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CONTENTS
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HE ROUNDTABLE: ANESTHESIA T Anesthesia devices continue to play an important role in health care, but they can be difficult to maintain. TechNation reached out to a variety of individuals in the HTM industry to get insights regarding anesthesia device features, maintenance and more.
Next month’s Roundtable article: AEDs/Defibrillators
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WE WANT YOU- HTM PROFESSION AMID RETIREMENT EXODUS As the inventory of experienced biomeds and imaging professionals is depleted, the effort to replace them is becoming more of a challenge. The problem is a matter of timing. It is estimated that a fifth to a quarter of the entire HTM field will retire in the next 10 years and many already have.
Next month’s Feature article: Regulations and Standard: PM changes, AEM, targeted/ predictive maintenance
TechNation (Vol. 8, Issue #9) September 2017 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
SEPTEMBER 2017
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CONTENTS
INSIDE
PUBLISHER
John M. Krieg
VICE PRESIDENT
Kristin Leavoy
ACCOUNT EXECUTIVES
Jayme McKelvey Lisa Gosser
ART DEPARTMENT
Jonathan Riley Jessica Laurain
EDITOR
John Wallace
EDITORIAL CONTRIBUTORS
Roger Bowles K. Richard Douglas John Noblitt Todd Rogers Manny Roman David Scott Cindy Stephens Steven Yelton Alan Moretti Jeff Kabachinski
WEB DEPARTMENT
Cindy Galindo Kathryn Keur
ACCOUNTING
Kim Callahan Lisa Cover Laura Mullen Jena Mattison
CIRCULATION
Linda Hasluem
WEBINARS
EDITORIAL BOARD
Eddie Acosta, Business Development Manager, Colin Construction Company Manny Roman, Business Operation Manager, AMSP Robert Preston, CBET, A+, 2014 Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System James R. Fedele, Director, Biomedical Engineering Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer
Departments P.12 SPOTLIGHT p.12 Department Profile: Catholic Health’s Biomedical Engineering Department p.16 Professional of the Month: Paul W. Kelley p.18 Biomed Adventures: Captive in Tehran P.21 p.21 p.26 p.28 p.30
INDUSTRY UPDATES News and Notes: Updates from the HTM Industry AAMI Update ECRI Institute Update NESCE Update
P.32 p.32 p.35 p.36 p.38
THE BENCH Shop Talk Tools of the Trade Biomed 101 Webinar Wednesday
P.55 p.55 p.56 p.58 p.60 p.62 p.65
EXPERT ADVICE Career Center Ultrasound Tech Expert Sponsored by Conquest Imaging The Future Thought Leader Tech Knowledge Roman Review
P.69 BREAKROOM p.69 Did You Know? p.71 The Vault p.72 Bulletin Board Sponsored by MedWrench p.77 Alphabetical Index p.74 Service Index Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag
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SPOTLIGHT
DEPARTMENT PROFILE
Catholic Health’s Biomedical Engineering Department BY K. RICHARD DOUGLAS
P
roviding care to Western New Yorkers is not-for-profit Catholic Health in Buffalo. The system’s biomedical engineering department is an unusual mix of professionals with different affiliations.
better contract pricing to support a medical device in-house. I respect our relationship with both vendors, because Renovo and TriMedx would actually let me know if it would be more cost effective to sign a contract with the OEM,” White adds.
“We provide clinical engineering support to our five Catholic Health (CH) hospitals and their associated offsite locations. We are responsible for properly maintaining/supporting medical equipment and medical systems to support a safe patient care and treatment environment,” says Allison M. White, manager of biomedical engineering at Catholic Health. “Catholic Health biomed provides medical equipment contract management for the health care system and manages the risks associated with the use of medical equipment
REPURPOSING AND ALARM SAFETY PROJECTS The department has been involved in assuring the best use of retiring medical equipment along with having a say in expenditures for new equipment. “We are fortunate enough to be a key player in capital planning here at Catholic Health. We just recently completed the implementation of a multi-year patient monitoring project. We spearheaded the initiative and led the project from planning to completion,” White says. “As much as we love managing new
Information Technology umbrella at Catholic Health,” White says. “We can see past all our identification badges and understand our one shared vision; to lead the transformation of health care here in the Buffalo/Niagara region,” she says. The unique composition of the department has helped with managing service contracts, controlling costs and
“We take pride in stepping up to provide solutions to problems here at Catholic Health.” - Allison M. White technology. We also manage the retired medical equipment repurposing program, coordinate medical equipment training for clinical staff, educate our biomed staff and train biomedical engineering students,” she adds. The department is a rare conglomeration, with associates affiliated with three different entities. “The department is comprised of Catholic Health, TriMedx and Renovo Solutions associates. We have 20 people in the department. The Biomedical Engineering department falls under the
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keeping much of the work in-house. “Service contracts for medical equipment are centrally managed through clinical engineering. Catholic Health’s clinical engineering department has contracts directly with original equipment manufacturers and some through Renovo Solutions and TriMedx,” White says. “Our partnership with Renovo Solutions and TriMedx allows us to bring equipment to be supported in-house. In many cases, Renovo Solutions and TriMedx would offer
medical technology in biomed, we also enjoy repurposing outgoing and no longer needed medical equipment. Clinical engineering spearheaded the repurposing medical equipment program for Catholic Health’s Green Committee. Twice a year, we would gather up no longer required medical equipment at each site and work with Centurion Service Group to schedule pick-ups. Centurion Service Group will include our retired equipment for auction. Proceeds from the auction are used for Catholic Health charities.”
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SPOTLIGHT
The Catholic Health Biomedical Engineering Deparment takes pride in its work.
The department is intimately involved in alarm safety. They assembled a multidisciplinary team to discuss the different critical care alarm parameters throughout the system. It was a long process to standardize alarm parameters, but the team is happy to finally be in the middle of the configuration changes. They assist with patients’ heart health as well. “When our Mercy Hospital site rolled out the Transcatheter Aortic Valve Replacement (TAVR) program as part of the Catholic Health Valve Center, our clinical engineering team was very much involved,” White says. “Our biomeds worked on laying out equipment in the room, set up different displays, ran many cables, to make sure all equipment function properly and are sending images and information to the right displays. Every day, our biomed techs at Mercy Hospital of Buffalo would go up prior to each case to make sure everything is hooked up correctly and safe to use,” she adds. BUILDING AND RENEWING CONFIDENCE White says that the team is always ready and willing to problem solve and be involved whenever possible. “We take pride in stepping up to provide solutions to
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
problems here at Catholic Health. Our sites are notorious for requesting impromptu medical equipment moves. Our biomeds make sure that patient monitoring equipment, telemetry access points, fetal monitors, etc. are moved properly to ensure safe use for patient care,” White says. She says that the teams involvement in the TAVR program has enabled the cardiology and cath lab department to feel comfortable in using the equipment. She says that they know that the department’s biomeds understand the urgency and importance of timely and safe patient care. “Our IT department reaches out to us to manage the infant abduction system. Our Sisters of Charity biomed team takes pride in supporting this equipment no matter what time of day it is. Tom Monnier, (who is the team’s resident guru on our infant security systems) for example, would help the system go back up, if IT is unable to restart services,” White adds. As a blended team of professionals, the biomedical engineering team at Catholic Health Buffalo prove that the whole is greater than the sum of its parts. They coordinate to keep the health care system’s medical equipment running smoothly as they earn the confidence of their clinical counterparts.
SEPTEMBER 2017
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SPOTLIGHT
PROFESSIONAL OF THE MONTH
Paul W. Kelley, CBET: Environmentally-Conscious HTM Director BY K. RICHARD DOUGLAS
W
hile an environmentally friendly focus is the job of the whole community, health care facilities can play a more active role with the right leadership and direction.
Paul W. Kelley, CBET, is the director of Biomedical Engineering, the Green Initiative and Asset Redeployment at Washington Hospital Healthcare System in Fremont, California. Kelley has dedicated his interest in a clean environment to guiding his hospital’s response to helping the local community. He has led his hospital’s Green Initiative and Green Team since November 2007. Working on the mechanical and electrical side of health care was not Kelley’s first ambition. He saw himself wielding a scalpel instead of a voltmeter before his college days. “I always wanted to be a doctor – a surgeon actually,” he says. “In college, I had an identity crisis and decided that it wasn’t what I wanted to do. I didn’t want to be in school for half of my life, nor did I want to be on call 24/7. I took a career planning class, and was told about biomedical engineering technology. I asked; ‘Like with pocket protectors and tape on the glasses?’ I found a local community college that taught it, and never regretted it.” “It turns out that I am always learning, and on call 24/7,” he adds jokingly. Kelley graduated from Napa
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Community College with an associate of science degree in biomedical electronics technology and an associate of science degree in electronics technology. “I graduated on a Friday, got married on Saturday, took a two-week honeymoon, and then moved to Los Angeles – 380 miles away – to put my wife through school. A few weeks later, I got a job inspecting pipe welding machines. About a month later, I received two offers for a BMET position. I took the one at UCLA Medical Center,” Kelley says. “After my wife graduated, we moved back to the Bay Area. I took a temporary job at Santa Clara Valley Medical Center in San Jose, and that led to a 15-year permanent position. I received a call from Washington Hospital in Fremont (where I live) offering me to bring the department in-house. I took it (no commute) and have been there for 19 years now,” Kelley adds. MAKING IDEAS WORK Kelley says that the challenges in HTM are one of the things that makes the field enjoyable. He has shown his resourcefulness and foresight in this regard. “I was asked to make a device one time for a research project. This was back in the ’90s, I think. There was a doctor who wanted to make a device to passively exercise paraplegics’ legs. So, I built it for him. We took a rowing machine, placed
magnets on it, and a TENS unit. The tens would fire, cause the legs to straighten, the magnet would turn it off, and the seat would come to rest. It would then repeat. He did his research and got it published,” Kelley says. He also remembers another special project; which was successfully leading EQ89 to publication. “Starting a standard from scratch is a very interesting, and a complicated process. I was also part of the group who renamed the profession to Healthcare Technology Management. I am currently the co-chair of the Supportability Task Force for AAMI,” Kelley says. HOBBIES, PASTIMES, AWARDS AND FAMILY Fitness and creativity have been pastimes for Kelley, and these days catching up on his favorite team or race, are favorite pursuits. “I love bicycling, and used to be an avid cyclist. I was trained in photography and had my own darkroom. I was doing a lot of stained glass, and had two commissioned pieces. Currently, I am more of a sports fan. I enjoy watching the San Jose Sharks, San Francisco 49ers and car racing, especially open-wheeled,” he says. Kelley has been married to his wife Kathy for 38 years. “She helps support our Vets as a Recreation Therapist for the VA,” he says. His son, Aaron, is married and works with Salesforce, as well as being
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SPOTLIGHT
FAVORITE BOOK I read a lot, but a recent favorite is “Seveneves” by Neal Stephenson.
FAVORITE MOVIES “African Queen, “The Day the Earth Stood Still” (original), and most science fiction films.
FAVORITE FOOD Japanese
HIDDEN TALENT I played 12 instruments in high school.
FAVORITE PART OF BEING A BIOMED DIRECTOR?
Paul W. Kelley is always ready to lend a hand.
“I have a good team who I can rely on,
in a successful band (Phoenix Ash) that is signed in Asia. His daughter, Shawna, lives in Los Angeles and works in movie production. AAMI honored Kelley with the organization’s BMET of the Year award in 2011. Kelley has also twice been president of the Bay Area Chapter of the California Medical Instrumentation Association (CMIA). GREEN INITIATIVES His foray into environmental concerns in the health care environment began when he went to a workshop about e-waste in hospitals in 2007. “I reported the results up to administration. It turned out that our CEO had put The Green Initiative on the institutional agenda for 2008, and I was tapped to lead it. In those days, the organization that evolved into Practice GreenHealth was funded by an EPA grant. Once it became a membershipbased organization, we applied and became a very early charter member,” Kelley says. When he started his hospital’s Green Team, it evolved into including members from almost every area of the hospital. The initiative has had great success with meaningful results.
“One was implementing reusable sharps containers. This program eliminated 9.1 tons of plastic from the incinerator,” Kelley says. “Another big, and very effective project, is our ‘Let’s Go Green Together’ Earth Day event, that we partner with the City of Fremont. It is a one-day educational and fun event that draws about 1,000 people.” Kelley says that the Practice GreenHealth awards application is very thorough. “The application takes months to fill out, and many different people have to provide input. They look at all kinds of areas. Their main chapters are leadership, waste, EPP, energy, water, food, chemicals, greening the OR, climate, and green building,” he says. “The questions are not just to collect data. They are also to help with a self-assessment process, and each year they ratchet it down by adding items and pushing the envelope as technology and ideas change.” “I am very happy that we have won seven years, and this year we not only won the GreenHealth Partner for Change, but also the Greening the OR for the first time. These truly do take a village, and while I lead the efforts, it is definitely not just me,” Kelley says. The efforts have led Kelly to be
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
and that really helps when planning for, or reacting to changes. I like seeing and being involved with ‘the future’ and steering us into the right direction to be prepared.”
WHAT’S ON MY DESK/ BENCH? People who have been to my office know I have too much on my desk! I always keep a few fidget toys that I play with when I am thinking, or on a conference call/webinar. Les Atles’ book is always handy, as is my reusable Peet’s coffee mug and AAMI water bottle.
appointed by the Mayor of Fremont to the Environmental Sustainability Commission as its business representative. What TechNation readers should know about Kelley; “I am passionate – and a perfectionist – about what I do, and I love giving back. If I can inspire just one person to step up and get involved, I will be happy,” he says. This biomed director has made much happen by being involved himself.
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SPOTLIGHT
BIOMED ADVENTURES Captive in Tehran BY K. RICHARD DOUGLAS
F
ew people have ever had to wonder if the people they share a building with are going to shoot them in the minutes or hours ahead or the next day. It is a situation that keeps the adrenalin pumping and the edginess of the moment unpredictable and uneasy.
