ICE - March/April 2017

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G s G I N a to r I M A i n i st r F O R Ad m N E Weers &

Eng

• PREMIER ISSUE •

ADVANCING THE IMAGING PROFESSIONAL

MARCH/APRIL VOL.1 NO.1

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2017 IMAGING

REIMBURSEMENTS REDUCTIONS IMPACTING THE BOTTOM LINE PAGE 40

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WELCOME Our imaging service industry has needed a quality resource for news and information and I am ecstatic to finally see the new ICE magazine be launched. To be able to provide a real “community” resource, where engineers and administrators can keep their finger on the pulse of the industry, plus have the ability to connect and network, we are beyond excited for ICE to hit the market!”

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"The journey of a thousand miles begins with a single step" After launching the Imaging Conference & Expo (ICE) almost 4 years ago, we are thrilled to offer ICE the Magazine! The question is why??

That's easy ... we kept asking the question ... where do Imaging Service Engineers and Administrators go for news and information on the imaging industry? Do they have a community to join together, share information, help each other grow personally and professionally? Do they have a live conference to network, learn new techniques and cost-saving procedures and share best practices? When all the answers came up "NO," we jumped in and created the ICE Community; ICE the Magazine, ICE the Conference and imagingigloo.com. Three distinct ways to help advance the imaging professional!

Subscription’s are complimentary, simply go to www.imagingigloo.com and join the other thousands of Imaging Service Engineers and Administrators who are part of our phenomenal community.

We hope you enjoy our new magazine, and don't hesitate to let us know how we are doing. We also invite you to nominate your department or an imaging service professional for the next issue.

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As always, we appreciate your continued support!

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contents

ICE FEATURES

March/April 2017

“ There are so many competing expenses. We’re all fighting for a fixed amount of dollars. Imaging leaders must perform due diligence to figure out what they really need and be good stewards.

Do the work beforehand, and map out all of the numbers.”

40 2017 Imaging Reimbursements

26 Professional

Reimbursement reductions continue to challenge health

Mike Watson is the imaging

care facilities. Industry insiders weigh in on how facilities

team lead for all of Sacred

can best meet the needs of patients and discuss different

Heart Health Systems. He

approaches to upgrade diagnostic imaging equipment.

has 39 years of experience in diagnostic imaging service

About The Cover Photo The high-end CT Somatom Force from Siemens Healthineers offers individualized diagnoses, especially for very young patients, the seriously ill and obese patients. Early detection examinations and functional 4D imaging can be conducted using a lower radiation dose.

(Photo courtesy Siemens Healthineers) WWW.IMAGINGIGLOO.COM

that has included dealing with a hurricane and being presented with a statewide honor.

ICEMAGAZINE

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contents

ICE DEPARTMENTS

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26

March/April 2017

31

39

news

people

products

14 Industry News

26 Professional Spotlight

31 Ultrasound Product Focus 44 DICOM Debrief

20 People on the Move

28 Department Spotlight

32 Ultrasound Gallery

47 Imaging Matters

39 Tools of the Trade

49 Imaging Service 101

22 Imaging Webinar

insight

50 Career Center 52 ICE Job Board 54 Bridging The Gap

MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 Phone: 800-906-3373 Fax: 770-632-9090

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Account Executives Jayme McKelvey Chandin Kinkade Warren Kaufman

Contributors

K. Richard Douglas Matthew N. Skoufalos Jim Carr Cindy Stephens John Garrett Alan Moretti

Accounting Kim Callahan

Circulation Lisa Cover Laura Mullen

Web Department Taylor Martin Adam Pickney Cindy Galindo

ICE Magazine (Vol. 1, Issue #1) March/April 2017 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.imagingigloo.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

Reproduction in whole or in part without written permission is prohibited. © 2017

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ADVANCING THE IMAGING PROFESSIONAL

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BJÖRN SEGALL, CEO BBS MEDICAL IN SWEDEN

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robeHunter is the test system that validates the performance of ultrasound probes in real time, all brands. The software and hardware solutions are built on a very advanced programmable platform and as the CEO Björn Segall, BBS Medical in Sweden, expresses it; It is Future ready, already designed to meet future ultrasound probe technology.

The experiences from the Nordic countries when it comes to Quality assurance of ultrasound probes are now spreading.

It was already in year 2002 ultrasound transducer testing was implemented at hospitals in Scandinavia by the company BBS Medical. The Royal Institute of Technology in Stockholm performed a study confirming that 40% of the ultrasound probes at non tested hospitals needed to be attended to.

The company BBS Medical has over a time of 15 years tested thousands of ultrasound probes, in daily use, at hospitals and they confirm the results of the study.

- It is bad, but the good thing is that you can do something about it. Introducing a Probe Care program, educating staff about how to handle these fragile instruments, use only approved gel and cleanser and test the probes frequently will take the faulty frequency down from 40% to 10%. Why not lower? Even new probes sometimes have defects. In addition the hospital will save costs – Björn Segall continues- finding problems early and test before warranty ends are some of the guidelines.

The ProbeHunter testsystem is developed in close co-operation with Scandinavian Bio Med Engineers. They have over the years learned what to look for. You will not see the problem on the image of the ultrasound system. When you do, it is probably many hundreds of patients to late.

For Patient Safety it is important for the Clinicians and Bio Med Engineers to understand the complexity of detecting the defects. You need a tester and test frequently, declares Bjorn Segall. I know, even though I speak for my own product, but an air test or a test phantom will not do

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ProbeHunter displays their Swedish products with pride.

the job, you need a real time tester. There has been some very serious cases reported in Sweden from ultrasound examinations where patients have been misdiagnosed because of suspected defect probes, even as serious as abortion of healthy fetuses.

Björn Segall continues; Pro active testing is a must, a frequently used probe, should from my opinion, be tested at least every month. In the Nordic countries the Bio Med Department has taken on the responsibility for Patient Safety and invested in own test-systems at the hospitals or shared one within a region.

The ultrasound industry is awakening and ProbeHunter is installed by some OEM´s for internal testing, hospitals, Probe Repair Labs and MVS in Europe and US. The system is easy to use, just connect the probe or use an adapter for it, use the Touch Screen and start the test. The procedure only takes approx. 2 minutes and you will have a detailed report.

New adapters are released every month.

In Scandinavia the tender system is in use and when hospitals purchase new ultrasound systems there are now new demands on the OEM´s to include testprotocols with new sales and also show that the OEM can provide an adapter to a test system. The OEM should also show how they monitor the probes over time.

By validating the performance of ultrasound probes frequently and make it a routine, the quality of care is increased.

For patient safety; If you know you can test it, there is no excuse not to, concludes Björn Segall.

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news

IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

Philips Cleared To Market ElastQ Imaging Shear Wave Elastography Royal Philips recently announced 510(k) clearance from the U.S. Food and Drug Administration to market its ElastQ Imaging capability, further expanding the functionalities of its EPIQ family of ultrasound systems.

ElastQ Imaging enables simultaneous imaging of tissue and assessment of its stiffness, which is essential for the diagnosis of various liver conditions. With ElastQ Imaging, clinicians have a comprehensive solution to assess and diagnose liver conditions without the pain or expense of a liver biopsy. Using shear wave elastography to focus sound waves to assess soft tissue stiffness, ElastQ Imaging is non-invasive, reproducible and easily executed.

Liver disease, which includes hepatitis B and C, liver cancer and cirrhosis, is a growing global health issue due in part to rising obesity rates and an aging population. To determine the stage of liver dis-

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ease and damage, a liver biopsy is typically performed by extracting a small piece of liver tissue for microscopic examination.

Research suggests that instead of costly and painful biopsy procedures, ultrasound exams using shear wave elastography could become routine for assessing liver disease status and may reduce or avoid the need for conventional liver biopsies.

“Philips aims to provide the tools necessary for assessing and managing chronic conditions that so many people face, and liver disease is no exception,” said Vitor Rocha, Ultrasound Business Leader at Philips.

Philips ElastQ Imaging Shear Wave Elastography offers a larger field of view or Region of Interest (ROI), color-coded quantitative assessment of tissue stiffness, real-time feedback and intelligent analysis, and quantitative measurements with multiple sample points. •

Toshiba Medical Introduces Customized PM Service Offering

To ensure imaging systems are operating safely and at optimum performance with appropriate and preventative maintenance, Toshiba Medical introduces its customized PM Only Service Agreement to customers. The PM Only Service Agreement allows providers to fulfill and document that they are compliant with the Centers for Medicare & Medicaid (CMS) Directive and The Joint Commission’s (TJC) guidelines of ensuring all imaging equipment meets manufacturers’ specifications.

Toshiba Medical’s PM Only Service Agreement provides ongoing preventative maintenance and service of all imaging equipment according to specifications designated by the manufacturer. A completed PM Checklist for each diagnostic imaging system records all PM inspections, enabling health care providers to validate compliance with the CMS Directive and/or TJC, if requested.

Health care providers unable to show they are meeting these specifications may be penalized – including cuts in reimbursement.

“We listened to our customers’ needs and in response created a simple solution to verify that health care providers are being compliant with this directive,” said Tim Peeler, vice president, Service Business Unit, Toshiba America Medical Systems Inc. “The PM Only Service Agreement also benefits providers by reducing unnecessary system downtime and ensuring equipment is operating safely and effectively.” •

ADVANCING THE IMAGING PROFESSIONAL

Barco Offers New Color Display For Radiology, Mammography Health care imaging specialist Barco has that require excellent grayscale rendition introduced a new diagnostic color display and detail, especially appreciated in mamwith a 5.8 megapixel resolution, making mography and breast tomosynthesis. In it suitable for general radiology as well as addition, it includes sophisticated calibratbreast imaging, including breast tomosyn- ed color that also improves gray images, a thesis. It comes with Barco’s unique color feature previously only available on Barco’s calibration technology for consistent im- Coronis Uniti display system. ages, whether in color or in grayscale, to With its 5.8 megapixel resolution, the ensure the accuracy of the display and to new Nio offers more pixels than traditionsupport confident diagnostic decisions. al mammography displays, so you can see Many radiologists will order supple- more of the image. Its aspect ratio is a permentary imaging exams to see additional fect fit for tall X-ray images – especially for detail and get a more holistic view of a the MLO view in mammography – resultpatient’sAPPROVED condition. It’s why color imaging ingNEEDED in less panning and zooming for a betPROOF CHANGES is more and more important and why the ter reading experience. It also comes with consistency of color images matters.

