Medical Dealer - August 2017

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CONTENTS_Features 46 THE NEVERENDING BATTLE TO DO MORE WITH LESS Hospitals in the United States are in survival mode. Beset by shrinking reimbursements, spiraling operational costs, and a constantly shifting political landscape, they press on along an endless drive toward peak efficiency at a desperate pace that affords no slack. For some facilities, even that will not be enough.

52 SOUTHWESTERN BIOMEDICAL ELECTRONICS Southwestern Biomedical Electronics (SBE) is an aftermarket parts and service company that has outlived the original equipment manufacturer (OEM) it was established to support. After Spacelabs migrated exclusively to direct sales and service, SBE became the preferred independent equipment service center.

Medical Dealer (Vol. 20, Issue #8) August 2017 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

POSTMASTER: Send address changes to Medical Dealer at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.medicaldealer.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2017

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MEDICALDEALER 9

INDUSTRY UPDATE 13 News & Notes MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 (800) 906-3373 Fax: (770) 632-9090 Publisher

John M. Krieg john@mdpublishing.com

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Art Department Jonathan Riley Jessica Laurain Kara Pelley

18 People on the Move 21 OEM Update

MARKET ANALYSIS Imaging: Nuclar Medicine 27 Market Analysis 28 Product Showroom 32 Preferred Vendors Med/Surg: Telemetry 37 Market Analysis 38 Product Showroom 40 Preferred Vendors

Account Executives Jayme McKelvey Lisa Gosser

Contributors

Jim Fedele Matthew N. Skoufalos Dan Bobinski

SLICE OF LIFE 56 Dan Bobinski 58 Jim Fedele 60 Pay It Forward

Accounting

Kim Callahan

Circulation

Lisa Cover Laura Mullen Jena Mattison

63 Marketplace 64 Categorical Index 66 Alphabetical Index

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INDUSTRY UPDATE_News and Notes

Staff Reports

NEW PARTNERSHIP ANNOUNCEMENT FOR PROBEHUNTER The ProbeHunter team, the Scandinavian-developed system for quality assurance of ultrasound probes, has announced that the business is expanding. Imaging First Ltd. in Manchester, UK, is representing ProbeHunter in England and Ireland.

Imaging First will offer ultrasound probe testing services as an accredited provider that will suit both NHS services and independent operators. Imaging First is ponounced. The ProbeHunter product line is a leading sitioned to offer an end-to-end specialist service dedicat- global provider of ultrasound probe testing systems. ed to “all things ultrasound.” This includes system sales, A Quality Assurance system like ProbeHunter, testing ultrasound probes in daily use, will increase quality of distribution, repairs, Q&A, servicing and consultancy. care, save hospitals cost and increase patient safety,” “In our continuing growth for patient safety, the states BBS Medical AB CEO & founder of ProbeHunter ProbeHunter Network is expanding and soon addiBjörn Segall. • tional new distributors for other countries will be an-

ADVANCED COOLING THERAPY IS NOW ATTUNE MEDICAL Advanced Cooling Therapy (ACT), an expects,” Clinical Marketing Director emerging medical device manufactur- Melissa Naiman said. er, has announced that it is changing Attune Medical’s proprietary its corporate name to Attune Medical. technology simplifies access to the The name change reflects the compatient’s core and allows providers to pany’s commitment to temperature control patient temperature, whether management therapy in all clinical warming or cooling, through the esophcontexts and better represents the agus when clinically indicated. This corporate culture of remaining atprompted the renaming of Attune Medtuned to clinical needs, patient safety ical’s primary device, the Esophageal and the state of science.

Cooling Device (ECD) to EnsoETM, Over 20 million patients in the reflecting the product’s simplicity and United States experience a clinical the broader focus on Esophageal Temevent that warrants active temperaperature Management. ture management each year, but The EnsoETM is designed researchers estimate that less than 10 to modulate and control patient percent receive the appropriate ther- temperature through a single-use, apy, and that part of this discrepancy fully enclosed triple lumen system is attributed to workflow challenges. that is inserted into the esophagus.

“We believe simple solutions can Two lumens attach to an external solve complex problems. Our outsized heat exchange unit while a third, growth in the temperature manageindependent, lumen simultaneously ment marketplace has been driven allows gastric decompression and by the need for a simple solution in drainage. The EnsoETM can be the face of a continuous stream of rapidly placed by most trained health new clinical evidence and practice care professionals, in similar fashion guidelines that define the importo a standard gastric tube, and can tance of core temperature across the be used to control patient temperaclinical spectrum. Having taken this ture in the operating room, recovery into account, our transition to Attune room, emergency room or intensive Medical aligns our strategic focus care unit. No other products on with what the marketplace needs and the market are approved to use the WWW.MEDICALDEALER.COM

esophageal environment for wholebody temperature modulation.

“This transition to Attune Medical reflects the ability of our technologies to apply high fidelity body temperature ‘tuning’ which can be customized to specific warming or cooling needs. Our technology platform’s ability to ‘tune’ patient temperature – regardless of the direction or the goal – goes well beyond the concept of cooling,” commented Robin Drassler, VP North American Sales.

Attune Medical (as Advanced Cooling Therapy) received FDA de novo clearance for the EnsoETM (Esophageal Cooling Device or ECD) in 2015 for use with the Medi-Therm III by Stryker. It received FDA 510(k) clearance in 2016 for use with the Blanketrol II and III Hyper-Hypothermia systems made

by Cincinnati Sub-Zero, a Gentherm Company, and FDA 510(k) clearance for use with the Altrix System by Stryker in 2017. It received its CE Mark in Europe in 2014, with an expanded indication for use up to 120 hours in 2016 and a CE Mark for use with the Altrix System by Stryker in 2017. It is also licensed for sale in Canada and Australia. • MEDICALDEALER 13

INDUSTRY UPDATE_News and Notes

TRI-PULL SECURE SHOULDER SOLUTION ASSISTS SURGEONS The Tri-Pull Secure Shoulder Solution, from Innovative Medical Products, employs three proven systems to confidently secure, distract and control precise rotation of the shoulder during surgical procedures. IMP’s Tri-Pull solution includes the Reznik Universal Shoulder Positioner, De Mayo RoTractor, and the Phase 4 Gel Splint.

The patented Reznik Universal Shoulder Positioner provides controlled shoulder distraction with three planes of adjustment for maximum flexibility. The positioner’s patented vertical safety stops eliminate concerns about the equipment slumping or falling onto the patient during surgery, for additional protection. The positioner is designed for surgery in the lateral position or in conjunction with a Beach Chair Positioner.

The De Mayo RoTractor adapter delivers complete surgeon control of the patient’s shoulder, holding the arm securely in place in varying degrees of rotation. The patent-pending De Mayo RoTractor provides the surgeon not only access to the surgical site but also the ability to “dial” in the rotation and lock it in place while maintaining distraction.

The easy-to-apply, non-irritating Phase 4 Gel Splint is designed with a natural wrist contour for increased com-

Staff Reports

fort while maintaining patient anatomy and improving patient safety. The splint’s three positioning holes work with any company’s pole-style shoulder positioner that utilizes hooks. In addition, these holes align perfectly with the De Mayo RoTractor adapter, allowing it to rotate and securely position the patient’s arm.

These three IMP systems also work independently and can be used with many manufacturers’ positioning products. •

KEY SURGICAL AND INTERLOCK MERGE Key Surgical Inc. and Interlock and Europe for our expertise, broad Medizintechnik GmbH have product offering and exceptional merged to create a provider of customer service. Together, we will sterile processing and operatoffer hospitals and surgical centers ing room supplies. Water Street a comprehensive portfolio of prodHealthcare Partners, a strategic ucts and supplies that support the investor focused exclusively on industry’s highest quality standards the health care industry, led the for patient care and safety in the merger of the U.S. and European surgical setting.” providers and invested in the newKey Surgical, founded in 1988, ly combined company. is a U.S. provider of products that “We are tremendously excited clean, protect and identify surgical about the combination of our cominstruments. Interlock, a European panies and the benefits it will bring provider to central sterile supply to our customers,” said Scot Milch- departments, recently expanded man, chief executive officer, Key its portfolio and geographic reach Surgical. “Key Surgical and Interwith its acquisition of Clinipak lock are highly regarded in the U.S. Ltd. in the United Kingdom. As 14 MEDICALDEALER | AUGUST 2017

one company, Key Surgical and Interlock will offer a broad range of sterile processing and operating room products and supplies to nearly 10,000 hospitals and surgical centers around the world.

Financial terms of the transaction are not being disclosed. • MEDICAL EQUIPMENT, PARTS & SERVICE

_News and Notes

RICHARDSON ELECTRONICS SELLS PACS DISPLAY BUSINESS Richardson Electronics Ltd. has announced the sale of its picture archiving and communication systems (PACS) display business, including the Image Systems brand, to Double Black Imaging.

The Image Systems product portfolio includes 2MP, 3MP, 5MP, and 6MP color and grayscale displays. Included in the sale is Image Systems proprietary calibration software, known as CFS, which is designed to simplify the conformance and calibration of all Image Systems diagnostic and clinical use displays. This ensures DICOM compliance and proper calibration throughout their life cycle.

Double Black Imaging is a well-known provider of PACS displays for the diagnostic and clinical display market. Double Black Imaging was launched in July of 2002. The company is privately held by the Lloyd family in Colorado and Minnesota.•

TECHNICAL PROSPECTS RECEIVES ISO 9001:2015 CERTIFICATION Technical Prospects has received ISO placing them in the hands of TECHNICAL PROSPECTS 9001:2015 certification for the disascustomers.”

Experts in Siemens Medical Imaging sembly, repair, refurbishment, quality The ISO certification is just assurance, technical support, and one avenue Technical Prospects technical training of medical imaging uses to achieve quality results. certified. Training courses are led by of products.

“The company’s commitment to industry professionals with over 100 “Technical Prospects, a company quality is also evident in its electroyears of imaging experience,” accordspecializing in Siemens medical imagstatic discharge (ESD) prevention ing to the release. “Courses are a blend ing equipment, continues its commitmeasures. Team members wear ESD of classroom lecture and hands-on lab ment to providing quality Siemens grounding devices in every step of training. parts, training and support through part preparation from harvesting to Recent student Roy Morris, director ISO 9001:2015 certification,” according shipping in order to protect parts of biomedical engineering at the Interto a news release. from electrostatic damage,” according national Children’s Heart Foundation “For over 20 years Technical to the news release. “The company’s commented, “Technical Prospects Prospects has been committed to commitment to quality is carried has one of the best training labs I have providing customers with quality through with its unique packaging; seen with world-class instructors. The Siemens medical imaging parts, some of the best packaging standards training is very organized and methodtraining and support. Providing in the market according to customers. ical with full-hands-on-training.” parts that meet OEM specifications For large-heavy parts, Technical ProsTechnical support is another is an essential element in keeping pects handcrafts custom crates that ISO-certified service provided by customer equipment up and runintegrate the components minimizing the company. Every day, Technical ning,” the release adds. “To accomthe potential for shipping damage.

Prospects’ engineers and technicians plish this goal, Technical Prospects These detailed measures help the assist customers with part identificauses quality assurance procedures company achieve one of the lowest tion and guide engineers in the field to include: testing parts on complete part DOA rates in the market.” on troubleshooting procedures. systems in quality assurance bays, The company also offers training.

