TechNation - July 2016 by MD Publishing

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VOL. 7

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

JULY 2016

Company Showcase Philips Healthcare

News and Notes Industry Updates

Roundtable Ultrasound

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TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

HE ROUNDTABLE: ULTRASOUND T TechNation reached out to ultrasound professionals to find out the latest regarding ultrasound systems including new technology, budget concerns and factors impacting the market. Next month’s Roundtable article: Sterilizers

REQUIREMENTS FOR DIAGNOSTIC IMAGING: THE NEW JOINT COMMISSION STANDARDS The Joint Commission's new diagnostic imaging requirements, that apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, went into effect on July 1, 2015. TechNation looks at the impact this measure has on the HTM community. We also ask experts what we can expect in the future. Next month’s Feature article: Shifting Landscape: More women, and retiring baby boomers

TechNation (Vol. 7, Issue #7) July 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.

JULY 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

Adam Pickney Taylor Martin Cindy Galindo

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 Company Showcase: Philips p.16 Department of the Month: University of Colorado Health Clinical Engineering p.18 Biomed Adventures: Caleb Campbell p.22 Professional of the Month: Frank Cabrera p.24 Company Showcase: MW Imaging

P.29 INDUSTRY UPDATES

p.29 News and Notes: Updates from the HTM Industry p.32 ECRI Institute Update p.34 AAMI Update

P.36 THE BENCH p.36 p.39 p.40 p.42

Shop Talk Tools of the Trade Biomed 101 Webinar Wednesday

P.64 EXPERT ADVICE

p.64 Career Center p.66 Ultrasound Tech Expert Sponsored by Conquest Imaging p.68 Thought Leader p.70 The Future p.72 Tech Savvy p.74 Roman Review

P.76 BREAKROOM p.76 p.78 p.80 p.82

Did You Know? The Vault AAMI Scrapbook MedWrench Bulletin Board

p.85 Index

Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer

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MULTI-VENDOR SERVICE

and the ability to track the service history and related cost for each individual unit of equipment. But, more importantly, asset management is about identifying and delivering strategic actions to optimize your clinical asset services and operations.

ssets in the healthcare environment represent a significant expense to any organization; second only to labor costs. Managing these assets and their associated expenses requires a combination of expertise, experience and proven tools.

Serving as a Multi-Vendor Service provider for 20 years, Philips has worked closely with HTM teams to help take care of the complexities of clinical asset management so patient flow remains on track and clinicians can focus on delivering the best in patient care. TechNation magazine quizzed Philips on the latest in asset management and new developments announced at the AAMI 2016 Conference & Expo in Tampa, Florida.

WHAT IS ASSET MANAGEMENT?

PHILIPS: At a basic level, managing assets begins with an accurate inventory

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JULY 2016

HOW CAN PHILIPS MULTIVENDOR SERVICES HELP AN HTM DEPARTMENT? PHILIPS: We help optimize clinical assets, optimize work teams and optimize engagement with their organization’s leadership. We help clean up asset inventory data and get our InfoView tool up and running so that the HTM department can self-manage all of their clinical assets independently. We also offer support services where we work side-by-side in a shared service capacity. And, if required, we have the expertise to lead an entire biomed program with on-site management.

TELL US MORE ABOUT YOUR INFOVIEW TOOL?

PHILIPS: Built on a leading edge, cloud-based platform, InfoView provides an integrated solution for asset management, service and work order management, preventive and corrective maintenance, and real-time reporting to manage clinical assets from “inception to retirement.” After performing the task of initializing your organization’s asset data into the InfoView system via

our standardization and formatting protocol, InfoView provides a centralized repository for tracking and managing all relevant asset information including location, service history, costs, contract and warranty status as well as replacement forecasting. The tool automatically creates work orders for routine, preventive maintenance based on both AEM and OEM equipment maintenance strategies. For unscheduled corrective maintenance, work orders are quickly and easily created and routed to the appropriate Service Engineer. Nurses and other clinicians are able to request service, and check the status of existing requests through the online service request portal which immediately notifies HTM staff on their mobile devices. Engineers have real-time access to data, enabling them to quickly locate assets, view work orders and tasks, update work order status, materials, labor hours, comments and more. InfoView can also track engineer training, easily identifying which technicians are trained on what devices and where technical training gaps are. InfoView is totally scaleable and customizable to support your hospital’s unique processes. Our tool allows for easy extracting of relevant/actionable information through simple-to-create reports and dashboard that can automatically and proactively be delivered to biomeds, department managers, or the C-Suite.

REAL RESULTS, REAL SOLUTIONS COMMUNITY HOSPITAL IN SOUTHEAST, 450+ BEDS. • Deployed InfoView and Biomed Service Program in 2015 • Philips provides staff management • InfoView tool supports service maintenance program record keeping for 10,000 clinical assets

Philips InfoView is offered via the Philips Multi-Vendor Service program, through which HTM teams can recieve a broad range of diagnostic imaging, asset management, and clinical engineering services tailored to their facilities' needs.

HOW CAN ASSET MANAGEMENT ASSIST WITH COMPLIANCE ISSUES? PHILIPS: The robust data tracking and real-time reporting capabilities delivered by InfoView provide you with comprehensive documentation support for associated Joint Commission and other regulatory compliance requirements.

HOW ELSE CAN INFOVIEW HELP MAINTAIN MEDICAL EQUIPMENT?

PHILIPS: InfoView provides real-time full transparency on the status/ readiness of clinical assets to everyone involved in supporting the patient flow. For example, we have customers use large screens in their surgery center to communicate key readiness data like work order status, recent history, availability of mission critical assets, and whether or not a BMET is currently on site. Real-time asset information enables the entire staff to make immediate decisions on how to best manage patient workflows accordingly.

CAN YOU TELL ME MORE ABOUT YOUR PARTICIPATION ANNOUNCED AT THE AAMI 2016 CONFERENCE & EXPO? PHILIPS: We shared details of our new development platform that allows for deployment of InfoView across hundreds of sites. We demonstrated the capabilities of InfoView that now boast over 150 data management features. Enhanced features include expanded service requests and service event tracking, seamless parts ordering, benchmarking and capital planning, and expanded data analytics.

HOW ELSE CAN PHILIPS HELP WITH BIOMEDICAL SERVICES?

PHILIPS: The Philips Biomedical Services Program is far more than a repair service. It’s a comprehensive program for asset planning and management. The goal is to reduce equipment life cycle costs and maximize the organization’s capital investments. FOR ADDITIONAL INFORMATION about Philips, visit: www.philips.com/mvs.

• Prior to Philips deployment: 90% PM completion for general biomed assets • Post Philips deployment: 95%+ PM completion for general biomed assets • Post Philips deployment: Philips provides excellent EOC data for stat tracking to use for EOC committee and various other purposes • InfoView provides high-quality customizable reports for any medical equipment tracking purpose • InfoView has safeguards built in for field security against fraudulent entries

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SPOTLIGHT

DEPARTMENT PROFILE Memorial Hospital: University of Colorado Health Clinical Engineering By K. Richard Douglas

outhern Colorado is known for mountains, its famous ski and vacation destinations and hot springs. It is also the home of Memorial Hospital, part of University of Colorado Health (UCHealth).

Recently, Memorial received a top five hospital designation in Colorado from U.S. News and World Report. All of UCHealth hospitals are ranked in the top 10, according to Clinical Engineering Operations Manager Ryan Titus, CBET, BSM, MBA. “As a team, we support more than 13,000 assets which are worth more than $165 million, two hospitals and multiple offsite clinics that are increasing in numbers every few months,” Titus says. Those two hospital campuses in Colorado Springs are Memorial Hospital North and Memorial Hospital Central. The North campus has 80 beds and the Central campus has 427 beds. Children’s Hospital Colorado is building a tower on the North campus as well. As operations manager, Titus is responsible for the daily in-house operations including the technical

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JULY 2016

staff and clinical equipment techs. The team consists of two managers, three imaging engineers, two senior biomeds, three intermediate biomeds, three associate biomeds, six clinical equipment techs (CET) and one vendor support. The department also includes one intermediate biomed and two clinical equipment techs, who are based at Memorial North. The rest are based at Central. The techs from Central help support Memorial North. The group includes Imaging Engineer Ronnie Griffin, CBET; Imaging Engineer Clint Carter, CBET, CRES; Imaging Engineer Tim Stoecker CBET, A+, N+; Senior Biomeds Steve Harding, CBET, and Leticia Reynolds, CBET; Intermediate Biomeds Corey Weeden; Dave Raduns, CBET; Isaac Montoya; Associate Biomeds Amoria Poth, Larry Anders and Thomas Lycett; Carol Lewis, CET; Daniel Williams, CET; Annie Garcia, CET; Christine Abram, CET; Christopher Davis, CET; Dallas Carter, CET; Janet Carlton; Vendor Support and Vendor Services Manager Daniel Klausmeier, BA, MBA. “The Vendor Services Manager oversees all of the medical equipment contracts and vendor services for Memorial. Any service performed by a vendor on medical equipment at Memorial is tracked by the Vendor Services Manager. This includes documentation of work performed, quarterly reviews, contract analysis and system semi-annual reviews,” Titus says. The Vendor Support position reports

to the Vendor Services Manager and assists with record keeping, parts orders, requisitions for POs, department supplies and any other administrative duties needed for the department. “This position also handles the process of sending all scope, camera and OR electrical instrumentation repairs to a vendor for evaluation,” Titus adds. The team’s techs are assigned to a specific department. “This allows them to become familiar with the clinical staff and equipment within those departments. In short, they are essentially specialized in the departments they are assigned,” Titus says.

PROJECTS AND PROBLEM SOLVING “The Clinical Equipment Techs are responsible for cleaning and par’ing equipment in clinical departments. Several years ago, we discovered that clinical staff was spending a significant amount of time each day trying to locate and clean infusion pumps and similar

From left to right back row: Tim Stoecker (Imaging Engineer), Isaac Montoya (Intermediate Biomed), Corey Weeden (Intermediate Biomed), Dave Raduns (Intermediate Biomed), Ronnie Griffin (Imaging Engineer) From left to right middle row: Carol Lewis (CET), Clinton Carter (Imaging Engineer), Ryan Titus (Operations Manager), Daniel Williams (CET), Christopher Davis (CET), Daniel Klausmeier (Vendor Services Manager) From left to right front row: Amoria Poth (Associate Biomed), Thomas Lycett (Associate Biomed), Janet Carlton (Vendor Services Support), Leticia Reynolds (Senior Biomed), Larry Anders (Associate Biomed). Not pictured: Steve Harding (Senior Biomed), Christine Abram (CET), Annie Garcia (CET), Dallas Carter (CET).

devices that float from department to department. After careful analysis, it was determined that having a team that cleaned and par’ed equipment within the clinical units was beneficial financially and freed up more time for the nurse to be at the bedside. This has been a successful program since its inception.” “Thanks to the great relationships our department has with Supply Chain and PDC (Planning, Design and Construction), we are involved with many new projects that involve medical equipment. Just recently, Clinical Engineering has been involved with a new Radiation Oncology building, multiple Acute Care floor remodels, install of a new MRI, CT, EP Lab, full integration of our infusion pumps with our EMR, OR room remodel, install of new monitors in several locations and the new tower at Memorial North,” Titus says. He says that the department is

responsible for multiple 10-year replacement plans for capital equipment. “Any time devices like beds, pumps or stretchers that span are shared by multiple departments, it makes sense for Clinical Engineering to plan for these replacements,” he says. The plans, created during the past two years, allow the organization’s CFO and executive team to plan ahead and know what funding will be requested in the coming years. This allows them to keep on top of current technology. The team has also put on a detective hat from time to time and used innovative thinking to problem solve. “Recently, we had an unusual amount of pulse oximeters being tagged for service,” Titus says. The team developed a process to ensure that the pulse oximeters are updated with the latest technology. They have a robust system to work with the vendor for software updates. All of the department’s technicians

are members of the Colorado Association of Biomedical Equipment Technicians (CABMET). They regularly attend quarterly meetings and annual symposiums. Titus sits on the association’s board. The team of clinical engineers also goes the extra mile to make sure that the equipment it sends through Project C.U.R.E., a non-profit organization that provides donated medical supplies and equipment to developing countries, is in top condition. “Some of our techs have volunteered to help Project C.U.R.E. test all of the equipment they receive from donations,” Titus says. The clinical engineering team at Memorial Hospital’s campuses gets the job done for UC Health with professionalism and innovative thinking, and most importantly, for patients.

SPOTLIGHT

BIOMED ADVENTURES Getting there by ATV, Snow machine or Dogsled By K. Richard Douglas

nown as "The Last Frontier," the state of Alaska is the biggest state in the U.S. and nearly twice the size of Texas. It is home to North America’s tallest mountain, Denali (formerly Mt. McKinley) and has coastlines on three different seas. The land was purchased from Russia, by the U.S. in 1867, for $7.2 million. There are 100,000 glaciers in Alaska; representing five percent of the entire state. With less than two people per square mile, it is the least densely populated state in the U.S. Those glaciers, and the opportunity to gaze at the tallest peak in North America, may have been two of the reasons that a biomed born in Flat River, Missouri and raised in Nashville, would make the long trip north and never look back. Caleb Campbell is a Biomedical Repair Specialist with Alaska Clinical Engineering Services – a division of the Alaska Native Tribal Health Consortium (ANTHC). He has also always been an avid sportsman. “Our organization is contracted with various tribal health organizations to provide preventative maintenance services to their member clinics,” Campbell says. “I travel throughout the state to provide

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JULY 2016

Caleb Campbell Biomedical Repair Specialist

these services. Our scope of maintenance is very similar to most other ISOs, however, we also offer radiological contracts, biological hoods, dental, and even veterinary services. We are unique in that everyone on our team services every piece of equipment. I’m more of a general biomed.” What may differentiate Campbell from his more southern fellow biomeds, besides the expansive area he serves, is the fact that he often travels by “small airplane, four-wheeler, snow machine and even dogsled.”

NOT LIKE THE LOWER 48 Beyond its mountains and glaciers, Alaska has 6,640 miles of coastline, not including islands. It boasts 70 potentially active volcanoes. Each year sees approximately 5,000 earthquakes. Despite these things, Campbell says that some of the challenges of living there are more mundane. “One challenge is being able to obtain fresh produce,” he concedes. “Produce

arrives in Anchorage via barge, and if there are any shipping delays, you may or may not be able to find what you are looking for. Even when you do find what you are looking for, produce tends to arrive either overly ripe or under ripe.” He also says that ordering overnight shipping, when shopping online, can be challenging. Shipping costs sometimes exceed the cost of the item, and other times, retailers just don’t ship to Alaska. He goes on to describe some other trivia that those in the lower 48 may not have considered. “Alaskans do not celebrate the Fourth of July with fireworks. During the summer, we have close to 20 hours of daylight,” he says. “The majority of the state is not on the road system. Travelling to most communities involves at least (one) flight, boat, or ATV ride.” And, he says that encounters with wildlife are the norm. It is not unusual to have to stop in traffic for moose or bears, even in Anchorage.