Barco’s SpotView technology to get a closCLIENT SIGN–OFF: That’s why Barco introduced the Nio er look at a particular region of interest.

Color 5MP. It has been designed especialLike most of Barco’s displays, PLEASE CONFIRM THAT THE FOLLOWING ARE medical CORRECT ly for demanding radiology applications Nio Color 5MP comes with a set of tools to

LOGO

PHONE NUMBER

WEBSITE

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help radiologists work smarter, not harder. These include features for dimming of auxiliary displays, enhancing visualization of details, and personalizing display settings, such as Clearbase or BlueBase, switchable on the same display, even per radiologist.

Enabling visualization of both general radiology and mammography images, Nio Color 5MP eliminates the need for separate workstations. This leads to reductions in display cost, real estate, and the operational expenditure required to maintain an enterprise-wide display fleet. •

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news FDA Clears MAGNETOM Sempra MRI System Siemens Healthineers has announced that the Food and Drug Administration has cleared the MAGNETOM Sempra, a 60-cm 1.5 Tesla magnetic resonance imaging system. The MAGNETOM Sempra is distinguished by its low operating costs, innovative technologies, and full-coverage service contract, which help radiological practices and groups, as well as small- and medium-sized hospitals, operate profitably despite rising industry cost pressures. Additionally, the system’s standardized workflows are designed to help facilities achieve consistent, userand patient-independent levels of quality.

“Siemens Healthineers is pleased to offer the MAGNETOM Sempra, an MRI system designed to address the needs of radiology practices, smaller hospitals, and other providers in delivering high-quality patient care in a cost-effective manner,” said Murat Gungor, Vice President of Magnetic Resonance at Siemens Healthineers North America. “As with the other MRI systems in our portfolio, the MAGNETOM Sempra can help providers increase productivity and address profitability while delivering a highly positive patient experience.”

With Day optimizing throughput (Dot) workflow engines, the MAGNETOM Sempra enables the user to adjust to each clinical case and to the condition of each patient while simultaneously maintaining exam standardization. The system comes equipped with three Dot engines to automate and streamline workflow for brain, spine, and large joint procedures. These Dot engines cover roughly three-quarters of the average exam volume and help users increase productivity in addition to avoiding unnecessary and costly repeat scans. • For information, see www.usa.siemens.com/sempra

Tri-Imaging Solutions Achieves ISO 9001:2015 Tri-Imaging Solutions, an independently owned diagnostic imaging parts, technical training, technical support, and support services company for the diagnostic imaging market, has achieved ISO 9001:2015 certification.

This standard is based on a number of quality management principles including a strong customer focus, the motivation and implication of top management, the process approach and continual improvement, according to the International Organization for Standardization (ISO) website.

“This certification not only reflects the consistent quality standard our reputation has been built on by providing quality products and services but also demon-

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strates our continued commitment to customer satisfaction,” Tri-Imaging President Eric Wright said. “This is a great accomplishment for our team. I am proud to work with a group focused on quality and outstanding customer service.”

ISO 9001:2015 specifies that Tri-Imaging Solutions meets or exceeds requirements for a quality management system that includes the ability to consistently provide products and services that meet customer and applicable statutory and regulatory requirements. ISO 9001:2015 also indicates that Tri-Imaging Solutions aims to enhance customer satisfaction through the effective application of its quality management system.

SOLUTIONS

“At Tri-Imaging Solutions, we strive to live up to our name and be a solution for our customers and Empower the Engineer,” Wright says. “Our mission is to impact lives by creating individual, customer-centric experiences based on a shared core belief in bettering patient care through personal accountability, integrity and admiration.” • For information about Tri-Imaging Solutions, visit triimaging.com.

ADVANCING THE IMAGING PROFESSIONAL

GE Healthcare Announces FDA Clearance of GSI Xtream on Revolution CT GE Healthcare has announced U.S. FDA struction, deliver spectral CT workflow 510(k) clearance of GSI Xtream on Revo- that’s twice as fast. lution CT, complete with a series of cliniSpectral CT allows clinicians to go cal images and first installations at Duke beyond anatomy visualization to tissue University Medical Center (USA), Robarts characterization, allowing for differentiaResearch Institute (Canada) and The First tion between similar HU densities such as Affiliated Hospital of Dalian Medical Uni- cysts and enhancing lesions. With a conversity (China). trast-to-noise ratio 60 percent higher at GSI Xtream on Revolution CT is the first 120 kV than single energy CT, monochrovolume spectral CT technology designed matic images improve lesion detection to improve small lesion detection, tissue and enhance contrast. characterization and metal artifact reduc“Our design goal for the Revolution tion, with a simplified workflow.

CT was to deliver outstanding clinical caFrom setup to post processing, GSI pabilities in spatial resolution, temporal PROOF APPROVED CHANGES NEEDED Xtream is as intuitive as a single ener- resolution and wide coverage. With GSI gy exam. GSI Assist and Clinical ID help Xtream, we’ve extended the platform with CLIENT SIGN–OFF: standardize and automate protocol se- volume spectral CT that’s upgradable lection with images directly transferred for all Revolution CT users,” says Scott PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT to PACS and/or AW. These improve- Schubert, General Manager, Global PremiPHONE NUMBER ADDRESS ments,LOGO combined with native GSI recon- um CT. WEBSITE GSI Xtream enhances Revolution

PROOF SHEET

CT’s platform with wide collimation and 50 cm FOV to deliver the only volume spectral CT. Enabled by ultrafast kV switching, clinicians can scan more challenging patients and reduce the effects of motion.

The Gemstone Clarity detector combined with ASiR-VTM delivers dose neutral exSPELLING ams for patients of any GRAMMAR size. •

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news

Philips Launches Next Generation Azurion Platform Royal Philips has announced the global launch of Azurion, its next generation image-guided therapy platform, which forms the new core of its integrated solutions portfolio for the fast growing image-guided therapy market. Philips offers integrated solutions comprising interventional imaging technologies and planning and navigation software combined with interventional devices – including catheters for diagnosis and therapy – and a broad range of services, all aimed at helping clinicians to provide superior care at predictable costs.

Following the acquisition of Volcano in 2015, the company is now further cementing its position in the image-guided therapy market with one of its largest

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global product launches in recent years.

Philips’ Azurion image-guided therapy platform for interventional labs is the result of a multi-year development program conducted in close collaboration with leading clinicians in the field.

This next generation platform features a state-of-the-art ergonomic design with an easy-to-use intuitive user interface, enabling clinicians to swiftly and confidently perform a wide range of routine and complex procedures in the interventional lab.

With the rapid growth of image-guided therapy procedures, hospitals and health systems are increasingly faced with the need to control costs, while improving their standards of care.

Azurion has been designed to address these challenges and is equipped with new workflow options and performance dashboards, as well as an upcoming range of productivity improvement services.

The Azurion platform also features over 1,000 new components, including an enhanced flat-panel detector, and Philips’ newly developed ConnectOS operating system for the seamless integration of real-time information from all relevant technologies in the interventional lab. All of these components work together to deliver high image quality at ultra-low X-ray dose and real-time image processing on multiple work spots within the interventional lab. •

ADVANCING THE IMAGING PROFESSIONAL

M.I.T. Presented With Neusoft Rookie Of The Year Award Rick Player, President of M.I.T., has accepted the Neusoft Medical Rookie of the Year award on behalf Varian Medical Sysof the entire Medical Imagtems has announced ing Technologies staff. This for the fourth year in achievement was awarda row that its Eclipse ed to M.I.T. for their work treatment planning and dedication to bringing software has been named Category Leader for Oncology Treatment Neusoft Medical diagnostic Planning in the 2017 Best in KLAS: Software and Services Report by imaging equipment to the KLAS, an independent research firm specializing in monitoring and U.S. market. reporting on the performance of health care vendors.

This work began early in 2016 when M.I.T. announced they Eclipse software is in use at some 3,400 cancer treatment would be a new contact for sales and service of Neusoft Medcenters around the world. The software creates an optimized ical equipment.

The service team at M.I.T. underwent training radiotherapy treatment plan based on a physician’s dose inon various Neusoft modalities throughout 2016. The M.I.T. staff structions, and information about the size, shape and location PROOF APPROVED CHANGES NEEDED was honored to be the company that installed the first Neusoft of the tumor to be treated with radiation. The Eclipse softNeuViz 64 CT in North America. ware SIGN–OFF: incorporates unique features such as RapidPlan knowlCLIENT Neusoft Medical is a leading manufacturer of medical equipedge-based planning, which makes it easier and faster to plan ment and service. Currently, Neusoft Medical’s products have been sophisticated cancer treatments intensity-modulated PLEASE CONFIRM THATlike THE FOLLOWING ARE CORRECT exported to over 100 countries and regions around the world. radiotherapy (IMRT), image-guided radiotherapy (IGRT), and LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR M.I.T. offers system sales, parts and service on various NeuRapidArc radiotherapy. • soft Medical Imaging products. •

Eclipse Treatment Planning Software Named Category Leader

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news

PEOPLE ON THE MOVE 1

Patrick Pyers has been appointed the new Director of Business Development for Parker Medical Inc. (PMI). Pyers has been in the radiology field for more than 20 years, primarily in the non-invasive diagnostic X-ray test instrument market, holding top management positions. Pyers will help grow the PMI product line and will oversee the expansion of its newly acquired tube reloading business.

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PartsSource Inc. of Aurora, Ohio, has named Mark Tomasetti its new Chief Technology Officer. Tomasetti was most recently vice-president of product management for six different lines of business at TMW Systems. He has a bachelor’s degree in electrical and electronic engineering from Virginia Tech and an MBA from Carnegie Mellon University.

Also, Jina Tweed has been named the head of healthcare quality initatives for PartsSource. Tweed handled similar responsibilities at GE Healthcare and Philips Healthcare, and has 13 years of quality assurance experience in the field of medical products.

3

Rebecca Capostagno has joined the Orlando, Florida-based Ziehm Imaging as a staff accountant. Capostagno brings 17 years of accounting, operations, and software implementation experience. The company also has added Duane Day as a Region Account Manager in the Central Florida Region.

Day will be responsible for providing client support and generating new business.

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Elisha Finney is retiring as Vice-President and CFO of Varian Medical Sys-

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tems of Palo Alto, California. Finney has spent 18 years as Varian CFO and 29 with the company overall, managing a team of about 400 employees worldwide and overseeing numerous business transitions.