“We pride ourselves in providing running multiple electronic tests “Technical Prospects’ commitment excellent post-purchase support of and visually inspecting parts to ento quality continues with its trainthe parts we sell,” Jeff Rindfleisch, sure they meet specifications before ing program that is ISO 9001:2015 vice president of operations stated. • WWW.MEDICALDEALER.COM

MEDICALDEALER 15

INDUSTRY UPDATE_News and Notes

TRIMEDX AMONG MOST ENGAGED WORKPLACES TriMedx is one of the Achievers 50 Most Engaged Workplaces in North America. The annual award, issued by Achievers, an industry provider of employee recognition and engagement solutions, commends top employers that display leadership and innovation in engaging their workforces.

TriMedx will be honored alongside the other recipients of the Achievers 50 Most Engaged Workplaces Award at an awards gala to be held September 11 at the historic Saenger Theatre in New Orleans as part of the Achievers Annual Customer Experience Conference (ACE).

“Employee experience remains a top priority for employees in 2017,” observed David Brennan, Achievers general manager. “The impressive Achievers 50 Most Engaged Workplaces Award winners are using rewards and recognition to foster positive, productive workplaces. We’re excited to learn from them and honor their accomplishments.”

The Achievers 50 Most Engaged Workplaces Awards are judged by a panel of academics and thought leaders in the field of employee engagement. The 2017 judging panel also included representation from the Society for Human Resource Management (SHRM), HR Technol-

Staff Reports

ogy Conference and HRO Today. The judges evaluated each applicant company based on the Eight Elements of Employee Engagement: Communication, Leadership, Culture, Rewards & Recognition, Professional & Personal Growth, Accountability & Performance, Vision & Values and Corporate Social Responsibility.

Barb Burcope, Senior Vice President, Human Resources, TriMedx adds, “At TriMedx we focus on engaging and rewarding our associates through a variety of programs, including our recognition program ‘Sparx’, which is facilitated by Achievers. Receiving this award the past two years shows the impact of our efforts as our leaders work to remain engaged with our ever-growing, dispersed workforce. I, along with our associate engagement team, look forward to attending the awards gala in September and celebrating this accomplishment with other honorees.” • For more information about TriMedx, visit www.trimedx.com.

NUVOLO CLOSES $10 MILLION SERIES A FINANCING Nuvolo, a cloud-based enterprise maintain and measure their enterasset management (EAM) company, prise assets, work spaces, facilities recently announced $10 million in and suppliers.”

Series A funding. GE Ventures led Built on ServiceNow, Nuvolo is the round with participation from a, cloud-based platform that meets seed round investors New Enterthe highest standards for ease of prise Associates (NEA) and Serviuse, security, availability and perceNow Ventures. The financing will formance, according.to the press accelerate the company’s global release. Nuvolo’s growth is being expansion plans and substantially driven by success in health care, increase investments in innovation, life sciences and regulated manusales and customer success. facturing, with broader adoption “Nuvolo is a disruptive technolacross a broad range of industries ogy that is delivering previously for facilities EAM, according to the unachievable improvements in press release. enterprise service management for According to Noah Lewis, our customers,” said Tom Stanford, managing director, GE Ventures, CEO of Nuvolo. “We are leading the “Together with NEA and ServiceNindustry by transforming the way ow, we are thrilled to back Nuvolo’s that organizations manage, track, fast growth as they continue to 16 MEDICALDEALER | AUGUST 2017

delight customers with mobile-first solutions and scale to be a leader in the multi-billion-dollar enterprise asset management market. Nuvolo’s ability to enable the health care industry to optimize operations and better manage costs is core to our investment strategy.”

Market leadership in cloudbased EAM is measured by broad adoption globally. Nuvolo is responsible for managing more than 5.8 million clinical devices across more than 3,125 health care providers and 3,750 service workers utilizing its EAM platform.

For more information about the Nuvolo EAM platform, visit www.nuvolo.com.

MEDICAL EQUIPMENT, PARTS & SERVICE

Staff Reports

BC GROUP, RTI FORGE DISTRIBUTION RELATIONSHIP

BC Group International Inc. and RTI Electronics Inc. have announced a partnership between the two organizations for the distribution of the RTI Imaging product line. BC Group is a leader in manufacturing, servicing and selling biomedical testing equipment and RTI is a leader in manufacturing, servicing and selling imaging testing equipment.

“BC Group is excited to add the RTI product line to our BC Market Place offering. BC Marketplace provides over 75 product lines of test equipment and tools in addition to our extensive offering of BC Biomedical products,” said Mel Roche, President of BC Group. “We have been looking to expand our Marketplace offering to include imaging test equipment for some time now. With RTI’s great reputation and outstanding product offering, it is the perfect product line to fill out our one-stop biomed shop concept.”

For more information, all the RTI and BC Biomedical products are online at www.bcgroupstore.com.

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MEDICALDEALER 17

INDUSTRY UPDATE_People on the Move

Matt Skoufalos

PEOPLE ON THE MOVE

The Latest Personnel Moves in the Medical Equipment Field GE CEO and Chairman Jeff Immelt is resigning. Immelt will be replaced by GE Healthcare President-CEO John Flannery on August 1, but will retain his post as chairman throughout 2017. Flannery will in turn be replaced as CEO of GE Healthcare

by Kieran Murphy, who is currently president-CEO of GE Healthcare Life Sciences. The company said it had been planning for Immelt’s succession since 2011.

Merlin International of Vienna, Virginia, has named John Hays its director of federal healthcare solutions. Hays has spent more than 25 years in management and technology, including 12 years with the Department of Veterans Affairs.

Care Synergy of Denver, Colorado has named Tricia Ford its first vice president of operations. Ford will oversee strategic planning, direction and management of patient care-related shared services, group purchasing, and group contracting for Care Synergy and its four affiliate organizations: The Denver Hospice, Halcyon Hospice, Pathways, and Pikes Peak Hospice & Palliative Care.

Kindred Healthcare of Louisville, Kentucky has appointed Brian Holzer president of Kindred Innovations, a new position created for him. Holzer joins the company from Highmark Health, where he formed and presided over HM Home and Community Services (HMHCS).

Halyard Health has named Joseph F. Woody the successor to retiring CEO Robert Abernathy. Abernathy will continue as chairman of its board of directors, to which Woody will also be added. Woody has spent his career in the medical technology business, most recently as president-CEO of Acelity.

Clear Guide Medical of Baltimore, Maryland has named Bob Cathcart its new CEO. Cathcart, who has spent 33 years in the sales and marketing of medical devices, was most recently senior vice president of global sales at Hansen Medical. Cathcart succeeds Clear Guide Medical co-founder Dorothee Heisenberg, who will stay on as an executive vice president.

Kaiser Permanente of Oakland, California has named Linda Knodel its chief nurse executive and senior vice president of national patient care services. Knodel is a past president of the American Organization of Nurse Executives, and joins the organization from Mercy Health System, where she was senior vice president and chief nursing officer.

Technical Prospects of Appleton, Wisconsin has added former Siemens Field Service Engineer Chris Watson. Watson has more than a decade of expertise in preventative maintenance, repair guidance and equipment calibration in all Siemens imaging modalities.

18 MEDICALDEALER | AUGUST 2017

CareRise of New Orleans, Louisiana has named Terry Sullivan its chief medical officer (CMO). Sullivan has spent 30 years in health care and was most recently CMIO for OnPointe; his career also includes a stint as CMO of COMS Interactive, vice president of medical affairs for Golden Living Centers, and regional vice president and CMO for Humana Senior Products. Sullivan is a former chairman of the Colorado Board of Health.

Magstim Group of Morrisville, North Carolina has named Lothar Krinke its CEO and a member of its board of directors.

Krinke was GM of the Medtronic global deep brain stimulation business, has been vice president of business development at Celera Genomics, vice president at AT Kearney New York, and senior engagement manager at McKinsey & Company.

MiraMed Global Services of Jackson, Michigan has added Stephanie A. Griffin as its Chief Compliance Officer. Griffin’s position “centralizes existing functions responsible for identifying and managing risk and compliance across the MiraMed family of companies,” the organization said in a statement accompanying the announcement. Griffin is an attorney and registered nurse who’s spent more than 14 years working in health care compliance.

MEDICAL EQUIPMENT, PARTS & SERVICE

_People On The Move

Center for Medical Technology Policy (CMTP) Founder and President-CEO Sean Tunis has been named president of Health Technology Assessment International (HTAi) of Baltimore, Maryland. Tunis has been HTAi vice president for the past two years and serves on a number of advisory boards. He was recently director of the office of clinical standards and quality and chief medical officer at the Centers for Medicare and Medicaid Services (CMS), and has been director of the health program of the Congressional Office of Technology Assessment.

Pat Pyers has been named sales and marketing manager at CIRS Inc. of Norfolk, Virginia. Pyers has spent 25 years working in diagnostic and radiation therapy.

Integrity Applications Inc. of Wilmington, Delaware named David Podwalski its chief commercial officer. Podwalski was a senior consultant at Ernst & Young, former senior director of global commercial effectiveness at Aventis Pharmaceuticals, and formerly worked at Hoechst Marion Roussel Inc.

Buffkin/Baker of Nashville, Tennessee has added HIT executive Mark Farrington as a partner in its health care technology practice. Farrington has spent 35 years in the field, and was most recently chief innovation officer and chief information officer at Premise Health.

Collective Health of San Francisco, California has named Adam Kovalevsky senior vice president of product development. Kovalevsky has spent more than 20 years in product and engineering, most recently as executive vice president of product and engineering operations at SAP SuccessFactors, but also at Oracle, PeopleSoft and eMeter Corporation.

DJO Global Inc., of San Diego has appointed Jeffery McCaulley global president of DJO Surgical. He succeeds Brady Shirley, who was promoted to president-CEO in November 2016. McCaulley joins the company from Smiths Medical, where he was president and CEO.

Find weekly installments of People on the Move at MedicalDealer.com/magazine.

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INDUSTRY UPDATE_OEM Update

XENEX ANNOUNCES LIGHTSTRIKE DISINFECTION POD LightStrike Disinfection Pod. Xenex Disinfection Services’ LightDesigned to quickly disinfect reusStrike Robot with pulsed xenon ultraviable mobile equipment such as isolettes, olet-C (UV-C) light technology destroys ventilators, pressure monitors, wheeldeadly viruses, bacteria and spores chairs and workstations, the LightStrike before they pose a threat to patients and Disinfection Pod enables the power of health care workers. LightStrike Robots the LightStrike Robot’s, germicidal light help health care facilities reduce their to be used anywhere in a facility.

The HAI rates by destroying the microscopPod is collapsible, mobile and can be ic germs that may be missed during the positioned in a hospital hallway or othmanual cleaning process. Xenex robots er areas without disrupting or impeding use pulsed xenon, a noble gas, to create daily workflow. Its proprietary design full spectrum, high-intensity UV light integrates reflective interior fabric that quickly destroys infectious germs ensuring 360 degrees of UV light covin less than five minutes. erage over difficult-to-clean equipment Now, for the first time, hospitals including anesthesia carts, ventilators can utilize the power of LightStrike and mobile imaging machines.

