

TUBES/BULBS

ULTRASOUND ATS Laboratories

www.atslaboratories-phantoms.com

73

Bayer Healthcare- MSV

Ph: 844-MVS-5100

www.mvs.bayer.com

15

Conquest Imaging

Ph: 866-900-9404

www.conquestimaging.com

11

GMI/ Global Medical Imaging

Ph: 800-958-9986

www.gmi3.com

2

MW imaging

Ph: 877-889-8223

www.mwimaging.com

92

Summit Imaging

Ph: 866-586-3744

www.mysummitimaging.com

4

Trisonics, Inc

Ph: 877-876-6427

www.trisonics.com

73

Ampronix

Ph: 800-400-7972

www.ampronix.com

27

Bayer Healthcare- MSV

Ph: 844-MVS-5100

www.mvs.bayer.com

15

Dunlee

Ph: 800-238-3780

www.dunlee.com

3

Engineering services

Ph: 888-364-7782 x11

www.eng-services.com

6

First Call Parts

Ph: 800-782-0003

www.firstcallparts.com

35

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Ph: 800-729-4776

www.mit-tech.com

81

RSTI

Ph: 800-229-7784

www.rsti-training.com

67

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

70

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

31

X-RAY

96

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Company Info

ALPHABETICAL INDEX AIV, Inc. ……………………………

41

HTTM, Inc. …………………………

30

Prescott’s …………………………

Ampronix ……………………………

27

iMed Biomedical ……………………

37

Pronk Technologies ………………… 5

ATS Laboratories, Inc.………………

73

Injector Support and Service, LLC …

85

Quantum Biomedical ………………

81

Bayer Healthcare- MVS ……………

15

Integrity Biomedical Services, LLC…

77

Repair MED …………………………

45

BC Group International, Inc. ……… BC

International Medical Equipment & Service ……………………………

39

Rigel Medical, Seaward Group ……

43

Interpower Corporation ……………

58

RSTI …………………………………

67

J2S Medical…………………………

30

RTI Electronics ……………………

70

KEI Med Parts ………………………

75

Southeastern Biomedical …………

79

Maull Biomedical Training LLC ……

45

Southwestern Biomedical Electronics

7

MedWrench ………………………

97

MIT …………………………………

81

MW Imaging ………………………

92

NCBA ………………………………

PROOF APPROVED CHANGES NEEDED Engineering Services …………………

6

83

BETA Biomedical Services …………

47

Bio-Medical Equipment Service Co. 20, IBC Blue Ox Medical Technologies ……

50

Capital Medical Resource LLC ……

75

Conquest Imaging …………………

11

Dunlee ………………………………… 3 ECRI Institute ………………………

90

Elite Biomedical Solutions ……… 24-25 First Call Parts ………………………

35

Fluke Biomedical …………………

51

CLIENT SIGN–OFF:

Ozark Biomedical …………………

49

Pacific Medical LLC ………………… 8

Philips HealthCare ………………… 59 PLEASE CONFIRM THAT THE Global Medical Imaging ………………

2 FOLLOWING ARE CORRECT Precise Biomedical, Inc. …………… 21 Gopher Medical 41 LOGO ……………………

PHONE NUMBER WEBSITE ADDRESS

70

Stephens International Recruiting Inc. 47 Summit Imaging ……………………… 4 TechNation Webinar Wednesday …

49

37 PROOF SHEET Tenacore Holdings, Inc. …………… 26 Technical Prospects ………………

Tri-Imaging Solutions ………………

31

Trisonics, Inc. ………………………

73

USOC Bio-Medical Services …… 12-14

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BREAKROOM

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    

Flow Pressure Temperature Humidity O2 Concentrations

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