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Matt Tomory is the new Head of Strategic Advancement at Bayer HealthCare. He will be responsible for developing long term partnerships with health care providers, manufacturers, and imaging support organizations for patient-centric cost-effective solutions for ultrasound transducer repair, MRI coil repair and computed and digital radiography support and sales. Tomory previously served as Executive Vice President of Sales and Marketing at Conquest Imaging.

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Exclusive Medical Solutions has added Kenny Scally as account executive of its West Zone of Development. Scally is a fouryear veteran of medical imaging with a focus in ultrasound and quality patient care who earned his bachelor’s degree in nursing while playing NCAA football.

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Hologic has added Medtronic executive Amy Wendell to its Board of Directors as well as to its Audit and Finance Committee.

Wendell also serves on the boards of Ekso Bionics, AxoGen Inc., and the nonprofit Por Cristo. She holds a master’s degree in biomedical engineering from the University of Illinois.

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Siemens Corporation CEO Eric Spiegel left the company and is succeeded

by Chair and CEO Lisa Davis, and Judith Marks, who will be the CEO of Siemens U.S. Marks has been with the company since 2011, when she was President and CEO of Siemens Government Technologies Inc. She will retain her current role as executive vice president at Dresser-Rand, a Siemens business.

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Curtis P. Langlotz, M.D., Ph.D., was named to the Board of Directors of RSNA of Chicago, Illinois. Langlotz will serve as the board liaison for information technology. Director Valerie P. Jackson, M.D., was named board chair, and Matthew A. Mauro, M.D., will become its education liaison.

Langlotz is a professor of radiology and bioADVANCING THE IMAGING PROFESSIONAL

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medical informatics and associate chair for information systems at Stanford University; he also serves as the medical informatics director for Stanford Health Care, and has been a longtime member of the RSNA Radiology Informatics Committee.

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Siemens Healthineers North America has named Matt Hoffman Vice President of Interventional Radiology and Advanced Therapies Sales Management.

Hoffman will drive go-to-market strategies for IR and will lead the company’s angiography field sales team. He was most recently the Siemens Healthineers Modality Regional Vice President in South Texas. Hoffman is a graduate of Boston University, and holds a BSBA in management. Also, Anthony Medigo has been named Vice President of Cardiovascular Solutions at Siemens Healthineers North America. Medigo joined the company in 2016 from Cardiovascular Systems Inc., where he was Northeast Regional Director of Sales; he has also held sales leadership positions with AccessClosure and Boston Scientific. Siemens Healthineers North America has also named Hanno Dotzel its VP of Radiation Oncology. Dotzel will head up marketing, sales, and collaborations for the company’s CT, MR, and PET-CT radiation therapy portfolio. Dotzel has been with the company since 2007, having held various roles.

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Quest Diagnostics of Madison, New Jersey, has appointed President and CEO Stephen H. Rusckowski the Chairman of its Board of Directors, effective January 1, 2017. He succeeds Daniel C. Stanzione, Ph.D., who was named Lead Independent Director.

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Conquest Imaging of Stockton, California has named Michael Lubliner its National Accounts Manager as WWW.IMAGINGIGLOO.COM

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part of a broader reorganization of its account management team. Lubliner, who joined the company in 2015 from Royce Medical, will be responsible for managing key national accounts and the company’s West Coast Regional Account Executives. At the same time, Laci Yocum has been named Conquest’s Senior Director of Strategic Sales, and will lead sales for new product development and expansions of the company’s product lines, including its in-house probe repair service. Yocum joined Conquest Imaging in 2013 from MedRad, where she was National Account Manager.

served more than 21 years as General Manager of Biomed Services and MV Operations Manager for GE Healthcare. His educational background includes a degree from Rochester Institute of Technology in Electrical Engineering Technology.

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Brian Delphia has been named Vice-President of Imaging Support and Operations for Nationwide Imaging Services of Manasquan, New Jersey. The 11-year industry veteran will help expand Nationwide’s service department.

TROFF Medical President and Founder Michael Helms is retiring.

Helms established the company in 1991 and is closing its operations effective April 1, 2017.

Helms said he will entertain future opportunities, but looks forward to focusing on family and his hobbies.

15

The InterMed Group has announced the hiring of Scott Nudelman as Chief Operating Officer effective immediately. Nudelman will report directly to CEO Rick Staab and will be responsible for all operations including Imaging Services, Biomed Services, Asset Management and Jump Team (including Project Support, Physical Inventories and Cybersecurity Assessments).

The InterMed Group supports all areas of Healthcare Technology Management. Nudelman has built a successful 30-year career in the industry. Prior to joining InterMed, he

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Medical Imaging Technologies (M.I.T.) of Thomson, Georgia, has added sales representative Billy Anguish.

Anguish, a recent graduate of University of Central Florida, will handle sales and service for MIT customers in central and southern Florida.

ProHealth Care in Wisconsin has named Deb Parkhurst its new Biomed Tech Procurement Specialist.

Parkhurst replaces the recently retired Mickie Wong.

Amid the spin-off of its imaging components business into Varex Imaging Corporation, Varian of Palo Alto, California has also made changes to its senior leadership. Magnus Momsen will replace Clarence Verhoes as Varian’s SVP and corporate controller; Verhoef will in turn become the Varex Imaging CFO. Ruediger Naumann-Etienne and Eric R. Reinhardt are leaving the Varian board of directors to join the board of Varex Imaging. Varian has reduced the size of its board to eight members.

Find weekly installments of People on the Move at imagingigloo.com

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news

Webinar

Wednesday

WEBINARS OFFER

Imaging Service Insights

T

he 2017 TechNation Webinar Wednesday series is off to a great start with more than 200 individuals tuning in for “Mammography Detector Plate Repair” by Kyle Grozelle, Manager of Global Education and Training at Summit Imaging.

Webinar attendees were eligible to receive 1 CE credit from the ACI. During his presentation, which was sponsored by Summit Imaging, Grozelle shared new expanded capabilities for the repair of detector plates for Hologic Selenia mammography systems. Summit Imaging’s research has provided insight into extending the service life of these valuable detector plates.

They have also uncovered many symptoms and failures that are not related to the receptor plate.

Webinar attendees learned how mammography detector plates work as well as how new advances allow for a lower cost of ownership for these critical imaging devices.

Grozelle said the environment in which the machines are working are often the cause of the damage to these well made devices. When there is a problem with these devices it is often an electronic issue or actual physical damage.

He also examined and discussed failure examples, including pixel correction, while also providing an in-depth look at subcomponents that can lead to issues with operation.

Grozelle wrapped up his informative presentation with a Q&A session. Webinar attendees were invited to submit questions to Grozelle as well as Summitt Imaging CEO Larry Nguyen and James Taylor from the R&D team.

Another recent presentation of the Webinar Wednesday Series was the Conquest Imaging-sponsored webinar “Verifying Image Quality, How to Use an Ultrasound Phantom.”

Webinar participants were eligible for 1 CE credit from the ACI. 22

ICEMAGAZINE | MARCH/APRIL 2017

“ The Webinar Wednesday series is a must for every HTM professional. I share info from the webinars in my staff meetings and encourage staff to participate.” Salim K. Mammography Detector Plate Repair

by Kyle Grozelle

Conquest Imaging Training Director Jim Rickner did an outstanding job of explaining what can sometimes be a complex subject.

Rickner, who has over 30 years of experience working on a variety of electronic equipment, is a renowned instructor and sought out speaker in the ultrasound industry.

“ I’ve been in the biomed field for over 10 years and I learn something new in every session.” Clifford W. During the webinar, Rickner reviewed some poor image quality complaints from the field, described and illustrated the purpose of an ultrasound phantom and discussed multiple test descriptions and procedures for using a phantom in evaluating image quality.

The webinar concluded with an insightful Q&A session. Rickner fielded questions from attendees and provided helpful answers. Attendees were also encouraged to email him questions.

Attendees shared their evaluations of the sessions in post-webinar surveys.

“This is my first Webinar Wednesday, but I will continue to attend them as much as possible when they discuss things that are

Verifying Image Quality, How to Use an Ultrasound Phantom

by Jim Rickner

relevant to my current position and where I want to go in biomed. Thank you for the free education and keep up the good work,” Joe H. shared.

“I’ve been in the biomed field for over 10 years and I learn something new in every session,” Clifford W. said.

“Webinar Wednesday is a revolutionary idea to aiding HTM’s continued learning and advancing toward providing better patient care from the equipment reliability side,” Daniel T. wrote.

“The MD Publishing Webinars are a fantastic way to stay up to date with the latest trends in biomedical technology, and for refreshing your memories on topics you have trained on in the past and could use some brushing up on. The speakers are all industry personnel who are knowledgeable and generous with that knowledge and their time,” Eddie F. shared.

“The Webinar Wednesday series is a must for every HTM professional. I share info from the webinars in my staff meetings and encourage staff to participate,” Salim K. wrote. ICE For more information about the webinar series, including a calendar of upcoming webinars and recordings of previous webinars, visit 1TechNation.com/webinars.

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Optimizing workflow – small changes can equal big impact In an increasingly consolidated health care environment, efficiency and workflow optimization are vital for hospitals and imaging centers.

A new server-based suite of tools from Philips can help change the way hospitals and imaging centers operate.

OmniSphere offers applications designed to increase business efficiency and optimize operations by gathering and presenting utilization data for administrators, radiologists, imaging technicians, and hospital IT teams to assess, analyze, and put into action.

Traditionally it has been overly tedious and labor-intensive to run detailed reports that allow for in-depth analysis of how an organization’s ultrasound systems are being used across a site or a networked system. Because of this, staff often work around inefficiencies on a daily basis without addressing the root cause, resulting in lost time and increased costs. Driven by customer insights, OmniSphere’s Utilization Optimizer and Remote Technical Connect applications are designed to make it easier to optimize equipment utilization for reduced costs and increased productivity.

Utilization Optimizer gives ultrasound managers a clear view into workflow, staffing, and equipment utilization and downtime. The platform provides easy access to deep levels of data through an intuitive interface and can help users customize the level of reporting based on their needs. Based on the existing landscape, easy access to staffing

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“ The health care landscape is changing,” shared Vitor Rocha, CEO of Philips Ultrasound.