Former U.S. Army Chief Warrant Officer Four (CW4) and biomed Doug Stephens, CBET, founder of Stephens International Recruiting, can attest to the mood when captors are nearby. A stint in Vietnam, as a Marine, would be enough to prepare a lot of soldiers for just about any situation, but it was a duty station in Iran that tested Stephens and his Marine training. During 1979 through 1981, the world’s attention was focused on 52 captives being held hostage by Iran. That saga lasted 444 days from November 1979 to January 20, 1981, ending just after President Ronald Reagan’s inauguration. A year before the hostage crisis, Stephens arrived in Tehran with his wife, Cindy, and then 5-year old daughter, Dianna. The new assignment seemed like a good one to Stephens and he recalls it was a beautiful day, with great weather when they arrived at the Mehrabad Airport. “My job was to provide biomedical, plant operations and communications support for the hospital and evaluation of biomedical equipment maintenance needs for the U.S. Embassy, Tehran,” he says. “Also, Tehran hosted some great summer to winter resorts. Needless to say, we loved going to Tehran and, I really did not enjoy the environment in Vietnam,” Doug adds. He says that the assignment was a great one for a newly promoted Chief Warrant Officer 3. The environment was quite different than what he remembered of his arrival in Da Nang, Vietnam in 1966, which was extremely hot, very humid and raining hard.
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“We went to Tehran with our eyes open, and were warned of the culture shock. Our friends prepared us, for the most part, of what to expect when we arrived,” Doug says. “Of course, words don’t give the entire picture – not like actually seeing it. There had been ‘incidents’ involving Americans both driving and shopping, so we were told to take all precautions necessary. We believed those incidents happened because they were not careful. We never dreamed our safety would be in question,” he recalls. SIGNS OF IMPENDING DANGER The work in the hospital sheltered them to some extent from knowing the brewing political atmosphere and they only really got a heads up from Cindy’s parents who watched demonstrations and signs of political unrest in Iran on the news. In contrast, the U.S. Embassy told them to ignore the news reports and that there was nothing to be concerned about. Some of the early signs of a cultural shift were the long lines to get gas, which was causing disorder among Iranians. Then, on one trip to the hospital compound, Cindy says that the Iranian security guard, who was new, pointed a rifle directly at Doug. It was the first experience with some tension. “Realistically, we didn’t know who to trust or not to trust when it came to the Iranians,” Cindy Stephens says. “Even one of our very educated, and trusted, Iranian hospital employees turned out to be one of the Revolutionaries.” Another time they were having dinner with friends and a Molotov cocktail was thrown through the kitchen window, which luckily did not explode. Outside that day, there were writings painted on a wall that stated “Americans go home” and “death to Americans.” Near the end of August of 1978, the family of three visited Germany for 10
days to attend a conference and get some shopping in. “Doug was informed by the U.S. Army HQ Command in Germany that there was indication of more uprising in Tehran, and we were both informed to remain cautious and safe,” Cindy says. They returned to Tehran around September 3. At that time, the airport and entire city were besieged with Iranian soldiers and tanks. The realization that things had really taken a turn for the worst was evident. Then, Black Friday occurred on September 8, when those protesting the Shah of Iran, were shot and the city fell under martial law with a 6 p.m. curfew every night. “All the hospital dependents were starting to be evacuated from the hospital in late November and early December 1978,” Doug says. “[In] late December, there was a mass evacuation of all U.S. military and civilian family members, but the hospital was to remain staffed. Cindy remained, as she was in charge of the medical records as the Patient Records Administrator/Patient Assistance Officer, and CHAMPUS Advisor. Cindy and Dianna were the last of the hospital dependents to leave Tehran. They were to fly out on January 1, but the Revolutionaries threatened to shoot the planes down, and there were reports of gunfire at the planes, so the pilots aborted their mission and returned to Germany. The pilots returned on January 2, 1979, heavily armed, equipped and ready to fight if necessary,” he says. “On the 16th of January, Mohammad Reza Shah Pahlavi was forced to leave Tehran and it was announced that the Ayatollah Khomeini was to return to Iran on February 1, 1979. Now, the protest against the Americans and the Imperial Guard started getting very violent and became too dangerous to be out on the streets,” Doug says.
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SPOTLIGHT
He says that on February 1, 1979, the Ayatollah returned and things started getting worse. All remaining Americans went into hiding as crowds of protesters searched for them. On February 14, 1979, the revolution started. “I was in direct communications between the U.S. Embassy and the hospital,” he says. “All our guards fled the compound now, and we became worried that we would be taken away to prison or worse.” HELD CAPTIVE The increasing hostility towards the West finally became very real for Doug as things morphed from rhetoric in the streets to an incursion of the hospital compound. No longer did the compound offer a place of refuge. “The Mujahedin — called the Islamic Revolutionaries — entered our compound at the U.S. Hospital on February 15, 1979 at 13:30 hours. We all were taken at gun point out into the compound, interrogated, searched, and lined up in front of the compound concrete wall,” Doug says. “We were a little concerned about our safety at this point. We had no idea what they would do They were young and did not appear to know what they were doing – and they were carrying weapons,” he says. “They immediately spray painted on the wall, ‘Down with Carter.’ They kept us for about four hours in that position and it was a very chilly day. There were six Revolutionary members of this group and they were searching the hospital for contraband and weapons. They did find one gun, which a Major failed to tell them about, so they lined us up again and we thought for sure we were all going to be shot at that wall,” Doug says.
“But they finally told us to return to our duty assignments and that they would maintain a group at our location. No one could come in or leave the compound,” he adds. “We were refused any type of communication except between the hospital and U.S. Embassy. However, I had quietly connected a telephone line in my office to call direct to the U.S. (after all, I am a CBET), and I was in direct communications with my wife, Cindy, every day,” Doug says. “She, in turn, took action since it did not appear the U.S. Embassy was ever going to get us released. She got both of our parents, along with the other wives from the U.S. Army Hospital, to contact state representatives. She personally contacted Congressman John B. Anderson and Missouri Senator John Danforth,” Doug adds. “On June 20, 1979, the U.S. Embassy finally negotiated our release and 10 of my fellow captives went home. However, the embassy requested that someone retrieve all of the medical records of the American patients and U.S. dignitaries, so I again volunteered to assume that mission of the hospital medical records and send them to Heidelberg, Germany, our Medical Command headquarters. I completed my assignment and was given a flight home on July 18, 1979,” Doug says. His training as a Marine in Vietnam helped him keep a cool head. He says that two of the group’s leaders, who were university students, even admitted that there were things they enjoyed about Western culture and said they would like to visit the U.S. some day. Those held captive were treated well by their captors. In light of current events, Doug can now
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contrast the approach of his captors with today’s terrorists. “I think when you are in a situation like I was, you have to be very quiet, not share your opinion about anything, and respect the people for what they believe in as long as they don’t go so far as to take people hostage and kill people like the radicals are doing today,” he says. “Our captors never pressed their beliefs on us and vice versa. Most of the time, the 11 of us captives would play cards, read and do some playing of softball and football. The young Revolutionaries eventually joined us and we had an enjoyable time during the last few days we were there – under the circumstances. We had to do what we could to relax and keep busy,” Doug adds. EXPERIENCING CAPTIVITY & FREEDOM Today, Cindy is president and CEO of Stephens International Recruiting Inc. and Doug assists with the business. In his spare time, Doug has maintained the retired 670A/202A Warrant Officer contact list. He continues to promote the military BMET career field as well as professional training for this career field. He is a supporter of the AAMI CBET Certification Program, and had been the sponsor for the 2005, 2012 and 2015 AAMI CBET Study CD. It was after Cindy and their daughter left Tehran that Doug recounts his wife had a realization regarding freedom. “Cindy said this is the one time in her life she really felt what it was like to totally be ‘free’ – when they got off the airplane at the Air Force Base in Greece and saw the American flag. She said she felt liberated, and it finally hit her, how truly in danger we all had been,” Doug says.
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NEWS & NOTES
Updates from the HTM Industry CHILDREN’S HOSPITAL LOS ANGELES AMONG ‘MOST WIRED’ IN 2017 Seamless. Secure. Simple. Ask any company’s Information Technology department what a healthy, reliable computer network looks like and it often boils down to those three words. But when thousands of doctors, nurses and families need access to hundreds of thousands of patient records from multiple locations across Los Angeles County and across the nation, it takes quite a bit of work to ensure seamless connections, secure channels and simple interfaces. That’s why Children’s Hospital Los Angeles (CHLA) receiving a Health Care’s Most Wired 2017 designation from the American Hospital Association’s (AHA) Health Forum is especially meaningful. “Most Wired hospitals are recognized not only because they hit industry benchmarks, but more importantly because they stay ahead of the curve for technology adoption and innovation,” says CHLA President and CEO Paul S. Viviano. “This recognition is a testament to the unceasing work of our information services team, a confirmation of the technological roadmap we’ve laid out for the future of our health system, and an affirmation to our patients and families that their
medical records are secure and complete across our entire continuum of care.” Hospitals & Health Networks, an AHA publication, annually assesses the level of health information technology (IT) adoption in U.S. hospitals and health systems through an extensive survey. The survey measures how each organization’s investment in technology supports patient safety, quality care and best practices. This year’s Most Wired list included 461 of the 698 total participants surveyed. CHLA was one of 21 children’s hospitals to receive the designation. “Safeguarding each child’s health, safety and privacy is at the core of Children’s Hospital Los Angeles’ mission to offer transformative, compassionate care,” says Steve Garske, PhD, CHLA’s chief information officer. “This means each patient family – as well as our entire network of clinicians and specialists – must be able to depend on an intuitive, robust technology infrastructure.” In the past few years, the CHLA Information Services team has implemented several new systems and technologies. As a result of these and other initiatives, CHLA has been able to better consolidate and analyze the vast
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amount of data generated by the hospital, which in turn has helped drive policies and procedures leading to noticeable, beneficial results for patients and for hospital efficiency. “The Most Wired hospitals are using every available technology option to create more ways to reach their patients in order to provide access to care,” said AHA President and CEO Rick Pollack. “They are transforming care delivery, investing in new delivery models in order to improve quality, provide access and control costs.” Health care organizations participating in the Most Wired survey are required to submit comprehensive information about health information technology investments in four key areas: infrastructure; business and administrative management; clinical quality and safety; and clinical integration between ambulatory services, physicians, patients and community partners. If any advanced capability requirements are not met, the organization does not receive a Most Wired designation. The 2017 Most Wired Survey was conducted in cooperation with the AHA and Clearwater Compliance LLC.
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USB CHARGER FOR PATIENT-CARE VICINITIES INTRODUCED Tripp Lite, a manufacturer of power protection and connectivity solutions, has introduced a USB wall charger certified to UL 60601-1 standards. Tripp Lite says it is currently the only USB charger on the market fully compliant for use in patient-care vicinities. Compliance gives this new USB wall charger approval for use in patient-care vicinities in hospitals, clinics and other medical facilities. Approval is based on regulations established in the 2012 edition of the National Fire Protection Association (NFPA) 101 Life Safety Code and the 2012 edition of the NFPA 99 Healthcare Facilities Code. Ideal for patient, visitor or staff use, this wall charger provides one USB Type-A port with 2.5A of power for fast, efficient charging of smartphones, tablets, MP3 players or USB devices used in health care applications. It is compact and can be installed in patient rooms, nursing stations and treatment rooms, or sold in hospital gift shops for
visitor and patient use. This new solution joins a family of health care-focused products developed by Tripp Lite for use inside and outside of patient-care vicinities. The product line includes power strips, surge protectors, UPS systems and isolation transformers. Key features of Tripp Lite’s New Medical-Grade USB Wall Charger includes protection against over-heating, overcurrent and overcharging. It has an integrated mounting tab that allows for optional permanent installation on an outlet wall plate for compliance and security. “Most USB chargers are not safe for use in patient-care vicinities, and that is what sets this new solution apart,” said Tripp Lite Director of Healthcare Solutions Jim Folk. “Because this USB wall charger is tested and compliant to UL 60601-1, it offers the safety and protection needed in health care environments, both for compliance and for peace of mind.”
CONQUEST IMAGING OFFERS FREE PROBE EVALUATIONS, TRANSPARENT PRICING Conquest Imaging has announced the launch of SIMPLIFY – a Better Probe Repair Program. The program offers free transducer evaluations and the opportunity for customers to get a customized price sheet for their probe inventory. This allows facilities to budget for probe repair spend and process repair orders easily. “Much like repairing a damaged car, if the repair costs more than the car is worth, the best decision is to simply replace the car. But without knowing the cost of the repair or the value of a replacement, how can you make that decision? The medical device industry hasn’t made it easy for hospitals to make an informed decision about their probes because nobody offers upfront pricing for repairs,” explains Conquest Imaging President and Co-Founder Mark Conrad. “By offering pricing upfront, our customers are empowered to decide – repair? loaner? replacement? And place the order the same day. This reduces the decision process by days and even weeks.”
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Conquest Imaging offers tiered pricing upfront to their customers, allowing a facility to spend and budget more intelligently. Often a medical facility budgets capital expenditures separate from repair expenses, making it difficult to control its probe repair and exchange spend. Conquest’s Transparent Pricing allows a medical facility to budget based on failure history and current pricing. Conquest Imaging has been successfully offering probe repair for several years and with SIMPLIFY, is able to reduce the pains of probe repair for their customers. SIMPLIFY adheres to Conquest’s Quality Assurance 360 standards, offering a six-month warranty on standard probes. To receive a customized price sheet, a customer sends their inventory of probes to Conquest Imaging or can work with an account executive to build their list. Within a few days they receive a comprehensive list of probe repair capabilities and pricing for their inventory ranging from minor to major
Because Quality Matters. repair, including exchange pricing. Conquest Imaging’s free probe evaluation is offered with no obligation. The SIMPLIFY Program options include an exchange program (send in a damaged probe, a replacement probe can be overnighted at a competitive exchange price, which is often less than the repair price), loaner repair program (send in a damaged probe, a loaner probe is overnighted while your probe is evaluated free of charge. A repair quote is sent within 48 hours. Once repaired, the probe is sent back. And a straight repair program (send in a damaged probe, your probe is evaluated free of charge, and a repair quote is sent within 48 hours. Once repaired, the probe is sent back.)