ADVENTUROUS LIFE While some things may just be minor inconveniences, and others momentary challenges, it’s the great outdoors that has won over Campbell. “My wife and I have both hiked the Matanuska Glacier and Portage Glacier. Glaciers can be particularly dangerous. Warm gear and crampons are a must. The most treacherous thing about glaciers is watching out for crevasses. One misstep and you can be severely injured or die,” he says “I would encourage anyone looking to travel to Alaska to explore at least one glacier. They are truly a sight to be seen.” In addition to exploring glaciers,

Campbell has experienced another Alaska activity that is uncommon for residents elsewhere. “Gold panning is still a common pastime here in Alaska, on both a professional and recreational level,” he says. “I sometimes pan recreationally up near Independence Mine in Hatcher’s Pass. While I’ve found little gold, the excitement is what keeps my interest. Generally, my wife and I will hike upstream and find a suitable location. We will spend several hours sifting through gravel with our pans. We may encounter moose, bears, and porcupines. It’s pretty neat to see the salmon swimming upstream in the summer time. We definitely don’t ever make a living out of it but the experience pays for itself,” he says. Hunting is another pastime that Campbell has enjoyed, including hunting for moose. “One thing people may not realize is just how large a moose is. Moose can grow to around 5.5 feet to 6 feet from hooves to shoulder and weigh in around 1,200 pounds,” Campbell says. “Transporting one of these animals out of the woods can be quite a chore as the quarters can weigh anywhere from 150 pounds to 200 pounds each. Typically you find moose in swamps and bogs so just reaching the animal can be grueling in itself. In Alaska, you don’t call in sick from work but it’s perfectly acceptable to call in and say that you won’t make it in

because you’ve downed a moose.” If the moose hunting and gold panning weren’t unique enough features of an Alaskan lifestyle, it is the travel between remote locations that also sets Campbell’s experiences apart.

“In Alaska, you don’t call in sick from work but it’s perfectly acceptable to call in and say that you won’t make it in because you’ve downed a moose.” He says that flying by small plane is a way of life in Alaska. “Most of the larger bush carriers utilize the Cessna 206 aircraft. The Cessna 206 is a fixed wing, single prop aircraft. It is not uncommon to be flanked on either side by incoming mail and other weary travelers. We often transverse huge distances, rugged terrain, and less than

ideal weather. We land on gravel runways in the middle of the tundra. The whole village usually greets the plane and mail and supplies are distributed,” Campbell explains. Campbell says that once you debark from the plane, the journey still may not afford the comfort of a car or truck for transportation. He says that more likely, you will continue your trip to town by way of ATV, snowmobile or dogsled. “Generally the locals will have a makeshift trailer attached to the rear of the transport vehicle and everyone needing a ride will pile in,” he says. “The town may or may not be fairly close to the runway. A short, white-knuckled ride later, and we arrive in town. It is not uncommon to be covered in mud and snow by the time you arrive. Allow at least 10 minutes for your beard and other appendages to thaw out.” At the time of this writing, Campbell was planning a rafting trip. “We are putting in at Paxson Lake in Paxson, Alaska and are rafting roughly 50 miles through the wilderness to Gulkana, Alaska. During this trip, we will be fly fishing for King Salmon, Sockeye Salmon, Rainbow Trout, and Dolly Varden. We will also be scouting for a caribou hunt that we are doing this fall via the same route,” he says. Just when you thought you knew the life of the typical biomed; here comes this guy on a dogsled.

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PROFESSIONAL OF THE MONTH

Frank Cabrera, CBET, CRES By K. Richard Douglas

any successful biomed careers start from humble beginnings. In the case of Frank Cabrera, CBET, CRES, senior director of Clinical Engineering for Banner Health, it all started with medical training in the U.S. Navy and progressed to overseeing the day-to-day operations of a major clinical engineering program.

Cabrera didn’t start out as a biomed, but curiosity about the profession one evening sparked the beginning of a long career. “My fi rst exposure to the biomed profession was very early in my Navy career. I was working in the emergency room at a small clinic in San Diego as an EMT one night and I noticed a couple of vans pulling into the parking lot. Several people exited the vans with what looked like tool bags and cases,” Cabrera remembers. “They all came into the facility and began turning on and checking/testing all the medical equipment going from department to department.” With curiosity getting the better of him, Cabrera talked at length with one of the biomeds when they took a break and learned who they were, how they received their training and how to apply for the job classification. “I then applied, and eight months later I was on my way to Denver, Colorado to attend the joint Army/Navy biomed training facility (USEMEOS),” he says. He completed the program’s basic training in 1981 and the advanced training in 1982. After completing the initial training, Cabrera was assigned to a small hospital in Twenty-Nine Palms, California as a general biomed tech. He spent a year in that role.

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JULY 2016

FRANK CABRERA, CBET, CRES

Senior Director of Clinical Engineering for Banner Health

“Upon completion of the advanced program, I was assigned to Portsmouth Naval Hospital for three years, where I focused on biomed as well as diagnostic imaging service. Highlights of this tour consisted of performing over 25 Radiological Acceptance Inspections in remote areas such as: Kefl avik, Iceland; Naples, Italy; Rota, Spain; Bermuda; Puerto Rico; Cuba; and several sites in Virginia and North Carolina,” Cabrera says. His next tour of duty was to be a part of the commissioning crew for the USNS Comfort (T-AH 20) hospital ship. He says that the ship included an 80 bed ICU, 12 ORs, complete diagnostic imaging department to include CT and angiographic capabilities, 75-bed

casualty receiving area, full laboratory, full pharmacy as well as capabilities to produce its own fresh water and oxygen. “When the ship was completed, our team ensured that all the equipment that was installed, operated to manufactures' specifications. Notable deployments while assigned to the USNS Comfort (T-AH 20) include: Desert Storm/Shield, Operation Sea Signal, and Iraqi Freedom,” Cabrera says. When his tour on the hospital ship ended, he was transferred to the National Naval Medical Center (NNMC) in Bethesda, Maryland, where he ran the clinical engineering program for five years. This was a rare opportunity, since Cabrera’s team had responsibility for the Medical Executive Treatment Unit, the White House, Air Force One and Camp David, along with other smaller clinics in the area. The land of the rising sun was the next stop for Cabrera, where he worked in the Naval Hospital in Okinawa for three years. There, he ran the logistics program. After his time in Japan, he was selected to be a part of the inaugural staff at the new DOD biomed training facility at Sheppard Air Force Base. He returned to the USNS Comfort for his last tour to wind up a 24-year

Frank Cabrera is very involved in youth sports with his children. Here is his seen with a 14-year-old travel team that won 6 tournaments in 2013. Cabrera believes in "team work" at work and when coaching young athletes.

naval career after returning from Operation Iraqi Freedom. Today, Cabrera oversees the day-today operation of the Banner Health Clinical Engineering program. The Phoenix-based health care system includes 30 hospitals in seven states and has more than 300,000 pieces of equipment in inventory with a net asset value in excess of $30 billion. “We have a very strong service organization, with over 130 technicians and specialists, and we pride ourselves with a cost of service ratio (CSR) of less than five percent,” Cabrera says. The extremely low CSR is achieved “by facilitating vendor partnerships/ relationships which empower the Banner Health service engineers to have access to all the diagnostic tools and support the original equipment manufacturers (OEM) have at their disposal as well as negotiating very aggressive parts discounts,” he adds.

REDUCING COSTS When it comes to taking on special projects, Cabrera has been focused on cost savings. “I like to think outside the box for ways to reduce operational service expense for the organization,” he says. “With that said, several years ago I looked into the possibility of consolidating and

internalizing surgical service for Banner Health. The equipment involved in this category included: rigid/flexible endoscopes, handheld surgical instruments and surgical power tools.” What he found was that this type of service was decentralized amongst several departments in the facility. He says that because of this, there was a lot of opportunity for reducing the expense with consolidation. The end result is a program that has exceeded expectations by delivering greater than 20 percent expense reductions.

ON THE HOME FRONT “I am currently married for 26 years to my high school sweetheart, Debbie,” Cabrera says. The couple have four children, ranging in age from 17 to 24; Seth, Aolani, Tyrus and Kiyomi. He says that he and his wife are “very close to becoming empty nesters.” Away from work, Cabrera enjoys coaching youth baseball, working on cars, gardening and tinkering with home improvement projects. Cabrera describes himself in uncomplicated terms; “I’m a pretty simple guy who always strives for improvement no matter what the occasion presents; could be in the gym, on an athletic field, business or in service opportunities. I also enjoy coaching and teaching.”

Frank Cabrera is on a “Successful Tuna Trip” with his sister, Judy. Cabrera works hard and enjoys being outdoors during his time away from work.

FAVORITE MOVIE:

“Furious 7” I have not seen all of the Fast and Furious movies but this one had me on the edge of my chair the entire time.

FAVORITE FOOD:

My favorite food would be Sushi.

HIDDEN TALENT: Teaching and coaching

FAVORITE PART OF BEING A BIOMED:

“Knowing that I am making a difference in people’s lives by ensuring the clinical teams have all the tools in their tool box to perform the duties and responsibilities required to take care of patients”

WHAT’S ON MY BENCH

• My laptop; wherever my laptop is that is where my office is. I could be out in the field, in one of the facilities and you might find me in the shop or the cafeteria catching up on emails between meetings. • My cellphone; I take pride in my responsiveness so I am always filtering through email when I am away from the office. This is both good and bad but a necessary evil so that I do not miss out on any service escalation opportunities • My special drink would be G2 as it is important to stay hydrated in Phoenix, Arizona. • Wasabi coated peas • My latest TechNation magazine.”

SPOTLIGHT

COMPANY SHOWCASE Celebrating 25 Years

Imaging celebrates 25 years of outstanding service and growth in the ultrasound industry this year. The company’s growth can be attributed to its focus on customer service as well its commitment to seeking out quality employees.

MW Imaging Founder and President Robert “Bob” Grzeskowiak knows his company’s success and longevity go hand-in-hand with his intense and unwavering desire to provide the best possible customer service. This trait is nurtured in a company-wide atmosphere that consistently produces excellence. “I think our key to success is customer service. Providing our customers with reliable quality parts, probes and systems, immediate call back response, 24/7 free technical support, six-month warranty for most parts and a reliable competent staff that meets and exceeds our customers’ expectations,” Grzeskowiak says. MW Imaging Operations Manager Amber Sportsman loves the company’s unique approach. “We say it all of the time, but honestly, our personal approach to our business is what has led to our loyal customers. MW Imaging has become a trusted name in the ultrasound industry. We aren’t saying other companies don’t have loyal customers but to our customers, we are rock stars,” Sportsman explains. “Our customers have our cell numbers, they know they can call us anytime and we’ll pick up the phone. They know we’ll come in on a weekend to get parts

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JULY 2016

out for Monday morning delivery. We know about their families, we value so many of them as friends – it’s not always just about the business.” MW Imaging Northeast Director Bob Coyle points out that industry expertise is another factor in the company’s growth because it goes hand-in-hand with providing outstanding customer service. “We are a small, privately owned company that focuses on what we do best which is medical ultrasound. Our service professionals average over 30 years of experience in the ultrasound field,” Coyle explains. “Our extensive inventory enables us to solve most system issues with one site visit. This service results in quicker uptimes and a reduction in parts, labor and travel costs,” Grzeskowiak adds. MW Imaging’s Matthew Nafziger says the company evolves with the newest technology and devices in ultrasound. It is just one more way MW Imaging provides excellent service. “We’re always adapting to the recent changes in the ultrasound field. Whether it’s a new system or new process, I feel like we’re always ahead of the industry,” Nafziger says. “Even though we may not advertise it right away, we’re always spearheading new

Bob Grzeskowiak President, MW Imaging

systems, technologies, and the capabilities of a ultrasound system.” MW Imaging Senior Field Service Engineer Tom Hanak is confident in the capabilities of MW Imaging’s proven team. “I’m excited about all our products and services, it’s a great feeling walking into a ultrasound room knowing that you can fi x just about anything that is going wrong with their system,” Hanak says. Coyle says MW Imaging stresses the importance of providing customers with what they need, sometimes before they even know what is coming up in the ultrasound industry. “We work with the departments to try and tailor our services to their particular needs. If the department prefers to tackle the service we are there to provide tech support and parts support and to provide onsite service when needed,” Coyle says.

“Our extensive inventory enables us to solve most system issues with one site visit. This service results in quicker uptimes and a reduction in parts, labor and travel costs.” – Bob Grzeskowiak “We work to stay ahead of the curve with new product introductions. We make certain that when a new product is introduced that we will be ready to support it with parts and technical expertise once the warranty period has expired,” he adds. Teamwork among the entire MW Imaging staff is another strength of the organization. “I believe businesses are faced with

challenges every week, every day, every hour. They can be as large and unique as the advancement in technologies or as small as helping a customer over the phone. In every instance, we are able to overcome these obstacles as a team,” Hanak says. “Our experienced staff combines to hammer out these challenges as they come up.” MW Imaging’s facilities empower the team to do the work they do and achieve

exceptional results for customers. “Our 10,000-square-foot facility supports our research and development/ technical support group, probe repair unit, PCB repair unit, shipping department, administrative staff and warehouse,” Grzeskowiak says. However, MW Imaging will never outgrow its core beliefs. “Honesty, integrity, knowledge, experience, and that personal touch are the foundation of MW Imaging’s mission,” Andrew Geidel says. “Expect the best, expect the commitment, and expect success!” MW Imaging’s founder and president attributes the company’s success to his employees. He is excited about MW Imaging’s 25th anniversary and is looking forward to another 25 years. “MW Imaging will be celebrating its 25th year of providing our customers with reliable products and services in 2016,” Grzeskowiak says. “The company started in a modest garage setting and today is one of the top third-party products and services company in the U.S. and international markets. This success would not be possible without the dedication of our current staff. I’m truly grateful and appreciative of their hard work and dedication.” FOR MORE INFORMATION, visit www.mwimaging.com

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NEWS & NOTES

Updates from the HTM Industry GBIS 2016 REGISTRATION NOW OPEN

BLOCK IMAGING AND MIT INC. EXPAND CT CAPABILITIES WITH NEW PARTNERSHIP Block Imaging recently announced a new strategic partnership for GE Healthcare CT Parts with Medical Imaging Technologies (MIT), an independent imaging equipment service provider throughout the southeastern United States. This shared investment in GE CT technology will increase equipment uptime for MIT customers and expand Block Imaging’s capabilities and capacity in CT parts inventory and repairs. Chad Seelye, vice president of parts sales at Block Imaging expressed his excitement at the new partnership. “As a company focused on servicing imaging equipment across the southeastern United States, MIT is always looking for new ways to get their customers the parts they need faster than ever. As a global equipment and parts provider, Block Imaging is always looking to build relationships within the field service community. This partnership is a big win for both companies and the doctors, techs, and patients we serve – especially in the area of GE CT scanners,” Seelye said. MIT service customers who use GE Healthcare CT are now enjoying the benefits of expanded, instant access to systemtested parts from the provider they already know and trust.

The Georgia Biomedical Instrumentation Society (GBIS) has announced exhibitor registration for its annual technical conference. The two-day GBIS 2016 Technical Conference kicks off about a month before the college football season. The conference opens at 7 a.m. on Friday, August 5 and ends at 5 p.m. on Saturday, August 6. Attendance is free for biomeds and students. There is a special discount for corporate members. The conference, a popular destination for HTM professionals working in the metro Atlanta area and within the state of Georgia, will be held at the Children’s Healthcare Office Park, 1680 Tullie Circle in Atlanta. “We anticipate more than 100 attendees, 11 technical classes and 30 exhibitors,” according to the GBIS website. A Meet & Greet Event will be held on Friday, August 5 from 6:30-9:30 p.m. A special guest speaker is also planned. Exhibitor registration includes a one-year updated membership, one booth and the company’s logo will be displayed on the GBIS website with a link. Registration also includes breakfast, lunch and refreshments. Exhibitors will have ample time to demo products and will receive a list of attendees after the conference, according to the GBIS website. There are different registration options for exhibitors and sponsorship opportunities. For information visit GBISonline.org or contact Horace Hunter at 229-244-4539 or via email at gbisexecutive@gmail.com.

