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ICE FEATURES
September/October 2017
Better in-house technical training can also build morale. It shows staff that management believes in their capabilities, and supports cohesion in a teamcentered approach to care.
36 Coach ‘Em Up
20 Professional
For professionals who want to advance their technical skills
Lewis Free became an imag-
in the medical imaging space, professional certifications are
ing service professional by
provided by a handful of individual organizations, special-
following the advice of a
ized training schools or from OEMs. However, other training
mentor. He has excelled in
and educational opportunities do exist.
his role and continues to have a successful career
About The Cover Photo Photo provided by the Radiological Service Training Institute(RSTI). RSTI offers educational programs focused on the repair and maintenance of today’s high tech diagnostic imaging systems. RSTI’s training center is equipped with over 45 fully functional imaging systems.
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that he believes is in part powered by his positive outlook on life.
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ICE DEPARTMENTS
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16 ICE Conference
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18 People on the Move
44 Imaging Service 101 47 Bridging the Gap
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ICE Magazine (Vol. 1, Issue #4) September/October 2017 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. For subscription information visit www.imagingigloo.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2017
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ADVANCING THE IMAGING PROFESSIONAL
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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY
Conquest Imaging Offers Free Probe Evaluations, Transparent Pricing Conquest Imaging has launched “SIMPLIFY – a Better Probe Repair Program,” according to a news release. 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 President 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.” 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.
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Acertara R&D Team Receives U.S. Patent for Ultrasound Probe Tester
Because Quality Matters.
SIMPLIFY adheres to Conquest’s Quality Assurance 360 standards, offering a sixmonth 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 repair, including exchange pricing. Conquest Imaging’s free probe evaluation is offered with no obligation. SIMPLIFY Program Options: • 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. • 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. • For more information, visit www.conquestimaging.com.
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
Acertara, an independent ISO/IEC 17025:2005 accredited medical ultrasound acoustic measurement, testing, and calibration laboratory, and ISO13485:2003 certified probe repair and new product development facility, has announced that its research and development team has been awarded United States patent #9,696,356 for a device and method of testing ultrasound probes. “This patent represents the 25th patent our team has been awarded relative to diagnostic ultrasound system and probe testing devices,” Acertara President and CEO G. Wayne Moore said. “Our engineering team first developed the modern ultrasound probe testing paradigm more than 17 years ago when we introduced FirstCall at Sonora Medical Systems. Continuing that legacy at Acertara has led to the development of several important new probe testing devices including Aureon and ATLAS which have continued to pave the way for our advanced probe repair capabilities.” The research and development team at Acertara Acoustic Laboratories has been awarded more than 45 United States and international patents ranging from 3D ultrasound products to devices that deliver super-saturated levels of oxygen to myocardial tissue of heart attack patients. • ADVANCING THE IMAGING PROFESSIONAL
news
FDA Clears MAGNETOM Vida 3T MRI System The Food and Drug Administration (FDA) has cleared the MAGNETOM Vida 3 Tesla (3T) magnetic resonance imaging (MRI) scanner from Siemens Healthineers, which features new BioMatrix technology that addresses inherent anatomical and physiological differences among patients, as well as user variability. By reducing this variability among patients and users, the scanner’s BioMatrix technology can lower the number of rescans and increase productivity to improve MRI’s cost efficiency. The MAGNETOM Vida with BioMatrix technology helps health care providers perform a full range of routine and complex examinations while delivering robust results for each patient. BioMatrix Sensors built into the scanner’s new patient table automatically track respiratory patterns as soon as the patient lies on the table, providing information that can help formulate the optimal exam strategy. In addition to helping users avoid costly rescans, BioMatrix Tuners improve the quality and reproducibility of whole-spine diffusion imaging via individual slice adjustments that mitigate distortion that otherwise may occur, especially at 3T. Biomatrix Interfaces
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help ensure consistently high exam quality, accelerating scanning by up to 30 percent and improving patient care. The scanner’s intuitive user interface permits correct one-touch positioning of the patient table based on intelligent body models. The patient table provides motorized assistance, enabling users to move patients who can be difficult to move (i.e. immobile, trauma, and extremely heavy patients) to and from the scanner. The new system architecture of the MAGNETOM Vida offers extremely high performance and long-term stability without the need for additional space. The scanner’s 60/200 XT gradient system offers the most powerful commercially available gradients in a 70-cm bore scanner. The 55x55x50 cm field of view enables coverage of larger body regions in one step. The GO technologies of the MAGNETOM Vida automate and simplify workflows from the start of the scan through quality control of the image data. The result is increased productivity for routine examinations of the brain, spine, and joints – from touch-of-a-button patient positioning to the transfer of clinical im-
ages to the picture archiving and communication system (PACS). The system’s new user interface not only enables automated image acquisition and processing, but also allows advanced post-processing applications to run at the scanner. The MAGNETOM Vida also includes the company’s Compressed Sensing Cardiac Cine clinical application, which can accelerate MRI scans by a factor of 10 to allow free-breathing cardiac MRI examinations. The MAGNETOM Vida offers a new generation of ultra-high-density Biomatrix coils with a patient adaptive design that enables increased accuracy, flexibility, and speed. The BioMatrix Spine coils acquire and display patient respiratory data without requiring user interaction. The Biomatrix Head and Neck coils possess CoilShim technology to ensure reproducible image quality in every patient. For orthopedic applications, the new Shoulder Shape and Tx/Rx Knee coils possess an anthropomorphic design that permits greater flexibility to accommodate large patients. And for multipurpose imaging, the UltraFlex Large and Small coils combine ultra-high coil element density and high flexibility. •
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news
RAYENCE INC. CONFIRMS DISTRIBUTION AGREEMENT Rayence has announced that a distribution agreement has been reached with X-CEL-X-RAY Corp. to sell this manufacturer’s line of HF X-ray equipment, further solidifying Rayence’s position in the podiatry market space. Rayence’s own DR Podiatry solutions – the 1210SGA flat panel detector and XmaruView V1 Podiatry acquisition software – perfectly compliment X-CEL X-ray products. This syzygy of digital flat panel detector and X-ray technology will satisfy the daily diagnostic needs of every podiatrist. In addition to complimenting each other’s products, both companies share a deep commitment to providing total customer service and support along with DR imaging technology and X-ray equipment. •
SIGNA Premier 510(k) Cleared by the US FDA GE Healthcare has announced SIGNA Premier, a new wide bore 3.0T magnetic resonance imaging (MRI) system, is now available for sale in the U.S. SIGNA Premier is the result of a fouryear collaboration with the National Football League (NFL) and research institutions around the world working to design new imaging tools, particularly to aid researchers in the detection of biomarkers for the potential diagnosis of mild Traumatic Brain Injury. SIGNA Premier delivers a new level of clinical performance with additional research-focused capabilities, especially for neurology and oncology research. “We are thrilled to bring SIGNA Premier to clinicians,” said Eric Stahre, president and CEO of GE Healthcare MRI. “We believe that its advanced applications and breakthrough innovations will deliver research-focused clinical capabilities and wide-bore patient comfort. This new system will help clinicians push the boundaries of what’s possible with MR.” SIGNA Premier features GE Healthcare’s latest, short-bore, high-homogeneity 3.0T superconductive magnet; the most powerful gradient system GE Healthcare has ever developed for a wide bore 3.0T system; and a new, digital RF transmit and receive architecture. Clinical and research applications benefit from this high-performance hardware as well as machine learning software that includes cloud analytics. SIGNA Premier is powered by the innovative SuperG gradient technology. The SuperG gradient coil introduces outstanding performance and superb stability, which is designed to deliver the performance of ultra-high-performance, research-class 60 centimeter MRI system in a 70 centimeter bore. The RF technology of SIGNA Premier provides 146 independent receiver channels that allow the simultaneous acquisition of patient data from multiple high channel-density surface coils for faster scanning, higher image quality, and overall enhanced clinical performance 12
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
compared to GE Healthcare’s previous generation MR systems. The 48-channel Head Coil delivers improved clinical performance compared to GE Healthcare’s previous generation MR systems for virtually every patient. A fit-adaptable design addresses 99.99 percent of the population – including patients with extremely large heads and short necks – while preserving high signal-tonoise ratio (SNR) and outstanding image quality. Additionally, SIGNA Premier can perform a routine fast brain examination in under five minutes by leveraging HyperSense, a new speed scanning tool, delivering up to eight times faster scanning,” which is part of the HyperWorks application suite. • ADVANCING THE IMAGING PROFESSIONAL