Germ-Zapping Robots to quickly disin“Epidemiologically speaking, mofect mobile equipment. Pathogens like C.diff, Acinetobacter baumannii, MRSA bile equipment may play a significant and Vancomycin-Resistant Enterococci role in room-to-room transmission of HAIs. Studies have found alarming (VRE) can travel throughout a health levels of bacteria on mobile equipcare facility on mobile equipment. To address this gap in the infection control ment like workstations, IV pumps, process, Xenex recently partnered with pulse oximeters, isolettes, and even patient charts. We want to help Mintie Technologies Inc. to create the FDA APPROVES HOLOGIC’S GENIUS 3D MAMMOGRAPHY EXAM Hologic Inc. has announced that the often require additional imaging, which can result in increased Genius 3D Mammography exam is patient anxiety and unnecessary now the only mammogram that is costs. Perhaps most importantly, FDA-approved as superior to stanwomen with very dense breasts dard 2D mammography for routine are four to five times more likebreast cancer screening of women ly to develop breast cancer than with dense breasts. women with less dense breasts. To The Genius exam has been comincrease awareness of this issue, 31 mercially available in the United states require some level of breast States since 2011, and the newly approved physician labeling is based density notification after a mammogram, but often this can result in on clinical studies proving that confusion for women receiving the the exam improves invasive breast cancer detection while reducing un- notification letters.

“Radiologists and referring phynecessary recalls among women of sicians needed an answer for how all breast densities, including those to screen the roughly half of women with dense breasts. with dense breasts, because until Between 40 and 50 percent of now, this patient population was women ages 40 to 74 have dense confused and frustrated without a breasts. Density is only identifiable on a mammogram or other imaging clear path forward,” said Pete Valenti, Hologic’s division president, modalities, and reflects how much breast and skeletal health solutions. fibrous or glandular tissue is in the “We are pleased today to provide breast. Women with dense breasts WWW.MEDICALDEALER.COM

Staff Reports

hospitals ensure that their mobile equipment is not carrying dangerous pathogens from room to room and that’s what the LightStrike Disinfection Pod can accomplish. We believe this is a major step forward for room disinfection and patient safety,” said Dr. Mark Stibich, co-founder and chief scientific officer of Xenex. •

this definitive guidance from the FDA that the Genius exam is a superior screening solution for women with dense breasts. This is yet another reason referring physicians can feel confident in recommending Hologic’s Genius exam.”

The new density labeling is the latest notable claim for Hologic’s Genius exam, which is the only mammogram clinically proven to detect 20 to 65 percent more invasive breast cancers compared to 2D alone, with an average increase of 41 percent.

The Genius 3D Mammography exam is only available on a Hologic 3D Mammography system. It consists of a 2D and 3D image set, where the 2D image can be either an acquired 2D image or a 2D image generated from the 3D image set.• To learn more about the Genius exam, visit http://www.mygenius3d.com/.

MEDICALDEALER 21

INDUSTRY UPDATE_OEM Update

FDA CLEARS SIEMENS HEALTHINEERS DEVICES Siemens Healthineers has anportfolio, customers tasked with nounced that the Food and Drug reaching a certain price point no Administration has cleared Bilonger need to make compromises ograph Horizon Flow edition, a in the PET/CT technology they cost-competitive positron emission offer patients,” said Doug Darrow, tomography/computed tomography vice president of molecular imag(PET/CT) system that features the ing at Siemens Healthineers North company’s revolutionary FlowMoAmerica. ‘The Biograph Horizon tion continuous bed motion scanFlow edition is the ideal PET/CT ning technology. system not only for progressive Initially introduced on the community hospitals but also for company’s premium Biograph satellite campuses of large healt mCT Flow PET/CT platform in care networks that are looking to 2013, FlowMotion continuous bed provide the same premium conmotion technology differs from tinuous bed motion technology as conventional step-and-shoot PET/ their flagship facilities.”

CT scanning in that it enables In other news, the FDA has personalized exam protocols based cleared the MAGNETOM Vida 3 on patient anatomy. These protoTesla (3T) magnetic resonance cols can be configured based on imaging (MRI) scanner from Siethe radiology department’s most mens Healthineers, which features commonly scanned indications to new BioMatrix technology that support standardization. With the addresses inherent anatomical and extension of FlowMotion continphysiological differences among uous bed motion technology to patients, as well as user variability.

Biograph Horizon Flow edition By reducing this variability among scanners, users can define up to patients and users, the scanner’s four distinct scanning regions, each BioMatrix technology can lower with a different bed speed. the number of rescans and inAdditionally, specific exam crease productivity to improve reconstructions can be applied to MRI’s cost efficiency. each scanning region or to mulThe MAGNETOM Vida with tiple regions. Biograph Horizon BioMatrix technology helps health Flow edition facilitates high-resocare providers perform a full range lution reconstructions and reof routine and complex examinaspiratory gating, which can help tions while delivering robust results improve the ability of clinicians to for each patient. BioMatrix Sensors detect lesions. built into the scanner’s new patient “With the addition of Biograph table automatically track respiratory Horizon Flow edition to the patterns as soon as the patient lies Siemens Healthineers PET/CT on the table, providing information 22 MEDICALDEALER | AUGUST 2017

Staff Reports

that can help formulate the optimal exam strategy.

In addition to helping users avoid costly rescans, BioMatrix Tuners improve the quality and reproducibility of whole-spine diffusion imaging via individual slice adjustments that mitigate distortion that otherwise may occur, especially at 3T. Biomatrix Interfaces help ensure consistently high exam quality, accelerating scanning by up to 30 percent and improving patient care. The scanner’s intuitive user interface permits correct one-touch positioning of the patient table based on intelligent body models. The patient table provides motorized assistance, enabling users to move patients who can be difficult to move (i.e. immobile, trauma, and extremely heavy patients) to and from the scanner. • Further information is available at www.siemens.com/healthineers.

MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Update

CIM MED MEDICAL MOUNTING SOLUTIONS RECEIVE ACCOLADE The height-adjustable S-series mounting solutions from CIM med have been rated as best in category by the INDUSTRIEPREIS 2017 award team and are now entitled to carry the corresponding certificate and logo. This award recognizes advanced products that have a considerable level of economic, social, technological and ecological benefit.

The new S-series won over the judges with its optimized design, user-friendly installation and cable integration system (CIS). The CIS was developed by CIM med and raises the standard of bedside care by protecting cables that supply power and data to the patient monitor. It ensures flawless connections and offers advantages in terms of hygiene and infection prevention. Germs are unable to settle on exposed sections of cable and the sleek design of the arms provides large one-wipe surface areas for ease of cleaning.

The use of the most modern aluminum alloy also All CIM med products are EN60601 compliant and benefit reduces the weight of the arms. This also helps with from a maximum carrying capacity of 22 kilos. the stability testing of mounts placed on carts as well as The arms boast a customizable internal rotation stop reducing transportation costs for delivery. It all adds to at every pivot point, making it possible to limit the arms the “green thinking” behind the product. range to suit its use and environment. It is particularly Also, CIM med GmbH was awarded the latest ISO useful when used in anesthesia, to assist in stability.

13485:2016 accreditation earlier this year. •

PHILIPS UNVEILS INTELLIVUE X3 IN EUROPE Royal Philips has announced the clinical network and Philips family of release of the IntelliVue X3 in Europe. central stations. Data from the IntelliDesigned for portable, uninterrupted Vue X3 is also integrated into mobile monitoring during in-hospital transapplications, the hospital network, port and at the bedside, IntelliVue X3 and interfaces that connect the system provides an intuitive smartphone-style to other medical devices and to the operation that quickly and easily hospital’s electronic medical record enables continuous monitoring during (EMR) system. As part of this larger transport for the most critical patients. patient monitoring portfolio, X3 assists When patients are transferred from clinicians in providing the best possione department to another, clinible care for patients across all levels of cians often struggle with incomplete acuity and supporting institution-wide data records leading to inefficiency standardization. due to multiple systems operating “The challenge of delivering care independently. Getting a complete efficiently and effectively within view into patient data to allow for hospitals’ acute environments coninformed clinical decision support tinues to increase,” said Felix Baader, requires manual steps and can conbusiness leader, patient care and tribute to a higher potential for error, monitoring solutions, Philips. “Health especially when dealing with critical systems need accurate and transparent care patients. IntelliVue X3 integrates information and processes to help clinseamlessly into the existing IntelliVue ical staff make faster, more consistent Patient Monitoring system, including decisions based on patient conditions bedside and transport monitors, the and history. With the development WWW.MEDICALDEALER.COM

of the IntelliVue X3, we’re aiming to ensure that data isn’t being lost during transitions and that we’re able to better equip clinicians with the information they need, when they need it.”

In addition to providing complete data records, IntelliVue X3 provides a comprehensive and scalable set of clinical measurements, ranging from basic to advanced monitoring. It allows for advanced monitoring during stationary and transport situations, including dual invasive blood pressure, built in mainstream CO2, a choice between three SpO2 technologies and state-ofthe-art ECG/Arrhythmia.

The IntelliVue X3 has received the CE Mark in Europe. Pending 510(k), not available for sale in the U.S. • For more information on Philips full suite of patient monitoring solutions, visit www.philips.co.uk/healthcare/solutions/patient-monitoring .

MEDICALDEALER 23

INDUSTRY UPDATE_OEM Update

Staff Reports

SENOGRAPHE PRISTINA INSTALLED AT U.S. FACILITY GE Healthcare has announced the may cause tensing of pectoral first U.S. installation of Senogmuscles, making it hard to raphe Pristina in an outpatient acquire pristine images, they imaging center, at SimonMed’s can lean comfortably on the Thunderbird location in Glendale, armrests, relaxing their musArizona. Senographe Pristina is cles to simplify positioning, next-generation mammography compression and image acquitechnology designed to deliver a sition. By improving patient more comfortable mammography comfort, technologists can experience for women. focus on precise positioning, “Senographe Pristina is anpotentially making the exam other new, amazing technology easier and faster. from GE Healthcare with its focus SimonMed has a unique on improved patient experience approach to breast health will help us get better results for leveraging different imaging patients,” said Dr. John Simon, modalities to create a cusfounder and CEO of SimonMed. tomized approach to screen“The quicker and more coming, diagnosis and treatment fortable exam leads to accurate depending on the patient’s diagnoses, and also helps us to get individual risk factors. Sibetter compliance with patients as monMed, one of the largest they are less fearful of the mamoutpatient medical imaging mographic exam. This technology providers, uses mammogcomplements our GE Automatraphy, digital breast tomoed Breast Ultrasound systems synthesis, automated breast (ABUS), which are critical, new ultrasound equipment, and tools in diagnosing early breast breast MR to help personalize cancer, particularly in women with the imaging and diagnosis for dense breasts.” patients. The Invenia ABUS Senographe Pristina was deis a comfortable, non-ionizing signed to completely revolutionize alternative to other supplethe patient experience to make mental screening options for it more comfortable. The gentle, women with dense breast tisrounded corners of the bucky, sue. When used in addition to where the breasts are positioned, mammography, Invenia ABUS help reduce patient discomfort. can improve breast cancer Instead of requiring women to use detection by 55 percent over conventional handgrips, which mammography alone.• 24 MEDICALDEALER | AUGUST 2017

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PRODUCT FOCUS_Nuclear Medicine_Market Analysis

Staff Reports

BRIGHT FUTURE FOR NUCLEAR MEDICINE N

uclear medicine is a growing segment of the health care imaging landscape, according to several reports.