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NORTH CENTRAL BIOMEDICAL ASSOCIATION CONFERENCE BEGINS SEPTEMBER 20 The 23rd annual North Central Biomedical Association (NCBA) Conference will be held September 20-22, at Arrowwood Resort and Conference Center in Alexandria, Minnesota. The updated education schedule is available online at https://ncba.wildapricot.org/ under the “2017 conference” tab. Attendee registration is $75 and vendor registration starts at $650. An email from NCBA Vice President George S. Reyad lists highlights of this year’s conference that include a keynote address from Herman McKenzie, an Engineer in the Department of
Engineering at The Joint Commission. In his role, he provides standards interpretation, reviews survey reports, conducts intracycle monitoring conference calls, and serves as faculty for educational programs. Other speakers include Bryce Austin, CEO of TCE strategy. He is a well-known cybersecurity consultant in the Twin Cities. He is a leading voice on communication techniques with over 10 years experience as CIO and CISO. He will discuss the challenge of cybersecurity in today’s healthcare technology management. Pat Lynch
will present a CHTM Study prep for managers interested in becoming certified healthcare technology managers. FOR MORE INFORMATION about the conference schedule, visit https://ncba.wildapricot. org/Schedule.
DELL SETON MEDICAL CENTER OPENS STATE-OF-THE-ART TEACHING HOSPITAL Dell Seton Medical Center at the University of Texas recently held the grand opening of its state-of-the-art health care facility. Dell Seton, a teaching hospital, opened on May 21, 2017 and is the centerpiece of a new health district in downtown Austin. Dell Seton will leverage Sonitor’s Sense RTLS platform to increase efficiencies for caregivers by helping to manage workflow and capacity, quickly locate and track equipment to ultimately deliver seamless, best-inclass care for patients. To support those goals, Sonitor’s Sense RTLS platform has been installed throughout the facility including in the OR, PACU, ED and in all patient rooms. In addition, Sonitor’s SmartTags will be deployed to doctors, nursing staff and attached on medical equipment such as wheelchairs and IV pumps. Sonitor’s Sense RTLS will provide actionable location and event-based data that allows the facility to make informed decisions on how to best improve staff work flow and patient flow, as well as manage and maintain assets and inventory.
“This is also about staff satisfaction and the impact it has delivering quality care. At the end of the day what we want out of an RTLS is to make life easier for caregivers, make it easier to track and locate equipment and underscore for patients that they are in a world-class facility,” said Doug Burkott, PMP, FHIMSS and Program Manager at Dell Seton. “Patients may not notice the RTLS location transmitters overhead and the SmartTags that the staff are wearing, but they will experience how smoothly things run and that the staff has more
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time to pay attention to their needs and be responsive enabling us to make a positive difference in their care.” “Huge congratulations are in order for the Dell Seton community on the development of such an impressive new, state-of the-art medical facility,” Sonitor Technologies President and CEO Anne Bugge said. “It has been such a pleasure being part of the effort to bring their patients and community the very latest technology which is so central to quality health care delivery. We look forward to partnering together in the future.”
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CIM MED CERTIFIED ACCORDING TO LATEST STANDARDS CIM med GmbH fulfills the requirements of the new ISO 13485:2016. This makes the internationally operating manufacturer of medical-grade mounting solutions one of the first suppliers on the market who has consistently translated the stringent requirements of the new standard into its management system. The changes of the new standard versus the previous version (dated 2003) primarily affect risk management, which now includes all processes of the management system. Also, the focus is now increasingly directed toward feedback mechanisms and the more intensive monitoring of suppliers as well as outsourced processes. Furthermore, design and development requirements were refined (plans and proof of verification, validation and design transfer). Altogether, the new ISO norm takes the requirements of the 21 CFR (Code of Federal Regulations) part 820
into account to a much higher extent. Managing Director Manuela Deverill regards the successful certification as an important quality feature for the sustainability of her company. “Currently, we are a major step ahead of other suppliers on the market. We now permanently demonstrate our performance and our awareness for quality by complying with the latest standards in the development and production of our modern advanced carrier systems as well as through our highly efficient documented processes,” Deverill said. In principal, all mounting solutions are inspected by CIM med for quality and functionality from development to delivery. They comply with the Medical Devices Directive 93/42/EEC and bear the CE marking. With regard to material resistance they meet the requirements of DIN EN 60068-2-74 as well as DIN EN ISO 2409:2013 and
therefore are long-term resistant to disinfectants against multi-resistant pathogens. Furthermore, the Fraunhofer Institute attests that the support arms by CIM med can be cleaned and disinfected with wipes by “simple wipe cleaning.” As a medical product risk Class 1, all solutions conform with EN 60601-1, 3rd edition.
CLEARWATER COMPLIANCE JOINS NATIONAL CYBERSECURITY EXCELLENCE PARTNERSHIP Clearwater Compliance, a provider of cybersecurity and compliance solutions, has joined the National Institute of Standards and Technology’s (NIST) National Cybersecurity Excellence Partnership (NCEP) at NIST’s National Cybersecurity Center of Excellence (NCCoE). Clearwater joins 28 cybersecurity market leaders as part of the publicprivate industry collaboration that is focused on providing real-world, standards-based cybersecurity capabilities that address business needs. As an NCCoE NCEP member, Clearwater has pledged its cyber risk management software, methodology and expertise. “Joining NIST’s National Cybersecurity Excellence Partnership is a significant milestone for Clearwater,” said Bob Chaput, CEO of Clearwater
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Compliance. “Protecting critical information systems and assets from cybersecurity threats and criminals is a national priority. The velocity of change in the attack vectors is alarming and requires vigilance and innovation to protect these systems and data. It is no longer sufficient to sit behind a firewall and pretend you are safe. It takes a partnership of the best industry and federal resources to provide best practices, instruction, methodologies and tools to counteract and defend our national digital assets. We are honored to work side-by-side with our federal partners and industry experts in sharing insights and expertise to develop the solutions necessary to secure the U.S. economy against cybersecurity threats.” Clearwater worked closely with NIST and the NCCoE on a newly
published guide to help health care organizations better secure wireless infusion pumps. The new NCEP membership marks a significant step forward in Clearwater’s plans to share best practices with the varied critical infrastructure sectors. “The challenge of cybersecurity cannot be solved by a single organization,” said Tim McBride, deputy director of NCCoE. “At the NCCoE, collaboration across government, industry, and academia helps accelerate the adoption of secure technologies and, ultimately, helps strengthen the cybersecurity posture of our nation. We’re excited to work with innovative, standards-based companies like Clearwater Compliance to meet the challenges of improving cybersecurity.”
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BY AAMI
AAMI PRESENTS
Vision for Future of Health Care in Special Supplement
W
ith an article in a special supplement distributed in USA Today, AAMI offered its perspective on issues to consider as more healthcare technology moves outside the hospital, emphasizing the need for standardization, simplicity and designing with empathy.
This supplement was part of Mediaplanet USA’s Future of Healthcare campaign, which brought together industry leaders to highlight the biggest innovations and issues the health care system will face in the coming years. “As healthcare technology moves outside hospitals and traditional care environments, there are a number of tough questions that need to be answered,” said AAMI President and CEO Robert Jensen. “AAMI is committed to helping find solutions through our standards, education programs, and publications – and we do so with diverse stakeholders, each of whom brings a valuable perspective to these discussions. Being featured in a national publication that is distributed as widely as USA Today gives us the opportunity to get in front of new eyes and encourage even more people to consider how we can best realize the full benefits of connected health.” In the article “Keeping Patients in Mind as Healthcare Technology Breaks Free of Hospitals,” Sean Loughlin, AAMI’s vice president of communications, highlighted the five “clarion themes” from a summit the association hosted in collaboration
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with the Food and Drug Administration on the topic of home health care: • D eepen stakeholders’ understanding of the use environments and their remarkable variability. • C oordinate multiple and recurring transitions in care to improve patient safety. • A dopt a systems approach to redesign the full spectrum of health care in nonclinical settings. • S tandardize and simplify. • D esign with empathy. More details about the vision for “anywhere, everywhere health care” that emerged from this event can be found in the official summit report, which is available at www.aami.org/ summits. AAMI, IAMERS AGREE TO SHARE INFORMATION, BEST PRACTICES AAMI is partnering with the International Association of Medical Equipment Remarketers and Servicers (IAMERS) to work with the association’s members to adopt new or improve their existing quality management systems. AAMI President and CEO Robert Jensen said the agreement with IAMERS underscored AAMI’s commitment to forge partnerships that advance safety in healthcare technology and promote the sharing of valuable information and best practices that ultimately benefit the patients. “We can learn from one another and support professionals in the field with
this agreement,” Jensen said. “In the end, innovation and safety are advanced when organizations collaborate on solutions to the shared challenges we face in healthcare technology.” AAMI has developed a number of education programs related to quality management systems that it will now offer to IAMERS members on a discounted basis under the terms of this agreement. According to IAMERS, all of its members are expected to employ quality management in their organizational structure, policies, procedures, processes and resources. In May 2017, IAMERS members unanimously approved recommendations related to complaint management, identification and traceability, competence, awareness and training, inspection of equipment, and data management. “IAMERS members are striving to achieve the best solutions for their clients, and of course, continuing to address patient safety,” said IAMERS President Diana Upton. “We know engaging with AAMI will greatly help us with these efforts. We are delighted to enter into this understanding with AAMI. We hope we too will bring important insights about our member businesses.” AAMI and IAMERS will also provide opportunities for representatives from the other organization to participate in specific committees and conferences to reinforce information sharing and open discourse relevant to both groups’ missions.
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‘AAMI NEWS,’ ‘HORIZONS’ HONORED FOR PUBLICATION EXCELLENCE Two of AAMI’s flagship publications have been recognized with an APEX Award for Publication Excellence. This annual awards program, which drew nearly 1,400 entries in 2017, honors excellence in publishing by professional communicators AAMI News earned an Award of Excellence in the category of “1–2 personproduced newsletter,” while the association’s peer-reviewed journal supplement, Horizons, won an Award of Excellence for “one-of-a-kind publications (health and medical)” for the spring 2016 issue focusing on the sterilization and reprocessing of medical devices. Sean Loughlin, AAMI vice president of communications, said the honors speak to dedication of staff editors as well as the volunteer authors who ROVED contribute CHANGEStoNEEDED AAMI’s publications. “We’re fortunate to have editors who care deeply about the quality of our OFF: editorial content,” he said. “And our publications would be far thinner without ONFIRM THAT THE FOLLOWING ARE CORRECT the volunteers who submit articles, papers, and ideas about the trends, GO PHONE NUMBER WEBSITE ADDRESStechnology. SPELLING GRAMMAR challenges, and solutions in healthcare Working with them, our editors are able to give readers the news and information they want and need to be able to succeed in their field and support safe, high-quality patient care.”
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BY ECRI INSTITUTE
ECRI UPDATE
Ransomware Attacks: Do’s and Don’ts to Protect Your Medical Device Systems
T
he WannaCry ransomware attacks and the recent Petya attacks have infected thousands of computers, and could compromise medical device systems running on Windows OS. ECRI Institute recently published recommendations with protective actions you can take to keep your medical devices and health systems safe from attack.
WHAT IS RANSOMWARE? Ransomware is a form of computer malware used to make data, software and IT assets unavailable to users. It uses encryption of data to hold systems hostage with an associated ransom demand, often in Bitcoin (a virtual currency that is difficult to trace). This encryption is used to extort money from users, with the hacker promising to give the victims access to their data if the ransom is paid. For example, WannaCry, ransomware affecting Windows-based operating systems (OS), was released on May 12, 2017, and quickly spread through numerous countries, infecting thousands of computer systems. Propagating mainly through e-mail using attachments and malicious links, it caused significant disruption to IT systems worldwide. Several hospitals in the United Kingdom and Indonesia experienced severe disruptions to hospital operations, resulting in cancellation of appointments, postponing of elective surgeries, and diversion of emergency vehicles. Unfortunately, any data that was not appropriately backed up has likely been lost in systems infected with WannaCry, which is characteristic for such ransomware attacks. Similarly, on June 27, 2017, a
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ransomware called Petya started affecting Windows-based systems globally, exhibiting many similarities to WannaCry. Petya reportedly has infected numerous organizations, including some hospitals in the United States. Some medical device systems may be at risk for these types of ransomware attacks, and a threat to patient care may exist. While your facility’s IT department is likely tackling the ransomware threats with the currently available Microsoft security patches, some Windows-based medical device systems will remain susceptible to ransomware attacks like WannaCry and Petya because either they are based on an older version of the Windows OS (for example, Windows XP) and can’t be upgraded, or they have not been validated for clinical use with the latest security patches. Such systems are often managed separately from regular IT assets to ensure appropriate clinical functionality through adherence to manufacturerspecific setup and requirements. In this article, we recommend protective actions you can start to take, and point to some critical differences in how attacks on medical device systems should be managed as opposed to general hospital systems. WHAT SHOULD MY FIRST STEPS BE? Common best practices should always be followed when dealing with software updates and suspicious e-mails containing links and attachments, as the first line of defense against any ransomware or other malware. Continuing education should also be provided frequently to all levels of staff to promote awareness of and
compliance with these best practices. There are also specific do’s and don’ts to follow. These recommendations are intended for the medical device security lead, who is commonly someone from clinical engineering or IT, depending on the facility. DO’S 1. Identify networked medical devices/ servers/workstations that are operating on a Windows OS. Useful sources for this information may include: • Medical device inventory (i.e., computerized maintenance management systems) • Change management systems • Manufacturer Disclosure Statement of Medical Device Security (MDS2) forms obtained during device purchase • Medical device manufacturers • Alerts from the Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) – a list of some medical devices impacted by WannaCry and Petya can be found here: https://ics-cert.us- cert.gov/ alerts/ICS-ALERT-17-135-01I 2. I dentify whether connected medical devices/device servers have the relevant Microsoft Windows OS security patches. (All Windows versions without the MS17-010 security patch may be vulnerable to the WannaCry and Petya ransomware.) 3. Consider running a vulnerability scan on your medical device networks to identify affected medical devices. • Vulnerability scanning can be used to identify devices that may be vulnerable to malware.
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• This method should only be used if (1) information is not available through other sources about the existence of a Windows OS and the associated vulnerabilities on your medical devices and (2) you already have a list of which devices and systems are compatible with vulnerability scanning. ECRI Institute is aware of medical device failures that occurred when systems incompatible with vulnerability scanning were scanned. 4. If medical devices/servers are identified that didn’t receive the security patch, contact the device vendor to determine the recommended actions for dealing with the current ransomware threat. Request written documentation of those recommendations from the manufacturer.