news Carestream Enables Reading of MR Perfusion, MR Diffusion Studies Directly From Vue PACS Diagnostic Viewer Carestream Health has introduced new MR Brain Perfusion and MR Brain Diffusion modules that enable radiologists to read these imaging studies from a Carestream Vue PACS diagnostic viewer. The company has received FDA 510(k) Clearance for use in the United States, and these new tools also have been approved for use in Europe and other countries across the globe. “Carestream is one of the first suppliers to support reading of both types of studies from the diagnostic viewer,” said Thierry Verstraete, Carestream’s Worldwide Product Manager for Clinical Solutions & Analytics. “Other companies require viewing on dedicated workstations with 3D post-processing software, which limits access and can delay diagnosis and treatment.” Carestream’s MR Perfusion and MR Diffusion modules successfully completed clinical evaluation at a prominent French hospital. “The Carestream software was simple to use and Carestream’s modules showed better consistency of perfusion and diffusion maps and results than our existing software. This new software will be very useful in making clinical decisions for treating acute stroke and lesions,” said Dr. Daniel Reizine, Neuroradiology, Hospital Lariboisière, Assistance Publique Hôpitaux de Paris, University Hospital of Île-de-France. Carestream’s CT Brain Perfusion module provides interactive tools for analyzing tissue blood flow, tissue blood volume and capillary permeability. Blood perfusion parameters are automatically calculated and displayed as a set of user-friendly maps and tables that summarize the results. Carestream’s MR Brain Perfusion module provides interactive tools for analyzing tissue blood flow, tissue blood volume and capillary permeability and delivers automatic generation of perfusion maps and a table of quantitative data that can be inserted into the radiology report. Both CT and MR perfusion modules provide automatic identification of arterial input function, venous output function and brain centerline with the ability to edit and select additional vessels. Motion correction and ROI tools are available for improving diagnostic confidence. Perfusion maps and quantitative measurements can be included automatically in the Vue Reporting module so this diagnostic information can be readily available to clinicians and referring physicians. Carestream’s MR Brain Diffusion module provides interactive tools to ease analysis and comparison of MR diffusion-weighted images (DWI) and MR diffusion tensor imaging. The module is used to visualize local water diffusion properties from the analysis of diffusion-weighted MR data. Automatic display of DWI images as well as calculation of ADC maps can improve efficiency and diagnostic confidence. Carestream’s Vue PACS lesion management tool enhances assessment of oncology patients with quantitative measurements, bookmarking and comparisons over time to aid oncologists who are making diagnostic and treatment decisions. It accepts prior exam results as baseline images from third-party PACS and from numerous modalities. •
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ClearRead CT Installations Accelerate With the radiologist’s increasing workload, tools that improve reading efficiency while increasing reading accuracy are imperative. Radiology centers and services are utilizing ClearRead CT as a way to standardize care based on proven reading benefits, ease of use and ease of installation. Leading centers such as, Duke University Medical Center, Saint Luke’s Kansas City, Einstein Medical Center, University of Maryland, and the University of Michigan have deployed ClearRead CT technology along with multiple radiology reading services. As a result, ClearRead CT is now processing data from nearly 50 CT scanners that include all major manufacturer CT devices, while being read on the sites existing picture archiving and communication systems (PACS). “Riverain’s ClearRead CT has been deployed as a part of our routine chest CT exams, including patients in our lung cancer screening program,” said Dr. Jared Christensen, Division Chief of Cardiothoracic Imaging and Imaging Di-
rector of Duke’s Lung Cancer Screening Program. “The ClearRead CT technology has helped us to detect lung nodules that may have otherwise been missed. Based upon our early experience, the workflow is faster and more accurate than existing technologies.” ClearRead CT is the first advanced visualization product cleared by the FDA for concurrent reading, enabling radiologists to read the original series and the processed CT series simultaneously. ClearRead CT is proven to achieve a 26 percent reduction in reading time and reduce missed nodules by 29 percent. ClearRead CT processes CT scans from all manufacturers and automatically places the processed series into the existing patient file prior to the exam review. The seamless integration and ability to process cases from varying acquisition devices and protocols allows the ClearRead CT technology to be deployed enterprise wide, establishing a standard of care for the patient population.•
Varian Medical Systems Receives FDA 510(k) Clearance for Halcyon Treatment System Varian Medical Systems has received FDA 510(k) clearance for its Halcyon system, its new device for cancer treatment. Halcyon simplifies and enhances virtually every aspect of image-guided volumetric intensity modulated radiotherapy (IMRT). “We are proud that Halcyon has now received both 510(k) clearance and CE mark,” said Kolleen Kennedy, president of Varian’s Oncology Systems business. “With its human-centered and user-friendly design, Halcyon is engineered to revolutionize clinical workflow. These two clearances are very important milestones in the availability of this new system and advancing cost-effective cancer care worldwide.” Halcyon is an advanced system that is more comfortable for the patient while delivering ease of use for health care providers,
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accelerated installation timeframes, expedited commissioning, simplified training, and automated treatment. With its streamlined workflow, the system only requires nine steps from the start to the end of treatment compared to up to more than 30 steps with older technologies. Halcyon is well suited to handle the majority of cancer patients, offering advanced treatments for prostate, breast, head and neck, and many other forms of cancer. Halcyon features large touchscreens on both sides of the machine to assist in easy patient set-up. For increased patient comfort, Halcyon is up to 2x quieter than other systems, has a low couch height for easy patient access, and soft indirect ambient lighting in the gantry opening. To create a closer connection between patient and therapist during Halcyon treatment, the sys-
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
tem includes an integrated couch-mounted camera for the therapist to watch over the patient during treatment, and an integrated noise-cancelling sound system that makes it easy for patients to converse with the therapists. With 510(k) clearance, Varian can begin selling the Halcyon system in the United States. The system requires Eclipse 15.1.1 treatment planning software, which is currently 510(k) pending. For more information, visit www.varian.com/halcyon.
ADVANCING THE IMAGING PROFESSIONAL
news
Fujifilm Launches Synapse PACS Version 5 Fujifilm Medical Systems U.S.A. Inc. has need to collaborate and deliver the best announced the release of its Synapse PACS possible patient care,” said Bill Lacy, vice version 5 in the United States. Featuring the president of medical informatics, Fujifilm latest server-side rendering architecture, Medical Systems U.S.A. Inc. “Synapse 5 ofSynapse 5 is one component of Fujifilm’s fers a transformational enterprise imaging comprehensive enterprise imaging portfo- opportunity for new customers, while prolio which includes Synapse VNA, Enterprise viding unprecedented value to our existing Viewer, Cardiovascular, 3D, RIS and cloud PACS customers, many of whom have been services. A disruptive technology that sets using Synapse PACS for 18 years.” new standards for enterprise imaging, SynIdeal for enterprise imaging, Synapse 5 PROOF APPROVED CHANGES NEEDED apse 5 is now available to Fujifilm PACS ranks among the fastest medical imaging customers as a software upgrade – includ- solutions in the industry. With a focus on CLIENT SIGN–OFF: ed in their maintenance agreement. speed and interactivity, Synapse 5 provides “Highly functional software designed sub-second, on-demand access to massive PLEASEworkflow, CONFIRM THE FOLLOWING AREtoCORRECT to streamline alongTHAT with speed datasets and the ability interact with the and precision, are what practices and data – resulting in optimized health care LOGO PHONE NUMBER WEBSITE ADDRESS health care systems across the country delivery. Advances in efficiency and ergo-
PROOF SHEET nomics facilitate productivity and a better overall user experience. The latest design includes server-based image rendering and a zero-download viewer with browser flexibility – leading to significant IT benefits for SPELLING GRAMMAR many organizations. •
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IMAGING CONFERENCE AND EXPO CONTINUES TO GROW ICE Hits Vegas this Winter
I
CE is everything an imaging service professional or director needs to be successful in a sometimes overlooked profession. MD Publishing continues to build a specific community for these intelligent and hardworking professionals via a three-prong approach. The Imaging Conference and Expo (ICE), the Imaging Community and Exchange (ICE) website (ImagingIgloo.com) and the ICE magazine all work together to empower imaging service professionals. After four successful summer conferences, including this past July in the Washington, D.C. area, the Imaging Conference and Expo is moving to the early part of the calendar. ICE 2018 will be held February 16-18 in Las Vegas, Nevada at The M Resort. In other exciting news, the ICE magazine will be published monthly beginning in January 2018. These are all measures designed to continue to grow the ICE community. ICE 2017 in Washington, D.C. showed continued growth with the ICE18 Leadership Summit, a reverse expo, top-of-theline educational sessions and an exhibit hall full of industry-leading vendors. Wendy Stirnkorb, director of imaging services at Regional West Medical Center, was impressed by the reverse expo. She was not alone as attendees and exhibitors shared their thoughts on what made ICE such a beneficial event. “This kind of forum is enlightening from my perspective,” Stirnkorb said. “ICE18 is a great way to network with a group of people you normally wouldn’t be able to. Having biomeds and imaging 16
in one room is a great benefit,” said Mario Pistilli, director of imaging at Children’s Hospital Los Angeles. “The panel discussion was great. The other speakers were great. I just saw this as a good place to get a widespread variety of information that pertains to the clinical engineer and the biomedical engineer and it’s not really available anywhere
By John Wallace, Editor Exhibitors and attendees stressed the importance of the high-value networking at ICE 2017. “It is a great opportunity to network because the variety of people who attend and the fact that a lot of the attendees are very influential and active in other advocacy organizations is just an added bonus,” Browne said.
“ There are a lot of networking opportunities, a lot of educational opportunities and I took away a lot of priceless information that I can’t wait to take back to my hospital.” Ryan Kishun, BS, CBET else,” Andrea D. Browne, Ph.D., DABR, Diagnostic Medical Physicist Department of Engineering, The Joint Commission said after her keynote presentation. She also encouraged imaging service professionals and directors to attend ICE 2018 for a variety of reasons. “First of all, it’s, I think, a good size,” Brown said. “You have an opportunity to visit all of the exhibitors that you can’t always get to at larger meetings. So, that is good. The exhibitors are very focused on what you are interested in, so the information that you get from them is valuable, focused and right on point.”
