1technation.com
Vol. 8
EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL
MAY 2017
20 Mickie Wong
So Much to Treasure
38 Biomed Education
Who Will Teach the Next Generation
56 Roundtable
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94 AAMI Preview
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56 62
TECHNATION: ADVANCING BIOMEDICAL / HTM PROFESSIONALS
56
HE ROUNDTABLE: IV PUMPS T HTM professionals are no stranger to IV pumps. Preventative maintenance requirements and high demand for these devices keep them on the minds of all biomeds from the newest hire to department leaders. TechNation reached out to a industry insiders to find out more about IV pumps, including how to extend the life of these devices.
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A LOOK AT THE GROWTH OF THIRD-PARTY SERVICE PROVIDERS Third-party parts and service providers continue to have an impact in the world of Healthcare Technology management. We look at the growing popularity of third-party options and how different HTM departments are creating a blend of services to fit their unique needs. Next month’s Feature article: State of the Industry: TechNation Survey Results
Next month’s Roundtable article: Test Equipment (Imaging) TechNation (Vol. 8, Issue #5) May 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.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
MAY 2017
TECHNATION
9
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 Jena Mattison
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: Roger Streidl p.16 Company Showcase: RepairMED p.18 Department of the Month: The Christ Hospital Health Network Clinical Engineering Department p.20 Mickie Wong p.24 Biomed Adventures: Service Engineer Visits Germany p.26 Company Showcase: Select Biomedical P.31 INDUSTRY UPDATES p.31 News and Notes: Updates from the HTM Industry p.36 ECRI Institute Update p.38 Biomed Education P.43 p.43 p.46 p.48 p.52
THE BENCH Shop Talk Tools of the Trade Biomed 101 Webinar Wednesday
P.70 p.70 p.72 p.74 p.76 p.79 p.82 p.84 p.86
EXPERT ADVICE Career Center Ultrasound Tech Expert Sponsored by Conquest Imaging Tech Savvy Thought Leader Product Management for HTM The Future Tech Knowledge Sodexo Insights Sponsored by Sodexo
P.88 BREAKROOM p.88 Did You Know? p.90 The Vault p.92 Bulletin Board p.102 Index
MD Publishing / TechNation Magazine 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com
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MAY 2017
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It’s the Thrill that Makes Us Forget Everything Else At five years old, I knew I wanted to be an engineer, building rocket ships and satellites. Just after college I lived my childhood dream of working as an electronics engineer building or improving electrical trains, micro-electronics, and ultimately designing and testing satellites. I’ve also had the privilege to work as a software, hardware and mechanical engineer, improving different aspects of our world. Now, at Conquest Imaging, I am doing some of my most important work. I lead a team of 12 research and development technicians with one mission: find ways to do what we do best so more people have access to accurate diagnoses and better, affordable health care. By analyzing and researching all aspects of the product and creating new processes for improving performance, we are improving our methods and extending life cycles on systems. By extending the life of imaging systems we enable health care providers to lower costs while increasing ROI and patient satisfaction. Our team earned ISO 9001:2008 certification, meaning we passed the most rigorous quality assurance requirements worldwide. We achieved this through our Quality Assurance 360 program which covers multi-point inspections and analytics for every product we recondition and sell. As an engineer that wants to give back to others, I chose to be a Conquest Imaging engineer because it gives me the ability to change lives. And doing so changes mine for the better.
I am Antonio Morales, Senior Research and Development Engineer for Conquest Imaging, and this is what drives me:
“I do not think there is any thrill that can go through the human heart like that felt by the inventor as he sees some creation of the brain unfolding to success . . . Such emotions make a man forget food, sleep, friends, love, everything. – Nikola Tesla
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SPOTLIGHT
PROFESSIONAL OF THE MONTH Roger Streidl, CBET BY K. RICHARD DOUGLAS
J
ust outside of Dayton, Ohio is the suburban community of Beavercreek. It is the largest city in Greene County and offers a cross section of shopping, restaurants and recreation.
The health care needs of the area are served through the Indu and Raj Soin Medical Center, which opened its doors to patients in 2012 and is part of the Kettering Health Network. Roger Streidl, CBET, is a biomedical equipment specialist at the Soin Medical Center in the facility’s biomedical engineering department. “I had a family friend that went through the biomedical electronics program at Kettering College, and it sounded very interesting to me,” he says. “I was interested in something in the medical field and I thought it would be interesting and challenging to work on medical equipment.” He attended Kettering College of Medical Arts in Kettering, Ohio right after graduating from high school in 1983 and graduated from the Kettering program in 1985. “The last semester of college was clinical time spent at different hospitals in the Dayton area, and one of them was at St. Elizabeth which was a 600-bed hospital. They had an opening, and they hired me as soon as I completed the last semester,” Streidl says. “I worked there for 15 years until the hospital closed in 2000, and I had worked my way up to department manager at that point. I was contracted to help liquidate the medical
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Roger Streidl, CBET equipment which took over a year.” Beyond that initial biomed training at Kettering College, Streidl has invested extensive time in training and keeping up-to-date on industry practices. “I worked for a year for Anderson Medical, [in] Milford, Ohio, which was a company that bought and sold used equipment and offered biomed services to surgical centers and other outpatient centers. I spent three years working for Signature Medical in Dayton, Ohio, whose primary service was servicing sterilization equipment, but with my biomed background, they could offer biomed service to outpatient centers,” Streidl adds. In 2005, Streidl moved back into the hospital environment and started working at Grandview Hospital in Dayton, Ohio, which was part of the Kettering Health Network. “In 2011, I transferred to a new hospital in our network that was just getting ready to open, Soin Medical Center, which is where I currently work,” he says.
Streidl has been fortunate to have his training enhanced through participation in numerous service schools. Some of the service seminars he has attended in recent years include Drager Apollo Anesthesia, Fabius Family Anesthesia and V500/C500 ventilators, Medtronic/ Covidien PB840 ventilators, Philips V60 ventilators, Baxter Prismaflex dialysis machines, Cook medical laser, Medgraphics pulmonary function testing system, Philips Intellivue monitors/Philips PIIC iX central monitors/Philips PIIC Classic Central monitors/Philips Telemetry ITS, Philips Epiq ultrasound machines and GE Panda/Giraffe infant warmers. More training can mean fewer service contracts. “I feel fortunate that my employer has invested in training me for all these devices, but at the same time I feel that it has saved them money in the long run,” Streidl says. BUILDING UP AND TAKING APART Asked about challenges on the job, Streidl reflects on the large task of closing and opening a facility. “It was kind of a ying and yang situation to close down a hospital and then be responsible to open one up,” he says. “Especially in today’s EMR connectivity environment, and then being part of a seven-hospital network and tying into existing systems, it was a big project to get off the ground.” When Streidl was faced with opening the new facility, he was the only biomed onsite. Department managers were not available prior to the opening which left
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SPOTLIGHT
FAVORITE BOOK: “Bourne Identity”
FAVORITE MOVIE: “Fast and Furious”
FAVORITE FOOD: Italian
HIDDEN TALENT: Smoking meats
FAVORITE PART OF BEING A BIOMED:
“I enjoy working in the biomed field as there are always new challenges and opportunities to learn – which keep it interesting.”
WHAT’S ON MY BENCH • • • • • •
A cup of coffee My computer Some rock music playing Trusty tool bag Telephone Vocera
Roger Streidl, CBET, checks a patient monitor at the Soin Medical Center
him without a decision maker to consult. “There was a limited time frame to get the equipment unboxed, inventoried, inspected, configured and ready for use,” Streidl recounts. “Some of the equipment was installed by the OEM vendors, but there was still time spent scheduling it and taking care of all the logistics once they were onsite. Imaging equipment needed PACS and network information configured, or passed along to the OEM reps to configure it. Applications training on the equipment for the staff had to be coordinated, which I assisted with,” he adds. “Once we opened, even though the staff had gone through applications training, there was definitely a learning curve with the equipment. There were staff from all different backgrounds and there were no ‘experts’ in the units as you would typically find in an existing hospital.
So, there was a lot of clinical support that needed to be provided early on with the equipment,” he adds. On the flip side, shutting down a hospital was another project that proved to be a challenge. The hospital was a 600-bed, 1 million square foot facility. “I was contracted by a liquidation company. Initially I gave tours to buyers that would prospectively buy the equipment as a lot, so there was a lot of walking,” Streidl says “The challenges were a lot of buyers wanted to cherry pick the high-end items that could easily be resold, but the more common or older equipment was harder to sell.” “What eventually ended up happening was a local hospital bought the majority of the equipment that hadn’t been sold and a used medical equipment remarketing company then came in and sold off the remainder. I was involved with the process for over a
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
year, and the process was still ongoing when I left. It was hard to see a facility, that you worked at for 15 years, be picked to the bone,” Streidl adds. AWAY FROM WORK Off the job, Streidl enjoys some of the simpler things in life. “I enjoy anything to do with cars, especially my 1995 Toyota Supra; working with our horses and hiking,” he says. “I have two children, Seth and Shelby, and my significant other; Kim.” Like so many biomeds, Streidl is dedicated to his profession and his role in the hospital. “I’m very passionate about my job and enjoy working in the hospital environment. I take pride in the work that I do and take every effort to represent the biomedical engineering department in a positive way every day,” he says.
MAY 2017
TECHNATION
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE R
epairMED (Image Quest Inc. dba RepairMED) is a leader in component-level depot repair capabilities that provides biomedical services to health care facilities, medical equipment resellers, and independent service organizations of various sizes. The company has brought together innovative and proprietary technical expertise from the high-tech industries of electronic manufacturing, aeronautics, biomedical engineering and military applications to take the repair of medical equipment to the next level in quality, turn-around, service and cost-reduction.
Geddes: RepairMED is a small but very capable company focused on cost-effective true depot repair for biomedical devices. We have strong research and development capabilities. We have engineers with long-term component level engineering backgrounds. We are able to keep our operational cost to a minimum, thereby allowing us to position our offerings aggressively in the marketplace.
RepairMED’s services include the most comprehensive and cost-effective flat rate pricing in the industry with a no-hassle warranty on all repairs. RepairMED also offers committed one-stop and cost-plus contracted flat rate pricing to customers who wish to create the most efficient and cost-effective service model for all their biomedical depot repairs. TechNation interviewed RepairMED CEO Diane Geddes to find out more about the company.
Q: Can you tell us about your company’s history and how you achieved success? Geddes: Having worked many years with a host of companies in the HTM industry, I have experienced first-hand the effect of corporate acquisitions and divestitures on not only the employees that made those companies successful, but also the health care institutions they serve. In 2013, having experienced another turn of events from a corporate direction, I knew it was time to take a step back and consider alternatives. For several years, I had been keenly aware and interested in bringing true depot repair options for biomedical devices to the third-party market. At the same
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Q: What are some challenges that your company faced last year? DIANE GEDDES CEO at RepairMED
time I was considering alternatives for a career path in HTM, a group of highly skilled component level engineers I knew were also looking to provide depot repairs to this market. They needed a partner to facilitate making that happen. Fortunately, the timing was right. We knew we had unique, expert skill sets, experience, and the devotion to bring a good product to the industry.
Q: What are some advantages that your company has over the competition?
Geddes: With any small company, growth always brings challenges in supporting the opportunity, without over extending or over forecasting. I believe staying grounded and credible is key in managing and leading an exciting young company. Listening to customers, staying connected to the HTM industry, and being involved on a daily level has really helped us grow, and continues to help us learn where we can be of value as a company and partner in this industry.
Q: Can you share your company’s core competencies and unique selling points? Geddes: RepairMED’s operation is
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SPOTLIGHT
“ RepairMED is a small but very capable company focused on cost-effective true depot repair for biomedical devices. ... We are able to keep our operational cost to a minimum, thereby allowing us to position our offerings aggressively in the marketplace.” modeled through the ISO 9001 Quality Management System. Our technicians are factory trained and hold various technical and electro mechanical degrees. With a combined 30-plus years of experience, our technicians are capable of troubleshooting complex issues down to the board level. Also, we have established good relationships with various suppliers of components and parts not available from the OEM.
Q: What product or service that your company offers are you most excited about right now? Geddes: RepairMED is in the process of obtaining an ISO certification. As an ISO certified company, we will be able to cater to the repair needs of various medical institutions in the country ensuring the integrity of the products and services provided.
Q: What is on the horizon for your company? Geddes: RepairMED is constantly looking for new opportunities that will allow us to expand our service offerings, and support the HTM industry across a broader spectrum. We look forward to launching new service offerings as we go into the next quarter of this year.
Q: Has RepairMED ever “saved the day” for a customer? Geddes: We have numerous stories that we could share, but primarily the message to customers is that RepairMED is very consultative. If there is a challenge or a struggle to find the right solution for a piece of equipment that involves electronics, chances are we can provide a very strong alternative option.
Q: Can you tell me about your employees?
customer support staff. Our employees are dedicated, goal-oriented people who are excited to be part of the HTM industry.
Q: What is most important to you about the way you do business? Geddes: Integrity, plain and simple. I want customers to know, without a doubt, that RepairMED is a company founded on integrity. It’s crucial for customers to see for themselves that we are highly competent and experience our dedication to integrity.
Q: Is there anything else you want readers to know about RepairMED? Geddes: I would encourage the biomed community to reach out to us and get to know us. RepairMED is committed and passionate about supporting the needs of the HTM industry, and the health care community we serve! FOR MORE INFORMATION, visit www.repairmed.net or call 855-813-8100.
Geddes: RepairMED’s staff consist of highly skilled and experienced engineers, as well as a wonderful
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
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SPOTLIGHT
DEPARTMENT PROFILE The Christ Hospital Health Network Clinical Engineering Department BY K. RICHARD DOUGLAS
I
n the greater Cincinnati area, the Christ Hospital Health Network has been treating patients for 125 years. The main hospital campus, Christ Hospital, is located in the Mt. Auburn district of Cincinnati. The hospital has been nationally ranked by U.S. News and World Report among large metro hospitals. It has also been awarded Magnet recognition for nursing excellence.
The hospital’s clinical engineering team lives up to their health network’s stellar reputation. The department began in October of 1979 and was briefly outsourced for a few years. Now it is back to an in-house model and the group has submitted a request to change the name of their department from Clinical Engineering to the contemporary moniker Healthcare Technology Management (HTM). “The Christ Hospital Health Network (TCHHN) consist of the main hospital, 555 beds not-for-profit acute care facility; one Medical Office Building; seven Ambulatory Outpatient Centers (AOC); two Surgical Centers; one Urgent Care; and with a new hospital/medical center slated to open in 2018,” says Gregory Herr, MBA, CCE, CHTM, director of clinical engineering. Herr’s department also consists of two managers, one supervisor, one biomedical lead (senior), three CVIS, four CE-IT biomeds, 13 biomeds (including two co-ops), six imaging specialists and a business operations supervisor. The manager of CVIS/CE-IT/vascular tech is Douglas Wolff, BSEET, MIS. Janell Conner, BSBME is the manager of clinical engineering. Megan Haussler, BS, is the supervisor of Business Operations. The department reports to the Executive Director, Shared Clinical Services and Indirectly to the Chief Operating Officer.
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“ We encourage and try to develop a close working relationship with IT, and depend on them for key services. HTM calls going to IT help desk get referred to HTM, as well as IT calls to HTM.” CMMS is used for data collection. “All service events, purchase order, purchase price, warranty and contact information, and technician hours are documented,” Herr says. “Reports, documentation for Joint Commission, Ohio Department of Health, etcetera are reported out of this CMMS.” Each BMET/specialist has a tablet or laptop, which they carry whenever possible. “Documentation is started with the call to the dispatch line and completed by the assigned person,” Herr adds. One of the unique features of the department is its cutting edge internal IT sub-team. Herr points out that the
group is part of clinical engineering, and is separated from the organization’s IT department. “This CE-IT team covers the gray area between what is traditional in CE’s realm and IT’s realm. CE-IT is staffed with clinicians and engineers that have years of clinical experience but whom are also IT and tech savvy and are the liaisons between clinical staff, IT supporting clinical informatics systems, and device integration with Epic,” he says. “However, our CE-IT team integrates with the hospital’s IT department in regards to computer owned hardware, hospital switches, and hospital interfaces. We encourage and try to develop a close working relationship with IT, and depend on them for key services. HTM calls going to IT help desk get referred to HTM, as well as IT calls to HTM,” Herr adds. PROJECT FOCUSED Responsible for an inventory of 22,393 assets, the department was “reinvented,” in Herr’s words, in 2012 when it was brought back in-house and resources for imaging and CE-IT were developed to minimize contracts. CVIS had been in-house all along. The department handles budgeting and the managing of service contracts for medical devices. “CE has two cost centers; one for hospital division and another cost center for physician division,” Herr says. “Contracts are aligned in these two groups based on ownership.” The group has had its collective hands full the past few years with a number of projects.
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SPOTLIGHT
The Christ Hospital Health Network Clinical Engineering Department is responsible for more than 20,00 assets.
“Since 2012, four Ambulatory Care Centers have been built, with CT, MRI, ultrasound, echo/vasc, cardiac, nuclear, digital rad, and mammo,” Herr says. “Each AOC has new physician offices either created or relocated. In 2015, a second outpatient surgery center was developed in one of the AOCs. HTM acted as equipment planner and (handled the) installation of systems. HTM works with IT each time the EMR is upgraded, to test and update interfaces/integration between systems. A new Joint Spine Center at the main hospital location was completed in 2015. Having its own in-patient beds, OR and central rooms, imaging center, outpatient physical rehab and more,” Herr adds. Herr says that the department acted in the capacity of equipment planners, coordinating purchase, installation and final check-off. And, he is already trying out the new proposed department label. “Each year projects to replace systems, or expand, are scheduled, e.g. oncology, ED, etcetera,” he says. Since 2012, when the department returned to an in-house service, the
inventory has increased from about 8,200 devices to over 27,300. In 2012, the Christ Hospital had two physician offices and today there are over 160. With some of these recent projects out of the way, the department got busy on a new set of projects in this current year. More recent projects included the replacement of defibrillator/monitors, vital sign monitor replacement and integration with EMR, replacement of 900 IV pumps and integration with EMR in the next year – this is a CE project and most of the services provided were from the clinical engineering team members. The team is also tackling enterprise replacement of ICU and moving telemetry monitoring systems to a new platform and an upgrade of eICU A/V servers. The rest of 2017 won’t offer much opportunity for putting on the brakes. “Currently, we are building another medical center/hospital to be opened in January 2018 and estimate another 2,200 devices. We also act as the equipment planner for the medical equipment in this project,” Herr says.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
The team also helps with the addition and on-boarding of three to five new physician practices a year. They have also assumed responsibility for UV-C cleaning robots and assisted radiology in bringing up dose monitoring system for CTs and have expanded the EKG system from cardiology to an enterprise system including physician offices. Resourcefulness and the newest technology allowed the department to comply with a recent Joint Commission request. Herr says that they “designed and 3D-printed an antenna grommet for the ceiling to comply with a Joint Commission request to close a 1/8-inch gap. Over 200 were printed.” The Christ Hospital Health Network Clinical Engineering Department certainly embodies their network’s tagline “Founded in Compassion. Driven by Excellence.” With a diverse skill set among it’s contingent, the department deserves to be recognized as “HTM,” as it continues to bring the evolution of HTM into its daily procedures and practices.
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SPOTLIGHT
MICKIE WONG So Much to Treasure
STAFF REPORTS
O
ne of the best decisions ProHealth Care HTM and Biomedical Engineering Manager Rob Bundick ever made was the day he hired Biomedical Equipment Parts Procurement Specialist Mickie Wong.