SODEXO AND MEDISEND PARTNER TO ASSIST VETERANS Sodexo is partnering with Medisend to support the General Richard B. Myers Veterans Program in its capacity as an accelerated educational pathway to careers in the health care industry. In support of this program, Sodexo has developed professional workshops to help participating veterans develop the business and leadership skills important to success in a clinical environment. The workshops combine observation and practical learning to expose the veteran technicians to industry expectations and the Sodexo culture of building talent and resources. “Medisend is grateful to Sodexo for this unique addition to the General Richard B. Myers Veterans Program and

the opportunities this partnership offers our veterans. We are truly appreciative of the talent and resources that Sodexo is sharing with our veterans and for the dedication of Sodexo representatives in spending so much meaningful time in this endeavor,” said Medisend President and CEO Nick Hallack. Sodexo’s workshops first became available to veterans in the General Richard B. Myers Veterans Program in April and will continue throughout the rest of the year. “Sodexo’s partnership with Medisend in support of the General Richard B. Myers Veterans Program provides us with a tremendous opportunity to give back to

INDUSTRY UPDATES

those who’ve dedicated their lives to protect our freedom while helping to develop skilled new biomedical equipment technicians,” said Steve Cannon, senior vice president at Sodexo Clinical Technology Management. “We are confident that our workshops will be a very valuable resource to veterans seeking a biomedical professional career and we are excited by the prospect of program graduates seeking a career within Sodexo.”

JULY 2016

1TECHNATION.COM

SIEMENS HEALTHINEERS – NEW BRAND FOR SIEMENS’ HEALTHCARE BUSINESS Siemens Healthcare has unveiled its new brand name – Siemens Healthineers. “The new brand underlines Siemens Healthcare’s pioneering spirit and its engineering expertise in the health care industry,” according to a press release. “It is unique and bold and best describes the healthcare organization and its people – the people accompanying, serving and inspiring customers – the people behind outstanding products and solutions.” Siemens CEO Bernd Montag said the new name fits the company’s past and future. “We have an exceptional track record of engineering and scientific excellence and are consistently at the forefront of

developing innovative clinical solutions that enable providers to offer efficient, high-quality patient care. Going forward as Siemens Healthineers, we will leverage this expertise to provide a wider range of customized clinical solutions that support our customers business holistically. We are confident in our capability to become their inspiring partner on our customers’ journey to success,” Montag explained. “Our new brand is a bold signal for our ambition and expresses our identity as a people company – 45,000 employees worldwide who are passionate about empowering health care providers to optimally serve their patients.” As part of its Vision 2020 strategy

Siemens AG announced nearly two years ago that its health care business would be separately managed as a company within the company with a new organizational setup. “Siemens Healthineers will continue to strengthen its leading portfolio across the medical imaging and laboratory diagnostics business while adding new offerings such as managed services, consulting and digital services as well as further technologies in the growing market for therapeutic and molecular diagnostics,” according to the press release. The name of the legal entities will remain unchanged.

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JULY 2016

POWER SOURCES UNLIMITED INC. BUYS ASSETS OF OEM MARKETING AND SALES

UPS SYSTEMS WITH MUTABLE ALARMS HELP WITH ALARM FATIGUE Tripp Lite, a manufacturer of power protection and connectivity solutions, now features medicalgrade UPS systems with mutable alarms. These UPS systems are ideal for use in hospitals and clinics needing to improve critical alarm management, creating a quieter environment for the benefit of patients and staff. As the use of technology has grown in health care environments, the number of alarms sounding in hospital units has increased dramatically. Tripp Lite’s medicalgrade UPS systems feature alarm mute/alarm quiet modes, helping to ensure patients are not disturbed when the device – rather than the patient – needs attention. Silencing nonactionable alarms also reduces occupational stress and “alarm fatigue” on clinicians, enabling hospital staff to focus on performing critical patient care responsibilities. Tripp Lite’s medical-grade UPS systems comply with UL 60601-1 specifications, making them approved for use both inside and outside patientcare vicinities. Key features of Tripp Lite’s Medical-Grade UPS Systems include: • battery backup and surge protection • mutable alarm helps improve critical alarm management and creates a quieter environment for patients • built-in isolation transformer with Faraday shield • hospital-grade plugs and outlets “Alarm management is a key aspect of patient safety gaining increased focus,” said Jim Folk, Tripp Lite’s Director of Healthcare Solutions. “Our medical-grade UPS systems help reduce negative impacts on patients trying to rest and on clinicians focused on providing quality care.”

Power Sources Unlimited Inc. recently announced that it has signed and executed a definitive agreement to acquire the assets of OEM Marketing & Sales–Franklin for an undisclosed amount. The acquisition is expected to close in late June 2016. The Company will finance the acquisition using available cash and expects the acquisition will become accredited to earnings in early fiscal 2017. Based in Wrentham, Massachusetts, OEM Marketing & Sales-Franklin was founded on September 1, 1988 and is a manufacturer’s representative firm, with a history of success in selling synergistic power, packaging, motion control, interconnect and thermal management products into the New England marketplace. OEM’s customer base includes industrial, instrumentation, medical, security, data/telecom, military/ COTS-Hi-Rel and LED lighting. “We expect that this acquisition will enhance our customer base as OEM has an extensive and very detailed targeted mailing list that will help us drill deeper into the New England market and secure additional design wins and OEM production business. When coupled with our aggressive marketing campaign, inside sales tenacity and build-out strategy will provide the opportunity for accelerated market share and future growth in sales and profitability,” Ray Newby, president and founder of Power Sources Unlimited Inc. stated. Download full product specifications and procure parts online at www.psui.com.

INDUSTRY UPDATES

ECRI UPDATE

Medical Device Cybersecurity: When Will Your Pacemaker Be Hacked?

n 2013, the Washington Post (among other news outlets) reported that Vice President Dick Cheney’s cardiac pacemaker had its wireless capabilities disabled when implanted in 2007 to eliminate any potential cyberintrusion threat. This old headline, with the more recent U.S. Food and Drug Administration (FDA) cybersecurity alert that the Hospira Symbiq Infusion System was hacked in 2015, has many hospital leaders wondering whether they have the risk of medical device cyberhacking under control. General consensus is they don’t. Many information technology (IT) leaders certainly have many cybersecurity risks under control: passwords are required, servers are secured behind locked doors, policy has been established if any protected health information is sent to a wrong email address or hacked. However, these practices have largely been applied to network infrastructure and the electronic health record (EHR). A medical device, such as a vital signs monitor or an infusion pump, is a cybersecurity threat vector that probably has not been subjected to the same risk-mitigation scrutiny. The U.S. Food and Drug Administration (FDA) is aiming to get all stakeholders on the same page by encouraging participation in an Information Sharing and Analysis Organization (ISAO) so that threats and vulnerability information can be shared rapidly and nonpunitively. The FDA hosted a public workshop in January 2016, called “Moving Forward: Collaborative Approaches to Medical Device Cybersecurity.” FDA, in collaboration with the National Health Information Sharing Analysis Center, the U.S. Department of Health and Human Services, and the Department of Homeland Security, brought together diverse stakeholders to discuss complex challenges in medical device cybersecurity that affect the medical device ecosystem.

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KNOW WHERE THE THREATS LURK As we know, medical devices are no longer just machines attached to or used by the patient. They are often connected to the EHR – either hardwired or wirelessly. A typical patient in a critical care unit could easily be connected to 10 or more networked devices. While the information on the medical device may not be useful to a hacker, the medical device can be used as a conduit for accessing patient information in the EHR, like home address and social security number, which can be used to perpetrate identity theft or real theft in the patient’s home while the patient is hospitalized. Potential threats in medical devices include the physiologic monitor that runs on an outdated operating system, the ventilator with a USB port, and usernames and passwords for the vendor’s field service engineers and

in-house technicians that are hard-coded. Other industries have largely solved these types of issues years ago. As a further example, in-house biomedical engineering technicians and vendor field-service engineers typically have administrative rights to access performance records and to apply service diagnostics. These are typically not a managed credential and at many hospitals are the same for everyone with this level of access to the device. What happens if a technician or field-service engineer leaves the hospital or the vendor? The password leaves with the person, with no hospital policy or procedure to update the access codes. In its 2015 Cybersecurity Survey, the Healthcare Information and Management Systems Society (HIMSS) noted that user-accesscontrol security solutions were implemented in just 55 percent of responding hospitals and mobile device management tools and that access control lists were implemented in only 50 percent of respondents. Also, at many hospitals, no clinical engineering or IT staff can tell you which medical devices connect to the EHR, how they connect, or what version of operating software is running on each device. Often, basic security information is nowhere to be found regarding medical devices used in patient care.

WHAT TO DO • Include clinical engineering, IT, and risk management staff when creating cybersecurity policies and procedures. • Proactively assess medical device cybersecurity risks, working with manufacturers as appropriate. • Keep up with the latest updates and patches for operating systems and anti-malware software. • Limit network access to medical devices through the use of a firewall or virtual LAN. • Audit the log-in process to all medical devices to ensure that an access-control method is being followed. • Set up a process to monitor and report on cybersecurity threats and events.

INCLUDE THE RIGHT STAKEHOLDERS TO CREATE POLICIES AND PROCEDURES In the Top 10 Health Technology Hazards for 2015, ECRI Institute recommended that a hospital or health system clinical engineering, risk management, and IT departments jointly take these steps to mitigate cybersecurity threats. Also, medical device security should be thoroughly vetted during the purchasing process of all medical devices and equipment, with a team that includes clinical engineering, IT, and risk management personnel to assess what the vendor has done regarding design and policies for patch and update management. One resource to aid in this process is the Manufacturer Disclosure Statement for Medical Device Security questionnaire developed by HIMSS and the American College of Clinical Engineering, and then standardized during a joint effort between HIMSS and the National Electrical Manufacturers Association. It provides medical device manufacturers with a means for disclosing to health care providers the security-related features of the medical devices they manufacture. 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 more guidance on mobile stroke units and other novel, new, or emerging technologies. 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

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AAMI UPDATE

AAMI Honors Healthcare Technology’s Best and Brightest

n impressive lineup of healthcare technology experts and innovators, along with patient safety champions, standards volunteers, young professionals, and students received an AAMI award or scholarship at this year’s AAMI Conference & Expo.

“We are delighted to be able to recognize the outstanding achievements of each of these individuals,” said AAMI President Mary Logan. “We had some phenomenal nominees this year, and the winners reflect the depth of knowledge, commitment, and passion that exists within the healthcare technology community. Because of their contributions to the development, management, and use of healthcare technology, they have helped improve the lives of patients throughout the world.” The 2016 AAMI Award winners are: • The AAMI Foundation’s LaufmanGreatbatch Award: Ary L. Goldberger, M.D., Beth Israel Deaconess Medical Center and Harvard Medical School; Roger G. Mark, M.D., Ph.D., and George Moody from the Massachusetts Institute of Technology • The AAMI Foundation & ACCE’s Robert L. Morris Humanitarian Award: Roy G. Morris, CBET, director of biomedical engineering for the International Children’s Heart Foundation in Memphis, Tennessee • The AAMI Foundation & Institute for Technology in Health Care’s Clinical Solution Award: James Piepenbrink, director of clinical engineering and Clinical Alarm Task Force at Boston Medical Center in Boston, Massachusetts

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• AAMI & Becton Dickinson’s Patient Safety Award: Maria Cvach, DNP, RN, FAAN, director of policy management and integration for Johns Hopkins Health System and a clinical safety specialist for the Armstrong Institute for Patient Safety and Quality in Baltimore, Maryland • AAMI’s HTM Leadership Award: Stephen L. Grimes, FACCE, FHIMSS, FAIMBE, managing partner and principal consultant for Strategic Healthcare Technology Associates, LLC • AAMI & GE Healthcare’s BMET of the Year Award: Carlos Villafañe, CBET, CET, a biomedical equipment technician III at St. Joseph’s Hospital in Tampa, Florida • AAMI’s Young Professional Award: Jennifer DeFrancesco, CCE, CHTM, chief biomedical engineer for the Indianapolis VA Medical Center and VISN 10 • The Spirit of AAMI Award: Larry Hertzler, MBA, CCE, vice president of technical operations at Aramark Healthcare Technologies in Charlotte, North Carolina The AAMI Foundation scholarship winners are: • Sarah Brockway, who is working toward a master’s of science in biomedical engineering at the University of Connecticut in Storrs, Connecticut

• Victor Makwinja, who is studying for a postgraduate diploma in healthcare technology management at the University of Cape Town in South Africa • Jay McKinney, who is working toward a bachelor’s degree in healthcare engineering technology management at Indiana University-Purdue University Indianapolis in Indiana • Conrad Robinson, who is working toward an associate of applied science degree in biomedical equipment technology and medical imaging certificate at Texas State Technical College in Waco, Texas

AAMI DESCRIBES QUALITIES IT’S LOOKING FOR IN NEXT PRESIDENT AAMI is on the hunt for its next president and CEO and knows exactly what it’s looking for: a new leader who can help the association grow and thrive. AAMI’s CEO Executive Search Committee and Korn Ferry, the global executive recruitment firm in charge of the project, have developed a detailed position description that outlines key responsibilities, year one success factors, and necessary professional experience and qualifications. Some of these qualifications and experience include: • A bachelor’s degree. • A minimum of 15 years professional leadership experience in an organization of comparable size and scope. • Proven business and financial acumen. • Ability to effectively prioritize and balance a variety of issues and stakeholders. • Track record for proactively addressing new opportunities and reacting to unanticipated crises or

“The goal of the framework is to provide a consistent and repeatable methodology by which each hospital can gauge where it is in addressing alarm fatigue and thereby move closer to becoming a high-reliability organization.” - James Welch, CCE

changes to the business environment that impact AAMI and/or its stakeholders. The full position description is available at www.aami.org/CEOposition. Applications and nominations are being accepted through the Korn Ferry website. The first round of interviews is scheduled to begin in August.

AAMI FOUNDATION PROVIDES FRAMEWORK TO HELP REDUCE NONACTIONABLE CLINICAL ALARMS The AAMI Foundation’s National Coalition for Alarm Management Safety has published a framework that it believes will provide a “consistent roadmap” for hospitals trying to reduce the number of nonactionable alarms. The framework, which was published in the May/June 2016 issue of BI&T (Biomedical Instrumentation & Technology), AAMI’s peer-reviewed and award-winning journal, is based on the Capability Maturity Model developed by the Software Engineering Institute at Carnegie Mellon University and tailored to alarm management. The framework comes at a time when health care delivery organizations are under mounting

pressure to improve their alarm management practices. For example, at the start of this year, The Joint Commission began requiring hospitals to establish and implement policies and procedures for managing clinical alarms. “Alarm fatigue is a challenging sociotechnical problem, and hospitals often do not know where to start in addressing this issue,” said James Welch, CCE, executive vice president of product development at Sotera Wireless and lead author of the BI&T paper. “The goal of the framework is to provide a consistent and repeatable methodology by which each hospital can gauge where it is in addressing alarm fatigue and thereby move closer to becoming a highreliability organization.” HTM professionals can play a crucial role in developing effective alarm management policies and practices, whether helping to export data from devices for reports, setting effective alarm configurations, helping clinicians understand the alarm functionality of devices, teaching them how to use the device software to customize alarms for individual patients, or sitting on their organization’s alarm management committee.

INDUSTRY UPDATES

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

SHOP TALK

Conversations from the TechNation ListServ Q:

How important are some of the basic information technology certifications (including CompTIA Network+ and Security+) for biomeds? Are they worth the time and effort? Will they make me better at my job?

A+ covers a broad base of everything you need to know for a job in desktop support. Network+ gives you a good footing as to how networks work. Security+ covers the basics of security. I highly recommend A+ and Net+ to everyone (they are relatively easy to pass and will give you a nice base knowledge to stand on). As far as Security+ or moving on to Cisco or MS certifications, those are very path dependent and depend on what it is exactly you want to do with your life when you grow up (still trying to figure that out myself). But A+ and Net+ would benefit everyone in the field as most biomed education programs sorely lack this aspect. Also, those two certifications will cover everything you need to know from an IT perspective for the CBET.

Yes! IS does not understand my needs and in a lot of cases don’t know what to do, any knowledge you have that will make it easier for you to work with networked systems, especially as EHR and medical systems are being more and more integrated, you will want this knowledge.