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
John Garrett, clinical engineering manager at Good Samaritan Hospital in Cincinnati, also praised the networking aspect of ICE. “We have the opportunity to network with vendors at a level that is much more candid than trying to show up at your office. You can actually go and work with them – the people who actually have something to offer instead of waiting for somebody to come to you,” he said. “This also leads to finding new services. You are able to discover possible solutions to problems that you didn’t know existed – I actually had two of those happen to me this year.” ADVANCING THE IMAGING PROFESSIONAL
“I get to network with other professionals who understand the same challenges who maybe have better practices or better answers to issues and problems that I face or vice verse,” Garrett added. “I may have a solution to a challenge that they face. It is a great opportunity to sit and discuss what you are facing and how you are dealing with it and coming up with some best practices that help overall quality and capability of the industry.” Jina Walls with the Department of Veterans Affairs in Indianapolis, Indiana made connections while at ICE 2017. “The biggest benefit is networking. There is so much you can learn, especially from different companies, from training, from parts (suppliers) and also getting to know what other hospitals have in store for the future,” Walls said. Walls also said the educational sessions were beneficial and that she learned something from one of the classes that she will be able to implement as soon as she returns to her facility to help with an issue they have been experiencing with MRI scans of patients with stents. Ryan Kishun, BS, CBET, biomedical imaging engineer at New York-Presbyterian Hospital, said the education was informative and provided excellent insights. “I’ve learned a lot through the educational seminars. It gave me exposure to different modalities that I did not have before including MR and CT. I am looking forward to heading back to work and applying what I learned,” Kishun said. “(ICE) is probably one of the best things you can do. It’s laid back, it’s fun, it’s informative. The networking opportunities here are tremendous.” “I would definitely recommend ICE because it’s fun. There are a lot of netWWW.IMAGINGIGLOO.COM
working opportunities, a lot of educational opportunities and I took away a lot of priceless information that I can’t wait to take back to my hospital,” he added. April Lebo, director of sales and marketing at Trisonics Inc., said ICE provides great value for her company. “For Trisonics, we are able to reconnect with our customers and to be able to attend sessions like the Dealer Meeting so that we are up to date on everything that is going on in the industry,” Lebo said when asked about the benefits of attending ICE. Dick Branca with Cool Pair Plus said the conference provides a venue for meeting new customers. “From a dealer perspective, it is probably twofold. First you are going to see new customers and potential clients,” Branca said when asked about ICE attendance. “And, also from a networking standpoint, you are here seeing and talking to a lot of different vendors who you might be doing business with as well.” Summit Imaging Manager of Global Education and Training Kyle Grozelle pointed out several ways businesses benefit from ICE attendance. “It is a great opportunity to be an exhibitor. We get a chance to connect with our customers,” Grozelle said. “We also always take advantage of the opportunity to do the reverse expo at ICE. It is a great time to sit down and be face-to-face with a group of leaders in the organizations that we work with and get some great feedback but also learn some ways that we can support them.” Grozelle did not hesitate to encourage hospital employees to attend the conference every year.
“If you are a hospital employee, I would say one of the main reasons to attend an ICE conference would be to come to these seminars and take home knowledge of where the industry is going, especially around things like developing trends and our new quality management systems that are coming from the FDA or other governing organizations,” he said. When asked what he would say to an imaging service professional who was thinking about attending ICE 2018 in Las Vegas, Garrett said simply “Attend!” “There is not a wasted moment,” Garrett added. “You can get anything out of this that you decide you want to get out of it. If you simply show up and walk around and talk to people – that alone is worth the time you spent (to attend). Then, the educational aspect of it just takes it to the next level. There are so many opportunities for training that you can kind of pick and choose what serves your needs.” ICE
For additional information about ICE 2018, visit AttendICE.com. If you are interested in participating in the ICE18 Leadership Summit, a precursor to the conference where a group of 18 plus handpicked imaging leaders come together to network with the best and brightest in the industry to share invaluable knowledge which will help you and your department grow and prosper, visit www.attendice. com/ice18/ to apply. Find out more about the Imaging Community and Exchange website and magazine at ImagingIgloo.com.
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news
PEOPLE ON THE MOVE 1.
GE Chairman and CEO Jeff Immelt has announced the appointment of Kieran Murphy as president and CEO of GE Healthcare. Murphy is previous president and CEO of GE Healthcare Life Sciences. Murphy succeeds John Flannery who has been appointed CEO and chairman elect of GE. Murphy, 54, was appointed CEO of GE Healthcare Life Sciences in September 2011. Since then, he has overseen significant revenue growth and geographic expansion of the molecular medicine business, which now accounts for more than $4 billion in annual sales with 11,000 employees in more than 100 countries. Murphy joined GE Healthcare in 2008 from Whatman plc, a global supplier of filters and membranes for laboratory research, life sciences and medical diagnostic applications. He has over 20 years’ experience in the global life sciences and biotechnology industry, beginning his career with Janssen Pharmaceutical, a division of Johnson and Johnson, followed by leadership roles with Mallinckrodt, veterinary medicines provider Vericore, Novartis, Adprotech, ML Laboratories and Innovata plc. Having earned his bachelor’s degree in 1984 from University College, Dublin, he subsequently graduated from the University of Manchester Institute of Science and Technology with a master’s degree in marketing.
2.
Mediware Information Systems of Lenexa, Kansas, has added Bill Miller as its CEO. Miller was most recently CEO of OptumInsight at the UnitedHealth Group subsidiary Optum, and succeeds outgoing CEO Kelly Mann.
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3.
Change Healthcare of Nashville, Tennessee named Samuel Allen Hamood as its executive vice president and chief financial officer, effective August 21. Hamood joined the company from TransUnion Corporation, where he has been executive vice president and chief financial officer since February 2008. He succeeds retiring executive vice president and chief financial officer Randy Giles.
4.
Mach7 Technologies Inc. of Burlington, Vermont has added Michael Jackman as its new CEO. Jackman has spent nearly 30 years in the global healthcare IT business.
5.
Blue Cross and Blue Shield of Eagan, Minnesota named Kurt C. Small its senior vice president and president of government markets. Small was most recently chief operating officer of Virginia Premier Health Plan in Richmond, Virginia and senior vice president of health plan operations for Highmark Inc.; he has also held government and commercial executive leadership positions at Aetna throughout a 15-year tenure there. Small has a MBA from Yale and a bachelor’s degree from the College of William and Mary.
6.
IsoRay Inc. of Richland, Washington named Mark Austin its controller of principal accounting and financial officer, effective July 24. Austin is a CPA who has spent more than eight years with KPMG, where he was most recently senior manager for financial statement and internal control audits within its technology sector.
7.
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
HIMSS has appointed Harold Wolf III its president and CEO. Wolf, who
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joins the company from The Chartis Group, succeeds retiring president-CEO H. Stephen Lieber. Wolf has previously been senior vice president and chief operating officer of the Kaiser Permanente Federation, has worked as chief information officer for Quest Communications/USWest, and has spent four years with HIMSS.
8.
ECRI Institute of Plymouth Meeting, Pennsylvania, will replace outgoing President and CEO Jeffrey C. Lerner, who will retire at year’s end. Lerner joined the company in 1984 as its vice president for strategic planning; he became CEO in 2001. Global executive search firm Korn Ferry has been retained to find a successor.
9.
Community Health Accreditation Partner (CHAP) of Washington, D.C. has named Board Chairwoman Barbara McCann as interim president-CEO to replace the resigning Karen Collishaw. McCann, who has served on the CHAP board since 2013, will leave her position with Interim HealthCare Inc., where she spent 20 years in executive leadership.
10.
Adventist University of Health Sciences of Orlando, Florida has promoted provost Edwin Hernández to president upon the retirement of founding president David Greenlaw on July 31.
11.
Dennis W. Pullin has been named president and chief executive officer of the Virtua health care system of Marlton, New Jersey. Pullin will succeed Virtua’s 22-year president, Richard P. Miller, in fall 2017. Miller has been Virtua president-CEO since its formation in 1997.
ADVANCING THE IMAGING PROFESSIONAL
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Kaiser Permanente of Oakland, California announced its board of directors for the planned Kaiser Permanente School of Medicine, which will open in 2019. Holly J. Humphrey, dean of medical education at the University of Chicago, will chair the board, joined by directors Ronald L. Copeland, Patrick T. Courneya, Imelda Dacones, Edward Ellison, Mary Hentges, Peter Lee, Sharon Levine, Julie Miller-Phipps, Valerie Montgomery Rice, Gilbert Salinas, Maria Salinas and Anne Wojcicki.
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Valley Presbyterian Hospital of Van Nuys, California has named Janice Klostermeier its new senior vice president of finance and chief financial officer. Klostermeier joins the hospital from Hollywood Presbyterian Medical Center, where she was executive vice president and chief financial officer. She has a master’s degree in health services administration from Southwest University in New Orleans, is a CPA, and a fellow of the American College of Health Care Executives (FACHE).
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15.