“ With larger networked systems and more consolidation, it will be more important than ever for leaders to get a clear picture of their operations through data analysis. The Philips OmniSphere suite makes evaluating efficiency quick and easy so professionals can build it into their regular routine and start confidently making choices backed by data.”

and equipment usage reports has the potential to increase productivity and recapture lost revenue. For example, if an hour of downtime for an ultrasound costs $175 in potential revenue, a lost eight-hour day of downtime can cost $1,400. Utilization Optimizer allows users to filter and manipulate data to guide more informed decision-making for purchasing, staffing, training, and workflow.

insights that allow them to increase their productivity and uptime. There are many scenarios that cause frustration and setbacks when biomeds are out in the field, such as bringing the incorrect equipment or wasting travel time. Enabling biomeds to provide first response remotely and be more prepared when they arrive to service equipment can save labor hours and associated costs, not only freeing them up to service other needs but also increasing equipment uptime.

Further, if a biomed engineer earns a median wage of $41.45 an hour, reducing inefficient travel time and unnecessary repair trips can quickly add up to meaningful cost savings.

Philips is dedicated to improving both the patient and provider experience with tools that make a difference.

Driving better business models and workflow efficiency leads to less wait time and a better patient experience.

Every manager wants to make smart decisions based on data, and Philips OmniSphere can uncover inefficiencies to help administrators make more informed business decisions. Philips believes that meaningful solutions – those that make a real difference – are developed in partnership with customers, with an understanding that quality patient care extends outside the hospital walls.

The Remote Technical Connect application delivers quick, easy, and secure access to ultrasound systems to help biomeds and IT teams gain

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Mike Watson

T

he Florida Biomedical Society (FBS) named Mike Watson the 2016 BMET of the Year. Watson is an imaging team lead with TriMedx, working at Sacred Heart Health Systems in Pensacola.

When an imaging service professional is recognized statewide for his achievements and contributions, it’s a big deal. There are many deserving imaging service engineers in any particular state and selecting the best one is always a tough decision – especially when also considering all of Florida’s HTM professionals for the same award.

Watson has been at Sacred Heart since 1997, but has been in the profession for 39 years. He is the imaging team lead for all of Sacred Heart Health Systems, responsible for three hospitals and several clinics.

“I have been part of many changes in the industry, including the migration from hard copy film to digital imaging, analog to digital systems, and electronic storage of images,” Watson says.

Watson says that he didn’t find his career, it found him shortly after he earned an associate degree in applied science in electronic technology at United Electronics Institute in Little Rock, Arkansas.

“After completing my degree in electronics, the college had several companies offering jobs for new technicians. I took a position with a local X-ray dealer as an entry-level tech installing, deinstalling and refurbishing used equipment. After several years I started field service work,” he says.

He joined Sacred Heart to start an inhouse imaging support program. The program he helped create continues to this day under the management of TriMedx.

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Mike Watson TriMedx at Sacred Heart Health Systems in Pensacola “I currently serve as imaging team lead for all of Sacred Heart Health Systems. Regular responsibilities include service and maintenance of general X-ray, mammo, CVL labs, and CT systems, as well as back up for all other imaging modalities,” Watson says.

“Our imaging team also has the opportunity to mentor biomed students from Pensacola State College on a regular basis.”

Watson’s continuing education has included classes at Pensacola Junior College in digital electronics fundamentals, microprocessor concepts and introductions to UNIX. He also has learned directly from original equipment manufacturers (OEMs).

“I have attended OEM training from Kodak, Konica, Philips Medical, GE Medical, Siemens Medical, Varian Medical and other independent manufacturers,” he says.

His education and years of experience were especially helpful when a natural disaster struck. Watson says one of the biggest challenges he has faced as an imaging professional was in 2004. Pensacola was the hardest hit area when Hurricane Ivan made landfall in September of that year.

“Biggest challenge was probably keeping the departments functioning after Hurricane Ivan. We were pretty much doing damage control with Facilities during the storm. Then, after the storm passed, the hospital was on emergency power so only equipment that was supplied was operational,” Watson says.

“To make matters worse, we had no AC, so even though the equipment was operational, we had to move portable coolers and fans to keep things going. Also the network was down, which took down the PACS for the radiologists,” he adds.

AWAY FROM WORK Watson had the opportunity to visit Serbia through the TriMedx Foundation, which was created in 2004 to “address the international need for medical equipment repair and support,” according to the organization’s website. The Indianapolis-based organization works in “partnership with medical mission organizations.”

Watson’s experience is unique because of how the trip came about and because the group was the guest of royalty.

ADVANCING THE IMAGING PROFESSIONAL

Mike Watson was named the 2016 BMET of the year by the Florida Biomedical Society.

GET TO KNOW THE PRO Favorite book I don’t read many books. More of the news and magazine type.

Favorite movie

“Biggest challenge was probably keeping the departments functioning after Hurricane Ivan. We were pretty much doing damage control with Facilities during the storm.”

“Greg Ranger, president of TriMedx, had met Princess Katherine during a conference here in the states. She requested a visit to Serbia so we could evaluate the state of their health care equipment as they were rebuilding after the Soviet occupation,” Watson says.

“We had a driver and translator supplied by the palace and visited multiple health care facilities. At first, we were impressed with the quality of the equipment we were seeing. The translator reported back to Prince Alexander and Princess Katherine after the first day, and the next thing we knew, we were at the palace getting lectured on how the country had been devastated,” Watson remembers. “That’s when we realized the Serbian people we were meeting were trying to impress us. After that we started explaining why we were there and then started to see the real needs.”

As pastimes to relax, Watson has a green thumb.

WWW.IMAGINGIGLOO.COM

“I enjoy yard work and plant a vegetable garden each year,” he says. “I was busy with the kids for years doing sports and club activities. Now that they are grown, I really haven’t gotten into anything new. I keep telling myself it’s time to start fishing again.”

In the past, he has volunteered with Habitat for Humanity, Make a Difference Day and Helping Hands. He has been a member of the Gulf Coast Biomedical Society for 15 years.

He has been married to his wife, Betty, for 32 years. They have a son, Scott, and daughter, Jessica.

Watson remains humble about his work as an imaging service professional. The FBS award has not changed his approach to solid teamwork with respect for his peers and everyone he works with at Sacred Heart Health Systems.

“I was honored to just be nominated; then to win was over the top. A very special honor for sure,” Watson says. ICE

Outlaw Josie Wells Favorite food Gulf shrimp cooked any way you can!

Hidden talent I can fix just about anything around the house and am often called on by friends to help them when something isn’t working.

Favorite part of being an imaging service professional “It’s a good job with benefits, seeing the appreciation of the staff when you complete a repair and they have their equipment back in use. Also, I enjoy getting new training as the industry changes.”

What’s on my bench?

• Smartphone (don’t know how we got by without them) • Diet Pepsi • Service laptop • Mints • Large water mug

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people

By K. Richard Douglas

DEPARTMENT SPOTLIGHT ProHealth Care’s Imaging Group

P

roHealth Care is a leading provider of health care in Wisconsin, offering services to those living in Waukesha County and surrounding areas. ProHealth Care’s imaging service group sets a high standard with well-trained imaging specialists and technicians. The department is part of the health care system’s HTM and Biomedical Engineering department. Rob Bundick is the manager of the HTM and biomedical engineering department. Tom Roberts is the senior biomedical imaging engineer in the imaging group.

The overall HTM team consists of 22 members. There are seven pure biomed equipment technicians, five imaging specialists, three technicians who cover both areas, an infomatics specialist, two purchasing specialists, a third-market used equipment sales specialist, a system administrator, a supervisor and a general manager.

The department provides equipment maintenance support to two hospitals, a standalone ER, an outpatient cancer and imaging center, and more than 16 clinics. In addition, ProHealth Care has partnership agreements with a local rehabilitation hospital and surgery center. As part of that agreement, they provide labor support for their imaging and biomed equipment.

“We have almost 200 imaging devices and nearly 17,000 pieces of medical equipment that we support,” Bundick says.

Roberts says that training is important and is a priority for his talented crew.

“We maintain a robust training budget and justify our technical training from the 28

ICEMAGAZINE | MARCH/APRIL 2017

“ The imaging team is blended with the biomed department to allow us to develop staff and to provide cross coverage. This benefits the organization and provides a career path for biomed technicians to develop imaging repair skills.”

OEM through ROI analysis. The organization supports the imaging team servicing the equipment in-house and justification for maintaining highly trained engineers,” he says. “We also partner with the OEMs to develop training agreements that allows us to supplement the original training with developing secondary and tertiary trained techs.”

EXPERIENCED TEAM Roberts says that the individual members who make up the imaging service team have various amounts of experience in the imaging service realm.

Those individuals include Roberts, who has 25 years in GE Medical X-ray, nuclear medicine and MR manufacturing and eight years as an in-house biomedical imaging service tech. Jim Bales, with 27 years military/ civilian aviation and medical electronics, 12 years GE imaging manufacturing and two years experience as an in-house biomedical imaging tech as well as some general biomedical experience. Zach Benson has one year of experience with Philips diagnostic imaging and two years as an in-house imaging tech. Bruce Jahn has five years as a Philips service engineer and 30 years as an in-house imaging tech. Chris Kendziora has

20 years of biomedical experience with five of those in imaging, and 10 years as a service department lead in electronics for Everbrite electronics. Adam Kohl has five years biomed and two years imaging experience. He performs services in both roles. Bob Nix has 25 years in electronics, 15 years in CT, nine years in Linac and six years with in-house imaging.

“The imaging team is blended with the biomed department to allow us to develop staff and to provide cross coverage,” Bundick says. “This benefits the organization and provides a career path for biomed technicians to develop imaging repair skills.”

“The scope of our department is simple; out-perform OEM service providers in every measureable service statistic,” Roberts says.

“We are also involved in creating revenue by selling assets that would otherwise be scrapped. We provide input for equipment purchasing decisions and facility construction and remodeling projects.”

The imaging team services all modalities of imaging equipment. Its factory-trained technicians provide service for Linac, Cyberknife, MRI, CT, IR/Cath, mammography, nuclear medicine and general X-ray. The team is also trained to service contrast injectors, computer radiography ADVANCING THE IMAGING PROFESSIONAL

printers/readers, ultrasound and other mobile imaging-related devices.

The ProHealth imaging service group’s approach to managing service contracts is “pro-active.”

“A thorough understanding of the ProHealth Care’s equipment and service needs has been cultivated and has an understanding of what OEMs are offering as their baseline level of service arrangements. We leverage this knowledge to compel the OEMs to get creative if they wish to do business with us,” Roberts says.

“The result is custom-tailored service contracts from parts-only contracts to discounts on OEM labor rates. The goal is to keep service contracts to a minimal amount and provide service in-house where possible,” Roberts explains. “PHC has a strong annual training budget to keep techs competent and gain access to OEM proprietary tools to assist in timely repairs.”