“Mickie has meant a lot to not only this department, but to ProHealth Care. She has been a valuable member of our team and will be missed by all of us,” Bundick said about Wong’s retirement. “Mickie was key in developing both our parts sourcing program and equipment disposition program. We would have had a difficult time achieving the success we have had without her.” A positive outlook and can-do attitude are just two of the qualities Wong brought to work with her on a daily basis. She radiated a feel-good karma that infects the rest of the HTM department creating a wonderful workplace for everyone. The positive vibe was an added bonus to Wong’s amazing work. She produced significant cost savings and fueled an efficient operation throughout an HTM department that covers approximately 15,000 pieces of medical equipment from patient monitors to diagnostic imaging devices. The department utilizes an equipment disposition process to improve how equipment can be redeployed, sold, traded-in, donated or salvaged. Wong helped the department fine-tune this process and create a number of avenues for the parts disposition process. Wong was the parts procurement specialist and was also in charge of equipment disposition. She looked at
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MICKIE WONG any equipment that was not being used in the organization and came to a conclusion about each piece in regards to redeploying it within the organization, if there is a need at another campus or at one of the health care system’s clinics. “She also looks at trade-in versus selling it,” Bundick said in a previous interview. “Sometimes when you are getting rid of a device, or replacing it with another device, or are offered a trade-in value from the company that we are purchasing the new equipment from, her job is to try to source it on the secondary market to see if we, as an organization, are better off selling it ourselves or trading it in to get the better value.” When there was not a trade-in, Wong considered selling equipment. The department has developed a workflow process with a centralized location for this equipment. Wong would create an inventory and the department would
send it out to buyers with pricing and the offer of purchase. They will then negotiate the price if there are multiple vendors involved. If she could not sell it or we redeploy it within the organization, she looked at other options, including using the device for parts to maintain other devices still within the organization. ProHealth Care Purchasing Director Tom Lindl, who serves as Bundick’s director, was impressed with Wong long before she set foot in one of the ProHealth Care facilities. “I first worked with Mickie in the early 1980s when she was a newly minted LPN (yet-to-be RN), and I was a purchasing manager. We both worked on the Product Evaluation Committee and even at that early time in her health care career she distinguished herself. Qualities and characteristics that she harnessed and refined over the years include tenacity, an unwavering focus on goals, a strong practical curiosity and interest in technology, a genuinely sweet manner of engaging with customers and co-workers, and a positive outlook,” Lindl said. Lindl left that organization only to cross paths with Wong a few years later. “In the mid-80s, I moved on to take a lead role in an emerging consulting firm,” Lindl said. “Several years later, Mickie joined the company working for one of my managers, and what a tremendous hiring decision he made when bringing Mickie on board! Mickie earned several roles over the years with that company, lead roles that included managing technical staff at customer locations around the United States; technical and business analysis and diverse self-starting
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SPOTLIGHT
management responsibilities. Now, that degree of tenacity, focus on goals, and the other characteristics … well, Mickie thrived during those years of professional challenge, and notably her manner of dealing with coworkers and customers remained true to her nature, her natural self – warm, genuine, welcoming.” Lindl changed jobs and left that organization to join ProHealth Care around 2007. “And one day, Rob Bundick presents me with his two semi-finalists for the newly created parts sourcing position, which was a critical hire. One of whom was incredibly over-qualified – Mickie! Unpredictable circumstances of life created this amazing coincidence, I’ve been blessed again to be working in the same place and focused on some of the same objectives with the very talented, accomplished and very nice Ms. Mickie Wong,” Lindle exclaimed. Wong’s decision to retire generates bittersweet feelings for her colleagues. They are happy for her, but she will be missed. “Mickie, I have appreciated your contributions to work over the course of your career, and have valued your uplifting disposition and effect on those around you including me! My very best wishes to you in every respect,” Lindl said. ROVED CHANGES NEEDED “Mickie Wong, so much to treasure,” he concluded. Deb Parkhurst will be taking over as Biomed Tech Procurement Specialist. She OFF: can be contacted at 262-928-4081 or via email at debra.parkhurst@phci.org. ONFIRM THAT THE FOLLOWING ARE CORRECT GO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR
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SPOTLIGHT
BIOMED ADVENTURES
Service Engineer Visits Germany
BY K. RICHARD DOUGLAS
F
rom the autobahn to great engineering, punctuality to soccer, Germany is a country that has beaconed travelers for decades. It’s the land of good beer, Octoberfest, bratwurst and lederhosen. Given a chance to visit, even for the purpose of training, is an opportunity that most would welcome.
That is exactly what Christopher Brown, a service engineer II with St. Bernard’s Medical Center in Jonesboro, Arkansas did. “My trip was for the Siemens Uroskop Omnia that we purchased as a urology surgical operating room. The training was mandatory for working on the Omnia system and some prerequisites were needed depending on the level of X-ray experience,” Brown says. “The first week of training was dedicated to learning the Siemens Flourospot Compact software. The software was designed specifically for Siemens and requires factory training to get permission to log into the system,” he says. “The main reason I ended up in Germany was because of Siemens Medical. Siemens does not offer this training outside of Germany, unless you have special permission from the factory. In fact, one of my instructors was planning his trip to China for a different class. Siemens does have a training center in the United States at Cary, North Carolina,” Brown adds. The class attracted biomeds from Sweden, France, Spain, South Korea, China, Austria, Canada, Germany, as well as the U.S. Brown learned that a common spoken language wasn’t always needed to interact during his coursework. “I was very impressed with the knowledge of the biomeds from around the world. I’m sure you know that English
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is the universal working language. So, each of the non-[English] speaking students had some level of English training and they were very well spoken. If you consider how we all troubleshoot problems, we all use schematics that are universal symbols as well. During the troubleshooting exercises, there were no language barriers, just teamwork, solving the problems,” Brown says. Brown says that the most impressive people at the Siemens training center were the instructors. He says that most of them spoke at least three languages and were very knowledgeable on all of the Siemens modalities. “Germany was a great experience from training to meeting people from around the world. The people were very friendly and even most of the locals spoke at least a little English. I did make most of them laugh when I tried to speak the few words I learned for the trip,” Brown says. “My training and hotel accommodations were both in Erlangen, Germany. The city was wonderful, with the community split into thirds, with one third being Siemens, one third the university and the last third the local housing,” he adds. TRAINING AND TOURISM As is the case with training courses or business trips overseas, there is often some time beyond the obligations of the trip to explore and get a sense of the
Frauenkirche, known as the “Church of Our Lady,” is in the middle of Nuremberg, Germany. Männleinlaufen, a mechanical clock that commemorates the Golden Bull of 1356, is activated at midday. People will gather and wait for the bells to ring followed by the trumpeters and drummers. The clock was so important to the people of Nuremberg, that they took it down during World War II and buried it hundreds of feet underground to make sure it wasn’t damaged.
culture and sights. Brown was able to partake in both. “I stayed in the NH Erlangen and thought it was nice, but a lot of things were missing since they were in the middle of remodeling. The hotel did not have an on-site laundry for guests, but they still made a commercial laundry service available,” he says. “The rooms were very nice and offered a nice place to relax. The workout room/gym and sauna areas were not available because of the remodel. The hotel was a little over a mile to the training center and not far from many key Erlangen attractions.” The tourist part of the trip included
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SPOTLIGHT
castles, historic churches and statues. Exercise was on the agenda also, although it was not part of a formal program. Brown got more than his fill of walking around Erlangen. “On the way to Nuremburg, we were delayed at the Frankfurt Airport for more than an hour and the rental company gave my car away to another person,” Brown recounts. “So, for the week of school, I literally walked to school in the snow. Lucky for me it was flat and not uphill both ways, but I had fun telling my kids the story.” Landing in a new culture can often bring some surprises or revelations, including things you were expecting and others you weren’t. Brown was really surprised at the degree to which the Germans engaged in walking and cycling. “In Erlangen, the sidewalks were wide with different colored sections for walkers and bikers. Also, in the older sections of town, sidewalks were reserved for only pedestrians so bike lanes were added to the roads. With everything being so close, it only made sense to walk if the weather permitted,” he says. He also noted the distinct dialects between different regions. “Every area of Germany knows the proper German, but no one speaks it,” Brown explains. “Each area has their own version and different words for the same things. We had three German people in class and they all spoke differently. Also, a student from Austria spoke another version of German that he learned growing up in school. Sometimes they would all discuss which words were used in certain situations.” Brown learned that the German people tend to be reserved at first until they get to know you. “If you are lucky enough to make friends with a German, you will have a friend for life,” he says. The timing of the training course did not coincide with a couple of events that attract tourists from near and far. “I missed the biggest events for the region. Nuremburg is famous for
The entrance gate door to the Imperial City is located between two Nuremburg Castles, Kaiserburg and Burggrafenburg.
“ If you are lucky enough to make friends with a German, you will have a friend for life.”
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Oktoberfest and Christkindlesmarkt,” Brown says. “Oktoberfest, the beer festival and fair, is now held during the last two weeks of September. Christkindlesmarkt is one of the largest Christmas markets in Germany and one of the most famous in the world. I was able to get a couple of Christkindlesmarkt cups as souvenirs for my kids to use for cocoa.” BACK IN THE STATES Brown has been an HTM professional since 1999. “Currently, I work as the biomed project leader and designer for new areas and remodeling along with X-ray and biomedical duties. We are building a new surgical and ICU tower and we
are expanding our cardiac cath lab areas,” Brown says. “I’m helping layout the patient monitoring and cath lab areas, before we start on our pediatric expansion. I still maintain the patient monitors and telemetry throughout the hospital. I also serve as the primary biomed for our Level 3 NICU,” he adds. Most days, he can be found working in the hospital completing repairs or doing preventative maintenance. The trip to Germany was a memorable adventure for Brown. And the training will be put to good use. And, as the German’s say: “Andere Länder, andere Sitten;” which translated means “Other countries, other customs.”
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE Biomedical
“F
rom a competitive standpoint, I would have to say Select Biomedical has been a disrupter in the marketplace,” CEO and President Tom Fischer said. “We have been fortunate to pick up on early trends and be a leader in providing custom-developed, end-to-end solutions to our customers as opposed to the traditional break/ fix model. We are continually flattered by how our competition copies our innovations – from advanced exchange programs to customer-focused online tools. Being out front in our competitive landscape is something Select will continue to invest in.”
TOM FISCHER CEO and President, Select Biomedical
The uptime of medical equipment is critical to health care facilities. The experts at Select know that doctors, nurses and other clinicians rely on HTM to make sure every piece of equipment and every medical device is running perfectly. HTM departments can depend on Select when something goes wrong or when they need an extra hand. The company’s expert technical team saves departments money in the maintenance of key acute care units in health care facilities, including pumps, patient monitors and other important equipment. Customer look to Select to be a long-term partner – regardless if they need parts, a fast repair, or refurbished pumps to complete a hospital expansion. Select works with each
customer to develop the right plan to make sure HTM professionals and their managers and directors are able to accomplish their important mission. Select also serves as an important partner for third-party companies supporting these critical medical team members. By remaining neutral in the marketplace when it comes to OEM preference, Select is able to maximize their strong relationships with OEMs and all the different product lines to benefit customer outcomes. Select has 17 years of experience and an expertly trained staff with over 150 years of combined technical and production experience. They use only OEM parts in their service and hardware processes and are easy to work with via a simple web-based barcode ordering process.
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Also, Select never charges the customer if for some reason they are unable to fix an asset and there is never a charge if no trouble is found. Select also offers free evaluations. “Our primary core competency is our focus on customer results. Sure, we repair our customers’ equipment, but we develop end-to-end solutions to repairs customers’ equipment that maximizes the return on that investment – both in total time to repair and in quality of workmanship,” he adds. “We also sell refurbished equipment. But in today’s Internet of Things environment, understanding machine-to-machine connectivity is making sure the equipment we provide is ready and able to work with our customers’ complicated networks.” Select places a high value on time, especially their customers’ time. “We believe there is a tremendous opportunity to educate our customers on the value proposition of ‘What is your time worth?’ Often, labor is not factored into the standard parts or repair solution,” Fischer said. “Our philosophy is simple: Don’t touch it – just ship it!” “As a full service company, we are committed to having inventory on hand, refurbished and ready to ship,” Fischer said. “Our total time to repair is industry leading and we offer industryleading solutions such as advanced exchanges, same-day shipment, custom configuration and unique technical
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SPOTLIGHT
“ Select truly values cusservices including a top-notch research and development team.” Customers know they can depend on Select and its experienced staff. “Over the past six months we’ve added to our team,” Fischer said. “We have also added a key member to our management team in Sales/Marketing Manager Patrick Dunn. He comes to us with a wealth of experience and knowledge. We are poised for growth!” “We are lucky to have the best tech staff in the business,” Dunn said. “Our technical group is our best sales tool – getting on the phone and working one-on-one with our HTM customers helping to solve their questions, working to solve their M2M connectivity issues, or go that extra mile to ship a demo so as to ensure product safety and reliability.” Select truly values customer service and is always looking to help. There have been many instances when the company has “saved the day.” “The one that stands out is fulfilling a last-minute need for a customer that required 200 devices to arrive on site within 5 days,” Fischer said. “Clearly
someone over committed and under delivered. We saved the day by having the equipment in stock with crosstrained staff and a can do attitude. The equipment was configured to exact specifications, refurbished, warrantied for a year and received on time – everything worked!” “Secondly, we have been awarded many preferred multi-vendor partnerships over the years with large organizations that rely on us to provide a quality service, on time – every time!” In summary, Select Biomedical is an innovative source for solutions. “Our mission statement is relatively simple: Innovation focused on Customer Outcomes,” Fischer said. “We know the future holds complex challenges for our customers. For over 17 years, Select Biomedical has been innovating solutions to help our customers meet these challenges with end-to-end solutions that dramatically improve customers stated outcomes.”
tomer service and is always looking to help. There have been many instances when the company has ‘saved the day.’ ”
FOR MORE INFORMATION about Select Biomedical, visit www.selectpos.com.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
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Providing support services and quality rebuilt equipment for over 15 years! BIOMED DEPARTMENTS… • Our technicians repair circuit boards, pump mechanisms and LCD screens at the component level. • We can provide major internal parts on advanced-exchange or outright sale. • Biomed Departments like our low flat rates, quick turnaround times and flexible service options.
EQUIPMENT PURCHASERS… • We sell and rent the highest quality refurbished infusion pumps available. • We work with you to provide tailored solutions specific to your equipment needs. • Our IOT experience ensures we can help with your M2M connectivity issues.
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INDUSTRY UPDATES
STAFF REPORTS
NEWS & NOTES
Updates from the HTM Industry FLUKE BIOMEDICAL COMPANY EXPANDS RADIATION SAFETY OFFERINGS Unfors RaySafe, a leader of X-ray quality assurance solutions, has introduced the RaySafe i3 to its suite of real-time dosimetry products. The announcement came at the European Society of Radiology in Vienna. The RaySafe Real-Time Dosimetry solution, introduced in 2012, helps physicians and clinical staff visualize X-ray exposure in real time using easy-to-read bar graphs displayed on a monitor. The instant feedback empowers hospital staff to adapt their behavior around radiation, to help minimize unnecessary exposure. “The improvement in radiation protection has been more than dramatic at the URMC. There is no substitute for a constant and real-time reminder of the dose being received,” said Labib H. Syed, M.D., M.P.H. of University of Rochester Medical Center. The RaySafe i3 is designed to improve wearability, prolong life cycle and increase measurement accuracy. The RaySafe i3 can be used in low-dose procedures and in hybrid OR environments. “RaySafe i3 helps keep the medical staff in-the-know, at all times, about the level of radiation exposure, for themselves and their colleagues, in real-time,” said Bart Leclou, personal
dosimetry business area manager for RaySafe. “The decision to implement the RaySafe i3 shows a commitment and dedication by a department to keep their staff safe from excessive radiation exposure. FOR MORE INFORMATION, about real-time dosimetry, request a quote or demo, visit www.raysafe.com.
TRI-IMAGING SOLUTIONS ACHIEVES ISO 9001:2015 Tri-Imaging Solutions, an independently owned diagnostic imaging parts, technical training, technical support, and support services company for the diagnostic imaging market, has achieved ISO 9001:2015 certification. This standard is based on a number of quality management principles including a strong customer focus, the motivation and implication of top management, the process approach and continual improvement, according to the International Organization for Standardization (ISO) website. “This certification not only reflects the consistent quality standard our reputation has been built on by providing quality products and services but also
demonstrates our continued commitment to customer satisfaction,” Tri-Imaging President Eric Wright said. “This is a great accomplishment for our team. I am proud to work with a group focused on quality and outstanding customer service.” ISO 9001:2015 specifies that Tri-Imaging Solutions meets or exceeds requirements for a quality management system that includes the ability to consistently provide products and services that meet customer and applicable statutory and regulatory requirements. ISO 9001:2015 also indicates that Tri-Imaging Solutions aims to enhance customer satisfaction through the effective application of its
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
SOLUTIONS quality management system. “At Tri-Imaging Solutions, we strive to live up to our name and be a solution for our customers and Empower the Engineer,” Wright says. “Our mission is to impact lives by creating individual, customer-centric experiences based on a shared core belief in bettering patient care through personal accountability, integrity and admiration.” FOR INFORMATION about Tri-Imaging Solutions, visit triimaging.com.
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INDUSTRY UPDATES
STAFF REPORTS
ACERTARA LAUNCHES NEW WEBSITE AND E-COMMERCE SITE Acertara, an independent ISO/IEC 17025:2005 accredited medical ultrasound acoustic measurement, testing, and calibration laboratory, and ISO13485:2003 certified probe repair and new product development facility invites visitors to explore its new website and E-store. The new website (www.acertaralabs. com) has been designed to provide the ultimate user-friendly experience with improved navigation and functionality throughout, allowing customers to access detailed product information and videos as well as the convenience to purchase ultrasound products and accessories online. The newly added Acertara eStore offers a wide selection of ultrasound
products and accessories with a convenient, easy online shopping experience. Acertara plans to continue adding products that will provide visitors a one-stop source for a variety of items from ultrasound systems to probe cleaning products and quality assurance solutions. “We have updated the look and feel of our site to represent our more modern, growing brand and enable our customers to easily access our site regardless of the device being used,” said G. Wayne Moore, President and CEO of Acertara, “With the addition of the Acertara eStore our team continues to define the market and provide customers with solutions that will enhance patient care.”
POPLIN JOINS THE INTERMED GROUP BOARD OF DIRECTORS The InterMed Group has announced that Dr. Brian Poplin, president and chief executive officer of Elior North America, has joined the organization as a director for the company’s board. Since April 2015, Poplin has served as president and CEO of the former TrustHouse Services Group, the American contract-catering subsidiary of the Paris-based Elior Group which became Elior North America in May 2016. Prior to this role, he held the role of president and CEO for Medical Staffing Network after leaving his post at Aramark where he served as the president of Aramark’s Healthcare Technologies business. Poplin started his career in 1990 in the United States Air Force, and joined Servicemaster in 1994 where he became a Certified Biomedical Equipment Technician. He obtained a bachelor of science in business administration from
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Indiana Wesleyan University in 1996, a master of science in business management in 1998 and a doctorate in health administration and policy from the Medical University of South Carolina in 2010. “The InterMed Group has been a growing provider in the clinical technology management industry for many years and I am pleased to join the organization,” Poplin said. “The team at InterMed brings a unique culture of customer focus combined with innovative solutions to health care providers and suppliers. My anticipation is that the organization will continue to grow rapidly in the coming years as an alternative to traditional service companies.” InterMed CEO Rick Staab said he looks forward to working with Poplin. “Dr. Poplin brings more than 25 years of clinical technology
management experience to the organization and when combined with his executive leadership, the result will create strong support for our organization’s growth strategy,” Staab said. “I look forward to working together with Brian to accelerate the services and offerings the InterMed Group can bring to the market.”
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INDUSTRY UPDATES CONQUEST IMAGING LAUNCHES 2017 ULTRASOUND TRAINING PROGRAM
SAGE SERVICES GROUP ANNOUNCES ISO CERTIFICATION
Conquest Imaging has announced the successful opening of its 2017 training season. The training registrar reports 15 percent of Conquest’s training seats were sold prior to the opening of the school year, prompting an additional ultrasound Boot Camp to be added to the calendar to accommodate high demand. “We can be confident classes will fill up quickly, especially with the addition of the E10 and Aplio 500 class this year,” Conquest Imaging Global Training Director Jim Rickner said. The addition of GE Voluson E10 and Toshiba Aplio 500 classes were part of a $100,000 technology investment announced earlier this year. During opening day festivities, students and employees enjoyed using a new electronic white board and sampling new technology. Students obtain digital manuals, support videos and training presentations to take home with them on the tablet computers they receive at the start of each class. The first class also used the tablet computers to interact with the presentation being simulcast on the whiteboard. “I enjoyed the class very much. The information was in depth but not overwhelming. Jim made sure we understood each topic before proceeding,” Anthony Passalacqua, Supervisor, Sodexo CTM, stated. Students value Conquest Imaging’s training program as it covers system aspects more clearly and thoroughly than the classes they take with the OEM – as stated in multiple 2016 course evaluations. “The ‘real-world’ approach to training from a biomed’s perspective is what makes the difference,” Rickner said. These ultrasound training programs are highly interactive, which helps students learn by “doing” versus “listening.” Hands-on instruction with actual Toshiba, GE, Philips and Siemens systems in the classroom is an essential component to every training course offered. Conquest offers scholarships to Active Duty Military, Veterans, the VA and California Medical Instrumentation Association (CMIA) members. FOR ADDITIONAL INFORMATION, visit conquestimaging.com.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Sage Services Group officially transitioned from the ISO 9001:2008 standard to the ISO 9001:2015 standard in SERVICES GROUP late February 2017. The scope of Sage’s certification includes “Repair, Replacement Parts, Refurbished Equipment, Patient Cables and Designer of Accessories to the Medical Industry.” This transition exemplifies Sage’s commitment to high-quality services and products by providing consistently great business processes and exemplary customer interactions. When the new ISO 9001:2015 standards were released at the end of September 2015, Sage immediately began a significant review of its Quality Management System in order to adhere to the new requirements. In addition, Sage improved its focus on employee engagement in the processes, executive involvement in quality assurance, and more integrated processes throughout the company. This focus on the three most common quality control struggles in the industry enables consistently higher quality and customer satisfaction at Sage. Although complying organizations are given three years to conduct a transition audit, Sage’s transition audit was performed in December 2016 – roughly one year after the new standard was released. An external auditor conducted an extensive assessment of the processes and facilities. Employees were evaluated based on their individual comprehension of the company’s quality management system. Now, Sage is proud to announce that the company has officially transitioned from ISO 9001:2008 to the most recent ISO 9001:2015 standard. Ed Decker, Senior Integration Director at Sage, has been involved in implementing the Quality Management System since the company’s initial ISO 9001:2008 certification in 2014. “We have invested a great deal in our Quality Management System and in communicating to our entire team that each person is a critical contributor to quality,” Decker said. “These investments are increasing our ability to exceed customer expectations by consistently delivering top-notch products and services. I’m proud of our team and what we have accomplished together.” TO LEARN MORE about Sage Services Group visit www.SageServicesGroup.com or call 877-281-7243.