Carolinas HealthCare System of Charlotte, North Carolina has named H. Stacy Nicholson president of the children’s service line for the health care system as well as the Sara H. Bissell and Howard C. Bissell Endowed Chair in Pediatrics. Nicholson’s career includes a stint as physician in chief at Phoenix Children’s Hospital, and faculty positions at Oregon Health & Science University (OHSU) and Children’s National Medical Center (CNMC). He is a pediatric oncologist with an undergraduate degree from Furman University, a medical degree from the Medical College of Georgia, and a master’s degree in public health from George Washington University. ICE
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Huntington Hospital of Pasadena, California has added Lori Morgan as its president and CEO, effective September 2017. Morgan was most recently corporate vice president of Legacy Health in Portland, Oregon, and president of Legacy Emanuel Medical Center, its largest hospital. She succeeds current president and CEO Stephen A. Ralph.
EXCELLENCE IN
people By K. Richard Douglas
PROFESSIONAL SPOTLIGHT Lewis Free, Director of Biomedical Engineering & Imaging
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t was practical advice from a mentor that got Lewis Free into the biomed field, and eventually, into a career path in imaging. Free is director of biomedical engineering and imaging engineering at Cape Cod Hospital and works for Sodexo Clinical Technology Management. Much like the old adage about death and taxes, he learned early on that there would always be a need for those who repair medical equipment; a more positive truism. “I was introduced to the biomed/ imaging service profession by one of my engineering professors, while researching various companies, to submit my resume [to], for an internship while in college. He informed me that a biomedical/clinical engineer does an amazing job maintaining medical devices for the safe use on patients,” Free says. “I always had the thought of designing and constructing machines for release to the market but had not given much thought to the maintenance of the machines. What convinced me was his statement ‘there will always be a need for skilled individuals that can repair these devices, and the more complicated the system, the more in demand that individual is.’ With research, I decided that I would pursue the biomed field,” he adds. Free says that he began to learn the skills that were required of a biomed by shadowing another employee that his manager assigned him to. During that time, he learned some simple rules that 20
Lewis Free Director of Biomedical Engineering and Imaging Engineering, Cape Cod Hospital
would serve a biomed well; beyond realizing that not everything can be gleaned from shadowing. “The exception was you were expected to know essential problem-solving,” Free says. “One is a critical thinker. For every problem, start in the middle; the second don’t over-think it. And when I was working on a problem, I was unable to resolve, I would ask, and they would hand me the book – service manual – even if,
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
and especially if, they know the answer. It wasn’t until later in my career, when I took a job with Sodexo, that I received formal training in imaging from DITEC and RSTI on various imaging modalities,” Free says. Free’s introduction to imaging happened through happenstance. “I was fortunate to assist a senior biomed staff on a service call from the radiology department,” he says. “After seeing the system complexity, and the challenge it poses, I knew I had found my career path in the field.” Since joining the biomed and imaging professions, Free has served as a Biomed I, Biomed II and Biomed III; a lab specialist and [an] imaging engineering specialist prior to his current position as director of biomedical engineering and imaging engineering. Trusting In-house Resources Free says that it can be a challenge to convince some clinicians that the trained in-house expertise of imaging specialists is up to the task as much as factory engineers. “The most challenging thing in this field is convincing the radiology manager that the OEM is not the only vendor that has experienced service engineers to repair, calibrate and PM the imaging system,” he says. “Additionally, the OEM does not have a moratorium on service engineers; we (all vendors) pick the service engineer from the same pot. In this age of competition, we cannot just be the imaging guy/girl only. What I have done, that has been very effective in winning over the radiology ADVANCING THE IMAGING PROFESSIONAL
GET TO KNOW THE PRO Favorite book “Total Money Makeover: A proven plan for financial fitness” by Dave Ramsey Favorite movie “Braveheart” Favorite food Soup Hidden talent Resolving the issue that others find difficult. What’s on my bench?
Lewis Free is seen with a TrueBeam system.
• Phone • Cup of coffee
department and allowing us to take over more imaging systems, was: being proactive and injecting myself into imaging systems that have been a problem in the past with the OEM and their inability to resolve the problem,” Free adds. He says that he has stepped in to find the problem and contacted the OEM, because the system [was] under contract, and together we resolved the issued. “This approach works, because as third-party imaging engineers, we are expected to be right every time, unlike the OEM. And this shows the radiology department staff that we are not lower in skill than the OEM,” Free says. “In my role at Cape Cod Hospital, I have been assisting the hospital each year with their budget as it relates to planning and ordering medical devices throughout the hospital. Additionally, I am on the project committee, EOC committee, radiation safety committee and heading a biomed sub-committee,” Free adds. Free says that prior to joining Sodexo; WWW.IMAGINGIGLOO.COM
he had started his own company called Freesystems Technology, which specialized in repairing and calibrating X-ray systems throughout the U.S. He said the enactment of a new standard made it difficult to continue the company. “I took a job with Sodexo CTM, and within a year of my employment, I won Imaging Engineer of the Year from Sodexo CTM,” Free says. Start Each Morning the Right Way Free is part of a family of four. “I am blessed to have a lovely wife, Nicola, and two daughters Alivia (11) and Alanna (3),” he says. Away from work, he enjoys repairing electrical devices. Free also believes having the right attitude is important when it comes to being successful. “I am a passionate guy that loves to joke around and not take things too seriously. I am also competitive and self-motivated. My drive comes from words that I live by,” he explains.
• Task for the day • Laptop • Allen wrench set
Those words come in a quotation attributed to Don Montano that state: “Every morning in Africa, a gazelle wakes up. It knows it must run faster than the fastest lion or it will be killed. Every morning a lion wakes up. It knows it must outrun the slowest gazelle or it will starve to death. It doesn’t matter whether you are the lion or the gazelle; when the sun comes up, you’d better be running.” The imaging systems at Cape Cod Hospital are in good hands with a imaging engineering director who hits the road running every morning. ICE
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people By K. Richard Douglas
DEPARTMENT SPOTLIGHT Maury Regional Health Imaging Services Department
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he city of Columbia, Tennessee lies south of Nashville in Maury County. Maury Regional Medical Center, a 275-bed facility, serves the area in a region of rolling hills just west of the Cumberland Plateau and the Blue Ridge. The hospital has been around for more than a half century. The medical center is the flagship of the Maury Regional Health System which was named one of the nation’s top 15 health systems by Truven Health Analytics. It is the largest health system between the cities of Nashville and Huntville, Alabama. The health system boasts more than 3,000 employees. Other facilities in the system are the Marshall Medical Center, Wayne Medical Center and Lewis Health Center in the counties of the same name in southern Middle Tennessee. Maury Regional Health also includes the Maury Regional Medical Group; a network of physician practices in the same counties. The imaging inventory, among the three hospitals and eight offsite facilities, includes eight CTs, four MRIs and 43 fixed rooms, including about 120 pieces of equipment total. Caring for this imaging equipment is an imaging service department consisting of three imaging engineers. “Our shop, Imaging Services, is physically separated from biomed, but is paired with them as a part of the Health22
care Technologies Management Department,” says Eric Mann, an imaging engineer III in the department. “We cover pretty much anything in the Maury Regional Health network that is a piece of imaging equipment: CTs, MRIs, X-ray rooms, R&F rooms, cath labs, C-arms, mammography, bone density, portable
for training, whether it’s through the OEM, an ISO, or a third-party company. We try to keep with the OEM, though, for equipment-specific training as it’s helped us with licensing and access to service keys. We’ve used companies like RSTI for the introductory and non-vendor specific courses to train a few of the
“ The imaging inventory includes eight CTs, four MRIs and 43 fixed rooms, including about 120 pieces of equipment total. Caring for this imaging equipment is an imaging service department consisting of three imaging engineers.” X-ray, ultrasound and some nuclear medicine,” Mann says. “We’ll be adding PET/CT to the list in the very near future.” Mann says that the only equipment they don’t service internally are the nuclear medicine cameras. They plan to add that expertise in the future but just don’t have anyone trained on the equipment currently. The department does a good job of keeping current on training and utilizes a number of approaches depending on what is required to be able to repair their devices. “We try to utilize any option available
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
engineers that were new to the shop and career field,” Mann says. Tackling Challenges The three engineers act almost like an imaging procurement department alongside their maintenance duties. They are very hands-on in the process. “We’ve become very involved with all aspects of purchasing new equipment. We’re there from the initial sales presentations, through negotiations and during installation,” Mann says. “The three of us are able to source parts, call in third-parADVANCING THE IMAGING PROFESSIONAL
Jimmy Meredith performs a PM on an OEC C-Arm.
