TechNation - April 2017 by MD Publishing

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ADVANCING BIOMEDICAL / HTM PROFESSIONALS

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APRIL 2017

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Vol.8

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22 Biomed Adventures

Where Did I Come From?

46 Roundtable

Endoscopes

83 Scrapbook

HIMSS

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TECHNATION: ADVANCING BIOMEDICAL / HTM PROFESSIONALS

HE ROUNDTABLE: ENDOSCOPES T Endoscopes are known to be very fragile and to create other challenges for health care workers. TechNation sought out HTM professionals familiar with endoscopes and asked them about the latest technologies and what their colleagues need to know about these devices.

Next month’s Roundtable article: IV Pumps

REGULATIONS & STANDARDS- PM CHANGES, AEM, AND TARGETED MAINTENANCE As HTM professionals seek to comply with evolving rules and regulations, some areas are in need of clarification while others beg for national standards. There have been two parallel discussions that have existed for several years; frequency of preventative maintenance (PM) and completion rate requirements. TechNation takes a closer look. Next month’s Feature article: A Look at Growth of Third-Party Service Providers

TechNation (Vol. 8, Issue #4) April 2017 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

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APRIL 2017

TECHNATION

INSIDE PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Warren Kaufman Jayme McKelvey Chandin Kinkade

ART DEPARTMENT

Jonathan Riley Jessica Laurain Kara Pelley

EDITOR

John Wallace

EDITORIAL CONTRIBUTORS

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

WEB DEPARTMENT

Taylor Martin Cindy Galindo Adam Pickney

ACCOUNTING

Kim Callahan

CIRCULATION

Lisa Cover Laura Mullen

EDITORIAL BOARD

Eddie Acosta, Business Development Manager, Colin Construction Company Manny Roman, Business Operation Manager, AMSP Robert Preston, CBET, A+, 2014 Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System James R. Fedele, Director, Biomedical Engineering Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer

Departments P.12 SPOTLIGHT p.12 Professional of the Month: Princess Sayas p.16 Company Showcase: J2S Medical p.20 Department of the Month: W.G. (Bill) Hefner VA Medical Center Biomedical Engineering Department p.22 Biomed Adventures: Where did I Come From? P.26 p.26 p.30 p.32

INDUSTRY UPDATES News and Notes: Updates from the HTM Industry AAMI Update ECRI Institute Update

P.34 p.34 p.38 p.41 p.44

THE BENCH Webinar Wednesday Biomed 101 Shop Talk Tools of the Trade

P.62 p.62 p.64 p.66 p.68 p.70 p.72 p.74 p.76

EXPERT ADVICE Career Center Ultrasound Tech Expert Sponsored by Conquest Imaging Tech Savvy The Future Sodexo Insights Sponsored by Sodexo Building your AEM Program Thought Leader Roman Review

P.78 BREAKROOM p.78 Did You Know? p.80 The Vault p.83 HIMSS Scrapbook p.88 Whats on Your Bench? Sponsored by MedWrench p.90 Index

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Jim Rickner Global Training Director Conquest Imaging

With Training, Work Becomes A Passion There’s nothing confusing about the power of good training or why it’s my greatest passion. Watching ‘the lights go on’ when someone I teach discovers they can do something they didn’t know they could do is what makes me happy. For nearly 11 years, I’ve served Conquest Imaging as field service engineer and lead instructor, training biomed experts and clinical engineers all around the U.S., helping them achieve operations and financial goals. Our knowledge and ability to share discoveries through unparalleled training processes have positioned us as the leading provider of all things training for ultrasound. My courses have helped students to achieve thousands of dollars in repair cost savings, avoid downtime and improve service for their patients. Helping others advance their professional and personal goals, and love what they do, while helping patients 24/7 is what makes my work a calling, not a job.

I’m Jim Rickner, Global Training Director for Conquest Imaging, and this is what drives me:

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Princess Sayas BY K. RICHARD DOUGLAS

t’s not often that we profile the administrative assistant in a biomed department, but for those biomed departments that have one, their role is critically important. And when an admin is the one who is nominated to be the TechNation Professional of the Month, it is obvious that the individual has made an impression among her colleagues.

At the University Medical Center of Southern Nevada in Las Vegas, Aramark’s Princess Sayas has been the clinical engineering department’s administrative assistant for eight years. Sayas knows that the professional spotlight generally features biomeds, so the news left her somewhat astonished. “Wow; I am speechless. I am honored that someone nominated me for Professional of the Month, and being an admin, I’m surprised and I don’t get too many surprises in my life since I like to plan everything ahead,” she says. Sayas did not set out to be an admin when she began in the field. It started out as a secondary responsibility. “I was at the point in life where I needed a change and wanted something different,” she explains. “I started as an Equipment Distribution Tech for Aramark Healthcare Technology at University Medical Center of Southern Nevada back in January 2009. But they had me covering the administrative assistant position during that time as well.” She was given the administrative assistant position six months later. “Now, eight years later, I’m working with a compassionate manager, Jorge Ramos and getting guidance from his direct report, Marcus Thomas,” she says. “I want to challenge myself again

TECHNATION

APRIL 2017

and become a biomed tech in the future. I do believe that [the] biomed field has a lot of potential career growth,” Sayas adds. When Sayas says that she wanted to do something different, she was referring to a busy work life that started in her late teens. “I’ve always held two jobs since I started working when I was 18,” she says. “I worked at Peter Piper Pizza as a party coordinator/hostess. During that time as well, I was working for Super Pawn Central as a jewelry cleaner and pricer. The Super Pawn ended up closing, so I started working at Sallie Mae as a student debt collector. Then I moved to become an assistant manager at a cigar shop at the Venetian Casino and MGM Casino.”

Her formal education was more on the creative side. “I graduated from College of Southern Nevada back in 2010 with an associate degree in commercial photography,” she says. “I have a side business called ‘Krafty Princess – Crafts, Events and More,’ that includes photography and crafty things like dessert tables or event invitations,” Sayas adds. Her education may not have been targeted to working as an administrative assistant, but Sayas has learned on the job. “I really didn’t get an actual formal training as an administrative assistant position; but I took classes on Microsoft Office Programs. I learn my position as I go. Being in the healthcare technology field, there is always something new,” she says. “Every day is a learning experience, whether it’s a new payroll program or new policies for Environmental of Care. I think training will never end.” Asked about challenges on the job, Sayas jokes; “Special challenges? Does EOC count? That’s always a challenge.” AWAY FROM WORK When asked what TechNation readers should know about her, Sayas points to the obvious before adding a few factoids about her life away from HTM. “Yes, Princess is my real name; everyone asks. I was originally from the Philippines and moved to Las Vegas in 1996. I love to travel. There are so many places to see and experience. I’ve been to China, Mexico, Spain, France, Italy,

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SPOTLIGHT

Princes Sayas lives an active life and has traveled throughout the world.

“ I love to travel. There are so many places to see and experience.

FAVORITE BOOK:

I’m a big fan of Nicholas Sparks and Stephen King.

I’ve been to China, Mexico, Spain, France, Italy, England and Ireland. I would love to see more of Asia for my next trip.” England and Ireland. I would love to see more of Asia for my next trip,” she says “I have no dogs or cats, but I have three beautiful desert tortoises named Columbus, Ohio and Wally-Cleveland. Funny story is that the previous owner thought Columbus was a boy but he is actually a she and I didn’t want to change her name. As far as the other two, I just didn’t know what to name them so I went with Ohio, and I just acquired Wally-Cleveland, which my nephew helped me name,” she adds.

FAVORITE MOVIE:

“The Notebook” and “Serendipity”

In addition to travel and tortoises, Sayas has several hobbies. “Where do I start?;” she asks in describing them. “I guess you can say I have a lot of hobbies. I love camping. I’m in charge of organizing my familyand-friends camping trip annually and we usually head out to Big Bear or Zion National Park every year.” “I have a love and hate relationship with running but who doesn’t, right? I like to read and listen to audio books; I usually read/listen to romance novels or a thriller. I love making things, whether it’s loom knitting or cake pops; I enjoy working with my hands,” Sayas adds. “I’m a Disney fanatic and I love the (TV) shows, ‘The Walking Dead’ and ‘Once Upon a Time,’” Sayas adds In terms of family, Sayas says she has been with her significant other, Antonio Gonzalez, since high school. She has three brothers and two sisters. She also has a few nieces and nephews. “It’s a full house when we get together,” she says.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

FAVORITE FOOD: Mexican food and fresh fruit crepes from Blueberry Hills Family Restaurant

HIDDEN TALENT:

“Putting up with all the craziness from my coworkers,” she jokes.

FAVORITE PART OF BEING A BIOMED:

“Ha ha! The guys will give me crap about this, but it’s the team that I work with. Being the only girl in the shop has its ups and downs, but there is never a dull moment in the shop. There’s always something new to learn, and the guys are kind enough to teach me how to solder or put a machine together. It’s just a fun environment to be in; and, oh yeah, bossing them around.”

WHAT’S ON MY BENCH • • • • •

My cup for water Lotion Pens Cellphone Notebooks

APRIL 2017

TECHNATION

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SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE J2S Medical

uality is the hallmark of J2S Medical’s success. The executive management team had a vision to create a brand focused on supporting the medical community in an efficient, reliable and cost-effective manner. Success came quick and fast growth demanded the need for the larger space the company occupies today.

Joe Stem, Jamie Charles and Sarah Stem represent senior leadership and bring their unique and individual strengths together to shape the vibrant culture J2S is proud to represent. “Our motto of ‘one customer at a time’ has paved a growth pattern that is laser focused on customer service. Each facility knows the face of their account executive and telling the J2S story is number one when developing a new account,” J2S Director of Sales and Marketing Sarah Stem explains. “All customers – from the largest hospital to the smallest rural facility – receive individual consultative attention with extending the facility’s budget the primary goal. Leadership is dedicated to incorporating customer feedback which supports the evolution of the J2S portfolio.” This is a banner year for J2S as April marks the company’s fifth anniversary! One key to the company’s growth and success is its ability to always remember each individual customer’s unique needs when crafting a solution. “J2S Medical is biomed owned and operated. This leadership advantage, in addition to OEM certifications and a large product catalogue, deliver a one-stop shop to the customer,” Stem says. “All products and services are provided with an OEM-matched

TECHNATION

APRIL 2017

J2S attributes its success to amazing teamwork along with outstanding leadership.

warranty. The company carries the highest level of liability insurance and its pricing is the most aggressive on the market.” “Meeting health care facilities’ needs on all levels delivers a peace of mind that results in retention and complimentary referral business,” she adds. “Being a customer-centric vendor that works hard to demonstrate savings while delivering quality products is also an advantage to choosing J2S Medical.” J2S offers a vast array of services, including delivery and pick-up, quick turn around, onsite repair and PM services, equipment competency training, an instructional video series, OEM alternative parts, capital and rental as well as in-person, consultative cost analysis. It is no surprise, then, that the company is growing. The company, located in Milford, Ohio, has a built-in advantage when it comes to growth spurts. “The great thing about the facility we inhabit is the contracted ability to expand as growth dictates. Last year,

the building was expanded by 3,000 square feet and will most likely grow again in 2017,” Stem says. The fast expansion J2S has experienced keeps employees on alert. “Challenges are seen in the growing pains of a small business,” Stem says when asked about the challenges the company has faced. “Strategic planning to address these challenges included adding staff, expanding our warehouse, training, product expansion and ISO certification – which is set to be completed by summer 2017.” The company’s core competency is infusion equipment, however its portfolio has expanded to include a number of modalities. A unique service that J2S offers is that all products and services are sold with a warranty for on average 50 percent less that what the OEM offers, according to Stem. The warranty includes service, parts, capital and rental. One provision of its OEM alternative plastic parts and depot repair service is that customers get the best price with a quick turn-around.