• Many medical device updates must be installed manually while the unit is removed from use (that is, they can’t be distributed remotely), and downtime can directly impact patient care. These factors should be considered when formulating an update response. 7. P rioritize response on any connected Windows-OS-based medical device systems as follows: • Life-critical devices • Therapeutic devices • Patient monitoring devices • Alarm notification systems • Diagnostic imaging systems • Other
5. If your device is managed by a third party or independent service organization, request prompt installation of appropriate security patches and documentation to support risk mitigation. Identify terms in the existing service contract covering responsibilities in regard to security patch updates.
8. If a malware infection is identified or suspected in a medical device: • If clinically acceptable, first disconnect the medical device from the network and then work with your internal IT department and the device manufacturer to contain the infection and to restore the system. • If any unencrypted patient data was involved, inform risk management so that the potential breach can be handled in accordance with HIPAA requirements.
6. Coordinate with the facility’s internal IT department to update affected medical devices in accordance with the manufacturer’s recommendations as soon as practicable. • Medical devices require all updates to firmware and software to be validated, which often delays the availability of patches and updates. For any medical device vendors without a validated security patch, demand expeditious validation.
DON’TS 1. Don’t overreact. • Even with good software update practices, it’s not unusual to find medical device systems running outdated OS software. • Don’t assume that the presence of outdated software on your systems is a threat in its own right. These systems should already be noted as exceptions in your facility’s IT patch update policy, and risk
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mitigation measures should already be in place. 2. Don’t install unvalidated patches. • Unvalidated patches can make medical devices faulty or inoperable, and a thorough supplier validation process can take some time. • Prior to installing any security updates or patches, ensure that they have been validated by the manufacturer. Ask the manufacturer for documentation of the validation. 3. Don’t simply turn off or disconnect all networked medical devices that have Windows OS. • Consider the implications of disabling network connectivity as a risk mitigation strategy on a case-by-case basis. Work with frontline clinicians to understand what the connectivity is used for and the workflow disruption that will result from disconnecting a medical device from the network. • In some cases when workflow disruption is deemed acceptable, a disconnection might be an appropriate risk mitigation strategy until the security patches have been installed per the manufacturer’s recommendations. ECRI Institute published this guidance article, “Ransomware Attacks: How to Protect Your Medical Device Systems,” on June 29, 2017, as a free public resource to aid healthcare facilities in tackling immediate concerns in relation to ransomware like Petya and WannaCry. For additional information about membership in ECRI Institute’s Health Devices System, visit www.ecri.org, e-mail clientservices@ecri.org or call (610) 825-6000, ext. 5891.
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NESCE
The New England Society of Clinical Engineering
T
he New England Society of Clinical Engineering (NESCE) is hosting its Northeastern Healthcare Technology Symposium this fall in Mystic, Connecticut. NESCE is a not-for-profit, educational organization focused on medical technology management and its impact on improved patient care. NESCE clinical engineering, at all levels, as a highly desirable career. NESCE empowers it members to succeed and advance by supporting retention, recruitment, and advancement within the clinical engineering field. NESCE has nearly 1,000 members throughout the New England area and continues to grow. Every three years, NESCE hosts a symposium to bring together some of the greatest minds in Clinical Engineering.
Join us for the Northeastern Healthcare Technology Symposium in Mystic, Connecticut on October 24 through October 26, 2017. The symposium will provide three days of technical training, educational sessions and vendor networking opportunities. This year’s focus will be on cybersecurity and alternate equipment maintenance (AEM) programs. Steve Grimes and Axel Wirth will be hosting the cybersecurity sessions on October 24. Frank Painter will be hosting the AEM sessions on October 25. Our keynote speaker will be James Piepenbrink who will be presenting on the future of clinical engineering and challenges we all face in the Healthcare Technology Management field. As Deputy Executive Director of the Association for the Advancement of Medical Instrumentation (AAMI), he will also shed light on AAMI and AAMI Foundation initiatives. Technical training will include injectors, ultrasound, anesthesia, and operating room integration. There will also be a special session on lasers. Additionally, the University of Vermont will be hosting a Certified Biomedical Engineering Technician (CBET) review course that will span the entire three days.
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Please visit nesce.org and stay tuned for registration information or check us out on social media. We are on Facebook and LinkedIn as New England Society of Clinical Engineering (NESCE). Don’t miss out on the opportunity to network with fellow professionals and gain insight into the latest industry trends. NESCE will be hosting a special dinner at the Branford House on October 24 which will require a separate registration. Use this opportunity to elevate your program to the next level. If you would like to become a member of NESCE, please go to nesce.org/ membership and fill out an online application today. NESCE is currently accepting vendor sponsorships and booth registrations for the exposition held at the conference on October 24 and 25. Sponsorship opportunities include providing coffee breaks, lunch, and registration materials. If you are interested in either, please email NESCEVendor@gmail.com. NESCE appreciates your support; our Northeastern Healthcare Technology Symposium has proven to be an opportunity for companies to connect with a HTM professionals.
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SHOPTALK
Conversations from the TechNation Listserv Q: Has anybody attended a TechNation Webinar Wednesday?
A:
The TechNation webinars are one of the most effective mediums for healthcare technology management personnel to learn and grow in the field. The investment of MD Publishing in our career field is something to be recognized. Additionally, if you are a certified professional by the AAMI Credentials Institute (ACI – CBET, CRES, CLES and CHTM) and you do not attend these free webinars, then shame on you! These webinars are an opportunity for you to earn continuing education credits for your journal that is required to maintain your certification every three years. It is easy and it is no cost to you, you cannot lose.
A:
I have attended a bunch of them. Most likely it will be a presentation from a biomed test equipment vendor steering you towards that company’s products. However, they are generally informative.
A:
The webinars have been one of the best sources for information I have had in a long time.
A:
The webinars are beneficial. The presenters have been well prepared and the material relevant. Some apprehensions about the motive of the presenter, i.e. presenting just to sell the product they market, have really not been founded. There have been
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“nuggets” out of each presentation that provide value regardless of if you own or purchase the product that is represented by the presenter.
A:
I have attended a few Wednesday Webinars and have been glad they exist, there is always something to be learned. It can’t be any easier … nowhere to drive to, no price for administration, and no bad seats in the house. You choose if you want to join that week’s topic. How can you go wrong?
Q:
What kind of testing do you do on electrical outlets in the patient care areas, non-isolation systems only?
A:
According to NFPA 99 6.3.3.2.1 The physical integrity of each receptacle shall be confirmed by visual inspection. 6.3.3.2.2. The continuity of the grounding circuit in each electrical receptacle shall be verified. 6.3.3.2.3. Correct polarity of the hot and neutral connections in each receptacle shall be confirmed. 6.3.3.2.4 The retention force of the grounding blade of each electrical receptacle (except locking-type receptacles) shall be not less than 115g (4 ounces.)
A:
that the inspections described were upon installation. Have you discovered any frequencies for the test? I remember in the old days with flammable anesthetics, there were very specific tests to be done on an annual basis.
A:
NFPA 99 6.3.4.1.1 Where hospital-grade receptacles are required at patient care bed locations and in locations where deep sedation or general anesthesia is administered, testing shall be performed after initial installation, replacement, or servicing of the device 6.3.4.1.2 Additional testing of the receptacles in patient care spaces shall be performed at intervals defined by documented performance data 6.3.4.1.3 Receptacles not listed as hospital-grade, at patient bed locations and in locations where deep sedation or general anesthesia is administered, shall be tested at intervals not exceeding 12 months. My interpretation of these requirements would be that inspections should be completed at least annually and shorter intervals if the documented data collected by biomed/maintenance (inspecting department) warrants it. THE SHOP TALK article is compiled from TechNation’s ListServ and MedWrench.com. Go to www.1TechNation.com/Listserv or www.MedWrench.com/?community.threads to find out how you can join and be part of the discussion.
I read the same but it was unclear on what frequency, annually, bi-annual, etc. My interpretation was
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Buying Repairable 9800 / 9900 HV Cable Cores Call or email us the condition of the cable(s) and we will submit an offer to purchase the part. We will then inspect and test the part to see if it can be repaired. If it is deemed repairable, we will process the transaction and mail you a check the next day.
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he all-in-one test device for medical technicians, independent service providers, anesthesia and respiratory equipment manufacturers is the CITREX H5 gas flow and pressure analyzer. It offers the most advanced user interface for demanding applications on a high-resolution 4.3 inch multi-touch screen. It is portable and precise. Users can customize the measurement screens to suit needs. The CITREX H5 is designed to support a variety of daily applications. Thanks to its precision and reliability, the CITREX H5 can be used to test a wide range of medical devices such as respiratory and anesthesia devices, oxygen flow meters, pressure gauges and suction devices. Learn more on this product by visiting imtmedical.com.
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BY BRENNAN STICE
THE BENCH
BIOMED 101
Why Health Care Facilities Should Look at Workflow Optimization
F
or clinical engineering, it can be overwhelming searching for quality suppliers and original equipment manufacturers (OEMs) within the day-today operations. It can take more than 45 minutes per call to get the information needed for ordering one medical product. As a result, health care facilities can risk incurring hidden expenses and miss savings opportunities.
According to PartsSource research, the majority of a clinical engineering team’s time is spent on ordering items under $1,000. Out of those items, more than 50 percent are purchased only once per year. Therefore, when considering the amount of calls, that is a lot of time spent on items making little impact on return on investment (ROI). ENHANCING PRODUCTIVITY WITHIN THE PROCUREMENT WORKFLOW Intelligent consolidation can produce substantial savings for a health care facility. Innovative approaches to consolidating suppliers beyond traditional boundaries are critical to maximizing the value from repair parts and services spending. Faster access to key content can lead to increased efficiency and give clinical engineers additional time in the day to spend on initiatives that are more important. To enhance productivity, the answer is always in the data. Because clinical engineering spend spreads across various departments within the hospital, the budget can get lost; and medical equipment can get misplaced if there isn’t a system established for tracking inventory. Increasing visibility into the medical procurement workflow is vital. By using
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improvement within the workflow. It is important for health care facilities to depend on a single technology-based solution that helps drive workflow efficiency and provides high-quality care to patients. As long as the supplier has ISO 9001, it is a quality supplier. This certification validates the strength of a technology provider’s quality management system. Choose a procurement platform that leverages quality data to help make better decisions for organizational success.
BRENNAN STICE VP of Business Development, PartsSource
procurement technology to enhance visibility and create efficiency within the overall medical procurement process, health care facilities will be able to see where bottlenecks exist. INCREASING QUALITY BY LEVERAGING A TECHNOLOGY-BASED PLATFORM A technology platform facilitates better procurement. For example, PartsSource uses a patented Supplier Ranking Module that contains qualitative and quantitative data to evaluate the quality and price of over 1,000 original equipment manufacturers and 5,000 after-market suppliers. By simplifying and automating interactions with select, preferred medical suppliers and OEMs, health care facilities will be able to focus on supply chain development, resulting in support for more strategic initiatives regarding sustainability, innovation, risk reduction and other key organizational initiatives. All of which affect ROI and the bottom line result. Quality analytics can help drive supply chain efficiencies in areas needing
GETTING STARTED WITH WORKFLOW OPTIMIZATION To minimize procurement costs and improve processes, the health care organization’s procurement workflow needs to be evaluated by an expert. This requires the creation of a streamlined and structured procurement workflow to make the most of the organization’s resources. By working with an expert to integrate a technology-based platform into the computerized maintenance management system (CMMS) or enterprise resource planning (ERP) system, health care facilities can make meaningful changes that will address shortcomings and improve outcomes. Discover some key advantages to streamlining the overall procurement process by downloading a white paper titled, “Streamline Your Workflow to Increase Efficiency” at https://goo.gl/ T43agS. It will explain more about how to improve workflow optimization to drive the success of a clinical engineering department. – Brennan Stice is the vice president of business development for the western U.S. at PartsSource.
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THE BENCH
STAFF REPORTS
Webinar
Wednesday
WEBINAR WEDNESDAY Hundreds Attend Latest Sessions
T
echNation’s Webinar Wednesday series continues to draw HTM professionals eager to expand their knowledge and receive continuing education credit.
Almost 500 people attended the live presentation of the Fluke-sponsored webinar “Medical Device Quality Assurance Testing: Best Practices For Patient Risk Reduction.” Jerry Zion, global training manager at Fluke Biomedical, discussed applying the Hippocratic oath: “first, do no harm.” He addressed reducing patient risk using an effective quality management program; sources of patient risk; ensuring the clinical staff know how to get the most from their medical devices; maintaining the medical device history record and compliance to GMP (repairs, inspections, etc.) as well as keeping instrumentation current with innovations in medical devices. At the end of the session, participants understood the sources of patient risk and that human error is not managed using instrumentation or technology alone. They also learned about the ways others have managed patient risk sources and how they can instruct and improves one’s plans. Zion pointed out that the importance of maintaining the medical device history record is a responsibility the hospital biomedical/clinical engineering department cannot avoid under the USA FDA GMP 21 CFR requirements, even when repair, calibration services are outsourced.