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INDUSTRY UPDATES
STAFF REPORTS
GE HEALTHCARE UNVEILS REPAIR OPERATION CENTER GE Healthcare welcomed dignitaries, visiting hospital personnel and members of the media to the grand opening of its innovative new Repair Operations Center (the ROC) in Oak Creek, Wisconsin on March 17. At the grand opening, GE Healthcare announced that it plans to add 70 jobs at the ROC bringing the facility’s total workforce to 220 people. Joe Shrawder, GEHC Global Services, President and CEO, spoke to the importance of the ROC describing it as a “key pillar of our service business.” “We do things here rather than out in the field so that our field engineers can spend more of their time helping customers on more critical issues,” he said. “We also get quality, efficiency and scale by bringing all of these repairs together in one place.” “Besides repairing here, what you will see in our facility is that we refurbish, we harvest parts and we do recycling,” Shrawder said. “So, bringing everything through one site here in our repair world allows us not only to achieve economic performance but it’s the right thing to do ecologically. We get the maximum reuse of every return, end of service life medical device we bring in here and ensure we get the utmost out of recycling opportunities as well as refurbishing and reuse.” “Soon, this will be the center for all
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of our returned asset recovery, including our GoldSeal refurbishing business,” he added. “Refurbished medical devices are an important contributor to our health care economy for smaller, more remote providers, for independent outpatient imaging centers, for customers who just need high technology but can’t afford the price of something brand new. We bring it here, refurbish it and make it like new, give it a second life. It is a huge part of our business and we’ll be doing that right behind the walls over here.” Sen. Tammy Baldwin (D-Wis.) was at the grand opening and addressed those in attendance. A guided tour of the 280,000-squarefoot facility provided an up close look at the repair, remanufacturing and recycling center. The ROC is the consolidation of several facilities and is GE Healthcare’s largest and most advanced repair center in the world. The ROC is an innovative repair, remanufacturing and recycling facility servicing imaging, diagnostic and patient monitoring equipment. It is located just a few miles away from GE Healthcare’s industry-renowned Global Healthcare Institute and several GE Healthcare corporate offices. GE Healthcare’s Brilliant Factory platform combines lean and advanced
manufacturing, 3D printing and advanced software analytics that enable productivity and impact customers’ satisfaction. The ROC is ISO 13485 and 14001 certified, and fully aligned with the GE Brilliant Factory standards for efficient and quality repair services. One example of the center’s advanced automation technology is OTTO, self-driving vehicles that streamline material flow throughout the facility. The ROC is equipped to handle much more than repairs. When a piece of equipment has reached the end of its service life, it offers a wide range of recycling and remanufacturing programs that keep 94 percent of the material it receives out of landfills. The GoldSeal program is celebrating its 20th anniversary this year with a move to the ROC. The GE Healthcare Institute (HCI) in Pewaukee, Wisconsin, is also undergoing changes from asset performance management to the latest in education and training techniques. Renovations are in the plans for this global training facility to enhance onsite learning and hands-on training, including simulator training in the traditional sense as well as via the use of a HoloLens. Post-training support is also something GE Healthcare is working on at HCI.
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INDUSTRY UPDATES TRIMEDX ADDS TO LEADERSHIP TriMedx, a leader in clinical engineering and medical equipment management services, had announced that Henry Hummel has joined the company as its new Chief Executive Officer. Hummel will provide strategic leadership to TriMedx as it continues to enhance its technology and service capabilities and expand its offerings to further position the company to meet the evolving needs of the health care industry. Hummel is a seasoned leader within the global health care industry and brings to TriMedx a proven track record of growing businesses in mature and expanding markets through product introductions, technology and service enhancements, as well as operational improvements. He has held a variety of executive roles for several organizations, including multiple leadership roles over the course of 25 years with GE Healthcare as well as other senior positions with Covance, Johnson Controls and, most recently, Tenneco. “Since the company was founded almost 20 years ago, the TriMedx team has become a recognized leader in medical equipment management services,” said Hummel. “I am excited to lead TriMedx in the next phase of its growth as the company
continues to expand its product and service offerings and invest in value-added technology and informatics capabilities to better serve its current and future health care partners. This growth will not only positively impact the TriMedx organization, but will help us achieve our ultimate goal of improving health care delivery.” “TriMedx is well-positioned for tremendous growth in the health care market,” said Greg Ranger, TriMedx’ Founder, former Chief Executive Officer and current Board Member. “Henry was selected following an extensive national search by TriMedx’ board of directors. He is a proven leader who shares our deep commitment to the company’s values and culture, and I am confident that Henry’s accomplishments and experience will help drive TriMedx forward as a leading and innovative partner to both health care providers and medical equipment and device manufacturers.”
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ECRI UPDATE
You’re Getting Warm: Uncovering Forced-air Warming Units
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orced-air warming units heat patients convectively (i.e., warm air is gently blown across the patient beneath the air blanket). These units were originally used in the postanesthesia care unit (PACU) for whole-body warming following surgical procedures; they have since moved into the operating room (OR) for warming parts of the body during surgery. In all cases, they are designed to reduce hypothermia and speed recovery time. In order to speed healing, shorten hospital stays, and reduce wound infections, maintaining normothermia in the perioperative setting is advised. Although these units are used mostly on surgical patients, they are also employed in the emergency department for rewarming hypothermic patients.
When the body loses too much heat and cannot maintain its normothermia of 36.6 to 37.5 degrees Celsius (97.9 to 99.5 degrees Fahrenheit), the body is in a state of hypothermia. Upon admission to the PACU, adult surgical patients can become hypothermic due to large heat losses sustained during surgery. Induced heat loss is the intentional lowering of the patient’s body temperature by heat exchange through a heart/lung machine or by surface cooling; it is used before cardiopulmonary bypass surgery to help induce cardiac arrest and to reduce metabolic oxygen demand. Inadvertent heat loss that results in average temperature drops of 0.5 to 1.5 degrees Celsius (0.9 to 2.7 degrees Fahrenheit) occurs for a number of reasons. The body attempts to regain heat lost in the OR by shivering during the postoperative period. Shivering, which can intensify to tremors or violent shaking, poses extreme danger to the postsurgical patient because of the high energy demand required to sustain the shaking. The adverse consequences of the metabolic stress imposed by this increased energy demand include the following: • Interference with a patient’s
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emergence from anesthesia • Increased risk of ventricular fibrillation, stroke, postoperative deep-vein thrombosis, and pulmonary embolization • Increased blood viscosity (red blood cell sludging) • Decreased perfusion of vital organs • Inhibition of hepatic and pancreatic activity, leading to changes in glucose metabolism • Decreased renal blood flow, resulting in decreased glomerular filtration, loss of proteins, and subsequent increased risk of wound infection Forced-air warming units are used to combat hypothermia and related deleterious effects. Other measures to prevent hypothermia include raising the OR temperature, keeping the patient covered with warmed blankets as long as possible before surgery, using heated humidifiers in the anesthetic breathing circuit, and using fluid warmers. Because most of these measures are too diffusive to be effective or may impede surgical procedures, they have not gained wide acceptance.
PRINCIPLES OF OPERATION A forced-air warming unit consists of a thermostatically controlled heater, a fan (blower), a control panel, a disposable accessory (e.g., blanket, gown) and a flexible hose that attaches to the disposable accessory. A filter is mounted at the blower air intake, and dust and bacteria are removed from the incoming air. The filtered air is warmed by a heater and directed into the flexible hose that connects the blower to the blanket. A remote sensor at the hose inlet monitors the temperature of the air being directed to the patient. When the temperature of the heated air reaches the set point (e.g., 44 degrees Celsius [111.2 degrees Fahrenheit]), a thermostat turns off the heater to prevent thermal injury to the patient. Patient warming blankets are placed on top of the patient’s bed or operating table and may be secured with clips. Some blankets may have an adhesive strip to affix the blanket to the patient and to prevent air from blowing into the operating field. Warming blankets used in the OR are designed to cover only the upper or lower body; a full blanket cannot be used because of the need to establish the operating field and to maintain sterility. Blankets for the PACU or emergency department are full-body blankets, with the hose inlet usually located by the patient’s feet. These blankets generally offer access panels that allow a nurse to easily lift up a portion of the blanket to check the patient’s dressings, infusion lines or skin tone. Blankets come in various sizes,
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including pediatric, adult, lower body, upper body and full body. Specialized sizes designed for pre- and postoperative care are available from some manufacturers. The blanket material, which is usually latex-free and nonflammable, is bonded into tubular channels. Warm air entering the blanket fills the channels, causing them to inflate and the blanket to flex concavely around the patient. Small slits or holes on the patient side of the blanket allow warm air to blow on the patient. The result is a layer of warm air between the patient and the blanket. Forced-air warming units use convective heating in contrast to circulating-water warming units which use conductive heating (i.e., heat absorbed from hotter objects in contact with the skin). Whether convective or conductive heating is more effective is still a matter of debate; however, proponents believe forced-air blankets are easier to transport and store and are more comfortable for the patient than circulating-water blankets. REPORTED PROBLEMS Forced-air warming units, like other heating devices, have the potential to cause burn injuries. Patient burns with forced-air units usually result from improper placement of the blanket under the patient or from use of the device for extended durations on maximum temperature settings. One study identified the following operator errors, which have resulted in patient burns: • Warming of nonperfused or poorly perfused skin • Contact of heated plastic with skin when the unprotected side of the blanket is placed against the patient (labels indicating which side of the blanket should face the patient are intended to prevent this misapplication) • Constant contact of the blower hose with the skin of the lower extremities
• Use of a unit without a dedicated blanket (i.e., a warming hose inserted under bed linen) • Use of another manufacturer’s blanket • Use of a model intended for unanesthetized patients on anesthetized patients (models for unanesthetized patients have a higher heat output). Use of the device for prolonged durations may not be safe under some circumstances, even when the device is used correctly. A general guideline to follow is that the maximum temperature setting should not be used on patients in the presence of the following conditions, which could increase the risk of thermal injury: • Low cardiac output • Peripheral vascular disease (occlusive or diabetic) • Total immobilization • Unconsciousness • Poor peripheral perfusion • Marginal cutaneous perfusion Additionally, the maximum temperature setting should not be used on patients who require warming for an extended period of time, unless they are under constant supervision. The operator should frequently check patient temperature and vital signs during extended usage. In all cases, operators should reduce the temperature or end treatment when normothermia is achieved. Users should also be aware of the potential for thermal damage to medical devices. Heat from a warming unit can increase the pliability of medical tubing. It is not uncommon for tracheal tubes to kink within the airway, where they are exposed to body temperature. Air jets, which cause an uneven concentration of air, can interfere with the distributed warming process and result in burns at localized hot spots. This can occur if blower air is not distributed evenly. Blanket ballooning is
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another potential complication that occurs if the blanket cover is made from a nonbreathable material. There is increasing scrutiny of forced-air warming units and a possible link to infection as a result of airborne contamination. While studies have shown no proof of this, there is still a concern that the blanket can increase bacterial contamination to the surgical site. Replacing air filters at recommended intervals may help prevent these problems. ECRI INSTITUTE RECOMMENDATIONS ECRI Institute recommends that forced-air patient warming units have audible and visual overtemperature alarms because they increase the likelihood that a caregiver will quickly respond to a device-related problem. The highest temperature setting should be limited to 46 degrees Celsius (114.8 degrees Fahrenheit); higher temperatures increase the risk of thermal skin injury. As an additional safety feature, an internal thermostat should turn off the heater circuit if the temperature reaches 53 degrees Celsius (127.4 degrees Fahrenheit). Warming units should have single-use disposable blankets (with labels indicating which side of the blanket should face the patient); single-use blankets help minimize crosscontamination during surgery. The unit and/or the heater should automatically shut off if a fault causes the air temperature to exceed the unit’s setting. Dual safety thermostats provide extra overtemperature protection. A warming unit should have HEPA-grade or better air filters to reduce the risk that airborne dust, bacteria, and mold will be blown onto the patient or into wounds. THIS ARTICLE IS ADAPTED from ECRI Institute’s Healthcare Product Comparison System (HPCS), a searchable database of technology overviews and product specifications for capital medical equipment. The source article is avail-
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BY JOHN WALLACE
BIOMED EDUCATION Who Will Teach the Next Generation?
I
n 2015, Money magazine listed “Medical Equipment Repairer” (a.k.a. HTM or biomed professional) number 2 on its list of “The Best 5 Jobs You’ve Never Heard Of.” The problem is educational opportunities to become an HTM professional have been disappearing since Money magazine’s list debuted.
DeVry University, ITT Technical Institute and Brown Mackie College are among the larger institutes of higher learning that have eliminated all or some of their HTM programs. Smaller technical schools, junior colleges and community colleges have also shuttered programs. Jenifer Brown, president and owner of Health Tech Talent Management, works to help place HTM professionals in jobs throughout the United States. She has also worked in higher education. She explained that colleges must maintain a certain job placement ratio in order to offer financial aid to students from federal funds. The problem is that students sometimes sign up for HTM without realizing there is an expectation that they be willing to relocate in order to find an entry-level job. “You have to make sure they know they have to relocate and they have to keep up the placement ratio,” Brown said. She added that there are many high-quality institutions offering HTM degrees and biomed training in the U.S. Armed Forces is another great option. “To me it is not difficult to find a job in biomed if they put forth the initiative. Some schools do not require an internship. The majority of good biomed programs require an internship as part of an associate degree. It is one
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thing to be book taught and another to actually be working inside a hospital,” Brown said. “If a student is not required to do an internship, they should take it upon themselves to knock on the hospital’s door and volunteer. Hands-on experience is important.” Brown said military biomed training comes with hands-on experience. “A lot of them have hands-on training so it makes them more attractive to an employer,” Brown said. Educators and those working in the HTM profession see a shortage of qualified biomeds to fill vacancies. Many report that this is a huge concern as more and more HTM professionals retire in the coming years creating an even greater
programs close, this becomes extremely difficult. I don’t think, at this time, that health care is adversely impacted, but staffing is getting more and more difficult and in the future health care could be adversely impacted.” Bill Sansagraw, instructor of electronics technology at Jefferson College, said he sees a real need for more HTM professionals. “I have found that most hospitals prefer you to have an associate degree in biomedical technology, but are willing to hire those with an associate degree in electronics,” Sansagraw said. “With the recent changes in the educational sector, we have lost a lot of ground work for those seeking to hire
“ The country has about 3,000 hospitals – how can we have just a handful of academic programs? We cannot expect the profession to have visibility and grow if there are no graduates to fill vacancies.” - Barbra Chrisie, PhD need for talented HTM professionals. Steve Yelton, a professor at Cincinnati State Technical and Community College, said there is a need for HTM professionals. “In addition to my role teaching HTM courses, I also work as a senior consultant for a large health network in Cincinnati, Ohio,” Yelton said. “One of our biggest concerns is where would we get qualified technicians if the local biomedical program didn’t exist? We are also striving to keep our senior technicians who have specialized training and service schools. As these
biomedical technicians. The employers that I work with have positions that are open for months and have a hard time finding qualified biomeds. The demand for qualified and skilled HTM/biomeds tells me that we do not have enough students or programs to meet the needs of the health care field.” Jewel C. Newell, Program Lead for Biomedical Equipment Technology at Brown Mackie College, Dallas/Ft. Worth campus and Network Recalls Manager at JPS Heath Network, said the question whether enough educational programs exist for future HTM
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professionals depends on the student. “Well, that truly depends on what the prospective student is hoping to gain. If it is a 4-year bachelor of science in biomedical engineering, then the answer is, yes,” Newell said. “There are colleges and universities all over that offer this type of degree. A biomedical engineering degree is multifaceted and allows the student to either focus on design and implementation of medical devices, go into research and compliance of medical devices, or repair and maintain them. However, if the prospective student is not looking to do all of those things, then the answer is, no, we no longer have a strong offering of colleges that can support the number of interested people in our field. With schools like DeVry, ITT, Brown Mackie, and Jefferson, closing its doors or just dropping the biomedical equipment technology programs, the national pool has diminished significantly.” University of Connecticut Professor and Clinical Engineering Internship Program Director Frank R. Painter said the recent closings will impact the profession. “All of my clinical engineering students get multiple job offers when they graduate in May. To me this means the demand is higher than the supply,” Painter said. “As well, on the HTM/ BMET side, when a hospital advertises for BMETs there are usually very few qualified applicants, also indicating the demand is stronger than the supply.” “Hospitals and vendors will have to hire candidates outside the field and train them,” Painter added when asked how the decision to close some educational programs could affect health care. “This is more expensive, more time consuming and more frustrating because if someone leaves after training, the resources put into the person are gone. This is normally how things are done in countries with limited resources, like Namibia and Ecuador. There are very few BMETs, the hospital must train them and then they leave for greener pastures. If the number of untrained BMETs entering
the field decreases, the number of positions will increase because the amount of technology in the hospital is increasing. This will entice BMETs to change jobs more often. This will either drive up health care costs or decrease the quality of the technology service provided. This problem is universal, affecting in-house, third-party and vendor-based support programs and their BMETs.” Barbara Christe, Ph.D. is the director of the healthcare engineering technology management program and an associate professor in the engineering technology department at the Purdue School of Engineering and Technology at Indiana University-Purdue University Indianapolis. She said the recent closing of some DeVry campuses coupled with others leaves a void. “I do not think there are enough programs. With DeVry’s closings (not all campuses), very few bachelor of science programs are left in the U.S. The country has about 3,000 hospitals – how can we have just a handful of academic programs? We cannot expect the profession to have visibility and grow if there are no graduates to fill vacancies,” Christe said. “As an educator, I know many hospitals contact me seeking graduates to fill openings – for which I have no one to recommend. Currently, our students are finding employment prior to graduation so we don’t have folks looking for a position when openings happen. How does this impact health care? I think the employers have to answer that – but I would assume a lack of available candidates means that hospitals must hire folks with less than desirable qualifications … such as a degree from another field (such as electronics).” Douglas Dreps, director of eastern regional clinical engineering for Mercy Health sees a need for health care facilities to develop relationships with institutes of higher learning, especially in regards to replacing retiring baby boomers. “I recommend reaching out to all educational institutions within their state
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
JENIFER BROWN
President, Health Tech Talent Managment
STEVE YELTON
Proffessor, Cincinnati State Technical and Community College
BILL SANSAGRAW
Instructor of Electronics Technology, Jefferson College
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FRANK PAINTER
University of Connecticut Professor and Clinical Engineering Internship Program Director
BARBRA CHRISIE, PHD.
Director of the Healthcare Engineering Technology Management Program, Purdue School of Engineering and Technology
DOUG DREPPS
Director of Eastern Regional Clinical Engineering, Mercy Health
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BY JOHN WALLACE
and outside of your area. We have hired many that did internships or externships with us. With recent closings of electronics and BMET programs locally – i.e. ITT, Brown Mackie, and Jefferson College this month – we feel the need to reach outside of our area to other institutions, as we need future candidates. I am even going to reach out to Owens Community College in Toledo Ohio, where I received my AASEE/ BMET degree.” “I am looking at convincing our leadership that we need to have an apprentice program, where we hire technicians 1-2 years before retirements, so they can get technical training and on-the-job training with seasoned technicians,” Dreps added. “Many of the imaging manufacturers have these programs and that is helpful in having trained technicians fill retirement positions. For many imaging modalities, and some biomedical systems, it takes years to be proficient. Costly high-dollar contracts can be the driving force to help us make this happen. Supply and demand could drive wage wars among hospitals, ISOs and OEMs.” Sansagraw said as more and more HTM professional from the baby boomer generation retire the need for HTM professionals will only increase. “This is a growing problem for all of the employer partners that I have worked with,” Sansagraw said. “They have people retiring faster than they can find qualified technicians. There has been some talk in other areas of skilled labor to start growing their own technicians. This might not be the perfect answer, but when you cannot find people willing to do this kind of work then you have to get creative.” All of the changes that are taking place in education have students, faculty, and administration worried, Sansagraw said.
“I think that education should be the last item to be cut from any budget,” he said. “If we do not have an educated workforce, we as a country will struggle. I wish I had a way to fix all of the problems with the lack of qualified technicians.” Newell hopes to provide a solution with the creation of a new source for highly trained and experienced HTM professionals. “As of today, I, and Douglas Redwine, clinical engineering manager with Texas Health Resources in Ft. Worth and an adjunct instructor for biomedical equipment technology, are in the process of opening a nonprofit technical college that focuses on the four major areas in our field,” Newell said in March. “Students will earn associate degrees in biomedical equipment technology, radiology equipment repair technology, information technology-security, and information technology-health care. We will also offer certificates for specialized training on certain radiology devices through our training partner.” “In fact, as part of our radiology equipment repair program, students will spend one week each semester at our partner’s facility for advanced training,” she added. “We believe that these programs and added trainings will answer the call to what is needed in our field. We will be working on a SACSCOC accreditation for the college, and an ABET accreditation for our programs. We understand that this is a very large endeavor, but we feel that there is a definite need in the industry for well-trained, quality technicians. We take a holistic approach to teaching and training our students, so that they are well informed and prepared for what they are going to do. We hope to start taking our first students in January 2018, and it is our sincere hope that the technicians that we create will be an added value to any organization.”