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SPOTLIGHT

“J2S consults customers to leverage down low-acuity repairs which demonstrates a partnership that is focused on keeping high-failure equipment patient ready. From endoscopy to IV pumps, J2S is saving hospitals time and money,” Stem explains. “Most exciting is that we are able to support customers with current technology as well as being competent on technology that is no longer supported by the OEM,” Stem adds. “Both populations can find a costeffective solution to their service and capital needs at J2S Medical. 2017 brings a fresh focus with new partnerships going into place that are going to further expand the product portfolio.” Stem says the company is excited about the future for several reasons. “ISO certification is an exciting accomplishment set to be completed this year. J2S manufactures plastic replacement parts and currently has several projects underway to expand what is currently being offered. Beyond parts and service the provision of capital and rental is a growing dynamic that is stretching hospital dollars, at times allowing for a two-to-one expense versus

“Most exciting is that we are able to support customers with current technology as well as being competent on technology that is no longer supported by the OEM. Both populations can find a cost-effective solution to their service and capital needs at J2S Medical.” the manufacturer,” Stem says. “Also on the horizon is an expanded work force. J2S is committed to job creation. Supporting student learning and retaining that spirited talent has been a program that we have successfully enjoyed and now expanded.” The company’s success is a result of amazing teamwork along with outstanding leadership. “The senior leadership team would not be where they are today without two outstanding professionals who have stood by our side since day one – Garry Willoughby in our service department and Lupe Lopez in sales,” Stem says. “Garry is a dynamic team player whose attention to detail is what our team loves to talk about with customers in the field. Lupe is the most

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

enthusiastic and positive person employed at J2S Medical. Her energy fills a room and when she visits with her customers it is the highlight of her day. Delivering high-quality, friendly cost-saving plans is her specialty and few people in the industry could forget the smile that will accompany her presentation. These two outstanding members of the J2S team create inspiration for junior associates and are what keep the brand growing.” Thank you to all customers, partners, and staff for the support which has put J2S on the map. Exciting will be our next banner year in 2022. FOR MORE INFORMATION about J2S, visit j2smedical.com.

APRIL 2017

TECHNATION

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TECHNATION

SPOTLIGHT

DEPARTMENT PROFILE

W.G. (Bill) Hefner VA Medical Center Biomedical Engineering Department BY K. RICHARD DOUGLAS

stablished in 1753, Salisbury, North Carolina is the county seat of Rowan County and located in the state’s piedmont. Two-hundred years later, the W.G. (Bill) Hefner VA Medical Center opened in Salisbury. The Center serves the health care needs of veterans living in a 24-county area.

It is one of the fastest growing VA health care systems and covers the middle strip of North Carolina from Charlotte to Greensboro. Two new health care center (HCC) facilities, in Charlotte and Kernersville, North Carolina opened recently. The main hospital campus is in Salisbury and is a Complexity 1C facility with 259 operating beds including inpatient wards, long term care, hospice and mental health. The centers in Charlotte and Kernersville offer most medical services but do not have inpatient beds. These facilities were built to expand services and offer them closer to veterans’ homes. Additionally, there is a communitybased outpatient clinic in Charlotte, which is smaller than the health care centers and offers primary care, mental health, lab and radiology services Responsibility for maintaining the medical equipment for all four campuses falls on the 13-member biomedical engineering department. “Our department’s growing rapidly alongside the growth of the system and is being driven by the goal of not just maximum uptime of equipment, but also maximum overall support to clinical staff, be it technical consulting and planning, process improvement or branching out into new areas (i.e.

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APRIL 2017

networking),” says David Sledge, chief biomedical engineer, who has oversight of all four sites. Sledge and eight of the technicians work at the main facility in Salisbury. The facilities in Charlotte and Kernersville each have two in-house technicians. “The department not only maintains the usual biomed modalities at each facility (operating rooms, imaging, exam room equipment), but are moving into the realm of information systems and server management,” Sledge says. “Most equipment has a NIC or wireless card, and many transmit and store data on a server. Networking and data

responsibility for server space and responsibility, which includes writing their own ACCESS Control lists and troubleshooting most of the medical device connectivity problems, including switch level issues. “It has become apparent in the last couple of years that IT and Biomedical Engineering need to work together for the organization to be effective, and we are fortunate to have an IT department that is willing to collaborate and train in deficient areas,” Sledge says. “This is an ongoing effort, with the end goal having network expertise as a core competency for a number of technicians.”

“ It has become apparent in the last couple of years that IT and Biomedical Engineering need to work together for the organization to be effective, and we are fortunate to have an IT department that is willing to collaborate and train in deficient areas.” - David Sledge, Chief Biomedical Engineer

management is becoming a crucial part of the profession.” The team’s technicians are constantly looking for ways to bring services in-house, Sledge says. “For instance, staff recently began repairing dental hand pieces in-house with an expected cost savings of over $50,000 annually. This was a result of a technician identifying an unnecessary cost and proactively seeking a way to reduce it,” he says. Sledge says that the department, working alongside IT, shares

PROFESSIONAL CONTINGENT The biomed team is made up of specialists who have unique responsibilities at the different facilities. Besides Sledge, the team also includes Robert Monroe, the network biomedical equipment support specialist (BESS) for all three sites who is responsible for a number of regional medical information systems such as cardiac EKGs. “Robert was selected as the National BESS of the Year within the VA for 2016, for his work supporting a

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SPOTLIGHT

W.G. Hefner VA Medical Center Biomedical Engineering Department

revamped network security profile, while simultaneously supporting the opening of the two Health Care Centers,” Sledge says. Mark Gridley, Lee Fisher, Frank Walton, Jeremy Brown, Danny Papageorgiou, Jim Cherry, CBET, and Lauren Wylie, CBET, are the department’s biomedical equipment support specialists (BESS). Gridley is responsible for the operating room. Fisher is focused on lab, sterile processing and endoscopes. Cherry specializes in cardiology, imaging and telemetry. Brown specializes in imaging, optometry and audiology. Biomedical equipment support specialists Jeff Murphy and Lisa Morton serve the Kernersville HCC. Robert Naranjo and Carl Murray are the two biomedical equipment support specialists who serve the Charlotte HCC. They cover all areas of their respective facilities on an as-needed basis. NETWORKS AND NEW CENTERS The team participates on a national Networked Medical Device Database work group aimed at effectively tracking networked devices. Sledge says that tracking is the first step toward making smart decisions, which in this case is related to network security and secure patient information. “The group was critical to

successfully activating two new Health Care Centers in 2016; one in Charlotte and one in Kernersville,” he says. “The new Health Care Centers are amongst the largest to date in the VA, both accounting for approximately 400,000 square feet each, and gives the ability to offer more services to veterans closer to their homes. Biomedical Engineering was a major part of the planning for the new sites and implementation throughout the construction and installation processes,” Sledge adds. Sledge says that the biomedical engineering department has been integral to steps to tighten up the security of the system’s networks. “Hospital network security is a very hot issue as network cards are finding their way into many of our medical devices,” he says. “Last year, new policies were put in place to greatly enhance security across the entire VA. Much of this work fell to Biomedical Engineering, as some of the most crucial databases, and systems storing patient health and identifying information, are managed by us,” Sledge says. There was a tight deadline to ascertain that the system had security in place that met new enhanced policies as soon as possible. “In an effort to do things the right way, Biomedical

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Engineering reorganized itself to include a Network Specialist (who at the time had very little formal training),” Sledge says. The new specialist was tasked with learning as much as possible while actively working with IT to implement the new security features. “Our thought was that this was not a one-time thing, but would be an ongoing effort and that we really needed the capabilities to do the work ourselves. While the process started slow, as the specialist (Rob Monroe) began to learn the subject, he began to take on more and more of the responsibilities, up to the point of total ACL writing and some switch/router monitoring,” Sledge adds. The new position has allowed the department to position itself, working with IT, to improve efficiencies and target higher quality solutions. “The project was completed with no adverse patient care results (i.e. delays), but just as significant Biomedical Engineering was able to firmly take on a number of networking duties that have drastically improved response time to network issues on our equipment and servers,” Sledge says. Veterans in Salisbury, and the other areas that this department covers, can feel confident that a team of biomeds and network specialists have their backs.

APRIL 2017

TECHNATION

SPOTLIGHT

BIOMED ADVENTURES Where Did I Come From?

BY K. RICHARD DOUGLAS

art of knowing who we are is knowing our roots. Who were our ancestors? What is the history of our family name? What did our family members do for a living? Where did they originate? For many Americans, the answers remain shrouded and elusive. For others, delving into their family history has become a hobby and a passion.

The study of genealogy was not a planned pursuit for David Braeutigam, MBA, CHTM, CBET, system director of Healthcare Technology Management for Baylor Scott and White Health. A simple day trip sparked his quest to trace his family tree. “My wife and I wanted to take a trip to Fredericksburg, Texas for a weekend in 1989. Fredericksburg is about 90 miles northwest of San Antonio, Texas. I thought it would be interesting since I knew my dad was born there. Maybe I would ask around and find some relatives,” Braeutigam says. As Braeutigam and his wife were walking around town, they came upon the Nimitz Museum; named after Admiral Nimitz. Next to the museum was a non-descript building with a cornerstone that read; “O.H. Braeutigam 1929.” Surprised, Braeutigam asked someone in the building about the cornerstone and they referred him to a guy named Johnny Braeutigam “at the men’s store.” It turned out that the guy with the same last name at the men’s store had a mother who was Braeutigam’s dad’s godmother. It also turned out that there were a number of people with the same

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APRIL 2017

last name living in Fredericksburg. “I later found out that a family history was privately published in 1970. I quickly obtained a copy of it and devoured the contents,” Braeutigam says. “I soon learned who we were, where we came from and how long we had been in Texas. We had arrived in the then Republic of Texas in December 1845 and were among the first to settle in Fredericksburg in May 1846.” It was a revelation that prompted Braeutigam to get a genealogy program and start plugging in names to construct a family tree. His reasearch led to a family reunion in 1989 and every year since. Much of his early work to discover his ancestors and larger family was done before the many online resources of today were available. He relied on making phone calls, writing letters and making trips to central Texas to “visit relatives, courthouses, museums and libraries.” The Internet has added a number of helpful resources for genealogical research. “Eventually, as the Internet grew, I started using Ancestry.com and resources like county history websites to expand my family tree. As I became more adept at the research, I developed a guide to help others use the resources I had found,” Braeutigam says. ANCESTRY SURPRISES As in many families, there are some challenges to gathering information. “My parents divorced when I was in the third grade so I didn’t know a lot of my dad’s family. So, everything I learned was new to me,” Braeutigam says. “One of my first surprises was to

learn my great-great-grandfather, Johann Wolfgang Braeutigam, built a store and a saloon along the road from Fredericksburg to Austin,” he says. “Here he also started the oldest county fair in Texas dating back to around 1881. On September 3, 1884, four men came to the store and robbed Johann Wolfgang of the prize winnings from the prior day. Johann tried to fight the men but they shot him dead on site.” Learning more about his great-greatgrandfather led Braeutigam to discover why his ancestors chose to leave Germany and settle in Texas. It was Johann Wolfgang Braeutigam’s father who made that decision. “Johann Valentin Braeutigam was the one who decided the family should move

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SPOTLIGHT

“ My parents divorced when I was in the third grade so I didn’t know a lot of my dad’s family. So, everything I learned was new to me. One of my first surprises was to learn my great-great-grandfather, Johann Wolfgang Braeutigam, built a store and a saloon along the road from Fredericksburg to Austin.” from Kaltenlengsfeld, Germany to the then Republic of Texas,” Braeutigam says. “As I read a book on the German pioneers that came to Texas, a reference noted that a document could be found at the Texas Land Grant office in Austin, Texas where all the original contracts were held of the original pioneers,” he explains. “I drove to Austin to find this document fully assuming they would

look at me in wonder trying to decide what I was talking about. To my surprise, it literally took just a few minutes for the gentleman to come back with the original document my greatgreat-great-grandfather had signed in Germany to come to Texas. The document was in German but it had his signature on the second page. I couldn’t believe I had a document that he had signed,” Braeutigam says. TIPS TO GET STARTED Unlike some hobbies that might demand a special skill set or athletic prowess, genealogy is available to anyone with a computer, some resourcefulness and an inquisitive interest in their family history. The best source of information is found in the generation ahead of us. Because of this, there is some urgency in gathering information while you can. “I always tell people to start researching your family history as soon as you can. Start with your immediate family — parents, aunts and uncles — and start to build your tree,” Braeutigam suggests. “You can use off the shelf genealogy software or use Ancestry.com to help

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

build your tree. Using Ancestry.com is easier since you will have links to other family trees already built and access to census records up to 1940,” he adds. “As you reach out to your relatives, start to collect photos and stories to help add to your tree. The stories behind the photos add so much more to the history of your family. I have been able to share many of the photos I have collected with family members who either never knew their relative or never saw the photo,” Braeutigam says. He says that one reason this is rewarding is because he has also been on the receiving end. “I also created a website many years ago so others can find the photos and download them if desired. Ironically, the website created another find. I had a person email me about a friend of his that was researching the robbers and murderers of my great-greatgrandfather. He put me in contact with the writer. I eventually met the gentleman and shared the photo I had of Johann Wolfgang Braeutigam. When he wrote his next book, he published the photo and gave a more detailed account of how the Texas Rangers hunted down the four killers,” Braeutigam says. When not researching the past and family histories, Braeutigam can be found on the job as the System Director of Healthcare Technology Management for Baylor Scott and White Health. The department manages the medical equipment for over 20 hospitals and almost 500 clinics all over Texas. To handle this task, they have 81 technicians, team leads, managers and directors that manage about 120,000 items of medical equipment. Braeutigam has learned much more about his family’s history. His discoveries have been both an interesting look at the history of one family’s past and a treasure for future generations of the Braeutigam family. He encourages others to explore their family history. It just takes an Internet connection, some resourcefulness and a passion to discover where you came from.