PROJECTS AND CHALLENGES The imaging service professionals at ProHealth Care have been very busy in recent years.

“In 2015, PHC opened a new Cancer WWW.IMAGINGIGLOO.COM

ProHealth Care’s imaging service group sets a high standard with well-trained imaging specialists. Some members of the group include (clockwise from top left) Jim Bales, Tom Roberts, Zach Benson, Chris Kendziora, Adam Kohl and Bruce Jahn.

Treatment Center and Outpatient Imaging Center,” Roberts says. “This was a big project for the imaging team as it required expanding services in almost all modalities and relocating Cyberknife, Linacs, CT, mammography, and various other imaging equipment from our hospitals to this new facility. This year we added 3T MRI at the new campus.”

When asked about challenges, Roberts answers with just two words – “physicist reports.”

“The reports that cause me an inordinate amount of pain would be the reports generated after the annual physicist evaluation of nuclear cameras. A few years ago, more stringent criteria were adopted by ACR for nuclear camera accreditation. During system evaluation, physicists used to acquire uniformity floods that stopped at 60,000 kilo-counts.

Under the new ACR guidelines, the physicists acquire uniformity floods using 120,000 KCounts; something that would never be used clinically,” he explains.

“I’m not sure why ACR developed the new criteria. That would be a story in itself. The

longer uniformity floods reveal all kinds of non-uniformities in the resulting images. This forces the hospital to call the OEM to correct the problem, a problem which has never affected image quality. I finally got fed up with it and took meticulous notes while I observed the OEM service engineer the last time he corrected such a problem. When the next nuclear camera failed a physicist’s evaluation I was able to make corrections without the aid of an OEM service engineer,” Roberts adds.

Each member of the imaging service team is a member of the Wisconsin Biomed Association, while some team members also have AAMI and HIMSS memberships. They give their support and help when they can.

“We assist our state association with annual conferences when our local association sponsors the event,” Roberts says.

The talented ProHealth Care imaging service team takes pride in providing expert service that keeps every piece of diagnostic imaging equipment, regardless of modality, operational for the health care system’s clinicians and patients. ICE ICEMAGAZINE

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products

ULTRASOUND PRODUCT SPOTLIGHT Ultrasound systems market to reach $5 billion by 2023

T

he ultrasound systems space, which covers 39 major markets, is set to rise steadily from $4.2 billion in 2016 to $5 billion by 2023, representing a compound annual growth rate (CAGR) of 2.5 percent, according to research and consulting firm GlobalData.

The company’s report states that the growth will primarily be driven by the rising prevalence of diseases and expanding demand for cost-effective quality health care.

“Ultrasound technology has developed greatly over the past few decades, and the market has become mature. With the growth of the elderly population and rising prevalence of diseases worldwide, the need for ultrasound systems is growing consistently,” Tina Deng, MSc, GlobalData’s Analyst covering Medical Devices, explains. “Real-time 3D/4D ultrasound systems lead the market with a steady growth which can be attributed to their effective functionalities and advanced features. 3D ultrasound systems draw a respectable portion of revenue of the ultrasound business due to cost-effective offerings. Additionally, today’s handheld ultrasound systems with better image quality and more advanced modes have consistently gained acceptance.”

The Asia-Pacific region is the largest market owing to a large patient base, demands for better quality health care, and increasing government initiatives from emerging economies to expand health care facilities, according to GlobalData. India is the fastest-growing market of all, demonstrating a CAGR of 5.4 percent. In North America, the WWW.IMAGINGIGLOO.COM

primary factor for growth in the ultrasound systems market has been the rise in technological innovation and a continual shift toward cost-effective diagnosis.

“The European markets will fare the worst with a combined CAGR of 1.3 percent, as they are very saturated,” Deng continues. “The modest growth in market volume is largely offset by negative pricing pressures and cost-containment measures

betes, and cancer), increase in number of ultrasound diagnostic imaging procedures, demand for minimal invasive therapies, and rise in awareness for early disease diagnosis,” according to Research and Markets.

“The factors such as rise in public and private investments and grants and funds for the development of more advanced ultrasound devices as well as to create awareness about the advantages offered by these

“ Ultrasound technology has developed greatly over the past few decades, and the market has become mature. With the growth of the elderly population and rising prevalence of diseases worldwide, the need for ultrasound systems is growing consistently.”

Tina Deng, MSc, GlobalData’s Analyst in health care systems, resulting in only slight revenue growth in the cart-based ultrasound market. However, the increasing demand for point-of-care devices will drive growth in these regions.”

Research and Markets also predicts growth in the ultrasound market.

“The world ultrasound devices market was evaluated at $7,050 million in 2015, and is projected to reach $10,476 million by 2022, with a CAGR of 5.8 percent over the forecast period. This is primarily attributed to the large number of technological advancements (such as 3D and 4D imaging) in ultrasound systems, increase in prevalence and incidence rates of chronic diseases (such as heart disease, stroke, type 2 dia-

devices also drive the market growth. Conversely, the major restraining factors of the market include dearth of skilled and experienced sonographers, globally.”

“In terms of key market players, the competitive landscape in the global ultrasound systems market has remained relatively stable,” according to GlobalData. “Market players are subject to intense competition based on product design, performance, pricing, quality, and service. GE is the leader in the ultrasound systems market, followed

by Siemens and Philips, as these companies continue to improve on image quality, ease of use, mobility, reliability, and flexibility with a robust portfolio of specialized ultrasound transducers.” ICE ICEMAGAZINE

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products

Carestream Touch Ultrasound Systems Carestream Touch Prime and Touch Prime XE Ultrasound Systems offer a sealed, all-touch user interface, compact profile and easy maneuverability. Adjustable features improve ergonomics for sonographers. These systems provide exceptional image quality and streamline measurements to expedite clinician access to critical imaging information while boosting staff productivity. The Touch Prime platform offers an increased frame rate, improved penetration and uniform focus throughout the field of view. Wireless connectivity provides rapid transfer of images and data to PACS, RIS or other systems. •

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ADVANCING THE IMAGING PROFESSIONAL

products Esaote MyLab Eight Ultrasound System Esaote introduces the MyLab Eight Ultrasound System*; the flagship platform in its ultrasound portfolio. The MyLab Eight system is the culmination of Esaote’s commitment to R&D to meet the increasing demands of the modern health care environment of outstanding image quality and ease of use. The MyLab Eight system incorporates the new eMPowered Engine to optimize high-density single crystal transducers to enable images to be captured deeper in the body, with unprecedented quality, even for difficult-to-scan patients. The new WideView visualization technology offers sharp diagnostic image clarity with enhanced spatial and contrast resolution. With high-frequency imaging, advanced hemodynamic evaluation tools such as XFlow and HD CFM, and a complete portfolio of probes, Esaote offers solutions covering radiology, cardiovascular, obstetrics and gynecology as well as interventional and surgery. • * This device is currently not available for sale in the USA; pending FDA clearance.

Whale Imaging Sigma P5 Ultrasound The Sigma P5 Ultrasound is a lightweight, portable system that offers an intuitive workflow, superb image quality, and long battery life – all in one economic package. Whale’s Sigma P5 offers superior imaging for multiple applications including pointof-care, musculoskeletal, pain management and general imaging.

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FUJIFILM SONOSITE SonoSite X-Porte system FUJIFILM SonoSite Inc. develops cutting-edge ultrasound solutions and provides world-leading education to enable point-of-care visualization access to clinicians around the world. The highly portable, SonoSite X-Porte system incorporates Extreme Definition Imaging (XDI) with a user-friendly, customizable touchscreen interface that offers real-time educational visual guides and tutorials. FUJIFILM SonoSite builds durability into every ultrasound device which is why an industry-leading 5-year warranty is standard and expedited service ensures you never go without ultrasound visualization. •

Siemens Healthineers ACUSON SC2000 PRIME edition Siemens Healthineers ACUSON SC2000 PRIME offers a new level of precision with up to 90°x90° unstitched real-time imaging from volume color Doppler, even in patients with arrhythmia. Engineered for versatile, reliable performance, the ACUSON SC2000 system, PRIME edition, is a complete solution for your 2D and 3D TTE, TEE, and ICE needs. What’s more, the AcuNav V is the first real-time volume ICE catheter, which supports 3D assessment of LA structures relevant to AF ablation – critically important when sizing for novel ablation and occlusion devices. • 34

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ADVANCING THE IMAGING PROFESSIONAL

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GE HEALTHCARE LOGIQ E9 XDclear 2.0 With the LOGIQ™ E9 XDclear™ 2.0 ultrasound system, we’ve rethought virtually every element of the imaging chain, from the pulse of the probes to the clarity of the pixels. The result is our highest level of imaging performance yet – a leap forward you have to see to believe. To learn more, visit gehealthcare.com/ultrasound. •

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products

Mindray TE7 Touch Enabled Ultrasound System Mindray’s TE7 Touch Enabled Ultrasound System offers fast focused assessment with superior image quality, responsive operation, and simplified workflow.

It supports rapid and confident evaluation in multiple point-of-care (POC) settings. The gesture-driven, intuitive interface, superior image quality with one-touch image optimization, and exam presets improve both diagnostic confidence and efficiency. Simply tap to open or close functions, drag to adjust parameters or move objects, pinch to zoom in or out, slide for selections, and even swipe to expand the image – all with the touch of a finger. •

Toshiba Medical Aplio i-series The Aplio i-series ultrasound solution is made up of the Aplio i700 and Aplio i800.