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SHOP TALK
Conversations from the TechNation ListServ Q: We recently had an imaging tech who received CT training and a few other high-dollar classes at the hospital’s expense resign and take a position with GE. Should techs be required to stay with the company for a certain length of time after completing OEM training/certification?
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We have them sign an agreement to work for a certain amount of time after training or pay for it prorated if they leave.
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Usually there is some signed agreement that the employee will stay with the organization one year or if the class was expensive (as imaging may be) two years. Otherwise they have to pay the tuition back and certainly their final paycheck would be withheld until settled.
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This is a serious situation. Having worked for decades in the in-house component of clinical engineering I have heard of this a few times. The best way to prevent this type of behavior is to have the employee sign an agreement listing their obligations to the hospital in exchange for the training being offered. This is also the time to show support to the employee by offering a raise over time due to the new skill they will be offering the hospital in its quest to save money.
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I think the only solution to this issue is to choose wisely the personnel you want to educate. Once educated, pay them fairly and treat them properly. Hospital administrators may not understand this process and it is up to us professionals to educate our
administrators of the value the salary requirements and needs of our “higherend” professionals. Areas where we fail as HTM leaders is treating imaging educated professionals differently than the highly competent biomedical technology individuals. In my program, my career ladder only has a single path. There is not two career paths, one for imaging engineers and one for biomedical technicians, the old “us versus them” conflict that destroys teamwork. I recognize my high-end biomedical professionals (technicians that master skills on clinical laboratory gear, laser technology, operating room technologies, information systems/ networking technologies, etc ...) equally as those professionals with imaging skills. My imaging skilled personnel will work on biomedical devices, yes, even IV pumps. If I have a nuclear person doing a PM on a SPECT camera and there is an IV biomedical gating monitor in the room, that same professional will do the PM on the monitor. There will not be a separate service event by another HTM professional for the PM on that monitor. That is wasteful (expensive) due to the inefficiency in the use of labor. Back to your original issue, choose wisely, and educate the hospital/health system administrators as to what it takes to drop several hundred thousands of dollars in service agreements, i.e. higher salaries and benefits for technical staff. Some OEMs and some third-party providers seem to be heading down a path of poorly educating their field service personnel while also “loading” them up with many more systems to
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cover in their region than the staff can handle in an effort to maximize margin. This is all translating to poor service experiences for the customer. Your team can deliver your imaging staff and your patients a much better experience for service, it just takes us as HTM leaders to educate health care administrators on the value in that proposition and then deliver it!
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I have a few comments on this one. Why did he leave? Pay? Benefits? Work hours? Management? Personal issues? I don’t think they just left to leave, there’s an underlying issue.
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We had an employee in our department a couple years back who retired shortly after receiving some expensive Varian training. The employee had 27 years at our hospital and had no plans to retire, but they announced planned changes to the hospital pension and retirement plan and the employee stood to lose out on significant monies by not retiring then. However, our director at the time was very upset over it and put in a tuition payback “contract” that many of us in the department felt was a “knee jerk” reaction to a situation that had never come up before, and was a situation created by the hospital. The plan put in place said that if you had a class up to $10,000 you were obligated for one year of service, if you left prior to that you were responsible for paying back the entire amount. If you had a class over $10,000 you were obligated to work two years. If you left before one year, you paid back the entire amount. If you worked one year,
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but left before the second year, you paid back half. All in all it wasn’t an awful plan, but we thought it would be more fair to say for X amount of dollars you worked a month. In this case if you had a class that was $11,000 you may only have to work 13 months instead of 24. Conversely, if the class cost $25,000 the employee could be obligated for up to 30 months. Also there were no exceptions for unavoidable circumstances that might keep the employee from fulfilling these obligations. In my case, I have had heart troubles that have caused me to undergo heart surgery twice. Up to this point I have been fortunate in that I recovered fully and am still able to work at 100 percent. But what if something happened that left me disabled, I would like to think they would take that into consideration, but it wasn’t in the language of the agreement, so there was nothing there to keep them from demanding repayment. It also left a bad taste in the mouths of some of the longtime techs. This happened only one time in the 35 years I have worked here, and then only because of changes they made to the pension plan. We felt it showed a sudden distrust of us, many of us have been loyal employees for over 25 years. Less than two years later, the hospital discontinued any insurance for retired employees and the technician that left and started all this actually ended up coming back to work for our department. With all that said, I can understand a hospital wanting to protect their
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STAFF REPORTS
investment, but maybe do it in a way that shows more trust of long-term employees. Maybe make techs with less than 10 years sign an agreement, maybe trust that anyone with more years than that is in it for the long haul and possibly have no agreement, or possibly a less stringent one for them. Consider not sending anyone (to training) who is within a couple years of being eligible to retire. Try to come up with a fair system of prorating payback based on time already served and be sure to put in reasonable exceptions that take into account potential unforeseeable hardships that could affect an employee. A little more than 2 cents worth, but hopefully some good food for thought.
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Our policy states you must be with the organization for two years post a “high-dollar” training. If you leave on your own free will, you must pay it back prorated. We also have a “no compete” clause with the major vendors in which we cannot work for their company and they cannot work for our company for 12 months after leaving on their own free will. Termination is a different story.
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Likewise, about, oh, 15 years ago … we sent a new tech to DICOM for a week of training. Two weeks later, poof, GE snatched him up and doubled his salary. It surprised all of us here and it created some sour feelings for a while, but we didn’t have any redress. The idea of an agreement was definitely kicked around for a while afterwards. But I think our HR department eventually decided that it
would not be enforceable, because we would have to guarantee the tech a job for the length of the agreement. Doubleedged sword. So they solved it by not sending anyone to a week-long school any longer. By the way, that tech is still with GE. I just saw him last week.
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As part of the training request we agree to stay for 12 months from the end of training (unless terminated by the company), or we have to reimburse the company for the cost of the training. I don’t know how enforceable that really is beyond maybe withholding our final paycheck, but it is company policy. It’s a sticky situation. How long is long enough? I would never fault someone for wanting to improve their position, but it does feel pretty unethical to take the training you were given and immediately sell it to the highest bidder. I wouldn’t do it.
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It cuts both ways. I worked for a company that put their field service engineers through three months of training. It was a combination of classroom, production, QC, bench, and field training. While I was there we had one tech that six months later got hired away by a large hospital group. We had 3-5 day refresher training once a year so a week of training would not have been considered “expensive.” Employees do not automatically deserve a raise because they received training paid for by their employer while they were being paid to attend. When I wanted a promotion I went out and paid for college and took classes on my own time.
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A:
A:
I’ve worked for places where you had to pay back the full amount if you left within a year and also have had prorated agreements. Currently, we don’t have any type of agreement that is required for training and we send techs away to schools for various equipment all the way up to MRI with little turnover. I think if the $5-10K of training is all that someone needs to leave then there are other issues. It comes down to picking the right technicians to train, working with HR to ensure proper compensation and benefits, and its also on the managers to provide a good work environment. If someone wants to leave they are going to with or without that agreement and most likely all the hospital will get is the final check. Legal actions don’t come cheap and generally the end result is not worth the expense. One of my favorite sayings on the
training topic: “What if we train our employees and they leave? What if we don’t and they stay?”
A:
The reality is that none of these agreements are legally enforceable, so I don’t see the point in making someone sign one in the first place. Having someone leave after being trained is a risk every organization faces. Also, if you’re going to hold someone responsible for the cost of the training, then you need to be looking at the manager, not the technician who quit. People leave managers, not companies. I prefer to make a “gentleman’s agreement” with a technician, and tell them that we value them, and we’re going to invest in their future by having them trained, and my expectation is that they won’t be quitting in the near future, and that if they aren’t happy to please discuss it with me before making any final decisions.
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A no compete agreement works well in your case. But what I would suggest is get GE to reimburse you for the class or request that they give you an additional class at no charge. Depending on how long from when the tech completed class and then went to the OEM for employment. The no compete is very specific to enforce. For example, your tech would have had to go for training on a specific model and then took employment with the OEM working on that exact same model. You would have to prove damages. The tech could say that he went to training for lightspeed but he was employed for a different series CT. Very hard to enforce.
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A:
A non-compete clause may not be legally enforceable, but good luck getting any company to expend the legal fees to fight a lawsuit in order to hire you.
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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TOOLS OF THE TRADE Rigel Medical PatSim200
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igel Medical has launched its simplest and fastest vital signs simulator for routine testing of medical equipment.
The PatSim200 can produce a 12-lead NSR ECG simulation, as well as simulating respiration, body temperature and IBP. In a unique new feature, healthcare technology management (HTM) professionals can save their five most used simulations and recall them at the touch of just two buttons – which means no more scrolling through tree-style hierarchies. The device’s ease-of-use makes it a great product for entry-level HTM professionals and experienced engineers alike. The unit itself is compact and lightweight, and the color screen can be easily adapted for use in low-light environments through its high-contrast low-luminance setting. Its cable ports are compatible with most hospital legacy IBP and temperature cables, making it Rigel Medical’s most versatile simulator yet. PatSim200 comes with a 90-day returns policy and a five-year warranty. For a free online product demo, visit www.rigelmedical.com/medica
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MAY 2017
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THE BENCH
BY LARSON HOLYOAK, MIKE BUSDICKER AND PRIYANKA UPENDRA
BIOMED 101 HTM Workload Tracking:
How Tracking Can Work for You
D
eveloping an accurate way to document technician workload in a Healthcare Technology Management (HTM) environment can be a daunting task1. This article will discuss the process of deriving workload metrics for a Clinical Engineering (CE) team at an Intermountain Healthcare facility. The CE team at Intermountain’s Utah Valley Hospital performed five different time studies of various lengths over a 10-year time frame, to gauge the different activities performed by our CE techs as well as the time spent doing these activities. These studies were performed during peak Preventive Maintenance (PM) periods and also during slower times. The goal was to gather time spent over a variety of work experiences so the data collected could be useful for workload history. The load tracking methodology outlined in this article has helped the Utah Valley Hospital CE team. It is not to be understood as an industry standard until piloted and validated by other CE teams.
INTRODUCTION Utah Valley Hospital is a 395-bed full-service tertiary and acute care facility serving Utah County and rural central Utah, as part of the Intermountain Healthcare system 2 . It is a Level II Trauma Center3. The CE and imaging engineers at Utah Valley Hospital manage Utah Valley Hospital, four rural hospitals in Central Utah and 35 medical clinics which are all part of the South Region system of Intermountain Healthcare. TRACKING CE WORKLOAD Healthcare technology managers should be well versed in what it takes to run their department and to know how many biomedical equipment technicians (BMETs) it takes to keep the hospital equipment maintained. There have been many articles written on the pros and cons of having an in-house HTM program and we believe it works for us. More so, for over 30 years, productivity and staffing continues to be a debatable topic for the clinical engineering community4. However, as a department, we need to prove our worth to the facility and tracking workload had been the way to accomplish that. (Figure 1) We decided to do a time study to establish a base line for the different activities that a BMET could perform in a normal day and also the time it took
48
TECHNATION
MAY 2017
TIME DEFINITIONS Productive Activities
Non Productive Activities
P1
Design Modification
N1
Budgeting
P2
Documenting other produvitve activities
N2
Committee meetings
P3
Documenting service reports
N3
Conventions/seminars
P4
Documenting PM’s
N4
Documetation of non-productive time
P5
Incoming inspection
N5
Keeping up with the field
P6
Line isolation monitor test
N6
Maintenence of inventory
P7
Travel time
N7
Maintenence of technical library
P8
Operator error repair time
N8
Personal time breaks
P9
Performance verification
N9
Public relations effors
P10
Pre-purchase evaluation
N10
Re-Repairs/call backs
P11
Prventative maintence
N11
Supervision
P12
Repairs (including parts activity)
N12
Training of personnel
P13
Safety modifications
N13
Vendor control
P14
Safety testing
N14
E-Mail response
P15
Service contract evaluation
N15
General Admin duties
P16
Installation
N16
Other (need to explain)
P17
Calibration of test equipment
Figure 1 - Definitive list of productive and non-productive activities.
to accomplish that particular activity. We put the activities into two categories of “productive” and “non-productive” time (see Figure 1). Productive time, for
the most part, can be defined as the time spent by a BMET working on medical equipment and documented on a work order in the computerized
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MONTH
maintenance management system (CMMS). The activities include, but are not limited to, preventative maintenance (PM), repair, medical equipment or systems setup, and calibration. Non-productive time, in the traditional sense, includes activities such as attending meetings, education/ training and time spent responding to emails. We ran our first baseline time study for a full month. The BMETs were asked to document their activities in 10-minute time periods. This was overwhelming for the team members. However, after they understood the importance of the time-study they were willing to document their time. Each staff member was given a spreadsheet that would allow them to document their time. They placed a code from the list of productive and non-productive definitions next to the time slot. In some cases, a “P12” was placed in several consecutive time slots. After the month long tracking process, all of the time was combined from the different techs. This was put into a master spreadsheet so calculations could be performed (see Figure 2). This first study set a baseline for future studies. Over the next 10 years this study was performed 5 different times. We had turnover of staff during this period which was beneficial to the other studies. Different people work in different ways, so we were able to get a fuller picture of how technicians spend their time. Once we established a baseline, the next step was to develop a spreadsheet that is updated monthly, so each technician could monitor their own workload. This data can also be combined as cumulative data which helps in management of our CE department (see Figure 3). Productive or documented activities are easy to collect but we also should be tracking our “non-productive” hours. A technician will perform many beneficial actions during their work hours but some of these things will not be documented. That is where the time study has been useful. From the study, we can calculate how much time is spent in these non-documented activities and apply a percentage to help figure and round out a full day of work. (Figure 3) We then take the process one step further and combine the data into a technician calculator (see Figure 4). This technician calculator was developed by Scott James, CBET, and CE director in the north region of Intermountain Healthcare. This was published in the Journal of Clinical Engineering, Oct/Dec 2007 edition5.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
TECHS Week 1
Week 2
Week 3
Week 4
Total Hr
P1
2.00
1.33
0.00
2.33
5.67
0.74%
P2
1.67
2.00
4.33
1.67
9.67
1.26%
P3
4.67
3.33
5.83
11.67
25.50
3.33%
P4
2.33
3.17
3.17
5.67
14.30
1.87%
P5
2.17
5.33
0.33
1.50
9.33
1.22%
P6
0.00
0.00
0.00
0.00
0.00
0.00
P7
6.67
8.50
4.50
5.17
24.83
3.25%
P8
0.83
0.83
4.00
1.83
7.50
0.98%
P9
4.83
2.17
1.17
4.83
13.00
1.70%
P10
0.50
0.00
0.17
1.67
2.33
0.30%
P11
13.50
24.33
11.67
20.67
70.17
9.17%
P12
94.67
100.50
101.17
83.00
379.33
49.58%
P13
1.33
0.00
0.00
0,17
1.50
0.20%
P14
1.00
0.67
0.00
0.00
1.67
0.22%
P15
0.00
0.17
0.00
0.00
0.17
0.02%
P16
21.50
5.17
1.33
9.00
37.00
4.84%
P TOTAL
157.67
157.50
137.67
149.17
602.00
N1
0.00
0.00
0.00
0.00
0.00
0.00%
N2
0.00
0.00
1.83
0.00
1.83
0.24%
N3
4.33
2.17
3.50
4.17
14.17
1.85%
N4
0.00
0.00
0.00
0.00
0.00
0.00%
N5
1.83
0.83
1.00
2.33
6.00
0.78%
N6
3.83
4.67
0.83
4.33
13.67
1.79%
N7
2.50
8.50
8.33
6.50
25.83
3.38%
N8
0.33
0.33
0.00
0.00
0.67
0.09%
N9
5.17
833
7.67
6.00
27.17
3.55%
N10
10.67
8.33
8.33
6.50
33.83
4.42%
N11
0.00
0.17
0.50
0.00
0.67
0.09%
N12
0.00
0.33
2.33
0.00
2.67
0.35%
N13
1.83
2.17
0.00
1.33
5.33
0.70%
N14
0.17
0.67
0.00
1.00
1.83
0.24%
N15
1.83
2.33
0.67
1.33
6.17
0.81%
N16
0.00
3.17
6.17
3.33
12.67
1.66%
N17
0.00
4.00
5.00
1.67
10.67
1.39%
N TOTAL
32.50
46.00
46.17
38.50
163.17
100%
TOTAL
190.17
203.50
183.83
187.67
765.17
P%
78.68%
N%
21.32%
Figure 2 – Productive and nonproductive averages post time study.
MAY 2017
TECHNATION
49
THE BENCH
BY LARSON HOLYOAK, MIKE BUSDICKER, AND PRIYANKA UPENDRA
Figure 3 – Monthly tracking sheet
Tech
Total PM Items
Life Support/ High Risk
Non life Support
Tech 1 Tech 2
1,024
32
668
922
23
549
Tech 3
1,353
231
547
Tech 4
985
28
760
Run to Fail
Actual PM
Actual CM
Documented total WO & PM Hrs
Actual Available Work Hrs.
324
287
350
459
574 196
Productive Documented Percent Available PM/SR Hrs
848
1,135
1,685
65%
693
1,153
1,686
65%
369
884
1,253
1,799
65%
287
915
1,202
1,746
65%
Actual Needed FTEs
Current Staff
Staff Deficit
1,095
1.04
1
(0.04)
1,096
1.05
1
(0.05)
1,169
1.07
1
(0.07)
1,135
1.06
1
(0.06) (0.20)
Tech 5
1,243
75
732
435
482
889
1,371
1,754
65%
1,140
1.20
1
Tech 6
1,599
30
1,037
532
499
737
1,236
1,654
65%
1,075
1.15
1
(0.15)
Tech 7
1,158
72
698
388
378
782
1,159
1,639
65%
1,065
1.09
1
(0.09)
Figure 4 – Biomed Tech Calculator
50
TECHNATION
MAY 2017 2017
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THE BENCH A national leader in the sale of new, used, and refurbished medical equipment.
Members of the clinical engineering team At Utah Valley Hospital have performed five time studies.
The information from the tech calculator is what we use to justify hiring either replacement or additional staff. This calculator can show if you are running under or over staffed. It has become an effective tool in our human resource management. (Figure 4) MEANINGFUL METRICS There is a certain amount of trust that goes with a technician’s documentation. In all honesty, it is not productive for a manager to micromanage an employee. You ask them to do the job, help them understand the importance of that job, and then trust that they will have enough integrity to do that job. We have explained to our technicians the reason for all of this documentation. They have been good about accepting the fact that in order for us to survive as a department we need this data. After completing the first time study, we were pleased with how these calculated percentages helped to assess how team members were completing day-to-day activities. After completing the final time study, we found that the percentages stayed quite close to the first study. Our first time study gave us a results of P=78.68% and N=21.32% our final study showed P=77.19% and N=22.82%. As you can see the numbers have stayed pretty consistent. CONCLUSION As we continue to spot check documented and undocumented time, we have found these averages continue to hold
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care. Larson Holyoak, BS, CHTM,•isIVthe south• Laboratory • Lymphedema Pump • Miscellaneous • Monitor • Nutrition Pum Pump • Ophthalmology • OR/Surgery • Out the Door • Pediatric Respiratory • Suppl region clinical engineering directorOB/GYN at IntermounTherapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pump • Feeding Pump tain Healthcare. Priyanka Upendra, BSBME, MSE, CHTM, is the clinical engineering compliance manager at Intermountain Healthcare. References 1. Joseph F. Dyro. Clinical Engineering Handbook. 1st ed. Burlington: Elsevier Academic Press, 2004; 200. 2. Hospital Information. Utah Valley Hospital. Available at: https://intermountainhealthcare.org/locations/utah-valley-hospital/hospital-information/. Accessed Oct. 5, 2016. 3. Hospital Information. Utah Valley Hospital. Available at: https://intermountainhealthcare.org/locations/utah-valley-hospital/hospital-information/. Accessed Oct. 5, 2016. 4. Wang B, Rui SIT, Fedele J, Balar S, Alba T, Hertzler L, Poplin B. Clinical Engineering Productivity and Staffing Revisited: How Should It Be Measured and Used? Journal of Clinical Engineering. 2012; 37: 135-145. 5. James, Scott. Biomed Tech Calculator: An Equipment Priority-Weighted Approach. Journal of Clinical Engineering. October/ December 2007; 32(4): 184-185.
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Webinar
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WEBINAR WEDNESDAY Webinar Series Earns High Praise
H
TM professionals around the world continue to flock to the TechNation Webinar Wednesday Series for nocost continuing education. One reason the series is so popular is the quality of the webinars. Another is that webinar participants are eligible for 1 CE credit from the ACI.