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Participants also developed an understanding of how establishing meaningful key performance indicators (KPIs) and keeping daily visual management up to date, helps HTM and visitors understand the role of biomeds better and their value in patient risk reduction. Zion shared additional knowledge during an informative Q&A session. The presentation received several positive reviews via a post-webinar survey. “I was a Gunner’s Mate in the U.S. Navy during Operation Desert Storm/ Desert Shield. I have been a Biomed for about 15 years specializing in surgery equipment. Kudos to Jerry Zion, he not only completely covered the topic but he really understood what he was discussing and gave full and concise answers to questions afterwards,” Travis S. wrote. “Today’s seminar provided very clear explanations of the importance and logistics of making accurate measurements for preventive maintenance as it impacts patient safety. The explanations of the complexity of Joint Commission and CMS regulations, and the changes to them, were enlightening. It’s great to have a better understanding as I explain to my staff why we need to do things differently and better,” David M. wrote. “I’m new to the series, and I really enjoyed it, honestly it’s the first time I’ve attended an event online and it was great! I’m looking forward for the next Wednesday,” Daniel L. wrote. “The investment by MD Publishing and TechNation into the HTM career
“ These webinars are of great value to me, though I have been in the field for some time there is always a bit of knowledge that can be picked up from it.” - Dennis C.
field is remarkable and a tremendous value to all HTM professionals. Webinar Wednesday is one of the great ‘arrows in our quiver’ to make us better professionals and provide our patients with an exceptional experience,” Christopher N. wrote. TechNation Webinar Wednesday approached 1,000 attendees for the Jack Barrett and Rebecca Adkins presentation “Electrical Safety Testing – Planned Preventative Maintenance” sponsored by Rigel Medical. The July webinar boasted the highest attendance for 2017 with 939 people watching the live broadcast. It also received high marks and tons of positive
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InfoView
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feedback in the post-webinar survey. During the webinar and an informative Q&A session, Barrett, national business development manager, and Adkins, biomedical sales engineer, at Rigel Medical reviewed the importance of electrical safety testing. The webinar provided an overview of test criteria, classifications, terminology and safety standards, including IEC60601, IEC62353 (direct, differential and alternative techniques) and NFPA99. The Rigel Medical-sponsored webinar as well as the overall TechNation Webinar Wednesday Series received high praise in the post-webinar surveys. “I am supervisor of the medical equipment area of the Copper Hospital in the city of Calama, Chile. I found it a unique experience to have the opportunity to be with electrical safety experts. I know this will complement my work and will help me to provide security to the hospital facilities,” Sebastian H. wrote in his survey “This webinar was very insightful in explaining the background of why we perform electrical safety testing, and references to the regulations and requirements for performing this testing,” Dennis D. said. “I look forward to Webinar Wednesday weekly, as I enjoy the array of topics and the chosen experts who provide the classes,” said William N. “TechNation continues to provide a very useful avenue for HTM technicians in the field to be able to get current information and continuing training through the use of Wednesday Webinar series,” wrote Albert R. “The Webinar Wednesday is a valuable tool for our shop mainly because we have several new techs who really benefit from the base knowledge normally presented,” Jimmy B. wrote. “These webinars are of great value to me, though I have been in the field for some time there is always a bit of knowledge that can be picked up from it,” added Dennis C. “From specific info on devices/modalities down to the most basic fundamentals of medical device repair/ maintenance, Webinar Wednesdays have consistently been a great source of knowledge utilized by our entire team,” said Ryan M. “Webinar Wednesdays are great for refreshing, gaining and expanding your knowledge on specific subjects. Both easily accessible and informative organizers, why not spend an hour for your own benefit,” Keven S. shared. FOR MORE INFORMATION about the TechNation Webinar Wednesday Series, including a schedule of upcoming webinars and an archive of previous webinars, visit 1TechNation.com/webinars.
To schedule a free demo, call 978-659-7127 For a brief overview, visit Philips InfoView at www.philips.com/mvs
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ROUNDTABLE
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ROUNDTABLE
ROUNDTABLE Anesthesia Devices
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nesthesia devices continue to play an important role in health care but they can be difficult to maintain. TechNation reached out to a variety of individuals in the HTM industry to get insights regarding anesthesia device features, maintenance and more.
Participating in this roundtable article on anesthesia devices are Ashish Dhammam, director of corporate sales, Soma Technology; Pete Feldman, senior biomedical electronic tech at Waukesha Memorial Hospital; Diane Geddes, CEO, RepairMED; Thomas G. Green, president of Paragon Service; and James Jumper, BMET I, Baylor Scott & White Health.
ventilation (PSV), synchronized intermittent mandatory ventilation (SMMV) and synchronized mandatory minute ventilation (SMMV) and various derivatives of each mode. These modes are a very nice feature for orthopedic cases where the patient initiates the breath and the ventilator completes the breath.
Q: WHAT ARE THE LATEST ADVANCES OR SIGNIFICANT CHANGES IN ANESTHESIA EQUIPMENT? WHAT TECHNOLOGIES ARE WORTHY OF THE INITIAL INVESTMENT?
Feldman: The anesthesia equipment of today is trending toward a compact ergonomic design for ease of use and surfaces that are easier to keep clean to reduce nosocomial infections. This equipment has integrated cutting edge monitoring that is versatile and customizable to increase diagnostic confidence. The ventilator has ICU quality ventilation across all patient categories and has low flow and minimal flow anesthesia modes to improve anesthetic delivery and reduce financial impact. Anesthesia equipment using the latest vent technology such as turbo vent ventilation with airway pressure release ventilation (APRV) and volume auto flow which provides protective ventilation therapy in the OR for all patient categories is worthy of the initial investment.
Ashish Dhammam, Soma Technology Dhammam: Recent models have added new ventilation modes and most manufacturers are trying to increase the similarities between their ventilator and anesthesia monitor interfaces. The advancement of low flow technology and savings on anesthetic agent spend have also been a focus. Geddes: Manufacturers continuously introduce technological advances in their equipment which focus both on patient safety and efficiency. The integration to the hospital information system is worthy of the initial investment. Green: The main improvements in anesthesia equipment over the past 10 years have been ventilation modes that were previously only used in ICUs. These include pressure support
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Jumper: Target controlled, low-flow anesthesia systems have been around for a few years now, but these machines can automatically adjust flow and vaporizer settings based on end values preset by the anesthesiologist. Also, new technology for the CO2 absorbers such as the spiralith which is a lithium-based absorber that does not generate the dust that traditional soda lime canisters do. Soda lime dust is a huge issue in maintenance.
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ROUNDTABLE
Q: HOW WILL THOSE CHANGES IMPACT THE ANESTHESIA EQUIPMENT MARKET IN THE FUTURE? Dhammam: Newer ventilation modes, even though not used as extensively in anesthesia settings, can lead to better patient recovery outcomes. There will also be a push for efficacy in integration platforms by purchasing patient monitors, anesthesia monitors and anesthesia machines from the same manufacturer. Diane Geddes, RepairMED Geddes: There’s a huge market in the future especially with aging equipment. Hospitals will be looking to replace the old systems with more reliable and efficient equipment. Green: If an anesthesia provider deems these ventilation modes necessary for patient care, then it could result in the sale of replacement equipment. Feldman: I think that as the technology advances in ventilation and anesthetic delivery we are going to see the market demand more anesthesia equipment that benefits patients across all categories. This equipment will be easier for the provider to use and will have a low consumption of costly anesthetic agents. Setup, self-checks and routine maintenance will be fast and simple. Accessibility to patient data and complete clinical information will be at your fingertips in one compact ergonomic system that ensures a good return on investment. Jumper: As these technologies grow older and more commonplace it will likely become more affordable and more broadly used leading to increased patient safety and faster patient recovery times. Q: HOW CAN A FACILITY WITH A LIMITED BUDGET MEET THE ANESTHESIA EQUIPMENT NEEDS OF TODAY? Dhammam: Refurbished and demo options are the best way to save money without compromising quality or features. Geddes: Third-party vendors will be able to support facilities with limited budgets at significantly lower costs of repair and maintenance. Thomas G. Green, Paragon Service Green: Purchasing refurbished modern anesthesia equipment from a reputable refurbisher is a great alternative.
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Feldman: Start by identifying the types of surgery cases that are performed at your facility. If all you are doing are ortho cases as opposed to everything up to heart cases the need for anesthesia equipment is vastly different. Choose anesthesia equipment that meets the needs of your surgery patient mix but also gives you the best access to the latest technology from an OEM with a solid history of manufacturing anesthesia equipment. Buy only what you need to have safe patient outcomes with a good return on investment with respect to your surgery patient mix. Jumper: Even with budget restrictions a facility can ensure that the patient has a safe and effective anesthetic procedure by ensuring proper maintenance and calibration of the anesthesia equipment and vital signs monitoring equipment. Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR IN AN ANESTHESIA EQUIPMENT PROVIDER? Dhammam: Service and response times, long-term costs, maintenance costs and local support are key. Geddes: Training and knowledgeability of the equipment. Availability of OEM replacement parts is crucial in order to ensure the integrity of each device. Green: Check the refurbisher/service provider’s resume. Are they factory service trained on the device to be purchased/serviced? Do they perform field service to hospitals and surgery centers? Where do they obtain parts? Do they have adequate liability insurance? Will they provide local references? Feldman: A worldwide manufacturer with a long-standing reputation of designing, manufacturing and product support of high-quality anesthesia equipment. What I mean by that is the equipment manufacturer should have a proven history of making equipment that is well designed with a high level of safety and function and does not have numerous safety recalls or lawsuits against it. This equipment should be dependable, long lasting, and have parts, product support, product updates and field service for at least 10 years of service life. There should also be manufacturer training available as well as complete service manuals. Jumper: For me, important attributes for an equipment provider are offering continuous support, equipment that is technician friendly when it comes to repairs and maintenance, and offering training schools to biomedical equipment technicians.
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ROUNDTABLE
Q: IS IT POSSIBLE TO KEEP UP WITH THE LATEST ANESTHESIA EQUIPMENT ADVANCES AND IMPROVEMENTS WITHOUT BUYING BRAND NEW? Dhammam: Absolutely! Demo/refurbished vendors oftentimes carry the latest models. New manufacturers also often have options for floor models when budgets are limited. Geddes: It is only possible if manufacturers will provide upgrade options to equipment at a minimal cost. Pete Feldman, Waukesha Memorial Hospital Feldman: If you purchased a product from reputable manufacturer then you should already have equipment that has the ability of being updated as far as software and vent advances as they become proven and available. Most manufactures will support their product for at least seven years but your top-notch manufacturers will not only support their product for seven years but they will incorporate new advances in the industry in some form into their existing platforms. This should carry your current anesthesia equipment well past the seven year mark making it easier to stay close to the latest technology. Green: Yes. Most anesthesia equipment refurbishers have modern anesthesia equipment models in stock for a great alternative to purchasing new at a savings of 25-35 percent. Jumper: Some add-ons or replacement parts with technological advancements can be purchased to upgrade existing anesthesia equipment such as the spiralith absorbent mentioned earlier or upgraded patient monitoring equipment. These additions can increase effectiveness or patient safety for older equipment. Q: HOW CAN A BIOMED EXTEND THE LIFE OF ANESTHESIA DEVICES? Dhammam: Proper maintenance is a major factor in extending the life of any medical equipment. Good clinical training, with a focus on the proper usage of anesthesia machines, can help reduce staff abuse, wear and tear. Geddes: Biomed technicians should be trained and certified on maintaining these devices. The clinical engineering department should ensure that, at a minimum, the recommended preventive maintenance is strictly implemented. Feldman: A good rule of thumb is to follow the manufacturer’s recommendations for preventive maintenance. Most manufacturers have a list of tests, verifications or calibrations that are to be completed at least every six months. Some manufactures have preventive maintenance kits
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that are to be installed at least once a year. There are also some manufacturers that have no preventive maintenance kits and it is up to the technician to identify and replace valves, gaskets and such as they determine necessary. In any event, following the manufacturer’s recommendations is crucial in keeping your anesthesia equipment running for as long as possible. Jumper: The easiest way to extend the life of the devices is to follow the manufacturer’s recommendations for maintenance and ensure that the clinical staff is also maintaining and using the equipment properly. Offer training to the clinical staff if needed. Q: WHAT ELSE WOULD YOU LIKE TO ADD OR DO YOU THINK IS IMPORTANT FOR BIOMEDS TO KNOW ABOUT ANESTHESIA EQUIPMENT? Dhammam: No matter how daunting a new anesthesia machine model may appear, the principles of repair remain the same. While automation has advanced in an effort to reduce human error, basic troubleshooting is enough to detect and fix common problems, including leaks. By keeping in mind the fundamental aspects across all anesthesia machines, biomeds can apply their current knowledge while also expanding to include the latest technological advancements. Geddes: Training is crucial for the biomed departments that are responsible for working on anesthesia devices. Green: Always check the reputation and background of each company, especially in these days of Internet buying. How long in the medical business? Does the company specialize in anesthesia equipment or just sell everything? What are the owner’s qualifications? Feldman: My rule is to treat anesthesia equipment as if one of your family members was going to be the next person it’s going to be used on. This equipment is life support and as such it needs to be treated with the upmost care. If there is something that is not quite right do not ignore it. Take the equipment out of service and get it repaired correctly! The OR staff may get upset with you but it is your responsibility to keep that equipment working as it was intended to without harming anyone. In the big picture the OR staff will understand it is better to postpone a case rather than have a unintended outcome. Jason Jumper, Baylor Scott & White Health Jumper: Anytime you perform maintenance try to treat it as if you could be the next patient on that machine.
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COVERSTORY
BY K. RICHARD DOUGLAS
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ost large brick and mortar retailers use an inventory system that monitors the stock of items that they sell, and it either reorders automatically or alerts those responsible for restocking. This keeps items on the shelves so that when a customer needs an item, it is available. Unfortunately, it is not so cut and dry with the HTM profession. As the inventory of experienced biomeds and imaging professionals is depleted, the effort to replace them is becoming more of a challenge. In this case, it’s more than just a matter of disappointed customers who can move on to the next retailer. Patients and clinicians are dependent on a fully stocked contingent of HTM professionals in every health care setting. There is little wiggle room. The problem is a matter of timing. The second largest sub-population in America are the baby boomers. They are defined as those people born between 1946 and 1964. In 2011, the first of the baby boomers hit retirement age and the entire 76 million are either retired or approaching retirement. It is estimated that a fifth to a quarter of the entire HTM field will retire in the next 10 years and many already have. This requires a “restocking” of sorts to ascertain that staffing remains at levels that can sustain the demands of every health care system and facility. Adding to the issue is the stealth nature of the HTM profession; a profession that is so “behind the scenes” that most high school students have no idea it exists and most career changers have never heard of it. At the intersection of retiring baby boomers and this obscure profession lies a challenge that needs to be addressed. How will the
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
restocking work? And, just as troubling, how do you replace on-the-job experience? “I believe we are starting to see the effects of an aging workforce in HTM. Many employers are recognizing the gap that is coming and a limited supply of incoming technicians,” says Roger A. Bowles, MS, Ed.D, CBET, professor of Biomedical Equipment Technology at Texas State Technical College in Waco, Texas. “Many people still do not know what a biomedical equipment technician does and we are competing with other higher profile occupations to attract and retain students. This is especially true with high school age students,” he says. Barbara Christe, Ph.D., program director of healthcare engineering technology management and associate professor in the engineering technology department at the Purdue School of Engineering and Technology, Indiana UniversityPurdue University in Indianapolis, adds that the concern is also related to academic expectation. “I believe the profession is facing some hurdles in hiring for today and planning for retirements. Many institutions are not as forward-thinking as they should be; in my opinion. The desperate search for employees has set-aside discussion of academic quality or reputation,” she says.