I think the usefulness of them is variable, depending on your employer, and your own attitude towards your profession. Let’s look at it this way:

1TECHNATION.COM

JULY 2016

The Pros: •G ives you confidence in your own level of knowledge, when managing network systems • Displays an industry-recognized level of technical competence • Increases the prestige of your profession (and your organization) by demonstrating a multi-disciplinary competence that is necessary for your job • Leverages the ease-of-assistance in resolving problems, from your IT department (assuming that they are different from clinical engineering/ HTM/biomed) – they are more likely to treat you as a “fellow professional” as opposed to a “L-USER” Now, the Cons: • CompTIA Certifications are very difficult (hardest exams I’ve ever taken) • You are unlikely to be reimbursed for the exam fees (much less any study materials or classes) • You are unlikely to get any recognition from your employer for your accomplishments (but they will happily “brag” on your certifications) • You need to re-certify every 3 years for CompTIA (unless you can demonstrate CE credits specific to that certification … extremely unlikely) The end result: If you think it’s worth it … then it’s worth it.

To know basic computer and networking is very essential for current biomeds. As you know that most hospitals are going to EHR. This means that many bedside monitors are connected

to the cloud and a doctor can retrieve the data any time and anywhere. Thus, we have to know how to configure the network, diagnosis, and troubleshoot any problems related to these technologies. As a certified CompTIA A+, Net+, and Security+, I do not have problems resolving any issues. It is to be one of the core knowledge sets for biomeds now.

Some of the basic certifications are mostly for people to know your basic skill sets have been verified. Any biomed should get his CBET certification and a computer certification of some kind. Instead of a generic NET+, I went with a CCNA but a NET+ is fine, I think. A CCNA is a lot harder to get. You will not use those Cisco skills more than likely. IT and biomed are merging more and more every year. I think of certifications as being for my next job search to a certain degree. An A+ would not hurt.

It is my opinion that the IT certifications (networking, cybersecurity, etc ...) are very valuable for our career field. If HTM departments are not involved in some way, shape or form in the IT space, then I would classify them as dinosaurs and we know what happened to the dinosaurs, they became extinct. I would venture a guess that at least 60 percent of the medical device inventories in our acute care facilities in the U.S. touch the hospital network. This fact should keep HTM personnel up at night as well as the facility leadership and board of directors. How are facilities protecting patient PHI that are either stored or

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

collected by these medical devices? Do you, the HTM professionals, know which devices in your inventory contain PHI? Are you exploiting the power of your CMMS system to manage your risks associated with medical devices in your inventory? Can you provide your IT and facility leadership with a clear inventory of devices that touch the network and contain PHI? Does your CMMS identify and document which devices are encrypted or have other software protections and who manages those strategies, i.e. OEM, IT, HTM? HTM professionals can no longer bury their heads in the sand as it relates to these risks. If they do decide to go down that route of, “Hey, that is not my job, that is the job of IT” then they have just relegated themselves to the way of the dinosaurs, extinction. Your facility will find someone who will manage this technology and provide strategies for managing these risks that exist with medical devices on the network. I personally felt that this area of Healthcare Technology Management was so important for me that I pursued and earned certifications in cybersecurity and HIPAA standards. I feel these certifications have provided great value for my employer and the patients that I serve. These posts are from TechNation’s ListServ go to www.1TechNation.com/Listserv to find out how you can join and be part of the discussion. vc_TechNation_Clr Ad_7x4.5_16Jun1.pdf

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JULY 2016

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ChargeMax is a product that offers charging, storage, security, and chemical-free general purpose disinfection for mobile devices. The digital timer on ChargeMax can set disinfection UV light for 1 to 5 minutes and can also set the time to start and stop charging of tablets. ChargeMax comes in various sizes of 10, 30, 40, 50, 60 and 65 slots for tablets and can be customized to meet the unique requirements. For more information, visit www.cetrixtablets.com/product-details/chargemax-charging-stations/.

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1TECHNATION.COM

BIOMED 101

The Importance of HTM Contribution to Medical Equipment Purchases By Ben Lewis, MBA, CHTM

etting a pallet of new equipment at your shop’s doorstep that you and your team knew nothing about is not unheard of in the HTM field. In fact, if that has never happened to you, you have likely had a fairly short career. There are many reasons that your HTM department should not only be aware of incoming equipment, but HTM should also have an active role in the screening and selection of medical devices. For those who are not involved in medical equipment procurement, or for those who are involved but not to the extent that they should be, it is up to the HTM leadership to make a case to capital purchasing committees and to administration regarding the importance of HTM’s role in the selection process. Whether you are a single biomed in a stand-alone, 100-bed hospital, or a system director in a 10-facility system, it is up to you to make a case for your involvement and the importance of your input.

MAKING YOUR CASE For those who are DNV certified, NIAHO standard in PE 7 SP.1 states that, “The organization shall establish a Medical Equipment Management System that provides processes for the acquisition” of equipment. Provide this information to the appropriate committee and up the appropriate chain of command and this should allow you to become involved in medical equipment selection. Prior to July 1, 2016, The Joint Commission has made a case for the HTM department to be included on

1TECHNATION.COM

JULY 2016

equipment purchases. EC.02.04.01 states in the first element of performance that, “The hospital solicits input from individuals who operate and service equipment when it selects and acquires medical equipment.” However, beginning in July, over 130 EPs will be deleted and will be no longer scored. Hospital discretion was given as the reason for the deletion of EC.02.04.01 (prior to 7/1/16) with regards to whose involvement is needed in the selection of medical devices. Outside of regulatory reasoning for your inclusion into the acquisition of medical equipment, you may also want to provide leadership with other reasons why there is a need for your input on medical equipment selection. Here is a short list in no particular order: • Budgeting Purposes: Being involved early will allow you to build a more accurate service budget. While many of your purchases will come with a one-year warranty, there are often costs that can hit earlier, like a PM or software contract. Being involved in purchases will allow you to maintain a more accurate budget.

BEN LEWIS, MBA, CHTM

Director of Clinical Engineering GA/FL with Novant Health Inc.

• Negotiation of Service Related Options: Go buy a car, cut a check, and then tell them you would like a new set of tires at no cost to you. There is a very high chance you will be breaking out your checkbook again if you are going to get new tires. The same principle applies with the acquisition of medical equipment. The time to negotiate an extended warranty, a lower cost service agreement, or free or reduced education is before the purchase and no one is better equipped for negotiating such things than the HTM department. If you are not involved early, it’s too late. • Software Upgrades: I am not telling you that you will be able to get all of your future software upgrades for free, but you can’t get something without

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asking. Software to consider at the point of purchase is the life cycle of the operating software. Windows 7 is at end of support in less than 4 years, so, if you are on a network transmitting PHI with the equipment you are purchasing now, there will be no security patches released without updating the OS on equipment you buy today running on Windows 7. Getting an agreement to keep your equipment on a secure OS is something that you can reach for, as the FDA is already putting pressure on manufacturers to provide postmarket management of cybersecurity vulnerabilities. I advise that any such agreement be added to the purchase contract and the purchase order. •

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on the form may include: CLIENT SIGN–OFF: • Is there a contract need for this PLEASE THAT THE FOLLOWING ARE CORRECT equipment? PriceCONFIRM of contract? www.keimedparts.com PHONE NUMBER WEBSITE ADDRESS SPELLING • Is educationLOGO needed and available?

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Price of school, travel, and accommodations? Expected impact to service budget? Does this equipment operate on the network? Does it store PHI? Does this equipment run on operating software? Which one? When is the end of support of OS? Does this equipment use accessories that Material Management stocks? Example: cuffs, SP02 cables, EKG leads, etc.

Knowing the answers to these questions can save you time, money, and headaches in the future by allowing you to plan and negotiate accordingly. Understanding what equipment is coming to your facility and gaining influence on what comes through the door will make you a valuable contributor beyond just the service of medical equipment. Hopefully, your administration can see the importance and value in the early involvement of HTM departments regarding medical equipment purchases and that HTM contribution is a regulatory, operational, and financial win for both your department and your organization.

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IMAGING WEBINAR AMONG BEST IN 2016 One recent Webinar Wednesday “Image Quality and the Imaging Chain – A Service Prospective” featured John DiPasquale, Technical Trainer for Technical Prospects LLC and is among the highest rated webinars of 2016. DiPasquale discussed image quality and how it is affected, as well as how to identify the components that comprise the imaging chain. He explained the importance of the different service tests/ verification and adjustments performed as well as their influence on the various items in the chain. The importance of the system specification sheet and how it relates to preventive maintenance and the imaging chain were also covered. An informative Q&A session capped off the popular presentation. Attendees rated the webinar, sponsored by Technical Prospects, 4.3 on a 5-point scale with 5 being the highest possible score.

AED WEBINAR SMASHES ATTENDANCE RECORD The TechNation Webinar Wednesday presentation “AEDs: What You Need to Know – FDA Updates, Best Practices, and More” provided expert knowledge on Automated External Defibrillators (AEDs)

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from the team at webinar sponsor Fluke Biomedical. The webinar proved popular among HTM professionals setting a new all-time attendance record. Presenter Ashton Solecki, Fluke Biomedical Product Marketing Manager, said the FDA has increased its scrutiny of AEDs due to an increased high failure rate. She shared her insights into one of the most highly regulated medical devices in the industry. The webinar concluded with an informative Q&A session. The presentation was a hit before it even started with a record 1,035 people registered to attend. A new record for the number of attendees was set with 576 people joining the live webinar.

CONTRAST INJECTOR WEBINAR WOWS ATTENDEES The TechNation Webinar Wednesday series continued with “Introduction to Contrast Injector Operation and Service” sponsored by Maull Biomedical Training LLC. Steve Maull’s excellent educational and training skills were on display during the hour-long session. The webinar provided an introduction and overview to contrast injectors. Maull covered what contrast injectors are used for, the three different types and the proper operation of a contrast injector. An introduction to concepts involving PMs

and calibration were also examined. Tools and test equipment needed for working on contrast injectors was another point of emphasis. The webinar was a hit with more than 300 attendees giving the session the highest rating of 2016 with a 4.4 on a 5-point scale with 5.0 being the best possible score.

ROUNDTABLE WEBINAR EXPLORES PATIENT MONITORS The webinar “Special Roundtable Webinar: What’s New in Patient Monitoring?” featured four sponsors – Fluke Biomedical, USOC Bio-Medical Services, Pacific Medical and Southwestern Biomedical Electronics. Each sponsor had a company representative present information about their company prior to an insightful Q&A session. Each company representative answered questions submitted by webinar attendees. Attendees benefitted from the one-onone exchange gathering answers to their top concerns while also listening to discussions regarding the issues their peers are facing around the world. The Webinar Wednesday series continues to prove popular with 316 attendees logging in for the roundtable session. The special roundtable format was a hit with attendees who appreciated

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NOVEMBER JULY 2016 2014

ROUNDTABLE Ultrasound

ltrasound systems have always been an important diagnostic imaging tool. These systems are becoming more popular for various reasons including advanced functionality and the lower cost options available compared to other imaging modalities. TechNation reached out to ultrasound professionals to find out the latest regarding ultrasound systems including new technology, budget concerns and factors impacting the market. The panel of experts includes Tri-Imaging Solutions Director of Sales (West) Shawn W. Bryant, MW Imaging National Sales Manager Andrew Geidel, Philips Healthcare Director of Technical Development Multi-Vendor Services Richard Gerler, Trisonics Inc. President Stuart Latimer, Global Medical Imaging (GMI) Point-of-Care Sales Manager Tom Siffringer, Conquest Imaging Executive Vice President of Sales and Marketing Matt Tomory, and Exclusive Medical Solutions Customer Service Engineer Carlos Vargas.

WHAT ARE THE NEWEST TECHNOLOGIES AND/OR THE LATEST ADVANCES IN REGARDS TO ULTRASOUND SYSTEMS?

Bryant: One of the latest advances in ultrasound is the mobility of the

systems. The industry is trending toward smaller portable devices, as well as wireless transducers. With that being said, there has been a huge advancement in transducer technology with the addition of the matrix probes. The matrix transducers are creating incredible images helping clinicians across the board. These are typically used in the cardiology environment. Siffringer: Siemens recently introduced the world’s first system with wireless transducers, the Acuson Freestyle. Siemens also launched the Acuson P500, the first laptop-style point-ofcare ultrasound system to incorporate technologies typically found on console systems. The P500 includes disruptive technologies such as “Auto Flash Artifact Suppression,” which features the most sensitive, artifact-free color imaging available today. Geidel: Image quality has improved exponentially in recent times with the addition of “high-definition,” also known as “high-resolution,” monitors and LCD displays, probes, and software. Progressive “p” resolution has been proven to be the faster, clearer picture, and less prone to blurring therefor allowing radiologists/cardiologists to achieve a much more defined diagnosis. Also, “compact” is the new kid on the block. Systems are being redesigned to be streamlined, lighter, less components, user-friendly, and most of all, have much greater mobility.

Gerler: The trends we are seeing are improved automation, smaller sized equipment and connected systems that are turning system data into actionable insights. For advanced applications, users achieve more diagnostic confidence and improved reproducibility with automation tools such as Anatomically Intelligent Ultrasound (AIUS). Such tools reduce the manual steps required for advanced quantification, and reduce variability in results. The smaller form factor in equipment size is increasing the use and availability of ultrasound. For example, transducers can now be plugged directly into a smartphone or tablet making it easier to perform ultrasound exams outside a traditional exam room. Lastly, ultrasound systems continue to advance with remote diagnostic capabilities that enable not only OEMs, but also in-house teams, to more rapidly identify the source of performance issues which results in faster service resolution and system uptime. Latimer: One of the biggest advancements we have seen over the last few years is in the size and mobility of the systems. Companies have brought ultrasound technology into handheld devices that can easily fit inside a pocket. The portability and image quality opens up many new market opportunities. Tomory: There has been major technological advancements in breast ultrasound imaging recently which addresses the challenge with imaging dense breast tissue. Mammography can

THE ROUNDTABLE

ROUNDTABLE Ultrasound

miss up to a third of cancers in dense breast tissue and almost 50 percent of women have heterogeneously or extremely radiographically dense breast tissue. GE has released the Invenia ABUS (Automatic Breast Ultrasound) system, Philips has added the AWBUS (Automatic Whole Breast Ultrasound) technology to their iU22 and Epiq systems and Siemens has the ABVS (Automated Breast Volume Scanner) option on the S2000 platform. Also, the trend continues for downsizing systems and higher levels of software functions which reduces hardware in the newest systems. Vargas: Ultrasounds are headed in the direction of substituting radioactive imaging in certain situations. Image processing along with advances in volumetric imaging has significantly improved image quality in ultrasounds allowing for clear, detailed images. Advances in circuitry and processing power have allowed ultrasounds to become smaller and more powerful. Modern technology has also allowed for further advances such as wireless transducers and Contrast Enhanced Ultrasound (CEUS).

HOW ARE THESE ADVANCES IMPACTING THE MARKET?