Left to right: Rodney Lockridge - Director Imaging Services, Jimmy Meredith – Imaging Engineer, Morris Dillehay – Imaging Engineer, Eric Mann – Imaging Engineer.
ty labor and provide any user training we can as needed.” “Negotiating service agreements or contracts has become one of my additional tasks, which was my reason for attending ICE 2017, I hadn’t done that prior to this and was hoping to pick up some tips; which I did,” Mann says, referring to the July 2017 Imaging Conference and Expo that was held in Washington, D.C. Mann says that the department has someone fully trained on almost every piece of equipment they service. For a three-man team, they have the expertise on nearly all modalities covered well. “I myself am trained on our CTs, MRIs, and am in the process of going to the OEM classes for our ultrasound units,” he says. “Once the PET/CT is purchased, I’ll be attending those classes as well, if it’s a vendor I’m not already trained on. We WWW.IMAGINGIGLOO.COM
have another gentleman trained on the portable X-ray, C-arms, cath labs, along with some general X-ray/R&F training. The other gentleman is trained on our mammography units, bone density and general X-ray.” The group has kept busy with maintaining current equipment and haven’t tackled too many major projects. One planned project recognizes the need for a continuous power supply for some of the imaging equipment. “Other than assisting with the planning of ‘turn-key’ MRI suites, we’ve not had the chance as of yet to work on many special projects. I’ve recently started a project where I’m trying to get an external UPS unit (outbuilding sized unit) installed that would be able to handle multiple imaging or surgical suites at one time,” Mann says. “This is due to whenever we run our
Morris Dillehay is seen verifying equipment on a Ziehm C-Arm. monthly generator tests, or there is a power outage, one or more of the pieces of equipment does not come back up. And, as we all know, down time equals lost money, which adds up quickly and makes for a very squeaky wheel,” Mann adds. For a small imaging department, the Maury Regional imaging service team brings big expertise and coverage to the system. ICE
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MINI C-ARM PRODUCT SPOTLIGHT Mini C-arms Elevate Global Market
I
n today’s world, imaging systems are an essential technology in every hospital. Specialists in almost every field of surgery, including orthopedics and cardiology use C-arms for intraoperative imaging. The devices provide high-resolution X-ray images in real-time, thus allowing physicians to monitor progress at any point during the operation and immediately make necessary corrections. As a result, treatment results are better and patients recover faster. In 2015, the global market for C-arms was estimated to be $1.7 billion. It is expected to exceed $2 million by the year 2021, growing at a compound annual growth rate (CAGR) of 3.2 percent during the forecast period of 2016-2021, according to Mordor Intelligence. “C-arms are currently being used in several areas of medicine and their varied applications are only expected to increase over time,” Mordor Intelligence reports. “These factors, coupled with the increasing demand for health care infrastructure in developing and third-world countries, are driving the global C-arms market. On the other hand, the growing use of refurbished devices and the low replacement rates of C-arm systems are hindering market growth. With increasing focus on the portability of C-arms, there is a great market opportunity for companies producing mini C-arms. However, the increasing cost concerns in emerging economies resulting in increasing pricing pressures are presWWW.IMAGINGIGLOO.COM
ently the greatest challenge to be overcome in order to tap the full potential of this market.” Research and Markets forecasts the global flouroscopy C-arms market to grow at a CAGR of 4.02 percent during the period 2016-2020. “The development of the C-arms increases the emphasis on MIS (minimally invasive surgery), leading to reduced hospital stay. Therefore, there will be an increase in sales of C-arm equipment components in the hospital sector during the forecast period. The growing number of ambulatory surgical centers that perform numerous procedures is expected to further increase the demand for mobile C-arms in the market during the forecast period,” according to Research and Markets. “One of the key trends for market growth will be effective results in combination of radiography and fluoroscopy systems,” Research and Markets adds. “The convergence of radiography and fluoroscopy systems is expected to have a positive impact on market growth during the forecast period. Recently, Philips Healthcare launched DuoDiagnost, com-
bining radiography and fluoroscopy devices in one system. The combination of equipment offers better price-perfor-
“ One of the key trends for market growth will be effective results in combination of radiography and fluoroscopy systems.” mance ratio, occupies less space, and can be used for several applications. Also, health care institutions can achieve a better return on investment by implementing such equipment.” Persistence Market Research also predicts continued growth for the global C-arm market. The global fluoroscopy and C-arms market is likely to exhibit a CAGR of 4.5 percent during the forecast period (2016– 2024) with market revenue expected to increase to $4.2 billion by 2024, according to Persistence Market Research. ICE ICEMAGAZINE
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products
GE Healthcare
OEC Elite MiniView The new OEC Elite MiniView is designed to improve the mini C-arm experience. Surgeons can easily maneuver and control the lightweight system single-handedly with speed and ease. With the innovative SmartLock system, there’s no need to manually turn multiple levers and dials to secure the C-arm position. Touch a button and it’s locked in place, preventing drift. The OEC Elite MiniView allows surgeons to see fine details more readily with large primary and reference images viewed simultaneously. With the largest dedicated support team in the world, you can count on your mini C-arm’s reliability to sustain higher productivity. •
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ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
ADVANCING THE IMAGING PROFESSIONAL
products
Hologic Fluoroscan InSight-FD mini C-arm system The Fluoroscan InSight-FD mini C-arm system with exclusive rotating flat detector technology provides imaging versatility right in the procedure or operating room. The system includes a new and innovative CMOS flat detector with exclusive rotating capabilities. It boasts CsI (cesium iodide) material, which provides high sensitivity, resulting in lower dose and high-quality images. It provides superb, distortion-free images that rival standard X-ray procedures and touchscreen controls that offer effortless image adjustment and rotation for clear and accurate visualization. •
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products
Siemens Healthineers Cios Fusion The Cios Fusion premium flat-panel detector system from Siemens Healthineers – part of the company’s new, completely redesigned C-arm portfolio – has two detector sizes: 30 cm x 30 cm and 20 cm x 20 cm. The system’s flat-panel detector technology offers greater visibility than image intensifier-based systems, ensuring greater anatomical coverage. The Cios Fusion features the same easy-to-use touchscreen interface and software options as the company’s ultra-premium Cios Alpha mobile C-arm, simplifying cross-training efforts. The touchscreen remote can be positioned at the operating table to control the C-arm from within the sterile work area. The Cios Fusion also includes intelligent power management to virtually eliminate overheating, which can cause delays and scheduling backups. •
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ADVANCING THE IMAGING PROFESSIONAL
products
Whale Imaging G-Arm B6 Duo Whale Imaging Inc. G-Arm B6 Duo is now FDA 501(k) approved. It is the next generation of the G-Arm with major improvements including axial tilt and greater table access. The B6 Duo improves accuracy while reducing time, infection and radiation. Engineers at Whale made the B6 Duo compatible with all surgical tables, and added many new features including axial tilt. Whale’s unique ability to fire two X-ray beams asynchronously provides the customer with bi-lateral video and images, giving the user a more comprehensive picture than a traditional C-arm. G-Arm utilizes this X-Beam technology, as well as iC-Clear algorithms to provide the best image possible, using the smallest dose of radiation. •
WWW.IMAGINGIGLOO.COM
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MAMMOGRAPHY PRODUCT SPOTLIGHT Global Mammography Market Nears $4 Billion
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inding breast cancer early and getting stateof-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer, according to the American Cancer Society. Breast cancer is easier to treat when it is found early. A mammogram is one type of breast cancer screening. “Regular mammograms can help find breast cancer at an early stage, when treatment is most successful. A mammogram can find breast changes that could be cancer years before physical symptoms develop. Results from many decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found early, are less likely to need aggressive treatment like surgery to remove the breast (mastectomy) and chemotherapy, and are more likely to be cured,” according to the American Cancer Society. The breast imaging and mammography markets continue to grow amid a more educated global population, increased awareness and advanced technology. Grand View Research predicts the global mammography market will approach $4 billion. “The global mammography market is expected to reach a value of $3.8 billion by 2025,”
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according to a new report by Grand View Research Inc. “The market growth can be attributed to the rising initiatives by various governments and NGOs to raise awareness about early diagnosis of microcalcifications in breast tissue. Some significant organizations such as the National Breast Cancer Foundation, CDC, and Breast Cancer Organization are promoting the
“In January 2016, FDA approved a new manual for digital mammography quality control by the American College of Radiology. The growing number of awareness campaigns to promote womens’ health services is also anticipated to propel growth,” Grand View Research added. MarketsandMarkets predicts even more growth.
systems capable of detecting cancer in women with dense breast tissues,” according to MarketsandMarkets. “In addition, the growing demand for breast imaging in emerging Asian countries, and technological advancements in breast cancer detection are expected to offer high growth opportunities for market players. However, factors such as
“The global mammography market is expected to reach a value of $3.8 billion by 2025.” early diagnosis of mammary gland calcification, which is one of the crucial factors expected to drive the demand over the forecast period.” “Based on a report published by the National Cancer Institute in 2015, it was stated that the proportion of women aged 45 to 65 years had increased to 81.1 percent in breast cancer screening,” according to Grand View Research. “Major mammography manufacturers are introducing new products and increasing the number of approved products, which is further expected to impel the demand in the coming years.”