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STAFF REPORTS

NEWS & NOTES

Updates from the HTM Industry TROFF MEDICAL FOUNDER RETIRES After about a quarter of a century, TROFF Medical President and Founder Michael Helms is retiring. The Hendersonville, North Carolina company began offering imaging parts and equipment in 1991 and grew thanks to great relationships with customers, vendors, and competitors in the industry. However, after conversations with family members, Helms decided to “close operations here at TROFF Medical effective April 1.” “I want to say ‘Thank you’ to an industry that has been really good to my family and me,” Mike said in a telephone interview. “I want to thank MD Publishing, all our customers, fellow vendors and all the people we have worked with over the years.” Helms, an avid fisherman, will now have more time for his hobbies. And he looks forward to having a relationship with his family outside work. “It’s time for me to find my fishing poles, boat, and my guitar and go to the coast and relax for a while,” he said. “I want to spend more time with my family. I want to spend time with my mother and father and spend time with my son outside of a work environment.” Helms said he will remain active in regards to some rental properties that he and his wife Pam own and he will entertain future opportunities in an entirely new light. “I will look at other opportunities if they come along, but I plan to relax,” he said. “I’m retiring, but nobody in my family really retires. I have rental properties to manage, but the day-to-day grind, I am ready to get away from it.” People often feel awkward when somebody retires or leaves the industry because they don’t know what to say, but Helms wants to hear from the “folks.” “Feel free to call me. I’d like to talk with you,” he said explaining that this is not a sad time. “I’m happy to be in this position! It’s kind of liberating (to retire). I’ve been in the medical industry for 37 years, having started when I was 25 and that’s long enough. I’m ready to go play without the guilt of not being on the job.” “I am looking forward with expectation to what God has in store for Pam and me in the future, and BTW…. the ponytail is just about here!”

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APRIL 2017

PRN NOW REPRESENTS MEDIMIZER AND DATREND SYSTEMS INC. Physician’s Resource Network

Physicians Resource Network (PRN) has announced a new partnership with MediMizer Inc. and DATREND Systems Inc. PRN is now an official representative for both companies in the northeastern United States. MediMizer Inc., founded in 1983, is an independent biomedical and facilities software company that offers a Computerized Maintenance Management Software (CMMS) for HTM professionals. DATREND Systems Inc. develops and manufactures biomedical instruments and devices for hospitals, clinics and medical equipment manufacturers. Since 1983, PRN Inc. has progressed to become a leader in the sale of new, used and reconditioned medical equipment. “PRN was born on the premise that reconditioned equipment can help our clients operate more profitably and our goal is to make the acquisition or selling of medical equipment a pleasant experience,” Robert M. Gaw, VP Purchasing/Service, Physicians Resource Network, wrote in an email announcing the new partnerships. “We encourage you to browse our site and to call us with any questions.”

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INDUSTRY UPDATES

QUALITY MEDICAL OPENS NEW SERVICE FACILITY Quality Medical, a Florida based business unit of Meridian Biomedical Inc., has opened a new biomedical equipment service center in Cartersville, Georgia. The new facility will service and repair respiratory, infusion, and patient monitoring equipment for various health care companies such as acute care, HME/DME, and EMS throughout the Southeast. Quality Medical will perform warranty and non-warranty service for a variety of respiratory and infusion equipment including Philips/Respironics, CareFusion, Chart Industries, Flight Medical, BBraun, Baxter, Abbott and others. “Our business in the Southeast is growing rapidly,” said PK Bala, CEO of Quality Medical. “This facility allows us to better serve all our acute care and HME customers in Georgia, Alabama, Tennessee, and North and South Carolina. One of the most important elements of great service is turnaround time, and this new facility helps us deliver great service in less time.” “The goal is to have five locations nationwide by 2020,” said Jim Worrell, SVP of Corporate Development. “This location in Georgia is an

important milestone toward this goal as we implement standard procedures of excellence across several locations.” In other news, Chart Industries Inc. has appointed Quality Medical as the authorized service center for customers in the Southeastern United States. Quality Medical will perform both warranty and nonwarranty service for Chart products from its new facility in Georgia. “Quality Medical is an experienced service provider for a wide range of biomedical equipment and will play an important role in maintaining the high level of service our customers have come to expect from Chart Industries,” said Miguel Cervantes of Chart Industries. Quality Medical is a 13-year-old biomedical equipment management company specializing in respiratory, infusion, and patient monitoring equipment. Their primary facility is located in Largo, Florida, just west of Tampa Bay. Meridian Biomedical Inc. based in Boulder, Colorado, acquired Quality Medical in September 2015.

CONQUEST IMAGING’S ULTRASOUND MAINTENANCE TRAINING PROGRAMS REACH A NEW LEVEL Conquest Imaging, a leader for training programs in ultrasound maintenance and operations, is taking its “best-inclass offerings” to a new level. Company Founder and President Mark Conrad has announced that the company is investing more than $100,000 in its Stockton, California training facility. These investments will include current technology tools that address how we learn today, and will make it easier for participants to incorporate their learnings into their existing digital assets. Training program enhancements include a new interactive touch panel whiteboard, tablets and smartphones that allow students to interact with presentations, a new dedicated printer that produces high-quality manuals and supplements, new state-of-the-art systems (GE Voluson E10, Aplio 500) and new updated manuals with videos

when viewed electronically “Our philosophy is that when we train people how to service and maintain their ultrasound equipment, we are furthering our entire industry through better and more reliable performance, and improved access to services for patients,” Conquest Imaging Global Training Director Jim Rickner said. “This is why investing in training facility improvements is one of our top priorities and will continue to be so.” Conquest’s programs are highly interactive, which helps students learn by “doing” versus “listening.” Each participant receives a digital tablet with the course curriculum so that they can interact with the course material and instructor in ways that are memorable and actionable and fully customized for their needs. Hands-on instruction with actual Toshiba, GE, Philips and Siemens systems in the

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classroom is an essential component to every training course offered. Rickner is a highly sought after training expert industrywide and is often a speaker at national events covering imaging and medical instrumentation. He has been leading Conquest’s training programs for the past 11 years. FOR MORE INFORMATION about Conquest Imaging’s courses and facility, and customized on-site programs, visit www.conquestimaging.com or call 866-900-9404.

APRIL 2017

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INDUSTRY UPDATES

STAFF REPORTS

MONROE PATTILLO NAMED ACCE/HIMSS AWARD WINNER Monroe Pattillo has been named the recipient of the 2016 ACCE-HIMSS Excellence in Clinical Engineering and Information Technology Synergies Award, a joint award sponsored by the American College of Clinical Engineering (ACCE) and HIMSS. The boards of directors of both organizations selected the recipient. The award recognizes individuals who have best demonstrated leadership in promoting or implementing significant synergies between the clinical engineering and information technology professions. Award recipients also must be members in good standing of both organizations. Nominees for the award are honored for professional or technical contributions to the professions, such as research, development of a new process or product, a paper of significance, and “trailblazing” work in a new application of clinical engineering and IT. “We are proud to honor Mr. Pattillo with this award. Mr. Pattillo’s many years of work creating and advancing technology for medical device and information systems interoperability exemplify the award’s goal of recognizing leadership in promoting synergies between the clinical

engineering and information management disciplines. Mr. Pattillo’s leadership roles in several IHE Patient Care Device Domain areas has contributed significantly to improving interoperability, and his active roles in IHE North America Connectathons and Interoperability Showcases have allowed him to bring to life his work in front of his clinical engineering and IT colleagues. Mr. Pattillo truly is a deserving recipient of the award,” said Petr Kresta, President, ACCE. “Monroe’s vast experience with health information exchange, including the development of IHE profiles, makes him a valuable resource for the HIMSS community,” said Carla Smith, MA, FHIMSS, CNM, executive vice president, HIMSS North America. “His unique expertise and collaborative efforts with HIMSS, and other governing bodies in the field of interoperability have helped advance interoperability, patient safety, and medical device integration.” Pattillo is an independent consultant in healthcare interoperability for alarm/ event notification, equipment management, and location services using IHE Profiles. He is a planning

committee co-chair for the IHE Patient Care Device Domain, a co-lead of the ACM Working Group, and lead of the Medical Equipment Management Device Management Communication and Location Services Working Group. As noted in his nomination for the award, technical specifications developed with his leadership have, and will have, direct, significant impacts upon patient care and organizational performance. For example, the PCD domain defines and demonstrates standards-based interoperability and makes medical device development, implementation and management less expensive and faster. It improves patient care by providing more data in a timely fashion, improving efficiency and effectiveness, and reducing transcription and use errors among other benefits. Pattillo’s leadership of the PCD domain and additional efforts to develop three profiles reflects deep technical knowledge, a commitment to improving patient care through medical device and information technologies, and dedicated time to stay current with profile developments in multiple IHE domains along with a variety of relevant standards organizations.

AAMI SEEKS VOLUNTEERS TO JOIN HTM GROUPS AAMI members interested in giving back to the healthcare technology management (HTM) field have the opportunity to join the association’s Technology Management Council (TMC) and the Healthcare Technology Leadership Committee (HTLC). Nominations are being accepted for openings on the TMC, which is a 26-member committee that represents the interests of biomedical equipment technicians, clinical engineers, and other HTM professionals. The TMC provides networking opportunities for its members; advances and promotes the HTM profession to others in health care and to the public at large; and develops

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APRIL 2017

career and technical resources for local HTM associations, health care facilities, manufacturers and other professionals. In addition, AAMI is seeking volunteers to join the HTLC. This committee seeks to nurture leadership skills among HTM professionals and to advance the professional interests of HTM managers. The HTLC has developed several books and other resources, such as the Electrical Safety Manual. Other committee projects include developing standardized job descriptions for the HTM field and uniform terms and definitions related to adverse events. AAMI members interested in serving

a three-year term as a TMC or HTLC member can apply via AAMI Connect. Members also can learn more about other available opportunities and opt-in to the volunteer pool, similar to “raising their hand” to say they want to get more involved with AAMI. Questions about the TMC or HTLC or the nomination process can be sent to Patrick Bernat at pbernat@aami.org.

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INDUSTRY UPDATES

NUDELMAN JOINS THE INTERMED GROUP AS COO

Scott Nudelman , Chief Operating Officer

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 served for 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. Nudelman brings to

InterMed deep experience in healthcare management, consulting, operations, technology and quality management. “I started working with InterMed nearly four years ago. From my very first interaction with the CEO, I knew this was a company I wanted to work with. Over the years as I watched InterMed grow, I saw the niche market opportunity created by the strong and agile leadership. I am honored to be a part of this team” Nudelman said. InterMed Group CEO Rick Staab said, “We are truly excited and honored to have Scott join our team. His operational experience and broad industry knowledge is an example of InterMed’s commitment to bringing on the premier level of talent in our industry. He immediately adds to our ability to develop nationally and to ‘Always Bring the Best.’ ”

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BY AAMI

AAMI UPDATE

Three Healthcare Technology Execs Tapped to Join AAMI Board of Directors

he AAMI Nominating Committee has selected three leading executives with diverse backgrounds in healthcare technology to serve on the association’s Board of Directors. The Board is made up of 18-19 representatives who are responsible for reviewing, revising, and approving strategic and business plans; establishing and approving policies; and providing guidance on strategic issues affecting the association.