Bryant: There have been a number of new ultrasound companies manufacturing a low-cost system, which is trending toward a commoditization of the product. This has the potential to impact the market. Which is why we are seeing companies like GE, Philips, etc. providing systems with advanced technology such as the matrix probe. Siffringer: For decades, clinicians have asked for wireless transducers – their

1TECHNATION.COM

SHAWN W. BRYANT

Tri-Imaging Solutions Director of Sales (West)

development would immediately solve a chronic problem, maintaining a sterile field. Without cables to get in the way, wireless transducers give the user more flexibility. The ability to completely submerge its transducers and batteries makes cleaning more effective as well. Geidel: More hospital off-sites, clinics, and private practices are able to afford these newer, compact, less expensive platforms than ever before. Being able to offer a patient a one-stop event rather than traveling to an imaging center and waiting for the imaging test results and having to make multiple appointments, creates a patient peace-of-mind scenario. Gerler: Driven by the market’s need to provide quality care at more affordable prices, these on-going advances in image quality and new levels of portability are challenging clinical departments to re-examine when they need to use their more sophisticated

NOVEMBER JULY 2016 2014

imaging equipment vs. an ultrasound system. Improved automation and ease of use reduce the amount of time it takes to perform an ultrasound exam and, in turn, increases patient throughput. This allows departments to increase efficiency and potentially reduce costs for each exam performed. The new smartphone app-based ultrasound concept brings with it new business models and expansion opportunities into the market. For example, Philips Lumify is a low-cost subscription model where no capital purchase is required by the customer. This model reduces barriers to entry into ultrasound, and allows health care providers to try the technology without substantial initial investment. Latimer: This has impacted the market by decreasing the cost of the systems so that more facilities and specialties can utilize the systems. We now see the smaller devices used in places such as the ER, point-of-care facilities, etc. This also enables providers in other parts of the world, who did not have access to ultrasound, a way to provide the service to their patients Tomory: Approximately 12 percent of women will develop breast cancer in their lifetimes so this emerging technology will continue to expand the women’s health care market for the foreseeable future. With the technology integration/downsizing, we will see more depot repair options offered by OEMs and ISOs as opposed to servicing in the field. Vargas: As a whole, the market is seeing a steady growth in ultrasound sales. New technologies allow for smaller, more powerful systems. Point-of-care ultrasound will show an impressive growth in the market.

WHAT IMPACT IS POINTOF-CARE (POC) IMAGING HAVING ON THE ULTRASOUND MARKET?

Bryant: With POC becoming more and more popular, it is allowing clinicians to give general scanning capabilities in their offices. In my opinion this is why the smaller, less expensive ultrasound units are becoming more and more popular. However, the reimbursement side of the POC is a little more complex due to having a trained clinician performing the scans to qualify for reimbursement. There are OEMs specifically focused on the POC market, especially in the MSK (Musculoskeletal) specialty, which is having a hard time getting market penetration into the POC; with orthopedic physicians not fully bought in. Siffringer: Systems certainly aren’t getting any larger – we increasingly find that space limitations affect equipment decisions. As hardware gets smaller, faster and more powerful, POC imaging is becoming the standard, not the exception. The growth of POC ultrasound, puts a premium diagnostic tool more easily and efficiently in the hands of clinicians, enhancing patient care and outcomes. Geidel: POC is redefining patient care. With the ever redesigning of ultrasound systems to a compact design and greater mobility, we are creating a more comfortable and less painstaking event for the patient. POC imaging is the new stethoscope in the doctor’s toolbag. Gerler: There are entirely new user models being created for ultrasound systems, and new market opportunities emerging in historically non-traditional locations. POC is bringing ultrasound

there is no end in sight with regards to POC imaging. Vargas: With portable systems becoming much smaller, this will allow consumers to purchase “Laptop” ultrasounds at an affordable price without reducing quality. Although the majority of the market is mostly larger ultrasounds, portable ultrasounds are becoming more practical and popular. In the past four years these systems have had a significant increase in growth.

HOW CAN A FACILITY WITH A LIMITED BUDGET MEET THE ULTRASOUND NEEDS OF TODAY?

TOM SIFFRINGER Point-of-Care Sales Manager Global Medical Imaging (GMI)

technology to users who are not traditionally trained in ultrasound scanning. In recent years we have seen a lot of growth in ultrasound used in regional anesthesia, emergency medicine, and sports medicine applications. In the future, I think we will see growth in ultrasound use by primary care providers and first responders. Latimer: Point-of-care imaging has impacted the market by increasing the amount of units used and the ability for providers to uncover conditions earlier and easier than ever before. Now, facilities are able to quickly look at the carotid artery or the thyroid right in their office at the time of service. Tomory: POC imaging has been and will continue to expand with the decrease in size and cost as well as increase in resolution of today’s systems. With ultrasound being an inexpensive and non-invasive modality coupled with expanding applications,

Bryant: One option is to purchase a refurbished unit versus new. I worked with several customers who had not set aside adequate capital money to upgrade their ultrasound units that had become semi-antiquated. We were able to locate systems with exceptional scanning ability that were only a couple of years old. The second option would be to lease an ultrasound machine. The initial low buy-in and monthly payments help with their budgetary restraints. It is very easy to create a metric for the customer to show reimbursements based on patient flow, easily identifying how soon the ultrasound unit will pay for itself. Siffringer: Facilities do not have to depend on the OEMs anymore. There are plenty of great organizations that provide new and refurbished equipment at considerable savings versus the OEMs. These same companies also provide cost-effective service contract and support options. In-house support is also a great way for facilities to manage budgets and ISOs provide training and technical support to make the transition easier.

THE ROUNDTABLE

ROUNDTABLE Ultrasound

this equipment can be higher quality than used equipment purchased from a third-party, and typically comes with updated software and a manufacturerbacked warranty. Latimer: Facilities with limited budgets can meet their customers’ needs much more easily today because the systems are more affordable and user friendly. Places you never would have seen using ultrasound 10 years ago are now offering the service. This is proving to be an invaluable resource to patients because they are able to receive the service at the time of care rather than waiting days to schedule with another center. RICHARD GERLER,

ANDREW GEIDEL

National Sales Manager MW Imaging

Geidel: There are several items of importance that need to be considered when embarking out into the ultrasound market. First and foremost, know your budget and your needs. Consider consulting with an applications person or sonographer in advance so that you can achieve the most out of your investment. Additionally, consider the applications/ options and probes that you will be using along with mobility and ease of use. And, lastly, consider how you want to pay for your investment. Leasing is always a viable option keeping in mind how you want to manage your ROI. Gerler: Ultrasound continues to be an appealing imaging modality due to its relative low cost and non-ionizing qualities. Most ultrasound manufacturers offer used or refurbished equipment which can be an ideal solution for purchasers with a limited budget. Coming from the manufacturer,

1TECHNATION.COM

JULY 2016

Tomory: Let’s face it, budgets are tight everywhere, reimbursements are at an all-time low and providers are always looking to save where they can. Purchasing reconditioned equipment as opposed to new, utilizing ISOs for parts, probes, training, service and migrating service in-house are all ways to reduce costs while not compromising patient care. Vargas: With portable systems now becoming more popular, facilities can target specific needs at an affordable price without risking quality. Facilities shouldn’t have to feel that name brands like Philips and GE are their only options. Many other OEMs offer ultrasounds for a limited budget with comparable quality.

WHAT DO TECHNATION READERS NEED TO KNOW REGARDING THE LATEST IN ULTRASOUND PROBES AND TRANSDUCERS?

Bryant: The OEM website is a great resource for new and upcoming

Director of Technical Development Multi-Vendor Services Philips Healthcare

technology. Another great resource is the sonographer, they have vast knowledge and are usually current on new technology. As previously mentioned, the newer matrix probes have really exceeded scanning expectations. A case in point are the 3D Transesophageal TE probes that are giving cardiologists a higher level of diagnosis in the treatment of heart conditions. Siffringer: In the good old days, transducers were single frequency and required multiple transducers to perform different types of scans. Those days are long gone, with the advent of broadband technology. a transducer can now cover a range of up to 13 different frequencies in the general market and up to 30 in specialized markets. Geidel: Probe/transducer technology is an ever changing situation. There are vast advances in 3D/4D probes creating a whole world of improvement in image

These new probes are providing superior images over those seen years ago. Tomory: The latest ultrasound transducers are extremely advanced compared to several years ago. Single crystal, matrix arrays, sophisticated construction utilizing different matching layers and lens shapes and materials all contribute to higher probe repair and replacement costs. Now more than ever, it is critical to ensure probe care and handling analysis and instructions are a part of every provider’s maintenance plans.

STUART LATIMER

President Trisonics Inc.

quality and diagnosis. High-definition 2D probes and cardiac matrix probes are the new norm in today’s diagnostic imaging centers and hospitals creating unprecedented viewing, greater ease of proper diagnosis, and shorter scan times for patients Gerler: As technology continues to advance probes and transducers are becoming more complex, and repair of these probes can requires advanced skills. To ensure optimal performance and not compromise diagnostic integrity, it is recommended that in-house service teams partner with an organization that has the skills and abilities to repair and/ or recommend replacement of probes not working properly. Latimer: Probes and transducers are also seeing advancement such as single crystal and mtechnology which is enhancing the image quality and the ability to see much more intricate detail within the scan.

Vargas: Transducers are looking toward the future. Some transducers are capable of multiple modes allowing customers to purchase one probe and be sufficient. Some probes are looking into the future and are even becoming wireless.

WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN CONSIDERING AN INDEPENDENT SERVICE ORGANIZATION (ISO) FOR ULTRASOUND SYSTEMS?

Bryant: I would encourage the customer to analyze their needs and match those needs with the services offered by the ISO. Most of the ISOs have a niche when it comes to a specific OEM. MD Expos are another great way to talk with your peers and see who they are utilizing. There are several ISOs that offer training and service support in addition to parts support. Siffringer: There are a number of great organizations to work with. At the top of the list should be reliability and breadth of work. When you are in a hard down situation, can you trust that company to resolve the issue quickly and correctly? What other services does the company

MATT TOMORY

Executive Vice President of Sales and Marketing Conquest Imaging

provide, such as technical support, parts, training and probe repair? Having a partner who can provide you with a wide array of quality services can make life much easier than having multiple providers for one modality. Geidel: Reputation, integrity, honesty are first to come to mind. Call around, inquire, and get referrals and recommendations. Don’t be afraid to ask for training documentation. Look at length of time in business and check with your local BBB. Gerler: As a leading multi-vendor service provider, we see a lot of variability in the quality of service being delivered by independent service providers. We feel that when qualifying any service provider, find out what sort of qualifications they have in place. Are they ISO certified? Do they subscribe to and have a documented process to maintain their equipment to the recommended OEM guidelines? How,

THE ROUNDTABLE

ROUNDTABLE Ultrasound

Siffringer: The ultrasound market changes just as quickly as the personal computer market. It seems as soon as one manufacturer develops a new offering and gets it to market, another company has developed something to make it obsolete. LCD monitors, SSD hard drives, RF touch screens, faster CPUs, high-capacity memory and matrix array transducer technology are just a few of the great advancements over the last 15 years.

when and where have their service engineers been properly trained? What kind of technical and clinical application support do they provide? What is the infrastructure to support primary and secondary level support? And, one of the biggest areas to be concerned with are where replacement parts are coming from and are they delivered with a solid warranty. A replacement part that is not compatible with current software levels, or is dead on arrival only extends downtime of the equipment. Asking these questions can ensure that your service strategy helps you obtain your business goals. Latimer: Some of the most important things to look for in an ISO are experience and expertise. You want to make sure the company you choose knows how to work and support all the different ultrasound manufactures, as well as be able to provide references to show quality and reliability. Another important factor is to inquire about the company’s commitment to a quality management system. Tomory: Independent service organizations are being looked at very carefully these days so it is critical to ensure your vendors have a comprehensive quality management system in place. There are no standards currently but International Organization for Standardization (ISO) certification is a good place to start. Also, longevity in the business, the service and support structure to back up the sale and reputation are all indicators of how smoothly a sale and after sale will proceed. Vargas: Quality should be the main thing to look for when considering a service provider. You want to look for competitive pricing from a quality source for your parts. Experience is also important, especially when dealing with service and tech support. A service provider should always be trustworthy and reliable.

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JULY 2016

Gerler: Ultrasound systems are safe, fast and easy to use. Coupled with enhanced image quality and reduced acquisition costs ultrasound is an appealing, flexible and mobile technology to improve diagnostic capabilities. CARLOS VARGAS

Customer Service Engineer Exclusive Medical Solutions

WHAT ELSE DO TECHNATION READERS NEED TO KNOW ABOUT ULTRASOUND SYSTEMS? Bryant: The ultrasound industry is very dynamic and with the advancement in computing power I feel the image quality and mobility parameters will continue to advance at a fairly high rate. Geidel: You have quite a number of options when it comes to ultrasound. I sometimes scratch my head when I see all the spin offs and startups in the ultrasound industry and on the same token, how quickly they disappear. Look for entities that encompass what’s on the horizon, new technologies and advancement, as well as supporting the existing and end-of-life platforms. As I profess to tell all my new/potential customers, “just give us a chance, give us a test drive, kick the tires, and let us show you how we bring new life to ultrasound!”

Latimer: It is important to keep in mind that as technology moves forward, the ultrasound systems of today are moving further away from a hardware focus to be more software intense. This is important, not only to the serviceability of the machines, but also because it offers the customer many more options. Tomory: Ultrasound systems are getting more complicated and integrated and the modality will grow for the foreseeable future. This modality can be supported in-house bringing about better service delivery and lower operating costs when providers partner with the right organizations. Vargas: The future is promising. Huge advancements are allowing ultrasounds to do more than ever before. A future where imaging is portable and has minimal to no radiation is key for patients and their safety. Advances in technology are allowing for clinics to purchase these machines within their budget limits. Also, physicians are able to perform procedures with extreme accuracy due to quality imaging.

THE ROUNDTABLE

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At Ed Sloan & Associates, our 25 years of experience is reflected in the science and fine art of selling imaging parts.

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YOUR SOURCE FOR QUALITY PARTS, EQUIPMENT, SUPPORT AND TRAINING Email: sales@ed-sloanassociates.com Web: www. edsloanassociates.com Phone: 888-652-5974 Fax: 615.448.6099

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By K

. Ri

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las

he rapid escalation in the use of CT scans and nuclear medicine for diagnostic purposes has exploded in recent years. In 1980, there were 3 million CT scans performed in the U.S. By 2006, that number

had increased 20-fold. With the steep escalation in the use of CT scans, the public has become more educated and concerned about the possible ill effects of increased radiation exposure. A 2010 Presidentâ&#x20AC;&#x2122;s Cancer Panel report suggested that clinicians keep a tally of the amount of radiation that patients are exposed to as a result of these imaging studies.

GOING MOBILE

The very real concern is that ionizing radiation can damage DNA. While the body has a miraculous ability to continually repair cellularlevel damage, there is the possibility that some damage goes unrepaired or that DNA becomes mutated. These mutations may lead to cancer later on. CT radiation dose is just one area of concern addressed in The Joint Commission’s new diagnostic imaging requirements. The revised diagnostic imaging requirements, that apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, went into effect on July 1, 2015. The Joint Commission (TJC) was founded in 1951 and evaluates and accredits more than 21,000 health care organizations in the U.S. The Joint Commission is the oldest and largest standards-setting and accrediting body in health care, according to the organization’s website. In 2010, the Centers for Medicare and Medicaid Services (CMS) named The Joint Commission a designated accreditor of advanced diagnostic imaging centers. With TJC’s focus on patient safety, the topic of modern-day diagnostic imaging was due to be revisited. The new standards have evolved through the recommendations of accredited organizations, professional associations and imaging experts. The new standards include areas that require

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Andrea Browne, Ph.D, DABR Medical Physicist in the Engineering Department, The Joint Commission

evaluation to ascertain that diagnostic imaging is conducted safely. The Joint Commission listened to the feedback and developed the new standards. Feedback came from professional organizations, such as AAPM, ACR, ASRT and many others. The new requirements cover MRI safety; the inspection, testing and maintenance of imaging equipment; CT radiation dose documentation; and training for the diagnostic CT technologist on radiation dose optimization, pediatric imaging and the safe operation of the CT unit used. Imaging has even more regulation than other areas within HTM, with the scrutiny of the American College of Radiology, CMS and the FDA.