The global nuclear medicines market is expected to reach $17.6 billion by the end of 2020, growing at a compound annual growth rate (CAGR) of around 12.29 percent from 2015 to 2020, according to Mordor Intelligence.

Grand View Research also predicts continue growth.

The nuclear medicine market is expected to reach $13.8 billion by 2024, according to a new report by Grand View Research.

The nuclear medicine/radiopharmaceuticals market is projected to reach $7.27 billion by 2021, according to another report by MarketsandMarkets.

Nuclear medicine uses in radiological imaging include magnetic resonance imaging (MRI), computerized tomography (CT), positron emission tomography (PET) and single proton emission tomography (SPECT).

“The use of nuclear medicines for diagnostic purposes has gained huge popularity all around the world. There has been increased use of SPECT, PET, CT and MRI WWW.MEDICALDEALER.COM

for diagnosis of cardiac diseases, brain diseases, cancer and many others,” according to Mordor Intelligence. “Nuclear medicine is being used for therapeutic purposes for treatment of Alzheimer’s disease, coronary heart diseases,

The nuclear medicine/radiopharmaceuticals market is projected to reach $7.27 billion by 2021 bone metastasis, cancers and different medical conditions affecting the thyroid gland, and scar tissue removal. Advancement in diagnostic imaging is bringing in more use of nuclear medicine. Nuclear cardiology has gained great popularity in North America.”

The Mordor Intelligence report lists several driving factors for the global nuclear medicines market. In addition, it sheds light on several opportunities that exist for

the market players. Some of the market drivers are the increasing incidence and prevalence of cancer and cardiac ailments, increasing application of SPECT and PET with advancement of technology, growing awareness amongst physicians and public awareness for better health care.

“The segmentation based on the application has been subdivided based on diagnostic and therapeutic application,” according to Mordor Intelligence. “The diagnostic application includes the application of SPECT and PET in cardiology, neurology, oncology and others. The therapeutic applications include application in oncology, thyroid, endocrinology and various other therapeutic areas.”

The global nuclear medicine market has been geographically segmented into North America, Europe, Asia-Pacific, Middle East and Africa, and Latin America.

Due to high technological advancement coupled with a developed economy, North America has the largest market share, followed

by Europe and Asia-Pacific.

“Currently, the segment of diagnostics holds the largest share in nuclear medicines market, where SPECT has the largest share,” according to Mordor Intelliegnce.

MEDICALDEALER 27

PRODUCT FOCUS_Nuclear Medicine_Product Showroom

Staff Reports

GE HEALTHCARE

Discovery NM/CT 670 CZT

GE

Healthcare is leading the CZT revolution. It started with the investment in its manufacturing and the introduction of dedicated cardiac and breast imaging systems powered by cadmium zinc telluride (CZT) technology. Now it is accessible in the world’s first commercially available general purpose SPECT/CT system, Discovery NM/CT 670 CZT. The Discovery NM/CT 670 CZT is engineered to reduce dose or time by 75 percent1 and improve lesion detection2, image quality and patient comfort. Combined with advanced quantitative applications provided through Xeleris 4.0, it can help clinicians continue their efforts to diagnose and stage diseases earlier. • Together with Clarity 2D/Evolution and compared to D670Pro/ES/DR without Clarity 2D/Evolution Improved detectability as demonstrated in phantom testing

1

2

28 MEDICALDEALER | AUGUST 2017

MEDICAL EQUIPMENT, PARTS & SERVICE

Nuclear Medicine_Product Showroom

PHILIPS

Vereos PET/CT

T

he Vereos PET/CT is the world’s first and only fully digital PET/CT. Providing improved detectability and characterization of small lesions1, uncompromised lesion detectability and quantification at half the PET dose2, and uncompromised lesion detectability in one-tenth of the time3, Vereos enables clinicians to go beyond current limitations in PET/CT imaging to enhance patient care. These advances in clinical performance are the result of the synergy between breakthrough innovations; Philips’ proprietary Digital Photon Counting (DPC) technology and faster Time-of-Flight performance, resulting in approximately 2x the volumetric resolution, sensitivity gain, and quantitative accuracy compared to analog4 systems. • Nguyen NC, Image Quality and Diagnostic Performance of a Digital PET Prototype in Patients with Oncologic Diseases: Initial Experience and Comparison with Analog PET, J Nucl Med 2015; 56:1378–1385.

2 Liu X et al, Impact of FDG Dose Reduction on Lesion Quantification in Dynamic PET: A Simulation Study Based on Clinical Trial Data SNMMI 2016.

3 Zhang J., Evaluation of speed of PET acquisition: How fast can we go? ‐ A validation of list mode PET simulation approach with true acquisitions, SNMMI 2017.

4 GEMINI TF PET/CT 1

WWW.MEDICALDEALER.COM

MEDICALDEALER 29

PRODUCT FOCUS_Nuclear Medicine_Product Showroom

Staff Reports

SIEMENS HEALTHINEERS

Symbia Intevo Bold

T

he new Symbia Intevo Bold SPECT/CT system from Siemens Healthineers combines high-performance CT with the company’s proven SPECT technologies to maximize dual-use capabilities. Users can add additional CT slice reconstruction with Interleaved Volume Reconstruction to better evaluate small structures, SAFIRE iterative CT reconstruction for lower dose, and iMAR metal artifact reduction for CT and SPECT/CT. The system’s established SPECT options include high-resolution xSPECT Bone and automated, accurate and reproducible quantification of 99mTc, 123I, 111In, and 177Lu1 isotopes with xSPECT Quant. • FOR MORE INFORMATION, contact your local Siemens organization for further details.

1

1 77Lu is not commercially available in some countries, including the US. 177Lu is not currently recognized by the U.S. FDA as being safe and effective, and Siemens does not make any claims regarding its use. Due to regulatory reasons, its future availability cannot be guaranteed.

30 MEDICALDEALER | AUGUST 2017

MEDICAL EQUIPMENT, PARTS & SERVICE

Nuclear Medicine_Product Showroom

TOSHIBA MEDICAL

Celesteion PET/CT

T

he Celesteion PUREViSION Edition PET/CT system significantly improves imaging quality and efficiency for excellent cancer patient care. A 70 cm true field-of-view and SUREFLiGHT reconstruction technology provide sharp images and high contrast for better tumor visualization. The PUREViSION 16-row CT detector helps acquire high-quality CT images, while SEMARTM reduces artifacts from metal implants. Prioritizing patient comfort and safety, the system features an industry-leading 90 cm wide CT bore and AIDR 3D iterative dose reduction technology. •

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MEDICALDEALER 31

PRODUCT FOCUS_Preferred Vendors

Staff Reports

PREFERRED VENDORS

NUCLEAR MEDICINE Global Medical Imaging 222 Rampart St. Charlotte, NC 28203 Toll-Free: 800-958-9986 Phone: 704-940-7755 Fax: 704-940-7756 Email: info@gmi3.com Website: www.gmi3.com

InterMed Group 13351 Progress Blvd.

Alachua, FL 32615 Phone: 386-462-5220 Email: Sales@intermed1.com Website: www.intermed1.com

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The InterMed Group is a premier provider of integrated technology management services. We are focused on enhancing PROOF APPROVED CHANGES CHANGESNEEDED NEEDED the overall quality, cost, and confidence in your equipment asset management. Our biomedical, diagnostic imaging specialists GMI sells, services and supports ultrasound systems and nuclear and unique “Jump Teams” are empowered to deliver unSIGN–OFF: CLIENT cameras across the USA. At GMI, we focus on one thing. Transparenmatched customer service and the industry’s best technology at cy. The truth is that we serve our customers with confidence knowing competitive rates. We invite you to discover how our innovative that PLEASE we can provide the best experience the industry.

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MEDICALDEALER 33

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PRODUCT FOCUS_Telemetry_Market Analysis

Staff Reports

GLOBAL TELEMETRY

MARKET ON THE RISE

T

he global telemetry market is expected to witness lucrative growth opportunities over the forecast period, according to Grand View Research Inc. A 2017 press release from PRNewswire also predicts growth in the cardiac monitoring (CM) and cardiac rhythm management (CRM) devices market.

“The global CM and CRM devices market is projected to reach $28 billion by 2021 from $22.19 billion in 2016, at a CAGR of 4.8 percent from 2016 to 2021. Growth in this market is mainly driven by factors such as rising incidence of cardiovascular disorders, growing use of mobile cardiac telemetry, and rise in private institutional nursing and home care,” according to the press release about a MarketsandMarkets report.

“On basis of product, cardiac monitoring devices market is categorized into ECG devices, implantable loop recorder (ILR), cardiac output monitoring (COM), and event monitors. The ECG devices segment is expected to account for the largest share during the forecast period due to the rapid technological advancements in the improvement of ECG devices,” according to the press release.

“New product launches and approvals were the key strategies adopted by major industry players to increase their market share and cater to unmet needs of the customers. Emerging and immature markets such as Brazil, Japan, China and India are lucrative for WWW.MEDICALDEALER.COM

CM and CRM devices,” according to MarketsandMarkets.

Advantages associated with telemetry include the ability to allow patients to move freely during cardiac monitoring procedures as well as increasing the transmission of meteorological data. These advantages are a factor in the expected

“Growth in this market is mainly driven by factors such as rising incidence of cardiovascular disorders, growing use of mobile cardiac telemetry, and rise in private institutional nursing and home care.” market growth, according to Grand View Research.

There is also a rising demand for the development of instruments that can remotely measure any data and that is expected to boost the global telemetry market.

“Moreover, telemetry has wide application areas such as oil & gas industry, water management, defense, flight testing, agriculture and health care,” according to Grand View Research. “Furthermore, rising demand for cloud computing in almost all

sectors such as law enforcement, military intelligence and health care are few factors driving global telemetry market.”

However, high capital investment associated with telemetry and low awareness levels are factors that could impede market growth.

“In 2014, health care, energy and utilities, and retail sectors are amongst the highest revenue generating product segments included in the study,” according to Grand View Research. “Increasing importance of medical monitoring of biological signals such as EKG, EEG and EOG, growing demand of such technologies in critical medical environment and rising need for wireless technology in order to transmit signals over a large distance are some factors attributing to its large share.”

“Wireless segment is anticipated to witness lucrative growth opportunities over the forecast period owing to the rising demand for such technologies in health care system such as wireless cardiac monitors and technological advancements in the field of wireless medical telemetry services,” according to Grand View Research.

Increasing prevalence of cardiovascular disorder and rising awareness among patients and health care practitioners regarding technological advancements in the field of telemetry is one of the key factors attributing to North America’s large share of this market, according to Grand View Research.

Key players operating in the global telemetry market include Philips Healthcare, GE Healthcare, Spacelabs Medical, Nihon Kohden, Astro Med Inc. and Lindsay Corp.