Both systems include iPerformance technologies that deliver extreme processing power and allow health care providers to see more. A new beam-forming technology, iBeam, optimizes efficiency of the beam, increasing penetration, spatial resolution and contrast resolution, while at the same time reducing artifacts and clutter. The i800 offers advanced clinical applications, including an ultra-high frequency transducer (24 MHz). The Aplio i-series provides intuitive ergonomics to boost productivity during daily routine and complex exams with iSense. The systems offer an image-guided user interface and feature touch control screens and real-time quick scan, which makes automatic image adjustments without pushing a button. •

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ADVANCING THE IMAGING PROFESSIONAL

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Philips EPIQ 7 Philips EPIQ ultrasound system features Philips’ most powerful architecture ever applied to ultrasound imaging, allowing users to truly experience ultrasound’s evolution to a more definitive modality. EPIQ is supported by Philips’ family of proprietary xMATRIX transducers, providing enhanced clinical information from each scan, and faster and more consistent exams that are easier to perform and allow for a high level of confidence, even for technically difficult patients. EPIQ features HeartModel, which brings advanced Live 3D quantification, automated 2D views and robust reproducibility to echocardiography. HeartModel automatically detects, segments, and quantifies the left atrium and left ventricle from a 3D volume. For more information about the EPIQ system, visit www.Philips.com/EPIQ. •

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2017 IMAGING

REIMBURSEMENTS REDUCTIONS IMPACTING THE BOTTOM LINE

BY MATT SKOUFALOS

Photo courtesy Siemens Healthineers

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ADVANCING THE IMAGING PROFESSIONAL

S

ometimes, change feels like the only constant in the world of health care, and nowhere moreso than in the context of Medicare reimbursement payments. In the world of medical imaging, the tug-of-war over rate reductions is a source of constant contention in an industry that battles the competing impulses of operational expenses and quality of service. Fallout from the latest edition in this ongoing saga moved to the forefront of discussion in January, as the latest in a series of reductions managed by the Centers for Medicare and Medicaid Services (CMS) took effect.

In April 2014, the federal government passed compliance legislation designed to make all health care providers meet the XR-29 standard published by the National Electrical Manufacturers Association (NEMA) for dose optimization and management of computed tomography (CT) scanners. Proposed implementation rules followed from CMS, and by January 2016, providers whose CT equipment is out of compliance with the XR-29 standard were subject to a 5 percent perscan reimbursement reduction. Effective January 1, 2017, that reduction was increased threefold, to 15 percent per scan.

Radiology provisions in the 2016 consolidated appropriations act – the mechanism whereby Congress determines federal funding for fiscal 2017 – counteracted these penalties somewhat, after a proposed 25 percent cut in the professional component multiple procedure payment reduction (PC MPPR) only took effect as a 5 percent cut. However, in exchange, analog X-ray reimbursements are now subject to a 20 percent reimbursement rate reduction in 2017 and beyond, and CR procedures will absorb a 7 percent cut from 2018 to 2022 and a 10 percent reduction in 2023 and thereafter. According to a February 2016 report from the Advisory Board, there may be WWW.IMAGINGIGLOO.COM

upwards of 8,000 CR X-ray machines still in use.

Laurie Schachtner, who directs the Imaging and Cancer Center at Presence Saint Joseph Hospital of Elgin, Illinois, said that in order to counteract any loss of revenue from reimbursement reductions, organizational leaders should rely on fundamental business strategies, including comprehensive, short-term, and long-range planning.

“You’ve got to be creative, business-like, and be prepared,” Schachtner said. “I made a strategic capital plan – 2017-2018, inclusive of specific quarters – for phasing out the specific analog Radiology Rooms/Portables into digital (full-room replacement versus retrofit) in order to minimize the reduction of reimbursement until we can get them all digital.”

When capital budgets are established months and years in advance, all equipment purchases must typically be requested, which requires commitment to a forecasting process that is by no means standard at every organization. The more strategic and prepared a system can be in planning for such purchases into its strategic capital budget, however, the less stressful the process becomes for the imaging department, Schachtner said. Yet even with the “cash cow” of outpatient reimbursement dollars on the table, capital purchasing is still subject to the same organizational priorities – financial competition, dwindling revenues, adjustments in lines of service – that can complicate acquisitions.

“You’ve got to be a good businessperson, an advocate, and do your research,” Schachtner said. “There are so many competing expenses. We’re all fighting for a fixed amount of dollars. Imaging leaders must perform due diligence to figure out what they really need and be good stewards. Do the work beforehand, and map out all of the numbers.”

When replacing equipment, Schachtner recommends performing business

Laurie Schachtner Director of the Imaging and Cancer Center at Presence Saint Joseph Hospital

“ There are so many competing expenses.

We’re all fighting for a fixed amount of dollars.

Imaging leaders must perform due diligence to figure out what they really need and be good stewards. Do the work beforehand, and map out all of the numbers.”

volume and capacity analyses for each proposed replacement piece to ensure the most appropriate use of resources are being requested. Instead of pushing for a one-for-one technology swap-out, replacing every analog X-ray machine with a digital counterpart, she said assets should be managed according to patient demand, scheduling and volumes.

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2017 IMAGING REIMBURSEMENTS R E D U C T I O N S I M PAC T I N G T H E B OT TO M L I N E

“The reimbursement reduction with digital equipment really does make you prioritize as far as how many radiology machines or rad rooms you really need,” Schachtner said. “Just because I have three analog radiology machines or rad rooms currently does not necessarily mean that I will need three digital machines or rooms to replace them.”

Schachtner’s strategic plan compares the current and planned future states of her hospital’s imaging technology inventory with the aims of balancing major purchases against other competing expenses. Short of that, she said, other traditional cost-cutting measures simply aren’t available to her.

“I cannot possibly cut staffing any more than I have,” she said. “We have been paring down rad staff within all modalities and imaging support functions over the past four years. We are cut to the bone.”

At a system level, Schachtner sees that many hospital groups are so preoccupied with sustaining their current-year financial operations that the idea of future forecasting may not be in the plan. Oddly, she said, the fiscal disincentive can help things somewhat by taking internal politics out of the in-house process.

“I’m glad for the reduction because that gets us the equipment we need,” Schachtner said. “Digital imaging is qualitatively superior over analog. The patient obtains the best diagnosis in the most expedient fashion with a cost-effective modality for the imaging study.

Isn’t the goal for future health care all about high quality in the most cost-effective manner?

“Direct Digital imaging is amazing for clinical quality,” she said. “It’s life-saving. It needs to be there in medicine. Radiology touches ER, OR, inpatient, and outpatient [lines of service]. This is the best thing you can do in medicine to help quality and acuity. If we’re talking about having fewer heads in the beds, this is the right thing to do.”

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ICEMAGAZINE | MARCH/APRIL 2017

Alan Moretti Vice President of Healthcare Technology Management for Renovo Solutions

“ Many times, purchasers are seeing the cost of the annual service that they now need to plan for could be a factor of 10-12 times greater. ‘I’m moving to new technology. I now have to maintain [new] equipment.’ How do they make up the difference?”

rate reductions don’t only have a budgetary impact; they can affect the patient experience as well. It’s a familiar refrain in a national health care system that is still focused on delivering value-based care, said Alan Moretti, Vice President of Healthcare Technology Management for Renovo Solutions.

Moretti said there’s a segment of the industry that has responded to these financial penalties as “forced technology advancement,” but another seg-

ment who shares Schachtner’s view that they’re also rightly about process improvement and patient safety. Technical improvements around dose reduction not only reduce the total body burden of ionizing radiation in the cases of modalities like CR and X-ray, but they also improve workflow by removing the steps associated with processing, shipping, transporting and filing films while offering better-quality images that improve diagnosis. Aside from being the future currency of personalized medicine, digital image archiving and retrieval also plays a critical role in physician referrals and specialized medicine, HIPAA law and other foundational elements of 21st century health care.

The trouble, Moretti said, is that most analog-to-digital service improvements don’t result in any billable value at the point of procedure; moreover, creating the systems that are needed to employ them requires financial outlay to which many facilities don’t have access.

“That’s some of the challenge,” he said.

“All of the stuff we’re talking about, you can’t charge more to the patient. There’s no revenue generated. This is all about expenses to make the equipment compliant.”

Instead, he suggested that health care systems must make broader strategic changes to drive sustaining income across a variety of revenue channels. Answering the questions of what kinds of changes may enhance or redefine their operations in other lines of business is the great challenge raised by the issues of reimbursement reduction. Simply put, Moretti said, the cost of making the upgrades is a layered one, and filling in the gaps it creates requires additional layering.

With newer equipment, “there’s a service cost that’s now going to be challenging,” he said. “Many times, purchasers are seeing the cost of the annual service that they now need to plan for could be a factor of 10-12 times greater. ‘I’m moving to new technology. I now have to maintain [new] equipment.’ How do they make up the difference?”

ADVANCING THE IMAGING PROFESSIONAL

“ Ten years down the road, they may have gone somewhere else. It’s the shift of being smart, and there’s no crystal ball out there for saying what you should do. It all depends on the patient mix you’re looking at. Sometimes you’ve got to say no and go to a less expensive technology.”

James Laskaris Emerging Technology Analyst at the consultancy MD Buyline

Money may be tight, said James Laskaris, Emerging Technology Analyst at the consultancy MD Buyline of Dallas, Texas, but from an economic perspective, so is competition in the health care space. Reimbursements may be shrinking, but copays are climbing; in short, he said, “somebody’s making some money out there.”

“One of the driving things that’s helped health care is that there’s more insured patients,” Laskaris said. “What that amounts to is now more patients have to be more aware of where they’re walking into and what the prices will be.”

Laskaris doesn’t believe the days of positive financial incentivization for standards compliance aren’t necessarily gone for good. But from the perspective of CMS, any carrot, left over in the stickand-carrot system are being diverted away from less efficient technologies and towards digitally optimized ones, like electronic medical records.

“Years ago, when digital mammography came out, they upped the reimbursement,” Laskaris said. “Now they’re looking more to a negative reimbursement.

CMS is saying why keep paying for something that’s past its time?”

WWW.IMAGINGIGLOO.COM

“CMS tries to incentivize good technologies out there, and EMRs are now the future,” he said. “Now we’re seeing incentives for the EMRs. To be able to send an image, it’s got to be digitized. There will be some vendors that will need to change their product lines, and now we’re seeing more facilities that are changing over to digital because it just makes sense.”

Laskaris believes that the multiple procedure package pricing clause of the CMS reforms could eventually drive savings at the payer level if insurers decide to charge accordingly as well. With more than 40 percent of every medical bill coming down to government subsidy in some form or another anyway, “hospitals are going to start having to get more efficient as it is,” he said.

“Everything’s all tied together,” he said. “The fat’s already out of the system, but still hospitals are going to have to address it.”

In response, Laskaris foresees an uptick in digital equipment purchasing, not only as a result of compliance mandates but also to address efficiency concerns.

As compared with analog technologies, digital gear is more expensive to buy and service, but it yields better results. In the age of personalized medicine, higher-quality diagnostics provided through digital imaging modalities can help avoid more expensive surgical interventions and triage complaints better overall.

“Can you avoid cutting somebody from stem to sternum?” Laskaris said.

“Nowadays, you should have a really good idea of what’s going on before you start to do something like that. It’s the same thing with imaging: do you do

a chest X-ray with a film that won’t give you the clearest study that you want, or the extra cost of mailing that image, or digitizing it to get it where it needs to be?