BALANCING DOSE AND QUALITY As mentioned previously, radiation is a concern with the public and just one element addressed in the new requirements. With CT scanning, it is part of an important balance to get right. “You may not just want to talk about reducing radiation exposure for a study,

because you can reduce it too much, and then it doesn’t have the diagnostic quality that you need,” says Andrea Browne, Ph.D, DABR, who is a medical physicist in the engineering department at The Joint Commission. “The phrase that is used is ‘radiation dose optimization.’ That means that you are using the minimal dose for a given condition with a given piece of equipment to produce a diagnostic result,” she says. “There’s a lot of work being done on how you design and implement CT imaging protocols that, in fact, optimize the dose and give you optimal images for diagnoses.” There are three areas of risk, as The Joint Commission sees it, in developing an updated standard and they are: making sure imaging equipment is functioning properly, which would include conducting annual imaging equipment performance evaluations; qualified staff supporting imaging services and conducting imaging exams, this includes using a qualified medical physicist; and making sure that staff is trained on optimizing CT radiation dose with processes in place to support safe imaging and managing safety risks in the MRI suite. What do the new TJC imaging standards mean for the HTM community? The implications for the HTM community are subtle. The new and revised requirements are broad in nature with the safety and well-being of the patient as the primary focus. The new requirements most impact radiologists, imaging technologists and medical physicists. “In The Joint Commission standards, environment of care chapter, there are standards that relate to safety and equipment. There were very general standards that equipment be tested and operation be verified, but there was not the specificity of the diagnostic imaging standards that first came out in 2014, and were revised, and came out in 2015,” Browne says.

“There really has to be a very symbiotic relationship between the biomedical engineer, who supports medical imaging equipment, and the medical physicist, who’s making measurements and knows what you can get out of that piece of equipment” – Andrea Browne, Ph.D, DABR

“There have always been standards that pertain to safety of the environment, safety of the equipment, but not as it addressed medical imaging in this degree of specificity,” she says. Browne points to one area of confusion that elicited a question directed at The Joint Commission engineering department as a result of the new standards. “There are very definitive quality control requirements, that are not necessarily from The Joint Commission, but the question came into The Joint Commission, because we say you have to set up a quality control program and follow it,” Browne says. “What do you set up, because if you have an organization that is multiaccredited, as their imaging department might be, in CT or MRI, you might be accredited by both the American College of Radiology and The Joint Commission. We’re saying, put a quality control program together and follow it. Then, the organization is saying ‘We’re going to do that, but who do we follow?’ ” “If the manufacturer gives you a set of instructions for preventative maintenance, that may have some testing involved, and the ACR has others — and they are very specific on what tests you do — what kind of parameters you track, [and] how you set the actionable limits. What do you do if they are not congruent with each other,” Browne asks.

She says that the answer was that the organization really has to look at what the manufacturer is saying. “Are they directing their instructions towards preventative maintenance, which is one set that the biomeds are going to be very involved in, versus daily quality control testing, or weekly or quarterly, which is prescribed by an accrediting agency,” she says. “That is one thing that I think organizations might want to look into. That is, when they get inspected, by an accrediting organization, that they’re following the appropriate plan and you know what the manufacturer’s instructions cover and how in-depth they are.” “Are they just talking about acceptance testing and then annual or semi-annual preventative maintenance versus this daily, weekly, monthly testing that the operator of the piece of equipment does. That’s two groups that have to talk to each other; the biomeds and the quality control tech or the imaging tech, who is actually doing the testing,” she says. The American College of Radiology (ACR), along with their professional partners, offers guidance to help negotiate the new standards. “ACR has the dose index registry that helps with meeting that requirement in terms of analyzing the data and confirm them against external benchmarks,” says Priscilla (Penny) Butler, M.S., FACR, FAAPM, senior director and medical

physicist, quality and safety, American College of Radiology (ACR).

THE MRI SUITE While a portion of the new and revised requirements have singled out CT, another portion of the new requirements provides recommendations for MRI. Those recommendations are primarily addressing the imaging technologist. Control of access to the MRI suite, and safety education and procedures, are highlighted in the recommendations. The technologist should know how to screen anyone who might enter the MRI suite. Browne points out that this would include the biomed. This is in light of the fact that many biomeds are handling the PMs of MRIs that might have been maintained by the vendor in the past. “It’s important that all of those biomeds are appropriately screened and know the hazards that are involved in working around a strong magnetic field. And, what equipment you can take in there and what you cannot,” Browne explains. “They should be part of the group that is screened and educated every year,” she says. “In terms of being knowledgeable about the hazards in the MRI suite, and knowing that nothing physically about the individual has changed that would affect their

DIAGNOSTIC GOINGIMAGING MOBILE

ONLINE RESOURCES CONFERENCE OF RADIATION CONTROL PROGRAM DIRECTORS MEDICAL PHYSICIST REGISTRY: WWW.CRCPD.ORG IMAGE WISELY: WWW.IMAGEWISELY.ORG IMAGE GENTLY WWW.IMAGEGENTLY.ORG/

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ability to enter the suite (any device or implant since last screening). They need to update their clearance to get into the suite.”

NOT TO BE CONFUSED While hospitals will certainly want to comply with any TJC imaging directive, there is a separate directive that hits the bottom line in terms of Medicare reimbursements. The National Electrical Manufacturers Association (NEMA) XR-29 Standard, which became effective January 1, 2016, specifies four attributes of CT scanners that relate to optimization of dose of ionizing radiation while producing a quality diagnostic image. If all four attributes are not in compliance, there will be a five percent reduction in reimbursement per scan. That figure increases to 15 percent on January 1, 2017. The penalty only applies in certain situations. For instance, it does not apply to interventional radiology procedures. “A lot of people are getting confused between The Joint Commission requirements and the XR-29 requirements, and they are different. The XR-29 requirements basically say that your safety equipment must have these features in it to get full reimbursement,” Butler says. The National Electrical Manufacturers Association (NEMA) XR-29 (MITA Smart Dose) Standard applies to CT equipment and to dose optimization and management. The XR-29 standard prescribes a balance between the dose of ionizing radiation and the image quality needed to deliver what is required by the physician. “Unfortunately, there is a lot of confusion regarding XR-29 and what solutions can be implemented to avoid the cuts. For many, there is not a good solution. Many manufacturers have made upgrading a very cost-prohibitive endeavor (it’s almost cheaper to buy a refurbished replacement scanner in some cases),” says David Harns, CT product specialist at Block Imaging.

David Harns CT Product Specialist, Block Imaging

“Some folks are investigating thirdparty solutions to become compliant but – as has been the case since January – we have not been given complete clarity from MITA and/or NEMA that these are (or will be) acceptable solutions,” Harns says. “We’re doing our best to advocate for organizations that have found themselves in a situation that was not of their own making. It has not been the smoothest implementation of new imaging equipment standards, that can be said for sure.”

EXPERT CONSULTATION Butler says that they have not heard from anyone who is necessarily having problems with the standards, but instead, just questions relating to the new standards. The ACR has developed some questions and answers to make navigating the new standards easier. A key component of the new requirements is the availability of a medical physicist. The medical physicist may be assisted with the testing and evaluation by an individual who has “the required training and skills, as determined by the physicist.”

“We’re doing our best to advocate for organizations that have found themselves in a situation that was not of their own making. It has not been the smoothest implementation of new imaging equipment standards, that can be said for sure.” – David Harns, CT Product Specialist

The Conference of Radiation Control Program Directors Inc. (CRCPD) has established a Medical Physicist Registry which offers a registry of board certified medical physicists. While the new standards directly address the role of the medical physicist, there is also an important support role for the HTM professional. Inspecting and testing refers to the medical physicist’s role and maintaining refers to the work of those in the biomed department. “The biomed might be the individual running the phantoms or collecting data for the physicist to look at, compile and make recommendations based on those results,” Browne says. “It’s entirely possible that you’ll see more biomed/ physicists working together to do the performance evaluations that The Joint Commission standards require.” “There really has to be a very symbiotic relationship between the biomedical engineer, who supports medical imaging equipment, and the medical physicist, who’s making measurements and knows what you can get out of that piece of equipment,” Browne says. Browne says that some of these standards – CMS, TJC and ACR – have emphasized the importance of the diagnostic medical physicist. “With the appreciation for the complexity of the equipment, the regulations that are out there that require the input of the expertise of the physicist,

there’s a big need, a demand in the field,” she says.

IMAGING WISELY AND GENTLY The Image Wisely and Image Gently campaigns emphasis the importance of optimizing radiation dose, along with practicing safe protocols for pediatric patients. The new TJC standards require annual training as it relates to the Image Wisely and Image Gently campaigns. The Image Wisely campaign comes from the American College of Radiology and the Radiological Society of North America. Recognizing the increased exposure to radiation by adults from medical imaging, they collaborated with the American Association of Physicists in Medicine and the American Society of Radiologic Technologists in developing the campaign. The campaign makes available resources for imaging practitioners and patients. The mission of the Image Gently Alliance for Radiation Safety in Pediatric Imaging aims “through advocacy, to improve safe and effective imaging care of children worldwide,” according to its website. The campaign offers free information for parents and imaging practitioners.

LOOKING FORWARD Diagnostic imaging will continue to evolve and require changes and innovations that may impact HTM professionals more directly. Fluoroscopy, network security and getting an imaging history into a patient’s

EHR are ongoing issues that HTM professionals will be exposed to or be directly involved with. Browne says that the next big area to get more scrutiny will be fluoroscopy. She says that since 2006, all fluoroscopic units must have a measure of radiation output that is displayed. There are four different ways that manufacturers actually make this measurement and display the information. “You have to calibrate these devices that measure the radiation from fluoroscopy [and that] is the biomeds bailiwick. They really have an important role,” she says. She points out that the physicist might make measurements, and determine that the device is meeting state guidelines for maximum output, as an example, but they must turn to the biomed and ask the biomed to adjust the device to make sure that the measurements are correct and the image quality is maximized. With some procedures, such as RF cardiac catheter ablation, the patient may be exposed to more radiation from fluoroscopic exposure than other common radiological procedures. As these procedures continue to increase in frequency, along with diagnostic imaging from CT and MRI, the focus on protecting the patient will result in new standards. The role of the HTM professional will continue to evolve as it relates to TJC updated diagnostic imaging standards and future standards may be grounds for additional training and more involvement.

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CAREER CENTER

Interview Fatigue By Todd Rogers

n late March or early April, I received an email from a high-caliber equipment service technician. I had coldcalled this guy about a year ago and at that time he just wasn’t interested in talking about other jobs. But, he agreed to hang on to my contact information and get back in touch with me if things changed. That’s pretty much how it goes in cold-recruiting: timing is everything and for this guy, it just wasn’t time for him to talk about a job change.

TODD ROGERS Talent Acquisition Specialist for TriMedx, Axcess Ultrasound eProtex and TriMedx Foundation

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JULY 2016

It was frustrating back then because according to LinkedIn this guy has “mad-skills,” the kind that we were really looking for. So, you can imagine that I was pleasantly surprised to hear back from him and that he was now ready to talk about a possible job change. Spoiler-alert: This story does not have a happy ending and the unfortunate outcome is the purpose of this piece. For this story, I’ll refer to this individual as “Jerry” (which is not the person’s real name). Jerry and I schedule a 30-minute call for the day after he emailed me. During the call, I collected the basic information about him and answered the questions that he had. As I typically do, I suggested to Jerry that he wait a few days and think over whether or not he was ready for a job change. If he was ready, I would schedule interviews. If he wasn’t, no problem … best wishes. So, we set up an in-person interview with a hiring manager, which according to both parties went well. The hiring manager asked me to set up a second interview for Jerry, which I also did. That too, went well. The hiring manager got the good feedback and instructed me to set up a third interview, which I did. This too, went well. Jerry took time to participate in three

interviews over an extended period of time and the prospect of a new job looked more promising after each one. The following day, I received an email from the hiring manager stating that he was not going to fill the job he had open and asked me to thank Jerry for his time. It was now up to me to call Jerry and tell him that there was no longer a job but that we were very appreciative for him taking the time to interview with us. I knew that this call was not going to be pleasant. If you’ve jumped through several hoops only to have the process summarily end for no apparent reason, you know what I’m talking about. Making calls like this one are among a recruiter’s least favorite. Jerry and I spoke for about five minutes. He took it as well as one would expect from a professional. He certainly wasn’t pleased for staying with us for three interviews only to have the prize taken off the table. And, speaking from experience, I doubt that Jerry will ever come to work for us. Additionally, there is another easily overlooked risk when things like this happen: the very real possibility that Jerry would probably have unflattering things to say about us if someone were to ask him. It is very true that word-of-mouth “advertising” can work against you just as easily as it can work for you. There is absolutely nothing that I could have done to affect the business circumstances that brought about the job being cancelled. It was just simply out of my hands. The part for which I am responsible is the process to get someone to that job-seeker finish line. It’s a balancing act between the employer’s interests in properly vetting a future colleague and the candidate’s willingness to participate in the vetting process. The candidate is in it because he either

“ It’s a balancing act between the employer’s interests in properly vetting a future colleague and the candidate’s willingness to participate in the vetting process.”

doesn’t like his current circumstances or he perceives working at your company as sufficiently better. Note that for a candidate, the process of interviewing is a lot of extra work as well as dealing with the risk of your current employer finding out that you’re interviewing. It’s stressful. But, if the interviewing candidate is told what to expect and if the experience matches what he was told, he is likely to endure the rigors of the process with the appearance of professional enthusiasm. Unfortunately, in the example I’ve provided, the process was compounded by the fact that interview stakeholders insisted on extending the vetting process beyond what was told to the interviewing candidate. The result was frustration and fatigue, which ultimately

lead to disappointment. So, in the future, when I attempt to reconnect with this person, I’m probably not going to be very warmly received, if he even takes my call. The lesson herein is directed mostly to hiring managers and interview stakeholders: agree to an interview and selection process that has clearly defined steps. Articulate and explicitly agree to those steps with other interviewers. Attend to the important discipline of keeping to that process and be certain that the process has been explained to the interviewing candidate. Finally, follow the outline that has been set up and explained. This will help prevent interview fatigue.

OVER 20 YEARS OF EXPERIENCE IN TALENT ACQUISITION FOR THE MEDICAL EQUIPMENT SERVICE INDUSTRY. EMPLOYER SERVICES • Talent search and acquisition • Talent retention and training • Workforce planning

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JENIFER BROWN Jenifer@HealthTechTM.com Ph: 757.563.0448 | www.HealthTechTM.com

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Troubleshooting the Toshiba Aplio 300/400/500 Ultrasound Systems By Matt Tomory

here is a relatively new family of systems in the U.S. ultrasound market from Toshiba called the Aplio 300/400 and 500 that have been gaining popularity rapidly. Unlike previous versions of the Aplio (80, MX XG), these systems are not a continuing evolution of previous platforms, but a brand new design. Here are some basic power troubleshooting and maintenance tips to get you started with supporting these systems.

MATT TOMORY VP of Marketing & Sales, Conquest Imaging

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JULY 2016

Let’s focus on the power subsystems. If the system does not fire or fires and then shuts down, the main power unit under the unit is a likely candidate for the cause. There are signal lines going to and from the On/Off momentary switch to the main power unit signaling the system power switch was depressed and then a signal returning indicating the supply is up so you need to verify a solid connection with the cables at the user interface and main power supply. There are also mini breakers (Toshiba calls them protectors) on the rear of the power unit next to the system’s main circuit breaker that can trip. These protectors are in line with OEM devices such as DVRs and printers. Be aware of the voltage selector switch next to them as the system is designed to run on 115VAC as well as 200VAC. Next, the systems have LED indicators in the front right of the power unit tray (when looking at the system from the front) which indicate fan activity in the front end card rack and cooling fan on the back end power supply, FE (front end power supply or PSA-N) and BE (back end power supply or PSA-D). The indicators are solid during normal operation and blink when a malfunction is detected. If all lamps are solid and the system still does not fire, the issue is likely the power supply, cable between the power unit and back end or the cable between

“This is just a first glance at these modern systems.” power unit and ATX/back end power supply. If the FAN led is blinking, check the cable between the power unit and the ATX back end power supply, the rack fan or the ATX power supply. If the FE light is blinking, check the main air filter, replace the power unit if frequent or replace the PSA-N (front end power supply). If the BE light is blinking, replace the PSA-D (back end power supply) or main power unit. There may be times a front or back end assembly is holding down one of these power supplies so you may have to unload them or reduce the system to minimum configuration levels. This is just a first glance at these modern systems. For more in-depth information, please call our technical support department at 209-942-2654 with any technical questions.