MEDICALDEALER 37

PRODUCT FOCUS_Telemetry_Market Analysis

Staff Reports

GE HEALTHCARE

ApexPro CH telemetry system

F

ocused on patient care and meaningful outcomes, GE Healthcare’s ApexPro CH telemetry system delivers clinical intelligence to help caregivers respond to critical situations faster and work more productively. Designed to be both backward-compatible and forward-flexible, ApexPro CH enables you to extract maximum value from your telemetry system while protecting your investment over time. The system’s reliability and flexibility helps reduce the possibility of transmission interference, dropout and downtime. Together with the comprehensive GE Healthcare suite of mobile, remote and bedside monitoring technologies, ApexPro CH telemetry helps you deliver information to the critical point of clinical decision-making. •

38 MEDICALDEALER | AUGUST 2017

MEDICAL EQUIPMENT, PARTS & SERVICE

Telemetry_Product Showroom

PHILIPS

Cardiac Telemetry Systems

C

ardiac telemetry devices are adapting to accommodate a more patient-centric environment to keep up with the shift toward value-based care, supporting varying patient acuities while enhancing current nursing practices and clinical workflows. In support of increased patient mobility, Philips designed a wearable device that is light enough and small enough to be comfortably worn by ambulatory patients needing cardiac patient monitoring. The IntelliVue MX40 provides continuous monitoring of ECG, SpO2, impedance respiration and other vitals wirelessly, allowing clinicians to view patient demographics, alarm settings, history and trends, as well as view and silence alarms at the patient’s side. •

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MEDICALDEALER 39

PRODUCT FOCUS_Preferred Vendors

Staff Reports

PREFERRED VENDORS

TELEMETRY ALCO Sales & Service Co. 6851 High Grove Blvd.

Burr Ridge, IL 60527 Phone: 800-323-4282 Fax: 800-950-1167 Email: info@alcosales.com Website: www.alcosales.com

SEE OUR AD ON PAGE 44,63

Since 1952, our family has been providing quality medical equipment and replacement parts to the health care industry. We provide our customers with multiple ordering options. Our four “full line” catalogs and various “product specific” catalogs compliment our new online ordering website that offers over 70,000 products for your facility.

Bio-Medical Equip. Service Company 2709 South Park Road Louisville, KY 40219-3545 Toll-Free: 888-828-2637 SEE OUR AD ON Phone: 502-361-4500 PAGE 42 Fax: 502-361-4526 Email: sales@bmesco.com Website: www.bmesco.com BMES is a global depot repair center founded 27 years ago that specializes in the repair of patient monitoring equipment. This includes telemetry, bedside modules, patient monitors, infusion pumps, as well as oxygen blenders, suction regulators, and fetal transducers. Additionally, BMES offers reconditioned equipment, accessories, and repair support for various other products within the medical environment across multiple OEM’s.

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Elite Biomedical Solutions SEE OUR 756 Old State Route 74, Ste. C, AD ON PAGE 41 Cincinnati, OH. 45245 Phone: 855-291-6701 Fax: 866-941-4887 Email: nsmith@elitebiomedicalsolutions.com Website: www.elitebiomedicalsolutions.com PROOF APPROVED CHANGES NEEDED

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MEDICALDEALER 41

NE CO 20

PRODUCT FOCUS_Preferred Vendors

Staff Reports

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pacmed.com Efficient, Reliable, Cost Effective Solutions

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42 MEDICALDEALER | AUGUST 2017

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Sage Services Group SEE OUR 506 Deanna Lane AD ON PAGE 2 Charleston, SC 29492 Phone: 877-281-7243 Fax: 866-345-5544 Email: harper@sageservicesgroup.com Website: www.sageservicesgroup.com Sage Services Group is the single source solution for all your patient monitoring needs. Whether it is depot repair service, the purchase of refurbished equipment, replacement parts or monitoring accessories we have a solution that fits your needs and budget. We service all manufacturers and models, take pride in our workmanship, and offer significant savings from the OEM by performing component level repairs.

Southwestern Biomedical Electronics 2511 S. Harvard Ave

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SEE OUR AD ON PAGE 52-55

Independent service organization specializing in the sale and service of Spacelabs patient monitoring and telemetry, Datascope Passport 2s, and Drager transmitters. SBE works closely with other service providers to offer service for GE and Philips patient monitoring.

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MEDICALDEALER 43

PRODUCT FOCUS_Preferred Vendors

Staff Reports

PREFERRED VENDORS

CONTINUED

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Tenacore Holdings, Inc. 1525 E. Edinger Ave. SEE OUR AD ON Santa Ana, CA 92705 PAGE 11 Phone: 800-297-2241 Fax: 866-776-3101 Email: customerservice@tenacore.com Website: www.tenacore.com Tenacore has expertise in driving the cost out of owning capital equipment. Our multi-vendor repair lab houses factory trained technicians that specialize in infusion pumps, vital signs monitors, ventilators, ESUs, telemetry, wall suctions, cables and more.

Our trained technicians put patients first with every piece of equipment they touch, including refurbished equipment for sale. IDNs have adopted Tenacore’s techniques which compliments biomed departments by lowering cost, increases training and consolidates vendors.

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even after restoring DSH cuts, the impact of repealing the ACA would hit hospitals to the tune of almost $166 billion.

46 MEDICALDEALER | AUGUST 2017

MEDICAL EQUIPMENT, PARTS & SERVICE

To Do More Reimbursement Hurdles, ACA Repeal/Replace and Anticipating CMS

By Matt Skoufalos

J

ust like many of the patients they see, many hospitals in the United States are in survival mode. Beset by shrinking reimbursements, spiraling operational costs, and a constantly shifting political landscape, they press on along an endless drive toward peak efficiency at a desperate pace that affords no slack.

For some facilities, even that will not be enough.

Policy-watching can be a bit like augury, but all bellwether discussions of health care revenue start with the Centers for Medicare and Medicaid Services (CMS), which offers even less clarity than usual in the current legislative climate. As millions watch to see whether the government will repeal or replace

WWW.MEDICALDEALER.COM

the Affordable Care Act (ACA), some wonder what will come of the arrangements brokered with the initial passage of the law.

Jim Leonard is director of Healthcare Business Development at GRM Document Management Services of Philadelphia, Pennsylvania and a former hospital CIO at the Regional Medical Center in Memphis, Tennessee. To his thinking, the biggest wrinkle in every reimbursement policy discussion is anticipated Medicaid reimbursement reductions; specifically, he’s worried about the fate of Disproportionate Share Hospital (DSH) funding under any repeal or replacement of the ACA. According to a June 2016 issue brief on Medicaid Hospital Payments, the Kaiser Family Foundation noted that the ACA would

cut DSH payments by $43 billion between 2018 and 2025, with annual reductions starting at $2 billion in fiscal year 2018 and hitting $8 billion annually by fiscal 2025. That same year, an American Hospital Association-commissioned study estimated that even after restoring DSH cuts, the impact of repealing the ACA would hit hospitals to the tune of almost $166 billion. (The same study also calculated that the DSH cuts alone would already cost the health care sector nearly $103 billion.)

“Prior to the ACA, hospitals would do what they could, but a vast majority of their care was written off as charity,” Leonard said. “Disproportionate share funding was provided to hospitals that wrote off more. ACA encouraged hospitals to contribute to their activity: as a component of ACA ramping up, that

MEDICALDEALER 47

To Do More Reimbursement Hurdles, ACA Repeal/Replace and Anticipating CMS

DSH funding ramped down over five years, and was ultimately towards 20 percent of what it used to be.”

According to a report issued by the Congressional Budget Office in late June, the latest version of the bill in the House of Representatives would cut Medicaid by $834 billion through 2026, and the Senate version would trim $772 billion. Either plan would remove some 14 to 15 million people from the rolls of the insured, and with neither of the current proposals reinstating disproportionate share funding, hospitals could be hit with volumes of pre-ACA charity care patients and no revenues to offset the impact. With many institutions running on incredibly slender profit margins, Leonard said the immediate impact could likely be mass closings of facilities catering to some of the most vulnerable populations in the country.

“We’re going to go back to the early 2000s with this charity care hitting the hospitals, but we’re not going to reimburse,” he said. “We already close about two hospitals a month across the U.S. because they can’t make ends meet.”

According to a 2017 count provided

by Becker’s Hospital Review, the country is shedding these hospitals fastest in rural areas. In the last six years, 80 such hospitals have closed, and Becker’s cites a February 2016 study that suggests some 673 of the remaining 1,829 rural U.S. hospitals are at risk of shutting down. Leonard foresees that the smallest community-based urban and rural hospitals that aren’t acquired by larger partners would simply be forced to close. The Regional Medical Center of Memphis, where he was CIO, was both a Level I trauma facility and a safety net hospital for local, indigent populations as well as those from neighboring Arkansas and Mississippi, for example.

“We had an awful lot of charity care from folks in the surrounding area that really didn’t have another alternative,” 48 MEDICALDEALER | AUGUST 2017

Wayne Webster, CEO of the Boston, Massachusetts-based Proactics Consulting.

"the real impact was on people who took perfectly good commercial machines and replaced them.

They spent a huge amount of money and basically don't have anything that's any better."

- Wayne Webster

Leonard said. “Memphis has Baptist Healthcare, Methodist Healthcare, and all these larger entities did not want the Regional Medical Center of Memphis to go away because they shunted a lot of what would have been charity care for them to the safety net hospital.”

“Grady in Atlanta, Martin Luther King in Los Angeles, Cook County in Chicago – these hospitals that are really now providing a lot of the safety-net services for inner-city areas will also be significantly damaged by this because of pulling people off Medicaid and not providing disproportionate share funding through the states,” he said.

But exactly how severe the impact of any reimbursement changes on the horizon might be is entirely uncertain due to the absence of any detail around the ACA and any changes to it.

“CMS can’t react to that until they get a bill that is actually law, and they begin to generate responses to that law that affect reimbursement to hospitals,” Leonard said. “No one knows what that law’s going to look like.”

Complicating matters further, he points out that the hospital industry was already “on the tail end of meaningful use” funding, which in itself yielded unintended consequences.

After facilities moved to new electronic health records and electronic medical records, many struggled to address “the drastic infrastructure cost increase” in supporting the newer, more expensive software, Leonard said.

“If you had a hospital that was running Meditech and then moved to Cerner, their operational costs to make that move – not buying, but running that EMR and staffing the people – you’re tripling your costs,” he said. “To run Epic, it’s quintuple costs. Yes, the funding associated from CMS paid for the acquisition of that EMR, but that funding is gone.”

“Those hospitals that didn’t pay close attention to that cost are in trouble,” Leonard said. “The ACA saved them, it kicked that can down the road.

MEDICAL EQUIPMENT, PARTS & SERVICE

Because more people came onto Medicaid, and we were doing less charity care, we covered our bases there for a little bit, and it covered up that problem with some additional monies coming from the Medicaid program.”

“Now we talk about those people getting dropped off of Medicaid, and the disproportionate share funding not coming back, and this massive operational cost,” he said. “It’s a perfect storm for these hospitals.

We’ve ramped up our cost structure to run the hospital without proper reimbursement to counteract it, and now we’re looking at Congress doing some things without understanding what they’re doing other than being fiscal hawk conservatives and trying to reverse the government spend.”

Trying to anticipate the direction of regulatory priorities is challenging enough for hospitals and other care providers; for technology vendors it can be a windfall or a calamity.

Software and hardware developers able to seize on new regulations can avoid financial penalties or maximize the benefits of a lucrative reimbursement structure, however temporary.

Denise Clarke, senior consultant at Boston MedTech Advisors in Dedham, Massachusetts, advises the startup businesses with which her company contracts that the steadiest path is the one centered on quality of care, health outcomes and cost savings.

“Some people might think FDA is the largest approval, but it’s the first that you go through,” Clarke said. “If you have a novel technology, you have to apply to get a new [billing] code, and once the code is created, that doesn’t even assure that you get coverage. It can be a long wait.”

