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CONTENTS
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HE ROUNDTABLE: T TEST EQUIPMENT Biomeds need test equipment to be able to do their job, but what is the latest in test equipment? TechNation reached out to test equipment manufacturers to find out what devices they have to offer. We also asked them to share any tips and advice they have for HTM professionals.
Next month’s Roundtable article: Patient Monitors
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POWER UP – NEXT GENERATION TEST EQUIPMENT IMPROVES EFFICIENCY Medical devices have been benefactors of a march toward smaller and faster technology, Test equipment used on those devices has also sen advances. Today’s test equipment is more portable and less cumbersome. It includes multi-purpose devices that feature more automation. The same advances that have been seen in computers, smartphones and tablets can be seen in the text equipment available to HTM professionals.
Next month’s Feature article: FDA Update
TechNation (Vol. 8, Issue #12) December 2017 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
DECEMBER 2017
TECHNATION
9
CONTENTS
INSIDE
PUBLISHER
John M. Krieg
VICE PRESIDENT
Kristin Leavoy
ACCOUNT EXECUTIVES
Jayme McKelvey Lisa Gosser
ART DEPARTMENT
Jonathan Riley Sarah Sutherland Karlee Gower
EDITOR
John Wallace
EDITORIAL CONTRIBUTORS
Roger Bowles K. Richard Douglas John Noblitt Todd Rogers Manny Roman David Scott Cindy Stephens Steven Yelton Alan Moretti Jeff Kabachinski
DIGITAL SERVICES
Cindy Galindo Jena Mattison Travis Saylor Kathryn Keur
ACCOUNTING
Kim Callahan
CIRCULATION
Lisa Cover Melissa Brand
WEBINARS
Linda Hasluem
EDITORIAL BOARD
Eddie Acosta, Business Development Manager, Colin Construction Company Manny Roman, Business Operation Manager, AMSP Robert Preston, CBET, A+, 2014 Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System James R. Fedele, Director, Biomedical Engineering Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Biomedical Engineer, MS, Clinical Engineer
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Departments P.12 SPOTLIGHT p.12 Professional of the Month: Michael Chisholm, BMET p.16 Department Profile: Chesapeake Regional Medical Center p.18 Company Showcase: imtmedical p.22 Biomed Adventures: The Land of Jacob P.27 p.27 p.28 p.33 p.34
INDUSTRY UPDATES MD Expo Recap News and Notes: Updates from the HTM Industry AAMI Update ECRI Institute Update
P.38 p.38 p.41 p.42 p.44
THE BENCH Shop Talk Biomed 101 Tools of the Trade Webinar Wednesday
P.62 p.62 p.64 p.66 p.69 p.70 p.72 p.75
EXPERT ADVICE Career Center Ultrasound Tech Expert The Future Tech Tips Beyond Certification Tech Knowledge Roman Review
P.76 BREAKROOM p.76 Did You Know? p.78 The Vault p.80 Scrapbook NCBA p.81 Scrapbook MD Expo p.82 Where is Ben C.? p.84 Service Index p.89 Alphabetical Index p.90 Parting Shot
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SPOTLIGHT
PROFESSIONAL OF THE MONTH Michael Chisholm, BMET The Coach Takes on Challenges BY K. RICHARD DOUGLAS
T
he HTM profession seemed to be a lot tamer than what he was doing many years ago, according to Michael Chisholm, a BMET in the biomedical services department at Lexington Medical Center (LMC) in West Columbia, South Carolina.
“When I was in college, I was working security at Beth Israel Deaconess in Boston and I came upon the biomed department. I found out they needed someone to do PMs at night and since I already had a certificate in computer repair, and was majoring in electrical/electronic engineering at Wentworth Institute of Technology, right down the street from Beth Israel, they made me an offer to work as a biomed performing PMs.” “As long as I completed the PMs, I could study and I found the job to be a whole lot safer than wrestling with drunk and drugged patients in the ER,” Chisholm says. He ended up working at Beth Israel Deaconess from 1985 to 1989. He coordinated the PM program and was
“I love what I do and look forward to coming to work each and every day with the challenges they bring.” assigned to all critical care units. Chisholm realized, after a year of working as a biomed, that this was his true passion. He liked the hospital environment and being a part of the patients’ care.
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Much of Chisholm’s biomed education came from attending technical training schools and on-the-job training. He took it upon himself to study anatomy and physiology, since the college curriculum he took did not cover those areas. “I worked with some outstanding biomedical techs when I first started at Beth Israel Deaconess and working in a teaching hospital afforded me some unique training opportunities not found in non-teaching facilities,” he explains. After working for Deaconess, Chisholm worked as a field service engineer for TRW Medical Electronics, which became Amsco Engineering Services (AES) and he covered hospitals and OEM equipment throughout all of New England. In his current position with Lexington, he serves as project coordinator, critical care specialist, Spacelab ICS administrator, IT integration specialist for medical devices and a mentor for University of South Carolina biomedical engineering interns who work at LMC. A CHALLENGING YEAR Not only does working as a biomed create some challenges on a regular basis but life can throw us challenges as
well. Chisholm has dealt with both, and in one case; simultaneously. He remembers one project that was a little more demanding than others back in 2005. “We just put on a $200 million expansion of all new operating rooms, PACUs and eight-story towers for patient floors, as well as an additional 18 beds of SICU,” Chisholm remembers. “One area that was really challenging was the PACU. I had to install bedside monitors and thin client PCs on 10 pneumatic booms with a very small work space,” Chisholm says. “I was able to use a 24-inch counter post mount from GCX, and from there, I was able to mount the Spacelab Monitor and the thin client PC all on the one mount.” He says that the PACU area also had 16 beds with wall space and he was originally given about two-feet of wall space to install the bedside monitors and PCs. That was before a change in design reduced the space to 18-inches. “This dramatically reduced the spacing so I had to change my plan and order 55-inch wall channels and move my power and network up higher due to the gas lines that were added in my space as well. Over all for the PACU, we ordered $35,000 worth of mounting equipment. This area was really demanding, due to the space and systems we had to mount the equipment too,” Chisholm adds. During this project, Chisholm was diagnosed with prostate cancer in October of 2005. “I had just had some blood work done to check my PSA and the numbers were very high,” he says “Initially, my doctor did not think much of it but still sent me to a urologist. He did some tests and did not see any
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SPOTLIGHT
FAVORITE BOOK “The Testament” by John Grisham
FAVORITE MOVIE “Shawshank Redemption”
FAVORITE FOOD Seafood
HIDDEN TALENT Teaching – I train new biomedical engineering interns that rotate through our department from the University of South Carolina.
FAVORITE PART OF BEING A BIOMED “Working with patients, staff and co-workers.” Michael Chisbolm, CBET, loves his job at Lexington Medical Center.
tumors in the ultrasound images, so he took a couple of biopsies and told me I would not need a follow up appointment and that they would call with the results,” he recalls. “A week later, I was called and told I needed to come in and meet with the doctor,” he adds. “I kind of knew something was not right, so the day before my appointment, I looked up prostate cancer so I would have some idea of what he would be talking about. Sure enough I met with the doctor and was informed that I had prostate cancer and there were cancer cells in my left side sample from the prostate; the test showed this is to be an aggressive cancer and my doctor would like for me to have radiation and chemo.” Chisholm met with the radiation medicine oncologists and was immediately set up for 48 treatments of radiation and four rounds of chemo. “After talking with some family doctors, they encouraged me to check into the surgical option, so I contacted Beth Israel Deaconess in Boston, since they have a top-notch surgery approach,” he says. Chisholm and his family flew up in November and learned that the surgery had to be done right away “So, at this point, I came back and
started the process of handing off the project to one of my coworkers and brought him up to date on all that had been done and what remained to be done,” Chisholm says. “On December 17, my family and I, along with our dog, moved to Boston for a month. On December 23 after five-and-a-half hours of surgery, I was informed by the chief resident of urology that I was very lucky, I had a very large nodule in my left prostate and it was good that I had surgery when I did, considering that in October, two-months prior, there was no nodule visible at all.” Chisholm returned to South Carolina in late January. “This was one of the most stressful moments of my life, trying to make sure the project was on track, and trying to make the right decisions for my cancer care was a bit overwhelming at times,” Chisholm says. THE COACH Besides dealing with some big challenges, Chisholm has garnered something of a reputation because of his focus on teaching. “I received a LEXY Award here at Lexington Medical Center,” he says “Every year, departments, groups of people and
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
WHAT’S ON MY DESK? “Apples, oranges and dark chocolate, any dark roast coffee with hazelnut — have to have my hazelnut – Atomic Fire Balls, my laptop and automated test equipment to test defibs. It would be tough testing defibrillators without it.”
individuals are recognized for outstanding contributions to LMC. I received the award for Service Champion. I have a nickname ‘coach.’ I was recognized for always being ready to ‘coach,’ whether it is an intern, co-worker, RN or physician; I am willing to help teach new processes or help someone understand a new device.” He recently was recognized by AAMI for a Bright Idea and an article was written about his idea. Chisholm and his wife, Michele, have a son and a daughter. Next month, the couple will celebrate 30 years of marriage. Sticking with biomed turned out to be a fulfilling choice in the long run. “I love what I do and look forward to coming to work each and every day with the challenges they bring,” Chisholm says. Chisholm looks forward to more opportunities to coach others and continue a tradition of sharing information.