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“ From one perspective, it is a career field wherein relevant technology is advancing much faster than the skills of the current workforce. Clinical engineering departments are challenged to attract skilled workers from a limited pool of available candidates.” GIOVANNA TAYLOR, MHSA, Director of Continuing Education-Health and Medical at St. Petersburg College
“The demands for academic credentials for some positions, when these requirements were not prevalent in the past, will continue to challenge HTM professionals who see shifts in credential expectations without pathways to achieve them,” Christe adds. Giovanna Taylor, MHSA, director of continuing education-health and medical at Saint Petersburg College in Clearwater, Florida finds an interesting dichotomy in the state of the HTM field today. “From one perspective, it is a career field wherein relevant technology is advancing much faster than the skills of the current workforce. Clinical engineering departments are challenged to attract skilled workers from a limited pool of available candidates. Many hospitals simply ‘steal’ qualified candidates from other employers, thereby creating an endless shifting of the labor pool, but never truly filling the gap,” Taylor says. She points out that providing ongoing training for the current workforce is limited by budgetary constraints and the number of candidates whose motivation and education make them a good investment. “Even in the case where a good candidate for advanced training may exist, obtaining such training makes
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them more valuable in the employment market at large, thereby putting the employer’s investment at risk of flight for higher pay with another company,” Taylor says. “In the fortuitous event the employee is committed to the employer and chooses to stay after receiving advanced training, the employee becomes the only resident ‘expert’ and may not be physically able to meet all of the employer’s needs in servicing that technology. The employer must then rely on the employee’s willingness and ability to share that information with fellow technicians,” Taylor adds. She says that this reality leaves employers in a constant state of crisis as they seek to maintain a workforce that is both sufficient in number, and adequate in the level of training, required to meet the demands of technological advances. “I’m getting calls from hiring managers with companies and hospitals I have never heard of. There does seem to be a big void of qualified candidates, as it appears that many employers are having to throw a much wider net to find suitable candidates,” says John Noblitt, M.A. Ed, CBET, BMET program director at Caldwell Community College in Hudson, North Carolina. Noblitt recalls another recent example that illustrates the state of the
field. He says that an X-ray service company contacted him offering employment opportunities to graduates without imaging experience. They were willing to take on much more training for new hires than in previous years. “Also, I’m receiving calls from health care organizations asking if they could participate in our internship program. However, when these facilities are too far away for the student to drive, they are not in a position to participate at the hospital with entry-level openings. Facilities might have to provide housing and possible paid internships to get these potential hires in their HTM department,” Noblitt says. There are more examples. “A company offered a recent graduate an internship after graduation. This internship was not an offer of permanent employment but was a paid position with no benefits,” he says. “Only a few weeks into the internship the student was offered a permanent position at another hospital and the student took the permanent job. Employers may not have the luxury of evaluating candidates over a longer period of time.” The reality of this state of affairs is affirmed by managers. “Yes I have a technician retiring this Friday. I am seeing a shortage of BMET IIIs
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COVERSTORY
RODNEY NOLEN, Manager of the biomedical engineering department at the University of Minnesota Health
right now. I currently have two open positions that I have no qualified applicants for,” says Rodney Nolen, manager of the biomedical engineering department at University of Minnesota Health. “I am doing nationwide recruiting to fill these positions working with all professional organizations and groups,” he adds. A requirement for seasoned biomeds and a scarce availability is seen in the southwest as well. “At Banner, we are definitely starting to see the baby boomer demographic exit the organization into retirement,” says Perry Kirwan, MSE, CCE, vice president of Technology Management for Banner Health. “The job market for biomed is scarce whether they be experienced technicians or new technicians but for different reasons. The experienced biomed is almost like free agency in athletics,” Kirwan says. “Not only do you have to work hard to attract talent; you have to figure out how to retain talent because these are sought after individuals. For new grads; it’s a slightly different problem because most prospective employees are being trained to be repair humans and not really biomeds.”
RETIREMENTS CREATE CHALLENGES The mass retirement of baby boomers is not a problem relegated to the HTM profession. The departure of this generation from the labor market is being felt everywhere. With roughly 10,000 baby boomers retiring daily through 2030, the exodus of experienced workers is a reality that impacts many industries. That is the year that the last of the baby boomers turn 65, and at that time, 18 percent of the population will be 65 or older. One factor that could blunt this departure rate, to a degree, for HTM and other industries comes out of a study by The Associated Press-NORC Center for Public Affairs Research. The study found that more than half of older Americans plan to work past the traditional retirement age of 65. In the 2017 TechNation State of HTM Survey, extracted from the 375 responses, it was revealed that 15.3 percent of respondents anticipated retiring in 12 to 15 years. More remarkable is that 8.3 percent of respondents reported that they planned to retire in one to three years and 11.5 percent reported plans to retire in four to seven years. That means that a fifth of HTM professionals, in a limited sampling, plans to hang up their test equipment and exit the profession in seven years or less. Another 15 percent expected to retire in eight to 11 years. More than a third of the profession plans to retire over the next decade based on the survey results. The topic of what traits employers are hoping to find in new hires was on the agenda at the 2017 AAMI conference in Austin. “The discussion at AAMI in the employer-educator roundtable was very interesting. In the session entitled ‘The Dream Employee: What are Employers Looking for Today,’ I heard employers characterize a wide variety of skills
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
including hands-on competence: folks who know how to change their own oil and can select the correct size screwdriver on the first try by assessing the screw head size as well as higher level skills like project management and quality assurance,” Christe says. “I believe we are trying to fill a wide variety of positions with graduates from just a few bench-tech training programs. While attending that session, I expressed my surprise that employers hadn’t mentioned that their dream employee had three to five years of experience. That’s the request I hear most; yet this experience (beyond an internship) isn’t something my program can provide,” she adds. FINE TUNING TRAINING Many HTM training programs include advisors who are experienced biomeds and many HTM departments offer internships, which give students hands-on experience. Some employers see the need to be proactive to assure qualified candidates are prepared to work within their departments. “For our entry-level folks; we have had to build an internal training program to supplement what is either de-emphasized, or not taught at all, in the programs that we have in our community,” Kirwan says. “We are also working to put advisors on educational boards to help shape the curriculum so that the programs are teaching/training the students on what they need to know in order to be successful. That too, has risks because competitors let you do the training and then poach your employees by offering them a dollar or two more,” Kirwan adds. “Certainly no easy answers to this one; but we try to stay very engaged with it.” Christe agrees with this approach. She says that debate is abundant as folks consider what is adequate preparation and what is appropriate preparation.
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BARBRA CHRISTE, PH.D, Program director of Healthcare Engineering Technology Management
“I believe most folks would ideally like to hire a graduate of an academic institution who has participated in a clinical internship. However, when no candidates are available with those credentials, employers must still fill the position with someone,” she says. “My contention is that employers must work to improve the number of available graduates available by partnering with academic institutions as other professions have done rather than to give up expectations of academic credentials or quality academic credentials,” Christe adds. Taylor also says that employers can drive the curriculum process. “Clinical engineering departments have the opportunity to influence the training and education of future biomeds by reaching out to educational institutions to bring attention to the need for more advanced training,” she says. “This is the ideal model for creating new educational programs. Too often, academic programs are created by educators who are not actively engaged in the field, or whose experience may be decades old, thus creating educational programs and degrees that do not accurately reflect the current skills needed in the field,” Taylor adds. Noblitt says that fewer training programs and fewer graduates is a double-edged sword. He says that it is
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great for the recent graduate, but it appears to be straining many employers. He says that the program at his college has gone from 30 to 40 students eight years ago to 15 to 25 today. The good thing is that enrollment for the current class is at the top of that range. “So, Caldwell will see about 35 students in the first and second year. Of 25 that will start the program, I only see about half of those students actually graduate and seek employment in the industry,” he says. He has taken a creative approach to helping attract new students through more awareness of the profession. “I have recently begun video interviews with former graduates to highlight their careers and opportunities. Hopefully these interviews can help market the program to perspective students, whether they be career changers or high school graduates,” Noblitt says. This type of recruiting method, that gives a student some sense of what the HTM profession is all about, and why they might want to pursue this career, is one example of what is needed to reach high school students. Christe says that it is this population that is not hearing the siren’s call. “When the economy is good, fewer people attend technical training programs. Workforce retraining money, and career changers who are unemployed, are less common. As a result, many HTM programs report fewer attendees. However, I believe that one of our downfalls may be that HTM academic programs do not attract traditionally aged students – those who come to college directly from high school,” she says. “That population continues to attend college at high rates, just not enrolled in our discipline. Surveys at several institutions, including my own, show that the most common way a
student learns about this major is through someone who is employed in the profession. That word-of-mouth method is not a sustainable recruiting technique, in my opinion, to meet the needs of the workforce,” Christe adds. “I have not reached capacity in my classrooms and wish I could recruit more students. I have tried multiple approaches (as have many other academic institutions) including visiting high school classrooms, attending career fairs, and collaborating with student groups such as HOSA-Future Health Professionals. My efforts have not been particularly successful,” she says. Bowles agrees with this assessment. “Our program has seen a slight downturn in the number of students. We have visited many high schools over the past couple of years but high school recruiting has always been less effective for us than plain ole ‘word of mouth’ advertising,” he says. “The majority of our students — at least the ones who are serious about it — are career changers; some transitioning out of the military, others looking for a stable career after trying others. The average age of our students is about 28 and that has been holding steady. Most of our students came here because someone they know works in HTM or another field in health care and told them about it,” Bowles says. Taylor also points out that there are challenges both with the development of biomed training programs and for students seeking educational funding. “There are several challenges to maintaining a biomed program; the most significant of which is probably hiring qualified faculty. Since the field itself is still relatively unknown, academic institutions have not endeavored to create an academic pathway that supports bachelor’s and master’s degrees in the field. This is significant since the path to accreditation requires
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“ There does seem to be a big void of qualified candidates, as it appears that many employers are having to throw a much wider net to find suitable candidates” JOHN NOBLITT, M.A. ED, CBET, BMET program director at Caldwell Community College
faculty that have the required academic credentials. For a regionally accredited school, that generally means a master’s degree with at least 18 graduate credits in the field (or specified related fields), such as in the case at St. Petersburg College. Finding faculty who have both the academic credentials, and the career experience, is vitally important for the success of the program, and equally as difficult to achieve,” Taylor says. “A related challenge is that programs that lack accreditation may have limited access to federal tuition assistance such as Pell grants and subsidized loans. As a result, students may pay higher tuition costs out of pocket. This further limits the pool of students coming into the program,” she adds. She says that since most schools are challenged to find sufficient numbers of faculty, some schools have over-utilized existing staff, which necessarily limits class size and offerings, resulting in a small number of enrollees and an even smaller number of graduates. All of this can spell impending disaster for a program, as unproductive programs are routinely found on the fiscal “chopping block,” Taylor says. STEPS TO IMPROVE THE NUMBERS Taylor says that employers can help ramp up the pool of candidates by being the squeaky wheel. She says that hiring managers, who have challenges in obtaining a prepared workforce, should make noise and be vocal. “Seek help from local community
colleges and technical schools. Most colleges have continuing education departments. Theses departments are much more flexible and nimble than credit-bearing academic departments and tend to focus on filling the needs of the local workforce. Reach out and ask them for help,” she says. She also suggests that employers may want to send an email to the local community college or technical school president and ask for a meeting to discuss your industry’s needs. “Most will quickly extend a welcoming invitation or extend a connection to the appropriate dean or department head,” Taylor says. “Talk with the local Workforce Board. These tax-funded agencies focus heavily on the local job market and are able to fund training programs through local training entities. They also often have grant funding that may not only provide training, but may even subsidize the training and hiring of new employees,” she adds. Bowles says that more help for training programs could improve things. “Get more skin in the game; provide more scholarships, donate newer equipment (manufacturers could do more here), and be present on campus,” he says. Christe echoes this theme. “Collaborate with academic institutions around you, connecting current HTM educators with nearby programs to offer training in our discipline. Recognize that waiting for
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
qualified applicants for open positions may not produce results – proactive efforts with long-term benefits may be the best way to fill future positions – which I acknowledge is not what hiring managers want to hear,” she says. Christe advocates for scholarships, training programs, apprenticeships and other academic partnerships to help employers “grow” the people they need. Noblitt says that hiring managers may have to look into paid internships or possibly making job offers during internships or before. “I do see hiring managers having to be much more aggressive in their pursuit of the very best candidates coming out of any BMET program,” he says. “I recently had a top candidate graduate and have to decide on three job offers. In 25 years, I can’t remember a graduate with three offers on the table at one time,” Noblitt adds. The solution will require input and active cooperation for all segments of HTM. “Finding qualified applicants is not a simple problem with an easy solution. Our profession needs a multipronged approach that involves forward thinking individuals and collaboration,” Christe says.
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CAREER CENTER
The Value of Professional References
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ven in today’s fast-paced environment where there are great industry websites for networking, like LinkedIn, there is still a high value placed on personal professional references! Be it a new position with another organization or advancement within your current one you need to always ensure that you can present great professional references! The medical equipment service industry is, as we all know, a very niche industry where everyone knows everyone else. So, those professional references can carry lots of weight. Personally, I will not present a candidate to a client until they have been able to furnish those. It always makes me and employers wonder if someone is not able to do so, and how viable they are as a candidate. The only exception is if they have only been with one organization and need to keep his or her interest in a new position confidential. In that case, I suggest coming up with other professional references – preferably from the industry – who may know them but are not with that same organization.