“The Nominating Committee had a slate of 11 outstanding candidates at the upper echelons of their fields who are passionate about AAMI’s mission. AAMI is fortunate to have such talented and active members who also are capable of providing their leadership and vision to the organization as Board members,” said AAMI Board Chair Phil Cogdill, senior director of sterilization and microbiology QA at Medtronic. “Our selection was based on what the Board needed at this time. We also wanted to add additional diversity and strengths in areas that are needed to meet the challenges faced by the healthcare community.” The nominees are Pamela Arora, senior vice president and chief information officer for the Children’s Health System of Texas; Rollin J. “Terry” Fairbanks, director of the National Center for Human Factors in Healthcare and associate director of the MedStar Institute for Innovation in Washington, D.C.; and Heidi Horn, vice president of clinical engineering service for SSM Health in St. Louis, Missouri. The official election of these individuals will occur during the association’s annual business meeting, which will be held during the AAMI 2017 Conference & Expo in Austin, Texas, June 9-12. Their terms will begin immediately thereafter.

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AAMI STANDARD OFFERS SOLUTION TO HOSPITALS FACING NEW CYBER RISKS Hospitals around the world face potentially costly and devastating risks to their patients and financial bottom line because of the vulnerabilities introduced when medical devices are connected to information technology (IT) networks. Those risks, however, could be significantly mitigated through the application of thoughtful and comprehensive risk management practices, according to a new resource from AAMI – called Health IT Risk Management – that lays out the business case for the use of a series of standards known as 80001. Whether it’s a software patch that takes down an entire fleet of life-critical infusion pumps or a network upgrade that winds up crashing a patient monitoring system, the threats posed by the highly technical and interconnected nature of modern healthcare are real and consequential. “Imagine having a plan in place that would help your staff know what to do under such alarming circumstances and help prevent such disruptions from happening in the first place,” reads Health IT Risk Management. “Fortunately, a standard was developed by a distinguished committee of medical device manufacturers, IT experts, and

others with a keen understanding of medical devices and IT systems – and how they must work together.” The 80001 series of standards provides IT and healthcare technology management (HTM) professionals working in hospitals with detailed guidance on how to safely incorporate medical devices into IT networks, as well as a solid framework to manage the ever-changing risks associated with these networks. Network troubles are serious matters in modern healthcare. According to the Ponemon Institute, the average cost of a data breach in the healthcare industry is a sobering $2.2 million. Another study by Emerson Network Power estimates that unplanned data center downtime costs close to $9,000 per minute for healthcare organizations. The 80001 series of standards defines the roles, responsibilities, and activities of health delivery organizations in managing health IT risks. Several of the key benefits of the 80001 series, according to Health IT Risk Management, include: • Providing a framework for analyzing and controlling health IT risks related to safety, effectiveness, and data and system security • Helping mitigate constant cybersecurity threats with proactive control measures • Ensuring “ownership” for every component of systems and networks • Promoting shared responsibility and partnerships for the safety of health IT among healthcare systems and vendors • Complementing quality system implementation and improvements

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• Reducing reactive labors and disaster-mode situations • Helping reduce costs associated with downtime and inefficiencies Health IT Risk Management can be downloaded for free at www.aami.org/HealthITRisk. AAMI has adopted all parts of the 80001 series as American National Standards or AAMI Technical Information Reports, which can be purchased through the AAMI Store, www.aami.org/store, or by calling 877-249-8226. NEW PODCAST WITH AAMI PRESIDENT ROBERT JENSEN In a conversation with podcast host Terry Baker, AAMI President and CEO Robert Jensen describes his vision for the association, how his time as a Marine officer helped prepare him for this job, and the opportunities (and challenges) he sees for the healthcare technology community. This AAMI podcast, along with more than a dozen others, is available at www.aami.org/newsviews/podcasts.

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BY ECRI INSTITUTE

ECRI UPDATE

Preventing Missed Ventilator Alarms – The Next Frontier in Alarm Management

he need to improve the safety of clinical alarm systems is a longstanding patient safety consideration. Alarm improvement efforts to date have largely focused on the alarms generated by physiologic monitoring systems – and with good reason: these alarms make up the bulk of the alarm load in many clinical care areas. But alarm management efforts cannot stop there.

appropriate staff about all conditions – with either the patient or the medical device – that require their attention. • The need to reduce the overall number of alarms to which caregivers are exposed, to combat alarm fatigue.

Alarm management teams should be using the lessons learned from their existing alarm improvement efforts to address the hazards associated with other alarm-equipped medical devices, such as intensive care ventilators. That’s the recommendation made by ECRI Institute in its recently released Top 10 Health Technology Hazards for 2017. Topic number three on this year’s list highlights the risks associated with ventilator alarms and discusses how organizations can adapt their alarm management programs to address the unique needs of this technology.

With ventilators, achieving this balance can be particularly challenging. Factors that complicate the process include the need for the devices to identify subtle changes in a patient’s condition, inconsistent terminology among ventilator manufacturers, exhaustive choices for setting alarms, variability in transmitted data, and the lack of a central location for studying all ventilator data.

THE CHALLENGE Ventilators are critical life-support devices, delivering positive-pressure breaths to patients who require total or partial assistance to breathe. Thus a missed alarm, signaling a problem with either the patient or the machine, could lead to severe patient harm or death. Causes of missed ventilator alarms or unrecognized alarm conditions include: • Alarm fatigue, in which staff become overwhelmed by, distracted by, or

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desensitized to the number of alarms that activate – ventilators are the most common sources of alarms after physiologic monitoring systems. • Alarm notification failures, in which alarms are not effectively communicated to staff – limited ancillary notification options make ventilator alarms particularly challenging to manage.

“ Adopt tools to facilitate compliance with good practices, including guides for optimal alarm settings for different treatment goals and patient conditions.” - Jaime Schlorff, a senior project officer in ECRI Institute’s Health Devices Group.

Ultimately, efforts to improve the safety of ventilator alarm systems must balance the same two opposing needs as with physiologic monitoring systems: • The need to reliably detect and notify

ECRI INSTITUTE RECOMMENDATIONS ECRI Institute’s report recommends four steps to help healthcare facilities overcome the challenges associated with ventilator alarm management:

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INDUSTRY UPDATES

First, initiate a comprehensive, multidisciplinary effort to address the challenges associated with ventilator alarm management. “This effort should be spearheaded by the existing alarm management committee,” notes Ramya Krishnan, a senior project officer in ECRI Institute’s Health Devices Group, “but additional stakeholders, such as respiratory therapists and other clinicians who routinely address and support ventilator alarms, should also be represented on the committee.” Second, understand how respiratory monitoring and ventilator alarms are used at your facility, focusing on the alarm load in each care area and the effectiveness of the established notification pathways. A successful alarm management program will require identifying where your vulnerabilities lie and developing appropriate strategies to limit the hazards. To gain this understanding, observe how the many different alarms are handled in each care area, review your reports of adverse events and near misses, and assess the care area for factors that could be hindering staff

recognition of or response to ventilator alarms. Consider collecting and analyzing alarm data to obtain a quantitative measure of the number and types of alarms that activate per device within a care area. This latter step can be accomplished by accessing alarm log data from individual ventilators or by using third-party alarm analytics software. Third, identify and implement strategies for reducing the alarm load. Using the information that you’ve collected, identify the nonactionable alarms – those that don’t require a clinical response – and work with frontline staff to identify and implement appropriate strategies for reducing the number of these alarms in each care area. “Adopt tools to facilitate compliance with good practices, including guides for optimal alarm settings for different treatment goals and patient conditions,” advises Jaime Schlorff, a senior project officer in ECRI Institute’s Health Devices Group. “In addition, utilize available ventilator functionality to improve patient-ventilator synchrony. Many ventilators offer advanced

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

capabilities that, when used appropriately, can ventilate the patient in a more effective or comfortable manner.” This could result in fewer alarms or faster weaning, allowing the patient to be removed from the ventilator more quickly. Fourth, identify and implement strategies to improve staff awareness of ventilator capabilities, effective utilization of device capabilities (e.g. ventilation modes and options for setting parameters), and appropriate responses to ventilator alarms. This might involve investigating whether to adjust staffing levels or staff deployment to improve responsiveness to the needs of ventilator patients. In ECRI Institute’s experience, assigning respiratory therapists to a specific care area, rather than having them float between multiple care areas, leads to the best alarm and patient response. Additionally, a healthcare facility might want to consider enhancing notification of ventilator alarms with secondary notification pathways, such as interfacing with nurse call or patient monitoring systems or implementing an ancillary alarm notification/alarm integration system. It is important to recognize, however, that the available alternatives have limitations, and facilities must test such notification pathways thoroughly before implementation. THIS ARTICLE supplements ECRI Institute’s Top 10 Health Technology Hazards for 2017. An Executive Brief of the report can be downloaded from ECRI Institute as a free public service. The full report, which includes detailed problem descriptions and recommendations for addressing the hazards, requires membership in certain ECRI Institute programs or separate purchase. For more information, visit www.ecri.org/2017hazards, or contact ECRI Institute by telephone at 610-825-6000, ext. 5891, or by email at clientservices@ecri.org.

APRIL 2017

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STAFF REPORTS

Webinar

Wednesday

WEBINAR WEDNESDAY Strong Start to Webinar Wednesday 2017

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. The webinar was eligible for one 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

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APRIL 2017

and James Taylor from the R&D team. The second Webinar Wednesday presentation of 2017 was “Best Practices for Standardizing Medical Parts Procurement” by Nicole Hemphill and Jason Meister. The PartsSource-sponsored webinar had 257 attendees, including one from Guam. The webinar was eligible for one CE credit from the ACI. Hemphill kicked off the presentation with examples of questions often heard when it comes to ordering parts. Questions included: How can I shorten the time it takes to place an order? And, How can I check the status of an order online? Meister followed Hemphill and proceeded to provide answers to those questions and more in an informative presentation. Webinar attendees learned about the benefits of process standardization and modern best practices for parts procurement. Meister provided an outline of the parts procurement process that includes medical parts identification, sourcing, ordering, tracking and reconciliation processes. The webinar concluded with a Q&A session in which Meister and Hemphill fielded questions from webinar attendees. The TechNation Webinar Wednesday Series continues to receive high praise from attendees. “Click, click, click and another hour of training in the bag,” Janet P. wrote after the Summit Imaging webinar. “Thank you Webinar Wednesdays!!” “Please keep the Webinar Wednesday(s) coming, we have a small department of three biomeds and find

“The Webinar Wednesdays are a great way to stay informed and get training on topics we would have to travel to obtain. Awesome use of a busy technician’s time.” - Donald A.

the webinars very valuable, and we love to keep informed with the latest information,” Mark H. shared. “I love the webinars. This is great continuing education for certification renewals! It is easy to access. I can listen to them while I keep working at my desk performing PMs and repairs. Keep them going. I appreciate all the time and effort everyone involved takes to put these together,” Brian J. wrote. “Not only (are the webinars) very informative and educational, it’s the best place to get CE points for CBETs who reside outside mainland U.S.,” Ian C. exclaimed. “This is my first of what I hope to be many more webinars. It was both easy and insightful,” Clifford W. wrote after the PartsSource webinar. “Thanks to Webinar Wednesday and to all the sponsors. I’m on the island of

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he other day I was speaking with a co-worker who is working on a bachelor’s degree in networking. As we spoke, the individual talked about potentially leaving the Healthcare Technology Management (HTM) field and transitioning to Information Technology (IT). As a member of the U.S. Army Reserves I have had conversations with other members of the Reserves who expressed the same sentiment. Recently, a few high school students visited my reserve unit with a recruiter and wanted to know more about the Army and potential jobs. When I informed them of Biomed, its many job openings and positive job outlook they looked at me puzzled. Many of them had never heard of the profession until then.