DECEMBER 2017
TECHNATION
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Real Needs. Real Partnerships. Real Solutions.
SPOTLIGHT
DEPARTMENT PROFILE Chesapeake Regional Medical Center’s Clinical Engineering Department BY K. RICHARD DOUGLAS
N
estled next to the resort city of Virginia Beach, in southeastern Virginia, is the city of Chesapeake. Part of the Tidewater region of Virginia, there are waterways that are prominent features of the area, with access to the nearby Chesapeake Bay and highway access to historic Williamsburg. Fishing, boating and bird watching are favorite pastimes in the Great Dismal Swamp National Wildlife Refuge, which is in Chesapeake.
Serving the health care needs of the people of Chesapeake, and more broadly, southeast Virginia and northeast North Carolina, is Chesapeake Regional Healthcare. The medical center uses an Aramark clinical engineering team to handle the management of its medical equipment. The department is made up of 11 members. The team supports Chesapeake Regional Medical Center, a 310-bed facility, as well as two surgery centers and imaging and diagnostic centers. The department’s director, Tony Bisese, describes Chesapeake Regional this way: “A local, independent, community-focused organization, Chesapeake Regional Healthcare offers area residents what they want: high-quality, technologically advanced health care delivered by people who openly display their caring, concern and compassion.” In addition to Bisese, the CE Aramark team is made up of Michele Laney, administrative coordinator; Mike Gamboa, biomed supervisor; Eric Irwin, BMET I; Ed Cooke,BMET II; Tim Moore, BMET III; Fermo Yanza, BMET II; Shawn Johnson,ISE I; Cecil Kemp, ISE II; Alberto David, equipment distribution tech and Vanessa Richardson, equipment distribution tech. “The Aramark team stands behind its mission to deliver experiences that enrich and nourish lives. The team is known for its innovation and ability to think outside the box to get the job done,” Bisese says.
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“I think the most noteworthy accomplishment of the team does not lean on the technical abilities but the ability to adopt the organization’s values in the hospital and the community,” Bisese adds. The team works as a unit and has a wide variety of skills to cover most devices. “The team is cross trained in many modalities; for example I have three trained technicians on sterilizers. It is
through clinical engineering. They are input into our CMMS. We begin assisting the hospital with service agreements at the point of sale,” Bisese says. AN EPIC PROJECT A recent project called upon collaboration between departments to get it done right. The CE team stepped up to the challenge.
“ The Aramark team stands behind its mission to deliver experiences that enrich and nourish lives. The team is known for its innovation and ability to think outside the box to get the job done.”
important for our hospital departments to recognize the CE department for its technical capacity and not an individual,” Bisese says. “Although the team may have a designated area they are responsible for during PMs, we share the load in rounding and service delivery to ensure the team is known for its contributions to the hospital,” he adds. The group is also active in the management of service contracts. “All service contracts are managed
“Our facility recently went to Epic and incorporated Capsule as the middleware. This was a project that would break down the team’s silo and really lighten the gray area between biomed and the IT department,” Bisese explains. “The team began to understand they no longer could operate within the unspoken rule, ‘biomed is responsible for everything up to the wall.’ The department started to shift from an us to them to now a we (a united service team that would consist of facilities and IT). All
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SPOTLIGHT
The Clinical Engineering Department: From left: Tony Bisese, Cecil Kemp, Eric Irwin, Fermo Yanza, Shawn Johnson, Mike Gamboa, Michele Laney, Ed Cooke, and Tim Moore.
departments would learn to have an appreciation for each other and would have a handshake agreement that patient care and the project completion was the top of everyone’s agenda,” Bisese adds. “I challenged the team to take the ball and run as far as they could with it. They turned into the water boy and when they were pointed in the right direction they did not stop and could not be stopped,” he says. Bisese says that the team even learned to use a new piece of test equipment called the Fluke LinkRunner AT-1000 to test network runs, identify IP addresses, network switches and more. “The team stepping up, and doing this level of troubleshooting, actually brought unity with our IT department. It was also fun to watch them get a quick lesson in HL7 and variable mapping. It was fun to be able to watch the data move from device to Capsule and on to the EMR,” Bisese says. He says that the results were a reward in itself, especially after hours spent on device and server build. “The department now manages all the calls from the device to the Capsule server. They don’t have to wonder if this is an IT or biomed issue. They call us,” Bisese says. “My advice to any department that is looking to move to Capsule: I would say
take ownership of it in the beginning and force the team into collaboration with the other departments. We came out a different and better department with strong relationships with our IT staff,” he adds. RESOURCEFUL MESSAGING Another time the team was faced with a challenge, they found a resourceful way to get information out to their clinical colleagues. “We were receiving a high number of work orders for bed repairs and infusion pumps. After reviewing the work orders, the team determined a lot of the work orders were related to use. It was determined the floors needed an in-service on the equipment. That is normally how we determine if there needs to be additional training on the floors when we see a lot of user errors or cannot duplicate,” Bisese says. They were faced with the problem of reaching the different departments. “Fermo proposed we become a part of the safety fair. It’s a fair that is mandatory for all employees that is held twice a year and we would be able to get the biggest representation of the floors,” Bisese says. “The team pulled together and trained staff on infusion pumps and hospital beds during the safety fair; manning the table for
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Ed Cooke checks an infant warmer.
12 hours a day for three days. The staff was very receptive to the training and even learned extra functions of the equipment. For example, the staff was unaware the beds had back-up batteries and can function unplugged. We saw an immediate decrease in work orders and the team had fun with the interaction they had with the departments. This is a great example of the innovative spirit the CE department at Chesapeake has,” Bisese adds. Outside of work, Bisese serves on the board of the Virginia Biomedical Association. Bisese sums up the teams approach in a favorite quote by Albert Einstein “We can’t solve problems by using the same kind of thinking we used when we created them.” It is that type of thinking that benefits Chesapeake Regional Healthcare’s clinicians and patients every day.
DECEMBER 2017
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE T
he international company, imtmedical ag has been developing medical ventilators and analyzers since it was established in 1999. Renowned for their high precision, reliability and user-friendliness, imtmedical’s products continue to impress with their customization options and superior performance, even in challenging situations. One reason for the company’s success is its close cooperation with IMT AG, which as a development company has extensive experience leading global companies. Thanks to this shared knowledge, imtmedical offers products that stand out from competing products. For more about the company, TechNation interviewed imtmedical Head of Marketing Ernst Willi.
Q:
What are some advantages that your company has over the competition?
Willi: We have short decision-making channels and a very close proximity to the market which enables us to respond quickly to customer requirements and to drive development according to their needs. Our employees are in close contact with our customers every day which means we know very well what they want. In addition, imtmedical stands for Swiss engineering, precision and reliability. Our customers value this very much.
Q:
What are some challenges that your company faced last year? How were you able to overcome them?
Willi: One of the greatest challenges was to get FDA approval for our bellavista 1000 ventilator. In order to receive this approval, a lot of work was necessary, including expanding our regulatory affairs department. Receiving FDA approval is a great success for us. Another challenge was the conversion of our production. We are now working with one of the world’s leading contract manufacturers, which in the early days took great effort until we reached our required high standards.
Q:
Can you explain your company’s core competencies and unique selling points?
Willi: Imtmedical’s development team is fast, precise and creative. Our development department employs several geniuses who are able to quickly realize innovations the
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market needs. In addition to numerous innovative functions our ventilators and analyzers have an exceptional design and a modern, very user-friendly interface.
Q:
What product or service that your company offers are you most excited about right now?
Willi: In our analyzer business unit, we are particularly pleased with the possibilities opened by our latest testing device the CITREX H5. We have already released several apps which make it much easier to test imtmedical’s ventilators. Another advantage of this device is its adaptability. The display can be configured according to the user’s needs which allows them to see exactly what they need in their daily work.
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SPOTLIGHT
“ We have short decision-making channels and a very close proximity to the market which enables us to respond quickly to customer requirements and to drive development according to their needs.”
Q:
What is on the horizon for your company?
Willi: Over the last two years we have been able to launch several new ventilation and biomedical testing devices, including the bellavista mr and the CITREX H5. We plan to keep the current development momentum so you can also expect several new products from imtmedical next year, naturally with the accustomed high quality and user friendliness of imtmedical.
Q:
Can you share some company success stories with our readers — one time that you “saved the day” for a customer? Willi: We are regularly able to really help people, especially in the area of ventilation devices. An example of this is an eight-year-old boy, who must be permanently ventilated due to chronic illness. Thanks to our ventilator, his comfort and well-being have been significantly increased, which is, of course, very pleasing to us.
Q:
How would you describe your company’s facility?
Willi: Our head office is located in the heart of Europe in Switzerland. The research, development, design and marketing departments are located here and this is where our products are developed so they are ready for fullscale production. Since 2016, imtmedical Pte. Ltd. has been operating in one of Asia’s most important business hubs. With that company, our contract manufactures, and our effective sales and service organizations, which are well established on all continents. We are close to our customers, no matter where they are in the world.
