TechNation- June by MD Publishing

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THE STATE OF

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1 2 3 %9.31

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Address Service Requested MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269

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VOL. 8

18 5>

Company Showcase Elite Biomedical

News and Notes Industry Updates

Roundtable Imaging Test Equipment

MD Expo Scrapbook

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THE STATE OF

HTM TechNation Reader Survey Results

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TECHNATION: ADVANCING BIOMEDICAL / HTM PROFESSIONALS

THE ROUNDTABLE: TEST EQUIPMENT (IMAGING) Maintaining diagnostic imaging equipment is of great importance in today’s health care environment. Maintaining these valuable pieces of equipment improve patient outcomes as well as patient satisfaction. It also helps with the bottom line. Technation shares insights on imaging test equipment from industry leaders.

THE STATE OF HTM: TECHNATION READER SURVEY RESULTS What is it like to be a biomed? Is it rewarding? Would an HTM professional recommend the profession to a friend and what advice would they offer? We look at these questions and others to determine the State of HTM in 2017.

Next month’s Feature article: Training to Succeed: Quality Training Options

Next month’s Roundtable article: Ultrasound Systems TechNation (Vol. 8, Issue #6) June 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

JUNE 2017

TECHNATION

INSIDE PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Lisa Gosser

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

Cindy Galindo Adam Pickney

ACCOUNTING

Kim Callahan

CIRCULATION

Lisa Cover Laura Mullen Jena Mattison

WEBINARS

Linda Hasluem

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: Derick Davis p.16 Department of the Month: The Veteran Health Indiana HTM Department p.18 Company Showcase: Elite Biomedical p.22 Biomed Adventures: Celtic Crusier In-Car-Nation P.26 INDUSTRY UPDATES p.26 News and Notes: Updates from the HTM Industry p.30 AAMI Update p.33 ECRI Institute Update P.36 p.36 p.40 p.41 p.44 p.47

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

P.62 EXPERT ADVICE p.62 Career Center p.64 Ultrasound Tech Expert Sponsored by Conquest Imaging p.67 Beyond Certification p.68 Tech Knowledge p.70 Sodexo Insights Sponsored by Sodexo p.72 The Future p.74 Thought Leader p.76 Roman Review P.80 p.80 p.82 p.84 p.87 p.88

BREAKROOM Did You Know? The Vault MD Expo Scrapbook Contest What’s on Your Bench Sponsored by MedWrench

p.97 Alphabetical Index p.98 Service 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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Hold the Vision. Trust the process. These words have inspired Mark Conrad of Conquest Imaging since 2000 when he and his wife Jean acted on their vision to change the ultrasound industry. And they did. Their vision lead to a process for reconditioning ultrasound parts and probes in ways that extend life cycles and enable facilities to lower costs while increasing ROI, customer and patient satisfaction. HERE’S HOW: • Conquest Imaging analyzes and inspects every detail of all parts and probes sold through an exclusive Quality Assurance 360 process • Any potential future problems identified are pre-empted by fixing them before they can go bad. • Expert technicians are trained continuously to master all brands and equipment available, making them experts on whatever equipment you own. It’s processes like these that give you 20/20 vision on what to expect from your ultrasounds, how to manage your investments and provide uninterrupted care for your patients. Conquest’s process is trusted by hundreds of delivery systems nationwide to help them provide accurate, affordable diagnostic care 24/7.

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Derick Davis, CBET, A+ BY K. RICHARD DOUGLAS

n any job, it’s good when management can recite some of your strengths and accomplishments.

“Besides becoming an outstanding technician, he has developed into a leader within the department. In his short time with Baylor Scott and White, Derick has been promoted twice and become a go-to tech for anything patient monitoring. He is a CBET and A+ certified,” says Carol Wyatt, MPA, CHTM, CBET, director of the Northern Region for the Healthcare Technology Management Department at Baylor Scott and White in Dallas, Texas. Wyatt is referring to Derick Davis, a senior biomedical equipment technician, who works in the health care system’s HTM department at Baylor University Medical Center. Davis’s route to fi nding HTM involved a series of detours before he landed in the HTM field through divine intervention, as he tells it. Moving from a tough location on the West Coast, he ended up going to college on the other side of the country. He was born and raised in South Central Los Angeles and attended college in Washington, D.C. “I graduated from Howard University with a degree in finance. At that point, I felt that I had it made and that I would be able to pick and choose where I wanted to work; well it didn’t turn out exactly that way,” Davis recalls. For a time, he worked for the Los Angeles School District, but felt the call of entrepreneurship beckoning, so he started a classic car business, which he

TECHNATION

JUNE 2017

says was very successful. “We moved our family to the Dallas area in 2005. I found a job doing Internet sales on eBay, which I really liked because I sold cars on eBay, when I had my business,” Davis says. “After being there a year and a half, and seeing the company go out of business, I ended up getting an opportunity to head an online sales department with a rent-to-own company. I was very excited about this opportunity; the director even mentioned that we could make six figures,” Davis adds. The assurances and the position did not turn out as promised and devolved into a lower level position. “I couldn’t believe the path I was headed; here I was cleaning appliances

until one day God said to me, I have something better for you than this,” Davis says. That better thing, of course, was the HTM profession. Divine intervention pointed him in the right direction. “I found out about a career in biomedical equipment repair after talking to my brother-in-law David Simon. I have always liked to fi x things, even when I was young, and I found out that they make a good salary with good benefits,” Davis says. “The only thing is that there are only a few colleges that grant degrees in this field, the closest one to me was in Waco which is 70 miles one-way from my house,” Davis explains. “I also wanted to go full time so I could get it out of the way, so I ended up quitting that job and I enrolled at Texas State Technical College (TSTC) in the fall of 2011. I would make that 140-mile round trip to school for five semesters.” Davis had heard that TSTC’s program was one of the best in the country and he felt that the fact that the program included an internship made it an excellent choice. “The instructors, directors were all helpful and very supportive. Their goal was to get me in the field and it showed,” he says. Davis’ efforts paid off as he graduated with a 3.85 cumulative average. Once he was out of school, he did some brief contract stints with GE and Spacelabs. He ended up getting an interview with Baylor Hospital in Carrolton, Texas, an hour from his house. He later learned of an opening at

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SPOTLIGHT FAVORITE BOOK: “The Purpose Driven Life” and “Hemotions”

FAVORITE MOVIE: “Redtails,” “The Bucket List” and “Wild Hogs”

FAVORITE FOOD: Cornbread dressing with cranberry sauce, crab legs, and shrimp.

HIDDEN TALENT: Drawing pictures

FAVORITE PART OF BEING A BIOMED: “Interacting with others, working on equipment, coming up with new solutions, and being an important part of a hospital.”

WHAT’S ON MY BENCH • • • • •

Coffee Lawson Procedures Digital Multimeter EKG simulator A card for my wife

“I have been at Baylor for over three years and can truly say that this is the best job I have ever had. And, when I look back on my journey, I can truly say it was well worth it.” the medical center in Dallas. Four interviews later, he got the job in Dallas. “I have been at Baylor for over three years and can truly say that this is the best job I have ever had. And, when I look back on my journey, I can truly say it was well worth it,” Davis says. ON THE JOB AND OFF While he works on many routine projects, Davis’s specialty areas include Philips monitoring, labs and networking. He also finds time to train others. “I have been involved in several projects at the hospital; some of them were the installation of client bridges used to monitor children’s vitals (pulse ox and

patients on ventilators), upgrading software on Philips telemetry devices, obtaining alarm records from both GE and Philips monitoring to assist with alarm fatigue studies and I also gave training classes for fellow biomeds for the CBET exam,” he says. Monitoring and networking are also a part of his daily routine. “I was involved in the installation of a telemetry system in a new wing of a hospital which included the installation of a patient monitoring room that consisted of 30 monitors, install telemetry in a seven-floor hospital wing; again this was part of my day-to-day assignment. The installation of the client bridges involved

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

connecting them to the network, verifying this connection by pinging the IP address and assigning them to the proper location; again routine work,” Davis says. When not on the job, Davis enjoys classic cars and fishing. He has been married to his wife for 21 years and has three daughters and a son. What should TechNation readers know about Derick Davis? “That I love the field and that I feel the need to share knowledge [which] should be a part of every biomed tech’s DNA,” he says. For a guy who took such a meandering route to HTM; he fi nally found his true calling.

JUNE 2017

TECHNATION

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SPOTLIGHT

DEPARTMENT PROFILE The Veteran Health Indiana HTM Department BY K. RICHARD DOUGLAS

he tradition of the Veterans Health Administration goes back to the end of the Civil War, when President Abraham Lincoln authorized a soldiers’ and sailors’ asylum to care for members of the Union Army and Navy. The program became the Veterans Bureau in 1921, as programs for World War I veterans required more specialized care. The program became the Veterans Administration nine years later. In 1989, the Veterans Administration became the Department of Veterans Affairs.

For the veterans in Indiana and Central Illinois, the Veteran Health Indiana health system provides a range of health services to address their needs. The system includes the Richard L. Roudebush VA Medical Center in Indianapolis as well as six community-based outpatient clinics (CBOCs). These clinics are located in the Indiana communities of Bloomington, Martinsville, Columbus, Terre Haute, Lafayette and the farwest side of Indianapolis. “The Indianapolis VA Medical Center is a tertiary care facility that is a part of the VISN 10 VA Healthcare system which encompasses Indiana, Michigan and Ohio VA Medical Centers,” says Jordan Keebaugh, biomedical engineer and acting chief of the medical center’s Healthcare Technology Management (HTM) Department. “The VA Medical Center provides acute inpatient surgical, medical, psychiatric, neurological and rehabilitation care with 159 available hospital beds,” Keebaugh says. Besides Keebaugh, the HTM department is lead by Staff Engineer Tucker Scherger. The HTM Department is made up of four different sections: Project Management; Networked Medical Systems Support; Electronics; and Medical Equipment Systems Support. Keebaugh says that the department is made up of 21 full-time employees. “The Project Management section is composed of two staff engineers. Medical Systems Support Section encompasses the more typical face of the general

TECHNATION

JUNE 2017

Healthcare Technology field. The section is currently made up of 12 Biomedical Equipment Support Specialists (BESS) that focus on the corrective and preventive maintenance of the medical center’s medical systems,” Keebaugh explains. Keebaugh says that the Electronics Section supports medical and non-medical systems throughout the VA Medical Center. There are currently two BESS within Electronics that manage the nurse call system, nurse call phones, the patient elopement system, TVs, and the medical center’s security systems (access control, security cameras, panic alarms, etcetera). “The Networked Medical Systems Support section was recently developed due to the vast expansion of networked medical devices and the heightened focus on cybersecurity. Rob Goins, a systems admin, is currently the only HTM member within this section,” Keebaugh adds. FORWARD THINKING Innovation, pre-planning and cooperation are all part of the HTM department’s focus on embracing new approaches to their processes, brain-storming and quest for customer satisfaction. “Veteran Health Indiana embraces a culture of systems redesign thinking when tackling identified problems of any caliber. Rapid Process Improvement Workshops (RPIW) are conducted with subject matter experts from various service lines throughout the medical center to breakdown an issue and critically think through the problem solving process,” Scherger explains.