Why is it that so many of today’s young adults look past the HTM profession and the vast number of job openings and choose IT careers instead? It comes down to money and prestige. Network Engineers make more money than today’s HTM professionals. They receive more recognition and hold a more prestigious position; this does not appear to be changing any time soon. When today’s young adults compare the HTM profession to a Network Engineer, or other IT positions, they see similar job requirements but drastically different pay ranges. Today’s Healthcare Technology Management profession is facing many challenges. The profession as a whole is currently struggling to find new candidates to fill vacancies nationwide while at the same time about 50 percent of the workforce is expected to retire in the next 15 years. While a majority of our profession is happy with their current position, a common complaint is the lack of respect from the C-suite and lower salaries when compared to our IT counterparts. With an aging work force, the perception of an underpaid profession and the lack of interest from today’s young adults how will the HTM profession continue to support their organizations in the future? Steven Yelton discussed this in the October 2016 edition of TechNation. Yelton spoke about a lack of qualified schools and a trend among the

TECHNATION

APRIL 2017

TYLER TRYON, MBA, CBET

remaining schools to downsize or discontinue their current HTM programs due to a lack of enrollment. He concluded that there is a need for new entrants into the field, yet the schools can’t find people to enroll. He says, “I thought students would be attracted to exciting and ‘techy’ programs where there are lots of jobs?” He is right, students want to work with the newest technology and work in a field with lots of growth potential. The requirement he missed, however, is a career that has a high salary potential. Unfortunately HTM only meets the first two; on the other hand IT, specifically Network Engineers, meets all three. Many of the younger HTM professionals see the drastic pay

difference between Network Engineers and HTM and openly talk about transitioning to IT. After working on patient monitoring networks, many times side-by-side with a network engineer, HTM professionals realize that Network Engineers don’t do anything that we can’t do. One network engineer I worked closely with on many projects commented about the number of devices we have to know intimately and said that he could never do my job. Yet the organization’s HTM department designed, implemented, maintained and troubleshot the patient monitoring network that was in place. While HTM didn’t have to do the layer 3 switching and IP routing that the Network Engineers did, these are skills that today’s HTM professional can learn in a short time frame. To compound the problem, Network Engineers are regarded as if they do magic and regularly receive positive recognition. IT is a more prestigious profession that is glorified by the media, recognized by the C-suite and sought after by today’s young adults. HTM, on the other hand, is still stuck in the basement, nobody in the C-suite knows what we do and recognition is a rarity at best. The pay difference between HTM and Network Engineers is astounding. Network Engineers make about 30 to 40 percent more than BMETs. The difference in pay between Network Engineers and HTM

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professionals provides little incentive for today’s young professionals to enter the field. When a senior in high school is trying to decide on a career to pursue in college they begin comparing potential paths. Unfortunately nobody knows what a biomed is, understands what Healthcare Technology Management does or truly understands the amount of technology HTM professionals use and work with. The one thing they see is a 29 percent difference in pay between the

my IT counterparts. I have learned to communicate effectively with my customers and as a result have garnered respect from many levels of leadership within my organization. Despite only having five years of experience it was common at my previous job for department directors to speak with me, seek my advice and lean heavily on my guidance over more senior and experienced HTM professionals. While they held the knowledge, my

career plan will help to align the HTM profession with our IT counterparts and provide substantiating documents to justify a higher prestige, increased salaries and recognition. In addition HTM professionals must begin to dress and act the part. This will help to change the perception of the profession, and as a result increase the respect that we get from organizational leadership. An additional benefit from requiring

“If the HTM field wants to meet the increasing demands they must get the attention of today’s youth through higher salary potential. The only way to compete with the highly regarded IT positions is to have similar requirements; this means a four-year degree for the upper levels of HTM.” two and a gap that only widens as you move up in the ranks. The only downside to becoming a network engineer is the requirement of a four-year bachelor’s degree. While many HTM professionals try and compare themselves to Network Engineers they unfortunately are not comparing apples to apples. Network Engineers require a four-year degree to even enter the profession. Additionally, Network Engineers conduct themselves in a professional manner with their attire, communication and attitude. When a network engineer walks into a room they look and act like a professional. Some HTM professionals or biomeds, as many still call themselves, still wear scrubs, fail to communicate properly with the C-suite and their overall demeanor results in a lack of respect from those holding leadership positions. While the HTM profession requires highly skilled professionals many “Biomeds” do not conduct themselves as such, nor do they have a résumé that demands respect and higher pay. As an HTM professional that wears button-up shirts, slacks and dress shoes to work I am consistently mistaken for

appearance, attitude and body language allowed me to gain higher levels of respect and prestige with leadership. If the HTM field wants to meet the increasing demands they must get the attention of today’s youth through higher salary potential. The only way to compete with the highly regarded IT positions is to have similar requirements; this means a four-year degree for the upper levels of HTM. Requiring BMET IIIs to have a bachelor’s degree will help align them with Network Engineers in prestige, recognition, education and – as a result – salary. Continuing the same two-year degree for some BMET I and BMET II positions will allow for a quicker entry into the field for today’s young professionals. With increasing college tuition costs and many college graduates having student loan debt that they cannot afford, a two-year degree will be a welcome alternative. Requiring BMET IIIs to have a bachelor’s degree allows for eight years from entering the field to complete the remaining two years of school, which can be completed online or at local colleges. In many cases the cost can be offset through tuition assistance from their employer. This

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

BMET IIIs to have a bachelor’s degree is the transition to management. Currently, the BMET III position requires an associate degree while the HTM Manager position requires a bachelor’s degree, this will become a problem as many of the profession’s leaders retire in the near future. Many of today’s BMET IIIs haven’t pursued a bachelor’s degree and therefore will not be qualified when management positions become open. Without qualified HTM professionals to fill the manager positions, the HTM profession will be lead by those who do not understand the profession or the difficulties that we face. This will only make our jobs harder. The HTM profession needs to increase its formal education and require BMET IIIs to have a bachelor’s degree. This combined with a transition to a professional appearance will change the perception of the field, increase salaries, attract new entrants to the profession and help provide respect and prestige within the C-suite. Higher education equals higher pay; this is the only way for the HTM profession to continue to meet the growing demands of today’s health care organizations.

APRIL 2017

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SHOP TALK

Conversations from the TechNation ListServ Q:

What is your policy pertaining to vendors bringing in equipment? Do you just safety check it and document that it’s in your hospital? Is that enough? Are you sure it’s safe for a patient? How do you know?

check with them. For our hospital, it is required. This insures the power supplies in the medical equipment meet or exceed UL 60601-1, remember the power strips from last year? That also pertains to power supplies.

We perform electrical safety and have the vendor show proof of a current PM before it is allowed for patient use.

We require the vendor to bring a copy of the current PM or manufacturer documentation stating no PM is required. We do a safety check as well.

It must be UL Listed or equivalent. It must have latest PM records available. We must perform an electrical safety test. It must be put into our database with a temporary asset number with a PM assigned 90 days out to check to see if item has left the hospital or, it’s due for factory PM.

We perform electrical safety, create a work order to document serial numbers (in case of an issue while at our hospital) and nothing comes in without a P.O. number from our purchasing department. We label non-hospital owned or trial and don’t assign an asset number because they never check out with us.

I just want to put out some information on the UL or equivalent rating for medical equipment (vendor or purchased) coming into the hospital. The insurance company insuring the facility will more than likely require this, you would need to

We require the vendor to provide the instructions for use to verify what needs to be checked during incoming inspection. We follow the manufacturer’s requirements and place a temporary equipment inventory sticker on the equipment for tracking. Most of the time the only thing required is electrical safety, but occasionally there are more requirements. We also see if regular maintenance is required and verify the vendor has been performing that maintenance. We recently had a piece of equipment come in that required annual PM but the sticker on the device had expired in 2013. There were numerous electrical safety stickers from various local facilities but no one had bothered to make sure the manufacturer was performing the required PMs. We obviously did not allow the rep to use the device. He came in the next day with a new unit from his company with updated inspections.

UL or equivalent is enforced by the Biomed shop which is backed up by the safety officer and Environment of Care committee. It’s common practice now for the sales rep to carry last PM info. The last two are through the Biomed shop. Any piece of equipment that does not go through the process and sneaks in, and we catch it, goes to the Director and Chief Nursing Officer, we don’t miss much if any!

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

How many of you are going to completely overhaul your PM program to meet the new Joint Commission standards for 100 percent PM completion?

I am completely reviewing our standards in Colorado to meet the 100 percent completion goal. This hasn’t been the practice in most organizations for all medical devices in the past.

This is a Joint Commission recommendation/standard and not sanctioned by CMS. I think in most cases it would be wise to stick with the policy you have in place until such time where CMS actually reviews this and renders a response. We all remember the confusion with CMS and “predictive maintenance” years ago. The standard says 100 percent complete or your policy. Our policy will stick with the old guidelines until this settles down. Seems CMS and Joint Commission are in a contest lately and we, the techs in the field, are taking the blunt of the blows.

The 100 percent completion to my understanding is for “high risk” devices. We were already using a 100 percent performance requirement on anything we deem to be a life safety device. Should that requirement expand to include less critical devices, we are going to have a problem.

Agreed. As long as we are meeting the guidelines stated in our policy 100 percent of the time, we are in compliance. Our policy states that we will complete a minimum of 95

APRIL 2017

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percent of scheduled preventive maintenance of non-high risk equipment each month. The 100 percent for high-risk equipment was already in place, so that hasn’t changed.

Unfortunately, that information is INCORRECT. I literally just completed a webinar with George Mills that was hosted by the ECRI Institute, my second webinar in the last couple of weeks with George. All medical devices that have a scheduled PM must be completed 100 percent for the month scheduled, unless the device is in use or cannot be found. In the case when a device is in use or cannot be found, you must document your activities to find that device, and have a plan when the device is discontinued on that patient or if the device is found.

Use to be 100 percent on life safety, 95 percent on everything else, changed to all 100 percent. I think all this will do in the long run is that it will create “could not locate” entries in the database.

That’s only explained half correctly. This is from The Joint Commission website: “The critical access hospital identifies the activities and associated frequencies, in writing, for maintaining, inspecting, and testing all medical equipment on the inventory. These activities and associated frequencies are in accordance with manufacturers’ recommendations or with strategies of an alternative equipment maintenance (AEM) program. Note 1: The strategies of an AEM program must not reduce the safety of equipment and must be based on accepted standards of practice, such as the American National Standards Institute/Association for the Advancement of Medical Instrumentation handbook ANSI/ AAMI EQ56: 2013, Recommended Practice for a Medical Equipment Management Program. Note 2: Medical equipment with activities and associated

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STAFF REPORTS

frequencies in accordance with manufacturers’ recommendations must have a 100 percent completion rate. Note 3: Scheduled maintenance activities for high-risk medical equipment in an alternative equipment maintenance (AEM) program inventory must have a 100 percent completion rate. Scheduled maintenance activities for non-high-risk medical equipment in an alternative equipment maintenance (AEM) program inventory may be deferred as defined by organization policy, provided the completion rate is not less than 90 percent.” In other words, it has not changed for many years. One hundred percent life safety, ninety percent all others. To me it sounds like The Joint Commission is trying to set a new standard without going through CMS. I know all facilities in my area which have had a Joint Commission inspection within the last two years, CMS does a “follow up” survey within two weeks of The Joint Commission inspection. I was involved in one of those and the whole inspection was an inspection where CMS was inspecting The Joint Commission, not us. We will continue our process as it has been for years until we hear something from CMS.

I think the difference here is being 100 percent compliant as opposed to 100 percent complete with the non-high risk equipment. You should still set a minimum for completion, 95 percent for us, but for the items not completed you need to have documentation that you searched for the equipment or that it is not available for PM, making you 100 percent compliant with The Joint Commission standard. You can’t just get to the end of the month and say I met my 95 percent goal and not have attempted to find the other 5 percent. They want to see a documented effort to do everything that was scheduled. During the webinar with George and Steve it was also brought up that The

Joint Commission wants to see that 100 percent of the manufacturer required PM steps were completed. Not sure how they are going to monitor that.

I would have to agree with you. The conversion to following manufacturer PM instructions has been easy enough. Over the course of the last year we simply review the manufacturer recommendations and adjust accordingly. On the rare occasions where we differed we either changed to their requirements or started an AEM. Generally we discovered that we were doing more tests, or testing more often. If required to have a 100 percent work order completion, then it will simply create a “close out frenzy” at the end of each month. I don’t perceive a strategic benefit to the requirement.

George Mills explained in the last two webinars, one hosted by AAMI and one by ECRI, that The Joint Commission information went to publication in September with the data you are presenting. CMS disagreed with The Joint Commission point that non-high risk equipment was compliant as long as we met metrics at 90 percent completion or better of scheduled work. George redacted that printing on the last two webinars and communicated that CMS has no wiggle room from 100 percent completion of scheduled work unless NHR (non-high risk) devices are in use or cannot be found. In the case of NHR devices, you must document efforts to find the device or communicate with clinicians about the device and its scheduled maintenance. Devices in use and cannot locate devices will not count against completion rates as long as you document your efforts. You must also have a communicated plan as to what the process is when a device is found or the device is discontinued from use on the patient. I invite you to review the recent webinar information from the AAMI and ECRI hosted webinars with George.