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
“The market is expected to reach $4.14 Billion by 2021, at a CAGR of 8.5 percent from 2016 to 2021,” according to MarketsandMarkets. “Growth in the breast imaging market is driven by factors such as the rising incidence of breast cancer globally; growing government investments and funding for breast cancer treatment and related research; increasing awareness about early detection of breast cancer; rising geriatric population; technological advancements in breast imaging modalities; and launch of advanced breast imaging
high installation cost of breast imaging systems, side-effects of radiation exposure, and errors in breast cancer screening and diagnosis are restricting the growth of the global breast imaging market.” “North America is estimated to be the largest regional segment in the global breast imaging market in 2016, followed by Europe,” MarketsandMarkets reports. Some of the key industry players are Fujifilm; Hologic; Philips Healthcare; Siemens Healthineers; Toshiba Medical Systems Corp. and GE Healthcare. ICE
ADVANCING THE IMAGING PROFESSIONAL
products
FUJIFILM ASPIRE Cristalle Digital Mammography System Fujifilm Medical Systems U.S.A. Inc. earlier this year announced that its Digital Breast Tomosynthesis (DBT), as an optional software upgrade for its ASPIRE Cristalle digital mammography system, has received premarket approval (PMA) from the U.S. Food and Drug Administration (FDA). Known as AMULET Innovality outside of the United States, Fujifilm’s optional DBT upgrade has been widely available in Europe, Asia and Latin America since May 2013. The ASPIRE Cristalle FFDM system with DBT combines Fujifilm’s state-ofthe-art hexagonal close pattern (HCP) detector design, advanced image processing and image acquisition workflow to optimize patient dose while maximizing image quality. •
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products
Siemens Healthineers Mammomat Inspiration with HD Breast Tomosynthesis The digital mammography system with optional High Definition (HD) Breast Tomosynthesis builds on the company’s established DBT platform, which has the industry’s widest tomo sweep of 50 degrees, delivers exceptionally clear images, and is the first solution approved for 3D-only mammograms. HD Breast Tomosynthesis incorporates new EMPIRE technology, which combines iterative and machine learning algorithms for clearer, more concise 3D reconstruction. While EMPIRE technology is approved as a 3D-only exam, it includes Insight 2D and 3D – synthetic software-generated visualization of tomo volumes in 2D and 3D. Insight 2D allows breast imagers to obtain a 2D image from the EMPIRE 3D image set, providing navigational support for 3D-only exams without adding dose. Insight 3D adds depth to breast anatomy visualization. •
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ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
ADVANCING THE IMAGING PROFESSIONAL
products
GE HEALTHCARE Senographe Pristina Senographe Pristina was designed to completely revolutionize the patient experience to make it more comfortable. The gentle, rounded corners of the bucky, where the breasts are positioned, help reduce patient discomfort. Instead of requiring women to use conventional handgrips, which may cause tensing of pectoral muscles, making it hard to acquire pristine images, they can lean comfortably on armrests, relaxing their muscles to simplify positioning, compression, and image acquisition. Senographe Pristina’s DBT delivers superior diagnostic accuracy at the same low dose as a 2D mammography exam, the lowest patient dose of all FDA approved 3D mammography systems. •
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N EW DAT E S FEBRUARY 16-18, 2018
Vegas
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ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
ADVANCING THE IMAGING PROFESSIONAL
NEW LOCATION T H E M R E S O R T, L A S V E G A S
Baby! A P P LY TO BE O N E O F T H E I C E 1 8 As one of 18 plus hand-picked imaging leaders, you will have the rare opportunity to network with the best and brightest in the industry, gaining invaluable knowledge helping you and your department grow and prosper. There will be several exciting networking events, including our “ICE18 Talks” where you can learn and share innovative and creative ideas. The event’s grand finale will have you take part in the Reverse Expo, which provides brief one-on-one introductions with vendors who will share product information that will assist with equipment and service needs. There is no charge for ICE18 participants to attend the Imaging Conference & Expo or the ICE18 Leadership Summit & Reverse Expo. Complimentary lodging is provided during the event.
A P P LY TO DAY AT AT T E NDICE .CO M/ ICE 18
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H C COA P U ‘E M
IMAGING SERVICE TRAINING BOOSTS BIOMEDS AND BOTTOM LINES BY MATT SKOUFALOS
or biomedical technicians, having a fundamental understanding of medical equipment and the ability to repair it is a critical skill set, if not typically attainable outside of a technical college, military service or certificate program.
The foremost credentialing institution in the healthcare technology management space, AAMI Credentials Institute (ACI), offers five certificate programs: Certified Biomedical Equipment Technician (CBET), Certified Laboratory Equipment Specialist (CLES), Certified Radiology Equipment Specialist (CRES), Certified Healthcare Technology Manager (CHTM) and Certified Quality System Manager (CQSM). For professionals who want to advance their technical skills in the medical imaging space, getting that education can be somewhat scattershot. Professional certifications are provided by only a handful of individual organizations, specialized training schools, or from the manufacturers of imaging equipment themselves. Some of that technical training may be provided exclusively to employees of those manufacturers; some of it may come around infrequently, and only thanks to the efforts of HTM professional associations. Much of it is expensive to acquire, ranging in the thousands of dollars for some device-specific training, or bears the added costs of travel and lodging in addition to time off from work. But when institutions invest in their employees’ professional development, there are savings to be had on a much larger level, to say nothing of improvements in departmental cohesion, the advancement of individual careers, and the overall quality of the patient experience. At places like the Radiological Service Training Institute (RSTI) of Solon, Ohio, individuals can gain valuable training that enables them to competently repair and maintain a variety of medical imaging equipment. RSTI offers four basic two-week courses. RSTI President Dale Cover said the time it takes to develop classes depends upon the complexity of the machine and its market availability (the sweet spot is those machines that have been on the market for three to five years). The company offers instruction in repairing devices from “basically ev-
COACH ‘EM UP ery manufacturer and most modalities,” from basic X-ray up through CT and MR, Cover said. Students split time between classrooms and the workbench, and their rosters include OEM and ISO employees as well as those from hospital biomed departments. By hosting the classes at its Ohio headquarters, RSTI gets to separate technicians from the day-to-day interruptions they might find at their workplaces, while also offering an opportunity for practical education. “We don’t talk about what the problem is; we go out to the labs and we go show you,” Cover said. “We interact with the machine. If a question comes up, we go to the lab and we can show you what works. Hands-on is the best.” From Cover’s perspective, that technical expertise is critical for the safe maintenance of medical equipment. The more training that professionals receive, the more work they can take on, including specific devices or entire classes of equipment – which often, if not always, means an increase in pay. Technical certifications don’t just help advance the careers of those who maintain the devices, they also help the departments that employ them to reduce or eliminate service contracts and save money. Cover estimates that standard service contracts can hit as much as 9 to 12 percent of the original cost of a piece of imaging equipment; training can allow a hospital to trim that figure to about 3 to 5 percent of the original equipment cost. “Some machines are going to be loss leaders, and some are going to be gravy,” he said. “You’ve got portables, which don’t really have a high cost for actual maintenance, so you can cut that out right away. But if you look at your CT and MR, you might be looking at experience issues that put you behind the eight ball, where you still have to call the OEM in too often, and that eats into your contract or what you saved on the contract.” Cover believes there’s a cost to the lack of education within a department, too; shying away from maintaining mission-critical equipment in-house means that health care organizations are prone to lost opportunity cost or potentially longer wait times for service when things break or need to be taken offline for preventive maintenance. Improved uptime 38
keeps imaging departments safer and able to generate more revenue; it also can mean that patients receive a higher quality of service and a better overall experience. “The depth of training has an effect,” Cover said. “In-depth knowledge will help the service technician identify correctly the part that’s needed so you don’t have to guess. [If you can] drop the contract, then you start whittling away what it costs to do the actual service work.”
Beyond the workplace, Bell praised regional professional associations like CABMET, CMIA, CEAI and NESCE for helping biomeds and imaging technicians network on monthly, quarterly, and yearly schedules, holding symposia on how to troubleshoot typical failures, and offering external education or on-the-job experience. Jim Rickner, Global Training Director at Conquest Imaging of Stockton, California, shares Cover’s perspective about the connec-
Better in-house technical training can also build morale. It shows staff that management believes in their capabilities, and supports cohesion in a team-centered approach to care.
Better in-house technical training can also build morale, he said. It shows staff that management believes in their capabilities, and supports cohesion in a team-centered approach to care. “I’ve yet to see a good employer spend money on questionable employees,” Cover said. “Training shows your engineers you believe in their abilities. When you’re responsible for your own equipment, you develop an ownership mentality, and that leads you to be more proactive because that’s your reputation on the line.” Robert Bell at Tri-Imaging Solutions of Madison, Tennessee, said that although very few biomeds are certified to work on medical imaging equipment, many more ought to be. Tri-Imaging offers a biomed-to-imaging certification, which Bell said underscores an institutional commitment to creating a culture of education. When employees can advance their knowledge bases, workplaces benefit on the whole, he said; especially those that ingrain supportive practices. “Put study groups together; have people that want to work on making themselves and the workplace better,” Bell said. “OEMs and ISOs should be progressing towards a goal of 100-percent certification in your role.”