Moreover, Clarke said even those technologies that offer better quality of care must offer more than an incremental improvement to be relevant to investors as well as to potential customers. Asking buyers to implement any new device, or to work with any new WWW.MEDICALDEALER.COM

vendor, is often an invitation to changing workflow, which can be a big part of the opportunity cost.

“For a physician to change the way he’s doing his practice over 15 years, it has to be better clinical outcomes, better reimbursements,” Clarke said.

“It’s hard to change people’s habits and behaviors. Hospitals love the status quo. Once they find something that works and works well and everybody’s trained, retraining staff on a new device, new procedures, new workflows, is an uphill battle.”

The most successful new medical equipment is that which is already aligned with reimbursement, Clarke

“When XR-29 was passed into law, people had to sit down and make rational decisions,” Webster said. “‘Am I going to spend thousands of dollars on another CT or look at my throughput and see how that reduced reimbursement’s going to impact me?’ For the OEMs, I’m sure it was a real shot in the arm for CT sales, but it was a one-time thing, and it doesn’t happen again and again.”

“If you chose not to put in the new software, you got paid less,” he said, “but the real impact was on people who took perfectly good commercial machines and replaced them. They spent a huge amount of money and basically

Trying to anticipate the direction of regulatory priorities is challenging enough for hospitals and other care providers; for technology vendors it can be a windfall or a calamity. said; for newer devices, developers must consider whether their technology will leverage existing reimbursement channels or must find new ones. She recommends that no manufacturer take on this task without the support of a reimbursement expert, and hopefully, with endorsements from professional societies who examine the clinical data around the technology in question.

Even for existing products, CMS policy changes can have real impacts beyond immediate reimbursement concerns, said Wayne Webster, CEO of the Boston, Massachusetts-based Proactics Consulting. Similar to Leonard’s observations about the increased costs surrounding EMR and EHR solutions, he said the impact of dose reduction requirements led many facilities to overspend in a rush to resolve their reimbursement concerns.

don’t have anything that’s any better.”

Any particular CMS policy may have an impact on reimbursement, Webster said, and generally, it’s a downward pressure. Even studying the changes published by the government agency fastidiously may only reveal the most minimal of impacts if they fall outside of a providers’ specific area of practice. When providers consider leaving, entering, or expanding a given line of business, Webster recommends running a five-year analysis, at minimum, to generate a well-rounded projection of the potential future landscape.

“We work with that assumption in a hypothetical way,” Webster said. “We run the numbers based on throughput and individual reimbursement going down 5, 10, 15, 20 percent over those five years, and ask, ‘Can you afford to do this if this happens?’ ” MEDICALDEALER 49

To Do More Reimbursement Hurdles, ACA Repeal/Replace and Anticipating CMS

Webster calls this “the supermarket discussion,” not only in that the operating margins of both hospitals and food purveyors are comparably slender, but also in that it’s not always possible to pass along the costs of those products and services to the customer. Instead, he recommends looking at lines of service in the context of how changing reimbursements move their practices.

“I think 5 percent of the people I talk to look at the reimbursement number and don’t look at anything else when they’re looking at a new area [of business],” Webster said.

“If you’re doing it for the money, that’s what you do. You find in hospitals, they worry about it, but you can always fine-tune. The only

way CMS can control the budget is over it, but I didn’t see clinics shutreimbursement.” ting down, and I didn’t see hospitals Webster foresees that in addition saying they’re not going to do more to downward reimbursement presCTs because they’re not getting paid sure, CMS will be looking to improve enough. The money is in the system, equipment usage time from levels but it’s very expensive. As certain of about 45 to 50 percent to about [procedures] become older and older, 95 percent. For hospitals, that will they’ll pay less and less.” raise questions of efficiencies across Webster doesn’t foresee a solution a variety of modalities, including how for rural hospitals, however, particuto generate more throughput. But he larly if throughput becomes a metric upon which reimbursements hinge. also points out that imaging reimWhen population or consolidation bursements have historically fallen aren’t feasible solutions to questions from their introductory rates, and of reduced reimbursement, the only PROOF doctors aren’t ordering fewer scans. answer may have to come in the form “CMS can lower the reimbursePROOF CHANGES of policy change. ment of aAPPROVED particular study, and moreNEEDED “The rural guy says, ‘Who am I going scans get ordered,” he said.

“Now CLIENT SIGN–OFF: to be bought up by?’ ” Webster said. they’ll pay for one acquisition and PLEASE CONFIRM THAT THE nuts FOLLOWING CORRECT “TheARE answer is ‘nobody.’ ” one setup time, and people went LOGO

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CORPORATE PROFILE

SOUTHWESTERN BIOMEDICAL ELECTRONICS

I

n an increasingly broad and diverse marketplace, sometimes the best thing to be is narrowly focused and small. Proof of the concept of knowing what you

know and doing it better than anyone else is Tulsa, Oklahoma-based Southwestern Biomedical Electronics (SBE).

Southwestern Biomedical Electronics begun in 1976 as a distributor for Spacelabs Medical Systems. After Spacelabs migrated exclusively to direct sales and service, SBE became the preferred independent equipment service center for Spacelabs technology, repairing and exchanging circuit boards, assemblies, telemetry, and monitoring devices. With a vigilant eye on the changing systems produced by Spacelabs – and a massive inventory of circuit boards, assemblies, monitors, telemetry systems, and cables – the company focuses on being “the very best provider for keeping Spacelabs equipment running for hospitals small and large,” said President Larry Neilson.

“It is my belief that SBE is the absolute best in servicing Spacelabs medical products,” Neilson said. “Why move into other medical device products knowing that we would not be the best 52 MEDICALDEALER | AUGUST 2017

possible service provider? SBE is successful doing what we do and doing it better than anyone else.”

“We have literally everything that a monitoring system contains, dating back 20-plus years,” he said. “To my knowledge, no one has such broad inventory.

That inventory coupled with our excellent technical abilities makes SBE the obvious choice to go to for service and technical support.

Doing this with the highest regard to honesty, integrity and business ethics while providing SBE employees with good wages and benefits are our core values.”

By staying in the market for so long, SBE has only seen the demand for its services grow from other independent service organizations (ISOs), Neilson said. Service partners not only ask SBE to perform repairs on their Spacelabs equipment, but they rely on SBE’s repairs and warehouse of replacement parts.

That accessibility allows its ISO partners to concentrate on their core businesses without trying to be everything to everyone.

“There is no higher compliment than other repair facilities having the trust to put their reputation on our services,” Neilson said. “We have had many references from the factory. Hospitals may have questions on an older piece of equipment, and they will say ‘We don’t service that anymore. You need to call SBE and here’s their number.’ ” “Our core business is, and always has been, the service and repair of Spacelabs medical equipment,” he said. “This is a very narrow market, but we are MEDICAL EQUIPMENT, PARTS & SERVICE

SPECIAL ADVERTISING SECTION

“It is my belief that SBE is the absolute best in servicing Spacelabs medical products. Why move into other medical device products knowing that we would not be the best possible service provider?”

Hugh Thralls Patient Monitoring Technician at SBE

so competent in this market, we could never provide customers with this level of service on any other type of equipment. The history of our company is our uniqueness.”

To keep pace with this increase in workload, SBE has re-invested in its Tulsa headquarters, where the 5,000-square-foot facility includes 2,000 square feet of onsite warehousing, and another 7,000 square feet off-premises. Four administrative offices are flanked by eight multi-function, dedicated workstations, with state-of-theart soldering equipment and LED lighting.

SBE recently invested in a large lot of Spacelabs Xprezzon and Qube monitors to enable the company to provide support for Spacelabs latest series of equipment. In addition to this equipment purchase, SBE sent Jeff Arneson, Senior Technician, WWW.MEDICALDEALER.COM

to a two-week training course at Spacelabs headquarters for the Xprezzon and Qube.

“Eighty to 90 percent of equipment is shipped to us; we repair it and then return-ship it,” Neilson said. “The other part of our business is an advance exchange program, where we replace a customer’s defective circuit board or assembly with one that has been calibrated/tested and burned-in.”

The only way to offer this kind of service, he said, is to maintain “a fairly large inventory” containing each and every part number and each and every revision of each and every circuit board. The parts room houses larger stocked inventory, such as power supplies, plastics, connectors, and cables. Small components are housed close to the workstations, and SBE also carries a large inventory of new and preowned flat-panel touchscreen displays. Effectively, SBE is an opera-

– Larry Neilson tional alternative to the Spacelabs factory itself, Neilson said.

“The factory should have everything,” he said. “After they have put a product into end of life, they have another seven years of support, and then they typically don’t offer parts anymore. The facilities that have this equipment that is no longer supported by the factory, don’t have the money in their budget to replace this patient monitoring device. Those facilities look to us for their support, parts, and technical assistance.”

With the financial pressures of the Affordable Care Act “squeezing everyone everywhere,” Neilson said, SBE is “extremely happy to be able to provide monitoring system upgrades to financially strapped facilities. In extreme cases, the company will provide short-term financing to these facilities.”

“Some customers are using 20-plus-year-old equipment, in MEDICALDEALER 53

CORPORATE PROFILE SPECIAL ADVERTISING SECTION

“I have always recognized that it takes everyone to make a company successful, and we will continue to run the good race, provide ethical, honest, valuable services to all customers.”

– Larry Neilson

Ron Trenary Telemetry Technician at SBE

part due to our support,” Neilson said. “Many cannot purchase new systems; SBE can exchange this older equipment with flat-panel touchscreen, arrhythmia analysis, EMR-compatible equipment that we can promise will be supported for another 20 years.”

That personal investment in its customers has been behind many “save-the-day situations” at SBE, Neilson said, from sourcing and shipping a critical part overnight, even one requested late in the day.

SBE recently fulfilled a request to ship 15 patient monitors and modules for immediate rental. The hospital called in the request at noon on a Thursday and all 15 monitors and modules were delivered the following morning via Fedex.

SBE also donates much-needed monitoring equipment to children’s hospitals through CURE International.

54 MEDICALDEALER | AUGUST 2017

The team at SBE is more of a family than what is seen at most workplaces, Neilson said, and he prides himself on keeping the atmosphere upbeat, friendly, and caring. Friday mornings bring company-wide breakfast and Scattergories in the break room.

In September, the company will host its sixth annual fishing trip to Eureka Springs, Arkansas on the White River. It’s not unheard of for coworkers to help each other with childcare needs, yard work, or to support the athletics teams of a co-worker’s child.

“We provide all employees a good wage, good retirement benefits, and very good health benefits, while always encouraging solid family life,” Neilson said. “We’re very close-knit. We only have nine employees – and we’re very much a family. It promotes a lot of harmony here in the shop.”

Neilson is the kind of boss who believes bonuses aren’t just for Christmas and that all of his employees deserve equal accolades. When an overly active day of shipping overnight or second-day assemblies surfaces, everyone will pitch in and get things done, he said. SBE staffers are encouraged to bring innovative ideas to the table, and to expand the applications of their technical excellence.

“I have always recognized that it takes everyone to make a company successful, and we will continue to run the good race, provide ethical, honest, valuable services to all customers,” Neilson said. “We know who we are and what we do best and will continue providing this excellent service to all our valued customers.”