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I was on the ECRI webinar as well. I also have firsthand experience of an TJC auditor that was performing a mock inspection this year at one of my sites quoting the new standard of 100 percent completion relative to the non-high risk category. One point that George did highlight during his presentation was that equipment that was deemed found in use (common examples of this category would be ventilators on critical patients) or unable to locate (infusion pumps) will not be counted against the 100 percent as long as the facility P&P annotated the protocol for found in use and unable to locate clearly in their respective P&P.

I’m trying to understand this standard from a CMS point of view and I have not seen anything from CMS which dictates the new Joint

Commission standard. If you have something please provide a link or website. I understand that George/ AAMI is pushing this, and by all means, this is no disrespect to George but for us to change policy we have to have strict guidelines to present to our EOC Committee. The way we read it was to comply with this standard or your policy. That, my friend, is no guidance as far as we are concerned. That’s why we are looking for a concrete CMS response. THE SHOP TALK ARTICLE is compiled from TechNation’s ListServ and MedWrench.com. Go to www.1TechNation. com/Listserv or www.MedWrench. com/?community.threads to find out how you can join and be part of the discussion.

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ROUNDTABLE

ROUNDTABLE Endoscopes

ndoscopes continue to be a hot button issue in the health care industry, especially when it comes to the proper cleaning of these devices. They are also known to be very fragile and to break easily. TechNation sought out those in the industry familiar with endoscopes and asked about the latest technologies and what HTM professionals need to know about these devices.

The expert panel for this roundtable article on endoscopes includes Mobile Instrument Service & Repair Inc. National Education Coordinator Amanda H. Coss, Olympus America Inc. Director of Marketing for Core GI and Service, Philip Doyle, KARL STORZ Director of Field Operations, Crit Fisher, STERIS Instrument Management Services Flexible Scope Product Manager, Jonathan Hart, Capital Medical Resources owner, Lee Ann Purtell and J2S MedicalDirector of Sales and Marketing, Sarah Stem.

Q: What are the latest advances in endoscopes? Amanda Coss, Mobile Instrument Service & Repair Coss: The focus of late seems to be less on enhancing image quality and more so on efficiency and cleanliness. In response to current incidents involving cross-contamination with conventional endoscopy, there has been development and testing of single use video endoscopes as well as a disposable sheath prototype for both a gastroscope and colonoscope. This endoscope allows complete isolation of the scope itself encapsulated with a disposable sheath system. The disposable sheath system includes a sheath cover and cuff which incorporates all working channels for suction, irrigation, and tool passage. This allows the contaminated part of the procedure, the disposable sheath, to be discarded after patient use reducing the risk of endoscopic bioburden cross-contamination and infections. As for the single use endoscope, upon completion of procedure the entire scope is discarded. Doyle: Flexible endoscopes for gastroenterology and pulmonology continue to evolve along multiple vectors in order to meet the simultaneous needs of doctors for better access to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

hard-to-reach parts of the anatomy, better image quality and advanced modes of visualization, more ergonomic handling, and durability that holds up under heavy daily use. Specialized endoscopes with larger channels, smaller diameters, enhanced imaging capabilities, and other unique differences are becoming available to help doctors choose exactly the right tool for each patientâ&#x20AC;&#x2122;s care. Highly advanced technologies like ScopeGuide compatibility (to create a 3D image of the shape and position of the scope inside the patient), Dual Focus (for on-demand close examination of the tissue) and Responsive Insertion Technology (for faster access to the cecum and more precise handling during therapeutic maneuvers) have added new clinical and economic value to endoscopes, even as the complexity of the endoscopesâ&#x20AC;&#x2122; internal design and manufacturing has increased accordingly. In addition, endoscope manufacturers continue to pay close attention to the cleaning and reprocessing of each endoscope model, ensuring that users have access to validated methods of disinfection for peace of mind. Fisher: There have been significant advances in the light output of rigid endoscopes over the past 5-10 years. Other milestones in the technology, however, have occurred in the functional aspects of rigid scopes, which have added new capabilities at times. A good example is a rigid rod-lens scope with technology designed to enable surgeons to select a desired direction of view using an adjusting knob. Another example is development of scopes that are used with near-infrared and ultraviolet light sources in combination with optical imaging agents to enhance imaging and aid in treatment of certain disease states, or to assess perfusion. Significant advancements also have been made in flexible scope technologies. Leveraging distal-chip technology, for instance, the industry is migrating more fully to the use of digital imaging versus traditional coherent glass fiber endoscopes, such as videoendoscope systems for ENT and GI applications, among others. Hart: Endoscopes are now being made smaller and with more technology packed into each device. Enhanced resolution (high definition), increased maneuverability, and decreased size of insertion tube diameter are just a few of the features being marketed by OEMs. An additional paradigm shift is

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moving away from traditional eye piece (fiber) scopes to video equivalents that have a much clearer picture and higher resolution, such as video ureteroscopes. This allows the surgeon greater clarity and ease of performing a procedure. Purtell: Throughout the last couple of decades there have been minimal changes to the overall design and functionality of endoscopes. Most of the design changes over the years have been to reduce the size of the scopes, while more recent developments offer scopes with rotation and “steering,” design changes that aid in easier cleaning, and more options for sterilization compatibility. The most significant advancements have come in the form of image technology. High definition has turned to “Ultra High Definition” and advanced imaging modalities within the camera system enhance the view of anatomy including fine detail, contrast, and improved clarity of tissue structures. These advancements are accomplished with changes to the scope optics and/or the camera settings. The Stryker AIM system for example, offers 5 imaging modalities including IRIS ENV, Clarity, Desaturation and DRE. Their light sources and SafeLight Cable enables the surgeon to perform minimally invasive surgery using standard endoscopic visualization or near-infrared fluorescence imaging so that enhanced visual assessment of vessels and the bile duct can be accomplished. Many of these newer technologies have not yet reached full market saturation.

Sarah Stem, J2S Medical Stem: The most exciting and valuable advances in endoscopy equipment would have to be high definition image quality, illumination and suturing assistance. That coupled with laparoscopic and capsule technology provide expanded imaging in difficult to reach body cavities. The major benefit is patient centered because these advancements require less invasive incisions, more accurate diagnosis and potentially a faster recovery period.

Q: How will those changes impact endoscope maintenance? Coss: With the disposable sheath technology, the cost of repair would decrease as the scope would not undergo high-level disinfection or sterilization. The methods used to process these scopes are harsh and compromise the internal and external integrity of the scope. However, the scope would require a more

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frequent preventative maintenance schedule due to the increased use of the scope. In regards to single use endoscopes, repair and maintenance spend goes to “zero.” We recently worked with a customer to review the cost per case of disposable scopes versus traditional ones. We used their actual repair spend with us and studied their reprocessing activity to arrive at a per case cost for reprocessing. What we found was that the disposable scope would cost $700 more per procedure compared to traditional scopes. And that was a total cost including repair and maintenance and reprocessing costs. The technology is promising but the financials simply do not support disposables now.

Philip Doyle, Olympus America Doyle: Endoscopes represent a sizable capital investment for health care facilities, but with careful handling and appropriate maintenance, they can provide years of reliable service in caring for thousands of patients. Because many of the newer capabilities of endoscopes are dependent on proprietary technologies and parts that are only available to the OEM, buyers will be more likely to protect their investment by having the OEM perform maintenance so that those unique capabilities are not lost through the use of outdated or third-party parts. Another concern that more and more customers have is whether endoscopes that have been repaired by someone other than the OEM are still validated for their endoscope reprocessor, calling the reliability of disinfection into question. Fisher: The FDA has made a huge push for OEMs to rework their IFUs to make reprocessing and sterilization processes more clear and concise, while also strengthening patient safeguards. It should be noted that many of the changes in current scope technology are internal, with LED components and digital chip control cables replacing the traditional glass image and light fibers. This technology shift has elevated the visual aspects of surgery, but the higher costs of digital technologies have also made increased care in the handling and maintenance of these often delicate devices a critical concern. Hart: Providing quality service to endoscopes is a science. When endoscope manufacturers release new products, service providers must invest in a rigorous engineering process in order to understand the complexity of the new device. Keeping up with these new product releases requires a robust process, including engineering, parts procurement and manufacturing, prototype and design

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verification, reprocessing efficacy testing, durability testing of materials, design and process validation, and service production. Purtell: While the OEM should be readily able to service specialized endoscopes and video systems with advanced imagining technology, ISOs may be slower to offer service on newer equipment technologies without altering the functionality of the product. It will be important for the users to ask if repairs to the scope or camera system will affect the use of the product as it is intended. Additionally, the smaller the scope, the easier it is to damage so increased frequency of repairs may become apparent. Stem: Sterile processing is where these changes impact maintenance. Endoscopy equipment exploring body organs is exposed to bacteria which if not properly cleaned provides serious risk. Normal precautions such as gloves and protective glasses can help reduce risk, in addition to proper disposal of waste parts.

Q: How can a health care facility with a limited budget meet its endoscope needs? Coss: When buying scopes, health care facilities need to coordinate a multi-disciplinary team including gastroenterologists, GI department nurses, sterile processing, infection control, materials management, coding and patient accounts. This collaboration allows the facility to see all costs of the proposed scope, quantity of scopes needed, and how many procedures can be performed to get a return on investment picture. One of the best ways to stretch your dollar is to prevent equipment damage through ongoing education and preventative maintenance to ensure your endoscopes are in top working condition. Often consolidating reprocessing can bring down costs per case as well. Doyle: Olympus offers – and other OEMs may offer – flexible leasing and financing options for customers to make even the most advanced equipment budget friendly. In addition, certified pre-owned and other non-new products are also available from Olympus, with the security of fully qualified OEM repairs and warranties but at a lower price point than brand-new equipment. To determine what initial investments to make, work with the manufacturer’s professional services team to develop an intelligent plan for upgrading your facility’s inventory based upon equipment usage and the number of years in service. This analysis can help establish a roadmap for which equipment to upgrade and when, based upon your allocated budget or other important factors.

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Crit Fisher, KARL STORZ Fisher: It all begins with education. It is imperative that all hospital employees that come in contact with endoscopes be thoroughly informed and trained on using proper techniques when transporting and handling these devices. In addition, tracking the scope throughout the process and gathering pertinent information can help generate outlying data. This information can then help in identifying and addressing specific problem areas where scope damage is taking place. This represents an important tool that supports customers’ efforts to bend the cost curve by reducing breakage and extending the mean time to repair. Hart: There are many service options available to customers. Understanding all available options is important. Customers should be weary that they might be sacrificing quality when choosing a less expensive alternative. Great quality repair that is budget friendly is what every health care facility desires. Get to know all service options from your vendor of choice. Purtell: One challenge for many facilities is not having adequate inventory to keep up with growing caseloads. Thus, facilities may take short cuts such as using IUSS (Immediate Use Steam Sterilization) or rush the cleaning, reprocessing and inspection process to turn over scopes quickly. This “rush” creates a greater risk to patient safety from inadequately cleaned scopes to equipment malfunction. Fortunately, there are many great options to secure additional equipment without breaking the budget. There are many reputable and highly rated sources for obtaining both new and preowned medical equipment that fits any budget. Budgets go beyond the initial acquisition costs so remember to include maintenance costs into the equation. Equipment leasing and financing are also a great option for many facilities and may provide a tax advantage to the purchaser. Maintenance and service agreements can also provide fixed costs for repairs on a case-by-case, or annual, basis. One of the most important considerations to reducing expenditures is to ensure that staff are properly trained in the care, reprocessing and inspection of the endoscopes. We highly advocate for facilities to have one or two dedicated endoscope specialists who are highly trained and have the appropriate testing equipment to inspect scopes at a high level to help reduce extensive repairs and to ensure that the equipment is safe for patient use. Take

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advantage of the training offered by your scope provider or repair provider or consider utilizing an independent organization to provide in-depth, technician-level scope training. Stem: Health care facilities with a limited budget are well served by an ISO partner that is capable of repairing their equipment to OEM specifications. This is especially helpful with equipment that falls outside of the standard service contract. The OEM will often elect not to repair and suggest a complete replacement where an ISO can complete a repair or exchange (with a pre-owned unit) for as much as 50 percent less than the OEM comparison.