Q:
What is your company’s mission statement, or if you don’t have a specific one, what is most important to you about the way you do business?
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Willi: Combining leading technology with affordable pricing is one of our credos. Our mission is to manufacture the best ventilators and analyzers in the world. They all stand for maximum precision, reliability and userfriendliness and are impressive due to their customization options and maximum performance, even in challenging situations.
Q:
Is there anything else you want TechNation readers to know about your company? Willi: We are currently actively expanding our market presence in the US. With Kerwin Sanger, we have a very capable sales representative on the ground who is in close contact with the medical profession and who takes part in trade shows at which biomedical devices are featured.
DECEMBER 2017
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SPOTLIGHT
BIOMED ADVENTURES Visiting the Holy Land BY K. RICHARD DOUGLAS
A
merica has an ally in the Middle East that believes in individual liberties and freedom of the press, with a backdrop of a diverse population. Israel is the home to three major religions, and the only Jewish nation in modern times. The land was once a part of the Roman Empire. Israel declared statehood in May of 1948.
Israel has Jewish, Palestinian Arab and Arab Christian populations living together. The country has the Mediterranean Sea along much of its western edge, offering waterfront resorts and beaches. Israel is bordered by Lebanon, Syria, Jordan and Egypt to the north, east and south. The country has always been a favorite destination for Americans for a number of reasons. The chance to visit Israel came for one American HTM professional, who was able to go there, in large part, because of his son’s education. “My son was awarded a scholarship to a Jerusalem university for his studies in international security and Middle Eastern studies,” says Chris Nowak, CBET, CHP, CSCS, corporate senior director of Healthcare Technology Management for Universal Health Services of Delaware Inc. in
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King of Prussia, Pennsylvania. “The opportunity to meet up with him in Israel as he completed his studies over the summer was fantastic. He was the tour guide for the visit. After being in the country for a few months, he had the opportunity to know where the good spots were to visit,” Nowak says. Nowak previously visited Tokyo and Santiago, Chile, but visiting Israel was definitely on his bucket list. “The 10-hour flight over and the 11-hour flight back in an ELAL Boeing 747 was an experience in itself, as the travelers around me on the flight were as diverse as the religious landscape in the country of Israel itself,” Nowak says. EVER PRESENT SECURITY Because of a series of terror attacks over many years, security is tight in Israel, while balancing the movement of visiting tourists. Nowak learned this during part of his visit. “One day, we visited Ammunition Hill, a memorial site of the 1967 Six-Day War. When we returned to the Old City area, our plan was to visit the Garden of Gethsemane. We exited the public rail system on the Muslim side of the Old City near the Lion’s Gate,” Nowak says. “The access to the Old City was
Chris Nowak and his wife, Suzanne, are seen in front of the Western Wall.
blocked by Israeli Defense Forces (IDF) and only people with appropriate credentials could pass through. There were a hundred or more men kneeling on carpets in the street near the access point.” “We managed to get up to the access point staying close together, and I was able to show my Missouri driver’s license (I did not have my
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SPOTLIGHT
passport), and the IDF smiled and sent me and the family on through the checkpoint,” Nowak adds. “As we walked along the road to the garden, it was eerily desolate,” he recalls. “Very few people were walking on the street. As we snaked our way around the corner on this street, we came upon a mass of Israeli Defense Force personnel. They were restricting all entrance into the Lion’s Gate into the Old City due to violence that happened the day before due to the installation of metal detectors subsequent to the killing of two IDF officers at this gate.” A large group, who were protesting and being restrained by the IDF, made it questionable if they were going to see the garden. Nowak asked a member of the IDF if it was ok to continue and was told yes. As they got closer, this area was blocked by the IDF and there were additional protestors behind barriers. This was only a few hundred feet from the garden. They skipped the visit at that time, but made it back later in the day. SEEING THE SITES Nowak says that getting around to tourist destinations is a combination of walking and catching a bus. There is plenty to do and see, but the requisite security concerns are always a part of the experience. He says that they saw “the Old City of Jerusalem and all of the sites inside of that city. Tourists will do a substantial amount of walking. We took public transportation to the Palestinian Authority side of the country — Bethlehem, Herodium, and Mar Saba.” “My son wanted us to experience the public transportation system. Did I mention he is a cheapskate too? Anyway, the bus ride was comfortable. On the way back into Israeli controlled territory, all Palestinians must exit the bus at the checkpoint. While the IDF check the credentials of these people, other IDF personnel enter the bus and want to see the
The view from Bahá’í Gardens in Israel.
The Church of the Nativity is a popular destination.
Chris Nowak and his son, Jeremy, float in the Dead Sea.
credentials of the Israelis and visitors who stayed on the bus,” Nowak adds. Once everyone’s credentials were checked the bus was released and it headed back to Jerusalem. “We rented a car and drove to Masada, an ancient fortress built high on a mountain overlooking the Dead Sea. A cable car ride to the top is amazing,” he says. “Of course a visit to the Dead Sea was in order so we could do some floating. With the massive amount of salt content, it is effortless to float in the water. A Dead Sea mud covering was also part of the visit too. The mud is supposed to have healing properties for all sorts.” “Before long, it was time to leave Israel and treasure the memories. I
found Israel and the Israeli people amazing, tolerant and welcoming. The history was amazing. To see and feel ancient history provided chills up my spine as I pondered the footsteps of those that came before me in these areas,” Nowak adds. “Transportation around Israel was easy. Public transit is widely available. However, when visiting Jerusalem and the western side of Israel, be very cognizant of the religious holidays and traditions. Many things are not open or transportation is very limited,” he says. For this HTM professional, a visit to Israel has been checked off his bucket list.
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Orlando, FL • October 5-7, 2017
MD EXPO SHINES IN FLORIDA MD Expo exceeded expectations in the Sunshine State. The recent MD Expo Orlando continued the tradition of providing top-notch education, signature networking events, and a world-class exhibit hall in a fun and inviting environment. Those interviewed during the biannual conference presented by TechNation magazine and MD Publishing pointed out their favorite aspects of this industry-leading conference. “This is my fourth MD Expo. I like getting to meet with all of my peers and the vendors that I deal with,” said Randall Guenin, Director of Biomed at Boca Raton Regional Hospital. “I get to take different courses to keep up with what’s going on in the industry. Also, I use (MD Expo) to maintain my CBET. It’s good to be in a group with other people and see what their concerns are and be able to ask questions,” shared Harmon Purviance from Grand View Hospital in Sellersville, Pennsylvania. “I really like the educational sessions and the ability to network with my peers. I like that it’s a smaller conference and feels more personable for networking,” said Jon Kocurek, Clinical Engineering Director at Dartmouth Hitchcock Medical Center. “I like MD Expo because I am exposed to different vendors and new stuff that is coming out. The networking and education side of it is
great. It is good stuff and I try to never miss one,” explained Georges Philoctete, Biomed Tech Specialist, South Miami Hospital. “Oh man! I come to all of the MD Expos. The education is it! It keeps one current on everything. It is invaluable to me,” said Danny Deaton, owner of Deaton Biomedical Services. “The best thing about MD Expo is networking. MD Expo makes face-to-face meetings possible to build trust and trust is the most important thing,” Ignacio Ortega, Manager, Larkin Community Hospital, Palm Springs said.
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“This was my first MD Expo and I think it’s awesome! I hope to come back next year. I’m not a mingling kind of guy but it’s really easy to talk to people here,” said Matt Harley, a BMET III at Sacred Heart in Pensacola, Florida. The next MD Expo will be held April 4-6 in Music City, USA. Find out more about MD Expo Nashville online at MDExpoShow.com. Imaging Service Professionals can attend a conference just for them at ICE 2018 this February in Las Vegas. Find out more about the 2018 Imaging Conference and Expo (ICE) at www. AttendICE.com.
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STAFF REPORT
NEWS & NOTES
Updates From The HTM Industry MEDICAL DEVICE INDUSTRY TAKES HIT IN PUERTO RICO Medical device manufacturers are calling on federal officials to help mitigate disruptions to the supply chain following Hurricane Maria, which devastated Puerto Rico after making landfall on Sept. 20. In a letter, AdvaMed, a trade group that represents more than 20 medical technology manufacturers on the island, asked the U.S. Department of Health & Human Services (HHS) to “prioritize” medical device manufacturers as power and communications services are restored. “We want to make sure we’re in the queue in terms of priority,” Greg Crist, a spokesman for AdvaMed, told The New York Times. “Because if there is an electricity shortage well into November, for example, how can we as an industry make sure we are in line for those priorities, once you’ve taken care of hospitals and essential needs?” Puerto Rico is home to about 30 plants that make medical devices, according to CNN, producing everything from heart valves, pacemakers, and defibrillators to advanced cancer diagnostics.