“Wow! These TechNation webinars are more satisfying than a cold brewski on a 90-degree day after baling 40 acres of alfalfa! You gotta get you some,” Wayne P. wrote in his post-webinar survey. And, he is not alone in his praise for the webinar series. “Another informative webinar that helps me with my job and recertification needs,” Kelly W. noted. “The information presented by the vendors on Webinar Wednesday is extremely educational and helpful,” Jim R. said. Those three testimonials came after one webinar, but it is not the only one HTM professionals gave stellar reviews. “Another great webinar. Always enjoy participating in these. Good refreshers on familiar topics and great information on topics that are new to me,” Allen G. wrote in his survey. “I’ve been in the biomed field for over 10 years and I learn something new in every session,” Clifford W. said. “The MD Publishing Webinars are a fantastic way to stay up to date with the latest trends in biomedical technology, and for refreshing your memories on topics you have trained on in the past and could use some brushing up on. The speakers are all industry personnel who are knowledgeable and generous with that knowledge and their time,” Eddie F. shared.
52
TECHNATION
MAY 2017
“The Webinar Wednesday series is a must for every HTM professional. I share info from the webinars in my staff meetings and encourage staff to participate,” Salim K. wrote. One recent presentation that drew a huge crowd was the Conquest Imaging-sponsored webinar “Verifying Image Quality, How to Use an Ultrasound Phantom.” Conquest Imaging Training Director Jim Rickner reviewed some poor image quality complaints from the field, described and illustrated the purpose of an ultrasound phantom and discussed multiple test descriptions and procedures for using a phantom in
probes is crucial in protecting an infant’s safety and health. Solecki discussed how to help protect the safety of the smallest patients. She also fielded attendee questions during the webinar. SPECT cameras were the subject of another webinar. The TechNation Webinar Wednesday presentation “Procuring Your Perfect SPECT Camera” by Universal Medical Senior Product Manager Craig Diener discussed which cameras work best for specific clinical applications and shared notable features and differentiators of various cameras during the webinar. Another topic covered in the presentation was patient volume in
“I’ve been in the biomed field for over 10 years and I learn something new in every session.” - Clifford W.
evaluating image quality. The webinar concluded with an insightful Q&A session. Ashton Solecki, the Product Manager of the Neonatal Test product line for Fluke Biomedical, discussed how to ensure proper performance of radiant warmers during another webinar. Her presentation included global testing standards, best practices for testing radiant warmers and skin temperature probe testing for incubators and radiant warmers. The webinar was sponsored by Fluke Biomedical. Validating the performance and safety of radiant warmers and ensuring proper performance of skin temperature
regards to demand for scans and workload limits for cameras as well as budget factors to keep in mind. Diener also reviewed a facility requirements checklist before taking questions from attendees in an informative Q&A session. FOR MORE INFORMATION about the TechNation Webinar Wednesday Series, including a calendar of upcoming webinars and recordings of previous webinars, visit 1TechNation.com/webinars. TECHNATION WEBINAR WEDNESDAY would like to thank the sponsors who participated in the webinars featured in this article.
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ROUNDTABLE IV Pumps
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MAY 2017
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ROUNDTABLE
H
TM professionals are no stranger to IV pumps. Preventative maintenance requirements and clinicians’ high-demand for these vital health care devices keep them almost constantly on the minds of all biomeds from the newest hire to department leaders.
However, technology changes fast and that means software updates and new features can become available at any time. TechNation reached out to a few industry experts to find out more about IV pumps. The members of the roundtable panel include Soma Technology Incorporated’s Ashish Dhammam, Elite Biomedical Solutions Vice President and Co-owner Nathan Smith, J2S Director of Sales and Marketing Sarah Stem, and AIV Incorporated’s Vice President of Sales and Product Development Jeff Taltavull.
Q: What are the most important features to look for when purchasing IV pumps? Ash Dhammam, Soma Technology Dhammam: The most important features to look for are design, ease of use, training the clinical team, service options, cost of service, and availability of repair parts. If part of a large IDN, system-wide compatability would be the best option to consider. If the pumps are complicated to use with many features, it will confuse users and lead to an excessive amount of errors. Smith: You have to identify what exactly the needs are of the hospital and find the device that matches those needs. The device should have a track record of reliability, minimal recall or advisory alerts and companies that can help support the device in a timely and cost-effective manner. Stem: The most important feature to look for would be patient safety software and warranty. Partnering with a company that provides warranty and addresses long-term repair and extended service options will also save the buyer money over time. Another measure buyers should check is the age of the technology and availability of administration sets. Taltavull: Safety and reliability along with ease of use should be in the forefront of any purchasing decision. Secondly, the facility needs a clear understanding of servicing options on the equipment, both OEM and secondary market. Thirdly, requirements for all necessary tubing sets should be considered to best coordinate long-term financial planning.
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Q: How can a biomed extend the life of an IV pump? Dhammam: Training and proper handling of the pumps by clinical staff would be key to extending the life of the units. Regular maintenance and PMs will extend the life of the pumps (per standards set by the OEM). Maintaining repair logs for each serial number would also help to identify repeated failures or failures due to user errors.
Nathan Smith, Elite Biomedical Smith: Identify companies that manufacture “new” replacement parts which can extend the life of a device even when the OEM discontinues support for the device. Also, seek out companies that have OEM-trained technicians who can service these devices in times of need. Stem: BMETs can extend the life of IV pumps by following OEM-specific preventive maintenance and sterile processing protocols, installing quality batteries and replacement parts, and by partnering with a third party that specializes in drug delivery device repair. Also helpful is continuing education sessions with RN staff which can cut down on repetitive repairs. Taltavull: The simplest starting point is assuring you maintain the OEM recommended preventive maintenance schedule. Routine maintenance, calibrations and safety checks can eliminate a lot of the simple failures that come along. Make sure all staff have a clear understanding of how to handle and operate equipment under normal circumstances and an understanding of how small things can lead to big repairs and increased costs.
Q: Do hospitals have to buy brand new pumps to get quality IV pumps? Dhammam: Not necessarily! As long as one is being diligent about buying IV pumps with a warranty, in good condition, and calibrated to OEM specs they should be good. And, they will last as long as new IV pumps. Please note that many large hospital groups are buying refurbished equipment to save on capital spending, and it is becoming a common practice. Software compatibility is vital before committing to purchase a refurbished unit. Smith: No, they can source units from companies that sell recertified units. Ensure these companies do full calibration on the devices, utilize new parts and take that extra step in ensuring cleanliness in all areas of the device.
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Srarh Stem, J2S Medical Stem: Hospitals can buy quality pre-owned medical equipment with a warranty. Not only does this provide a two-for-one cost savings but it doubles the number of available equipment during high census which keeps patient care the priority. Taltavull: No, the secondary market can be an excellent source for quality equipment. Purchasing from the secondary market does require some due diligence though. Crucial in that purchase is identifying a high-quality, ISO-certified vendor who not only is willing to provide the product, but will stand behind that product with warranty and downstream service options.
Q: What are the latest advances in IV pumps? How do these advances improve patient care and patient satisfaction? Dhammam: Wireless functionality, alarm management, the capability of measuring other parameters on the same device like CO2 and SPO2 are some of the advances made. Wireless monitoring of error logs and/or pump failures would be great additions in the future. Smith: CQI data collection is one feature in smart pumps that allows for hospitals to manage each individual pump and medication delivered. This helps understand where more training is needed with individual nurses and how they are administering the medication. Barcode scanning has also been introduced which minimizes any sort of human error associated with the patient’s information and the medication being used. Stem: Advancements in IV pump technology include safety software, therapy profiles, alarm management and patient barcoding. From a biomedical perspective, the most exciting advancement would be RFID tracking. This technology allows for expedited service during busy PM times and also during high census when locating lost pumps is essential if trying to avoid costly rentals. As RFID becomes more and more exact, the return on this investment for a hospital’s clinical engineering team will measurably save hospitals time and money.
STAFF REPORTS
Dhammam: Longevity of the pumps, few to no recalls, low service costs and quick service turn-around times would be key. When making the decision to buy, if clinicians and biomeds are involved in the process, it helps make the best decision for ROI. Smith: Purchasers can ensure good ROI by identifying quality companies that have a track record of doing the right thing. Also, purchasers should use companies that stand by their product and are willing to work with the customer to find the right solution. Stem: The best way for a buyer to ensure a healthy ROI is to partner with a provider that delivers an OEM-matched warranty, addresses long-term repair costs, offers training, and delivers competitive financing options. Look for a company that brings all of those aspects to the buyer’s table and allows for the customer to customize a program to ensure it falls within budget. Asking for flexibility on the provider side can also ensure the buyer receives what they need without compromising patient care due to budget constraints.
Jeff Taltavull, AIV Taltavull: Doing the front-end homework to identify the best options for their facility has to be the first step. Identifying qualified vendors and understanding the true cost associated with that equipment (i.e. servicing, parts availability, software integration, tubing costs) is important. One of the biggest complaints I hear in the marketplace is that a hospital decided to take on a massive acquisition of equipment that they bought into hook, line and sinker only to later find that they didn’t realize the OEM wouldn’t sell parts, or had mandatory secondary operations or limitations that weren’t understood by all at the onset. It is crucial that a facility’s staff not only evaluate the equipment themselves, but spend some time talking to people who currently own the same equipment and take time to understand their issues and concerns.
Q: How can health care facilities and HTM professionals protect patient data with cybersecurity measures in regards to IV pumps?
Taltavull: Smart pumps make it easier to store patient data as well as ease and safety of dosage calculation. Many of the pumps cross multiple delivery platforms using different modules or stacking features that allow a more all-in-one option where historically multiple pumps were needed.
Dhammam: An isolated network setup for a hospital with no outside intrusions would be helpful. Protocols need to be set up within every institute to clear all data from the pumps before they are shipped out for service, or sold from the hospital.
Q: How can purchasers ensure they will receive a good return on investment (ROI) when purchasing IV pumps?
Smith: I do know OEMs are incorporating cybersecurity measures into the software of their devices to help prevent attacks.
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Stem: Software driven equipment does pose a cybersecurity concern and facilities can address this by implementing strong security protocols. Incorporating firewalls on closed networks where outside access is not possible is common when trying to prevent hackers and protect patient safety. Taltavull: Cybersecurity continues to be a huge concern in today’s society. While there are huge benefits to the smart pumps and their ability to hold patient specific data, there clearly is an increased risk. Manufacturers are constantly doing updates to their software, so make sure to stay current with all service and upgrade recommendations.
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Q: What else do you think is important for TechNation readers to know about IV pumps? Dhammam: During the purchase process, please have a contract or agreement in place with vendors for service timelines, loaner availability or swapping out pumps; instead of waiting on a pump to be repaired and returned, which is definitely more time consuming.
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TRAINING PARTS REPAIR PM
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Smith: There are companies that manufacture new replacement parts and offer off-the-shelf new OEM parts to help support IV devices.
WE OFFER
Stem: It’s important for facilities considering new or additional infusion equipment to partner with providers that deliver efficient, reliable and cost-effective solutions. Look for a company that delivers a warranty with all of its products and services for continuous field support. Considering after-market and OEM-alternative parts is a great way to extend the life of a device while preserving capital. IV pumps that are software driven pose connectivity issues, buyers should be sure to match revisions when buying capital or parts to avoid interruption in service. Taltavull: OEMs are making it harder for end users to have flexible options to controlling their costs. I can’t emphasize how pertinent it is for a facility to do their due diligence when making a buying decision and making sure it includes feedback from all parties who will be using or implementing the product. A facility must understand the long-term costs, long-term servicing options and, more importantly, if there are options. They also need to be responsible when using third-party services on these ever changing pumps. They need to find reliable, educated and ISO-certified repair partners to help control their costs. That can be in depot repair, service parts, or calibration. And, the phrase that I say more than anything is that “Knowledge is the best buying power a hospital can have.”
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COVER STORY
A LOOK AT THE GROWTH OF THIRD-PARTY SERVICE PROVIDERS BY K. RICHARD DOUGLAS
hen a stock is bought or sold on an exchange, there have to be two parties to the transaction. The same can be said for gold or for something that was lying around the house before showing up on eBay. For any item sold, to have a value, there must be a buyer willing to pay a particular price for it. Although XYZ stock might have been bought at $20 a share, because the company’s future prospects and sales figures look promising, there may be a buyer who values XYZ’s stock at $25 a share and a seller could realize a profit. The idea of buyers providing the value to goods and services extends beyond the stock market or the commerce that occurs on eBay. The concept of free markets is as American as apple pie. In the U.S., if a person realizes a need or market for a product or service, they can bring that product or service to market and satisfy the market’s need for something that might not have existed before. These new providers are bolstered by the availability of financing from banks and other sources, while being
restrained through regulations, taxes or licensing requirements. The free markets could be considered pure capitalism, except that these government-imposed restraints make it more of a mixed capitalist environment, while a system without restraints would be a true free enterprise system. When free market forces are brought to the medical equipment sector, then the need for a third-party source for parts, service or repairs fills a void that exists because of pricing, flexibility or availability. Enterprising entrepreneurs realized a need existed in the medical equipment market and took a risk that they could fill that need and that there would be a continuing market for their products or services. This has created several industries, beyond the OEM or
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
the in-house biomed department, that offer needed products and services where there is demand. This demand is created by pricing or a lack of resources or the need for supplemental expertise. And, if anecdotal evidence can include stock prices, it would appear that the major ISOs are on to something. The stock performance of several ISO parent companies has been impressive in recent years. Positive feedback from biomed department leadership supports that contention. With shrinking hospital budgets, the opportunities for third-party providers to offer services or parts at attractive price points helps health care facilities and promotes a more robust market for competition and choice.
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FDA INQUIRY
come from a free market, including the reduced cost of parts and services because of increased competition. Without a substantial body of evidence that would suggest that non-OEM service or parts compromise patient safety, then the premise for the FDA’s inquiry becomes bewildering to many. The agency said that the discussion was sparked because “various stakeholders have expressed concerns about the quality, safety, and continued effectiveness of medical devices that have been subject to one or more of these activities that are performed by both original equipment manufacturers (OEM) and third parties, including health care establishment.” The OEMs argue that they are the
In light of these successes and the growth of the third-party market, the FDA has solicited comments from all “stakeholders” regarding “the service, repair, refurbishment, reconditioning, rebuilding, remarketing, and remanufacturing of medical devices.” During a two-day FDA Public Workshop last October, the agency listened to comments from a broad cross section of interested parties. The gathering followed a period where the agency solicited comments from stakeholders that were due in by early June of last year. A number of sources responded. AAMI pointed out, in a March article, that it was important that all stakeholders respond.
savings and availability of resources, challenges this mindset. The comments submitted to the FDA were, in many cases, self-serving. This is not a slight, since the FDA has the power, as a regulator, to impact the business success or failure of an ISO, require more time-consuming requirements from biomeds, or award exclusivity to OEMs; all with patient safety as the overriding and primary consideration. In the process, somebody’s toes are unintentionally stepped on.
A GROWING SECTOR
Third-party providers come in all shapes and sizes, with some mom-andpop operations providing local services and some massive enterprises offering
“ We use ISO’s for a variety of needs, from high-end modalities to simple screen repairs on monitors. All of our business relationships have to make good financial sense along with great quality. - BENJAMIN LEWIS, MBA CHTM, Diector of Clinical Engineering GA/FL, Adept Health Inc.
“If the information that the FDA receives is incomplete (because not enough organizations respond or because one or more segments of the industry do not provide detailed information), then it will make decisions using incomplete information. The FDA can only base its decisions on the information it receives or already have on hand,” AAMI concluded. The dynamics of this discussion are complex because there are not only competing interests, but concerns about intellectual property and the quality of service or parts versus the benefits that
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ones with their collective feet held to the fire. For this reason, they argue that they need to exercise more control over the maintenance, servicing and parts replacement of the equipment they manufacturer. Anybody else, whether an in-house biomed department or an ISO, is a third-party, and their work or parts selection, should be held up to scrutiny. Regulators can see something different than the market does. It may be that from a bureaucratic standpoint, some type of standardization is always the most reassuring state of affairs. This may be a practical consideration for approaching PMs, but the need for cost
services internationally. Compass Group (CPG), which owns Crothall Healthcare, has seen its stock price rise by 56.14 percent from March 16, 2014 to March 19, 2017. Sodexo, S.A. stock (SJ7), has seen a stock increase of 37.40 percent in that time and Aramark (ARMK) stock has experienced a 35.35 percent increase during the same period. These are just a few examples that would illustrate that these companies provide a needed service, reflected in the value that investors place on them. The success of these stocks could reflect the success that this market
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sector has enjoyed in recent years, or it may be something else. “Does that mean that smaller ISOs are being bought up or pushed out? Does it mean that mergers of systems have benefited the large ISOs that can assume such large risk? Is there no correlation of the companies HTM portfolios and their success over the past five years?” asks Benjamin Lewis, MBA, CHTM, director of Clinical Engineering GA/FL for Adept Health Inc. While Lewis poses some good questions, he also has an insight and appreciation for the value an ISO brings; his department is an ISO. “My department is an ISO, and as such, we have a healthy relationship with many specialized ISOs. We use ISOs to compliment the services we provide, which helps keep uptime high and costs low,” he says. “We use ISOs for a variety of needs, from high-end modalities to simple screen repairs on monitors. All of our business relationships have to make good financial sense along with great quality. On the biomedical front, companies that that are set up to complete component-level board repairs are very helpful at reducing repair costs and high-end modality technical and parts support can help keep your budget intact.” That budget impact can be accomplished in more than one way. The ISO is working at gaining more market share, while their presence can also prove to be a bargaining chip. “We utilize ISOs for an alternative to OEM service for cost savings and buying leverage with the OEM. They also work harder for our business as most are competing with OEMs,” says Matt Royal, CHTM, CLSO-M, CHC, CHFM, CBET, director of Biomedical Engineering at Eskenazi Health in Indianapolis. The clinical engineering department at Rochester Regional Health System in Rochester, New York has found a good balance in their use of ISOs.
“We use ISOs at times to perform PMs when we are short staff due to vacation, long-term disability, or training,” says Tony Alongi, MBA, the department’s technology management supervisor. “In addition, we would use an ISO for corrective maintenance if we are overwhelmed with service requests and our in-house team could not get to an issue in a timely fashion.” Alongi’s department utilizes ISOs in a ratio that is about 80 percent for repairs and 20 percent for PMs. “We also use ISOs for a particular service such as rigid or flexible surgical scope repairs and ultrasound probe repairs due to the cost effectiveness for the ISOs pricing structure. Moreover, we have used ISOs to source parts if we can’t get them from an OEM at a competitive price,” Alongi adds. “We utilize ISOs mostly for parts and board repairs. We will on occasion utilize them for flat-rate repairs, refurb parts, repairs, and PMs,” says Joshua Virnoche, MBA, CBET, manager of Clinical Engineering for JPS Health Network in Fort Worth, Texas. Resources and parts availability play into the decision to use ISOs at Baycare Health System in Clearwater, Florida. “We evaluate ISOs based on their ability to perform timely quality repairs for which we are unable to due to workload or competency or to procure repair parts which the OEM no longer has available,” says Walter Barrionuevo, director of Clinical Engineering and Client Services at Baycare Health System. Although the need to fill in when resources are needed is usually a temporary scenario, the ISO does fill an important niché that can often become long term. Hospitals are know to use ISOs for service, which includes both repairs and preventive maintenance. Some have established long-term partnerships with vendors, who help during times when hospitals are short staffed or have special projects.
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“ We evaluate ISOs based on their ability to perform timely quality repairs for which we are unable to due to workload or competency or to procure repair parts which the OEM no longer has available” - WALTER BARRIONUEVO, Director of Clinical Engineering and Client Services, Baycare Health System
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“ There is an advantage of using ISOs that sell parts in addition to service. Often, they are able to show up with ‘hero kits’ based on the symptoms and potential diagnosis of our engineers.” - BENJAMIN LEWIS, MBA CHTM, Diector of Clinical Engineering GA/FL, Adept Health Inc.
ISO can also be beneficial when it comes to the logistics of having to bring someone on site quickly for a short period of time. The same approach goes for using an ISO for sending equipment out for repair and PMs. On the other end of the spectrum is the biomedical engineering department at Texas Children’s Hospital in Houston. Director John Weimert reports that his department uses ISOs “very rarely.” “Most equipment is serviced in-house by the Biomedical Engineering technicians. However, we use manufacturer support on a time and materials basis, or service contract as needed,” he reports.
ANOTHER PARTS SOURCE
Are these same managers using ISOs for parts? “We generally use ISOs more for parts than equipment service. This is due to the complexity of keeping medical equipment current in terms of firmware and software levels for which most ISOs are unable to provide,” Barrionuevo says. “There is an advantage of using ISOs that sell parts in addition to service. Often, they are able to show up with ‘hero kits’ based on the symptoms and potential diagnosis of our engineers,” Lewis says. “This can reduce downtime and reduce cost because there should be no restocking fees in cases where the ISO brings parts in on a service call. Working with local ISOs, that have parts on hand, is an important relationship for any successful ISO or in-house program,” Lewis adds. TRENDS IN ISO UTILIZATION Has there been a shift in the industry in regards to how biomed departments utilize ISOs? It depends on who you ask. The level of engagement with ISOs, and the views of this segment in the future, are as varied as the biomed departments that use them.