He says that the HTM department has been involved in numerous RPIWs that have included sessions on improving temperature monitoring as well as equipment tracking processes. The results of these RPIWs have streamlined the department’s processes and have translated into increased efficiency of staff and a resulting cost savings to the medical center. “The concept of systems thinking is applied in a more direct manner for each department via ‘huddle boards,’ which are conducted weekly,” Scherger says. “A huddle board is a quick department gathering that strays from the typical ‘meeting’ mentality. The huddles are to introduce new improvement ideas and then to discuss other improvement ideas already in the works only; there are no minutes or managerial assignment of work as typical meetings would dictate.” “Staff have a chance to provide updates and elaborate on successes and failures in a peer setting. During FY17, the HTM department received a ‘Best Improvement Idea of the Week’ award for a simple, yet impactful, idea to designate a specific color of data cable for medical equipment. This change has already demonstrated decreased instances of medical device systems connectivity issues from improper patch cable management and also decreased incident response turnaround time during troubleshooting efforts of network problems,” Scherger adds. In addition, Scherger says that the HTM department has helped to charter a service line value stream process improvement; a combined effort between

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SPOTLIGHT

HTM, OIT, and Clinical Informatics to increase the systemic capacity for collaboration between the three services. “The ultimate goal of this value stream is to bolster inter-service relationships, which will reduce health technology downtime and increase customer satisfaction, ultimately leading to a better patient care experience. The group is reviewing process for planned and un-planned network outages and the subsequent contingency plans that this entails,” he says. Through careful planning capital purchases and special install projects are allocated for and accomplished with the necessary resources. “The health system has numerous High Tech/High Cost (HT/HC) medical equipment project installations that are underway and also in the pipeline. The VA has implemented a Strategic Equipment Planning Guide (SEPG) which allows a medical center to forecast medical equipment replacement dates and costs for any specified timeframe and turns this data into a strategic capital equipment plan,” Scherger says. He explains that this allows leadership at the local, regional and national level to

adequately forecast equipment-related expenses and for sites to submit equipment packages in a more organized and targeted fashion. The report breaks down the equipment due for replacement by equipment category or ‘type,’ summarizes associated asset value costs, and provides specifics on the equipment to assist in the facilitation of data gathering and equipment package compilation. “In FY17 alone, Veteran Health Indiana has successfully installed two new digital radiograph systems, one linear accelerator, and one SPECT/CT,” Scherger says. “The sum total of these projects exceeded $10 million in construction and equipment costs. HT/ HC projects installations in the pipeline currently for FY17 and FY18 include a hybrid operating room and an additional MRI to expand radiology services.” He says that the installation of the hybrid operating room will allow the health system to establish a transcatheter aortic valve replacement (TAVR) program which will help provide improved survival for veterans with severe symptomatic aortic stenosis. It will also expand the vascular surgical capabilities at the medical center.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SPECIALIZATION AND TRAINING Imaging and storage are all in a day’s work because of the specialized resources available through the Veteran Health Indiana HTM team. “Our relationship with the Radiology Department here at the Medical Center has expanded throughout the years. Scott McCammon, a senior BESS within the HTM Department, works cohesively with the PACs administrators to not only provide support to the PACs and dictation systems but also builds radiology workstations for in-house radiologists and tele-radiologists located throughout the country,” Keebaugh says. “Many of our technicians are Certified PACs (CPAs) Associates or have obtained more than one PACs administrator certification,” she adds. Training, in part, is accomplished through a sort of mentoring program that allows knowledge to flourish in the department. “The HTM Department actively participates in the VHA Technical Career Field (TCF) Program which partners tenured VHA employees with new hires in a particular career field,” Keebaugh says. “Here at the Indianapolis VA Medical Center, we have two biomedical engineering TCFs and one biomedical equipment support specialist TCF. The three TCFs have the opportunity to gain hands-on experience and absorb knowledge and expertise from more veteran individuals. This allows the VA to grow and develop the future workforce through a hands-on approach,” she adds. The VA has a cutting edge group of biomeds in Indiana who embrace forward-thinking medical equipment management for the ultimate benefit of the region’s veterans continuing a legacy of service to the men and women who have served their country.

JUNE 2017

TECHNATION

SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE

Real Needs. Real Partnerships. Real Solutions.

lite Biomedical Solutions supports hospital biomedical departments with new replacement parts, re-certified parts, on-site service, and repair services that keep clinical equipment performing at optimal levels.

Elite wants to thank all of our valued customers for their loyalty and trust over the last five years. We have and continue to work diligently to meet or exceed your needs. We strive to earn your respect and confidence so that you will want to know us on a first name basis. Our Elite team is always eager to help you with any of your needs. When you call Elite you will reach one of our friendly and knowledgeable staff members. We encourage and welcome all customer visits. It’s a great way to meet our incredible team. Elite celebrates our 5th year anniversary this month. This marks a huge milestone for our company and is evidence of valued partnerships and devoted customers. In order for Elite to continue to provide superior service we have increased our staff from 9 to 27 employees over the last five years. We currently occupy 16,500 square feet with the option to expand an additional 17,000 square feet to continue to meet our customers’ needs. Elite’s Quality Management System continues to meet the requirements of

TECHNATION

JUNE 2017

Pictured is the Elite Biomedical Solutions Quality and Product Development teams along with new Director of Manufacturing Nate Schlauch

extensive customer audits, ISO 13485:2003 and ISO 9001:2008 surveillance audits along with a recent scheduled FDA inspection. “All of these are a true testament to the excellence of Elite Biomedical Solutions’ Quality Standards,” states Brenda Compliment, Director of Quality. • ISO 13485:2003 • ISO 9001:2008 • FDA REGISTERED • FDA INSPECTED 21CFR820 Elite is annually audited by multiple, national Independent Service Organizations. In addition to the annual audits, Elite receives monthly/quarterly scorecard ratings with a 95% or greater rating. In the last rolling 12-month internal quality KPI, we achieved 99.98% fi rst pass yield. Service warranty return rate KPI is 0.8%. On

time delivery for non-OEM products KPI is 98.2%. Elite continues to bolster its in-house Research and Development. Our mission is to invest in building a world-class organization to better serve all of you. “We value the close working relationships with our customers to help achieve our #1 goal of patient safety,” states Dan Meiser-Director of Product Development. “We have implemented rigorous processes utilizing risk analysis, risk mitigation, precision equipment, and design controls to ensure new replacement parts’ verification and validation.” Elite has partnered with an independent lab to quantify, verify and determine our material selection versus the OEM. One of our goals is to select resins that strengthen and ensure that

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SPOTLIGHT

Elite Biomedical Solutions has grown from from 9 to 27 employees over the last five years.

“Do all the good you can. By all the means you can. In all the ways you can. In all the places you can. At all the times you can. To all the people you can. As long as ever you can.” – John Wesley our new replacement parts are more chemically resistant. Elite has the largest new replacement parts’ portfolio and thanks to our customers’ needs, we continue to successfully grow this product list. We encourage the opportunity to pioneer new product ideas with our customers. Introducing Elite Manufacturing, we are elated to announce that we are bringing manufacturing in house. Nate Schlauch our new Director of Manufacturing was selected because of his extensive experience in injection molding and his pursuit of excellence. Nate’s degree, certifications, experience, and leadership will strengthen our already highly knowledgeable/ experienced team. “In-house manufacturing, allows us to grow vertically, which has been a goal for Elite,” says Jeff Smith, President. “We pride ourselves in our

new replacement parts being 100% USA manufactured. We are excited this new expansion will allow Elite the opportunity to continue to offer new jobs within our community.” Elite strives to build close customer partnerships, implement state-of-theart equipment, hire talented professionals, reinvest money into the growth of the company, and implement continuous quality improvements. What this means to all of our customers: a reliable manufacturing partner, quicker product time to market, a one-stop shop for (in-house R&D, quality lab, and manufacturing), material/parts traceability control, and a partner that can grow with your replacement part needs. “I am excited to get started with such a great team, Elite truly has great values in caring for all of you, our customers,” Nate Schlauch states. “Our

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

vertical growth of manufacturing will allow your business partner, Elite, to better serve our customers. It will give us the ability to monitor and control every aspect of the component delivery from raw goods to fi nished goods.” ELITE GIVES BACK Elite’s Purpose Statement is “Improving the lives of our employees, customers, business partners, and communities one day at a time!” The Elite family is very committed to and focused upon giving back. Some of the company’s charity partners include Child Focus, Empower Youth, TriMedx Foundation, Pancreatic Foundation, Aruna Project, Clermont DD Empowers Me, and Children’s Tumor Foundation. Again, we thank our customers for all of your support, ideas, and continued business! Sincerely, The Elite Family

JUNE 2017

TECHNATION

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SPOTLIGHT

BIOMED ADVENTURES

Celtic Cruiser In-car-nation BY K. RICHARD DOUGLAS

or most people, a car is a means for getting from point A to point B. It’s a utilitarian tool that we look to for reliability, comfort and convenience. For some people though, a car can be a passion; the canvas to create a work of art or a platform for engineering excellence.

When Tom Bauld purchased his 1940 Ford Coupe, he knew he had the platform for something that would serve much more than the utilitarian purpose of reliable transportation. This was clay waiting to be molded. Bauld’s interest in cars goes back to his teen years. His first project car might have been a Chevy, but that wasn’t in the cards. “I was like any other teenager boy in the 1950s,” Bauld says. “I loved cars and had lived near my Uncle Ray Kirkpatrick, who had a 1928 Chevy coupe with a rumble seat, which was my spot when he, my Aunt Joan and I went for a drive. Ray sold it when I was 14 and I really had wanted to buy it, but I didn’t know it was for sale until it disappeared.” In 1958, when Bauld was 15, he saw an ad in the Philadelphia Inquirer for a 1940 Ford and he bought it for $125. “I’ve owned the car for 57 years. After having it for two years, two other buddies and I went in together and bought a 1939 Plymouth four-door sedan that eventually became mine alone. I sold it in about a year because the cost to fi x it in order to pass the Pennsylvania state inspection was too much for my meager budget. The next owner needed it as a parts car for a restoration in process. That was the only other old car I’ve owned,” Bauld says.

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Brandon Noonan & Tom- Autorama. Brandon worked on the car & is the grandson of Dick Noonan.

STREET ROD METAMORPHOSIS The evolving design of the classic Ford started in 1970. Bauld, and his wife Diane, began with the power plant and the interior. He installed a 1948 Mercury flathead engine while his wife reupholstered the interior in a black and white naugahyde, using the original bench seat, door panels and package shelf. “Over the years, as the car was disassembled and little-worked-on because we became a Scouting family and were very active, I was indecisive about whether to restore the car to nearly original or to transform it into a hot rod,” Bauld says. “I fi nally made the decision that it would be more fun and unique if I made it into a street rod. I arranged with my best friend’s uncle, Dick Noonan of Noonan Racing, to have him do the renovation in Oxford Michigan, about 75 miles from my home in Milan,” he says. The redesign and ground up

restoration started with acid dipping the old Ford’s body and removing every trace of rust, paint and rubber, according to Bauld. The process revealed many necessary repairs to the floor, the door hinges and the body panel below the trunk. “The frame was modified to install a Heidt’s front end with rack and pinion steering and disk brakes. Two parallel leaf springs replaced the single cross body rear spring,” Bauld says. “Dick and I collaborated on the body design with my priority to make it look really smooth and flow well. We eliminated the vent side windows, the bumpers and the separator for the two windshield pieces, added rear fender skirts, relocated the gas fi ller to the trunk, removed the door handles, rain gutters and the trunk handle,” Bauld adds. He points out that a special feature of the car is the rear folding jump seats that technically transformed the business

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SPOTLIGHT

coupe into an opera coupe. They came from a 1995 Ford Ranger pickup truck, requiring a lot of design and metalworking skill to make them fit. “The dash instrument cluster is from Dakota Digital and has blue LED digital gauges. Fuel level is indicated as percent full. Steering is through an ididit [brand] tilt column painted to match the exterior,” Bauld says. The exterior received a striking color scheme that gets it noticed. “The car is painted in 2010 Chevy Camaro Synergy Green,” Bauld explains. “I saw a unique and beautiful green Camaro going the opposite way on a freeway about six years ago, and after stopping at three Chevy dealers, I was able to fi nd the paint code. That green and similar colors are starting to appear on more and more cars.” A big benefit to Bauld’s project was that Dick Noonan had so many contacts in the car business. This resulted from years of building race cars and performing many restorations. When a specialist was needed for the interior renovation or new wiring, Noonan had many resources on which to call. “Dick was totally committed to using only the best quality components, which saves in the long run. For instance, the AC uses aircraft quality connectors and tubing,” Bauld points out. The car’s current power plant is a circa-1985 305 Chevy engine that was rebuilt in 2014. The interior was redone in 2015 and the car received its current paint scheme that year also. COMPLETION AND RECOGNITION After 2,000 hours of work, the car, nicknamed the Celtic Cruiser, was fi nally fi nished in October of 2015. Bauld says that in his capacity as designer and project manager, the project did not call on too many of his biomed skills because much of that kind of work was done by others.