Q: What are the most important things to look for when deciding to purchase an endoscope from an original equipment manufacturer or a third-party provider? Coss: OEMs will always offer the latest technology, but it comes at a cost. Clinically speaking, is the newest necessary? Does it improve patient outcomes or reduce case time? If not, purchasing pre-owned endoscopes can be an affordable option for getting your hands on great technology. Once purchased, reputable third-party repair companies can offer the same repair quality the OEMs offer at a lower price. Look for value added services when purchasing your endoscopes. A true repair partner offers additional services such as preventative maintenance, educational in-services and a comprehensive repair report to track repair trends. Doyle: How the endoscope is refurbished plays a vital role in how the endoscope is reprocessed. For example, Olympus does not sell patented, proprietary parts to others, so ISOs must do their best to recreate these parts and approximate OEM performance specifications. This reverse engineering by ISOs can lead to performance deficits. Should an endoscope purchased from an ISO not function as expected, the additional OEM repairs required to restore the endoscope to its original specifications could exceed any perceived initial savings the facility found attractive. While OEM CPO endoscopes are validated by the majority of AER manufacturers, AER manufacturers appear to be uncomfortable with guaranteeing the results of their reprocessors when used with endoscopes refurbished by ISOs. Before purchasing an ISO-refurbished endoscope, facilities should check with their AER manufacturer about whether the endoscope will be validated to minimize risk in the event of a lawsuit.

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Jonathan Hart, STERIS Hart: We all know that customers pay a premium for a brand new car versus a used vehicle, and the depreciation of that new vehicle hits as soon as you drive it off the lot. When purchasing a used endoscope, you must have confidence in the repair/refurbishment process of that vendor. Have you visited their repair facility? What is their engineering process? Where do they procure parts? Understand the warranty provided with the device. Purtell: Some important questions to ask are: What features do you want in the scope? Are you “adding” additional inventory or “upgrading” to a newer model? Do you need just the endoscope or do you require any additional instrumentation or video towers? Is the scope you are requesting compatible with the existing light source and video processor? Is the scope compatible with the sterilization method you intend to use? Does the repair vendor offer full service capabilities on the equipment they sell? (Even on new technologies? When repair is needed is the scope “repaired” or “exchanged”? Keep in mind that scopes that are “exchanged” lose SN# tracing.) What is the warranty and what does it cover or exclude? (Standard warranties typically exclude user damage or misuse.) What is the average and maximum cost to repair? Has the scope been previously overhauled? Was this overhaul from a third-party or OEM? (Either option may be acceptable however you may want to know the answer to this question in advance of the purchase.) Is the scope patient-ready? Are there any notable cosmetic defects such as dents/buckles or discoloration? Stem: The most important factors to consider when deciding to purchase endoscopy equipment is FDA clearance, warranty, and the cost of a service contract. J2S Medical provides repairs for equipment in addition to re-certified capital options, both of which extend the hospita’s budget and well below the OEM option.

Q: What do HTM professionals need to know about purchasing and servicing endoscopes? Coss: All too often HTM professionals find themselves in a “buy what I tell you” mode. Of course, HTM professionals defer to clinicians on these decisions, but top performing HTM

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teams help lead the assessment and acquisition process. Obtaining references on the ISO or OEM from other facilities to confirm the quality of repairs and reputation of the company is key. When purchasing endoscopes, make sure the company has a regional sales representation presence and is knowledgeable about the equipment. Ensure the vendor offers customer service support for real time diagnostic troubleshooting. Doyle: Buying certified pre-owned from a FDA-approved OEM is significantly different from purchasing a pre-owned endoscope from an ISO. When purchasing a CPO endoscope from an OEM, the refurbishments completed will bring the tool back to its original “like-new” specifications, using original manufacturer parts and components. ISOs are not regulated by the FDA, and are only responsible for returning the refurbished item to “within a reasonable approximation of the manufacturer’s specifications.” It is important to note that many OEMs do not sell the proprietary parts that enable endoscopes to function the way they were designed and FDA-approved to function – which is why many AER manufacturers will not guarantee the results of their reprocessors when used with endoscopes refurbished by ISOs. It’s always recommended that endoscopes in need of repair be returned to the OEM for servicing. Many OEMs offer service contracts to keep repair costs down and loaner equipment to reduce downtime. When it comes to making a purchase decision, education will prove invaluable. Research the manufacturer’s track record, the durability of the equipment and the manufacturer’s post-sale support. The investment should go beyond just the purchase of the equipment – the manufacturer should be a partner in ensuring staff is properly trained and the equipment is well-maintained. Fisher: Partnering with the appropriate vendor can pay off in the long run. Customers should also analyze and assess the total cost of ownership of their scopes and avoid focusing on transactional business. In addition, these professionals need to fully understand their facility and case volume. Studies have indicated that a lack of adequate par levels of equipment can lead to higher repairs because the products have to be turned over more frequently. Hart: As much as possible! These professionals need to understand their service provider’s repair methodology. What is their engineering process and repair process? What other value is the vendor providing to the end users? Inventory

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control analysis, department evaluations, preventative maintenance inspections, in-servicing and data analytics should all be provided by the vendor to the end user. The professionals should expect their vendor of choice to be a true partner in managing this portion of their business.

Lee Ann Purtell, Captial Medical Resources Purtell: While visual inspections remain the most important inspection step, staff are often challenged with lack of tools and expertise to fully validate the complete scope system, resulting in uncertainty and the increased risk of faulty or unsafe equipment making their way into the surgical rotation. Often overlooked are the inspection of the distal, internal optics, and lighting pathway, that can affect the performance and safety of the equipment. Regular validation, and the ability to troubleshoot the opto-mechanical systems will result in fewer end-user complaints, reduce repairs, and will maintain your equipment investment in top form for safe and effective use. Biomed, clinical engineers and sterile processing personnel can benefit from a scope inspection “station” that includes the ability to inspect and measure image quality, measure light output and document damage. Compliance requirements from regulatory bodies such as Centers for Medicare & Medicaid and The Joint Commission, and even manufacturer IFUs, suggest routine inspection and documentation of equipment inventory. Maintaining a written equipment inventory that includes incident history and documentation of preventive maintenance are two key components of a good equipment maintenance plan and can help you meet regulatory demands. Stem: HTM professionals need to know they are working with a partner that provides a quality product, an OEM matched warranty and the highest level of liability insurance. Service paperwork should be discussed as well. Repairs and purchased equipment should arrive with OEM specifications listed and image quality in a photo printed; all signed off with technician initials with the current date. Most health care facilities are comfortable with the ISO option and enjoy the deep discounts, friendly customer experience and quick turn-around versus the OEM.

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here are times when you need to put a fine point on a pencil and times when you need to put a fine point on a confusing issue because a part of it remains cloudy or unclear. Much like the Internal Revenue Code, that voluminous collection of rules and regulations that require interpretation by CPAs and tax attorneys, the rules in the health care setting are extensive. When it comes to ensuring the public’s safety, there has been a concerted effort to get it right and not overlook anything. As HTM professionals have sought to comply with evolving rules and regulations, some areas have remained vague, requiring clarification, and other areas beg for national standards.

There have been two parallel discussions that have existed for several years; frequency of preventative maintenance (PM) and completion rate requirements. With The Joint Commission’s new standard that became effective in January, the question of completion rates has effectively been put to bed. Most remaining questions about the standard concern devices in use and devices not located.

few lingering uncertainties remained. Unlike the legal profession, where settled law describes a rule or doctrine that is clearly established, there is no settled equipment maintenance rule or doctrine that every CE department follows. Despite the lack of a national standard template for every AEM program, the requirements for scheduled maintenance have become more straightforward and clear.

real need for frequent attention to devices that don’t require it and the available resources for carrying out this routine preventative maintenance. In the same way that CPAs and tax attorneys occasionally have to ask the IRS for their opinion on a specific point in a “private letter ruling,” the HTM community asked TJC for some clarification on the revised CMS requirement.

“Despite the lack of a national standard template for every AEM program, the requirements for scheduled maintenance have become more straightforward and clear.” In 2010, The Joint Commission (TJC) and the Centers for Medicare and Medicaid Services (CMS) met. CMS asked that TJC surveyors scrutinize the effectiveness of maintenance strategies more closely. The discussion continued past 2011 and questions about the frequency of PMs, approaches to alternative equipment maintenance (AEM) programs and putting a fine point on a

SETTING THE RECORD STRAIGHT CMS made a pronouncement that rattled the HTM community in 2011 by stating that AEM methods were not permitted. Maintenance frequency for high risk and any new equipment had to follow manufacturer recommended maintenance schedules. There was an immediate call from the HTM community for some clarification on the rule, in light of the

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Additional revisions followed in 2013 and 2014 and requirements were laid out for AEM programs. Change was afoot again in January of this year, when a new standard went into effect. In an attempt to address concerns, The Joint Commission’s George Mills, MBA, FASHE, CEM, CHFM, CHSP, director of the Department of Engineering at The Joint Commission and Stephen Grimes, FACCE, FHIMSS,

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FAIMBE, managing partner and principal consultant for Strategic Healthcare Technology Associates LLC, gave a webinar presentation to about 1,000 members of the HTM community in January. The webinar “Clarifying the Changes to Joint Commission and CMS Standards,” is available online at university.aami.org/diweb/catalog/item/ id/1431777. According to an AAMI January 11 news article Mills said that the TJC has moved to a “much more aggressive, ‘see it-cite it’ practice.” Under the new

or not it achieves this threshold will depend on the approach utilized and the effort to document everything. The only exceptions for scheduled maintenance would be equipment/ devices that are included in your AEM inventory, but are in use or not found. Equipment that is being used for a patient will need to be documented as such and tagged for later maintenance. Equipment that can’t be located should go through a process of discovery. These two areas have produced many of the remaining questions.

requesting they notify HTM when it is no longer in-use or has been found. Policies/procedures should also provide that periodic area ‘sweeps’ by HTM personnel include searching for previously unavailable equipment and conducting any overdue maintenance,” Grimes adds. Now, this topic can be put to bed and biomeds can do their job giving attention to the right devices, at the right intervals or supporting an AEM program that is based on a tried and trusted model – except the industry is not there yet.

“Hospitals should establish policies that account for the likelihood that some equipment will not receive maintenance on schedule because it is either in-use or non-locatable.” – Stephen Grimes, FACCE, FHIMSS, FAIMBE

elements of performance (EPs), hospitals are expected to complete all planned maintenance activities in line with manufacturer recommendations or an alternative equipment management (AEM) program 100 percent of the time.” A SIMPLER APPROACH In reality, the January webinar presented by Mills and Grimes, through AAMI, answered most questions about the new standard. It made clear that there is an expectation that 100 percent of both high risk and non-high risk medical equipment should be included in scheduled maintenance. The frequency of non-high risk maintenance can be determined by an AEM program. But, that AEM program must stand up to scrutiny. It must be defensible – whether

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“Any equipment scheduled for routine maintenance but unavailable for that maintenance either because it is in-use or non-locatable should not be factored in meeting a ‘100 percent completion rate.’ However hospitals should establish policies that account for the likelihood that some equipment will not receive maintenance on schedule because it is either in-use or non-locatable,” Grimes explains. “Those policies and associated procedures should provide methods for determining when equipment becomes available and for completing scheduled maintenance on the available equipment previously missed,” he says. “Previously unavailable equipment may be found by informing operators and department owners of any equipment that was unavailable and

There are lingering questions still being asked. Some of those questions have shown up on the TechNation listserv and members of the HTM community are helping each other understand the new requirements. Often it is webinar attendees helping those who did not attend. A key takeaway after the January 9 TJC release, and the anticipated HTM community response is: “Know and conservatively interpret the latest CMS and TJC requirements. Ensure that relevant policies and procedures are logical, consistent and thorough and that staff practices and documentation adhere to those policies/ procedures,” Grimes says. The good news is that TJC has streamlined and simplified some components of some standards that

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were deemed too complex by the organization.