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“I’ve spoken to several contacts, both in HTM departments and vendors that serve these departments, and the general consensus is that there is a move away from using ISOs for service, and utilizing them more for parts,” Virnoche says. “Additionally, from my interactions with these parties, the consensus is that it’s much harder done than said, and there is a multiple year implementation in most cases.” Beyond parts or service, the training provided through ISOs may offer benefits as well. “ISOs have been more willing to offer training at a reasonable cost, although it is not the same as OEM training, the value is that they are not filtered in discussing the real product issues and offer solutions that are in the best interest of value to a HTM program,” Royal says. Barrionuevo’s department has been leaning more towards the OEMs on balance. “We have seen a shift from partnering more with the original equipment manufacturer and utilizing ISOs less,” he says. “As the number of medical devices, that are networked to our hospital network has increased, the need to keep current with firmware and software levels have shifted our focus to relying more on OEM support as they are the only ones who can provide us with this level of support,” he adds. “In addition to firmware/software levels, with the focus on cybersecurity and keeping the medical equipment infrastructure safe and secure, the original equipment manufacturer is the only venue we have who can assist us in making changes to medical equipment software, applying necessary operating software/firmware patches or installing antivirus applications,” Barrionuevo says. If software updates are the province of the OEM, are there other areas where the ISO can make inroads? “The shift that I see is greater
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capacity on the part of the ISO for providing what is needed in the field by biomedical engineering departments,” Weimert says. “They are filling a void created by the lack of manufacturer willingness, or ability to provide more attractive parts pricing, parts availability, technical training options and other types of support,” he says. “Some of the ISO training that we have utilized is far less costly than that offered by the manufacturers, and is of high quality and is often more convenient to schedule,” Weimert adds.
reduce competition for their service industry and continue to pressure third parties out of the market or acquire them to corner the market,” Royal says. “AAMI support has been from OEM’s and local HTM societies get support from third-party service providers. That being said, in-house biomed programs and third-party service providers are under siege from OEM lobbying and the perceived AAMI lack of support.” Lewis points out that according to the FDA docket, anyone who is not the OEM is a third-party provider; even an in-house program. He says that it has
it’s returned to use,” he says. “Additionally, I’ve started to see many ISO’s state their limitations, and if they’re unable to resolve an issue, will suggest to tag the OEM for issues they cannot resolve. Ultimately, I’ve seen excellent and poor results from both OEMs and ISOs,” Virnoche adds. Weimert sees budgetary considerations as a key to the future use and availability of ISOs. “I believe the impact is tremendous, especially for those HTM programs challenged for funding. I believe that all biomedical engineering department
“ [ISOs] are filling a void created by the lack of manufacturer willingness, or ability to provide more attractive parts pricing, parts availability, technical training options and other types of support - JOHN WEIMERT, Director of the Biomedical Engineering Department, Texas Children’s Hospital
Lewis sees another trend that he thinks will be beneficial to ISOs. “ISOs are continuing to try to be more creative to set themselves apart. One recent development that I see becoming more popular is video conference troubleshooting,” he says. “I see video complimenting VPN diagnostics. This isn’t entirely new, but I do see this increasing in popularity in the coming years.”
FDA ASSESSMENT
The intention of the FDA docket elicits some cynical skepticism about motivation. The review really scrutinizes anyone who is not the OEM. Many leaders in HTM see a place for the ISO in their toolbox. “This will drive costs up without improving safety. OEMs are looking to
had little impact on the way he does business currently, outside of extra scrutiny on any imaging and laser service providers to ensure that all maintenance meets OEM specifications. “As the president of the Healthcare Technology Management Association of Georgia, the organization did sponsor a board member to attend the FDA Workshop and we are keeping a close eye on any new developments,” Lewis adds. While Virnoche’s department has been working to move most repairs, PMs and services in-house, he can see the concerns that might have sparked the docket. “I believe that in nearly all cases, HTM/biomed departments do a great job in vetting out non-quality repairs/ service, and in-house technicians should remain responsible for ensuring the equipment is functional and safe before
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
leaders need to be smart and resourceful when it comes to managing their medical equipment,” he says. “An ISO can be used as an important piece of the HTM’s overall strategy for managing costs, repair parts, technical training and service options, more now than ever before,” Weimert adds. With a number of compelling reasons for the use of ISO resources, and the concerns of the OEM as the standard bearer, the decision process still rests with the hospital, unless the FDA intervenes further. Health care facilities are paying more attention to their due diligence between OEM versus third-party support, according to some industry leaders. However, until the FDA releases additional or updated information regarding this issue, health care facilities are expected to continue the status quo.
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EXPERT ADVICE
BY TODD ROGERS
CAREER CENTER Keys to Great Presentations
H
ave you ever had to stand up in front of a group of people to give a presentation? Whether it’s three people or three hundred, if you are expected to deliver a presentation, two things are likely to be true: 1) you will be nervous immediately before your presentation, and 2) you will probably do just fine. However, instead of giving just an OK presentation, there are a few things that you can do (or avoid doing) that will easily make your presentation excellent. What follows is a short set of tips that you should consider when it’s the night before your event and you’re standing in front of the mirror rehearsing.
The first item relates to how you’re going to organize your message. You may have heard this before but the simplest formula for organizing a presentation is this: 1) tell them what you’re going to tell them, 2) tell them, and 3) tell them what you just told them. Your English teacher might call that the introduction, main body, and conclusion. In presentations, it’s incredibly helpful to briefly state what you’re going to cover. It sets expectations and gives the listener something to watch for as the presentation unfolds. Alternatively, consider going on a trip but not knowing where you’re going or how you will get there. It might be exciting but it might also be pretty frustrating. Not knowing what is important in a presentation sets the audience members on a course of investigation, which will distract and fatigue the mind. And, they will be busy trying to figure this out when what they should be doing is paying close attention to you. So, by not offering a presummary, you’re creating competition for yourself; you compete against the audience members’ own imagination. That is bad. However, it can be eliminated or greatly reduced if you just tell the audience in advance what you’re going to cover.
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Have you ever sat through a PowerPoint presentation and the speaker simply read from the screen? He puts his entire presentation in sentences, puts the entire thing on the screen, and proceeds to read from the top of the screen down to the bottom, adding in a few comments along the way. This is incredibly boring. If you’re anything like me, I read the entire slide and then start wondering what will be revealed on the next screen. Once he puts his cards on the table, in this case the big screen, I pay almost no attention to the presenter. In your rehearsal, try to make a conscious effort to note how many times you utter “Um,” “Ah,” or any of the dozens of non-word fillers. I consider myself to be an above average presenter. I recently watched a video of myself as I was presenting at a conference. I had no idea that I was a habitual “ahh” user. I actually believed that of all the presenters that I’ve seen who use non-words, I was not one of them. I was shocked. But once I discovered it, I made the change. In my case, I was using non-words when I was transitioning between my visual aid and my audience. I would make some comments and then refer to the screen, and then as my attention shifted back to the audience, I reliably said, “and …
TODD ROGERS Talent Acquisition Specialist for TriMedx
ahhh” like clockwork. The moment I realized that I was doing this, I immediately stopped. I didn’t even have to really work to make the change. It just happened. I hope that it’s as easy for you as it was for me. My final tip is something that usually comes naturally: breathing. Of course, no one really needs to think about breathing. It’s involuntary. However, there are two things about breathing and public speaking that are easily overlooked. First, as a person begins to experience stress, his or her breathing tends to become shallow. This is incredibly unhelpful of Mother Nature. Deep breathing relieves stress. Right before a presentation, you’re stressed. The second thing about breathing is, leading up to your presentation, you should be doing a lot of it – long, slow, and deep breathing. Not only does this calm your nerves but it also primes your lungs. Your lungs supply the air that you need in order to have a clear speaking voice. It’s sort of ironic: breathing is
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involuntary, stress-relieving, and makes you sound better. But when you need copious amounts of air, your body magically forgets to breath properly. My tip: get a Sharpie and write, “DEEP BREATHING” on your palm. I have found a technique called “box breathing” that works fabulously when I need to have optimal composure. In box breathing, you use three seconds to inhale, hold your breath for three seconds, use three seconds to exhale, and keep your lungs empty for three seconds. Repeat this box-cycle 10 times, 20 cycles is better. You will be simply amazed at how relaxed you become in a matter of seconds. If you’d like to see professionals in action, look no further than your evening news. Watch the weather person. He or she is usually unscripted and is standing in front of a large screen while speaking to a camera. Your local meteorologist does a 1-2 minute presentation and most likely doesn’t use a single non-word, doesn’t read from a screen that you can also read, and always sounds composed and comfortable. I offer one note of caution. Once you start paying attention to your own presenting style, you will never view anyone else’s presentation with an uncritical eye.
C
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Ultrasound QA & Training Phantoms
• Multipurpose • Small Parts • Breast • Doppler Flow • Endoscopic • Contrast Detail • Custom Design • Training ATS Laboratories, Incorporated www.atslaboratories-phantoms.com
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MAY 2017
TECHNATION
71
EXPERT ADVICE
BY MIKE DAVIS
ULTRASOUND TECH EXPERT
Sponsored by
Because Quality Matters ISO 9001:2008 CERTIFIED
Clearing Patient Data – Save Yourself a Service Call
A
s a Technical Support Specialist, I can’t tell you how many times I’ve received an urgent call from an end user who says their system is running slow and will not allow them to create a new patient. I am usually able to confirm fairly quickly that they’ve tried everything they know and nothing is allowing them to create a new patient. More often than I care to mention, we soon discover together the cause ...The storage space on the drive is full.
MIKE DAVIS Technical Support Specialist
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Storage space on the ultrasound is limited; however since the system defaults to saving patient data like images and videos on the system, the drive can quickly fill up. If the system is older, this can happen even faster. The result is a slow and sluggish system, unable to add new patients, unable to send images to PACS and this can cause a system to lock up. Removing older patient data is recommended at least once per year. If the system receives a preventive maintenance every 6 months, try to perform a data deletion at that time. Clearing patient data is normally a fairly simple process. The first step is to insure that you have the permission to delete the files—check with the lead biomed or technician before you begin. Once the data is off the system it is gone for good so be careful. There are several ways that you can remove the patient data. Directories can be removed one at a time or with a full database reset. Systems like GE and Toshiba offer the ability to fully reset the database. This is the preferred method as it will recover the maximum amount of storage space. Please use this method only after assuring that there is nothing on the system that the staff may still need access to. There are times where the staff has no server to transfer the patient data to and
they need to keep the patient records. If you run into this issue, your best course of action is to back up or transfer all the necessary files to a thumb drive or a CD/ DVD. Be sure to provide the backed up data to the staff for safe keeping. Never offer to store the files for them as this is a direct HIPPA violation. Removing the information from the system will vary from system to system and from manufacturer to manufacturer. Pulling up the patient data and deleting them from the patient screen can seem like a long and tedious method. This method does have advantages. It allows you to delete specific files plus it does not require any special codes or passwords. Some systems like GE do allow you to perform a full database reset with the proper passwords. Other systems like a Sequoia 512 will allow you do perform an AEGIS reset right from the system tab. While still others will require a special license to access the process. Any way that you choose to clean up the systems storage drive, just make it part of your normal routine. This will keep your sonographers happy and reduce your overall service call numbers. TO LEARN MORE about this issue call 866-900-9404 or visit www.conquestimaging. com to chat live with Mike or watch technical support videos.
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BY JEFF KABACHINSKI
TECH SAVVY
Wireless Networking Overview
I
n this column we will take a survey of wireless networking technology. Since 1997 wireless technology has grown in the IEEE802.11 standards realm. One of the best ideas of the 802.11 standards is the backward compatibility that’s baked in – although at slower data rates as you move down in standard revisions. New wireless routers typically come compatible with 802.11 a and b/g/n/ac. Let’s take a closer look into the different revisions to the 802.11 standard.
As mentioned, the standard allows switching between a variety of data rates dynamically. Poor RF conditions can cause the wireless nodes to step down data rates through the standard revisions to maintain the connection and step back up when conditions improve. In wired Ethernet terms, network traffic collisions are detected and data is retransmitted when the air is free. Wireless connections don’t have that luxury due to transmitting nodes that are hidden to the sender. Instead wireless technology uses a collision avoidance concept. This utilizes a request to send (RTS) packet containing just the sending and intended receiving addresses and intended transaction duration information. The intended receiver replies with a clear to send packet (CTS). Other nodes sensing these packets will hold off transmitting for at least the transaction duration. Table 1 shows the original standard with the several amendments and corrections. The standard revisions use the name of the main document – 802.11 plus the rev level. For example: 802.11b, 802.11g and so on. In other words, the rev level designates the physical medium specification. The IEEE standard first appeared in 1997 as 802.11. It was released with both a frequency hopping (FHSS) method and a distributed sequence (DSSS) method – both as spread
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spectrum. An interesting side note – Hedy Lamarr the famous actress of the 1940s co-developed a radio guidance system for torpedoes at the beginning of World War II. It used spread spectrum and frequency hopping techniques to avoid the radio jamming of the Axis powers. The principles of that work lives on in today’s Wi-Fi technology. Hedy and her co-inventor, composer George Antheil, are in the National Inventors Hall of Fame. (see table 1) REV A 802.11a defined in 1999 overcame some of the original 802.11 specs by moving to the 5GHz range from the 2.4GHz band. Higher data rates (up to 54MBs) are achieved by using Orthogonal Frequency-Division Multiplexing (OFDM). However, with its error correction code the actual data throughput is closer to 20MBs. OFDM OFDM uses many subcarriers that are closely spaced in an orthogonal (or 90 degree apart) fashion. Each subcarrier carries part of the data stream at a much slower data rate. Combined, the subcarriers add up to the faster data rate. OFDM techniques also deal much better with signal fading due to multipath. Multi-path occurs when reflected RF signals recombine causing interference, fading and phase shifting.
JEFF KABACHINSKI Senior Director of Technical Development, ITD
REV B 802.11b was the first generally accepted protocol and was in use earlier than 802.11a causing many to think that it was released before 802.11a. Rev B uses the original 2.4GHz range. While the 11MBs data rate beats the original 802.11 rate of 2MBs. Note that the 2.4GHz range can get interference from household appliances such as microwave ovens and cordless phones. Rev B uses Complimentary Code Keying (CCK) at a smaller chip rate than the original spec. The original used 11 chips per bit – in other words each digital 1 or 0 of data was represented by a series of 1 or 0 “chips” to help avoid RF interference. Rev B reduces the number of chips to 8 allowing for more data bandwidth but with higher RF interference probability. When network gear indicates that it works with Rev A or Rev B they actually run them side by side with the different frequency ranges used. REV G 802.11g took advantage of newer
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EXPERT ADVICE
Year Standard
Band
Encoding
Data Rates Mbps
Comments
1997
802.11
2.4 GHz
FHSS
1, 2
Didn’t catch on
1997
802.11
2.4 GHz
DSSS
1, 2
Small install base but a fallback scheme for future versions
1999
802.11b
2.4 GHz
DSSS/
1, 2, 5, 11
Added Complimentary Code Keying (CCK) for higher rates
1999
802.11b
2.4 GHz
DSSS/
1, 2, 5, 11
Added Packet Binary Convolutional Coding (PBCC) as an approach to achieving 5.5 and 11 Mbps data rates.
1999
802.11a
5 GHz
OFDM
6, 9, 12, 18, 24, 36, 48, 54
OFDM - Orthogonal Frequency Division Multiplexing for higher data rates. Came along in 1999, but hardware was not available until 2002
2003
802.11g
2.4 GHz
2009
802.11n
2.4 GHz & 5 GHz
2013
802.11ac
2.4 GHz & 5 GHz
Up to 54
Uses CCK, OFDM & PBCC to achieve higher data rates
MIMO-OFDM
Up to 600
Uses MIMO (Multiple Input, Multiple Output), channeling with 3 antennae at the access point to achieve much greater throughput and range. Heavily dependent on SNR.
MIMO-OFDM
Up to 1300
Supports simultaneous connections at
Table 1
encoding techniques to increase data bandwidth up to 54MBs. One additional idea was Packet Binary Convolutional Coding. PACKET BINARY CONVOLUTIONAL CODING A convolutional code is error-correcting by using parity symbols. With PBCC it’s within the data packet with a sliding function of a Boolean polynomial working on a data stream. The sliding function is the “convolution” over the data, which gives rise to the term “convolutional coding.” However newer techniques have taken over. Rev G was to be backward compatible with Rev B but reduced data rates in the process. REV N 802.11n adds multiple-input multiple-output antennas (MIMO) to the
scene. Rev N works on both main Wi-Fi frequencies – the 2.4GHz and the 5GHz bands. However, technically, support for the 5GHz bands are optional. It operates at a maximum net data rate from 54Mbit/s to 600Mbit/s. MIMO multiplies the transmit and receive antennas to utilize intentially generated multipath RF broadcasts to multiply link capacity. REV AC 802.11ac has a bandwidth that’s rated up to 1300 MBps on the 5 GHz band plus up to 450 MBps on the 2.4 GHz band. IEEE 802.11ac was released in 2013 building on the 802.11g protocol. The changes included wider channels from 40 MHz to 80 and 160 MHz in the 5 GHz band. Rev AC added up to 8 spatial streams and a higher-order modulation up to 256 quadrature
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amplitude modulation (QAM). This all adds up a 1300 MBps data rate. A new technology is also used, multiuser MIMO (MU-MIMO). Whereas Rev N is like a wired Ethernet hub that can only transfer a single frame at a time to all its ports, MU-MIMO can send multiple frames to multiple nodes simultaneously using the same frequency spectrum. In wired Ethernet terms think of this as behaving like a wireless switch. SUMMARY Other revs in the standard family not listed in Table 1 (c–f, h, j etc.) are changes used to add to the breadth of the standard, which can include corrections to a previous rev. Next month, Tech Savvy looks into wireless security.
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EXPERT ADVICE
BY ALAN MORETTI
THOUGHT LEADER Valuing HTM Service Productivity – Still a Moving Target
I
t’s essential to measure productivity appropriately. In-house HTM departments and vendor service providers seeking to raise their competitiveness will invest in methods to track their efficiencies from a service management and delivery perspective. Benchmarking software tools, outside consultants – experts in cost accounting and statistics – have heavily influenced the metrics that may be used as reference points. Most often the focus is on statistical productivity indexes that often have a varied pool of data. It is important to know how it was acquired and its concise method of measure. All too often, the data introduced, and its method of acquisition, vary and ignore the real every day challenges in-house HTM departments and vendor service organizations face in the clinical environment.
ALAN MORETTI Healthcare Technology Management Advisor
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Productivity measurement should focus on overall capabilities, not just on one set of parameters. How efficient is the in-house HTM department or vendor service organization in receiving and triaging service calls? Response times back to the clinical customer by phone or arriving at the site ready to assess a service event situation are important. The time involved in bringing remediation to a service event many times is not only comprised of actual on-site labor performance but also includes research required in aiding the task of solution as well as close-out event recording in the CMMS database. That’s what a productivity index should address. It is, as much as possible, a relationship between many physical inputs and their required outputs. Still, much of the “measuring of productivity” remains preoccupied with direct labor. At the national level, productivity figures do mean labor productivity. The U.S. Bureau of Labor Statistics, the primary source of productivity information, logically
enough focuses on labor productivity. Cost accounting also reinforces this bias. Perhaps the most important use of HTM service productivity measurement is as an objective source of information about long-term operating trends. Productivity comparisons can also inspire the useful exchange of ideas. Differences in the amount of vertical integration, subcontracting, accounting policies, and many other factors often obscure the relative productivity measure of an HTM service provider’s functions – this is true for both in-house and vendor service providers. Nonetheless, if an HTM service model finds itself a lot less productive than a competitor, it probably has a real valuation problem. HTM managers may insist that the productivity gap is overstated, and they may be right. They will be hard-pressed, however, to argue that it does not exist and defend the value of their HTM program’s competitiveness or, perhaps, their long-term existence as the preferred provider of choice!
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BY EDDIE ACOSTA
EDDIE ACOSTA
Implementing Project Management for HTM
T
he Healthcare Technology Management (HTM) professional can have a multitude of tasks to accomplish in their daily work routine. Many of these tasks involve medical equipment projects that need to be planned, budgeted, deployed, installed or removed. There are many efficiencies that can be had by having an effective project management program and understanding the Project Management Institute’s (PMI) 47 processes of inputs, tool, techniques, outputs and formulas can greatly assist the HTM professional in organizing and implementing a successful project plan. The biggest impact to a PMI program is understanding the process and realizing the influences that can affect success.