The other steps cost money.”

Removing the costs of those intermediate steps fall on the positive side of the equation for hospitals, Laskaris said, which must nonetheless compensate financially for the lag time between retiring old technology and installing its more efficient counterparts. The question for hospitals is whether they can account for that difference in the interim, and while losing significant percentages of revenues until they do. Hospital expansion to capture outpatient business helped correct for the effect somewhat, he said, but when the focus shifts from volume to quality, “all your equipment buying has got to be a lot smarter these days.”

“You’ve got to look at your patient mix and protocols,” Laskaris said. “If your break-even point for bringing in a service line is 1,000 patients per year and you only get 500, you’ve got to be a little bit smarter. Maybe that’s not the service line you want to compete with. If you have a 40 percent census in your hospital, maybe those beds need to be more outpatient clinics.

“What’s going to make the system even more complex is that in the United States, the patient population is very mobile,” he said. “Ten years down the road, they may have gone somewhere else. It’s the shift of being smart, and there’s no crystal ball out there for saying what you should do. It all depends on the patient mix you’re looking at. Sometimes you’ve got to say no and go to a less expensive technology.” ICE ICEMAGAZINE

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DICOM DEBRIEF W

elcome to the new column committed to Digital Imaging and Communications in Medicine (DICOM). DICOM is the openly shared protocol to enable communication among OEM diagnostic imaging players. The DICOM spec is humongous in an attempt to clarify all the grim details of multi-OEM DI communication. This column intends to unravel the aspects of what makes DICOM work. One of the biggest barriers is the terminology. However, like most application and network terminology, once defined it becomes obvious as to what it’s all about.

My plan is to describe the various aspects, functions and terminology of DICOM. Also, I plan to cover common DICOM processes like the all-important association process between DICOM network nodes.

Finally, methods will be discussed to help with system troubleshooting by becoming a DICOM node and packet analysis.

DICOM BACKGROUND AND INTENT DICOM is huge. It is comprised of 18 sections out of the original 20 (see sidebar). Please note that sections 9 and 13 are missing. They have been retired as they referred to pointto-point wiring before network communication came along. All of the sections are freely available at http://dicom.nema.org/. Click on “The DICOM Standard” under the menu box labeled “Products.” Once there, you’ll see a list of the 18 sections, each available for free download in various formats. Most are good remedies for insomnia!

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ICEMAGAZINE | MARCH/APRIL 2017

Each section is a separate document with its own rev level. Some are quite long like PS 3.3 Information Object Definitions with more than 1,600 pages. Specifically, the DICOM Standard specifies a non-proprietary data interchange protocol, digital image format and file structure for images and image-related information. For example, the PACS (Picture Archival & Communication System) accepts any image in DICOM format.

DICOM addresses five general application areas: network image management, network image interpretation management, network print management, imaging procedure management and off-line storage media management. Much of this must be arranged between two DICOM nodes prior to communication. The association process does a bunch of handshaking to ensure all the details such as image type, image resolution, gray scale used, and image compression type (if any) are fully understood for best results.

Again, the main objective is to facilitate communication and interoperability. DICOM addresses all of the technical aspects necessary to allow complying OEMs to be understood by such entities as hospital information systems.

WHAT’S NEXT Some upcoming topics include: DICOM and clinical data • Basic DICOM terminology • DICOM data dictionary • DICOM objects

Written by Jeff Kabachinski Senior Director of Technical Development, ITD

• DICOM information hierarchy DICOM configuration concepts • Processes such as the UID, IOD that help identify individual DICOM aspects • The conformance statement – how OEMs divulge what portions of DICOM they adhere to DICOM communication • DICOM Service Object Pairs (SOPs) • DICOM value representations • DICOM association process DICOM media and security • DICOM file formats • Sharing DICOM data in PACS • DICOM security DICOM association • Abstract syntax • Transfer syntax • Protocol data units (PDUs) • Application context • Presentation context • User Information Welcome to our journey through the DICOM standard. Once we gain an understanding of how DICOM approaches the communication of diagnostic imaging, we can start to poke into DICOM packets via a packet sniffer, how to set up a computer as a DICOM node, and how to better understand the communication process with tips on how to troubleshoot issues. ICE ADVANCING THE IMAGING PROFESSIONAL

COLLIMARE YOUR FIRST CHOICE

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Introduction and Overview

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Conformance

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Information Object Definitions

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Service Class Specifications

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Data Structures and Encoding

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Data Dictionary

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Message Exchange

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Network Communication Support for Message Exchange

9

Retired

10

Media Storage and File Format for Media Interchange

11

Media Storage Application Profiles

12

Media Formats and Physical Media for Media Interchange

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Retired

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Grayscale Standard Display Function

15

Security and System Management Profiles

16

Content Mapping Resource

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Explanatory Information

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insight

IMAGING MATTERS Implementation of the PM Specialist

T

he reason to have a specialist, in any organization, is to save money or meet a regulation that would otherwise not be met. The PM Specialist is no different. The most highly regulated items tend to be the most expensive and the largest gross income generating devices in the hospital.

For imaging this means (in no particular order) MRI, CT, cath lab, nuclear medicine, and mammography. During normal operating hours these units are making money.

Therefore the first, and perhaps biggest ROI, is having the PM Specialist work off shift. Having all preventative maintenance performed on second or third shift will typically show a ROI in the first year. Working second or third shift also allows time to perform a PM that is not rushed.

The third shift PM Specialist may show an added benefit of having face-to-face turnover after the completion of the shift.

If there were repairs or concerns noted during the PM, they can be passed on to the day shift for corrective maintenance or monitoring. Third shift also covers the time frame that most hospitals see the lowest activity in the imaging department.

Shift length is another serious consideration. Having a PM Specialist work four 10hour shifts, or three 12-hour shifts should be considered where geography and volume of PMs allows. The longer shift may allow more PMs to be completed in single WWW.IMAGINGIGLOO.COM

visits for a hospital system that is spread out geographically. There are also state laws and company policies on overtime pay to consider. When using a 10- or 12hour shift the overtime pay requirements may impact your final ROI calculations.

The scope and volume of equipment will determine how many PM specialists will be cost effective. If your hospital system has standardized equipment one PM specialist can cover a larger scope of modalities. For example, if all CT units are the same brand and model (or similar model) the PM specialist can take on other modalities. If the PM specialist has to be competent on multiple brands and models of CT units, this may reduce the number of modalities that may be added beyond the CT units. The range of brands and models of any one modality will inversely impact the ROI of the PM Specialist. The volume of any one modality is an important consideration beyond the diversity of that modality. In a large system it may be cost effective to have a PM specialist for each modality, depending on geography.

All of these items are individual considerations, however, it is how they come together that dictates if you will see a real ROI of the PM Specialist. Being able to schedule PMs in one geographic location for one full shift is the goal. For example, a PM Specialist may perform PMs on two CT units and a portable in a 12-hour shift,

Written by John Garrett Manager, Clinical Engineering at Catholic Health Initiatives.

depending on manufactures and models.

However, another night there may be a remote standalone ER or imaging center that has a single CT and a general X-ray room.

This may or may not be worth having a PM specialist perform these PMs. It is a gray area that would have to be calculated and decided on a case-by-case basis. ICE

John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine.

He has worked for third-party service companies and in-house imaging teams. He is currently employed as Manager, Clinical EnICEMAGAZINE

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insight Sponsored by Advanced Ultrasound Electronics (AUE)

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D EFI N I N G THE STA N D AR D

IMAGING SERVICE 101 A

lmost every aspect of servicing and maintaining diagnostic imaging systems has changed during my 40-year career. The large scale integration of digital electronics technology has resulted in systems that can produce detailed images in milliseconds, and which need to be repaired at the module or assembly level in the field rather than at the component level. Knowledge of computer science and networking is mandatory these days. In our connected world, almost all scanners are networked with one or more PACS, WAN or HIS devices. And most scanners use networking as a control bus within the system itself, and PCs for controllers and processors.

The set of tools needed to work on the equipment has also changed, although not always for the better. Some of the most important tools to have these days are a smartphone, training and documentation, and a laptop with DICOM testing and hard drive cloning applications on it. Most of us no longer have a use for a soldering iron or an oscilloscope. Some X-ray systems don’t even require an oscilloscope these days, with current source generators that need no adjustments, or built-in diagnostics that can be used to adjust the filament turn-on settings. I don’t miss having to lug an o-scope around all of the time. (One of my arms is a little longer than the other from running through airports with a Tektronix 465 for several years.) I do miss the ability to objectively troubleshoot a problem, especially when the diagnostics are WWW.IMAGINGIGLOO.COM

not that good or I’m locked out of them!

The regulatory aspects of servicing imaging systems are also a big part of most of our lives these days. (Filled out a form 2579 lately?) When I started doing field service on ultrasound systems in the mid-1970s, the FDA was mostly focused on regulating X-ray systems and was trying to figure out what to do with the manufacturers of other devices. The adoption of the Good Manufacturing Practices / GMP approach (21 CFR Part 820) was the solution that was adopted. Pretty much ever since then, they have been trying to figure out what to do with third-party, or non-OEM, service providers for imaging systems. Except for X-ray and laser systems, servicing of imaging systems is still largely unregulated. (In my opinion, that is both a good and bad thing, and will be the subject of an upcoming column).

One thing that has not changed in imaging service over the years is the importance of the non-technical skills. In other words, communication. Being able to listen to the customer, handle their concerns and objections using good customer service skills, explain your plan to address their issues, and keeping them updated on your progress is at least as important as being able to fix the system. The cellphone has made keeping the customer updated much easier (and safer) than it was back in the day, when one had to find a working payphone.

But the cellphone also means that everyone expects to be updated, and they won’t tolerate any excuses for not knowing what is going on. It also has made quick respons-

Written by Jim Carr Director of Services and International operations for AUE

es to text messages and emails important.

Also, electronic communication must be used carefully and thoughtfully, because it is fraught with danger of misunderstanding and miscommunication.

While it can be fun, and possibly even educational, to talk about how life as an imaging engineer has changed over the years, this column will focus on the way things are today in our business. I will provide tips and ideas that will help you be better at your job. (Did I mention how important communication with the customer is?) Even though each imaging modality has specific technical complexities, there are many issues common to almost all of us that I hope to discuss. Some of these topics are obtaining technical documentation and training, the importance and challenges of finding quality replacement parts, as well as OEM passwords and lockout strategies. I welcome your ideas and feedback. ICE

Jim Carr is Director of Service and International Operations for AUE. He may be contacted via email at JCarr@auetulsa.com.