With the fi nished product, the Baulds hit the show circuit. Their fi rst outing was a local show. “The first show that we entered was the Milan Car Fest, sponsored by the Backstreet Cruizers, where we won the best in class for 1934-1948 cars. That was indeed a surprise, but the experiences we had in the Detroit Autorama were very special,” Bauld says. The Detroit Autorama is held every year at Detroit’s Cobo Center, a giant 623,000-square-foot convention center. When Bauld exhibited his car there in February of 2016, the show featured nearly 1,000 cars. “Near the end of the show, entrants were invited to a large auditorium with many awards on the stage. After the naming of the top award, the Ridler (Award) given to the best car which had never been shown before, they began announcing the individual class awards,” Bauld recalls. “My wife kept saying, let’s leave, we’re not going to win anything, but I insisted on staying to see who won and soon after, they announced our names and we proudly accepted second-prize in the Semi-Modified Hot Rod Coupes class. The whole experience at Autorama was enjoyable and intense with hundreds of interesting

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

conversations with car owners and spectators,” he adds. “We continue to be amazed at the warm compliments the car generates at events.” Bauld has also driven his Ford street rod to, and entered, the Bristol Days Car Show in Bristol, Pennsylvania, outside of Philadelphia in October of 2016 and the Toledo Street Rods show in Ohio in August of 2016. ON THE JOB Bauld has been a biomedical engineer for 43 years, mostly managing biomedical departments in hospitals. In his current position, he works as a biomedical engineer for the Veterans Administration’s National Center for Patient Safety in Ann Arbor, Michigan. “It’s the best job I’ve ever had because I get to apply biomedical engineering and human factors engineering skills of incident investigation and device evaluations to work every day to reduce the risks of injury and illness of our veterans being treated in the VA healthcare system and to improve the purchasing of products that the VA uses,” he says. The mean green Celtic Cruiser has been transformed into automotive art and has provided one biomed with many years of leisure time enjoyment.

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NEWS & NOTES

Updates from the HTM Industry SIEMENS HEALTHINEERS OFFERS INFECTIOUS DISEASE TESTING Siemens Healthineers has announced that its newest addition to the ADVIA Centaur portfolio – the ADVIA Centaur XPT Immunoassay System – offers a comprehensive infectious disease testing menu for laboratory diagnostics, which enables lab managers to consolidate infectious disease testing on a single platform. The ADVIA Centaur XPT system offers laboratories a comprehensive infectious disease menu. Designed for hospitals and reference laboratories that demand high

throughput, the system can process up to 240 tests per hour and offers laboratories a portfolio of more than 70 assays. The ADVIA Centaur XPT system helps minimize hands-on operator time with automated maintenance and consolidates infectious disease testing otherwise conducted on multiple instruments for improved efficiency and better turnaround time. With products and solutions such as the ADVIA Centaur XPT, as well as a new name that underlines the company’s pioneering spirit and engineering

expertise, Siemens Healthineers – the separately managed healthcare business of Siemens AG – is helping to enable health care providers worldwide to meet current challenges and excel in their respective environments.

TRISONICS INC. DONATES ULTRASOUND SYSTEM TO VINCENNES UNIVERSITY Trisonics Territory Manager Tim Williams and Customer Relations Manager Andrew Head had the honor of presenting the BMET program at Vincennes University with the donation of an Acuson Sequoia Ultrasound system. Trisonics is happy to support a program designed to advance the biomedical field. The system will be an asset in continuing enrichment of the students enrolled in the program. The Biomedical Equipment Technician (BMET) program at Vincennes University is a two-year associate of science degree that includes technical and general education classes. The hands-on curriculum is engaging and career-oriented. Students in this program can expect to earn a solid education in biomedical devices/industry fundamentals, electronics, and computer/ networking fundamentals. The program

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provides the crucial skill sets desired by hospitals, medical equipment manufacturing, professional sales and contract maintenance companies. April Lebo, Director of business development at Trisonics, said it is great to work with students. “I was fortunate enough to meet Mr. (Bill) Harner at the Indiana Biomedical Society meeting in January,” Lebo said. “We spent time talking about his program at Vincennes University and how valuable an ultrasound donation would be to the students. It was a pleasure getting to work with him and the university on this project.” Harner, Biomedical Electronics Coordinator at Vincennes University, is grateful for the donation. “I want to thank Trisonics for donating the Siemens-Acuson-Sequoia ultrasound to our program,” Harner

said. “Without your help, we would not have been able to continue our handson training with diagnostic ultrasound.” Harner went on to thank Williams and Head for coming to VU to install and provide training on the unit. Lebo was commended for her commitment to organizing and coordinating the delivery of the system. Harner also expressed his appreciation for the quick turnaround time of 18 days from the date of the agreement, to when the system arrived on campus. Trisonics is an ultrasound imaging partner specializing in service, systems, and support.

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INDUSTRY UPDATES CABMET SYMPOSIUM SET FOR AUGUST The CABMET Annual Symposium will be held August 10-11, 2017. The organization has made a few changes, including a new Thursday/ Friday format. The Symposium will still be at Children’s Hospital Colorado, located at 13123 East 16th Avenue in Aurora, Colorado. The annual event will also include a Happy Hour and Poker Tournament on Thursday, August 10 at the Tin Cup, located at 50 S. Peoria Street in Aurora, Colorado. However, there will not be a golf tournament this year. CABMET has a room block where attendees will receive a discounted rate at the Spring Hill Suites. FOR MORE INFORMATION and updates, visit CABMET.org.

AAMI FOUNDATION LAUNCHES INITIATIVE TO ADDRESS COMPLEXITY OF HEALTHCARE TECHNOLOGY A new coalition – spearheaded by the AAMI Foundation – is tackling the challenge of the burgeoning development and use of complex healthcare technology. Over the next two years, the aptly named National Coalition to Promote the Safe Use of Complex Healthcare Technology aims to build a body of best practices to guide health care facilities and clinicians in their procurement, use and training of technology. These efforts kicked off in an April 12-13 meeting in Annapolis, Maryland. The considerations around improving the safety of complex healthcare technology are themselves complex. Addressing them will have far-reaching implications that stretch from the hospital to the patient’s home setting, and ultimately to industry, which designs the devices. That’s important because when clinicians don’t understand the intricacies of the device that they’re using, or the device is difficult to use, what results is too often an error by omission. “Patients are still at risk of getting hurt in hospitals because of shortcomings in properly preparing clinicians to utilize complex technology in the patient care setting,” said Jim Piepenbrink, deputy executive director of the AAMI Foundation. “Clinicians are inundated with technology with the intent of improving patient care and for providing better clinical information to manage the care of the patient. Through our collaboration with industry and

clinical leaders, we have found that there are limitations in most training programs because of the lack of time afforded clinicians. Too often, they’re left to figure things out on their own, or they receive training secondhand from someone else. The full breadth of what they need to know is not covered.” The first meeting of the coalition brought together a diverse group of the coalition’s approximately 100 members, including nurses, physicians, human factors engineers, and industry representatives. Participants cited a lack of investment in training and competency assessment – particularly in hospitals with resource constraints – as well as the need for manufacturers to design complex devices that are nonetheless intuitive to use. Coalition members will work to define what exactly constitutes a “complex” technology, a key consideration. The definition can cover technology that can be difficult to navigate because it contains many software levels, such as a mechanical ventilator. But it can also include technologically advanced equipment that is simple to use, but can be misused in a high risk, high stress situation, such as a defibrillator. While a deluge of new devices can overwhelm an already strained training and education infrastructure for clinicians, they are also struggling with designs that are complex for the opposite reason. Many devices (such as pagers) are

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hopelessly out of date and unintuitive. Divided into working groups, coalition members will collaborate on specific topics during the first two-year phase of the initiative. The topics they will cover include: • Developing best practices for selecting and purchasing complex technology • Guiding hospitals on where to focus their education and training efforts • Establishing minimal levels of proficiency and ways to assess that proficiency • Building the business case for hospitals to allocate financial resources to improve preparation by clinicians when using complex technology • Developing ongoing discussions with manufacturers regarding what the design and development of products may look like and how they will affect end users The coalition will reconvene in 2019 to discuss its progress and formulate its next phase. More information on the AAMI Foundation’s patient safety initiatives is available at www.aami.org/ foundation.

JUNE 2017

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PHYSIO-CONTROL LAUNCHES NEW DEFIBRILLATOR IN UNITED STATES Physio-Control has announced that the company’s HeartSine samaritan PAD 360P (SAM 360P) fully automatic external defibrillator (AED) is available for sale in the United States, having received U.S. Food and Drug Administration (FDA) Premarket Approval (PMA). HeartSine, acquired by PhysioControl in 2015, is the first to receive approval for a new AED product under the FDA PMA regulatory process, which is the most stringent for medical devices in the United States and is a new FDA regulatory requirement for the AED industry. “As part of our diverse portfolio of AED offerings, the SAM 360P is an intuitive, compact and cost-effective device that assists caregivers – whether at a business, care facility, or a public place – in delivering potentially lifesaving defibrillation in cases of sudden cardiac arrest,” said Ryan Landon, Physio-Control VP/GM, Workplace and Community. The SAM 360P will complement the SAM 350P and SAM 450P, which also have FDA PMA and are offered in the United States, by providing users with a choice of a fully automatic device, a semi-automatic device, and a device with

integrated real-time cardiopulmonary resuscitation (CPR) rate feedback. The Physio-Control HeartSine samaritan PAD 360P analyzes the cardiac rhythm and automatically delivers an electrical shock to a victim of sudden cardiac arrest in order to restore the heart to normal rhythm. This user-friendly AED provides easy-to-follow visual and audio prompts, including CPR coaching which verbally guides the rescuer through the CPR process. Shock delivery, if required, is fully automatic which means there is no shock button to press. With a durability rating of IP56, Physio-Control HeartSine AEDs provide the highest level of dust and water ingress protection in the industry, making the device well suited to a variety of usage locations – including places where exposure to the elements presents a challenge. All Physio-Control HeartSine AED models use the company’s interchangeable Pad-Pak cartridge, which has also received PMA approval. With a single expiration date for both battery and electrodes, the expense of tracking and maintaining accessories with different expiration dates is

eliminated. In addition, the Pad-Pak features a rapid replacement mechanism that enables the battery and pads to be replaced easily in seconds. Along with the SAM 360P, PhysioControl will offer a new HeartSine samaritan PAD Trainer that simplifies CPR and AED training. The new samaritan PAD 360P Trainer guides users through simulated analyses, simulated energy delivery and prompted CPR intervals with a training device which looks like a SAM 360P, is cost effective, and does not deliver defibrillation shocks.

NEW TOOL TRIGGERS FASTER DECISIONS ON NEW DRUGS, DEVICES Health care payers and providers don’t have to look far to get unbiased, independent judgment about the evidence on name-brand drugs and devices now that ECRI Institute has introduced The Evidence Bar. While ECRI Institute’s custom rapid reviews have long complemented health care professionals’ day-to-day value analysis and policy-making decisions, the newly enhanced executive summary equips users with a visual, at-a-glance tool. “With our new Evidence Bar and restructured summary format, health professionals can now more quickly and confidently inform their decisions on new and emerging interventions,” says Vivian H. Coates, MBA, vice president, health technology assessment, ECRI Institute. The Evidence Bar is ECRI Institute’s proprietary approach to weighing the benefits and harms of a specific, name-brand drug or device. The bar shows one of five possible indicators, each aligning with a specific judgment about the evidence on a technology: unfavorable, raises concerns, inconclusive, favors, or greatly favors the technology.