The first step is knowing what is a Project? The Project Management Institute states “a project as a temporary endeavor started to create a unique product, service, or result.” A project is an effort with limited time, limited budget, resource availability and limited performance specifications to meet the needs of the project’s customer. PMI has listed the five characteristics that consider what a work effort must have to define it as a project. 1. The project must have established objectives that are results-oriented. These objectives are called deliverables that must be produced or specific services that are provided. 2. The work required in a project should be performed within a specific time-period. 3. A project typically involves some element that has not been performed or is unique. 4. A project must meet specific time, cost and performance requirements. The constraints of time, cost and performance are called the triple constraints and are the work options and actions of a project that establish the completion schedule (time), budget (cost) and scope (performance). 5. One of the most important elements of a project is accountability. A project must have assigned resources for the assigned budget and assigned
EDDIE ACOSTA Business Development Manager, Colin Construction Company
individuals to accomplish the project. Because projects have a beginning and an end, the complete time duration represents a project life cycle. The project management process reveals that projects are generally accomplished in five distinct phases. The initiation phase is where the project charter is written to confirm the existence of the project and seek funding to complete the project. The planning phase is where the development of a project scope statement, work breakdown schedule (WBS), risk management plan, project schedule, communication plan, resources plan and quality plan take place. These plans will guide all the support for the rest of the project. The
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execution phase is where the work of the project is done and where the development of the deliverables and accomplish the product of the project. The monitoring and control phase manages the project and is designed to bring the project in on time and on budget or make the corrections needed for this result. The close out phase is where the project’s records are updated and where the project’s lessons that are learned are recorded. Once documentation is complete, the final payments can be made, and the project team can be released for other projects. The Project Charter is the most important document to create for a project. This will list the ideas of the project into a process that can be vetted and approved by those in the position. This charter should contain the project title that will be used to identify the project. A project description of why the project is being created with a mission or purpose of the requirements that are being achieved. This should also contain a description of the end-product and what that looks like. From the business side, a business case will be required and this should state why the project is being created. What are the competitive advantages to the project, are there cost savings or money making opportunities? Will additional patient care services be required and will the patients or the
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business benefit from the project? One of the most recent project requirements has been new regulation and that has been driving new projects. The budget should also be addressed and an initial high-level budget can be included. The project charter should also have the authority level of the project manager to spend the budgetary resources or modify project schedules. There should
BY EDDIE ACOSTA
same questions every day before starting a project to ensure that only the right projects are moved forward. ORGANIZATION There are five typical project organizations that most companies use in their processes to manage projects. There will be only a brief discussion of the types of project organization to stay on subject on
“ The project charter is designed to answer typical questions that anyone would ask before approving a large purchase, or a large project. This is where the who, what, when, and why must be answered in the project charter.” be some failsafes that ensure that your clinical engineering project, as the subject matter expert, is driven by the project manager but guided by your knowledge of the project. The key stakeholders should be listed so that you and the project manager know who is working with them to complete this project. There should be clear objectives with measurable results of the services performed that must be obtained. The significant points or events in the project must be listed in the milestones. These comments must state when the stakeholders expect to reach these points? When should phase one testing be complete or when should the new CT be ready in the hospital? The project charter is designed to answer typical questions that anyone would ask before approving a large purchase, or a large project. This is where the who, what, when, and why must be answered in the project charter. Who will be doing the work? What will be done? When will it start and when will the project end? Why are we doing this project work? Companies ask these
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integrating project management in clinical engineering. The project management industry groups the matrix organization into three separate categories. The functional organizations are similar to your typical biomed shop where the technicians report to a supervisor, and the supervisor reports to a manager that reports to a senior management person. This structure is well designed for typical day operations and not for complex projects. There are projects that are possible, but are typically done by one functional area. Replacing old equipment would be an example of a project that would not need much support from other departments. Project managers do not exist in this organization, but technicians may have a temporary title of project manager. A better description may be project coordinators to accomplish similar projects and would report to the manager. This lack of autonomy that a project manager requires when managing projects makes it very difficult to manage them in functional organization. The matrix organizations were
developed to support functional organizations to operate with crossfunctional teams from other functional areas such as IT, facilities and construction. The weak matrix, the functional manager retains project control and utilizes project coordinators on the project. The advantage of the weak matrix is that a cross-functional team assists in making the project much easier to accomplish. In a balanced matrix, project managers are aligned with functional mangers and are useful when the project is equally significant as daily biomed work. In the strong matrix, the project manager controls all resources for projects with a dedicated cross-functional team. This organizational type is used on projects that are of high value to a company. In a project-focused organization, the project teams are dedicated and separate from functional areas. These teams could be contractors and are used by large corporations for R&D projects, complex construction projects, and by the aerospace and automobile industry. METHOD In today’s project management, there are traditional and agile project management methods. The types discussed are traditional project management forms that are used for typical design and repetitive projects. Agile project management is used on hard to define projects that require innovation, where the function is known and are collaborative with many functional teams. Traditional and agile project management function very similarly. They both require a charter to get the project started and both require authorization to begin the project. The traditional project management system will be focused on the project scope that lists all the project requirements. This is also where the work breakdown schedule (WBS) will be developed that will outline all the work activities required to complete the project scope. The WBS has project elements for the cost estimation and development of a project budget, project schedule creation,
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risk management, and all the other CULTURE driving force for a hospital’s total components of the project plan. Another variable of how projects are strategic vision. The building blocks of In an agile project management managed is the culture of an organizaa company’s strategy are the successful system, the project typically starts from tion. The consequence of the organizaprojects they complete and by having an the customers’ requirements for tional culture on the project management effective project management program functionality and performance because process can affect projects in different with an action-oriented plan is the the specifics for the project cannot be ways. There is an affect on how departstrategic strength of a health care defined at the time the scope is written. ments are anticipated to cooperate and organization. The health care projects The difference is that the scope is support each other in the quest for such as new medical equipment developed as the project progresses and project success. The culture influences replacement, an ICU expansion or the deliverables are created. the commitment level an employee has implementation of new MRI technology Projects require the project manager with the project and other competing of a hospital organization is critical to to understand where to begin the work. projects and goals. Organizational its mission and strategic goals. This occurs in agile as well as traditional culture also influences the way projects Furthermore, the mission, objectives, project management where both begin by are planned, how work estimates are strategies, goals and plans of a health gathering the requirements from the key done, and the assignment of resources. care organization must all be stakeholders. In traditional project the culture similarly affects the incorporated in an effective project PROOF APPROVED CHANGES Lastly, NEEDED management, the requirements are way managers evaluate the project team’s management program. interpreted into a comprehensive scope. performance and outcomes. CLIENT SIGN–OFF: While in agile project management, the In conclusion, projects are the EDDIE ACOSTA, MBA, CBET(e), CLRT, is a requirements combined THAT into a scope “stepping stone” a health care member of the TechNation Editorial Board and PLEASEare CONFIRM THE FOLLOWING AREofCORRECT with very little detail. system’s strategy. The organization, Business Development Manager with Colin LOGO PHONE NUMBER WEBSITE ADDRESSConstruction SPELLING GRAMMAR method, and culture determine the Company.
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BY ROGER A. BOWLES
THE FUTURE
Higher Education Options Disappearing
I
n the past year, several colleges around the country have shuttered their biomedical equipment technology programs. This comes at a time when demand for biomedical equipment technicians, specifically entry-level technicians, has steadily increased. The Texas State Technical College System offers biomedical equipment technology at its Waco, Harlingen and Marshall campuses. At least it did until this month. Recently, it was announced that the Marshall campus will no longer offer this program. Reasons given were struggling enrollment and placement. Marshall is in a smaller town and many students do not wish to move. Also, fewer hospitals in the area mean fewer opportunities for internships. Plus, operating a biomedical equipment technology program is expensive and most programs have very limited budgets and rely on equipment donations.
With limited state budgets, that seem to get smaller every year, the TSTC system is like most colleges in evaluating the vitality of its programs. In Waco, probably due to our central location in the state, we are fortunate to have multiple internship partners and we tell prospective students that they have to be flexible about relocating. We still struggle with equipment but we have had some funds infused into the program lately and our instructors spend those funds very judiciously. With a large network of enthusiastic supporters and successful graduates, we are doing OK … but enrollment is still down. Word-of-mouth promotion from our successful graduates brings in many of our new students. Despite a large recruiting push by visits to high schools, career days and similar activities, the recruitment of high school students remains a challenge. Part of the problem is the starting salary of entry-level graduates. It has increased quite a bit over the course of 20 years, but it isn’t matching other industries. Our entry-
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level technicians have had starting salaries ranging from approximately $40,000 to $44,000 per year, depending on location. We have had several graduates start at over $60,000 per year with manufacturers. But other programs, such as Electrical Power Control, Instrumentation, Robotics, and even Welding, have average starting salaries that exceed $65,000 per year. Recently, these programs have even started offering their instructors market-based differentials to keep them from going back into the industry. The college is even offering a money-back guarantee to students in those programs if they cannot find a job (with many stipulations that inlcude attending job preparation classes, being open to multiple locations within the state, etc.). These tactics diminish the appeal of other programs. Two of the selling points of a biomedical equipment technology career that we have always stressed are job satisfaction and its steadiness. Other industries, especially in Texas, typically have big swings where jobs
ROGER A. BOWLES MS, EdD, CBET, Texas State Technical College
can dry up seemingly overnight. That hasn’t been the case for us. If someone is motivated and willing to relocate to where the jobs are … then he or she can always find work. We also stress the potential in this career field and the ability to pick many different career paths and locations. Plus, you get to work indoors and that is a big positive in Texas. So those younger students, who are still trying to figure out who they are and where they are going, sometimes chase the money without regard to long-term stability and overall job satisfaction. All of these factors makes recruiting pretty tough. Sometimes I wish someone would insert a BMET in one of those popular TV hospital shows like “Grey’s Anatomy” to increase the national visibility. In the meantime, we will continue to focus on contacting high school counselors and teachers and, of course, students to let them know what we do.
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BY GEORGE HAMPTON
TECH KNOWLEDGE
Succession Planning
W
hat will become of this place if I leave? That’s a good question! Have you contemplated this question? Every leader should. It may seem odd thinking about your own replacement, maybe even threatening. I would suggest that you look at this idea from the standpoint of your own success. Every good manager should look to advance to a more challenging position, hopefully with your current employer, but maybe not. Our industry thrives when we have a healthy flow of professionals through the career continuum. It’s not healthy to have individuals perpetually holding the same position for decades.
I have seen studies that indicate the average age of technicians in the clinical technology industry is over 45 years, probably closer to 50. We have seen a marked decrease in young people considering clinical technology as a career choice. I am sure there are several factors, such as competition with the IT industry, or other technology programs. Additionally, I would suggest that we can’t attract good, young candidates if we must admit to them that they will be in a long line for opportunities to advance, because “no one ever leaves here.” Now don’t get me wrong. I’m not saying “we should get rid of these old techs.” What I am saying is the ideal situation is where people in the shop have opportunities to move up based on their accumulated skills, and it’s not necessarily a bad thing for some to move out for better positions elsewhere. If this ideal situation occurs, we need to address the need to plan ahead for the event. We typically only get 2 or 3 week notice when someone is leaving, which isn’t sufficient for someone to pass on all they know to their replacement. That’s exactly why a succession plan is so important. The basics of succession planning are very simple: 1. Identify critical work positions. Besides
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the obvious leadership/manager’s position, there will be some essential technical positions that your program can’t do without such as your lead monitoring tech, operating room tech, or imaging tech. 2. Identify skills essential for these positions. These folks have achieved their level of value over time. They can also look back and identify the quickest way to pass on their skills by deleting dead ends and missteps. It wouldn’t be a bad idea to record these skills and make them a part of your annual skills assessment process. 3. Identify the people who have the potential to succeed in these important positions. I tried to be careful how I worded that sentence. I didn’t say the next guy in line, or the next oldest person. I am convinced we make that mistake too often. We need the right people in the right places, and the right person may be younger, or have complementary people skills that make them more acceptable than the “next guy.” 4. Formalize the process. Make the succession plan a formal process that is documented and supported by budgeted time. It might be tempting to see this activity as a thing you do when you have free time. That would betray the importance of the process.
GEORGE HAMPTON President of Tech Knowledge Associates
Make the tasks in the process a part of the tutoring technician’s job requirements and evaluation. Make the less experienced tech responsible for attending and documenting the training sessions. Both techs can use this activity to meet their certification demands, if applicable. This is a great way to encourage teamwork and show your techs you are serious about career development. The process for succession planning for the management or lead is a bit different. This position, more than any other, demands thoughtful selection for the potential replacement. This candidate must have the capacity to lead people, more so than a gift for fixing equipment. Certainly, a solid understanding of the daily operations of the shop is important, but the ability to lead people is paramount. I have seen people in leadership positions who have an amazing set of technical skills with little to no ability to deal with or inspire
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people. You are better off picking someone with moderate skills who demonstrates a gift for solving people problems and great communication abilities. Just take some time to reflect on the things that you do daily with your direct Individually EXAMINED reports, the committees you serve, and the external Individually SERVICED communication your position demands. Your choice for a succession candidate could cause Individually REPAIRED controversy in your work environment. This is too important with OEM parts to be influenced by petty politics. After establishing who you Individually feel is the best possible candidate for succession, you will need RE-INSPECTED to boil your various work responsibilities down to a few Individually categories. I would guess that your list might be: Financial, SIGNED OFF Human Resources, Daily Operations, Regulatory, and FOBI Medical services all blender models Hospital Committees. Precision Approved Due to the confidential nature of Human Resources, this FOBI GUARANTEED could be an area where you talk generally about job evaluations, corrective actions, and other such activities. The Blender Overhaul by FOBI Medical is a remaining areas are appropriate for job shadowing and whole new way of getting things done. one-on-one tutoring. It will be your responsibility to be PROOF APPROVED CHANGES NEEDED judicial about what activities are appropriate to share given 866.231.3624 the time allowed and the ability of the student. This process CLIENT SIGN–OFF: will likely take years to accomplish, which will give hospital INFO@FOBI.US clinical staff and administrators timeTHE to getFOLLOWING used to seeing this PLEASE CONFIRM THAT ARE CORRECT m e d i c a l FOBI.US individual and begin to develop trust in their expanding LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR Define. abilities. Good Luck! m eDiscover. d i c aDeliver. l
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SODEXO INSIGHTS Time Management as a Professional Development Strategy
T
ime management is paramount. I have had the opportunity to experience this phenomenon in my personal and professional life recently. As an academic student wanting to better my opportunities for advancement as well as a Biomedical Equipment Technician/Manager I have to be able to manage my time. Possessing the ability to recognize and prioritize important matters makes the difference between success and failure. Balancing your professional workload between making the immediate customer, the ultimate customer, your boss, and financial overseer happy, while ensuring regulatory and program compliance, presents opportunities and challenges the average individual would not understand. A lack of time management skills, creates a higher anxiety level, and lowers an individual’s time management abilities.
Stress can result in wrong or inappropriate decisions. Suggestions for ways to reduce stress management’s hasty decisions are: • Conduct a time audit. Keep a record of how much time you spend on the various activities. Start with mandatory activities and required meetings. Then, keep track of how much time you spend performing each activity. • Use time tracking to help identify time robbers. A good tip is, don’t confuse preferences with priorities. It may be your preference to prepare for that upcoming meeting but that might not be the best use of your time. On the other hand, you also don’t want to confuse sensible R and R (rest and recuperation) with laziness. Sitting in your office all day and skipping lunch in an attempt to find the exact wording for a report creates anxiety. Take short breaks throughout the day to walk around, drink some water,
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JARED DAYRINGER, AAS, BAST, MSAST On-Site Supervisor, Sodexo
and come back to the report with a fresh point of view. While I was researching, I found that if I laid things out it made everything run smooth throughout the day. • Elicit support and input from your supervisor, they should help set your priorities. • Instead of stopping to answer every email, send an automated message saying you will respond at a certain time. • Limit interruptions. Take breaks at times you schedule. Let the phone go to voicemail. • Clean your workspace before you start on a big project. You will spend less time looking for the right file or other resources.
time after each task is completed to consider strategies for managing things better the next time. You should try different tactics until you find one that works and then make it part of your overall time management plan. It may feel counterintuitive to spend time working on time management. However, consider the time spent developing a time management plan an investment. When you are able to manage your time well, you have invested in your own success at work and in your personal life. And the better you manage your time, the more time you’ll have for the things you truly value.
People tend to spend the most time on the least valuable tasks. That’s because we’re often reluctant to do those tasks, so we waste time resisting them. Take
JARED DAYRINGER, AAS, BAST, MSAST, is an On-Site Supervisor for Sodexo Clinical Technology Management at Seton Medical Center Harker Heights.
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o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-may-2017. Good luck!
SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing. com and you could win a $25 Amazon gift card courtesy of TechNation!
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BREAKROOM BREAKROOM
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new resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.
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Sodexo’s growing Clinical Technology Management Division is seeking talented Field Service Imaging Engineers across the country. Must have outstanding customer service and communications skills as well as a strong competency in troubleshooting/ repairing and maintaining diagnostic imaging devices. Associates Degree in electronics, biomedical engineering, or related field, 5 years technical expertise and 2 years management experience required.
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AAMI ANNUAL CONFERENCE
Spotlighting Cybersecurity, Big Data, Accreditation Requirements
W
ith more interconnected medical devices being introduced into health care facilities – and more threats to that technology emerging in the cyberworld – the questions of how this equipment is purchased, maintained, and used are more important than ever. So too are the healthcare technology management (HTM) professionals who manage these activities, serving a crucial role in patient safety and health care outcomes.
During the AAMI 2017 Conference & Expo, set to run June 9-12 in Austin, Texas, the HTM professionals who service and support a dizzying array of complex and often life-critical medical devices and equipment will have the opportunity to learn what they need to stay on top of the latest innovations, advances and risks. The Expo will allow attendees to see the latest upgrades and advances in medical technology from nearly 200 manufacturers. “The biggest challenge for healthcare technology moving forward is to fully integrate these complex systems into the patient care workflow while ensuring that the quality of care provided by health care professionals is not diminished, and that the safety and security of these systems are not
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compromised and vulnerabilities are not exploited by those who would do harm to the patients or the caregivers,” said Chuck Sidebottom, managing partner of PPO Standards LLC and former AAMI Board chair. Throughout AAMI 2017, industry experts and leaders will provide practical guidance and insights on the biggest trends and challenges in the healthcare technology sector, such as: MOVING BIG DATA TO THE BEDSIDE What if we could foresee a patient’s deterioration and take action to prevent it? What if the impending illness was so severe and the patients so vulnerable that this prediction would save their lives? And what if all we needed was little more than the medical devices and data that we already have? This isn’t part of some hypothetical future. This is a reality at the University of Virginia (UVA). During the opening general session, J. Randall Moorman, a clinical cardiologist and UVA professor of internal medicine, physiology, and biomedical engineering, will discuss how he and his colleagues have turned more than 100 terabytes of data collected from continuous electronic monitoring into a “risk estimation device” for deadly conditions, such as sepsis in premature infants and
hemorrhage and acute lung failure in adults. “I am completely committed to this idea that there are illnesses that we can detect early by analyzing the data that we already have,” Moorman said. SUBHEAD: Cybersecurity In hospitals today, it would be difficult to find medical device technology that does not critically depend on computer software. Network connectivity and wireless communication have transformed the delivery of patient care. But connectivity comes at a price – vulnerability to hackers, viruses and other malware. During the prestigious Dwight E. Harken Memorial Lecture, Kevin Fu, CEO and chief scientist of Virta Labs Inc. and an associate professor at the University of Michigan where he directs the Archimedes Center for Medical Device Security and the Security and Privacy Research Group, plans to probe the risks, benefits, and regulatory issues for medical device cybersecurity and provide insight into the development of trustworthy medical device software. “I hope that people will come out of my presentation with a less sensational view of the issues and a more optimistic view of the future of medical device security,” Fu said. “It’s
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not about eliminating risk but about controlling and managing risk. It can be done – it’s not impossible.” STRICTER JOINT COMMISSION REQUIREMENTS On the final day of AAMI 2017, George Mills, director of engineering at The Joint Commission (TJC), will take the stage to provide the latest information on TJC’s activities, discuss its plans, and explain how these will impact health care facilities. Attendees also will have the opportunity to pose their questions and concerns directly to Mills. For many HTM professionals, this popular standing-room-only session will be a prime opportunity to gain clarification on TJC’s new maintenance standards and get advice for compliance. A number of the education breakout sessions during the
conference also will focus on this issue, including best practices for developing an alternative equipment maintenance program and how to demonstrate the safety and effectiveness of device maintenance and management programs to accreditation organizations and regulatory agencies. “HTM professionals are constantly learning and adapting to changes in health care delivery and accreditation requirements, as well as to changes in the technology and systems themselves,” said Sherrie Schulte, AAMI’s senior director of certification and the annual conference. “In today’s interconnected world, HTM professionals are on the frontlines of not just patient safety but data security as well. In addition, HTM departments can play a leadership role in the implementation of novel, life-saving technologies. Attending
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
continuing education programs, such as the AAMI Annual Conference, helps HTM professionals stay on top of the latest innovations, advances, and risks in healthcare technology, giving them a leg up in their careers.” Full conference registration includes access to: • The general sessions described above • More than 50 concurrent education breakout sessions • The Expo Hall • AAMI University to view and download AAMI 2017 presentations • AAMI’s Career Center • Welcome Reception on Friday • Awards Reception on Saturday • AAMI’s 50th Anniversary Celebration on Sunday The full schedule of education sessions and events is available at www.aami.org/ac.
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Q&A WITH AAMI PRESIDENT
New Leader Robert Jensen Looks to the Future Q
: Can you tell us briefly about your previous jobs and how they prepared you to lead AAMI?