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JULY 2016

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THOUGHT LEADER FDA Please Pave The Pathway By Alan Moretti

ecently I sat in as a “listener” to a conversation that had a round able of HTM industry representatives chatting as to their “ongoing challenges and hurdles” in being able to reasonably acquire service keys, codes and what some may say is “proprietary information.”

ALAN MORETTI Vice President, Advanced Imaging & Radiation Oncology, Renovo Solutions

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JULY 2016

This discussion is not a new topic and for those “outside of original equipment service contracting relationships” can be a continued source of heartburn and frustration in many equipment support circles. There is a “buzz” within the HTM medical equipment service industry around the topic of “intellectual property” infringement and it is rumored that some original equipment manufacturers (OEMs) may begin to pursue legal channels after those perceived to be in violation. It sounds threatening but this posturing and pursuit of perceived “intellectual property” violators is not a new subject or action within the HTM service industry. Many HTM service professionals remember the 1980s and 1990s and the Independent Service Organization (ISO) battles with the OEMs over the acquiring of ionizing radiation medical equipment service documentation and the deciphering of just what the “Code of Federal Regulations - Title 21” really

meant. The real ability for enforcement of “21 CFR” is still considered a series of never ending hurdles with limited tangible results. Perhaps this most recent March 4 Food and Drug Administration (FDA) call to the “HTM community for comments” can enable these “hurdles” to finally be overcome. Hopefully, all advanced equipment service tools will be made available for transactional reasonable purchase to the betterment of the healthcare equipment servicing community and the mutual customer being served (that customer would be the medical equipment owner that is enhancing the delivery of patient care to the patients we all serve)! Many of today’s medical equipment technologies have become a “locked box” unless the HTM service technician has what is considered “intellectual service property” such as the service dongle, password string, or access through a service agreement to the OEM’s propriety service documentation in some cases. Though “Title 21”

“Intellectual property (IP) refers to creations of the mind, such as inventions; literary and artistic works; designs; and symbols, names and images used in commerce.” provides “rights” to necessary service documentation at a reasonable cost, this generally means not much more than the standard service and operator manual of a medical device. It’s these advanced “intellectual service tools and documentation” which provide a “deeper service access” capability that may still require the medical device owner to purchase some level of OEM service agreement in order to acquire needed resources and at a hefty price! So what is the message and take-away from this article you may ask? Good question – a change in ability to access and reasonably acquire through purchase these “intellectual property” tools is a crossroad that maybe the FDA can finally pave for all who support the medical equipment service support mission!

EXPERT ADVICE

THE FUTURE

Co-operative Education and Internships for HTM Technicians By Steven J. Yelton, P.E., CHTM

he old saying “What was old is new again” comes to mind as I write this column. One of the first articles that I published years ago was on cooperative education and internships for BMETs. Now, “BMETs” are becoming “HTM Technicians.”

Steven J. Yelton, P.E., CHTM HTM Professor, Cincinnati State Technical and Community College

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The importance of co-operative education (co-op) and internships with respect to training HTM technicians and engineers for that matter, in my opinion is more important now than ever. I believe that the “co-operative” model for HTM education is the future of education for our field. In the “cooperative education” model, the student alternates periods of in-class education with on-the-job training generally at a hospital, OEM or third-party vendor. Some college programs place students at work sites in the summers between school years for an “internship.” Co-op is much less prominent. If either model is executed properly, huge advantages exist for the educational institution, student and employer. This is also true of internships. Cooperative education assignments are generally paid and internships are not, but this is certainly not written in stone and I have seen paid and non-paid versions of each. I’m seeing a shift away from this slice of the educational pie nationally. As budget and curriculum cuts are mandated, it seems that the co-operative education part and, sometimes, the internship part of the curriculum feels the pinch. I feel that this short sighted and may degrade the quality of the training program which could hurt the student as well as the employers who

hire co-ops and full-time employees. This educational model provides the educational institution a partner to provide areas of education that may not be practical or may be cost prohibitive for the college. It enables the student to be trained in areas such as CT, MRI, cath lab, medical laboratory, etc. to name a few. Some colleges have these facilities on campus, but many do not. In my experience, the educational partners have provided leadership help to the program, worked as adjunct instructors, guest lecturers, mentors to students, and have donated equipment and supplies to the program. As a former department chair of a college program, my partners from hospitals and industry played a major role in the development and day-to-day operation of the program. They were a major component of my industry advisory board in addition to full-time employers and alumni. No significant change was made to the program without first discussing it with them. The employers also had an integral role in the accreditation of the educational program. They met with program evaluators from the “Accreditation Board for Engineering and Technology” (ABET) whenever they came to campus. The student graduates from the college program with significant practical experience in the HTM field. I feel that

“ I feel that this relationship is a win-win-win and I would encourage you, in whatever role you have, to get involved. This can be a rewarding and productive experience for everyone.” there is much learned on the job beyond just equipment repair. The student learns the importance of timeliness, work ethic, teamwork, as well as equipment repair and the hospital environment. Many times the co-op or internship employer hires the student full time upon graduation. This is an advantage to both the student and the employer. There are many instances when a student enters a field of study without truly knowing if this is really what they want to do for their lifetime career. In my opinion, the quicker they can enter the job environment and experience what the job entails on a daily basis, the better. I have had many instances where the student comes back to me after a semester of co-op experience with a renewed vigor for learning more about the HTM field. They have ideas and many times have additional courses that they would like to take in addition to the prescribed curriculum. On a very rare occasion, a student may come back and say that this field wasn’t for them. I have to say that this was very rare in the HTM field. The employers have the opportunity to have an extended period of time to work with a prospective employee to determine if they would be a good fit for the department. They are able to train

the student while paying a lower wage in the case of paid positions. This is a huge cost savings for the employer from the standpoint of getting a productive employee at a fraction of the cost. They are also cultivating a full-time employee. It is a huge advantage for a hospital, OEM, or ISO to have candidates for job openings available whenever they are needed. Many times these employees are able to provided needed help for overworked technicians with such things as: scheduled maintenance, entry level repairs, preparation for accreditation visits, etc. I feel that this relationship is a win-win-win and I would encourage you, in whatever role you have, to get involved. This can be a rewarding and productive experience for everyone.

House

STEVEN J. YELTON, PE, CHTM, is a professor at Cincinnati State Technical and Community College where he teaches biomedical instrumentation courses and is a Senior Consultant for HTM at a Health Network in Cincinnati, Ohio. He is a member of AAMI’s Board of Directors, AAMI’s Foundation Board of Directors, Vice Chair of AAMI’s Technology Management Council, Chair of AAMI’s HTAC committee and is a member of the ABET Board of Delegates.

EXPERT ADVICE

TECH SAVVY

Exploring NMAP By Jeff Kabachinski

his month’s installment of Tech Savvy takes a peek at a network utility called NMAP (Network Mapping). It’s been around for the past 20 years or so. NMAP is a free, open sourced (released under GPL) network security tool. It is a robust tool heavily supported and resourced. A quick search in Amazon reveals recent titles related to performance support of using NMAP. The NMAP GPL gives you the right to run, study, share, and modify the software. You can find the NMAP source code at: https://github.com/nmap/nmap.

Jeff Kabachinski Senior Director of Technical Development, ITD

NMAP is claimed to be the de facto standard for network mapping and port scanning. This gives the network administrator a way to find network nodes and services currently in use on your network as well as building a map of who/ what’s happening on the network. Although usually used for port scanning, NMAP offers many additional features: host discovery, operating system detection, service version detection, network information about targets, such as DNS names, device types, and MAC addresses plus the ability to scan for well-known vulnerabilities. When you download the NMAP utility you also get the GUI (Graphical User Interface) called Zenmap. This makes using NMAP much easier. Once instituting a scan Zenmap offers a number of different looks at the port scanning that NMAP provides. Zenmap’s main screen shows the results of the port scanning. You pick which host or network node to scan. Start by scanning yourself and see what ports you have active. NMAP categorizes scanned ports in 6 types: THE SIX PORT STATES RECOGNIZED BY NMAP • Open – An application is actively accepting TCP connections on this port, Open ports are an avenue for attack. The trick is to keep attackers from exploiting

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open ports while keeping them available to legitimate users. • Closed – A closed port is still accessible but without an application currently using it and continues to reply to NMAP probe packets. It can help to know that the node is running on a particular IP address and as part of OS (Operating System) detection. • Filtered – it cannot be determined whether the port is open due to packet blockage or filtering from firewalls or router rules preventing NMAP probes from connecting to the port. These ports discourage hackers because they provide so little information. • Unfiltered state means that a port is accessible, but can’t tell if it’s open or closed. Only the ACK scan, which is used to map firewall rulesets, classifies ports into this state. • Open|filtered – ports are placed in this state when it is unable to determine whether a port is open or filtered. This occurs for scan types in which open ports give no response. • Closed|filtered – ports are placed in this state when NMAP can’t determine whether a port is closed or filtered. TCP PORT NUMBER RANGES TCP port numbers or addresses are 2 bytes written as one number in decimal notation – from 0 to 65535. It’s helpful to know the TCP port

TRIM 4.5”

numbers when doing an analysis via NMAP. You can see who/what the various port assignments are by visiting www.iana.org. There are three groups of ports to consider: Port Numbers 0-1023 Are “well known ports” assigned by the IANA (Internet Assigned Numbers Authority). Some examples: http uses port 80, FTP (File Transfer Protocol) data – 20, FTP control -21, SMTP (Simple Mail Transfer Protocol) – 25, POP3 (Post Office Protocol) – 110, and DICOM (Digital Imaging and Communications in Medicine) – 104, 1044, and 4006. Port Numbers 1024-49151 Are requested from the IANA to become “registered ports.” For example: Googletalk has registered ports numbered 19294, 19295, 19302 Port Numbers 49152-65535 Unassigned open space or Free Space – PUBLICATION an area open to use and often where MEDICAL DEALER cybercriminals are apt to play. Keep an eye on what applications are using this BUYERS GUIDE port range. MONTH ZENMAP The first screen in Zenmap J F is called M A M J NMAP output. It shows the results of the DESIGNER: port scan for the selected target IPJL address. It shows port connections for all ‘non-closed’ ports as well as other details such as MAC (Ethernet) address, operating system in use, the network distance and service information. Another tab off the main screen shows more details on the ports NMAP found open. Other tabs include views of the network mapping, other scanned host details as well as scan histories. Zenmap also allows you to save scans. In this way you can create a baseline and have something to compare to when trouble arises. NMAP is worth a look if you’re interested in what’s happening on your network.

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EXPERT ADVICE

THE ROMAN REVIEW Power is Power By Manny Roman

was updating my presentation on PARA – Power, Authority, Responsibility and Accountability. As part of my research, I was reading an article about five forms of power as first proposed by social psychologists John French and Bertram Raven in 1959. They describe the five powers as legitimate, reward, expert, referent and coercive.

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

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In 1965 Raven added informational power. I won’t conjecture as to the source of this additional wisdom, except to note that it was around the start of the hippie movement and the widespread use of recreational drugs and the power to the people generation. Legitimate power is one that comes as a result of a formal right to make demands and expect others to comply. Your boss, the President of the U.S. and a general in the Army has this power. When I conduct my presentation on PARA I call this positional power since the source of the power is dependent on the person’s official position. Since this power is situational, it disappears in a puff of smoke once the position is lost. The alternative is to convert to expert power as a consultant. Reward power is based on the perceived fact that the person has the ability to provide compensation for compliance. You may perceive that your boss has the power to reward you for a job-well-done. In reality, his hands may be tied and he is powerless to provide a

reward due to organizational constraints and the performance evaluation system. Expert power is based on a person’s skill or knowledge as evidenced by experience, training and education. Your doctor has this power as evidenced by the prominently posted educational accomplishments. The numerous consultants that you hire to improve your present and future business situations are perceived to have this expertise power and thus they command the attendant fees. Referent power is the power that movie stars have. They are attractive and rich so they are worthy of your respect and adulation. They have the power to get you to purchase insurance, beauty products, beer and cat food. I call this power charisma and social class when I speak on PARA. Coercive power is based in the perception that the person has the ability to punish noncompliance. We all attempt to avoid punishment so we do what we are told. I guess that some

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people seek punishment, in many forms, however, we will leave that one alone. Informational power is based on the individual having access and controlling access to needed information. Consultants, instructors at training courses, and your bartender have informational power. Regardless of the particular power and how it was incurred, power can and does get abused and misused. Lord Acton said, “Power tends to corrupt, and absolute power corrupts absolutely. Great men are almost always bad men.” My experience is that this is likely a true statement more today than it was when he wrote it in 1887. The only way, in my very humble opinion, to prevent the corruption is to have a well-defined value system. By welldefined, I mean that you know, understand and remain within your established values. These values define your honor, courage, commitment, integrity, character, ethics and morals. They require that you possess and adhere to a commitment to personal responsibility and accountability. If you have a well-defined value system it is easy to remain within those values and reject everything that opposes those values. I caution that this value system is not conducive to becoming a rich person, monetarily that is. It will cause others to think you are a fool and may keep you from being a member of the in-crowd. You will, however, sit in righteous indignation as you sip your wine all alone. On a happier note let me tell you about a scene in “Game of Thrones” that was memorable at least to me. The Queen is walking with her three or four guards when she encounters one of the shady advisors. A discussion ensues about whatever and the man says to the Queen, “Knowledge is power.” The queen says, “Seize him.” The guards comply. “Cut his throat.” One guard draws his blade and is about to cut the throat. “Stop. Release him. Turn around.” They again comply. The man is very shook up. She leans in and says, “Power is power.” Fade to black.

DID YOU KNOW? Science Matters

An Alzheimer’s-blocking implant A thin capsule can be implanted under the skin to turn a person’s immune system against the chemical that forms tangled plaques in the brain – the cause of Alzheimer’s disease.

Abeta theory of Alzheimer’s

Human brain with Alzheimer’s

Amyloid beta protein

(Abeta) accumulates in different regions of brain, forming tangled plaques

Cerebral cortex shrinks Fluid-filled ventricles enlarge

Healthy brain Cerebral cortex Hippocampus

Microscopic view of plaques in mouse brain

Hippocampus shrinks

Thin implant holds off brain damage Researchers have demonstrated this procedure in mice 5 Mouse’s immune system detects tags and destroys 1 DNA is modified in lab; harmless amyloid beta – preventing virus carries the DNA into muscle-forming cells 1

2 The cells begin to produce specific antibodies

Antibodies

2 3

flat, 27mm (1 in.) long capsule, which is implanted under the skin

Flat capsule

Source: Neurodegenerative Studies Laboratory, Brain Mind Institute, Ecole Polytechnique Federale de Lausanne (Switzerland); Institute for Basic Science (Korea); Brain journal; Strickland Lab, The Rockefeller University (plaques image) Graphic: Helen Lee McComas, Tribune News Service

1TECHNATION.COM

Brain tissue without implant

3 Cells are sealed into a

damaging plaques

JULY 2016

4 Capsule

gradually releases antibodies, which “tag” (attach to) amyloid beta protein

Brain tissue with implant

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THE VAULT

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-july-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 GE DC defibrillator. This photo was submitted by Angelo Gioia. To find out who won a $25 gift card for correctly identifying the medical device, visit www.1TechNation.com.