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
tion between staff training and cost savings, which Rickner said typically hits exponential levels when departments are fully schooled. Whether reducing full contracts to shared-service or parts contracts, or removing them altogether, in-house professional development can save an institution tens of thousands of dollars annually if it’s willing to invest in staff and wait for the payoff. “There is typically a period of about a year where intense training is needed,” Rickner said. “What we have seen is that it can take up to four years to fully transition a biomed department off of service contracts to being fully self-sufficient.” Measuring the savings in service costs over time is one metric of success, but Rickner points out that qualitative, overall patient-care metrics like system uptime, quicker responses to problems, and not having to reschedule patient exams, are less visible but no less significant benefits to prioritizing institutional professional development. Today, he said, that charge is being led by independent service organizations (ISOs), which advocate a right-to-repair approach to connect technicians to device-specific schooling that may sometimes be closed off to them by original equipment manufacturers (OEMs). ADVANCING THE IMAGING PROFESSIONAL
PHOTO COURTESY RSTI
“This is a big trend right now, and it is not just about cost,” Rickner said. “It’s about patient safety and throughput. The qualified person who can respond and get in front of that down piece of medical imaging equipment the fastest is the in-house imaging engineer.” “There is a big push [among ISOs] for the right to repair, and clinical engineering directors are taking a strong stand on this topic,” he said. “The director of clinical engineering at a facility told me that his department is now one of the leading decision-makers on capital purchases. If the OEM is not going to fully train the imaging engineer to have full access to operating and diagnostic software so they can fully maintain the equipment, then that OEM will not be invited to the table when it comes to capital equipment in that facility.” Art Larson, general manager of global services training & documentation for GE Healthcare, said OEMs are aware of the fact that WWW.IMAGINGIGLOO.COM
hospitals have a variety of choices “on how best to employ their ‘inhouse’ biomedical and diagnostic technical staff,” and offer “relationship options” for cross-training and service needs. “In-house teams can be very successful in supporting 80-90 percent of a hospital’s device needs,” Larson said. “In the end, it’s about having 100 percent availability of any piece of equipment when you need it. One should be able to measure Time to Repair (TTR) and Fix Right First Time (FRFT) for the technical staff, and that helps to give quantifiable metrics on labor and material spend.” Larson also believes that “welltrained, well-balanced” in-house imaging service technicians contribute to “all the qualitative indices in a healthy organization: job support, work/life balance, teamwork, customer focus, safety, etc.” To achieve those ends, however, he believes the health care industry must overcome a talent gap on the technical service side if it is to provide the best
quality of care for patients. “OEMs, ISOs, and the variety of schools face a major challenge to train a new breed of engineer, and to do it in a way that takes advantage of the technology available today,” Larson said. He foresees an uptick in the use of augmented reality and virtual reality software overlays as part of training, but also as a replacement for “some of the intelligence that we assumed was part of our biomedical engineer.” “Those OEMs and health care professionals that understand this dramatic change in both technology and skill profile will be able to keep up with the growing cost challenges of our industry,” he said. That’s an attitude shared by Nanci Wozniak, vice president of education services at Siemens Healthineers, who said the educational content and strategy of customer support her organization has offered its clients has shifted in the past few years to outcomes-based training. Because so much is driven by the end-user or the technician servicing a piece of equipment, there are a number of indirect variables involved in making that calculation. Wozniak said that means the focus then becomes how to best create the outcomes clients say they most want to track. “So much of our education has transformed into a complicated engagement and personalized education planning process,” she said. “If it’s not making a positive impact on their business, no one has the time for it. It’s got to be very personalized to the key performance indicators.” To that end, Siemens Healthineers offers customized education programming for its customers, with plans tailored to metrics
they define, such as quality of care, patient outcomes, operational efficiency, or equipment utilization. Wozniak says such calculations allow institutions to measure the effectiveness of their trainings against prior needs assessments. To her, service technician training is an important step in improving quality and efficiency in a hospital environment, but so is keeping technicians, clinicians, and physicians in the loop to limit re-scanning and improve the accuracy of images captured. The difference in value of a highly competent technologist versus that of a generalist is $155,000 annually, Wozniak said, citing an Advisory Board study from November 2016. “Anybody that’s servicing that product can make sure they’re competent in what they’re doing and that the performance of that scanner is driving effectively,” Wozniak said. “If you have a less-than-competent technologist or just an average person who knows the basics of scanning, it’s costing money because they’re not able to generate the volume and quality of study that a competent technologist can.” “The whole health care game is around decreasing costs and increasing the quality of care,” she said. “Looking at education and measuring quality impact from training and education, we’ve got programs around each of the imaging specialties. The machine operating effectively is a critical step, but if the repairs and annual maintenance is not being kept and done appropriately, it sets everybody else up for failure downstream.” ICE Preparing for the CRES Test? There will be a CRES prep at the Imaging Conference & Expo, February 16-18, 2018, in Las Vegas. Visit attendice.com for more info. ICEMAGAZINE
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ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
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insight
IMAGING MATTERS Importance of Community
A
lthough I do not typically write in the first person, and I normally write about ideas and concepts that are very broad, this article will be a bit different. This article started with a conversation I had about the 2017 Imaging Conference and Expo (ICE) in the Washington, D.C. area. The conversation started when comparing calendars to ensure that all of the work that needs to be completed for the month of July would be done. June is the end of the fiscal year for me. This is a critical time of transfer into a new business year. When I indicated that I would be gone the third week of July to participate in ICE, I was given a small smile. The assumption was that I am going on a short vacation from work. Now, I admit, it is nice to see old friends. This is a small community and we are spread all over. So I do get to eat meals with people that I only get to see once or twice a year. I get to visit with individuals from every spectrum of imaging and every experience level. There is a sense of carnival or celebration during those few days that pass much too quickly. I also check email several times a day and follow up on phone calls from work while at ICE. I am discussing imaging issues, needs, ideas and theories for 12 hours
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a day. I am talking with vendors about what they have to offer and, more importantly, how they could change or improve to meet the needs we have in our health care system. I am honored enough to have been able to present at ICE. It is kind of exciting when someone at my presentation comes up the next day and shares a question or idea about the subject matter of my presentation and we discuss their ideas and challenges. I attend as many training sessions as I am able, and I take notes at the keynote speaker’s presentation. In short, I work the ICE conference. If I am going to be there I want to get as much out of it as I can. Even if I spend time discussing an issue or idea that is not directly impacting my daily work, I am better for knowing what is happening across the industry. I work the conference and expo hall, but it is fun work! Finally, after expressing the above to the individual that gave me the smile, I discussed the most important aspect of ICE. This, and other medical equipment conferences, is an opportunity to strengthen our community. We as a community can express what needs and desires we have. We are able to have some input into the future of our industry. We can become a resource for those just beginning in our in-
Written by John Garrett Manager, Clinical Engineering at Catholic Health Initiatives
dustry. Medical imaging matters now and it will only become more important. This is our opportunity to contribute to something bigger than ourselves. ICE John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine. He has worked for third-party service companies, manufacturers sales companies, and in house imaging teams. Currently, he is manager of clinical engineering at Catholic Health.
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insight
CAREER ADVICE Keeping Up with Technology and Training
P
reventative maintenance programs are a high priority in medical imaging service departments. Keeping up with new technological advances is important to provide the tools and resources imaging service professionals need to be effective while working on complex equipment. If an individual or an organization ignores technological changes, they quickly fall behind in attempts to efficiently service equipment and provide outstanding customer service. It is also extremely important to remain compliant with regulatory requirements that accredited hospitals use to maintain standards. Additionally, patient safety can be at risk if technology updates have not been followed. Many organizations are now asking their imaging service professionals to become certified. Certification for Radiological Equipment Specialist (CRES) is recognized as a professional achievement and enhancement to an imaging service professional’s career. However, as much as these individuals would love to become certified, many radiology service professionals feel that it is almost impossible to take time off from their duties for certification training and testing, or even learn more about their field. The good news about training, including CRES training, is that much of the training can be accomplished from a personal computer. Also, the Radiology Service Training Institute (RSTI) offers a very comprehensive CRES Instruction Self-study Program for a reasonable fee. There is a tremendous amount of Healthcare Technology Management (HTM) training online, and much of it is free. If a cost is involved, an organization 42
will pay for it if budgets allow. That should not be a deciding factor, though, as individuals should be willing to pay for some training. It shows dedication to their career and organization. There are informative articles in trade magazines such as ICE, TechNation, BI&T, etc. Many webinars and other resources are also offered online. OEMs offer online training and discussion forums. They also provide in-house training for new equipment users and other technical support to clients. Users have access to newsletters to keep them abreast of specific equipment updates, alerts and technical support. Local, regional or national professional association memberships provide a wealth of
Written by Cindy Stephens Stephens International Recruiting, Inc.