To learn more about Southwestern Biomedical Electronics, visit their website at www.swbiomed.com MEDICAL EQUIPMENT, PARTS & SERVICE

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SLICE OF LIFE_Bobinski

By Dan Bobinski

PUTTING QUALITY IN YOUR CUSTOMER SERVICE I

sometimes find myself shaking my head at companies that place little emphasis on customer service training. Notice I didn’t say “dollars,” but “emphasis.” Training in customer service doesn’t require much money. It’s mostly just instilling an attitude of service that permeates an organization.

Some companies do this well, and even celebrate employees who provide good customer service. Such is the case with Tsheets. Their service is online timecards that replace paper timecards, so employees can “clock in” on their computers or their mobile phones.

Their system even integrates with an organization’s QuickBooks software, so as you might imagine, customers sometimes have unique situations that require a phone call for help. During a recent conversation with a Tsheets software engineer, I learned that one of their customer service representatives recently spent five hours helping a client resolve an issue. The engineer said, “Where I worked previously, if anyone spent five hours resolving a customer’s problem they would have been reprimanded. The usual paradigm is ‘get off the phone as soon as possible.’ But customer service is part of our culture, so this guy was celebrated for sticking with the issue until it was resolved.”

Good customer service can reap great rewards, yet time and again we see companies fall down – and some56 MEDICALDEALER | AUGUST 2017

times even close their doors – because of poor customer service. Remember a company called Circuit City? Before their demise, they ran neck-and-neck with Best Buy. You could go into any Circuit City store and get a question answered because their commissioned sales staff knew their stuff.

But along the way, something shifted in Circuit City’s management philoso-

Dan Bobinski Workplace Consultant

phy, and they replaced their commissioned salespeople with hourly wage workers. After that, it became difficult for customers to get answers to their questions. And, rather than deal with incompetence, many customers just shopped elsewhere. The rest is history, and Circuit City is long gone.

So what does it take to win and keep customers? Doug Dvorak, an international speaker and trainer on customer

service, says providing quality customer service starts with authentically caring for the client. He says, “Most employees are focused on their jobs and their tasks, not what the customer may need or want. Putting yourself in their shoes may seem counterproductive, but this can be the first step to avoiding critical mistakes and losing clients due to poor customer service.”

Incorporating this very mindset is an organization known for setting the standard in customer service: the Ritz-Carlton hotel chain. Their customer service guidelines can be found in the book “Exceptional Service, Exceptional Profit: The Secrets of Building a Five-Star Customer Service Organization” by Leonardo Inghilleri and Micah Solomon.

In their book, the authors’ first finding is that it’s vital to define good customer service, and then keep redefining it over time. The reason behind re-examining the standards is to make sure they’re working, because if something isn’t working, it needs to be changed. That said, any change must have a bona fide purpose and genuinely contribute to an improvement in the quality of service. Changes can’t happen just for the sake of change, or to make things flashy.

The authors’ second finding is that employees must be trusted to act on established standards. I love this one because whenever employees must “check with the manager” before addressing a problem, customers begin to MEDICAL EQUIPMENT, PARTS & SERVICE

_Bobinski

feel their problems won’t get resolved to their satisfaction.

Besides, when a situation gets conveyed, details almost always get lost. When that happens, it’s easy for problems to be misunderstood and therefore not resolved correctly.

Also, when employees are entrusted to make their own customer service decisions, they take more mental ownership and see themselves more as ambassadors for their company.

Thirdly, service reps need to know that good listening skills are vital, because their focus must be on the customer and the customer’s needs. Every situation is different, so they must listen accurately to learn the details of each situation.

The fourth facet goes beyond active listening. The Ritz-Carlton model says people should be observing and anticipating a customer’s unspoken needs. This is not an upsell mindset, but rather a service mindset. Think about this from when you’ve been a customer. If someone has gone out of their way to anticipate your needs, then you know what a positive impression it can make, and you understand the value of this mindset.

Finally, Ritz-Carlton wants their people to be concerned about leaving a lasting impression. They believe that if things are done right, profits will occur, so rather than focusing on profits, we should be looking at doing something that creates a lasting relevance in the world.

This last point was a topic of conversation the other day when I ran into an old friend at a coffee shop. He’s the co-founder of a medical service company that has multiple locations in my state, and I hadn’t seen him in a few years.

When I asked how things were going, he said he was struggling because of some equity partners they’d brought on a few years back. “They don’t seem to understand the need for serving our clients well,” he said. “Their focus is only on money. They don’t realize that without top notch customer attention, we won’t have a good bottom line.”

I’ll close with this: A recent report found that 86 percent of adults in the United States are willing to pay more for a better customer experience, and 73 percent of American adults said a friendly customer service experience made them fall in love with a brand.

Companies like Tsheets and Ritz-Carlton understand this. Companies like Circuit City, as well as my friend’s equity partners, do not.

Dvorak agrees that companies should regularly remind their employees to provide quality customer service. He says, “Even the briefest customer interaction affects your bottom line.”

Daniel Bobinski, M.Ed., is the CEO of Workplace-Excellence.com, helping teams and individuals learn how to use Emotional Intelligence. He’s also a best-selling author and a popular speaker at conferences and retreats. Reach him at dan@workplace-excellence.com.

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THE OTHER SIDE_Fidele

By Jim Fidele

WHAT HAPPENS IF THEY GET WHAT THEY WANT? T

he recent barrage of regulation changes and proposals to medical equipment maintenance has certainly been unprecedented in my tenure as an HTM professional. In the past four years, we have had multiple CMS regulation changes and the FDA is also looking at how medical equipment is serviced and reported.

Some industry leaders suspect that this is OEM driven, stating the OEM is claiming that it is trying to protect the patient from poor maintenance practices. As I think about the situation, I wonder what happens if they get what they want. What happens if the OEMs are deemed the only people able to service medical equipment? I feel like that is the goal. I would like to share those thoughts with you.

The first thing I think about is cost when I imagine an industry that only permits the OEM to service equipment. Most of us spend a lot of time evaluating which service contract to purchase based on our own ability to service the equipment and its likelihood of an expensive failure. We know that OEM service is typically the most expensive option when managing medical equipment. If the OEM was doing all the service would 58 MEDICALDEALER | AUGUST 2017

the price be less? Economics tells us that when there isn’t any competition prices are generally not less.

My experience has been that OEM service is typically 50 to 100 percent more than a competing Independent Service Organization (ISO) price.

Given that we frequently hear and read about that we as a nation need to reduce health care cost relying singularly on the OEM would be contradictory to that initiative.

Another issue I think about is response time in an OEM-only environment. Many hospitals do not have enough of a single brand or type of equipment to warrant a dedicated on-site technician. Frankly it is what we, the onsite team, do best. We are in the facility and able to respond instantly. What currently happens with equipment on service contracts with the OEM is that my team is frequently asked to look at a stat problem to try to prevent patients from being rescheduled. If the OEM is the only method permitted for service it will most likely cause delays in patient care. This will not improve patient care. This will put patients at risk or at least force them to go to another facility for service.

The final situation I think about is the human resource. Where will OEMs get the technicians to handle the increased business? Logically, they would recruit them from in-

“ If hospitals are forced to use OEMs, they will need to reduce the in-house staff to cover an increased service cost.” house programs or even ISOs. I find this interesting as aren’t these the same people they are trying to protect the patient from? Again this happens now except in reverse, ISO and in-house programs recruit technicians from the OEM. Many of our third-party repair companies were born from OEM technicians that decided to start a business on their own. Even with the remote diagnostics there will still be a need for a person to replace the part or calibrate the machine; technicians will still be necessary. A larger looming issue is the “graying” of our industry, meaning that many technicians are reaching retirement age and new ones are starting to be hard to find. We also know that many in the workforce want a work life balance which means that being an on-the-road technician MEDICAL EQUIPMENT, PARTS & SERVICE

_Fidele

is not nearly as appealing as being an on-site technician.

I can understand how people not close to this situation could feel like the OEM is the best repair solution.

It is easy to surmise that the OEM would have the best training and knowledge of their device. However, at the end of the day, a human performs the duties. I have had great OEM technicians come to my hospitals and I have had really bad ones that I wouldn’t let work on a wooden box. The same is true for onsite technicians as well. I don’t say this to be derogatory. It is just a fact of life. How the OEM makes up for bad technicians is that they are able to throw parts at a problem until it is fixed, the in-house team has to be a bit more frugal.

However, in my opinion, for equipment service to be legislated away from a free market solution will not make patients safer. The fact remains that medical equipment is becoming more reliable; most problems occur at the user interface. If hospitals are forced to use OEMs, they will need to reduce the in-house staff to cover an increased service cost. I feel like this will negatively impact the relationship between servicer and user that is necessary today to solve problems with equipment. I stated equipment has gotten reliable, but it has also gotten more complicated. Users need a high level of interaction to maintain their competence in the use of equipment today. I just don’t see how OEM-only service would ever accomplish a safer outcome for patients.

JIM FEDELE, CBET, has been with Medical Dealer magazine for more than 12 years. He is currently the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments by email at editor@mdpublishing.com.

WWW.MEDICALDEALER.COM

MEDICALDEALER 59

SLICE OF LIFE_Pay It Forward

By Matt Skoufalos

PAY IT FORWARD MEDICAL BRIDGES

T

hroughout the United States, billions of dollars in surplus medical equipment goes to waste every year, victims of a domestic expiration date or the newest available technology. Yet many countries the world over would still find the bulk of these supplies perfectly suitable for their purposes, if only they could get their hands on them. That’s why a Houston, Texas-based nonprofit called Medical Bridges took up the mission to deliver that technology to the communities who could best make use of it.

The organization traces its roots to 1997, when surgeon Patricia Brock Howard and her pediatrician colleague, Margaret Goetz, took a mission trip to El Salvador.

Flying out of Houston, home to one of the largest medical centers in the country, in which they were surrounded by state-of-the-art technology, nothing could have prepared them for the absence of basic equipment on the ground, said Medical Bridges President-CEO Dorothy Bolettieri.

“They were using plastic bread sleeves as gloves when they were doing surgery, or washing the gloves from patient to patient to patient,” Bolettieri said.

60 MEDICALDEALER | AUGUST 2017

When they returned to the United States, the women brought back a deepened appreciation for how much of the technology discarded in their daily practices could make a life-saving difference for patients overseas. Together with a handful of their church

Medical Bridges equipped this operating room in the Philippines.

congregants, they formed Medical Bridges around Howard’s dining room table. In between going to work and building their organizational charter, the group collected medical equipment to deliver overseas, until Howard’s house was “overrun by the generosity of the institutions in the Texas Medical Center,” Bolettieri said.

“They leased a small run-down warehouse, where everything

was managed by volunteers,” she said. “When they outgrew that space, they moved to a second warehouse, and hired their first employee. In 2005, the Board of Directors was able to buy a 30,000-square-foot warehouse, and in 2006, they decided it was time to get professional about their operation.”

That meant that Medical Bridges had to start charging for the services it delivered, “which was a very difficult thing for this group to do,” Bolettieri said. In 2007, she was recruited to help grow the organization into a nonprofit business. By increasing its efficiencies, the group realized it could help more people “with product that they really need versus product that is available to be shipped,” she said.

Today, Medical Bridges has a strong presence in West Africa and South America. Last year, the group shipped 43 containers of medical supplies and equipment. This year, it’s on target for 50. In its 20 years of operations, the nonprofit has distributed more than $80 million in medical equipment, even after valuing “brand-new, within date, sterile” products at a 50 percent markdown for having been donated, Bolettieri said. Some of the efficiencies came from concentrating their efforts on a small number of targeted recipients.