With major news outlets reporting that roughly 90 percent of the U.S. commonwealth remained without power two weeks after the storm, medical device companies continue to confront a range of obstacles, according to The New York Times. Issues include locating enough diesel fuel for generators to run factories, helping employees get to work from areas where roads are damaged and blocked, and restoring the power grid and phone lines. “Even the facilities that sustained relatively minor damage are running on generator power,” Food and Drug Administration (FDA) Commissioner Scott Gottlieb said in a statement. “They could be without commercial power for months while crews work to restore stable power to the island. The generators allowed many facilities to re-start production, but certainly not all.” The FDA assured industry – and the public – that getting Puerto Rico’s medical device and pharmaceutical manufacturers back online was a top priority.
TRISONICS AMONG FASTEST GROWING COMPANIES IN CENTRAL PA Trisonics has been named to the Central Penn Business Journal’s 21st annual list of the Top 50 Fastest Growing Companies in Central Pennsylvania. This is the third time Trisonics has achieved this milestone. “Trisonics is honored to be receiving this achievement for the third year in a row. We continue to be committed to serving the medical community and are proud to be associated with the prestigious nominees,” according to a company blog. In order to be eligible for consideration, companies were required to show revenue of at least $500,000 in each of the fiscal years ending 2014, 2015 and 2016, as well as revenue growth in 2016, as compared to 2014. For-profit entities that are headquartered in Adams, Cumberland, Dauphin, Franklin, Lancaster, Lebanon, Perry and York Counties were eligible for nomination. The presenting sponsor of the program, Baker Tilly, calculated the nominations and then ranked the companies
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according to revenue growth over the three-year period. Both dollar and percentage increases were taken into consideration. This ranking formula led to the list of 50 winners. Trisonics and the other 49 winners were honored at an awards breakfast on September 25, 2017.
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HTM ORGANIZATION, ASHE MULL COLLABORATION On October 4, 2017, representatives from Make HTM Great Again, the South Carolina non-for-profit HTM association, had a conference call with task force members of the American Society for Healthcare Engineering (ASHE) Board of Directors and paid leadership. The purpose of the call was to form a relationship and explore options for collaboration and partnership between the HTM profession and ASHE. Make HTM Great Again Founder Pat Lynch and Leah Lough, consultant and former executive vice president at AAMI, were joined by Russ Harbaugh (2017 ASHE president), Bradley Taylor (2018 ASHE president), Dean Pufahl (2019 ASHE president), P.J. Andrus (ASHE executive director), Tim Adams (ASHE director of leadership development) and Keith Deline (ASHE Board member). “Our one-hour discussion covered many topics but was cut short by time restraints,” Lynch says. “There seemed to be a genuine attitude and desire to discuss how HTM and ASHE can move toward a much closer relationship. What that relationship will look like remains unclear.” Task force members shared some interesting and notable facts about ASHE’s membership. Currently, 3.5 percent of its members are responsible for, or have oversight of, the HTM function in their facilities. Approximately 400 ASHE members hold HTMrelated job titles. Four of the ASHE board members identify their responsibilities as HTM related. Lynch told task force members that Make HTM Great Again desires collaboration in the following areas:
•A national organization to link and coordinate the efforts of all its local and regional societies. •A dvocating important positions and issues to the public, the FDA, state, federal and local governments, and manufacturers. •A ddressing and solving the major problems threatening health care, hospitals, patients, and the HTM profession as a whole. •R ecognizing the value of HTM in the workplace and the general public. • S treamlining communication to consumers, members, and other health care delivery stakeholders. Lynch also voiced his desire to monitor state legislatures for pending bills that would limit, restrict or modify the rights of hospitals to select service options. Task force members explained that they already monitor state legislative activity via chapters and coordinate actions through their national advocacy liaison. Further, the liaison holds a quarterly conference call and publishes a newsletter. ASHE task force members were receptive to these areas of collaboration and would welcome an exchange of new ideas, input and ways to address issues that affect the future of HTM and facility managers. The ASHE task force plans to discuss the alignment and feasibility of welcoming HTM into ASHE in the future. Another call between the two groups is in the works.
MASERGY’S UCAAS SOLUTION VERIFIED BY GE HEALTHCARE TO WORK ALONGSIDE CENTRICITY SOFTWARE Masergy, a provider of hybrid networking, managed security and cloud communications solutions, has announced that its Global Unified Communication as a Service (UCaaS) has been selected to join GE Healthcare’s Centricity Partner Program. As a program member, Masergy’s Global UCaaS solution has been verified to work alongside the Centricity software suite, giving GE Healthcare customers the confidence that their global communications solution will meet clinical and business needs. “We’re proud to welcome Masergy UCaaS solution into the Centricity Partner Program,” said Neeti Gupta, director of independent software vendor marketing programs at GE Healthcare.
“Masergy’s UCaaS solution will prove to be a valuable asset for our health care customers seeking to leverage technology for better alignment of a patient-centric approach with organizational resources.” First launched in May 2016, the program recognizes interactive and complementary Centricity software and services partners and tests their offerings with GE Healthcare solutions. The program is created with input from GE Healthcare partners to help reduce implementation time for customers as solutions are tested together and common problems are resolved earlier. Masergy has made a strategic commitment to GE Healthcare, recently hiring Bob Morton as vice president of strategic accounts to manage and build
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upon Masergy’s global relationship with GE. Prior to Masergy, Morton spent 18 years with GE, holding various positions including chief marketing officer for GE Healthcare’s finance business. “Patient care is driven by communications, and a health care’s communications system and contact center is vital to this role,” Morton said. “Masergy’s UCaaS will help Centricity software users improve operations and patient care by providing flexible communications across all locations as well as a seamless experience for mobile and personal devices – unifying all communications into one transparent system.” Masergy’s UCaaS is used by health care organizations and GE Healthcare customers.
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INDUSTRY UPDATES
FDA CLEARS NEW ROBOTICALLY ASSISTED SURGICAL DEVICE FOR ADULT PATIENTS
CONQUEST IMAGING CHALLENGES COST FOR HIGH QUALITY PARTS Conquest Imaging has announced its Transparent Pricing Challenge, dropping several top-selling ultrasound part prices as much as 40 percent and challenging health care delivery systems to compare prices and quality against other ultrasound providers. The Transparent Pricing Challenge invites any member of a health care facility to survey ultrasound parts pricing. If another ultrasound vendor has the same part with the same warranty, Conquest Imaging will match the price of that part. Purchasing a part under the challenge also provides the buyer with a six-month warranty, free technical support, part number matching, sameday shipping for orders received before 4 p.m. PT and a pre-paid FedEx return label for the exchange core. Conquest Imaging introduced Transparent Pricing earlier this year with pricelists of topselling parts and probes on its website and applied the same model in SIMPLIFY, Conquest’s Probe Repair program. Having pricing available at a glance, allows ultrasound part and probe buyers to order necessary parts immediately to repair a down system and eliminate the quote step. “Many of our customers are regulated by hospital policy to get quotes from three vendors before they can purchase a part for their down system,” explains Conquest President Mark Conrad. “With our Transparent Pricing, we eliminate one of those quotes for our customers. Our parts warranty is best-in-class at six-months – I challenge you to find a better part at a better price.” Transparent Pricing was created to offer health care delivery systems an alternative to quotes for ultrasound parts and probes. By providing pricing up front, without eliminating services such as part number matching or technical support, Conquest saves the buyer time without compromising great service.
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On October 13, the U.S. Food and Drug Administration cleared the Senhance System, a new robotically assisted surgical device (RASD) that can help facilitate minimally invasive surgery. “Minimally invasive surgery helps reduce pain, scarring and recovery time after surgery,” said Binita Ashar, M.D., director of the Division of Surgical Devices in the FDA’s Center for Devices and Radiological Health. “RASD technology is a specialized innovation in minimally invasive surgery designed to enhance the surgeon’s access and visualization within confined operative sites.” RASD, sometimes referred to as robotic surgery, is one type of computer-assisted surgical system. RASD enables the surgeon to use computer and software technology to control and move surgical instruments through one or more tiny incisions in the patient’s body (laparoscopic surgery) in a variety of surgical procedures or operations. The benefits of RASD technology may include its ability to facilitate minimally invasive surgery and assist with complex tasks in confined areas of the body. The device is not actually a robot because it cannot perform surgery without direct human control. The design of the Senhance System allows surgeons to sit at a console unit or cockpit that provides a 3-D high-definition view of the surgical field and allows them to control three separate robotic arms remotely. The end of each arm is equipped with surgical instruments that are based on traditional laparoscopic instrument designs. The system also includes unique technological characteristics: force feedback, which helps the surgeon “feel” the stiffness of tissue being grasped by the robotic arm; eye-tracking, which helps control movement of the surgical tools and laparoscopic-type controls similar to traditional surgical equipment. The Senhance System is intended to assist in the accurate control of laparoscopic instruments for visualization and endoscopic manipulation of tissue including grasping, cutting, blunt and sharp dissection, approximation, ligation, electrocautery, suturing, mobilization and retraction in laparoscopic colorectal surgery and laparoscopic gynecological surgery. The system is for use on adult patients by trained physicians in an operating room environment. The Senhance System was reviewed through the premarket clearance (510(k)) pathway. A 510(k) notification is a premarket submission made by device manufacturers to the FDA to demonstrate that the new device is substantially equivalent to a legally marketed predicate device. The FDA granted clearance of the Senhance System to TransEnterix Surgical Inc.