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“Available evidence rarely addresses every key question and is almost never firmly conclusive. Whereas others may assign a low rating to inconclusive evidence – implying that one should disregard the technology – The Evidence Bar signals payers and providers to proceed with caution and stay tuned for more developments,” says Diane C. Robertson, director, health technology assessment, ECRI Institute. Value analysis specialists from large national health systems and medical policy directors from payers validated the tool and new-and-improved executive summary. They confirmed that the new approach provides a quick, clear picture of safety, efficacy, and future evidence development for committee meetings. Early feedback indicated that the executive summary is easily read and understood in less than three minutes. TO LEARN MORE about The Evidence Bar or ECRI Institute’s Health Technology Assessment Information Service, visit www.ecri.org/htais or contact ECRI Institute by telephone at 610-825-6000, ext. 5440.

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TRANSTATE ANNOUNCES NEW PARTNERSHIP WITH JORDAN HEALTH PRODUCTS Transtate Equipment Company has partnered with Jordan Health Products. “We couldn’t be happier about the partnership with Jordan Health Products,” said Dan Wheeler, President of Transtate. “Partnering with JHP allows Transtate to become part of an integrated team, offering a broader range of industry-best solutions without sacrificing the quality our customers have come to expect.” “We’ve been hearing from our customers that they would like to see Transtate expand the quality services we already provide and develop new offerings,” Wheeler said. “JHP provides the needed capital and market presence and is the ideal partner to back us in achieving these customer objectives.” JHP’s healthcare equipment and service business is focused on the complete lifecycle of medical, surgical, diagnostic imaging and oncology equipment, including sales, install, service, repair, sourcing and refurbishing. Transtate will be part of the JHP group of health care companies, providing incremental resources, networking and cross-selling opportunities. JHP is focused on a strategic expansion into the rapidly growing, highly fragmented global equipment market. Transtate joins the following companies as part of the JHP portfolio: • Global Medical Imaging LLC • DRE Medical Group Inc. • Integrated Rental Services Inc. • Oncology Services International Inc. • Pacific Medical Group Inc.

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AAMI UPDATE

HTM Standouts Enjoy Flood of Praise

or the past several years, AAMI has asked members of the healthcare technology management (HTM) community to nominate exemplary professionals as part of its HTM Week celebration. This year, it was as if the floodgates were opened. Supervisors wrote about employees whose dedication dazzles them; colleagues described peers whose expertise and energy inspires them; and team members commended bosses who make them proud.

MARY JACKSON Meet the “Queen of Biomed,” Mary Jackson, the biomedical engineering account manager at Colquitt Regional Hospital in Moultrie, Georgia. “Talented and personable, she is so valued by the facility that when The InterMed Group took over the in-house HTM program, the hospital felt very strongly that a MARY JACKSON special clause be written into the agreement allowing her to stay,” wrote Don Fletcher, vice president of clinical services for InterMed. “Mary unfailingly demonstrates an in-depth knowledge of regulatory statutes, personnel management, equipment life cycle management, and proactive maintenance.” Added Scott Nudelman, COO for InterMed: “In my 31 years in hospital technology management, I have rarely experienced such a complete employee and teammate. Her focus and energy is contagious, and the combination of technical knowledge and passionate delivery defines Mary as one of our best.” KELLEY GALLETTI He’s not a braggart, but he is a fi ghter. So says one team member about Kelley Galletti, the lead biomed at Peacehealth St. John Medical Center in Longview, Washington. “Kelley is doing an amazing job as our lead technician,” wrote Eugene Sobovoy, a biomedical equipment technician with KELLYE GALLETTI Peacehealth. “Since our manager covers two hospitals in different cities, Kelley does most of the ‘managerial stuff’ in our hospital. Besides that responsibility, he is a real leader in our shop, withstanding any challenges that come his way. He helps other biomeds succeed in their careers by teaching them from his great experience and fights for us in the managers’

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meetings. Although he is CBET and CRES certified, he does not boast about that, and he takes on routine items, such as preventive maintenance for IV pumps, himself. I’m really thankful for him and proud to work under his leadership.” ADRIAN BEST According to his boss, Adrian Best, manager of clinical engineering at Penn State Hershey Medical Center in Hershey, Pennsylvania, lives up to his family name: the best. “I’m proud of him and want to recognize the work he does every day,” wrote Samantha “Sam” Jacques, the director of clinical engineering at Penn State Health. What does ADRIAN BEST that work include? “He exemplifies incredible integrity by being consistent and fair to all staff and having the courage to ask hard questions of himself and others,” Jacques explained. “He does the right thing, always, regardless if it is easy or not.” Jacques added that Best’s expertise in contract utilization has saved the organization more than $500,000. Best, she said, also is committed to seeing his staff develop and thrive. “He is perpetually kind and keeps a positive can-do attitude, even in trying situations,” she concluded. WESLEY REID Holding the rank of master sergeant (MSG), Wesley Reid is the healthcare technology manager at Tripler Army Medical Center in Honolulu, Hawaii. In saluting Reid’s work, Elizabeth Gum, chief of the logistics division at the center, offered a list of impressive statistics. Reid, she said, has helped to reduce the hospital’s maintenance budget from $9 million in 2013 to less than $4 million in 2016; productivity increased

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INDUSTRY UPDATES from 5,000 completed unscheduled work orders to more than 10,000 every year after 2016; his team strategically replaced more than 1,400 aged medical devices valued at more than $70 million, increasing readiness and reliability for more than 200 customer departments; and a new radio frequency identification (RFID) system reduced monthly average “unable to locate device” reports from 18 to two. “His expertise is sought throughout the region as the subject matter expert for healthcare technology management in healthcare systems,” Gum said, adding that she “cannot recommend MSG Reid highly enough for recognition in our industry.”

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MICHAEL LANE The associate director of the Technical Services Partnership (TSP) at the University of Vermont in Burlington, Michael Lane is likely a familiar name to regular readers of BI&T, AAMI’s peer-reviewed journal. The work of that department has been profi led several times as a “Bright Idea.” That’s just one of the many reasons that Lane’s boss, Tobey Clark, the director of the TSP, nominated Lane for recognition. Among MICHAEL LANE the other reasons: Lane was the fi rst member of the 50-plus person department to earn the title of certified healthcare technology manager (CHTM); he’s presented at several AAMI annual conferences; and he is responsible for a multimillion dollar maintenance insurance program. “Michael is a true HTM professional who takes on difficult challenges with a can-do attitude; displays professionalism with healthcare customers, peers, staff, and other stakeholders; routinely works extra hours; and makes the proper efforts, despite any difficulties, to meet the needs of our organization,” Clark wrote. “Mike leads our service and support teams, which has resulted in continuous growth over the nearly 25 years of his tenure.”

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Visit www.aami.org/HTMWeek to read about other HTM professionals who are helping set the standard when it comes to the service and support of healthcare technology – and bringing value to their organizations. FALL ‘HORIZONS’ TO FOCUS ON CYBERSECURITY IN HEALTHCARE TECHNOLOGY AAMI will devote the fall 2017 edition of its award-winning journal supplement, Horizons, to the topic of healthcare technology cybersecurity and is seeking experts to contribute research articles, systematic reviews, case studies, and commentaries. Submission could cover an array of topics, including electronic health records, mitigating the risks and effects of cyberattacks, securing the cloud, cooperation and collaboration between hospitals and vendors, the role of HTM professionals in healthcare cybersecurity, and software flaws or defects. Interested authors should email Editor Gavin Stern at gstern@aami. org and briefly describe the topic of the proposed manuscript and how it will add to the literature on the subject by June 22. Initial manuscript submissions of 3,000 words or less will be due by July 15. Manuscripts will then undergo peer review to determine whether they will be accepted for publication. FOR MORE INFORMATION, visit www.aami.org/callforpapers.

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ECRI UPDATE

Lights, Camera, Action! Exposing Video Endoscopy Systems

ideo endoscopy systems allow the viewing of live, color images of the interior of the body during diagnostic and therapeutic endoscopic procedures. They also enable these images to be stored, retrieved, and otherwise electronically manipulated. The endoscopes are inserted through natural openings in the body or through small punctures; therefore, MIS procedures are much less traumatic than open surgical procedures and result in less discomfort and usually in shorter recovery periods. Consequently, some procedures can be performed on an outpatient basis. Laparoscopy allows minimally invasive examination and treatment of organs and tissue within the peritoneum during procedures such as cholecystectomy and appendectomy that previously required open abdominal surgery. Arthroscopy, an alternative to open arthrotomy, enables the diagnosis and treatment of many joint diseases and injuries. In gastrointestinal endoscopy, a flexible endoscope is inserted into the rectum or esophagus, allowing the examination and removal of foreign bodies and polyps and the diagnosis of ulcers and cancer. Bronchoscopy evaluates the interior of the respiratory tract, particularly the trachea and the bronchi of the lungs.

PRINCIPLES OF OPERATION Video endoscopy systems comprise modular image detection/processing systems, monitors, and recording devices, as well as other accessories such as insufflators, irrigation and suction pumps, and carts. The main components of the video image detection system are the endoscope, display, camera head adapter (if required), processor, and fiberoptic light source. The image detection system typically uses a photosensitive silicon sensor, called a charge-coupled device (CCD) or chip, which is composed of millions of photoelectric picture elements (pixels) arranged in a rectangular grid. Using a fiberoptic light source for illumination, the lens system focuses the light reflected from the field of view (FOV) onto the CCDâ&#x20AC;&#x2122;s pixels, which electronically capture the image. Standard two-dimensional (2-D) video endoscopy systems use either one or three monochrome CCDs. Newer three-dimensional (3-D) systems utilize two separate cameras for image capturing; other systems may use a complementary metal oxide semiconductor (CMOS) chip instead.

VIDEO CAMERA In the most commonly used single-chip system, a mosaic color filter overlies the CCD to obtain color images. The filter consists of different color strips that cover specific pixels. The white light reflected from the FOV is filtered into specific colors (e.g., blue, green, red), and each pixel then responds electronically to a specific color. The mosaic data from the pixels is sent to the video processor, where all the colored image signals are combined and converted to a balanced color image that is compatible with standard color video displays. The other single-chip system (known as RGB [red, green, blue] sequencing) uses a rotating color-filter wheel inserted in the path of a flashing light source. This causes short, rapid, sequential bursts of red, green, or blue light to be emitted from the tip of the endoscope, tinting the FOV. The red, green, and blue images are detected by the CCD and transmitted to the processor, where they are combined. Three-chip systems have a prism that separates the incoming white light into red, green, and blue beams, which are sent to one of three dedicated CCDs. These systems are designed to provide better color reproduction than singlechip systems.

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With traditional nonvideo fiberscopes and rigid endoscopes, an endoscopic camera (also called a camera head) containing the CCD is attached to the proximal end of the endoscope. The cameraâ&#x20AC;&#x2122;s lens directs the light to the CCD and determines the focal length. Endoscopic cameras are available with different focal lengths; some also have digital or optical zoom capability. On video endoscopes, the CCD is an integral component of the distal tip of dedicated rigid and flexible endoscopes; thus, a camera head is not required. The electronic image is then transmitted from the CCD to the video processor through the camera head or video endoscope cable. VIDEO PROCESSOR Video processors (sometimes called camera control units [CCUs]) have inputs for either one or two camera-head or video-endoscope cables. The front panel also usually has controls that can adjust the brightness and color of the image, capture and label videos and images, and in some cases select and adjust water, air, and suction. In addition to the electronics for image processing, processors used in

JUNE 2017

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gastrointestinal endoscopy sometimes also house integral fiberoptic light sources and air, water, and suction pumps. Air insufflation is typically used to expand the intestines to insert and maneuver the scope and increase the FOV. Suction helps remove debris from the distal tip of the endoscope and accumulated fluids, such as sterile water or saline used to wash the surgical site. Insufflation and irrigation during surgery (e.g., laparoscopy, arthroscopy, hysterectomy, ureterorenoscopy, neuroendoscopy) are accomplished with separate devices. The processor sorts the electric signal from the camera head according to pixel location and intensity, converting the image to a usable electronic format. It compiles the color elements into a full-color electronic image that is filtered and displayed on one or more monitors, output to a recording or storage device, or routed to remote sites such as a doctor’s office. Discrete pictures are displayed at a rate fast enough to appear continuous to the human eye. LIGHT SOURCE Successful illumination of the FOV is required to produce a useful video

TECHNATION

JUNE 2017

BY ECRI INSTITUTE

image. Light sources produce a high level of light, which is directed through a fiberoptic light guide cable and the endoscope to illuminate the surgical field. In addition to manual controls for adjusting the light level, many systems have automatic brightness modes that automatically detect and adjust the light level to optimize the image. Some systems also have a white-balancing feature to adjust the basic components of the color system according to the lighting conditions. The light source usually contains a xenon, LED, or metal-halide arc bulb (e.g., 300 watts) to produce the light required for video images; some light sources have backup bulbs and bulb-life meters. PERIPHERALS Since the fi nal image quality is limited by the weakest link in the video chain, display quality is important. When using systems marketed as “HD” or “high-defi nition,” it is necessary to use a display with a resolution matching or exceeding that of the output signal resolution produced by the video processor. Otherwise, the monitor may be used to “scale” the signal for

display, which may diminish image quality. Widescreen LCD or LED monitors, which can display a variety of formats, including HDTV, have become the norm. In some systems, the image occupies only a certain portion of the screen, allowing room for patient data. Many suppliers offer data-entry keyboards or touchscreens so that endoscopy staff can enter data into the video image frame. Several processing systems can display the image in various formats, including picture-in-picture and four images on one display, and many suppliers also offer remote controls for operating the processor and video systems. The processed images can be documented and archived using various recording devices. These components can be connected to the processor and display by standard video signal cables. Hard-drive, CD, DVD burners and USBs can be used to save data directly to a computer or network. VCRs offer various playback modes; special-effects playback includes freeze frame, frame-by-frame advance, onscreen picture search at high speed (shuttle search), and slow motion.