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JULY 2016

BREAKROOM

TECHNICAL PROSPECTS Experts in Siemens Medical Imaging

Your source for new, refurbished, & tested parts for your Siemens medical imaging equipment.

PROOF APPROVED

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CLIENT SIGN–OFF: PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT LOGO PHONE NUMBER WEBSITE ADDRESS

SPELLING

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WIDTH 7”

ONLINE AND COMPUTER BASED

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HEIGHT 4.5”

Contrast Injector Training WHEN you need it, WHERE you need it with a 100% Money-Back Guarantee! www.MaullBiomedical.com | 440-724-7511 JULY 2016

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SCRAPBOOK

1. 3.

AAMI Conference 2016

2. 4. 6.

Healthcare Technology Management (HTM) professionals gathered in Tampa, Florida, at the AAMI 2016 Conference & Expo. The 2016 conference concluded with a new record for attendance as HTM professionals attended classes to stay updated on the latest industry practices. Exhibitors and attendees made new valuable contacts while also reconnecting with old friends. TechNation was there and enjoyed meeting readers face to face in the exhibit hall, checking in with industry-leading companies and hosting our 8th Annual TechNation VIP Readership Party.

1. MW Imaging provides the latest technology in

2. Nearly 200 medical device and healthcare technology

4. The conference included a track of sessions devoted

ultrasound to AAMI attendees.

companies demonstrated their products and services on the Expo ďŹ&#x201A;oor.

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JULY 2016

The TechNation team showed AAMI attendees how to get lei'd by the Bay. to professional development, including this one which provided guidance on how HTM professionals can advance and thrive in their careers.

7. 8. 10.

11.

5. Kaylee McCaffery, MedWrench's Marketting and Sales Manager,

12.

6. Sales reps Jayme McKelvey and Chandin Kinkade pose with TechNation

discusses the new mobile MedWrench website. readers at the AAMI Conference.

7. The Joint Commissionâ&#x20AC;&#x2122;s George Mills addresses the crowd at AAMI 2016.

Mills told healthcare technology management professionals that itâ&#x20AC;&#x2122;s more important than ever that they properly document their work on medical devices and that they have that documentation available during surveys.

8. TechNation's Annual Reader VIP Party was a great success, bringing together more than 300 TechNation readers and advertisers.

9. Eddie Accosta and Chandin Kinkade network at the reader party.

8th annual TechNation

10. TechNation readers had a great time playing connect four, life size jenga and other games at the TechNation Reader Party

11. Cutty Jones preformed a variety of live covers to get the party started. 12. Party Sponsor Kaylee McCaffery from MedWrench and TechNation

representative, Kara Pelley stay refreshed drinking Green Beavers, the sponsored drink of the night! For more photos and to view our AAMI Gallery, visit www.1technation.com/aami-gallery

BREAKROOM

BULLETIN BOARD

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

UPCOMING EVENTS CANADA DAY! INDEPENDENCE DAY

ICE2016 JULY 20-21, 2016 â&#x20AC;¢ CHICAGO

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JULY 2016

Career Opportunities

WHERE IS YOUR BEN CALIBRATIN G FROM THE #MDEXPO?

Hiring for: Biomedical Equipment Technician

SHARE A PIC OF BEN C. ON THE MEDWRENCH FACEBOOK PAGE AND SHOW US WHAT HE IS UP TO FOR A CHANCE TO WIN LUNCH ON MEDWRENCH.

US Medical is currently hiring a Biomedical Equipment Technician to work in our St. Louis, Missouri location. Technicians should have an AA or 2-year certificate in Electronics Technology or Biomedical Engineering, an average GPA of 2.5 or above during technical school, and 3 or more years of experience in the biomedical field. They also must be able to work independently in repair, periodic maintenance and operational verification of medical equipment.

MAKE SURE YOU TAG MEDWRENCH AND LIKE OUR FACEBOOK PAGE FOR A CHANCE TO WIN.

If interested: Please submit your cover letter, salary expectations and resume to careers@usmedequip.com. For More Information Visit: www.usmedequip.com/ biomedical-equipmenttechnician-st-louis-mo/

SOLUT

IONS

CONTINUING EDUCATION

Visit www.MedWrench.c om/BulletinBoard for m ore details and to register for these upcoming classes .

Systems RSTI Advanced Radiographic Aug 8-19: rse Cou II se Maintenance - Pha SOLUTIONS

Tri-Imaging Solutions Essentials of DI Service Course - Aug 22-29

raining am Basics T Nuc Med: E-C ug 14-16 Course - A

BREAKROOM

1TECHNATION.COM

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Company Info

Pa ge

SERVICE INDEX ANESTHESIA BC Group International, Inc.

Ph: 314-638-3800

www.BCGroupStore.com.

Doctors Depot

Ph: 800-979-4993

www.doctorsdepot.com

Gopher Medical, Inc.

Ph: 844-246-7437

www.gophermedical.com

Government Liquidation

Ph: 480-367-1300

www.govliquidation.com

Ph: 480-367-1300

www.govliquidation.com

Ph: 800-654-9845

www.alphasource.com

Ph: 800-800-5402

www.rietermedical.com

Ph: 817-378-4613

www.imedbiomedical.com

Ph: 813-886-2775

www.seaward-groupusa.com

Ampronix, Inc

Ph: 800-400-7972

www.ampronix.com

First Call Parts

Ph: 800-782-0003

www.firstcallparts.com

Philips Healthcare

Ph: 800-229-6417

www.philips.com/mvs

12-13

Quantum Biomedical

Ph: 866-439-2895

www.quantumbiomedical. com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

Southwestern Biomedical Electronics, Inc.

Ph: 800.880.7231

www.swbiomed.com

RSTI

Ph: 813-886-2775

www.rsti-training.com

INS

Technical Prospects

Ph: 877-604-6583

www.technicalprospects.com

38, 79

AUCTION/LIQUIDATION Government Liquidation

BATTERIES Alpha Source Inc.

BEDS/STRETCHERS Rieter Medical Services

BIOMEDICAL iMed Biomedical

CALIBRATION Rigel Medical, Sweard Group

CARDIOLOGY

CARDIOVASCULAR

COMPUTED TOMOGRAPHY Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

Injector Support and Service

Ph: 888-667-1062

www.injectorsupport.com

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

KEI Med Parts

Ph: 512 -477 1500

www.keimedparts.com

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Technical Prospects

Ph: 877-604-6583

www.technicalprospects.com

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

INDEX

38, 79 45

JULY 2016

1TECHNATION.COM

CONTRAST MEDIA INJECTORS Injector Support and Service

Ph: 888-667-1062

www.injectorsupport.com

Maull Biomedical training, LLC

Ph: 440-724-7511

www.maullbiomedicaltraining.com

Capital Medical Resource LLC

Ph: 614-657-7780

www.capitalmedicalresources.com

J2S Medical, LLC

Ph: 844-342-5527

www.J2smedical.com

AIV, Inc.

Ph: 888-587-6759

www.aiv-inc.com.com.

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

J2S Medical, LLC

Ph: 844-342-5527

www.J2smedical.com

Ph: 866-439-2895

www.quantumbiomedical. com

Ph: 800-400-7972

www.ampronix.com

PaciďŹ c Medical

Ph: 800-449-5328

www.pacificmedicalsupply. com

Tenacore Holdings, Inc

Ph: 800-297-2241

www.tenacore.com

USOC Bio-Medical

855-888-8762

www.usocmedical.com

AllParts Medical, LLC

Ph: 866-507-4793

www.allpartsmedical.com

Bayer Healthercare- MVS

Ph: 1-844-MVS-5100

www.mvs.bayer.com

Cool Pair Plus

Ph: 800-861-5956

www.coolpair.com

Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

KEI Med Parts

Ph: 512 -477 1500

www.keimedparts.com

Global Medical Imaging

Ph: 800-958-9986

www.gmi3.com

Philips Healthcare

Ph: 800-229-6417

www.philips.com/mvs

12-13

Ph: 866-989-7057

www.MedWrench.com

800-906-3373

www.technation.com/webinars

Ph: 813-886-2775

www.rsti-training.com

INS

AIV, Inc.

Ph: 888-587-6759

www.aiv-inc.com.com.

BETA Biomed Services, Inc

Ph: 800-315-7551

www.betabiomed.com

ENDOSCOPY

INFUSION PUMPS

Quantum Biomedical

MONITORS/CTR'S Ampronix, Inc

MRI

NUCLEAR MEDICINE

ONLINE RESOURCES MedWrench TechNation Webinar Wednesday

PACS RSTI

PATIENT MONITORING

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JULY 2016

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Company Info

BMES/Bio-Medical Equipment Service, Co

Ph: 800-626-4515

www.bmesco.com

IBC

Doctors Depot

Ph: 800-979-4993

www.doctorsdepot.com

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

Gopher Medical, Inc.

Ph: 844-246-7437

www.gophermedical.com

J2S Medical, LLC

Ph: 844-342-5527

www.J2smedical.com

Paciﬁc Medical

Ph: 800-449-5328

www.pacificmedicalsupply. com

Philips Healthcare

Ph: 800-229-6417

www.philips.com/mvs

Quantum Biomedical

Ph: 866-439-2895

www.quantumbiomedical. com

Rieter Medical Services

Ph: 800-800-5402

www.rietermedical.com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

Southwestern Biomedical Electronics, Inc.

Ph: 800.880.7231

www.swbiomed.com

Tenacore Holdings, Inc

Ph: 800-297-2241

www.tenacore.com

USOC Bio-Medical

855-888-8762

www.usocmedical.com

Ph: 877-604-6583

www.technicalprospects.com

12-13

RADIOLOGY Technical Prospects

38, 79

RECRUITING/EMPLOYMENT Health Tech Talent Management Stephens International Recruiting Inc.

Ph: 757-563-0448

www.healthtechtm.com

Ph: 870-431-5485

www.bmets-usa.com

Ph: 800-800-5402

www.rietermedical.com

Ph: 614-657-7780

www.capitalmedicalresources.com

AIV, Inc.

Ph: 888-587-6759

www.aiv-inc.com.com.

BMES/Bio-Medical Equipment Service, Co

Ph: 800-626-4515

www.bmesco.com

IBC

Elite Biomedical Solutions

Ph: 855-291-6701

www.elitebiomedicalsolutions.com

Gopher Medical, Inc.

Ph: 844-246-7437

www.gophermedical.com

Paciﬁc Medical

Ph: 800-449-5328

Southwestern Biomedical Electronics, Inc.

www.pacificmedicalsupply. com

Ph: 800.880.7231

www.swbiomed.com

Tenacore Holdings, Inc

Ph: 800-297-2241

www.tenacore.com

USOC Medical

855-888-8762

www.usocmedical.com

BC Group International, Inc.

Ph: 314-638-3800

www.BCGroupStore.com.

Pronk Technologies

Ph: 800-609-9802

www.pronktech.com

RESPIRTORY Rieter Medical Services

SURGICAL Capital Medical Resource LLC

TELEMETRY

TEST EQUIPMENT

INDEX

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Company Info

Radcal Corporation

Ph: 800-423-7169

www.radcal.com

Rigel Medical, Sweard Group

Ph: 813-886-2775

www.seaward-groupusa.com

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Southeastern Biomedical, Inc.

Ph: 828-396-6010

sebiomedical.com

ATS Laboratories, Inc.

N/A

www.atslaboratories-phantoms.com

ECRI Institue

N/A

www.ecri.org

Ph: 440-724-7511

www.maullbiomedicaltraining.com

AllParts Medical, LLC

Ph: 866-507-4793

www.allpartsmedical.com

International Medical Equipment & Service

Ph: 704-739-3597

www.IMESimaging.com

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

AllParts Medical, LLC

Ph: 866-507-4793

www.allpartsmedical.com

Alpha Source Inc.

Ph: 800-654-9845

www.alphasource.com

ATS Laboratories, Inc.

N/A

www.atslaboratories-phantoms.com

Bayer Healthercare- MVS

Ph: 1-844-MVS-5100

www.mvs.bayer.com

Conquest Imaging

Ph: 866-900-9404

www.conquestimaging.com

Global Medical Imaging

Ph: 800-958-9986

www.gmi3.com

MW Imaging

Ph: 877-889-8223

www.mwimaging.com

Summit Imaging, Inc

Ph: 866-586-3744

www.mysummitimaging.com

Trisonics

Ph: 877-876-6427

www.trisonics.com

Ampronix, Inc

Ph: 800-400-7972

www.ampronix.com

Bayer Healthercare- MVS

Ph: 1-844-MVS-5100

www.mvs.bayer.com

Ed Sloan & Associates

Ph: 615-448-6095

www.edsloanassociates.com

Engineering Services

Ph: 888-364-7782 x11

www.eng-services.com

First Call Parts

Ph: 800-782-0003

www.firstcallparts.com

RSTI

Ph: 813-886-2775

www.rsti-training.com

INS

RTI Electronics

Ph: 800-222-7537

www.rtigroup.com

Tri-Imaging Solutions

Ph: 855-401-4888

www.triimaging.com

TRAINING

Maull Biomedical training, LLC

TUBES/BULBS

ULTRASOUND

24-25

X-RAY

1TECHNATION.COM

JULY 2016

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Company Info

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

Engineering Services ………………… 6

Pronk Technologies ………………… 5

AllParts Medical, LLC ………………

First Call Parts ………………………

Quantum Biomedical ………………

Alpha Source Inc. …………………

Global Medical Imaging ……………… 2

Radcal ………………………………

Ampronix ……………………………

Gopher Medical ……………………

Rieter Medical Services ……………

ATS Laboratories, Inc.………………

Government Liquidation ……………

Rigel Medical, Seaward Group ……

Bayer Healthcare- MVS ……………

HTTM, Inc. …………………………

RSTI ………………………………… INS

BC Group International, Inc. ……… BC

iMed Biomedical ……………………

RTI Electronics ……………………

BETA Biomedical Services …………

Injector Support and Service, LLC …

Southeastern Biomedical …………

Bio-Medical Equipment Service Co.……IBC

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

Southwestern Biomedical Electronics

J2S Medical…………………………

KEI Med Parts ………………………

Maull Biomedical Training LLC ……

MedWrench PROOF CHANGES NEEDED……………………… Doctor's APPROVED Depot …………………… 21

Blue Ox Medical Technologies ……

Capital Medical Resource LLC ……

Conquest Imaging …………………

Cool Pair Plus ………………………

ECRI Institute ………………………

Ed Sloan and Associates……………

CLIENT SIGN–OFF:

MW Imaging …………………… 24-25 Pacific Medical LLC ………………… 8

Philips HealthCare ……………… 12-13 THAT THE ElitePLEASE BiomedicalCONFIRM Solutions …………… 3 FOLLOWING ARE CORRECT

LOGO

PHONE NUMBER

WEBSITE

ADDRESS

Stephens International Recruiting Inc. 77 Summit Imaging ……………………… 4 TechNation Webinar Wednesday …

PROOF SHEET 26

Technical Prospects …………… 38,79 Tenacore Holdings, Inc. …………… Tri-Imaging Solutions ………………

Trisonics, Inc. ………………………

USOC Bio-Medical Services ………

SPELLING

GRAMMAR

WIDTH 7”

HOW TO USE

JOIN MEDWRENCH

BUILD YOUR BENCH

This will give you direct access to discussions, manuals, videos, and more.

STAY CONNECTED Stay up to date on industry news, product releases, featured articles, FDA Alerts, and more!

HEIGHT 4.5”

MedWrenchers have access to tons ofindustry resources from solving medical device problems to purchasing!

IN 4 EASY STEPS

POST TO THE COMMUNITY Ask tough medical equipment repair questions & help solve problems by sharing your expertise.

Create your FREE account today at www.medwrench.com

INDEX

"The United States is the only country with a known birthday." -James G. Blaine

1TECHNATION.COM

JULY 2016

BREAKROOM

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