Jensen: While I’ve worked primarily for three different organizations – MITRE, Noblis, and the U.S. Marines – I’ve been fortunate to have learned in a number of different positions within each of them. Beginning with my military service, the Marines have an extraordinary formal leadership program for their officer corps that has been extremely valuable in all phases of my career and life. For example, I apply some of the tenets I learned in my job today when I emphasize the three traits of character, competence, and courage within my team. Organizations with employees who have strong marks in each of these traits and a shared vision are synergistically capable of achieving more than the simple sum of the individuals. In my early civilian career at MITRE and then at Noblis (a nonprofit research corporation), I learned about networked organizations and how to function effectively within them. The military is necessarily hierarchical, and directive orders save lives when time is of the essence. On the other hand, organizations such as Noblis and MITRE have an administrative hierarchy, but they function like a network that requires more interactions, many of them subtle, across the spectrum of internal colleagues and external stakeholders. Finally, at MITRE I had a great opportunity to build the organization’s healthcare vertical pretty much from the ground up. I learned multiple skills in the positions I held there, including visioning, strategic planning, business case creation and execution, and building high-performing teams in a non-military environment. I think each of these stages in my career has influenced who I am and prepared me to come to AAMI.
Q
You served in the U.S. Armed Forces as a Marine. What was the biggest lesson you learned during your military service?
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Jensen: Tracers work both ways. Just kidding! The biggest lesson was to put those working for you before yourself. If we have an AAMI buffet luncheon, I eat last. If there aren’t enough chairs, then I stand and my colleagues sit. These seem like little things in the grand scheme, but putting other people first makes a positive difference in their lives that translates to making a positive impact on the organization and a positive change in the world. What could be better than that?
Q
What is the most exciting aspect of your job as AAMI president?
Jensen: There are two things I find very exciting as AAMI’s president and CEO. First is the opportunity to learn and grow. I had broad experience, education, and other lessons from my background to bring to the position, but there are different challenges here that are fulfilling me in new ways. Standing still is simply not an option for me because it narrows the future instead of expanding it. The second truly exciting thing about AAMI is the dedication to the mission. The employees, along with the extended family of volunteers, members, and stakeholders, care very deeply about the safe use of technology in health care WWW.1TECHNATION.COM
because they know the difference it can make. I never imagined I would see other organizations with the passionate dedication to the mission that I experienced in the Marines, but I see it here at AAMI.
Q
What are your goals as the leader of AAMI?
Jensen: There are three items I consider to be my top-level goals. The first is to do no harm. AAMI reached its 50th anniversary this year because it does some things exceptionally well for the stakeholders in healthcare technology. Maintaining the fundamentals that have made AAMI successful is one key to continuing to be successful in the future. Next is to look over the horizon at the changing landscape in health care and work hard to discover what products and services our members will need in the future. Capabilities and capacities take time to build, and most of our members are too busy to think deeply about and scan the environment for
“what’s next.” We need to serve them by getting ahead of the rapid changes in healthcare technology and patient safety, showing them which ones could impact their jobs and futures. Finally, I need to work with the staff and the Board of Directors to incorporate the products and services our members might need into our strategy. We have to position AAMI not just for today but also for tomorrow. There are a couple of old but true clichés that apply here: (1) What got you here won’t get you to the next level, and (2) If you want to score goals, skate not to where the puck is but to where the puck will be. AAMI is skating toward the future.
Q
What is AAMI’s most important role when it comes to serving the HTM community? Jensen: Great question. Since I’ve joined AAMI, I’ve learned about a number of different projects and programs that AAMI offers to support and advance the HTM community. For example, there’s
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
a lot of interest in regulatory news from CMS and The Joint Commission. At AAMI, we stay on top of that news, share it with the HTM community through multiple channels, and look for ways to help the community address concerns about proposed regulatory changes. Our online forums allow members to post questions, exchange information, and share their thoughts with one another. In addition, AAMI has a rich history of providing top quality training and resources in healthcare technology through webinars, our Annual Conference, and other training programs. We’ll continue to build on that success and make sure that we’re always addressing the issues facing HTM. It’s also worth noting that AAMI has a detailed HTM business plan that serves as the bible for our HTM activities. The plan calls on AAMI staff and volunteers to help advance the field through training and education; standardize the field by developing new HTM-oriented standards, which we believe is a better alternative to regulation; and promote MAY 2017
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the value of the HTM profession to the C-suite, students, and others. It takes all of us to get these things done, but AAMI is committed to leading in these areas.
Q
What is the one project or area of HTM that you feel strongly about?
Jensen: For me, it is having AAMI continue to raise the bar for the profession as a whole. This might include developing an AAMI fellowship program to recognize leaders in the field and provide strong role models that others can aspire to emulate, or helping academic institutions understand the competencies necessary to be successful in the field, and perhaps certifying qualified graduates of some institutions. Just as some of the health information technology credentials were in very nascent stages as little as 10 years ago, so too are some of the HTM credentials now. But the future in this space is very bright.
Q
What are some of the challenges HTM professionals are facing now? How can they navigate these obstacles?
Jensen: I think one challenge is official advocacy in Washington, D.C. One way AAMI maintains its objectivity in the health sector―and its ability to independently convene parties with differing opinions―is that we don’t do any advocacy work. That being said, any large group that is not represented on Capitol Hill when concerns arise in their professional space has no voice in the solution. I hope, with the help of HTM professionals and consultants who have been working in this space, to create a way they can get that support.
Q
What advice would you offer an individual who is just starting an HTM career?
Jensen: I would give the same advice that I would give to anyone who is just starting out in any career. First, get all the education you can afford from the most highly rated place you can get it. This doesn’t mean the most expensive; it means the best education. Second, get one or more mentors who you respect and admire to ask you the career questions you might not be thinking about. Most mid- to late-career individuals love to pass along their knowledge and expertise. Third, get and stay current in your field. Attend seminars and conferences, and keep reading relevant professional materials. If you don’t manage your career, someone else will, and it probably won’t be as fulfilling as it could be. Finally, create a life–work balance. None of us can work all the time, nor can we be successful in an environment where we’re not comfortable. Find balance to be at your very best.
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Q
Thank you for your time today. Is there anything else you would like to share with the readers of TechNation?
Jensen: Many of the people who work in technology and safety in health care are unsung heroes every day. If you drive home and don’t see a fire, you probably don’t think about being thankful for the local fire department and its fire prevention and safety efforts. And if your neighborhood is quiet and safe at night, you probably enjoy it but don’t think too often about the local police officers and what they do to keep it that way. In the same vein, when we go to our physicians or hospitals, we interact with medical devices that are manufactured and maintained with an extraordinary commitment to safety. Yet, we probably don’t think about the infection we didn’t get because the sterilization was done properly or the injury we didn’t sustain because the device was serviced expertly and on time. Everyone who works with healthcare technology truly makes a difference, and it’s worth saying “thank you” every now and then for that. Thank you for the conversation today, I enjoyed it.
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Bio-Medical Equipment Service Co. Booth #331 www.bmesco.com
Elite Biomedical Booth 338 www.elitebiomedicalsolutions.com
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Interpower Booth 439 www.interpower.com
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Conquest Imaging Booth #721 www.conquestimaging.com
Global Medical Imaging Booth #815 www.gmi3.com
Crothall Healthcare Booth #539 www.crothall.com
IMES - A Division of Richardson Healthcare Booth #1312 www.imesimaging.com
MedEquip Biomedical Booth #325 www.medequipbiomedical.com
MediMizer Software Booth 519 www.medimizer.com
Bayer Booth #919 www.radiologysolutions.bayer.com Draeger, Inc. Booth ​615 www.draeger.com BC Grou Booth #714 www.bcgroupintl.com 100
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Injector Support & Service Booth #318 www.injectorsupport.com
MEDiSURG Booth #245 www.medisurg.com
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MedWrench Booth #1301 www.medwrench.com
Minxrad.com Booth 346 www.minxrad.com
MW Imaging Booth 430 www.mwimaging.com
RepairMED Booth #239 www.repairmed.net
Rigel Medical - A Seaward Group Company Booth #633 www.seaward-groupusa.com
RSTI Booth #839 www.rsti-training.com
Sodexo CTM Booth #624 www.sodexousa.com
MEDICAL EQUIPMENT SALES AND SERVICE
Tenacore Holdings Booth #638 www.tenacore.com
SOLUTIONS
Southeastern Biomedical Associates, Inc. Booth 628 www.sebiomedical.com
Tri-Imaging Booth #228 www.triimaging.com
Stephens International Recruiting, Inc. Booth 648 www.bmets-usa.com
Trisonics Booth #329 www.trisonics.com
BIOMEDICAL YOUR CENTRIFUGE SPECIALTY STORE
Ozark Biomedical Booth #342 www.ozarkbiomedical.com
RTI, Inc. Booth #1231 www.rtigroup.com Summit Imaging Booth #913 www.mysummitimaging.com
pacmed.com
Pacific Medical Booth #815 www.pacmed.com
USOC Medical Booth #513 www.usocmedical.com
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INDEX
ALPHABETICAL INDEX AAMI ………………………………… 106
FOBI…………………………………
85
RepairMED……………………
16-17, 22
A.M. Bickford…………………………
22
Global Medical Imaging………………… 2
Rigel Medical, Seaward Group………… 3
AIV……………………………………
47
HTMA-Texas………………………… 105
RSTI……………………………………
69
American Surgical Instrument Repair… 99
iMed Biomedical………………………
83
RTI Inc…………………………………
73
Ampronix, Inc.…………………………
15
Injector Support and Service…………
53
Sage Service…………………………
78
Asset Services…………………………
85
Select BioMedical………………… 26-28
ATS Laboratories………………………
71
International Medical Equipment and Service……………………………… 21
83
41
91
Shared Imaging LLC…………………
Bayer Healthcare - MVS………………
Interstate All Battery………………… J2S Medical…………………………
42
Sodexo CTM…………………………
86
KEI Med Parts…………………………
83
Soma Technolgoy, Inc………………
60
Maull Biomedical Training……………
47
Southeastern Biomedical, Inc………
87
MedEquip Biomedical………………
54
Southwestern Biomedical Electronics…
7
MediMizer Inc.………………………
81 59
BC Group International, Inc………… BC BETA Biomed Services………………
21
Bio-Medical Equipment Services Co.… IBC Cadmet………………………………
71
Conquest Imaging……………………
11
Cool Pair Plus…………………………
91
Medisurg………………………………
Crothall Healthcare Technology Solutions…………………
MinXRad………………………………
53
54
Modern Biomedical & Imaging, Inc.…
77
Drager Medical Systems………………
61
MW Imaging…………………………… 6
Dunlee…………………………………
30
Ozark Biomedical……………………
ECRI Institute…………………………
89
Pacific Medical ………………………… 8
Elite Biomedical Solutions……………
14
PRN/ Physician’s Resource Network… 51
Engineering Services, KCS Inc………
29
Pronk Technologies, Inc. ……………… 5
35
Tenacore Holdings, Inc………………
55
The Intuitive Biomedical Solution Inc… 45 Tri-Imaging Solutions…………………
68
Trisonics………………………………
60
USOC Bio-Medical Services…………
23
TRAINING
SERVICE
Company Info
PARTS
22
Drager Medical Systems (215) 721-5404 • www.draeger.com
61
RepairMED 855-813-8100 • www.repairmed.net
1617, 22
Soma Technolgoy, Inc 1-800-438-7662 • www.somatechnology.com
60
P
USOC Bio-Medical Services 855-888-USOC(8762) • www.usocmedical.com
23
P P
Asset Management Asset Services 913-383-2738 • www.assetservices.com
85
Shared Imaging LLC 1-800-606-0266 • www.sharedimaging.com
83
Association HTMA-Texas 281-974-1409 • www.htmatexas.org
TECHNATION
Technical Prospects…………………
Biomedical
A.M. Bickford 800-795-3062 • www.ambickford.com
102
Summit Imaging………………………… 4
AD PAGE
Anesthesia
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
77
Stephens International Recruiting Inc.… 73
MAY 2017
105
P
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
BC
Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com
54
P P
iMed Biomedical 817-378-4613 • www.imedbiomedical.com
83
P
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
86
Calibration Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
3
Cardiology Sage Service 877-281-7243 • www.SageServicesGroup.com
78
P P
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
87
P P
Southwestern Biomedical Electronics 800-880-7231 • www.swbiomed.com/
7
P P
WWW.1TECHNATION.COM
INDEX
Computed Tomography Dunlee 800-238-3780 • www.dunlee.com
30
P
Injector Support and Service 888-667-1062 • www.injectorsupport.com
53
P
International Medical Equipment and Service 704-739-3597 • www.IMESimaging.com
21
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
83
P P
RSTI 800-229-7784 • www.rsti-training.com
69
P P P
RTI Inc 800-222-7537 • www.rtigroup.com
73
The Intuitive Biomedical Solution Inc 866-499-3966 • www.tibscorp.com
45
RepairMED 855-813-8100 • www.repairmed.net
1617, 22
Select BioMedical 866-559-3500 • www.selectpos.com
2628
Soma Technolgoy, Inc 800-438-7662 • www.somatechnology.com
60
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
23
P P
77
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
RSTI 800-229-7784 • www.rsti-training.com
69
P P P
Technical Prospects 877-604-6583 • www.technicalprospects.com
35
P
P
Laboratory Ozark Biomedical 800-457-7576 • www.ozarkbiomedical.com
Mammography
P P
Contrast Media
Monitors
Injector Support and Service 888-667-1062 • www.injectorsupport.com
53
Maull Biomedical Training www.maullbiomedicaltraining.com
47
P P P
Diagnostic Imaging Shared Imaging LLC 1-800-606-0266 • www.sharedimaging.com
83
P
Enoscopy
Drager Medical Systems 215-721-5404 • www.draeger.com
61
Select BioMedical 866-559-3500 • www.selectpos.com
2628
Soma Technolgoy, Inc 800-438-7662 • www.somatechnology.com
60
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
55
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
P
Cardiology
American Surgical Instrument Repair 937-592-9693 www.americansurgicalinstrument.com
99
Cadmet 800-543-7282 • www.cadmet.com
71
P
Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com
IBC
P
J2S Medical 844-342-5527 • www.j2smedical.com
42
P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
23
P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
51
P P
MRI
P
Hand Switches MinXRad 417-597-4702 • www.minxrad.com
TRAINING
81
SERVICE
MediMizer Inc. 760-642-2002 • www. medimizer.com
PARTS
CMMS
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
53
P P
Infusion Therapy
Bayer Healthcare - MVS 844-MVS-5100 • www.mvs.bayer.com
41
Cool Pair Plus 800-861-5956 • www.coolpair.com
91
International Medical Equipment and Service 704-739-3597 • www.IMESimaging.com
21
P
83
P P
P
AIV 888-656-0755 • aiv-inc.com
47
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
Patient Monioring
FOBI 888-231-3624 • www.FOBI.us
85
P P
AIV 888-656-0755 • aiv-inc.com
47
P P
J2S Medical 844-342-5527 • www.j2smedical.com
42
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
MAY 2017
TECHNATION
103
INDEX
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
J2S Medical 844-DIAL-J2S(342-5527) www.j2smedical.com
92
P P
MedEquip Biomedical 877-470-8013 • www.MedEqiupBiomedical.com
54
P P
Pacific Medical 800-449-5328 • www.pacificmedicalsupply.com
8
P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
51
RepairMED 855-813-8100 • www.repairmed.net
1617, 22
Sage Service 877-281-7243 • www.SageServicesGroup.com
Respiratory
P P
A.M. Bickford 800-795-3062 • www.ambickford.com
22
P
FOBI 888-231-3624 • www.FOBI.us
85
P P
AIV 888-656-0755 • aiv-inc.com
47
P P
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
J2S Medical 844-342-5527 www.j2smedical.com
92
P P
MedEquip Biomedical 877-470-8013 www.MedEqiupBiomedical.com
54
P
78
P P
Pacific Medical 800-449-5328 www.pacificmedicalsupply.com
8
P
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
87
P P
Sage Service 877-281-7243 • www.SageServicesGroup.com
78
P P
Southwestern Biomedical Electronics 800-880-7231 • www.swbiomed.com/
7
P P
Southwestern Biomedical Electronics 800-880-7231 • www.swbiomed.com/
7
P P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
55
P P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
55
P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
23
P P
USOC Bio-Medical Services 855-888-USOC(8762) www.usocmedical.com
23
P P
53
P P
Telemetry
P P
Portable X-Ray MinXRad 417-597-4702 • www.minxrad.com
Test Equipment
Radiology Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
Soma Technolgoy, Inc 800-438-7662 • www.somatechnology.com
60
P
Technical Prospects 877-604-6583 • www.technicalprospects.com
35
P
The Intuitive Biomedical Solution Inc 866-499-3966 • www.tibscorp.com
46
P P
Recruiting 77
Sodexo CTM 888-Sodexo7 • www.sodexousa.com
86
Stephens International Recruiting Inc. 870-431-5485 • www.bmets-usa.com/
73
Replacement Parts
104
TECHNATION
MAY 2017
P
A.M. Bickford 800-795-3062 • www.ambickford.com
22
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
BC
Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com
5
Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
3
RTI Inc 800-222-7537 • www.rtigroup.com
73
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
87
P P
P P
Training
Modern Biomedical & Imaging, Inc. www.modernbiomedical.com
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
TRAINING
IBC
SERVICE
Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com
PARTS
21
Company Info
AD PAGE
BETA Biomed Services 800-315-7551 • www.betabiomed.com/
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
29
ECRI Institute 1-610-825-6000. • www.ecri.org
89
Medisurg 855-233-4050 • www.medisurg.com
59
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P
P WWW.1TECHNATION.COM
WIDTH 3.25”
INDEX TRAINING
SERVICE
PARTS
AD PAGE
Company Info Tubes/Bulbs Cadmet 800-543-7282 • www.cadmet.com
71
P
Dunlee 800-238-3780 • www.dunlee.com
30
P
Technical Prospects 877-604-6583 • www.technicalprospects.com
35
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
ATS Laboratories atslaboratories@yahoo-com www.atslaboratories-phantoms.com/
71
Bayer Healthcare - MVS 844-MVS-5100 • www.mvs.bayer.com
41
Conquest Imaging 866-900-9404 • www.conquestimaging.com
11
P P P
Global Medical Imaging 800-958-9986 • www.gmi3.com
2
P P
MW Imaging 877-889-8223 • www.mwimaging.com
6
P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
51
P P
Summit Imaging 866-586-3744 • www.mysummitimaging.com
4
P P P
Trisonics 877-876-6427 • www.trisonics.com
60
P P
P
Ultrasound
HEIGHT 9.75”
TO GET INVOLVED WITH YOUR LOCAL HTM ASSOCIATION
61
HTM Professionals & Vendor Partners – JOIN & SUPPORT!
Phaco Vitrectomy Medisurg 855-233-4050 • www.medisurg.com
59
EVERYBODY BENEFITS FROM THEIR LOCAL ORGANIZATION!
X-Ray Bayer Healthcare - MVS 844-MVS-5100 • www.mvs.bayer.com
41
Dunlee 800-238-3780 • www.dunlee.com
30
P
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
29
P
RSTI 800-229-7784 • www.rsti-training.com
69
P P P
Technical Prospects 877-604-6583 • www.technicalprospects.com
35
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P P
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
YOU
P
Ventilators Drager Medical Systems (215) 721-5404 • www.draeger.com
WE WANT
P
HTMA TEXAS’ NEXT MEETING IS APRIL 11TH, 2017 AT BEN TAUB HOSPITAL.
WWW.HTMATEXAS.ORG MAY 2017
TECHNATION
105
REGISTER NOW!
Valuable Opportunities Under One Roof Explore the impact of the Information Age on the delivery of healthcare and how it will shape tomorrow’s landscape. At AAMI 2017, you’ll have the opportunity to: u Participate in 50+ education sessions and workshops.
u Engage with more than 200 medical equipment manufacturers.
u Hear captivating keynote speakers including Dr. Kevin Fu and George Mills.
u Celebrate AAMI’s last five decades and look into the future during AAMI’s 50th Anniversary Appreciation Reception!
u Take advantage of the career services center. u Discover new technologies.
For complete conference details and to register, visit www.aami.org/ac
Innovate. Connect. Advance.
BENCHTOP FLOW ANALYZER Get the Most Accurate Measurements with the PFC-3000 Ventilator Tester The PFC-3000 Series of ventilator testers measures a wide variety of parameters, including:
Flow Pressure Temperature Humidity O2 Concentrations
The PFC-3000 has adult, pediatric and high frequency measuring modes, allowing it to be used by ventilators, anesthesia machines and spirometers. The PFC-3000 distinguishes itself from other calibration tools with a user friendly interface and high precision tester. Users can easily save data directly to the tester for documentation purposes.
PFC-3000
COMPLETE OMPLETE YOUR OUR PFC-3000 WITH WITH ACCESSORIES CCESSORIES BC Group’s Lung Simulators are easy to use, portable, have quick assembly and replaceable parts. The LS-2000 Series has...
Adjustable Compliances Adjustable Resistances Variable Leakage Valve MGA-3050 The MGA-3050 Multi-Gas Analyzer is the perfect add on for the PFC-3000. It measures halothane, enflurane, isoflurane, sevoflurane and desflurane in percentage values.
Adult, Infant, Easylung and Neonatal
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