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PURCHASE CONSIDERATIONS ECRI Institute Recommendations The most important selection factor for surgical video systems is image quality. Although the image quality of 3-CCD systems generally surpasses that of 1-CCD systems, this specification is highly subjective. Hospitals should use each system on a trial basis before making a purchasing selection to allow surgeons to offer input. A video system should be compatible with many flexible and rigid endoscopes with appropriate adapters. Ease of use is also an important consideration. Since some surgeons prefer to have direct control over surgical video system functions, systems that allow control of multiple functions from the camera head, as well as from other components such as the front panel and keyboard, may be attractive. Recommended video processor features include autoillumination, auto-white balance, and zoom control. Video endoscopy systems should allow the user to output a wide range of video signal formats. Y/C connection should be standard on any system. 3-CCD systems should include RGB format to take advantage of their higher picture resolutions. It is recommended that systems marketed as “HD” or “high-defi nition” have at least one digital output. Some hospitals may also wish to purchase systems

Anesthesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pum Feeding Pump • General Medicine • IV Pump • Laboratory • Lymphedema Pump • Mi

with digital output (e.g., DVI, SDI, laneous • Monitor • Nutrition Pump • OB/GYN • Ophthalmology • OR/Surgery • Out the • Pediatric Respiratory • Supplies • Therapy • Ultrasound • Vascular • Gas Regulator • A HD-SDI, 3G SDI) for recording images thesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pump • Fe or video onto recording media or an Pump • General Medicine • IV Pump • Laboratory • Lymphedema Pump • Miscellaneo information system or to display Monitor •digital Nutrition Pump • OB/GYN • Ophthalmology • OR/Surgery • Out the Door • Ped Our equipment Respiratory • Supplies • Therapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • images on a surgical display. The video Stretchers • Cardiology • Endoscopy • Exam Room Extremity Pump • Feeding Pump • is tested and •serviced processor should have digital outputs eral Medicine • IV Pump • Laboratory • Lymphedema Pump in-house so that we• Miscellaneous • Monitor • that match the inputs of existing tion Pumpimage • OB/GYN • Ophthalmology • OR/Surgery • Out the Door • Pediatric Respirat can guarantee its Supplies capture devices or operating room• Therapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • Beds/Stretch integrity. Cardiology • Endoscopy • Exam Room • Extremity Pump • Feeding Pump • General Med integration systems. • IV Pump • Laboratory • Lymphedema Pump • Miscellaneous • Monitor • Nutrition Pum OB/GYN • Ophthalmology • OR/Surgery • Out the Door • Pediatric Respiratory • Suppl The camera should be compatible Therapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pump • Feeding Pump with the hospital’s preferred method of reprocessing. Systems that are compatible with multiple methods, including autoclaving, should be given Physician’s Resource Network strong consideration. The light source should not cause excessive heating at manufacturerrecommended illumination levels. For safety, light sources should be equipped with a standby feature to suspend light AUTHORIZED NORTHEAST output, which is active at start-up. DISTRIBUTER OF Output at startup differs: <10%, setting from last use, or standby. Light sources with LED lamps last 5,000 to 30,000 hours versus 500 hours for xenon lamps and therefore do not require lamp replacement like xenon lamps. 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 available online to members of ECRI Institute’s HPCS; learn more at www. ecri.org/components/HPCS.

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BY JOHN WALLACE

CALIFORNIA DREAMIN’ MD Expo Rides Huge Wave of Success

he 2017 MD Expo in Irvine, California exceeded expectations with more than 1,000 people in attendance, including representatives from more than 100 industry-leading businesses.

MD Publishing Vice President Kristin Leavoy said the conference even exceeded her high expectations. “We knew holding an MD Expo in southern California would gain some industry buzz, but we never expected it to draw the numbers it did,” Leavoy explained. “Our pre-registration attendee numbers topped any show to date and our total registration count was over 1,000 for this event. A first for MD Expo!” Being in beautiful California wasn’t the only factor contributing to the enormous success of the conference. “I know the location played a role in the success of this event, but I also feel that the incredible educational line-up

all commented on the success of the conference with many agreeing that MD Expo Irvine was “the best” yet. “AUE was very pleased with the turnout at MD Expo 2017 Irvine. The show is always very valuable to us because many of the exhibitors and attendees are OEMs and ISOs, like ourselves, and it provides an excellent chance to further our business-tobusiness relationships,” said George Hryshchuk, Director of Sales at

“[MD Expo] is an asset to all of us! As an HTM professional, I can’t thank MD Expo and TechNation (enough) for all the support in the field!”

- Dean Skillicorn, Philips Healthcare Manager

was a key factor. Add to that a sold-out exhibit hall with world-class vendors, and some of the best networking events the industry has to offer, and clearly, MD Expo has found the ingredients for success,” Leavoy said. “And I think a big shout-out is in order for our vendors and sponsors, without their support, MD Expo would not be able to continue to offer free admission for health care professionals.” Attendees, exhibitors and educators

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JUNE 2017

Advanced Ultrasound Electronics. “But this year, the end-user hospital attendance, and the presence of CMIA members really gave the show, and us, a boost with many great end-user conversations and sales opportunities. I think I have been to almost every MD show, since the very first one, and this was by far the best!” “This is likely the best attended MD Expo I think I’ve ever been to. I made some really great contacts and overall had

a really great time,” Numed Business Development Executive Krista Bryan said. “I have noticed that this event keeps on growing and growing. More people are attending this event with great participation. Congratulations to the Expo staff for a well-coordinated event,” said Edgardo Garcia Guel, clinical engineering senior manager, Banner Health. “The MD Expo was excellent. The content was on point and relevant for the attendees. The networking opportunities were excellent,” said Christopher Nowak, Corporate Director, Universal Health Service Inc. “This was a great show! This show has grown not only in attendance and size, but vendor wise,” Philips Healthcare Manager Dean Skillicorn said. “Great job. It is an asset to all of us! As an HTM professional, I can’t thank MD Expo and TechNation (enough) for all the support in the field!” Longtime MD Expo attendee Mercy Health Director Regional Clinical Engineering Douglas Dreps enjoyed the Irvine conference and said its success continues the trend of excellent events by MD Publishing. “I have had the opportunity to attend many MD Expos and Irvine was the best yet! The location and weather

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was outstanding. The education sessions and vendor expo are the main reasons I attend. I appreciate all the vendors that make these possible. I made some good connections and hope to save my hospitals dollars using vendor solutions I saw,” he said. “To me, the MD Expo is about networking and learning from others. Many can attend the conference at no charge, which is a huge savings. They offered networking, free happy hours, breakfast, lunch and closed the event with a backyard beach party!” The Reverse Expo is rapidly becoming a can’t miss aspect of the MD Expo for decision makers at health care facilities and businesses. The opportunity for one-on-one interaction continues to impress and link hospitals with the solutions they need from some of the top equipment and service providers in the industry. The MD Expo Welcome Reception, sponsored by Sodexo, followed the Reverse Expo providing the ideal setting for longer conversations by those who connected at the Reverse Expo. It also served as an oasis for the HTM professionals who participated in the

all-day CBET Review as well as a kick off ceremony for those arriving for the next day’s full slate of educational sessions. The educational sessions and exhibit hall were overflowing on the first full day of the conference. Interest in the conference was so high that additional space was made available to businesses and HTM organizations with smaller booths just outside the exhibit hall. The high energy of a busy and successful day carried over with an amazing atmosphere for the Happy Hour sponsored by AIV. It seemed as if everybody was adding to their list of industry contacts as they relaxed after a busy day. The final day of the MD Expo was filled with excitement from the start with a Renovo Solutions-sponsored Keynote Address from John Maurer from The Joint Commission. Maurer discussed hot topics for over an hour and, after a short break, attendees made their way to educational offerings. The exhibit hall was once again the place to be in the afternoon with a complimentary lunch provided by All Imaging Systems and more

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opportunities to network. The Door Prize Extravanganza was also a hit. The grand finale of the 2017 MD Expo was the Beach Bash sponsored by Jordan Health Products, MedWrench and USOC Biomedical. Everyone enjoyed delicious food, tasty beverages and a range of fun games as everyone celebrated a great conference. The MD Expo’s continued success is assisted by the support of sponsors. The sponsors who helped make MD Expo Irvine a success are Sodexo, DirectMed, USOC Bio-Medical Services, AIV, Renovo Solutions, Pacific Medical, Jordan Health Products, MedWrench, Tech Knowledge Associates, All Imaging Systems, MW Imaging, Alpha Source Inc., Philips, Crothall Healthcare, RPI, TriMedx, Technical Prospects, GE Healthcare, MedWest Surgical Resources, BC technical and CryoSRV. MD Expo returns to Orlando, Florida in October of this year with support from the Florida Biomedical Society. The conference will be held October 5-7 at the Hilton Orlando Lake Buena Vista. For details, visit mdexposhow.com/Orlando.

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Webinar

Wednesday

WEBINAR WEDNESDAY Experts Address Pertinent Topics

he TechNation Webinar Wednesday Series continues to offer 1 CE credit from the ACI with each presentation. Recent webinars continue to draw hundreds of HTM professionals seeking knowledge and tips to help them better do their jobs.

The webinar “Master RTI’s Ocean Quick Check QA Software” sponsored by RTI and presented by Key Account Manager Erik Wikström is just one example. Wikström, who has 30 years of experience in technical system sales with the last four years in the X-ray QA business, has global experience in advising and training imaging engineers and technicians in using X-ray QA software to drive workflow process improvements. RTI provides complete quality assurance solutions for all X-ray modalities and facilities. The webinar included a demonstration of RTI’s Ocean Quick Check QA software. Ocean Quick Check has helped many imaging technicians reduce the time needed for QA testing, while at the same time improving the quality and accuracy of their X-ray QA reporting. Webinar attendees gained valuable insights into new ways of improving efficiency in their X-ray QA workflow. The presentation concluded with a Q&A session in which Wikström provided answers to attendees’ questions. Almost 200 people attended the live webinar and shared positive comments on a post-webinar survey. “Amazing training as usual ... Thanks TechNation,” Luis M. said.