that is not defensible. You’re responding to a lack of resources, but you are not telling me that the DEFENSIBLE AEM PROGRAM equipment is going to be safe and Can you defend your AEM program reliable and that it is the right and it’s precepts, assumptions and decision to make,” Mills explains. conclusions? Mills has stated that an “However, if leadership came to AEM program that deviates from a you and said, ‘you have to cut three manufacturer’s recommendations FTEs’ and you said, ‘let me reshould be “defensible” when put to evaluate my distribution of my the test. If a biomed department can workload,’ and then you started choose from metered maintenance, applying some of the strategies of corrective maintenance, interReliability Center Maintenace val-based maintenance, reliabili(RCM) or others, then you said, I ty-centered maintenance or prediccan actually extend these PMs out tive maintenance, then the number safely, based on my history or my of variables becomes very large data or things that would be without a national standard. showing you that, then you are able “Developing a ‘defensible’ AEM to move that way, but it’s approach toward maintenance of a defensible,” he adds. particular device category requires Mills points out that the that HTM verify that the risk (i.e., difference is that with one, you are severity and probability) of just reacting and you don’t have an maintenance-related failure is assurance that it is the right sufficiently low that at least some of decision, versus making a resource the manufacturers’ recommended allocation based on, “yes, it’s activities and/or frequencies can defendable, it makes sense; it’s a reasonably be modified without good thing to do,” he says. significantly impacting patient Grimes adds that this scenario safety,” Grimes says. will also require coordination and “Ensuring that the AEM communication with leadership. program is defensible also requires “HTM must understand that – George Mills, MBA, FASHE, CEM, CHFM, CHSP HTM to periodically review the hospital HTM services are expected maintenance history of devices that to know what resources are needed have been placed in the AEM program approach this situation in light of to ensure compliance with all relevant and confirm they can remain in the updated requirements? regulations and that it is HTM’s program because there has been no “If I have short resources, and I know responsibility to inform the hospital’s significant increase in maintenancethat there are techniques available that leadership of the level of resources related failures,” he says. can make me really look at the allocation needed,” Grimes says. One of the challenges that many of my resources, I can apply that strategy “These resources will likely involve HTM departments have experienced hopefully to be able to say that I don’t some combination of in-house HTM recently is the retirement of baby-boom have to do the work to help me with my staff, service training, continuing generation biomeds. This reduction in shortened resources,” Mills says. education programs, test equipment staff and/or a less experienced “If I just said, ‘leadership has come and facilities, vendors services, etc. workforce creates challenges when it to me and said I would be cutting three HTM may be judged based on how comes to meeting the new standards. of my staff so I had to move all of my well a properly resourced service is How should HTM management PMs from quarterly to semi-annually,’ managed to achieve compliance. But it

“If I have short resources, and I know that there are

techniques available that

can make me really look at

the allocation of my resources, I can apply that strategy

hopefully to be able to say that I don’t have to do the work to help me with my shortened resources,”

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is the hospital leadership that will be judged responsible by regulators and accrediting organizations if, after being adequately informed, they fail to provide those resources necessary for compliance.”

found in the TJC newsletter Perspectives as well as in articles and presentations given by TJC staff,” Grimes says. “Hospitals should be well versed with the most recent CMS requirements and the standards associated with their accrediting organization. Hospitals should not only have a process that ensures continual updating of hospital policies, procedures and practices to

QUESTIONS REMAIN Some questions were answered in a Q&A session during recent webinars, but some are more specific and have been brought up in online forums, on the TechNation listserv and on social media sites. One of those questions asked: When a hospital’s EOC committee is updating its guidelines, do they wait for a strict interpretation from CMS or is the standard clear currently? For example, if 95 percent of PMs on NHR devices is the hospital’s policy; will this fly? “Technically CMS requirements take effect ‘upon issuance’ by CMS (i.e., immediately) and the most recent hospital equipment maintenance standards were published on December 20, 2013 (Ref: S&C: 14-07-Hospital). Updated TJC Environment of Care standards – those modified to align with new CMS requirements take – Stephen Grimes, FACCE, FHIMSS, FAIMBE place – were first published in July 2014 and additional EC revisions were published in January 2017 following some changes in reflect compliance with the latest TJC’s accrediting process,” Grimes says. requirements/standards but also should “Note that the January 2017 print ensure staff are sufficiently educated and online versions of the hospital about the updates and that they act accreditation manual do not reflect the consistently with those practices,” actual current (enforced) versions of Grimes says. EC.02.04.01 EP 4, EC.02.04.03 EP 2, Grimes points out that current CMS and EC.02.04.03 EP 3. The corrected requirements are for hospitals to language for these three EPs can be “strictly” adhere to manufacturer

recommendations or to their AEM policy requirements for scheduled maintenance activities and frequencies. “In its latest standards, TJC interprets CMS’s strictly adhere requirement as a ‘100 percent completion rate’ for all equipment regardless of whether it is high-risk, non-high-risk, manufacturer’s recommended maintenance or AEM,” he says AEM APPROACHES As mentioned earlier, there are a number of approaches to managing an AEM program and evaluating the best maintenance schedule for each device. Questions have arisen about devices that don’t have enough documented maintenance history. Will there be a national database that will be useful to all biomeds when using an approach that requires this big data? “Industry experts define risk as a function of both the severity of consequence (e.g., serious to negligible impact on people, assets, etc.) and the probability of a failure (e.g., frequently, sporadically, rarely),” Grimes says. “When considering the probability of failures related to maintenance or the lack thereof, examining maintenance history for an equipment category is one of the better predictors of future probability of maintenance-related failures,” he adds. He goes on to say that an organization can determine what is a sufficient maintenance history through statistical analysis. It would be necessary to have enough maintenance history and an adequate number of “device-years” to

“When considering the probability

of failures related to maintenance or

the lack thereof, examining maintenance history for an equipment category is one of the better predictors of future probability of maintenancerelated failures.”

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InfoView

STILL HAVE QUESTIONS? Mills suggests that HTM professionals with questions visit The Joint Commission website (jointcommission.org). The website suggests: “If you have access to The Joint Commission Connect, login and go to Resources-Standards Interpretation to submit your question. If you accessed this page via ResourcesStandards Interpretation, close your browser and submit your question.”

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

HEIGHT 9.75”

calculate the history on each device. When this data is not available, there are other avenues. “Organizations do not have to rely solely on their own maintenance histories when determining probability of maintenance-related failures,” Grimes says. If available, they can use maintenance histories from groups of hospitals, from independent service organizations (ISOs), from manufacturers or from other reputable sources (e.g., ECRI, AAMI, etc.). AAMI has established a Reliability Center Maintenance (RCM) task force that is in the process of collecting and analyzing maintenance histories from a large group of hospitals and this could serve as an appropriate source of such histories sometime in the future,” Grimes adds. Evidence-based maintenance has been evaluated by a number of people in the HTM community. In a 2011 TechNation cover story, it was stated that more people are considering “maintenance effectiveness” and that, starting a few years before that time, they had begun engaging in a grassroots effort through their own internal studies. Because of this, the approach has amassed some big data. Predictive maintenance can save money and downtime, and more specifically targeted predictive maintenance, can pinpoint exactly what will need to be replaced and when. This is achieved through predictive analytics. Done correctly, it removes any guesswork. This is about proactively fixing a problem before it occurs. Knowing what is most likely to fail allows for the stockpiling of the right parts. Cost benefit analysis is made easier and maintenance schedules can be adjusted to make the best use of available resources. Much of this is achieved through the learning systems on devices.

To schedule a free demo, call 978-659-7127 For a brief overview, visit Philips InfoView at www.philips.com/mvs

APRIL 2017

TECHNATION

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C O M E G RO W WIT H US Build Your Career at Crothall Healthcare Technology Solutions H O W FA R CAN YOU GO? Career opportunities abound when you are part of a growing Team. Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years. With growth comes new jobs and new opportunities.

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APRIL 2017

TECHNATION

EXPERT ADVICE

BY CINDY STEPHENS

CAREER CENTER Professional Memberships Matter

n every profession, there are opportunities to join specialized organizations or associations to advance your career through professional development and networking to learn about industry trends, utilize career resources, and even hear first about job openings.

We believe joining a professional association or organization is one of the best things you can do for your career. No matter what your career field is, you want to remain relevant and be known as a person who is “connected” in your career field. Of course, there are numerous ways to accomplish this, such as professional trade journals and networking with your peers. However, the best way to draw on all of the resources possible is to join a professional association. Too often, joining an association is a low priority, whether it is because of the daily responsibilities that a person is managing or that a person feels they just do not have time for any more commitments. However, by not joining, a person may miss out on the many benefits that a membership in a professional association offers. There are many associations with a local chapter or national trade organization where you will make valuable professional contacts, and have access to a wealth of useful information and resources. The following are some of the many benefits of a professional association membership. PROFESSIONAL DEVELOPMENT & EDUCATION Professional development might be the most obvious because it is one of the most important. Many associations offer

TECHNATION

APRIL 2017

members the opportunity to update their knowledge or acquire new skills through seminars, workshops, and conferences, as well as often offering courses and online training to keep members up-to-date on the latest industry trends. Joining a professional organization enhances and opens doors for your educational opportunities through professional development conferences with industry-related trade shows and facilitated networking opportunities. These training opportunities put you one step ahead of the competition. CINDY STEPHENS

DEVELOP LEADERSHIP SKILLS Professional associations also give you an opportunity to develop or improve your skills as a leader. This is important not only for your personal development, but for your progression in your firm. You can develop or improve these skills by speaking at industry events, or by answering questions or contributing content to the group’s newsletter or discussion forums. By establishing yourself as a trusted and respected addition to the group of industry leaders, you become a stronger leader in your field that will help you achieve your professional goals.

and brainstorm with others who are looking to share and learn new information. Another benefit of enhancing your network is that you may find a mentor to help you with your professional needs, or you can become a mentor. Participating in forums, chat groups, or discussion boards sponsored by the association is a great way to grow your network and enhance your professional skills. Networking is also a great way to meet new people and build a long-lasting network of friends who share common professional interests.

NETWORKING AND SOCIALIZING There are endless networking opportunities in professional organizations. Numerous events are sponsored by many associations throughout the year that allow you to connect with your peers where you can share ideas, ask for advice, volunteer to be a speaker, or even become a member of a committee. You also have opportunities to learn about “best practices” or new ideas, hear about key achievers in your field,

INDUSTRY UPDATES Your membership privileges usually include trade journals, magazines, and newsletter access which provides a wealth of information on the latest industry’s trends, equipment updates, and news. Most associations also provide access to unlimited resource information such as articles, books or white papers, case studies, or updates from certification commissions and other critical organizations to your

Stephens International Recruiting, Inc.

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EXPERT ADVICE

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career field. This information is vital to keep you up-to-date and relevant in your current position and throughout your career. CERTIFICATION Another important reason to consider membership to a professional association is to take advantage of its seminars, training or certification classes and resources. Often these classes can be done through web-based training, podcasts and training CDs so you don’t even have to leave your home.

VOLUNTEERING Professional associations support many community fundraising initiatives, whether it is a food drive or a fun run for a local charity. Volunteer and enjoy representing your association while supporting a great local charity. Bring the family and make a day of it. EMPLOYERS BENEFIT, TOO Professional memberships are important for the employee and the employer. There are quite a few reasons why. Most employers have a professional develop-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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JOB OPPORTUNITIES & CAREER RESOURCES Associations often have job listings available to their members. It is a great way to find targeted job postings for your area. Additionally, many associations have career resources available such as tips on effective resumes or cover letters, job searching strategies, and negotiating techniques. Don’t forget, listing your association membership on your resume is impressive to current and future employers as it shows that you are dedicated to your career and staying connected in your professional career field.

ment plan with company-paid benefits for training, conferences, and continuing education. Investing in employees’ continued professional development improves morale and the company’s bottom line. Through these efforts, employees become more competent, capable, and confident in themselves and their work. In turn, performance improves and productivity increases. These company-paid benefits demonstrate a commitment to employees and to their professional development. It fosters a culture of the company investing and supporting their employees, motivating their staff through achievement and recognition. This often leads to advancement within the organization. Increased employee job satisfaction results in reduced turnover; therefore, positively effecting retention. The word soon gets out, building a positive reputation that this is an employer who cares about its employees and strives to employ only the best. The company is then recognized as a great company to work for and the organization soon attracts better candidates. Whether you are looking for professional development, learning about job opportunities, gaining access to current technical information, or just meeting new people, joining a professional association is a step in the right direction! Being a member of a professional association is beneficial for your professional development and the future of your career. Your dedication for professional development and your desire to remain up-to-date with industry trends can be demonstrated through membership in a professional association or organization.

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APRIL 2017

TECHNATION

EXPERT ADVICE

BY ERASMO SANCHEZ

ULTRASOUND TECH EXPERT