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“Earlier this year, two medical-surgical units brought forward concerns about equipment availability. Our staff was having to hunt for oxygen and suction regulators, which were sometimes removed from the rooms. The Nursing Directors inquired about a tethering chain to secure these devices. They found an OEM chain and asked for quotes. At this point, FOBI was able to discover additional alternatives. FOBI provided sample regulators and lanyard solutions for a pilot on one of the floors and ultimately delivered a cost-effective proposal to replace all of the oxygen and suction regulators. FOBI partnered with the hospital’s engineering team to deploy their custom tethers. At the end of the project, the care units had newer equipment and assurance that gas regulators would beavailable in every patient room.” B.P. Clinical Engineering Manager Houston TX
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AAMI UPDATE
New Resource Takes Mystery Out of Developing an AEM Program
I
n the healthcare technology management (HTM) field there is a lot of confusion surrounding three little letters – AEM – starting with what the acronym even stands for, according to Matt Baretich, president of Baretich Engineering based in Fort Collins, Colorado.
“The Centers for Medicare & Medicaid Services [CMS] (the originator of the AEM concept) says that AEM is an abbreviation for ‘alternate equipment management,’” Baretich wrote in the introduction to his new AEM Program Guide. On the other hand, “The Joint Commission [TJC] … says it stands for ‘alternative equipment maintenance.’ … And that’s just the beginning.” In the AEM Program Guide, Baretich, who has been consulting on HTM-related issues for two decades, seeks to address AEM-related terminology, offer ideas for practical implementation, and explain how to remain compliant with applicable standards and regulations. “Unfortunately, there is not yet a consensus on exactly how to create an AEM program,” Baretich wrote. “Some of the proposed AEM policies I have seen are, in my opinion, simply not compliant with CMS and TJC requirements. That’s why the AEM Program Guide goes into such (excruciating?) detail about those requirements.” Eventually there might be a formal AEM standard for the profession – one is currently in development – but many HTM departments need guidance now. “This valuable document is designed to bridge from where we are today (limited resources) to a project that is just
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beginning and sponsored by AAMI: development of a formal standard focused on AEM,” George Mills, TJC’s former director of engineering, wrote in the foreword to the guide. “This document should begin to assure those curious enough to read it that implementing an AEM program is not only possible, but will result in improved HTM program management.” Those improvements? Saving time or money, or both, according to Baretich. “When we can reduce our costs while achieving the same level of safety, we should do it,” Baretich wrote. “Adopting an AEM procedure is not an academic exercise; it’s good business.” The AEM Program Guide can be purchased from the AAMI Store, www.aami.org/store. AAMI’S HORIZONS SUPPLEMENT HIGHLIGHTS HEALTHCARE TECHNOLOGY’S CYBER SENTRIES In the face of increasingly aggressive cyberattacks on protected health information, as well as the threat of medical devices being hacked by cybercriminals, AAMI has released the fall 2017 issue of its award-winning, peer-reviewed publication, Horizons. Horizons is the twice-yearly supplement to AAMI’s peer-reviewed journal, BI&T. This issue presents best practices from leading experts to help healthcare technology management professionals and health IT professionals lock down sensitive data, devices and systems. For more information visit www.aami.org/Horizons.
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BY ECRI
ECRI UPDATE
What You Need to Know About Ultrasound Therapy Systems
T
herapeutic ultrasound units convert electrical energy to high-frequency (i.e., 1 or 3 megahertz [MHz]) sound waves that penetrate tissues to produce pain relief and facilitate tissue healing through thermal and nonthermal physiologic reactions. This energy conversion occurs in the transducer, or sound or treatment head, of the machine. Ultrasound as a modality can be used independently or in conjunction with a neuromuscular stimulator to enhance pain-relief mechanisms and aid in the healing of soft-tissue injuries.
PRINCIPLES OF OPERATION When tissues absorb energy, most of that energy is converted into heat. Therapeutic ultrasound, a modality used in the treatment of soft-tissue injuries, relies on a transducer to apply energy to the patient’s skin in the form of sound waves at frequencies well above those audible to the human ear. A frequency of 1 MHz is used for deep (3 to 5 cm) tissue, while a frequency of 3 MHz is used for more superficial (1 to 2 cm) tissue. Low frequencies (below 1 MHz) are used on some units for greater penetration, but the ultrasonic beams are less focused. Some ultrasound therapy units accommodate the use of two transducers at a time either to treat two separate areas on one patient or to treat two patients at once. Ultrasonic energy is gradually absorbed and converted to heat as it travels through the tissue; the focusing of the ultrasonic beam makes it possible to heat the underlying tissue without overheating the skin itself. Muscle absorbs approximately twice as much ultrasonic energy as fat does; bone absorbs about 10 times more than soft tissue does. In traveling through the first 3 cm of muscle, the ultrasonic beam retains about 50% of its surface intensity value, a satisfactory amount for deep heating. The rate at which tissue temperature increases when exposed to the ultrasonic beam depends on the intensity (power per unit area, expressed as watts/cm2) and local circulation, since blood will carry heat away from the area.
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A therapeutic ultrasound unit has two basic components – a generator and a transducer. The electrical output of the generator is applied through a flexible cable to a piezoelectric crystal in the transducer. The crystal converts electrical energy into acoustic energy through the reverse piezoelectric effect: as the voltage alternates, the crystal expands and contracts, creating mechanical vibrations (i.e., ultrasound waves). This acoustic energy exits the transducer in a collimated beam pattern. A special coupling gel or water is used to facilitate transmission of the ultrasound beam from the transducer to the patient’s skin (not using gel or water, or using an inadequate amount, will cause heat at the transducer-skin interface instead of in the underlying tissues, possibly burning the patient). Some transducers are watertight, allowing for underwater therapy. Most units allow selection of a continuous mode, in which the output power is constant, or a pulsed mode, in which the output is switched on and off; the pulse rate is typically 50 to 150 pulses per second (pps), although some units operate at a higher or lower rate. Pulsed waves are further characterized by the duty cycle, the percentage of time that ultrasound waves are transmitted during a pulsed period. Typical duty
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cycles range from 5 to 50 percent. Because the output power of a pulsed waveform averaged over the on-and-off phase of the cycle is lower, it causes less heating than a continuous output on the same setting. This means that the pulsed setting has fewer thermal effects. Some studies have associated a reduced healing time with pulsed ultrasound. An important characteristic of the transducer is its beam nonuniformity ratio (BNR), which approximates the intensity across the transducer’s effective radiating area (ERA) – the actual area of the transducer that radiates ultrasound energy. The BNR is the ratio of the maximum intensity point on the transducer to the average intensity value across the transducer surface. Areas of high spatial intensities are known as “hot spots” and may cause excessive heating to the underlying tissue. A lower BNR indicates a more even distribution of energy from the transducer (see Figure 1). For correct application of ultrasound, the transducer must be kept in constant motion, using either a stroking motion or an overlapping circular motion. Stationary application can lead to a buildup of heat in one spot, causing a burn to the skin or to deeper tissue. It may also lead to the formation of standing waves, wherein the incident wave and the waves reflected from the tissue interface in the body are superimposed on each other so the peaks of both waves combine to either increase the effect or cancel out the therapeutic effect. Standing waves can damage the tissues that surround the wave and may cause clots to form in smaller blood vessels. Since there is no direct indicator of internal tissue temperature, the operator depends on patient feedback to adjust
the intensity of the treatment and prevent burns. The operator can, however, estimate the output strength by knowing the ERA, the sound-wave frequency, and the length of treatment. REPORTED PROBLEMS Ultrasound output may decline over time leading to less effective or inconsistent therapy. The instrument should be inspected annually and following any mechanical impact to the transducer (e.g., from dropping) to ensure satisfactory output calibration. The transducer assembly is prone to deterioration and should be checked frequently to verify proper transmission and water impermeability. The intensity levels of ultrasonic therapy are generally much higher than those of diagnostic ultrasonic equipment. Clinicians should therefore be aware of potential hazards (e.g., areas of insufficient blood flow that cannot handle the increased metabolic activity caused by ultrasonic treatment) and use therapeutic ultrasound with care. Inefficient coupling caused by a defective crystal, or an insufficient amount of acoustic coupling gel will also cause heat to build up in the transducer and thereby reduce the number of sound waves radiated into the treatment site. Therapeutic ultrasound is contraindicated for use in the eye, the uterus during pregnancy, the testes, and the spinal cord, as well as areas over the heart, pacemakers, malignant tumors, joint replacements with polyethylene or methyl methacrylate (a common glue type), prostheses, or epiphyseal (growth) plates in patients under the age of 20. In addition, ultrasound application may damage tissue that has been subjected to deep radiation treatments.