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“The information provided in the webinar was very interesting and explained well,” Erik B. said. “It’s great to have a vendor showcase their new test devices and how to use those devices in the field, which helps us with budgeting new test equipment or enhancing our preventive maintenance program,” Brian G. said. A recent PartsSource-sponsored webinar “The Messy Costs of Managing Multiple Vendors” continued the Webinar Wednesday series. During the webinar John Bowser, manager at Ohio Health, and Erin Tournoux, vice president of client services at PartsSource, discussed how to stop managing vendor performance and administrative tasks, and shift your staff’s focus to core business operations. The webinar shared data from PartsSource customers as well as some of its internal data to assist biomeds and their approach of sourcing parts. Some key points of the webinar included a look at common pain points that come with managing multiple vendors. It also provided insight into Ohio Health’s experiences with datadriven examples showing the impact of using multiple vendors on health care organizations. One key aspect of the webinar was a look at how to improve outcomes through supplier consolidation. The webinar also included a Q&A session where attendees were able to share challenges they have faced with Bowser and Tournoux offering expert advice. The webinar proved to be popular with the HTM community with 210 attendees for the live webinar. Those who attended the live

“I enjoy the wide range of topics Webinar Wednesdays offer. I do nothing but register; open the portal and I have access to information that can boost my career.” - Eveyln P

presentation shared their opinions in a post-webinar survey and had great things to say about the PartSourcesponsored session. “Great webinar with great speakers! Webinar Wednesdays are always a great asset to me and my learning. I love using PartsSource for my parts and supplies and I appreciate their focus on making my job easier. Thank you TechNation and PartsSource for all you do,” David M. wrote. “It’s great to have webinars that provide both information and data to back-up that information,” Richard S. wrote. “The webinar was a good addition to the Webinar Wednesday series and PartsSource did an excellent job communicating the issues,” Randall G. wrote. Attendees also praise the Webinar Wednesday Series after every webinar and encourage others to join them at the next webinar.

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“I’m new to Webinar Wednesdays and I really like having a resource that offers job-specific learning opportunities,” Gretchen K. wrote. “TechNation’s Webinar Wednesday series is a great way to get my CE credits. I always look forward to seeing what the upcoming webinars are going to be,” Jacob S. shared. “The Webinar Wednesday series is full of valuable information on a variety of topics,” Joseph D. added. “I think the Wednesday Webinars fit in perfectly with my schedule. No better way to end Hump Day than a good webinar and some CE credits,” Matthew F. wrote.

“I enjoy the wide range of topics Webinar Wednesdays offer. I do nothing but register; open the portal and I have access to information that can boost my career. I appreciate TechNation’s efforts encouraging my success,” Evelyn P. wrote. “The series of webinars has improved my understanding of numerous equipment issues. They answer questions I never thought to ask,” Jim D. explained. “Webinar Wednesdays continue to get my applause as it has been able to provide an important form of communicating information about current technologies for the HTM industry,” Albert R. said.

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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BY JOHN MAZUR

BIOMED 101 What Makes A Good Biomed? C

oming from a medical manufacturing background a long, long time ago, I found the skill set for a biomed to be quite different from my previous medical manufacturing job. It took some time to understand and adapt to the differences I was finding in the biomed field. Looking back now at my experiences and the hundreds of people I have met in the biomed field, I have compiled some characteristics that I consider important in a good biomed. When referring to a biomed, I am including the technicians and engineers found in hospitals, clinics, independent service organizations and other various organizations. A biomedâ&#x20AC;&#x2122;s main responsibility is to work on and manage the medical equipment found at the facility. To make it simple, I am referring to all the names and titles that biomed represents around the world including Certified Biomedical Electronic Technician (CBET), Biomedical Electronic Technician (BMET), Biomedical Technologist, Biomedical Technician, Biomedical Engineer, Clinical Engineer, Clinical Engineering Technician, Medical Equipment Technician and Healthcare Technology Management (HTM). There are also various levels of education found in this field varying from technical degrees or certificates, associate degree, bachelor degree, masters degree and doctorate degree. This article is referring not to the biomedâ&#x20AC;&#x2122;s educational background, but to some of the intangible characteristics found in a good biomed.

1. FEARLESSNESS Assuming you have the proper electronic and biomedical training in one of the above-mentioned degrees and certificates, I have found that good biomeds are fearless. Good biomeds are not afraid to tackle a problem, troubleshoot an issue or repair a piece of equipment they may not be all that familiar with. An attitude prevails that with a service manual anything is possible. A PM (preventive maintenance), testing a piece of equipment or even fi xing the equipment is always possible. This attitude is tempered with a balance of practicality and safety concerns. Specialized equipment like a MRI machine, anesthesia machine or ventilator would not be worked on without formal training. Also, you do not want to waste endless hours working on a piece of equipment that another colleague may be more familiar with and can fi x quickly. Nevertheless, an attitude of fearlessness is present.

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JUNE 2017

for an incoming inspection, the way you manage the incoming inspections must be efficiently planned. From unboxing and documenting to the actual testing, everything should be well thought out and a plan developed. Hours can be lost if you are not deliberate or are sloppy with your procedures. This also goes for preventive maintenance (PM) strategies for your departments. Of course, as you become more seasoned your procedures become better and better. However, a good biomed is always thinking of how to save time and become more efficient.

JOHN MAZUR

Sales Representative, Biomedequip Inc.

2. EFFICIENCY Because of the volume of equipment that is serviced by a typical biomed in a medical facility, the biomed must be very efficient. When you get 200 new infusion pumps coming into the facility

3. CURIOUSITY Medical equipment is always changing and advancing in medical facilities. Your know-how has to advance and change with it. You always need to be learning and changing with the advancements. You should be attending biomed conferences and local meetings to fi nd out best practices used at other hospitals and facilities while always keeping in mind that your ideas are not

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“All your technical skills, cost-saving measures or life-saving technical safety practices may have minimum impact if your communication skills are poor and your attitude is bad.” always the best. With the advancements of computers and computer networking, a biomed must know a lot about computer technology. Staying curious is a must. Volunteering and pushing for outside professional OEM training advances your skill set. The budget may or may not be there, but you should always be pushing for more education. 4. ATTENTION TO DETAIL We have all heard this: A good biomed works on medical equipment as if a beloved family member will be the next person using the equipment. There is no room for mistakes. Everything should be done with an acute attention to detail, including all documentation. 5. CUSTOMER SERVICE SKILLS Communication and customer service skills may be the most important characteristic on this list. Without customer service skills, all your good work may be in vain. All your technical skills, cost-saving measures or life-saving technical safety practices may have minimum impact if your communication skills are poor and your attitude is bad. The nurses, doctors and other customers only know you by how you treat and communicate with them. Your

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614-657-7780 appearance, your attitude, and your info@capitalmedicalresources.com handling of each service request in a professional manner matters. If you stay in the biomed shop all day, are rude on the phone when someone calls for service, or are short tempered with nurses or doctors, you may fi nd yourself AD SIZE PUBLICATION or your department outsourced or not 1/6 Page Vertical Call KEI Med PARTS! MEDICAL DEALER ORTODAY shown any respect by the CFO TECHNATION authorizing yourBUYERS department’s budget. GUIDE OTHER Parts are housed, tested, and shipped from KEI’s facility NOTES

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MONTH 6. PROMOTION Med The biomed, biomed manager and/or Replace images with hi re biomed J director F M should A Mbe promoting J J A S O N D the department and its staff whenever JL to do so. Most they DESIGNER: have a chance colleagues in the hospital or medical facility have no idea what a biomed is or ical Techn ort what they do. For example, biomeds Supp ed Provid save the hospital money, promote safety and promote patient care through high We have system parts and upgrades for: quality working medical equipment. Achieva, Intera, NT, Panorama 0.6T, Biomeds should be instructors and Symphony, Sonata, Harmony, Inﬁnion, Eclipse, promoters, instructing people on proper Polaris, MX8000 and all Brilliance CTs medical equipment use, sharing safety KEIMed PARTS specializes in concerns and also promoting the Philips, Picker/Marconi, Siemens biomed department’s usefulness in MRI & CT systems. money-saving strategies.

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JOHN MAZUR is a Sales Representative with Biomedequip Inc. in Bedford Heights, Ohio.

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SHOP TALK

Conversations from the TechNation ListServ Q:

Can anyone help me? I am facing a problem with Precision 500D table angulation. It doesn’t tilt and I can see the K2 relay energized but not K1, could that be the cause of problem?

on the base, it goes out of J7 pins 47 and 48 to J104 in the positioner rack

Inspect the main cable harness that goes from the tub to the table base. Cut wires in the cable harness can cause this problem.

[Follow up] Thanks sir. I checked that switch and it is good. After that I checked the limit switches again. I pressed one first and then the other one, both of them start and tilt. I think one of them was the problem. Thanks for you help.

I recommend you check the slide out step stool safety switch. I checked my unit and get exactly the same symptoms with the step pulled out even just a little. These switches will break after years of use and slamming the step back in hard. You may have to lie on the floor to get access to the bottom of the step cover. You may also look in the prints and find a bypass point to test but do not permanently bypass this or you could seriously damage your table. This switch is there for protection.

The step interlock switch is S7 connected to TS1 pin 19 and 20

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We have just installed a Siemens Artiste in our department. The error “Modulator Incomplete” is frequently occurring during the day. Its occurrence is random and does not have a trend. It can occur any time during warm up, exposure or waiting periods between two exposures. We were told that the error might be related to the oil pump and it will wane by time. Could it be true that this error occurs because the LINAC is new and it will become less frequent with time? Any suggestions?

The modulator incomplete error is a generic error that covers approximately 20 different faults from

the facility water flow to the oil temp and charge system. When this fault happens, do not reset, but instead enter the treatment room, go the left side of the machine and look at the K2 chassis. It has multiple rows of lights that start with facility water at the top left and continues left to right down three or four rows. Normal operation, all lights are green, orange is caution, and red is the fault. The way Siemens designed this assembly, the light that is red is the fault that caused “modulator incomplete.” Each light after the first red light will be red, but the first red light is the cause. With one exception (again, the way they designed it), the oil temp light will always be red when any other light is red. The oil temp light is the last light in the chain, if it is the ONLY light that is red, then oil temp is the problem.

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 Flexible Inspection Scope

he Healthmark flexible inspection scope Prosys Optical Inspection (FIS-003) features a 110 cm flexible shaft with graduation marks. Like other flexible inspection scopes it also includes a distal tip composed of a light source and camera lens at the end of the flexible shaft.

Designed for instruments 2.4 mm in diameter or larger, inspection is now easier on the interior of instruments with small diameters, including many flexible GI endoscopes. The camera and light are powered by the USB connection on a PC. Compatible with Windows 7, 8 and 10, the included software allows viewing and recording from most computers. Paired with the optional Flex Arm, the Flexible Inspection Scope can be securely fastened to workstations to free both hands for manipulation of the scope and the target medical device. It is the perfect tool to visually inspect lumened medical devices after cleaning.

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ROUNDTABLE

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STAFF REPORTS

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ROUNDTABLE

Diagnostic Imaging Test Equipment

aintaining diagnostic imaging equipment is of great importance in todayâ&#x20AC;&#x2122;s health care environment. Imaging has many diagnostic benefits. Maintaining these valuable pieces of equipment improves patient outcomes as well as patient satisfaction. It also helps with the bottom line as imaging devices generate a good deal of revenue for health care facilities.

Test equipment for HTM professionals tasked with maintaining and repairing diagnostic imaging equipment, of all modalities, are vital. The test equipment helps with troubleshooting to isolate the problem so that it can be repaired quickly and correctly. TechNation sought the scoop on this test equipment from Advanced Ultrasound Electronics (AUE) Director of Service and International Operations Jim Carr, Radcal Corporation President and CEO Curt Harkless and Acertara Acoustic Laboratories President and CEO G. Wayne Moore.

Q: What are the most important things to look for when purchasing test equipment for diagnostic imaging equipment? Jim Carr, Advanced Ultrasound Electronics Carr: It is important to use test equipment that reliably provides objective and repeatable results. An objective test that can be easily repeated provides meaningful and actionable results. Harkless: Since your test equipment represents a major investment that is critical to your business for many years to come, one should look for a partner who is proven, stable, reliable and established. Consider the lifecycle of the relationship including service, repair and calibration that are critical to operating and maintaining test equipment over the long run. As diagnostic imaging continues to grow and evolve, the requirements of your test equipment may grow and will likely evolve as well. One should select test equipment from a line that is modular, interchangeable and extensible to meet changing needs. Moore: Although it may seem self-evident, make sure that the device being purchased is capable of providing the answers

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you need to both diagnose a medical imaging device problem and ascertain if that device is functioning at its optimal level.