LIST OF REFERENCES VS. REFERENCE LETTERS Should you come to an interview with letters of reference or a list of references? The answer is both. Letters of reference should be provided in addition to, not in lieu of, a reference list. Professional letters of reference from previous employers or supervisors can only enhance your marketability if they are done properly and presented well. Always ask prior to leaving a position if your manager/ supervisor will write a letter of reference. Letters should always be specifically written for you and presented on a company’s letterhead. NOTE: An employer can usually tell immediately when a candidate has written his or her own letter and requested that a supervisor or employer just sign it. Lastly, keep the original letters and copies in a business portfolio to present at the in-person interview stage. LIST OF REFERENCES First of all, when providing a reference list in person, it should be on the same color/quality paper as your resume and cover letter to maintain a professional
JENIFER BROWN CEO and Founder of Health Tech Talent Management
look. The reference sheet should also have the same heading and fonts as your resume with your name, address, telephone numbers and email address. You should always provide at least three professional references. Prospective employers feel that they have checked you out satisfactorily if you have at least three. Those should be previous employers or managers/supervisors that you actually worked under, preferably in a related medical industry position. However, clients can also be a great reference especially if you worked for an
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ISO or third-party organization. Make sure you ask your references for permission to use them before you hand out your reference list and, most importantly, make sure that they will be a reference. I have seen it happen several times where a candidate had down a reference who did not give stellar feedback on that candidate. If you have a military background, try to use a military reference. It will carry a lot of weight, especially if you are new in the field! Many companies have formal reference forms, so complete addresses are important. LIST OF REFERENCES LAYOUT The proper layout of each of the three professional references should be: Name: John Doe Title: Technical Director Company/Hospital Name: General Hospital Full Address: 1000 Main Street City, State, Zip: Microsoft, MO 00001 Work and/or Cell Phone Numbers: 000.333.4444 Email Address: John.Doe@HospitalExample.com
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EXPERT ADVICE
BY JUAN JIMENEZ
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he user interface (UI) is one of the most critical components of an ultrasound machine and typically includes a touch panel with multiple buttons, TGC slide potentiometer and encoders. The UI is one of the most common parts to fail on an ultrasound system typically due to wear and tear of the mechanical encoders, tactile switches and/or elastomer membranes.
JUAN JIMENEZ Medical Equipment Technician Conquest Imaging
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The UI or control panel is the gateway for interaction between the sonographer and the ultrasound system. If the control panel is not working, the system will not be fully functional for the user. It is critical to make sure that the UI is working to maximize uptime. I recommend a thorough visual inspection of the user interface looking for cracks in the bezel, missing knobs or any gel on the UI when performing a system preventive maintenance. Look for anything that might affect its performance. The basic functionality of the control panel can be tested to ensure it is working correctly. This can typically be done through diagnostics – if you have access. The control panel can also be tested in imaging by pressing the buttons and turning the encoders to ensure they respond. If it is determined that the user interface is defective, I recommend that it be replaced with a compatible replacement which can be found by looking in the ultrasound field service manual. There is typically a sticker on the back of the user interface itself. It is important to ensure the compatibility of the replacement part by verifying it with the service manual.
“If the control panel is not working, the system will not be fully functional for the user. It is critical to make sure that the UI is working to maximize uptime. ”
At Conquest Imaging we have all makes and models of user interfaces; we refurbish user interfaces to manufacturer’s specification and can help you locate a compatible replacement. For free technical support and parts identification, feel free to give us a call at 866-900-9404 or visit us at www.conquestimaging. com for LiveChat. Juan Jimenez is a medical equipment technician who has been with Conquest Imaging for more than a decade.
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EXPERT ADVICE
BY JOHN NOBLITT
THE FUTURE
Tips for Career Advancement
A
s an educator in the HTM field, I often get questions from either recent graduates or people who have just started their careers about how they may be able to advance. My standard answer is you must participate. You must participate in the organization that employed you, and you should participate in your state, local or, possibly, national biomedical association. Last, but not least, you must also show that you want to advance and a great way to do that is to become certified.
JOHN NOBLITT, M.A.ED., CBET
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Whether you work for a local hospital, an OEM or a third-party service provider you need to participate in that organization. You must show leadership qualities. A great way to do that is to participate not only in the day-to-day job duties but also in extra activities that may be going on in your organization. Being involved in organizational activities such as a fundraiser for a local charity or any other type of community involvement can be most beneficial to career advancement. Most organizations have several opportunities for employees to be involved in extracurricular activities. Not only are you putting your efforts into a worthwhile cause, but also you are creating a bigger network of people who you can learn and grow from. Often, new employees will not get a chance to show their complete skill set while performing their entry-level job duties. Sometimes it can take years to have the opportunity to show your employer you have the skills needed to advance. Volunteering to participate in these opportunities allows you to show and sharpen the skills you have which can be utilized by the organization, and by you to advance your career. Stay in tune to what is happening in your organization and find something you are interested in that you can participate in to advance your career and possibly help a worthy cause. Another great way to advance your career is to participate in a HTM organization. If you do not have an organization close to you, maybe you should think about starting one. Personally, I have been very fortunate to be involved with the North Carolina
Biomedical Association. This organization has been very active over the years. I have enjoyed participating and learning from many other professionals in the career field. Again, participating in an organization such as the NCBA will allow you to expand your network of contacts in the career field. I have had the pleasure of meeting and working with many different people over the years such as Glenn Scales, Pat Lynch, Binseng Wang, Greg Johnson, Boyd Campbell and many others. Each of these industry leaders has taught me something that is useful in my career. By participating in such an organization, you can hone different skills that are useful to advance your career. Several skills that come to mind that I have honed over the years with my participation would be financial matters by being the treasurer in the organization. Sharpening my communication skills by writing for the newsletter and other leadership skills such as team building by serving as vice president or president. All the skills needed to advance the organization you participate with is considered a transferable skills. The skills it takes to advance a volunteer organization are often the same skills it takes to advance the organization where you are employed. All organizations are looking for future leaders and volunteer organizations may give you the opportunity to sharpen your leadership skills before your employer might. So, this is always a great way to advance your career and prepare for the future. A third way that may help you advance your career is to become certified. Whether you seek CBET,
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Looking for Parts? CRES, CLES, CHTM or any other credential shows a willingness to further your knowledge of the career field. Becoming certified does not necessarily make you the very best technician, but it does show your willingness to learn more and a desire to advance within your career. Often people will tell me there is no incentive to become certified. To that statement, I always tell them they are correct if they want to stay in the same job for the rest of their career. Many employers do not give incentives for different credentials such as CBET certification. However, many organizations do either give incentives to become certified or prefer employees who are certified because that certification tells the organization that you have a solid foundation and working knowledge of the career field. I advise people all the time that if they are happy with the job they have and want to stay in that job their entire career, certification is not necessary. However, if you think you may want to advance, even if your current employer gives no incentive for certification, the next advancement in your career may require PROOF APPROVED CHANGES NEEDED certification. So,SIGN–OFF: to recap, remember to participate. Participate in a professional CLIENT organization to grow your skills and your network. Participate in career organizations well. This alsoTHAT allows you to acquire new skills and expand PLEASEasCONFIRM THE FOLLOWING ARE CORRECT your network of resources to advance your career. Become certified in a LOGO PHONE NUMBER WEBSITE ADDRESS specialty such as CBET, etc. as this shows your willingness to further your education and your commitment to your career field.
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SEPTEMBER 2017
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EXPERT ADVICE
BY ALAN MORETTI
THOUGHT LEADER
How Do You See the Elephant in the Room?
O
f all the things we do as HTM professionals, talking is among the most visible and certainly among the most influential. Think about it. You don’t add your greatest value by virtue of your skill in navigating software, troubleshooting an equipment service event or turning wrenches. You add your greatest value by interacting with your HTM colleagues, clinical users (i.e. your customers!) and all the others you come in contact with primarily by communication either verbally or via written methods such as email, texting, social media and all the other new day technologies.
ALAN MORETTI Healthcare Technology Management Advisor
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It’s amazing how many books have been written on the subject of communicating. While most of them contribute to the discussion, their essence can be summed up simply as “We are most effective when we speak verbally so other people will listen and when we listen so other people can talk.” Because it requires honesty and clarity; true dialogue can sometimes be uncomfortable. And because people like to avoid discomfort, it’s tempting to allow some topics to remain unaddressed – sort of like leaving a splinter in your finger even though logic tells you the temporary pain of digging it out is not nearly as bad as the likely infection from leaving it in. All of us have been in situations where there’s a relevant issue that nobody seems willing to talk about. How many times have you thought: “There’s an elephant in this room, and I sure wish someone would deal with it – just not me.” OK, to domesticate and tame this elephant – the “undiscussable” – one must first acknowledge its existence and the positive and negative impact that it brings. A natural consequence of “undiscussables” is that fresh viewpoints can get deflected or pushed aside. These hurdles can seem unsurmountable by those wanting to ignore the “elephant in the room” so as
not to be ostracized by the individuals who are afraid of dealing with the clear issue(s) that exist. That’s contrary to the whole purpose of an “open and free to express” dialogue environment. It is truly a dangerous position for any organization interested in promoting and empowering staff and service excellence values. HTM professionals need to recognize and understand the difference between “implicit and explicit” communication. The “elephant,” an undiscussable subject is “implicit” and framed around it being undeclared – denial if you will. People talk about the “elephant” without acknowledging that it’s in the room and affecting everything that’s going on. It is when the elephant’s presence is made explicit – recognizable and obvious that true dialogue comes out in order to “tame this animal.” As HTM professionals, we need to seek out the “elephants in the room.” Yes, in this effort there may be hesitation in speaking up to avoid being ostracized or being viewed as “not a team player.” An individual’s private apprehension at being regarded as different can be a challenging pathway for many – let your ethical conscience guide you and I wish you safe travels!
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EXPERT ADVICE
BY GEORGE HAMPTON
TECH KNOWLEDGE
Suspending Disbelief in HTM: Looking Beyond a Traditional Point of View
“A
rticulate, intelligent individuals can skillfully construct a convincing case to argue almost any point of view. This critical, reactive use of intelligence narrows our vision. In contrast, projective thinking is expansive, ‘open-ended’ and speculative, requiring the thinker to create the context, concepts, and the objectives” - Linda Stone. Feb 6, 2011.
I couldn’t agree with Linda Stone more on this matter. I would only add that in the clinical technology world we apply a lot of historical perspective to dig into our philosophical foxholes. We often make the mistake of failing to carefully observe the new trends and requirements in our industry and step towards necessary changes to address these objectives. While our hard-earned lessons can be a great platform for continual success, they can also be a millstone around our neck if we don’t know how to let go when necessary. I’m sure all of us in healthcare technology leadership positions want to be ready for all the changes headed our way, but I would be a liar if I didn’t admit that I have seen many of us looking backwards more than forward. When I struggle to leave my traditional point of view, I often find myself analyzing the potential pitfalls of such a move by looking back on what worked for me in the past. The following concept is in no way original. Just do a web search on “suspending disbelief” and you may be amazed at what you will find. When I was writing a reflection for a meeting a few years ago, I wanted to write something that would get my team to consider a very important idea: “Consider that there’s a possibility that we should be changing everything we are currently doing.” I stumbled upon Linda Stone while doing that research. The term “suspending disbelief” sounded odd at first. It’s a more elegant way to say “stop not believing,” which doesn’t sound very
62
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GEORGE HAMPTON President of Tech Knowledge Associates
intellectual. But in fact, it is very practical. When I’ve wanted to move my team to a new place mentally, I’ve had to fight against the fact that where they are now was also established by an intellectual process. We have developed procedures based on our beliefs and goals at the time. I have worked with many biomed programs over the years. They all are very similar, and that’s because we all have the same basic mission; repair and maintenance of medical equipment. We have worked with the same regulatory requirements for many years, so our methods conformed to that environment. With that said, I truly believe we are looking at a future that is markedly different than what we have experienced in the past 20 years. I see sweeping changes in the way we do preventive maintenance, driven by the new CMS regulations. The AEM program directives have been a huge
concern for our group. I have three talented young leaders working hard to build our program to address all those concerns in a way that honors our lean workforce directives. You may have had a chance to hear them speak at one of our industry conferences. I also see an environment where capital dollars are going to be very sparse. We will be forced to view the whole replacement process in a different way. We might have to stop believing that an end-of-life notification from the manufacturer is the absolute trigger for capital replacement. We will likely be extending the life of many items well past the EOL notifications. ISO parts providers will be in greater demand. Scavenging from de-installed systems will be more common. Some of you might find this idea very distasteful; some are already experts in this practice. Less common, but more disturbing, is the belief that high-end imaging equipment can’t be effectively serviced by “in-house” or non-OEM service people. I have worked with institutions ranging from small rural hospitals to large academic medical centers, which have all their imaging equipment on full service agreements with the manufacturers. During my post analysis debriefings, I have had directors of radiology stare at me in absolute disbelief when I recommend training their current technicians and transferring the service responsibilities for their X-ray rooms, cath labs, CTs, even MRIs to their in-house program. They just can’t believe it’s possible. The millions of
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EXPERT ADVICE
Intuitive
dollars in savings, however, is a great motivator. While it’s intimidating to be at odds philosophically with someone as important as the director of radiology, it’s really most disappointing when the director of the clinical technology program doesn’t believe his folks can do this work. Too often the clinical technology program is relegated to preventative maintenance and minor repairs. They are the ones who make phone calls when something breaks. I find this very sad because I know how great it is to work in a shop that does everything. The comradery that can develop in a full-service biomed shop is very satisfying for a technician. Our industry is moving into a very challenging future. We will need to be agile if we are going to remain relevant and meet our new performance requirements. Why not sit down with your techs and brainstorm ways to do address the demands of your team? Give your technicians permission to suspend the beliefs that have shaped your services over the years. I am a great believer in shaping your future as opposed to letting it shape you.
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MANNY ROMAN, CRES
ROMAN REVIEW 90 Seconds
I
was doing some research about emotions for a presentation when I ran into something very interesting. Apparently our brain will maintain a particular emotional focus for 90 seconds and then move on. This concept was described by Brain Researcher Jill Bolte Taylor.