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Therapists administering ultrasound treatment are also exposed to vibrations passed through the housing of the transducer as they hold the applicator. These vibrations, known as parasitic radiation, may cause acute pain in the hand and finger joints of some therapists. ECRI INSTITUTE RECOMMENDATIONS Ultrasound therapy units should have transducers with connectors to permit user exchange; ideally, the ultrasound unit should operate at frequencies of 1 and 3 MHz and should have continuous and pulsed output modes. Transducers should be watertight and have a BNR of ≤6; pulsed rates typically fall between 50 and 150 pps. Preferably, the unit should come equipped with an automatic shutoff for inadequate transducer coupling. Dual-frequency units have transducers capable of emitting both frequencies through the same treatment head, which is often considered more convenient and easier to use. Buyers should consider units with a maximum output of at least 10 watts because greater energy output increases therapeutic value. If portability is a concern, buyers should consider units that weigh less than 3 kg (6.6 lb) to reduce risk of injury due to strain. Other specifications such as configuration and ERA are functions of patient and clinician preference as well as treatment location.
This article is adapted from ECRI Institute’s Healthcare Product Comparison System (HPCS), a searchable database of technology overviews and product specifications for capital medical equipment. The source article is available online to members of ECRI Institute’s HPCS; learn more at www.ecri.org/ components/HPCS.
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SHOPTALK
Conversations from the TechNation Listserv Q: A: I have a charging issue with a GE Healthcare AMX 4 Plus. First off, we had to replace the batteries as they were due for replacement. After replacement, the portable started having a problem with the breaker tripping. Prior to reaching a full charge, the breaker would trip. We calibrated the battery charger and now the charging meter does not reach full charge, stopping at two bars before it reaches full charge and the message never appears stating that the batteries have completely charged. We did the volt meter calibration before the battery charger calibration so I don’t understand why this is happening. No matter how long we wait, the display never indicates that the batteries have completely charged. We checked FIL/KVP and the input power to the charger board, connections to LVLE and CPU as well as battery voltage. Checked KHZ board connections and -- +24 Volts, recalibrated the unit and it still does not reach charge complete status.
A:
You stated you performed the cal volt meter procedure, but you didn’t say if you performed the cal generator procedure right after the for the volt meter calibration? This is critical, especially if you had a +/- 0.2V difference between the voltage display when compared to actual battery voltage measurement during the cal volt meter procedure.
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I read over your problem again and I think the cause can be described as: the internal capacity meter and the capacity displayed (batteries) are out-of-sync. This can indeed happen when a new battery set is installed followed by a volt meter calibration, just as you described. The percent capacity displayed is catching up to the internal capacity meter. One of the remedies you mentioned already was to charge until the “Charge Complete” is displayed, which in your case never happens. The other solution is to use the built in loop test diagnostic tool and force FF into a particular address location to get the percentage capacity display back to normal. The procedure I have works with certain firmware with certain Controller PCBs. I can’t speak to other combinations. FOLLOW UP: Yes, sorry, we also did the Cal Generator calibration, still giving the same issue. We will have to try the loop test tool as you described.
A:
If you load defaults it will reset the battery metering routines that will then require a full re-calibration. However, before you do that make sure you don’t a) have a bad battery and/or b) there is not a poor connection with your new battery pack. You should have a battery test strip. Make sure each battery is within 0.2 volts of all the others.
A:
I have had that problem many times. I’ll give you the procedure to correct that.
1. Begin with service switch in run mode (up position) and power on machine. 2. The boot sequence will began, after 3 seconds flip service switch down for diagnostics mode 3. Use KVP buttons to scroll the option until you see diagnostics mode then press MAS down to enter. 4. The system will prompt you for password which is MAS up MAS down KVP down KVP up (in the formation of a backwards U). 5. Continue by using KVP buttons to scroll to the system diagnostics option and press MAS down to enter. 6. Use KVP buttons to scroll to loop test and press MAS down to accept. It will ask you for an address. 7. The address is ocb4 then press MAS down. (Enter numeric values by pressing KVP up and Alphabetical values by press KVP down.) 8. Press MAS up for HEX 9. Press KVP down for write and press MAS down to accept 10. Then, you will need to type FF and MAS down to begin the looping process 11. Once you see looping on display hit MAS down 3 times and use KVP to scroll to end service and follow instructions.
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A:
We have been in the process of changing out power strips with the new ones that comply with the required UL standards for each use. We purchased some Tripp Lite PS-406HGULTRA power strips that comply with UL60601-1 (also UL60950-1) to use as “free floating” power strips in surgery whenever the need arises. I’ve found that the power strips don’t work at all, not even the LED power indicator comes on, when used in a surgery room with line isolation monitors in the room. The breakers were not popped. I’m not sure if it matters but our LIMs are very old. The strips work fine in an ordinary 120V outlet outside of our surgery rooms. Also of note, the power strips that meet the UL1363A standard for power strips that are mounted, work just fine in all applications. Has anyone else seen this problem? What did you do about it?
A:
I looked on the Internet and the description of the Tripp Lite PS-406HGULTRA says “patented protection circuit guards against shock hazards by preventing power from reaching the unit’s outlets in the presence of a fault. The protection circuit automatically resets itself and restores power once the fault threat is gone.” Does anyone know of a power strip that meets the UL60601 standard that will work with a line isolation monitor?
A:
Had the same problem with Tripp Lite Power Strips. There is a smart circuit in some models that see no ground with an isolated system and won’t work. Call Tripp Lite they can tell you which power strip to use.
THE SHOP TALK article is compiled from TechNation’s ListServ and MedWrench.com. Go to www.1TechNation.com/Listserv or www.MedWrench.com/?community.threads to find out how you can join and be part of the discussion.
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BIOMED 101
Ways to Enhance your Career
A
s a young HTM professional, I am constantly trying to figure out ways to improve and share knowledge. I seek ways to take my career to the next level and avoid being lackadaisical. Three take-aways that I have learned in the past few years are doing more without being asked, embrace challenges as a learning opportunity and strategically planning steps to reach goals.
Doing more work without being asked might sound far-fetched. Why would anyone do more work if the result appears to be the same as doing the bare minimum? By going above and beyond your workload it helps build character and challenges your limits. For some, doing just their job, or the bare minimum, is satisfying. As for me, I like to challenge myself to be better. Doing more shows not only myself, but my co-workers that I can balance my current workload and take on additional work. The additional work that I take on usually results in making my job or my co-workers’ job easier and more efficient moving forward. I do need to be careful when I take on more responsibility because I do not want to exacerbate my situation if more work is too much too handle. Knowing my limit is important. In addition, I embrace challenges and view them as opportunities to learn. I have encountered many situations in my limited time as a HTM professional where I do not know the answer or the solution is not straight forward and requires time and patience to figure out. Every challenge that I took on varied in result. However, the lessons that I learned by taking on those challenges have helped me become a better HTM professional. An example of a challenge that I took on was attending a code triage gathering where many upper leadership and management were present. Not only did the experience teach me more about the place where I work, but it made me more aware of the
roles that I can take on in an emergency situation and be more than the person that just services medical equipment. The whole experience made me want to improve my role and my department’s
“ Be the change that you want to see and do more, embrace challenges and strategically plan steps to reach your goal.” - Chansothea P.
BY CHANSOTHEA PHOK HTM Professional
role to be prepared for any emergency situation. Even though I am a small piece of the bigger puzzle, I felt the more I can work on my weakness or lack of knowledge by doing more and challenging myself every day I can take my career to the next level. Thirdly, I learned that I need to strategically plan steps to reach my goals. One tool that I use to strategically reach my goal is following the mnemonic acronym SMART The S stands for specific, M stands for measurable, A stands for achievable, R stands for relevant and T stands for time. When making goals, it might be arduous to achieve them if you are not
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
sure what to do to reach that goal. This method helped me stay focused on what is important and realize what I need to figure out so that I can be successful. Be the change that you want to see and do more, embrace challenges and strategically plan steps to reach your goal. I can challenge myself as long as I do not burn myself out. Also by challenging myself in ways that can better my role, I will put myself in a position to teach or bring a fresh idea to my coworkers. In order to be a better HTM professional, I believe I need to be able to teach what I learned as well as take on challenges to advance my career. An analogy that helped put all of the work and effort into being the best into perspective is the iceberg illusion. Everyone sees what is floating on top of the water, but underneath the water is the piece of iceberg that is much larger. Most people will see success as the end result, but they do not see all of the sacrifice, persistence, failure, disappointment, dedication, hard work and good habits that it took to be successful.
DECEMBER 2017
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THE BENCH
STAFF REPORTS
TOOLS OF THE TRADE Pronk Technologies Safe-T Sim
P
ronk Technologies introduces Safe-T Sim, the smallest automated electrical safety analyzer on the market. Safe-T Sim establishes a new standard for portability, automation and ease of use by performing a complete electrical safety test with a single touch. Onboard automated test sequences can be tailored to match the facilities’ preventive maintenance and service protocols, achieving new heights in efficiency and speed. Combined with the Bluetooth option and app, Safe-T Sim can also be operated from a smartphone/tablet to automatically generate electronic test reports, easily transferrable to a CMMS. Safe-T Sim also includes ECG/respiration simulation, “stay onscreen” battery operation and a four-year warranty. For More Information visit www.pronktech.com or contact us at 800-609-9802.
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WEBINAR WEDNESDAY Presenters Address Pertinent Topics
T
he Webinar Wednesday series continues to educate and impress HTM professionals throughout the world. These sessions provide 1 CE credit from ACI on a variety of pertinent topics. Check out 1TechNation.com/ Webinars for a schedule of upcoming webinars.