Q: What basic testing capabilities do HTM professionals need in their test equipment? Carr: An electrical safety analyzer and a DMM are basic and essential tools. Electrical leakage testing to assure the safety of patients and users is required by state and federal regulations for almost all imaging systems. For X-ray systems, a dosimeter is required test equipment and an oscilloscope may be needed. For X-ray and MRI, phantoms are needed for calibration and testing, and might be provided and kept with the system. For ultrasound, a general QA phantom (TMP) or some way to test transducer and system performance is needed for maintenance and troubleshooting. Harkless: In X-ray imaging, the name of the game is getting good imagery with minimal dose which is why ensuring that the system is operating correctly is so important. In assessing the behavior of the system, the following are standard measurement quantities: dose, dose rate, kV, mA, filtration, pulse number, and pulse duration. The ability to view and analyze waveforms of these quantities provides a much deeper understanding of the operation of the X-ray system, especially for the new dynamic mode switching systems. For HTM professionals working as part of a team, one might consider interoperability of sensor components enabling sharing of equipment amongst multiple users. Moore: When I founded Sonora Medical Systems more than 20 years ago, HTMs told me over and over that they needed to get to the answers about the performance and safety of a medical imaging device under test as quickly, as quantitatively, and as easily as reasonably possible. We invented the FirstCall probe tester with that criteria in mind.

JUNE 2017

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ROUNDTABLE

Q: What are the newest features biomeds should look for when buying imaging test equipment? Carr: Some of us are OK with the older tools that are often simpler to use and less expensive, and can be used on a wider variety of systems. For those that are doing the same types of tests on a frequent basis, there can be some great advantages in the automation and wireless networking available on newer test equipment. Programmable electrical safety analyzers and dosimeters also can improve objectivity and repeatability of testing. Some can store drawings and documents on them, and interfaces to CMMS systems can improve productivity of PMs.

STAFF REPORTS

Harkless: The ability to view the waveform provides a depth of understanding with regard to the operating state of the imaging system unmatched by point measurements. New innovations provide ever improving imaging capabilities with reduced effective radiation dose. These improvements come with added complexity that requires waveform display and analysis to effectively assess. Waveform analysis can seem daunting, but with the right equipment and software this analysis can be achieved with ease (and without the need for special equipment or scopes as in the past). Moore: It is a matter of preference on conveying test data and results; some HTMs prefer waveforms, others prefer graphical displays, with some devices both modes are available.

Curt Harkless, Radcal Corporation Harkless: With the advent of low-cost computer tablets, measurement systems providing two-line text displays are being displaced by those that integrate large, easy-to-read displays. These displays run sophisticated applications that automatically record and display all measurement details including time and date stamp, detailed measurement data, waveforms, and serial numbers of equipment used. In fact, use of iPads in hospitals has become almost ubiquitous and X-ray QA instruments are now available that offer the convenience and familiarity of an iPad or iPhone interface. As with everything else today, “there’s an app for that.” Since these displays are essentially tablet computers, all of the connectivity features such as Internet communication, emailing of reports, and remote printing of results are now accessible to the user. Moore: With our probe testing devices, such as Aureon and Atlas, we focused on developing technology that both matches and unravels the intricacies of complex OEM transducers now on the market, and those that will be coming on the market over the next several years. These include 2D matrix arrays, cMUT, as well as wireless probes.

Q: Why is it important to have testing equipment with a waveform display? Carr: An oscilloscope is required for service and maintenance on many imaging systems. That includes many MRI systems and almost all systems with an X-ray tube. An o-scope is very useful to anyone troubleshooting AC input issues, intermittent power supply problems and noise caused by RF and electromagnetic interference.

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Q: How can HTM professionals make sure their testing equipment will keep up with new features and technologies on future diagnostic imaging devices? Carr: The ability to upgrade and add options to test equipment can be important features that save money in the long run. For example, purchasing an X-ray dosimeter with a modular design that allows the addition of detectors for mammography and CT and options for different types of systems means you can service a new type of system without having to purchase an entirely new dosimeter. Some test equipment has add-on options to help with other aspects of service and maintenance. For example, Fluke has a light detector option for their RaySafe Xi dosimeter that can be used for CRT and LCD luminance measurements. Harkless: The X-ray field is experiencing a period of rapid development, especially in the area of mammography where tomography and novel filtration are improving imaging capabilities. Considering instruments that are software upgradeable so that new imaging modes can be rapidly accommodated would be advisable. Look for an instrument partner with a history of responding to emerging technologies with timely solutions.

G. Wayne Moore, Acertara Moore: Talk with the manufacturer of the test device, ask them what the design philosophy behind the device was, and how the hooks for adding new technology to accommodate testing of newer imaging devices was built into the system architecture of the test device. This is a great conversa-

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tion to have as it can double as a peek behind the curtain of new technologies coming down the line.

Q: What else do you think TechNation readers need to know about purchasing test equipment? Carr: It is important to identify the present and future needs for test equipment prior to comparing test equipment to purchase. Having test equipment with a lot of bells and whistles may mean you are paying too much, and it may actually take longer to do the job. The cost and availability of calibration and repair are also important criteria. Check with your calibration supplier for that, and ask if they have any PROOF APPROVED CHANGES NEEDED opinions regarding the equipment you are considering. Try to check SIGN–OFF: with existing users, especially if the equipment is CLIENT relatively new.

Harkless: Time is money when performing quality assurance on high usage systems. It is worth thinking through the QA process in its entirety including setup, measurement, analysis, reporting, and archiving of the results. Look for systems that provide hands-off automatic ranging, direct data readout, and avoid the need for applying manual corrections. Systems that provide the ability to generate forms tailored for a user’s individual needs that are completed automatically in the course of a measurement can dramatically reduce the timeline and effort associated with the measurement process. Forms in standard applications such as Excel facilitate archiving and subsequent retrieval in the future.

PROOF SHEET

Moore: Talk with the device manufacturer before you buy and, if appropriate, test the device, schedule a demo in the hospital and do some actual testing. See if it meets your specific needs and the requirements that may be unique in your setting.

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COVER STORY

“The health care industry will never go away and is one of the only fields that consistently has high growth across the nation” — Robert Axtell, Senior Manager, Alaska Clinical Engineering Services.

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COVER STORY

THE STATE OF

HTM TechNation Reader Survey Results BY K. RICHARD DOUGLAS

hat is it that the average employee wants most? Is it the biggest possible paycheck in their profession? Maybe, getting free lunch in the company cafeteria every day? Could it be an extra day off every year?

According to a May 2016 article in the Harvard Business Review, the answer is much more personal. It’s about recognition; being noticed. Employees want to feel like their contribution to the workplace counts for something and that their employers notice. It helps morale and helps an employee enjoy his or her work life. This goes a long way towards a person’s overall quality of life. For managers, motivating employees is about getting the most efficient and competent work from them every day. For employees, it is about the perception that they are valued by their employers and recognized for their efforts. It’s a delicate balance that defi nes the best managed and most successful businesses and organizations. Do biomeds feel appreciated by their employers? Do they work a lot of overtime or do they work a “standard” work week? Are they supported when it comes to seeking additional training? Do they have enough time away from work to be with family and/or pursue hobbies? What is it like to be a biomed? Is it rewarding? Would an HTM professional recommend the profession to a friend and what advice would they offer? We look at these questions and others to determine, through a sampling; what is going on in HTM. The 2017 TechNation State of HTM Survey is all about you – the HTM professional. Much like a president’s report on the state of the union; we take a look at the state of the HTM profession in a snapshot that reflects the experiences of a cross section of HTM professionals. We have sought to parse the data and the responses to characterize the current state of the HTM profession and the day-to-day participation in the profession in realistic terms.

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COVER STORY

HTM DEMOGRAPHICS JOBS BY TITLE

YEARS OF EXPERIENCE

BMET I .............................. 9.8%

< 5 yrs

BMET II ........................... 11.6%

14.2%

5-10 yrs

BMET III.......................... 19.4 % Other............................... 21.2%

16.5%

11-20 yrs

Imaging Engineer................ 16 %

15.8%

> 20 yrs

HTM Manager.................. 21.7 %

WHEN DO YOU PLAN TO RETIRE?

32.1%

AREAS OF SPECIALIZATION * Respondants may select more than one answer

1-3 yrs

8.2%

4-7 yrs

Surgery/OR....................... 34.8% Anesthesia...................... 32.5 %

11.3%

8-11 yrs

15.2%

12-15 yrs

15%

> 15 yrs

IT..................................... 30.2% Laboratory....................... 23.6% Imaging........................... 43.0 % 28.7%

Management.................... 40.4% General Biomed ............... 60.1%

The disbursement of 375 responses included 22 percent HTM managers, 21.7 percent from BMET IIIs, 19.4 percent from BMET IIs, 11.6 percent from BMET Is and 9.8 percent from imaging engineers. The largest group of respondents are veterans of the profession with more than 20 years experience. They account for nearly one-third of all of those who answered the questions. The next largest group of survey participants has five to 10 years of HTM experience. The biggest number of HTM professionals (20 percent) responded that they learned of the field in college followed by those who learned about HTM in the military or from a friend.

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The largest percentage of respondents also don’t anticipate retiring anytime soon. Just over 28 percent said that they don’t expect to retire for more than 15 years. Another 15.3 percent said retirement is 12-15 years away. DOING MORE WITH LESS There is an interesting inconsistency between the good intentions of most biomeds to be an integral part of helping patients, alongside their clinical counterparts, and working in a profession that many characterize as “stressful” or “overworked” or “understaffed.” At some point, the dynamics in many HTM departments have changed in recent years.

The highest percentage of respondents, 48.1 percent, characterized their work environment as “stressful.” More than 43 percent characterized themselves as “overworked.” As a possible precursor to both of these characterizations, 39.8 percent of respondents stated that their work environment was “understaffed.” To be fair, another 33.8 percent said their work environment was “ideal” and 33.2 percent described their work environment as “relaxed.” Most biomeds have a sincere interest in helping patients recover from illness and to be a part of the team that ensures their recovery. It has been a consistent theme observed and repeated in professional profiles as well as survey

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responses. Yet, those good intentions, are juxtaposed with survey results that indicate that a dose of stress and too much work are a by-product for many. Are these figures a result of retiring baby boomers or stretched hospital budgets that have resulted from changes in health care in recent years? From a morale and motivation perspective, HTM departments would benefit from starting a dialogue to address these concerns. Despite the feelings of challenges in the profession, job satisfaction still remained fairly high as evidenced by a question asking how satisfied participants were with their current job/ employer. The average score provided a rating of 3.7 within a range of five choices that progress from extremely dissatisfied (1) to extremely satisfied (5). While not a resounding endorsement of job satisfaction, it represents a weighted average that is between high neutral and satisfied. A related question, that asked for agreement or disagreement with the statement “Overall, my work experience is satisfying and rewarding,” responses again put the weighted average in the high neutral range nearest “agree.” Again, this consensus, while an average of a range of responses, may be more muted because of the perception of being overworked or understaffed in some departments. In comparison with other professions, the range may be just a broad indicator of the perception

WORK ENVIRONMENT Other.........................4.9%

Overworked............ 43.0%

Relaxed................... 33.2%

Understaffed........... 39.8%

Stressful................. 47.3%

Ideal....................... 33.8%

*Respondants may select more than one answer

WORK/LIFE BALANCE RATING:

(5 being ideal) employees in a variety of environments. Much of that perception can be influenced by the response to the following question on the survey. “I believe that I receive the right amount of recognition and acknowledgement from my manager.” The results of this statement may provide a “teaching moment” for leadership. As mentioned earlier, recognition is a key component of job satisfaction. Responses to the statement about recognition were more lukewarm in their enthusiasm by providing an overall 3.5 rating; which is neutral. On a bell-shaped curve, this would indicated that a number of respondents had a sense of recognition and acknowledgement, but this also indicates that many members of the HTM profession are missing out on an important ingredient in job fulfillment. In addition to survey results, several members of the HTM community were asked related questions. “I get satisfaction from knowing that, by maintaining hospital equipment, I am helping people. It may be behind the scenes, and no one really thinks about us biomeds, but I know that the work that I do is critical to helping people recover from illnesses,” says Jessica Wilkolak, CBET, with Fitzsimmons Hospital Services in Cleveland, Ohio.