MEDICAL EQUIPMENT, PARTS & SERVICE

_Pay It Forward

​A Medical Bridges worker prepares a ​Container of Hope shipment​.​

​Wheelchairs are among the items provided by Medical Bridges.

“We’d gone to 82 countries, realizing we’d send one shipment here, one there, and we weren’t making a significant impact in any one location,” Bolettieri said. “We try to focus on multiple shipments to single locations through a single sponsor. Rather than being a mile wide and an inch deep, sustainable, quality health care is what’s important.”

Medical Bridges gathers and donates every kind of medical equipment, from tongue depressors and surgical gowns to imaging equipment and blood analyzers.

A mobile blood testing van the organization shipped to Nigeria was converted into a mobile care clinic that delivered primary care and basic testing to rural villages that wouldn’t otherwise have had access to those services. In Ogun State, Nigeria, Medical Bridges helped supply and equip a 240-bed hospital and a medical school on the campus of Babcock University; in Ivory Coast, it has delivered disposable supplies and durable equipment needed for any setting from a primary care clinic to an operating room.

WWW.MEDICALDEALER.COM

The organization has also leveraged special partnerships. Together with BUILD, a student group from Texas A&M University that works to create mobile clinics out of shipping containers, Medical Bridges has helped vet and locate overseas communities in which to house those ersatz clinics. Students at the university work with volunteers to gather the materials to outfit the containers and manufacture them with guidance from professionals.

Since its inception, Medical Bridges has also hired an onsite medical technician to provide maintenance and support for the equipment it repurposes and ships. In 2012, when the nonprofit opened its first biomedical testing lab, its tech roster developed from young, student engineers to trained professional biomedical technicians. Today, any piece of equipment that comes into the organization is tested, repaired and shipped overseas with every accompanying piece of paperwork available.

“The World Health Organization says at least 70-80 percent of

​A patient rest​s​after walking ​a ​long ​ distance to see a doctor​.​

equipment that is donated from the developed world doesn’t work, is inappropriate for the location that it’s being sent to; they can’t get supplies, they can’t get parts if a piece of equipment breaks down,” Bolettieri said. “They haven’t been trained on the units.

Those are things that we’re really cognizant of when we prepare cargo for shipment.”

“We are also offering online maintenance support where, if there’s a problem, we can Skype with the technician in-country, similar to telemedicine communication,” she said. “We make every attempt to send equipment that has at least a five-year shelf life.”

Following the vision of its founders – outreach to entities in need of high-quality, basic health care – provides all the focus the organization requires, Bolettieri said. Put simply, Medical Bridges’ mission is to build a bridge between those who have and those who don’t.

“There are people dying simply because health care providers do not have an antiseptic to clean a wound properly,” Bolettieri said.

MEDICALDEALER 61

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CATEGORICAL INDEX

ANESTHESIA Multi Diagnostic Imaging Solutions…BC

Multi Diagnostic Imaging Solutions…BC TTI Travel……………………………………………… 50

ASSET MANAGEMENT Asset Management Associates, LLC… 35

IMAGING Injector Support and Service…………… 32 InterMed Group…………………………………… 3

AUCTION/LIQUIDATION Government Liquidation ………………… 63 BIOMEDICAL AIV Inc.………………………………………………… 50 Ampronix ……………………………………………… 7 Elite Biomedical Solutions ………………… 41 Global Medical Imaging …………………… 26 Integrity Biomedical………………………… 43 InterMed Group…………………………………… 3 Maull Biomedical Training, LLC ……… 25 Multi Diagnostic Imaging Solutions…BC Retrieve Medical Equipment…………… 65 Southwestern Biomedical Electronics, Inc.………………………………………………… 8, 52-55 CARDIOLOGY International X-ray Brokers……………… 33 Multi Diagnostic Imaging Solutions…BC COMPUTED TOMOGRAPHY Dedicated Imaging Solutions…………… 12 East Coast Medical Systems …………… 35 Ed Sloan & Associates ……………………… 33 International Medical Equipment & Service …………………………………………………… 19 KEI Medical Imaging Services ………… 63 Metropolis International ………………… 59 MTC/Medical Technologies Co. ……… 66 Multi Diagnostic Imaging Solutions…BC Retrieve Medical Equipment…………… 65 RSTI Exchange…………………………………… 35 Tri-Imaging Solutions…………………………… 51 CONTRAST MEDIA INJECTORS Injector Support and Service…………… 32 DIAGNOSTIC IMAGING Injector Support and Service…………… 32 ENDOSCOPY J2S Medical, LLC………………………………… 40 GENERAL ALCO Sales & Service Co.……………… 44,63 Government Liquidation ………………… 63

64 MEDICALDEALER | AUGUST 2017

IMAGING PARTS Diagnostic Solutions ………………………… 62 INFUSION PUMPS J2S Medical, LLC………………………………… 40 INFUSION THERAPY AIV Inc.………………………………………………… 50 Elite Biomedical Solutions ………………… 41 LABORATORY MTC/Medical Technologies Co. ……… 66 LASER Multi Diagnostic Imaging Solutions…BC MONITORS/CRTS Advanced Ultrasound Elec./AUE………… 17 Ampronix ……………………………………………… 7 Bio-Medical Equipment Service Co. … 42 Jet Medical Electronics……………………… 33 Multi Diagnostic Imaging Solutions……………………………… BC Tenacore Holdings, Inc.………………………… 11 MRI Carolina Medical Parts ……………………… 20 Dedicated Imaging Solutions…………… 12 East Coast Medical Systems …………… 35 Ed Sloan & Associates ……………………… 33 International Medical Equipment & Service …………………………………………………… 19 International X-ray Brokers……………… 33 KEI Medical Imaging Services ………… 63 MTC/Medical Technologies Co. ……… 66 Multi Diagnostic Imaging Solutions…BC Retrieve Medical Equipment…………… 65 NUCLEAR MEDICINE Global Medical Imaging …………………… 26 InterMed Group…………………………………… 3 International X-ray Brokers……………… 33 ONLINE RESOURCES MedWrench ………………………………………… 34

PATIENT MONITORING Bio-Medical Equipment Service Co. … 42 Integrity Biomedical………………………… 43 J2S Medical, LLC………………………………… 40 Jet Medical Electronics……………………… 33 Multi Diagnostic Imaging Solutions…BC Pacific Medical ……………………………………… 5 Sage Services Group……………………………… 2 Southwestern Biomedical Electronics, Inc.………………………………………………… 8, 52-55 Tenacore Holdings, Inc.………………………… 11 PROBE REPAIR Global Medical Imaging …………………… 26 RADIOLOGY Ampronix ……………………………………………… 7 Asset Management Associates, LLC… 35 Collimare, LLC……………………………………… 57 Engineering Services…………………………… 4 InterMed Group…………………………………… 3 International X-ray Brokers……………… 33 Maull Biomedical Training, LLC ……… 25 Metropolis International ………………… 59 Multi Diagnostic Imaging Solutions…BC Radon Medical …………………………………… 66 RSTI Exchange…………………………………… 35 RECRUITING Adel Lawrence Associations, Inc.…… 63 REPAIR SERVICES Sage Services Group……………………………… 2 REPAIR/REFURBISH Advanced Ultrasound Elec./AUE………… 17 AIV Inc.………………………………………………… 50 ALCO Sales & Service Co.……………… 44,63 Carolina Medical Parts ……………………… 20 Dedicated Imaging Solutions…………… 12 Ed Sloan & Associates ……………………… 33 Elite Biomedical Solutions ………………… 41 Global Medical Imaging …………………… 26 Government Liquidation ………………… 63 Injector Support and Service…………… 32 Integrity Biomedical………………………… 43 KEI Medical Imaging Services ………… 63 MTC/Medical Technologies Co. ……… 66 MW Imaging…………………………………………… 6 Pacific Medical ……………………………………… 5 Radon Medical …………………………………… 66

MEDICAL EQUIPMENT, PARTS & SERVICE

CATEGORICAL INDEX

REPAIR/SERVICES Ampronix …………………………………………… 7 Bio-Medical Equipment Service Co. 42 Jet Medical Electronics …………………… 33 Multi Diagnostic Imaging Solutions BC RSTI Exchange ………………………………… 35 Southwestern Biomedical Electronics, Inc. ……………………………………………… 8, 52-55 REPLACEMENT PARTS Advanced Ultrasound Elec./AUE ……… 17 AIV Inc. ……………………………………………… 50 Carolina Medical Parts …………………… 20 Classic Diagnostic …………………………… 25 Dedicated Imaging Solutions ………… 12 Diagnostic Solutions ……………………… 62 Ed Sloan & Associates …………………… 33 Elite Biomedical Solutions ……………… 41 Engineering Services ………………………… 4 Global Medical Imaging ………………… 26 Government Liquidation ……………… 63 International Medical Equipment & Service ………………………………………………… 19 Jet Medical Electronics …………………… 33 KEI Medical Imaging Services ……… 63 Multi Diagnostic Imaging Solutions BC Radon Medical ………………………………… 66 RSTI Exchange ………………………………… 35 Southwestern Biomedical Electronics, Inc. ……………………………………………… 8, 52-55 STERILIZERS InterMed Group ………………………………… 3 SURGICAL Ampronix …………………………………………… 7 SURPLUS MEDICAL Government Liquidation ……………… 63 TELEMETRY J2S Medical, LLC ……………………………… 40 Sage Services Group…………………………… 2 Southwestern Biomedical Electronics, Inc. ……………………………………………… 8, 52-55 Tenacore Holdings, Inc.……………………… 11 TRADE SHOWS TTI Travel …………………………………………… 50 TRAINING Maull Biomedical Training, LLC …… 25 WWW.MEDICALDEALER.COM

TRAVEL SERVICES TTI Travel …………………………………………… 50 TUBES/BULBS International Medical Equipment & Service ………………………………………………… 19 Tri-Imaging Solutions ………………………… 51

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AIV Inc. ……………………………………………… 50

Government Liquidation ……………… 63

MW Imaging ………………………………………… 6

ALCO Sales & Service Co. …………… 44,63

Injector Support and Service ………… 32

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Ampronix …………………………………………… 7

Integrity Biomedical ……………………… 43

Radon Medical ………………………………… 66

Asset Management Associates, LLC 35

InterMed Group ………………………………… 3

Ray-Pac ……………………………………………… IBC

Bio-Medical Equipment Service Co. 42

International Medical Equipment &

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Carolina Medical Parts …………………… 20

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RSTI Exchange ………………………………… 35

Classic Diagnostic …………………………… 25

International X-ray Brokers …………… 33

Sage Services Group…………………………… 2

Collimare, LLC …………………………………… 57

J2S Medical, LLC ……………………………… 40

Southwestern Biomedical

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Jet Medical Electronics …………………… 33

Electronics, Inc. ………………………… 8, 52-55

Diagnostic Solutions ……………………… 62

KEI Medical Imaging Services ……… 63

Tenacore Holdings, Inc.……………………… 11

East Coast Medical Systems ………… 35

Maull Biomedical Training, LLC …… 25

Tri-Imaging Solutions ………………………… 51

Ed Sloan & Associates …………………… 33 CHANGES NEEDED Elite Biomedical Solutions ……………… 41

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