The recent Webinar Wednesday session “Achieving Better Outcomes Through a Safe, Efficient and Cost-Effective Depot Repair Solution” sponsored by PartsSource was a hit with the HTM community. The webinar was presented by PartsSource Vice President of Product and Service Solutions Brian Tournoux and Vice President of Client Services Will Kinsey, MAP, PMP. They addressed the state of depot repair in an industry relying on safety, security and compliance. They also touched on transactional effectiveness gained from technology enablement, consolidation and process management. Almost 300 people attended the live presentation and more have viewed the archived webinar online at 1TechNation. com. Biomeds who attended the live webinar were impressed by the presentation and learned new things about PartsSource. “I attended the webinar aware that PartsSource does depot repairs, but I was unaware of the lengths that they go to for quality assurance and customer satisfaction. It was very interesting to learn that you are able to track your equipment during the repair process. PartsSource is definitely a company I will keep in mind
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for when I need assistance with certain repairs,” wrote Biomed Jennifer L. “The webinar on depot services was well presented, thorough, and had invaluable information on how to improve your service depot quality, processes, and other information to look into, in order to make it successful. I highly recommend this for everyone to peruse, be a part of, and take into consideration,” wrote Clinical Engineer George D. The webinar “Ultrasound Applications Essentials and Image Artifact Analysis” received the highest attendee rating of any webinar in 2017. The webinar drew 256 attendees and scored a 4.5 rating. Matt Tomory, BASc, head of strategic advancement at Innovatus Imaging, formerly Bayer Multi Vendor Services, presented the webinar. He has over 30 years of experience in the diagnostic ultrasound industry with manufacturers and independent service organizations performing a wide variety of roles including field service, service management, service technical training, technical support, technical writing, research and development, clinical applications, sales and marketing. During the webinar, Tomory presented essential ultrasound image optimization and terminology to empower attendees to better understand how ultrasound images are formed and manipulated. He also covered the topics of image artifacts and noise, their sources and various remedies. The webinar was sponsored by Innovatus Imaging. Innovatus Imaging is a provider for MRI coil, ultrasound transducer, CR reader and dry film printer repair.
“ I am always looking for more ways to increase my knowledge and this was a fantastic webinar. I am excited for future webinars and future learning.” - David B., Imaging Service Engineer
Attendees praised the webinar in post-webinar surveys. “After my experience with this webinar I feel that I have gained a better understanding of the basics of ultrasound. I am always looking for more ways to increase my knowledge and this was a fantastic webinar. I am excited for future webinars and future learning,” said Imaging Service Engineer David B. “Matt was very informative and held my interest the entire time. He explained subject matter in a way that was very
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understandable. He crossed over from imaging to design and performance features to service ultrasound,” wrote Portable Imaging Specialist Douglas B. “This webinar was fantastic! I really learned a lot! It was like taking a basics in ultrasound course except in only one hour. Matt was an excellent presenter. I hope to attend more ultrasound webinars,” Biomedical Engineering Manager Glenn H. said. The Webinar Wednesday session “Recovering from Natural Disaster: How to Prepare Your Department and Get it Back Up and Running” was sponsored by Universal Medical (UMRi). UMRi Senior Product Manager Craig Diener, who has over 23 years of experience in nuclear medicine including 19 with an OEM in multiple capacities, and UMRi National Service Manager Craig Snodgrass, who has 15 years of nuclear medicine knowledge and technical experience in the field, presented the webinar. They discussed an overview of environmental/natural disaster concerns, expert recommendations on how to prepare a department/clinic for unexpected natural disasters, what to do after the occurrence of a disastrous event and how to have a proper support/service plan in place. The webinar was popular with almost 200 attendees. “The webinar on disaster recovery and preparedness was top notch,” Biomed Keith M. wrote in his post-webinar survey. “Thank you for stressing the importance of preparing for a disaster before it happens rather than reacting to one that has already happened,” Biomed George S. shared. “As someone who had to deal with the post-hurricane recovery in Houston, this webinar was a good reflection on how our response compares with the industry, what we could’ve done better, and some things we wouldn’t have thought of,” Imaging Specialist Ryan M. wrote.
The September 27 webinar “RTLS Update: Choosing a Real Time Location System (RTLS) Technology Partner and Using RTLS to Transform Organizations” sponsored by Sonitor was a big hit. Doug Burkott, PMP, FHIMSS, program manager at Ascension Health Information Services discussed the selection process of an RTLS partner. Paul Schulz, healthcare consulting manager at Eide Bailly described a case study about how RTLS has impacted Altru Advanced Orthopedics resulting in transforming workflow improvement and team functionality. Almost 200 people attended the live webinar and several more have viewed a recording of the webinar online. Attendees praised the webinar.
expertise. I highly recommend it for new and established HTM professionals,” Lilly K., instructor/program head, said. “Webinar Wednesdays always presents new and interesting topics. I always enjoy seeing the new technologies – especially this one (RTLS). From equipment service to test equipment, I am always learning something,” Director of Clinical Engineering Jason R. wrote. “Webinar Wednesdays have allowed me to keep abreast and stay in step with current concerns and practices in the biomedical profession. The one-hour sessions are filled with the most relevant and readily useful information,” Bermuda Hospital Board Member Michael S. said. “The amount of information in the
“ Webinar Wednesdays provide great, timely content over a wide variety of topics which is unavailable to their audience in any other format.” - Ted L., Clinical Support Specialist
“Great presentation. I wish the FDA would make this type of system mandatory for all health care facilities by the year 2020 for portable equipment,” Area Manager Lori C. said. “A very informative webinar, well run by experts in the field,” Biomed Fred R. said. “This presentation was an outstanding way to learn about a new and different technology plus the decision tree criteria to select a vendor, very helpful,” Perioperative Clinical Engineering Supervisor Tim C. said. The Webinar Wedneday series continues to receive positive reviews. “The Webinar Wednesday series is a great way to keep abreast of new technologies, useful services and products, and areas outside of your personal
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Webinar Wednesday series is truly phenomenal,” said Tech Assistant Ryan Z. “Webinar Wednesdays provide great, timely content over a wide variety of topics which is unavailable to their audience in any other format,” Technical and Clinical Support Specialist Ted L. wrote. “I really appreciate the Webinar Wednesday series, good subjects and good speakers, as well as a great way to continue my education on current subjects,” Biomed Michael M. shared. For additional information about the TechNation Webinar Wednesday series, including a calendar of upcoming webinars and recordings of previous presentations, visit 1TechNation.com/webinars.
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ROUNDTABLE ROUNDTABLE
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ROUNDTABLE
ROUNDTABLE TEST EQUIPMENT
B
iomeds need test equipment to be able to do their job, but what is the latest in test equipment? TechNation reached out to test equipment manufacturers to find out what they have to offer as well as tips and advice they have for HTM professionals.
The members of the roundtable panel are Pronk Technologies Vice President of Sales and Marketing Greg Alkire, Rigel Medical National Business Development Manager Jack Barrett, Datrend Systems Inc. Vice President of Product Development Ron Evans and BC Group International Inc. Vice President of Sales and Marketing Ken O’Day. Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN PURCHASING TEST EQUIPMENT
Greg Alkire, Pronk Technologies
Alkire: The HTM community is more mobile than ever before, so having test equipment that is portable, easy to use with a high level of reliability are top priorities in deciding what test equipment to purchase. Products that are capable of testing a wide range of medical devices, not just a subset, and provide the flexibility needed for clinical engineers to test according to their procedures and processes are preferred. Durability and warranty are crucial to ensure that cost of ownership will not be high. Barrett: Positive impact on the clinical engineer’s timesavings, ease of use and reliability while achieving the process needs of the organization.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Evans: Purchase decisions should involve reducing time, costs and manpower through the use of automation as much as possible. Users should also consider maximizing their options by a) choosing scalable equipment to account for future capabilities; b) ensuring equipment will communicate with devices from different manufacturers; and, c) ensuring test devices will communicate with CMMS systems. Also you need to consider implementation and support from the manufacturer. O’Day: Since budgets are always limited, it is important to get the best value for the dollars you spend. This does not mean you should purchase the cheapest device available. Know what it is you are currently testing and how those needs may change in the future. When possible, purchase a test device that has an upgrade path. This allows you to capitalize on the money you have already invested and puts you in a position of future proofing your investment. Q: WHAT ARE THE FUNDAMENTAL TEST EQUIPMENT DEVICES EVERY HTM PROFESSIONAL NEEDS? Alkire: Every technician should have a dedicated set of test equipment to complete the most common tasks such as a multi-meter, electrical safety analyzer, patient simulators and any other device required to test specialized medical devices such as X-ray equipment. Where budget limitations prevent having dedicated sets of test equipment for each technician, test devices that are “share friendly” is a big advantage, such as kits that allow one technician to use an SpO2 simulator while a different technician can use the NIBP simulator. Barrett: Electrical safety analyzers are the most used without doubt. Patient simulators can be time-shared. Then, performance analyzers such as ESU analyzers, infusion pump analyzers, vent testers, defib analyzers and other specialty testers are typically one per shop unless it is a larger group.