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STRIKING A BALANCE A popular topic in recent years is the desire to achieve a fulfilling work-life balance. While work is a necessary part of putting food on the table, putting kids through college, paying utilities and funding vacations and retirement; leisure and family time is recuperative and enriching and recharges the batteries. Finding a meaningful balance between the two can contribute to happiness and fulfillment. There were 299 respondents to the question; “How would you rate your work-life balance?” On a scale of 1-5; one being poor and five being ideal, the resulting average was 3.1. This would not appear to be a resounding endorsement of HTM as a field that provides an ideal balance between the two competing components of an employee’s life, but it may be comparable to many other occupations. People just don’t like to feel they are taking the job home with them. For many in the HTM field, the work itself grows out of personal interests embraced from early in life and the opportunity to “fix things,” is fulfilling in itself. “The HTM field has provided a steady income for many families in our industry including mine. I have always liked to fix things my entire life. From

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COVER STORY

AVERAGE TRAINING ACTIVITES PER YEAR 1

27.9%

2-3

30.8% 13.9%

4-5 >5

5.9%

AVERAGE CONFERENCES ATTENDED PER YEAR 1

46.8%

2 3 4 >5

12.6% 8.8% 6.7% 3.1%

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JUNE 2017

replacing light switches and light fi xtures when I was young, to repairing automobiles when I was a teenager,” says Douglas Dreps, MBA, eastern director for Mercy Regional Clinical Engineering in St. Louis, Missouri. “I still enjoy doing these things today. The thought of fi xing equipment, and being part of health care that provides care for patients, brought me into this field. It still surprises me how many people have never heard of this field or thought about that someone needs to maintain medical equipment,” he says. “I have always enjoyed this field, as you never know what you will face each day, not to mention the next minute of the day. Helping my organization to make the best decision with huge investments on medical equipment technology gives me great satisfaction. Helping others grow in our field also brings me joy,” Dreps adds. While some HTM professionals find satisfaction in the very essence of what they do, many employees take their stress home or take home life issues to work. Referring to an international study, done by the fi rm Ernst and Young, a May 2015 article in U.S. News and World Report says that one in three full-time employees fi nd maintaining a healthy work-life balance difficult. The study of 1,200 workers in eight major economies found that this difficulty had increased in the past five years. If tightening hospital budgets is contributing to a more stressful work

environment, it appears that it may also be impacting opportunities for training and conference attendance. More than half of respondents indicated that they engage in 1-3 training activities annually; 28.1 percent get only one a year. Almost half — 47.2 percent — only attend one industry conference annually. AN EVER EVOLVING JOB One thing is certain about the HTM profession; it’s not for those who dread change. New regulations, new technology and privacy rights have all shaped and changed the job in recent years. It may be different from the jump from tubes to solid state, but change is a part of HTM. “The move from mechanical repairs to IT and connectivity matters is the major change I have seen,” says Ismael Cordero, biomedical engineering manager at Gradian Health Systems in New York City. “I have seen a big jump in some of the technology in higher end equipment. The radiology field has seen some amazing advancements with wireless detecting, digital imaging and multiple other advancements,” adds Richard Marshall, CRES, regional operations manager with HSS in Denver. Dreps says that integration into information technology has increased every year and will continue to do so forever. His perspective embraces one of the biggest changes in the field; the merging and overlap of biomed and IT. “Working with IT departments has been a challenge for most of us and building those relationships is paramount to our success,” Dreps says. “It does go both ways as IT departments have always had trouble with understanding the many regulatory regulations we must follow and mandates our manufacturers must follow from the FDA.” Additionally, he says that IT now is facing its own regulations. He thinks that HTM and IT will continue to work closer together as time goes on. “Changes by CMS and TJC have frustrated many of us, since we often feel

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our voices are not heard. We deal with the changes and move on, as our daily schedules continue to get busier year by year. I look forward to all the new challenges in the future, as we don’t even know what will be headed our way,” Dreps adds. “I’ve seen newer ventilators that are getting smaller and more portable, BiPAPs with larger, more durable touch screens,” Wilkolak says. “I’m also starting to see more integration with computers, such as downloading sleep study data off of pulse ox units to store as a PDF or Word file.” LEISURE TIME Pastimes, away from work, run the gamut. Biomeds fi nd enjoyment is a variety of hobbies, leisure activities and fitness-related pursuits. The survey found that 48.3 percent of respondents enjoy watching sports; no surprises there. More than 33.8 percent also enjoy participating in sports and nearly 29.2 percent are involved in coaching or teaching others. To round out the fitness-related interests that occupy the off-work hours of respondents, exercise or training is a lifestyle choice of nearly 23.3 percent. Hunting or other outdoor activities gets the nod with more than 41.2 percent of survey participants indicating

their participation in those activities. And, although it is not purely a fitness activity, 51.6 percent of respondents indicated that they enjoy traveling. Playing a musical instrument, working on classic cars, cooking and riding motorcycles were all activities enjoyed by sizable numbers of respondents. RECOMMENDING HTM Pointing others towards the HTM field is a solid endorsement of the profession. Many biomeds still feel confident suggesting HTM to others. The survey also asked; “What advice would you give someone considering the HTM profession?” “The HTM field is an excellent career path with a great deal of opportunity. As long as there are hospitals and patients, there will always be a need for someone to maintain and repair the equipment that is used in patient care,” says Andrea Brainard, CBET, director of Healthcare Technology Management (HTM) at Children’s Health in Dallas, Texas. “As an HTM professional, you arrive at work and you know that each day, you’re part of the bigger picture; saving lives. By properly maintaining equipment, critical patients are able to receive a heart transplant, or patients are able to breathe while being

“As an HTM professional, you arrive at work and you know that each day, you’re part of the bigger picture; saving lives.” — Andrea Brainard, CBET, Director of HTM, Children’s Health, Dallas, Texas

INTERESTS OUTSIDE THE JOB Other .................................... 21.3%

Automobiles ................ 26.3%

Watching Sports .................... 48.3%

Motorcycles ................ 23.6%

Participating in Sports ........... 33.8%

Cooking....................... 36.8%

Coaching/Teaching ................ 29.2%

Traveling ..................... 51.6%

Hunting/Outdoors .................. 41.2%

Exercise/Training ......... 23.3%

Playing Music/Singing ............ 28.6% * Respondants may select more than one answer

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JUNE 2017

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COVER STORY

transported for testing,” she says. “HTM techs make a huge difference in patient outcomes, and that’s probably the most rewarding part of the job. And, of course, the bonus is you get to work inside in a temperature controlled environment,” Brainard points out. A rookie’s perspective may be one that a new biomed can relate to. Pointing out the HTM professional’s role in helping make a patient’s time in a hospital a little better, Alyssa Merkle, clinical engineer at UMass Memorial Medical Center says; “I also love my job because every day is something different. I know my ongoing projects but there is always something new and I like the fact that I am always learning and increasing my knowledge about the field.” Another reason for recommending the HTM field finds its basis in a simple truth about health care; as long as there are humans, health care is a necessity. “HTM is a great field to work in. Anything in the health care field is a great option for a career. I have been in the HTM field for the past six years. The health care industry will never go away and is one of the only fields that consistently has high growth across the nation,” says Robert Axtell, senior manager of the Alaska Clinical Engineering Services.

ARE YOU ARE SATISFIED WITH YOUR CAREER?

(5 being strongly agree)

DO YOU FEEL YOU ARE COMPENSATED FAIRLY?

(5 being strongly agree) Marshall says there are several factors as to why he would recommend HTM. “The starting pay is higher than most other fields, opportunities for advancement are plentiful and this field will always be in demand with the advancement of healthcare technology,” he says. Survey responses concerning the advice that would be given to a would-be biomed were as thoughtful as they were diverse and ranged from “be prepared to think outside of the box” to “find a mentor and learn all you can” and “always be focused on patient safety and customer service.” When seeking a good mentor, a biomed’s boss may be an early choice. One survey question stated; “My manager/supervisor is a good coach/ mentor.” The resulting weighted rating was 3.4, which would indicated that more people agree with the statement than disagree. BRINGING HOME THE BACON While the starting pay for HTM is an attractive incentive, some biomeds feel that income is not a stellar feature of the profession. The survey revealed a general lack of enthusiasm. The average of all responses fell into the low-neutral range suggesting that this metric (one that many workers use to gauge their job happiness) may be lagging behind in HTM.

TECHNATION

JUNE 2017

“This profession although very challenging, is also very rewarding. The constant updates in technology keep it always new and the rewards of seeing your efforts resulting in better patient care are immeasurable. If you are getting into HTM for the money, you may be disappointed. But if you are looking for a unique combination of healthcare, technology, maintenance and management, this is the field for you,” Cordero says. A related question, that asked if survey participants feel rewarded when they go above and beyond, also produced a low-neutral rating. This could refer to a lack of financial bonuses for extra efforts or it could indicate a need for recognition in the minds of those responding. In any survey, an interpretation of results is often fraught with variables and inconsistencies. Hospital biomed departments can range from one person to more than 100. A survey question asking about the department’s budget produced a range from $2,000 to $13 million. Everyone’s experience can be influenced by these things and more. The goal was to look at the averages on a scale of responses, alongside feedback from across the field, and provide the State of HTM.

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EXPERT ADVICE

BY JENIFER BROWN

CAREER CENTER Managing Your Career

e it a new position with another organization or advancement within your current one you need to take assessment on what you consider success to mean and what you are or are not willing to do to get there!!

Here are the necessary steps to successful career management in order to reach a desired outcome! 1. Self-Assessment: Realistically analyze your own knowledge, attributes and skill sets in order to know how to align yourself with different types of positions. If you feel that it is difficult to be objective, get feedback from others. 2. Identify Your Ideal Position: An “ideal” position is how closely the performance, expectations and rewards of the position fit with your interest, values, and abilities. If you are new in the field or to this type of position you need to be flexible in accepting positions that offer some of your ideal aspects. 3. Gap Analysis & Action Planning: Analyze what “gaps” you may have from your self-assessment to obtain that ideal job. Gaps may include education, certification and/or training. Then you need to take action to fill in those gaps. 4. Personal Marketing: Here is a list of areas to market yourself for career advancement. • Cultivate and maintain a professional network 62

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• Maximize use of social media tools • Write an effective cover letter and resume • Prepare for all stages of interview process COMPETENCIES NEEDED FOR TODAY’S MARKET Managers: • Organizational alignment to ensure that yours and the department’s performance are in direct alignment with your organization’s objectives. • Agility to be able to quickly adapt as well as have your team adapt to changes in the organization’s priorities. • Business savvy to have the knowledge and experience to run your department as a lean but profitable business. • Strategic thinking to be able to provide action plan solutions for cost savings and/or financial growth. • High-level communication skills for building relationships with all levels of your organization, including the C-suite. Technicians: • Instead of just being tactical and/or reactionary be proactive and solution focused. • Combine strong technical ability with strong communication and customer relations skills. • Handle difficult people or situations with diplomacy. • Remember the value of human interaction and the need for face-toface time which is still important despite the current fast-paced and technology-driven environment.

JENIFER BROWN CEO and Founder of Health Tech Talent Management

REVIEW: CAREER TIPS TO BE MORE EFFECTIVE • Stay abreast of current and future industry changes. • Take the time and investment to continually update your skills to be current. • Be active in your regional and national associations for knowledge and networking. • Perfect marketing yourself and the value you bring from the resume presentation to communicating up. • Take control of your career – no one will take better care of your career then yourself.

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ULTRASOUND TECH EXPERT