She proposes that an emotion will last for only 90 seconds as a physiological response unless we somehow choose to maintain that emotion. If we do nothing but wait, the emotion will disappear. In other words, we are in control of how we respond to an emotion. We can choose to ignore the negative ones and they will simply disappear within 90 seconds along with the chemical component that it generates. We can lead a more calm and serene life by allowing unwanted emotions to dissipate and disappear rather than focus on them and continue the emotion. This concept started me thinking about how, when we communicate, we are generating and eliciting emotions from others. We cannot conduct a true conversation if people are not emotionally involved. Therefore, if we apply the 90 second concept to all emotions, we will lose people if we don’t get them to engage in the emotion. We will also lose people if
we stay on one point too long without retriggering the emotion. If we do not maintain the focus of the conversation by changing something in the presentation to retrigger the focus, the emotion and the person moves on. We have all experienced this. When I conduct presentations, I sometimes see the eyes and faces of some audience members go blank, especially if I speak on a particular point for too long. As I am interpreting the 90 second thing, I am assuming that the individual is captivated in one point with no retriggering. If the conversation is not kept moving along from point to point smoothly and frequently, the audience is going to move on. There are other ways that will cause people to move on however. Sometimes the blank face is caused by something I said or did that brings up a memory and poof, they move on. This is the biggest issue presenters face. Even if the presentation is fast, varied, relatively interesting and presented well using verbal and nonverbal skills, audience members will move on when memories are triggered. This now requires us to be perceptive enough to know when we lose the audience and find a way to bring them back. It is my experience that the best way to retrigger people is to focus clearly on conveying more of the message nonverbally and with intonation than
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
MANNY ROMAN, CRES AMSP Business Operation Manager
with the actual words. The nonverbal body language carries 55 percent of the message, the intonation (how you say the words) carries 38 percent leaving only 7 percent for the actual words. By constantly using voice variations and body language to convey the message, you will be causing the audience to change focus often enough to keep the retriggering process in place. If you observe the nonverbal actions of your audience, especially if it is one individual, you will begin to detect the blank face and take actions to bring them back. If they slowly begin to point their feet towards the door, the conversation is done. They have moved on mentally and wish to do so physically. So, move on to your next victim.
SEPTEMBER 2017
TECHNATION
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Become Hacker Resistant
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See how a ransomware attack might occur in your facility and what to do if you’ve been attacked. ecri.org/ransomattack
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DID YOU KNOW? Science Matters Right brain: Visual perception? Left brain: Language and logic?
Creative people’s well-connected brains
Self-help books preach that the key to creativity lies in the brain’s right side, but a new study suggests it's communication within the brain that sets highly creative people apart.
Links between the hemispheres
These linkages between the brain’s halves appeared in creative people
Top view of brain
1 Brains of people
studied, ages 22 to 61, were scanned with MRI that traces communications between nerve cells
2 The scans
Left hemisphere
(giant data files, 1 gigabyte each) were translated into 3-D maps – wiring diagrams of the brain
3 People studied were
tested for their creativity in problem-solving
4 They were also asked
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Right hemisphere
Study examined 68 brain regions that connect through the brain’s inner “white matter”
Significantly fewer linkages
were found in the brains of the least creative 15% of people examined
The ‘right-brain’ myth These results contradict the common belief that creativity is centered in the right hemisphere Non-verbal perception, yes; creativity, not really Source: Rex Jung of University of New Mexico, TNS Photos Graphic: Helen Lee McComas, Tribune News Service
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BREAKROOM
BULLETIN BOARD
A
n online resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.
Career Opportunities MedWrench Heads Charity Bowling Team! Position Title:
Electronics Repair Technician I
FLSA Status:
Full-Time, Non-Exempt
Reports to: Parts Department Manager
Department: Parts
Description:
Tim Nagel and friends participated in the annual “Bowl for Kids Sake,” a BBBS fundraiser. They were asked to come up with a theme and costume for the event. This is where MedWrench comes in. MedWrench was happy to donate a few shirts to be worn during the event. Read the Q&A with Tim Nagel and more here:
The electronics repair technician is responsible for troubleshooting and repairing electronic components of medical ultrasound parts. Repairs performed are to be completed through documented repair methods and under ISO 13485 and 9001 compliance. Adherence to these requirements is a demand not only for Summit Imaging’s commitment to quality, but primarily for the high level of patient safety that our customers expect from us.
Link to Apply: www.mysummitimaging.com/join-our-team
www.medwrench.com/bulletin-board/
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Visit www.MedWrench.c om/BulletinBoard for m ore details and to register for these upcoming classes .
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INDEX
SERVICE INDEX TRAINING
SERVICE
PARTS
Analyzers
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
Computed Tomography
IMT Medical 181-750-6699 • www.imtmedical.com
25
Anesthesia
Injector Support and Service 888-667-1062 • www.injectorsupport.com
57
P
JDIS Group 800-974-9729 • www.jdis.com
64
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
59
P P
A.M. Bickford 800-795-3062 • www.ambickford.com
6
Drager Medical Systems 215-721-5404 • www.draeger.com
61
Philips 800-229-6417 • www.philips.com/mvs
39
P P
Paragon Service 800-448-0815 • www.paragonservice.com
45
RSTI 800-229-7784 • www.rsti-training.com
78
P P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
31
RTI Electronics 800-222-7537 • www.rtigroup.com
37
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P P P
The Intuutuve Biomedical Solution Inc 1-866-499-3966 • www.tibscorp.com
63
P P
68
P P P P P
P
P P
Biomedical BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
BC
Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com
52
P P
iMed Biomedical 817-378-4613 • www.imedbiomedical.com
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
63
P
Contrast Media Injectors
Medisurg 855-233-4050 • www.medisurg.com
27
P P P
Injector Support and Service 888-667-1062 • www.injectorsupport.com
57
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
77
P P
37
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
70
Maull Biomedical Training 440-724-7511 • www. maullbiomedicaltraining.com
Diagnostic Imaging
C-Arm Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P
P
Calibration Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
3
Cardiology Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
52
P P
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
7
P P
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
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33
P P
JDIS Group 800-974-9729 • www.jdis.com
64
P P
Cadmet 800-543-7282 • www.cadmet.com
57
P
Healthmark Industries 800-521-6224 • HMARK.COM
53
J2S Medical 844-342-5527 • www.j2smedical.com
44
P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
77
P P
59
P P
Endoscopy
Hand Switches inRayParts.com 417-597-4702 • www.minxrad.com
Cardiovascular Technical Prospects 877-604-6583 • www.technicalprospects.com
P
P
Infection Control
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INDEX TRAINING
SERVICE
Drager Medical Systems 215-721-5404 • www.draeger.com
AIV 888-656-0755 • aiv-inc.com
44
P P
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
61
Nuclear Medicine Global Medical Imaging 800-958-9986 • www.gmi3.com
2
P P
Online Resource
Infusion Therapy AIV 888-656-0755 • aiv-inc.com
44
P P
FOBI 888-231-3624 • www.FOBI.us
67
P P
J2S Medical 844-342-5527 • www.j2smedical.com
44
P P
Select BioMedical 866-559-3500 • www.selectpos.com
4
P
31
P P
Mammography Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
RSTI 800-229-7784 • www.rsti-training.com
78
P P P
Monitors Drager Medical Systems 215-721-5404 • www.draeger.com
PARTS
Neonatal
53
Infusion Pumps
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
Healthmark Industries 800-521-6224 • HMARK.COM
AD PAGE
Company Info
61
Select BioMedical 866-559-3500 • www.selectpos.com
4
P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
54
P P
Monitors/CRTs Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com
IBC
P
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
31
P P
MRI
J2S Medical 844-342-5527 • www.j2smedical.com
44
Oxygen Blender FOBI 888-231-3624 • www.FOBI.us
67
P P
AIV 888-656-0755 • aiv-inc.com
44
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
BETA Biomed Services 800-315-7551 • www.betabiomed.com/
27
P P
Bio-Medical Equipment Services Co. 888-828-2637 • www.bmesco.com
IBC
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
J2S Medical 844-342-5527 • www.j2smedical.com
44
P P
8
P P
Philips 800-229-6417 • www.philips.com/mvs
39
P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
77
P P
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
52
P P
7
P P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
54
P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
31
P P
27
P P P
59
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Patient Monitoring
Pacific Medical 800-449-5328 www.pacificmedicalsupply.com
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
Phaco Vitrectomy
JDIS Group 800-974-9729 • www.jdis.com
64
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
59
P P
Philips 800-229-6417 • www.philips.com/mvs
39
P P
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Medisurg 855-233-4050 • www.medisurg.com
Portable X-ray inRayParts.com 417-597-4702 • www.minxrad.com
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INDEX TRAINING
Interpower 800-662-2290 • www.interpower.com
31
SERVICE
Power System Components
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
PARTS
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Company Info
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TRAINING
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SERVICE
AD PAGE
Technical Prospects 877-604-6583 • www.technicalprospects.com
PARTS
Company Info
P P
Test Equipment 20
A.M. Bickford 800-795-3062 • www.ambickford.com
P
Radiology
6
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
BC
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
IMT Medical 181-750-6699 • www.imtmedical.com
25
RSTI 800-229-7784 • www.rsti-training.com
78
P P P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
77
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P P P
Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com
5
The Intuutuve Biomedical Solution Inc 1-866-499-3966 • www.tibscorp.com
63
P P
Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
3
Recruiting
RTI Electronics 800-222-7537 • www.rtigroup.com
37 52
Aramark Healthcare Technologies www.aramark.com/careers
33
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
70
Training
Replacment Parts
ECRI Institute 1-610-825-6000. • www.ecri.org
66
P P P P
P P P
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
34
P
78
Technical Prospects 877-604-6583 • www.technicalprospects.com
RSTI 800-229-7784 • www.rsti-training.com
33
P
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P
Respiratory A.M. Bickford 800-795-3062 • www.ambickford.com
6
P
FOBI 888-231-3624 • www.FOBI.us
67
P P
J2S Medical 844-342-5527 • www.j2smedical.com
44
Tubes/Bulbs
Surgical 53
Telemetry AIV 888-656-0755 • aiv-inc.com
44
P P
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
14
P P
J2S Medical 844-342-5527 • www.j2smedical.com
44
Pacific Medical 800-449-5328 •pacificmedicalsupply.com
8
P
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
7
P P
54
P P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
TECHNATION
57
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
Conquest Imaging 866-900-9404 • www.conquestimaging.com
11
P P P
2
P P
Ultrasound
Healthmark Industries 800-521-6224 • HMARK.COM
76
Cadmet 800-543-7282 • www.cadmet.com
AUGUST 2017 SEPTEMBER 2017
Global Medical Imaging 800-958-9986 • www.gmi3.com J2S Medical 844-342-5527 • www.j2smedical.com
44
Philips 800-229-6417 • www.philips.com/mvs
39
P P
Ventilators Drager Medical Systems 215-721-5404 • www.draeger.com
61
WWW.1TECHNATION.COM
INDEX TRAINING
SERVICE
PARTS
AD PAGE
Company Info
A national leader in the sale of new, used, and refurbished medical equipment.
X-Ray Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
34
P
Philips 800-229-6417 • www.philips.com/mvs
39
P P
RSTI 800-229-7784 • www.rsti-training.com
78
P P P
RTI Electronics 800-222-7537 • www.rtigroup.com
37
Technical Prospects 877-604-6583 • www.technicalprospects.com
33
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P P
Become More Profitable With PRN
P
ALPHEBETICAL INDEX BC Group International, Inc………… BC
Anesthesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremit Feeding Pump • General Medicine • IV Pump • Laboratory • Lymphedema Pump laneous • Monitor • Nutrition Pump • OB/GYN • Ophthalmology • OR/Surgery • Ou • Pediatric Respiratory • Supplies • Therapy • Ultrasound • Vascular • Gas Regula thesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pump Pump • General Medicine • IV Pump • Laboratory • Lymphedema Pump • Misce JDIS Group…………………………… Monitor • 64 Nutrition Pump • OB/GYN • Ophthalmology • OR/Surgery • Out the Door Our equipment Respiratory • Supplies • Therapy • Ultrasound • Vascular • Gas Regulator • Anesthe KEI Med Parts………………………… Stretchers 59 • Cardiology • Endoscopy • Exam Room Extremity Pump • Feeding Pu is tested and •serviced eral Medicine • IV Pump • Laboratory • Lymphedema Pump in-house so that we• Miscellaneous • Mon Maull Biomedical Training…………… 37 tion Pump • OB/GYN • Ophthalmology • OR/Surgery • Out the Door • Pediatric Re can guarantee its Supplies • Therapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • Beds/S Medisurg……………………………… integrity. Cardiology27 • Endoscopy • Exam Room • Extremity Pump • Feeding Pump • Genera • IV Pump • Laboratory • Lymphedema Pump • Miscellaneous • Monitor • Nutritio Pacific Medical ………………………… OB/GYN • 8 Ophthalmology • OR/Surgery • Out the Door • Pediatric Respiratory • S
BETA Biomed Services………………
27
Paragon Service………………………
45
Bio-Medical Equipment Services Co.… IBC
Philips…………………………………
39
Cadmet………………………………
57
PRN/ Physician's Resource Network… 77
Conquest Imaging……………………
11
Pronk Technologies, Inc. ……………… 5
Crothall Healthcare Technology Solutions…52
Rigel Medical, Seaward Group………… 3
Drager Medical Systems………………
61
RSTI……………………………………
78
ECRI Institute…………………………
66
RTI Electronics………………………
37
Elite Biomedical Solutions……………
14
Select BioMedical……………………… 4
Engineering Services, KCS Inc………
34
Sodexo CTM…………………………
70
FOBI…………………………………
67
Southeastern Biomedical, Inc………
52
A.M. Bickford…………………………… 6 AIV……………………………………
44
Ampronix, Inc.…………………………
15
Aramark Healthcare Technologies…
33
Global Medical Imaging………………… 2
Therapy • Ultrasound • Vascular • Gas Regulator • Anesthesia • Beds/Stretchers • Cardiology • Endoscopy • Exam Room • Extremity Pump • Feed
Healthmark Industries………………
53
Southwestern Biomedical Electronics, Inc.…………… 7
iMed Biomedical………………………
63
Technical Prospects…………………
33
IMT Medical…………………………
25
Tenacore Holdings, Inc………………
54
Injector Support and Service…………
57
The Intuutuve Biomedical Solution Inc… 63
inRayParts.com………………………
59
Tri-Imaging Solutions…………………
68
Interpower……………………………
20
USOC Bio-Medical Services…………
31
J2S Medical…………………………
44
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Physician’s Resource Network
AUTHORIZED NORTHEAST DISTRIBUTER OF
1.800.284.0967 www.PRNwebsite.com
SEPTEMBER AUGUST 2017
TECHNATION
77
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We Know Telemetry Inside and Out...
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at
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Display Up to 18 Parameters Shown with optional accessories
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