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CAREER ADVICE Be a Customer Service Leader

M

ost of us have experienced poor customer service. As customers, we expect fairness, courtesy, and an overall pleasant experience. It’s the little things that leave big and lasting impressions.

Customer service is important in any business. In “nicer” restaurants, the chef will circulate through the dining area to see how people enjoy their meals and to see if there are any problems. At many other higher-end service companies, the manager will often check to see if customers have been taken care of and offer further assistance. These steps are taken because if customers have a bad experience, they’ll go somewhere else next time. Customers will also share their bad experiences with others, hurting the company’s reputation.

Sadly, the customer service experience is not the same in health care. Mainly because patients are not like customers other companies receive. Patients are usually customers out of necessity. They are concerned for their health and are often confused and worried. Their visit is not usually a pleasant experience. Many patients have become disillusioned with their local hospital and no longer expect good customer service. But, that should not be the case.

Patients should expect, and certainly deserve to receive, excellent customer service.

As radiology managers and imaging service professionals, you certainly won’t be walking around the hospital and clinics serving patients. However, customer service in your department should be a priority to you and your entire staff. Providing exceptional customer service is about understanding and responding to a cus50

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tomer’s needs and making them feel special. For imaging service departments, the customers are the clinicians who need the diagnostic imaging equipment in excellent condition.

Sometimes there are unavoidable delays when it comes to repairs. Another piece of equipment might have priority.

The imaging service professional may be waiting on a part to arrive. These are just two examples of how a delay can occur.

When delays do occur, it is important to communicate with the customer and keep them updated on the status of the repair.

Alerting a customer that there is a delay will ease some of the tension of waiting and lets them know that you have not forgotten about them. By telling the customer the expected length of time that they may be waiting, will illustrate to them that you care about their issue and that you have not forgotten about them. These little things are very important and should be part of the standard policy of any department.

With the right leadership, it is possible to provide quality customer service that will lead to an exceptional reputation for you, your peers, and the imaging service department. Reputations spread quickly, too, and it is an opportunity for your department to stand out in a positive manner.

To me, customer service skills are very similar to the “golden rule” we all learned as kids. “Do unto others as you would have them do unto you.”

Here are some basic customer service tips that may help: • No matter how you are feeling or what your day is like, always be pleasant. First impressions do count, and you always

Written by Cindy Stephens Stephens International Recruiting, Inc.

want to be polite and professional.

• Say, “How may I help you?”, “Please, and Thank You.” Speak directly with the customer you are addressing.

• Treat all patients like VIPs. Don’t treat them like they are a pain in the neck (even if they might be sometimes). Customers do not know they aren’t your most important customer, and they’d love to feel as if they are. Don’t ignore them and pretend like they don’t exist, and don’t let your staff do that.

• Be sincere and professional when you greet people, not annoyed at the distraction.

• Be attentive! If you are talking to colleagues or texting on your phone, stop what you are doing and free yourself to help the customer. Don’t make the individual interrupt you to get your attention.

• When answering the phone, remain pleasant and interested. Repeat the name and phone number, and ask questions to ADVANCING THE IMAGING PROFESSIONAL

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Intuitive Thinking Intuitive Works Intuitive Solutions ensure you have heard and understood the issue correctly. If you receive a message, be sure to return your calls in a reasonable time.

• Follow-up and follow-through! If you tell a someone you will get back with them, be clear on when you will respond with the information. Then do it.

• Do not be late for meetings. If you are going to be late, even a few minutes, give the appropriate person a courtesy call (or text) to notify them with an explanation and arrive as soon as you can break free.

• Always remain respectful and professional, and others will follow your lead!

Your leadership sets the direction by making customer service a key priority. You

must continue working toward excellent customer service in your department. Your promotion of quality service will enhance your department’s value.

Exceptional customer service is always about the customer and responding to their needs. Make them feel special. It takes a dedicated leader to continue building excellent customer service for your department and facility. Good customer service is the essence of any business, but it is especially important in the health care industry. Great leaders make customer service a priority. Keep these things in mind and you’ll be well on your way to developing a rewarding experience for your customers and yourself. ICE

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ICE JOB BOARD Position

Organization

Location

Position

Organization

Location

Assistant Professor, Imaging Science and Innovation

Geisinger Health

Danville, PA

Field Service Lab Technician I

Stephens International Recruiting

Chico, California

Biomedical Equipment Manager

Stephens International Recruiting

Los Angeles, CA Houston, TX

Field Service Technician

Stephens International Recruiting

Central US New York

Biomedical Technician Positions Available for ALL Levels!

Health Tech Talent Management, LLC

Various

Imaging Service Technician 1

Sodexo Operations LLC

BMET I

Stephens International Recruiting

Denver, CO Little Rock, AR Lancaster, PA

Marshalltown, IA Greensboro, NC Galveston, TX Lowell, MA Los Angeles, CA San Jose, CA Daly City, CA

BMET II

Stephens International Recruiting

Little Rock, AR Denver, Co Boise, ID Clinton, IA Monroe, LA Washington, D.C. Midland, TX

Medical Imaging Technician

Stephens International Recruiting

Los Angeles, CA San Francisco, CA Denver/Boulder, CO

Permanent & Temporary Biomedical Technicians

Stephens International Recruiting

Nationwide

BMET III

Stephens International Recruiting

Bronxville, NY Denver, CO Northern Maine

Radiology Service Engineer

Wellmont Health System

Kingsport, TN

Field Imaging MRI and CT Service Specialist Positions

Health Tech Talent Management. LLC

Various

Senior Imaging Engineer

Stephens International Recruiting

Northeast Territory Connecticut

Consensys Imaging Dallas, TX Service, Inc. St. Louis, MO

Senior Technical Support Manager

Sodexo Operations LLC

Franklin, TN

Field Service Engineer MRI/CT

Sodexo Operations LLC

Senior BMET Technician

Stephens International Recruiting

Silver Spring, MD

Field Service Imaging Engineer Level 3

52

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insight

BRIDGING THE GAP Clinicians, Service Pros Discuss Ultrasound

W

elcome to this first installment of the “Bridging the Gap” column. So, one may ask, what is the gap being bridged? Great question, this column will speak to the theme of each magazine issue and involve individuals to share the perspectives of clinical users and service engineers. One of the goals is to create a thought-provoking synergy and bond-strengthening relationship between clinical equipment users and the service engineering support group.

The theme of this month’s column is ultrasound. Joining me are two experienced ultrasound imaging professionals.

Julie Cardoso is an Ultrasound Clinical Director. Robert Dierkes is an Ultrasound Imaging Engineer. Julie and Robert were asked questions related to training, informatics (the IT thing), transducer care and the perception of skill/problem reporting all leading toward the “perceived and real gaps” that they see from their vantage points.

OK, here we go.

Julie and Robert, when discussing training and how that relates to service skills, said that original equipment manufacturers (OEMs) and Independent Service Organizations (ISOs) training 54

ICEMAGAZINE | MARCH/APRIL 2017

curriculums both have positives and negatives. The OEM training offerings are viewed by clinical users as the superior of the two options. This was not a surprise, but it confirms that there are significant perception hurdles that exist for ISOs to win over clinical users.

Now, when we discussed informatics (a.k.a. IT) you know that regarding the “interaction thing” the reaction was an overwhelmingly “V-tach” pain point. Both Julie and Robert went to town. A common disconnect both the clinical users and imaging service professionals clearly agree on is that there is a significant gap in each group’s understanding of how to navigate in an IT environment! What’s an AE title? IP and Mac address? What does bandwidth have to do with getting the image from the ultrasound equipment to the radiologist’s review station? Lots of education and improvement are needed for clinical users and imaging equipment service personnel alike.

Then, we spoke about transducer care and handling. This is another Pandora’s box and an opportunity for improvement, according to Julie and Robert. Pre-inspecting the transducers for nicks, cuts and pinholes prior to any cleaning was

Written by Alan Moretti Healthcare Technology Management Advisor

recognized as the number one gap improvement opportunity. Julie and Robert said they feel there is need for improved awareness and visibility. The outcomes induced when fluid invasion occurs is almost always traced back to a lack of clinical user QA. Also, imaging service engineers are still on the hook to fully examine each transducer from plug to applicator tip during every PM inspection.

How many of you really do that?

Lastly, the conversation with Julie and Robert turned to some brunt dialog as to how clinical users report equipment service problems and the expectations of those attempting to provide service solutions to remediate the reported equipment problems. The bridging of this gap is much better than some may think.

The comments shared by Julie and Robert gave the impression that reporting equipment service events are sent and received well enough that a collaborative effort exists to enable a service solution plan to successfully occur. Unclear communication, as we all hear so often, is the “weakest link of all chains.” So, I conclude this first Bridging the Gap column with a reminder that perception is 80 percent of reality. ICE ADVANCING THE IMAGING PROFESSIONAL

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ADVANCING THE IMAGING PROFESSIONAL

Until the next issue stay connected online. news • blogs • forums • job listings • community

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index

AUE

ADVANCED ULTRASOUND ELECTRONICS

D E FINING THE S TAN D ARD

Advanced Ultrasound Electronics p. 49

Health Tech Talent Management p. 24

Technical Prospects p. 15, 17, 19 PM Imaging Management p. 38

Bayer Healthcare Back Cover

IMES (A Division of Richardson Healthcare) p. 30

Choice Medical p. 7 Injector Support & Service p. 38

Probe Hunter p. 12

Quest X-Ray Accessories p. 48

Collimare p. 45

Tenacore Holdings, Inc p. 8

The Intuitive Biomedical Solutions p. 51

SOLUTIONS

KEI Med Parts p. 38

Rad Rays LLC p. 3

Diagnostic Solutions p. 51 KEI Medical Imaging Services p. 30

Radiology Business Management Association p. 48

Tri-Imaging Solutions p. 13

Webinar

Wednesday

Webinar Wednesday p. 46

Equipment Maintenance Solutions p. 23 MedWrench p. 53

Radiology Data p. 6

X-ray Parts, Inc p. 30

Field MRI Services p. 23

58

MW Imaging p. 2

RTI, Inc. p. 24

Philips Healthcare p. 25

Summit Imaging p. 11

ICEMAGAZINE | MARCH/APRIL 2017

ADVANCING THE IMAGING PROFESSIONAL

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