“If an individual or an organization ignores technological changes, they quickly fall behind in attempts to efficiently service equipment and provide outstanding customer service.” information. Regulatory agencies provide alerts and updates if an individual provides contact information. Many independent service organizations (ISOs) offer technical service forums, articles, webinars and technical support on their websites. While many companies do not require the CRES certification or continuing education, they do expect employees to be current with the latest technology, and to be flexible and work on multi-vendor imaging equipment. Additionally, service professionals must know how to maintain older imaging equipment in hospitals and
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
clinics that have not had an opportunity to upgrade because of budget constraints. There are generic classes taught by many colleges for entry-level individuals, such as an introduction to X-ray service class that will teach the basic concepts of X-ray systems that all operate under the same principles. There are reputable radiology equipment service training schools and some ISOs offer training. The best method of training is always the hands-on training gained on the job. It usually comes with the assistance of an onsite service engineer or manager. ADVANCING THE IMAGING PROFESSIONAL
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Conferences, such as the and assists with bringing serImaging Conference and Expo vice in-house. (ICE), MD Expo, AAMI, and others In departments with several provide excellent updates on radiology service professiontechnology. These conferences als, cross-training is especially provide a myriad of education- important. It creates a team al opportunities and attendees approach to the service departcan get expert advice from ex- ment, and it ensures complete hibitors as well. equipment coverage during the We are a leading Many health care organi- absence of the primary person X-ray parts distribution zations have developed on- responsible for servicing specompany in the United site training programs and/ cific imaging equipment. ProStates and around the or in-services to assist ser- viding a fully functional team world with quality previce professionals as well as for all of the radiology equipowned replacement the end-users of the complex ment is more productive overparts for all X-ray equipment. OEMs offer train- all and provides better customModalities. ing, especially with upgrades, er service. or training is included in the neAs technology continues SEARCH OVER gotiated terms of a new equip- to advance and become more 15,000 PARTS ment purchase. If necessary, complex, it is important to IN-STOCK OEMs canAPPROVED send in an instructor CHANGES keep up with NEEDED new trends and PROOF or specialist to provide on-site technological advances to reWe provide specialized De-Installation service training to a group of service inmain competitive and relevant CLIENT SIGN–OFF: throughout the United States. dividuals and end-users in the in this highly technical career department. This allows tech-THAT field.THE Ensure your department 330-998-6837 PLEASE CONFIRM FOLLOWING ARE CORRECT nicians to attend the training has the tools and resources for facebook.com/xrayparts18 PHONE WEBSITE ADDRESS SPELLING www.xraypartsinc.com GRAMMAR without LOGO taking significant time NUMBER imaging service professionals away from their duties. This is to provide efficient and effecespecially helpful toward the tive customer service. ICE WIDTH 7” end of an OEM service contract
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insight Sponsored by Advanced Ultrasound Electronics (AUE)
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ADVANCED ULTRASOUND ELECTRONICS
D EFI N I N G THE STANDAR D
IMAGING SERVICE 101 A
s I write this there is a bill, H.R. 2118, in the subcommittee on health in the U.S. Congress that is called the “Medical Device Servicing Safety and Accountability Act.” If passed and signed by the president, the law would amend the FDA laws to require all persons and companies that service medical devices in the United States to register with the Food and Drug Administration. It also would require those companies to comply with 21 CFR Part 820.198 on Complaint Handling. At first glance the only concern most service companies probably have is the additional cost of registration, especially small ones which have to pay the same annual registration fee as all other companies (that fee is $3,382 for 2017). And it is hard to argue with the idea that a servicer should report a potential safety issue with a medical device. But the 500 or so words contained in this proposed legislation have implications far beyond that. The FDA law regarding complaint reporting requires a documented process be in place for receiving, reviewing, and evaluating written or oral reports regarding the possible failure of a device, or its labeling or packaging. A record of the complaint needs to be kept, and each complaint needs to be evaluated to determine if there is a potential risk to patient safety. If there was a potential safety risk, it needs to be reported to the FDA as a MDR (Medical Device Report, 21 CFR Part 803). This administrative and reporting requirement would be additional work and cost for almost all service companies, and that is basically everyone except hospitals and the manufacturers. A service company is defined in the bill as any person or company other than the OEM that is involved with “refurbishing, reconditioning, rebuilding, remarketing, repairing, or other servicing of the device.” I believe there are larger issues than complaint reporting to be considered by service companies, many of which up to now have had no other regulatory con-
44
cerns beyond registering with state radiation boards and filing a 2579 form after changing an X-ray tube. Companies or individuals that are registered with the FDA are subject to regular inspection. They will also be at risk of having a “for cause” inspection due to a MDR or MedWatch report being filed that claims the company performed service activities that could have resulted in injury or death. I know from personal experience that an OEM can file a completely bogus MedWatch report with the FDA that triggers a “for cause” inspection. The FDA has no easy way of telling if the reported problem is real, and there is little or no risk for the company or person that filed the false report. An FDA inspection will use resources of time and money, and since an auditor or inspector can always find something that doesn’t exactly conform to requirements, it usually results in ongoing additional costs. Servicing imaging systems could be done more safely and effectively if the FDA would enforce the existing laws and ensure OEMs provide the information and
ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
Written by Jim Carr Director of Services and International Operations for AUE
tools needed to perform AIAT activities (assemble, install, adjust, and test). The most specific and stringent requirements are for systems that emit radiation, such as CT scanners, which is covered in Part 1000 of 21 CFR. Part 1000 has some valuable benefits for those working on X-ray systems, primarily because in section 1020.40 (9) it requires the manufacturers to provide the AIAT information at a reasonable cost. Unfortunately for those working on MRI, endoscopes and ultrasound scanners, there is not such specific verbiage. But even in X-ray we see manufacturers getting away with inadequate service manuals and not providing passwords needed to perform preventive maintenance or repairs. That type of behavior, like the legislation to regulate third-party servicers, has the effect of reducing choices and increasing costs for health care organizations. ICE Jim Carr is Director of Service and International Operations for AUE. He may be contacted via email at JCarr@auetulsa.com.
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BRIDGING THE GAP Clinicians and Pros Discuss Race to the Cure
A
s we begin autumn many changing attributes begin to emerge including cooler air temperature in the day and night. Color changes in the trees and foliage bring out a vibrancy that awes all who take in nature’s beauty. This season of the year also kicks off the American tradition of football. Another important segment of the fall season shifts focus to health care issues as the months of September and October bring awareness to childhood cancer and breast cancer, respectively. The battle that continues to be waged against all forms of cancer has seen significant advances over the past 50-plus years. Early detection of the disease has been a major factor in allowing treatment advances to truly be effective in providing the best possible quality of life to patients and their supportive families. This edition of Bridging the Gap will address two crucial clinical equipment areas – mammography and radiation therapy. Each of these are of vital importance in the battle against these chronic diseases. Mammography’s specialized medical imaging equipment uses lowdose X-rays to see inside the breasts and has continued to advance technologically with digital mammography, computer-aided detection and breast tomosynthesis. Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. X-rays, gamma rays, and charged particles are types of radiation used for cancer treatment. The radiation may be delivered by external-beam radiation therapy equipment such as linear accelerators, or it may come from radioWWW.IMAGINGIGLOO.COM
active material placed in the body near cancer cells utilizing internal radiation therapy, also called brachytherapy. For this column, I spoke with Director of Radiation Oncology and Women’s Health Leslie Adams and Imaging/Radiation Oncology Engineer Josh Elwell. The sensitivity of the patient care environment and its urgency in the mammography and radiation oncology departments are typically held at the highest level and regard in all health care organizations. It is this expectation and commitment to patient care accuracy and timeliness to diagnosis along with prescribed treatments that enable the best outcomes for the patient. When Adams and Elwell were asked to share their thoughts regarding this statement, they endorsed it and each pointed directly to the importance of “maximized uptime.” In short, this cancer detecting and treatment equipment must always be performing as intended without exception. Adams shared a business insight, that being as health care organizations continue to be challenged financially in regards to reimbursement of patient billed services, the clinical areas of mammography and radiation oncology from a billing perspective drive both strong top and bottom lines. When coupling together the business value proposition and, most importantly, the high level of patient delivery expectation, the need for effective and efficient equipment service and maintenance plans have little to no margin for error! The low availability of technically skilled mammography engineers and linear accelerator engi-
Written by Alan Moretti Healthcare Technology Management Advisor
neers limits the options of varying service and maintenance models other than depending on the original equipment manufacturer (OEM) or a qualified independent service organization (ISO). Elwell described the technical skill challenge and workforce availability dilemma as ongoing. It is an industry challenge that continues to be a high hurdle in designing effective alternative service and maintenance versus OEM direct modeling. One of the many gaps in these clinical screening/diagnosis and treatment areas revolves around a continued technological servicing workforce hurdle and is tightly linked to the highest expectation to timely and accurate equipment service performance as well as clinical availability to patients. The health care community, as it continues the battle in eradicating cancer, needs everyone’s continued effort and help. Let’s work together to clear all hurdles as we race to a cure! ICE ICEMAGAZINE
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index AUE
ADVANCED ULTRASOUND ELECTRONICS
DEFI N I N G T HE S T AN DAR D
Advanced Ultrasound Electronics p. 44
Technical Prospects KEI Med Parts p. 40
Premier Imaging Medical Systems p. 24
p. 46
Tenacore p. 6 Diagnostic Solutions p. 46
KEI Medical Imaging Services p. 24
Radiology Data p. 45
Ray-Pac® MEDICAL
Field MRI Services p. 15
SYSTEMS TECHNOLOGIES LLC
Ray-Pac p. IBC
The Intuitive Biomedical Solutions p. 40
Medical Systems Technologies p. 40
RSTI/ Radiological Service Training Institute p. 2 Injector Support & Service p. 49
SOLUTIONS
Tri-Imaging Solutions p. 4
Medical Imaging Technologies p. 19
Varex p. 3 RTI, Inc. p. 24 International Medical Equipment & Service p.13
Philips Healthcare P. BC Webinar
Stephens International Recruiting Inc. p. 43
Wednesday
Webinar Wednesday p. 48
THE JDIS GROUP CT • MRI • PET/CT • MOBILE
JDIS Group p. 5
PM Imaging Management p. 49
X-ray Parts, Inc p. 43 Summit Imaging p. 9
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ICEMAGAZINE | SEPTEMBER/OCTOBER 2017
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