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ROUNDTABLE
Evans: I don’t think the fundamental needs for test equipment devices has changed radically for quite some time. We all still need safety analyzers, patient simulators, performance testers (oximetry, NIBP, IBP, temperature, ventilators, incubators, infusion pumps, etc.). The changes we are seeing are the way in which some of these devices address the user interface, providing flexibility to meet the need to follow manufacturer’s scheduled test requirements, making user interaction and recording results more efficient, improving the CMMS communication, and allowing integrated automation scheduled testing to improve productivity.
Ken O’Day, BC Group International
O’Day: This is obviously dependent on the modalities the individual has under their responsibility. For those professionals handling the general day-to-day items, they would need a safety analyzer, DMM, pressure meter, patient simulator and tools. Many of the other test devices can be shared within the department like infusion pump, defibrillator and ESU analyzers. Many facilities have specialists within the department who cover imaging, anesthesia, respiratory, lab and surgery. Having a supplier who can supply all the needs is extremely valuable to the facility. Q: WHAT ARE SOME OF THE NEWEST TEST EQUIPMENT PRODUCTS HTM PROFESSIONALS MAY WANT TO CONSIDER PURCHASING AND WHY? Alkire: We just introduced a new electrical safety analyzer, Safe-T Sim. It is the smallest automated safety analyzer on the market with some unique features designed to make safety testing far more efficient and affordable. Biomeds can easily program the unit to run only the tests they want and set the test limits according to their procedures. Safe T-Sim completes the entire auto sequence without any user interaction. Bluetooth connectivity and the Safe-T Sim app provide additional features including automatically generating complete test reports that are easily uploaded to a CMMS. Barrett: Several safety analyzers have recently been introduced. Typically they are small, simple and easy to operate, but with enhanced capabilities such as ability to operate at various line voltages. And, most are below capital thresholds. Evans: The use of wireless connectivity is probably the biggest change in test equipment recently. Almost everyone uses a
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smartphone or tablet and would like to see the same type of capabilities in their test equipment. For example, by using tablet/ smartphone technology as both the user interface and the wireless communication link. Use of smart technology enhances the user experience and enables smarter testing that is adaptable as future requirements change. It would be worthwhile to consider this type of feature set for any new test equipment purchase. O’Day: Some test methods have not changed over the years and this permits the HTM professional to continue to use existing inventories of older models of test equipment. It is important to keep up with the new advances in medical equipment and to make sure that the test equipment being used is truly capable of calibrating and performing PMs to the level demanded by the OEM. ESU generators are a prime example of a medical device that has advanced beyond what most ESU analyzers are capable of testing. The OEMs require a high level of accuracy and some are now generating pulsed waveforms that most analyzers cannot even see. Having a device that can grow with the new developments can save the department a great deal of time and money along with insuring the patient’s ultimate safety. Q: WHAT ARE SOME FEATURES TEST EQUIPMENT SHOULD HAVE? Alkire: Test equipment features and accuracy specifications should be thoroughly reviewed when making a purchasing decision, to verify that the test equipment not only has the necessary features but also meets the accuracy required by the medical devices being serviced. Some test equipment, such as electrical safety analyzers, should provide a means to capture measurements into an electronic record and/or into a CMMS for facilities requiring records with data and those planning to implement it in the future. Jack Barrett, Rigel Medical National
Barrett: With the possible exception of safety analyzers, most are concerned with data capture and traceability. Test reports can be easily attached within CMMS in order to close out work orders. Ease of data capture without additional software is key as many do not want an extra time-consuming step in their process. Evans: I would suggest that test equipment with a high level of automation will result in the biggest impact. Facilities are looking for large savings in time, costs and manpower. Automation helps achieve these goals. And, as I noted previously, ensure your test devices can communicate with your CMMS system.
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ROUNDTABLE
O’Day: Connectivity to CMMS software can be a plus. There are so many choices of CMMS software available today, it is important to get test equipment that can interface with as many as possible. Avoid being limited to test equipment that can only communicate with that OEM’s software. Test equipment with an upgrade path is another feature that should be considered. It is very expensive to throw away a piece of test equipment because it can no longer perform to the level needed. Purchasing devices that can be modified or upgraded will provide that flexibility and protect your limited budget.
Ron Evans, Datrend Systems Inc. Evans: Look for a test equipment provider who has the technical knowledge of the test equipment and how it is used. The provider should be responsive to your needs in a timely manner, and be flexible and willing to work with you if a problem arises.
O’Day: Do your homework before you buy. Not everyone in the department needs the test device with all the bells and whistles. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO Purchase only what you need for each technician. As we like to KNOW ABOUT TEST EQUIPMENT GOING INTO 2018? say at BC Group, “One size does not always fit all.” Look for Alkire: New, innovative test products are being introduced for equipment that has multiple options so that you are not paying for performing preventive maintenance and service onNEEDED medical more than you need. If there is an upgrade path for the tester you PROOF APPROVED CHANGES equipment increasing ease of use and efficiency. Some examples are purchasing, it will help stretch your dollars. Check on where are improved user interfaces, customizable automation and higher the test equipment is manufactured and how difficult it will be to CLIENT SIGN–OFF: accuracy. These benefits will translate into better service of the have it serviced. Does it need to be sent out of the country if there medical equipment and reductions in errors. a problem or can you contact the OEM easily and locally? Look PLEASE CONFIRM THAT THE FOLLOWING AREis CORRECT into the quality program and make sure it meets the highest LOGO PHONE NUMBER WEBSITE standards ADDRESS SPELLING GRAMMAR Barrett: Compare and evaluate to ensure current, and potential available. Ask to view the certifications the company future, requirements are adequately addressed. says they have.
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COVER STORY
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N E X T G E N E R AT I O N T E S T E Q U I P M E N T I M P R O V E S E F F I C I E N C Y
BY K. RICHARD DOUGLAS
COVER STORY
A
HALLMARK OF THE ADVANCEMENT IN TECHNOLOGY HAS BEEN
SMALLER, LIGHTER, MORE PORTABLE AND SOPHISTICATED DEVICES. THIS CAN BE SEEN IN SMART WATCHES, LAPTOP COMPUTERS, DESKTOP COMPUTERS, CONSUMER MEDICAL DEVICES AND DIGITAL CAMERAS. The evolution in computer chips has been a key reason why technology has changed and improved. Newer generations of chips have become cheaper to produce, require less power and are faster. The scale of these newer chips is so small that it becomes hard to imagine. While a human hair is 75,000 nanometers in width, there are chips that will soon be a part of 10-nanometer technology.
Ultra-low-power computer chips will require
so little power that their sources of power will not have to be batteries. Radio waves, solar energy or even vibration will be all that’s required.
COVER STORY
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Computer chips will eventually take on a whole new form as current technology accelerates beyond current design parameters. And, these ultrasmall, low-energy chips will be only one advance in the appearance and functionality of technology. With these changes will come another generation of devices and gadgets that will improve upon the previous generation via incremental improvements in computer chips and other components. Medical devices have been benefactors of this march toward smaller and faster, including test equipment used on those devices. Today’s test equipment is more portable and less cumbersome. It includes multi-purpose devices and devices that feature more automation. The same increase in speed that might improve a netbook computer also improves many test devices. Automating features of test equipment is an advance that has allowed for fewer user interactions. Also upgradability, through software updates, helps extend the usefulness of a test device. The same interface characteristic that makes certain computers, smartphones, software and cars popular is the intuitive nature of some products and that goes for test equipment as well. If operation just makes sense, and doesn’t require much training; it’s a winner. Wireless technology has been a big part of the changes seen in medical device test equipment as well. Continuing the recent trend toward cutting wires in hospitals, along with everywhere else, the need for cables is forever shrinking. UTILITARIAN FEATURES Manufacturers, who consider the practical needs of the biomed community, are designing in features that make their devices easier to use and easier to get to the test site. “We are seeing a lot more combined test devices, i.e. seeing electrical safety analyzers with also patient ECG simulators. Instead of bringing two devices, the technician can achieve
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some initial testing with only one device,” says Jeff Ruiz, Aramark technology manager of healthcare technologies at Holland Hospital in Holland, Michigan. Asked what other features are sought after, Roger Streidl, CBET, biomedical equipment specialist at Soin Medical Center, Kettering Health Network in Beavercreek, Ohio says that portable power helps. “It depends on what you are testing and what the test equipment is. Most of the test equipment we have has the option of battery power, so that makes portable testing easier and is still important. I can’t think of other
“ Portability is still an excellent feature in test equipment. Our biggest comment is that it’s easier to perform a lot of PMs when you get on a roll.” Feldmeier features that we would be looking for at this point,” Streidl says. Neil Feldmeier, MBA, CHTM, director of biomedical engineering for Norton Healthcare in Louisville, Kentucky agrees. “Test equipment that has a long battery life, and combines many features, is the most preferred. If you only need to travel with one or two pieces, while being able to test a wide variety of medical equipment modalities, it reduces clutter on the service cart and unnecessary trips back to the shop,” Feldmeier says.
Raju Bharaj, CRES, a radiology engineer in the clinical engineering department at Good Shepherd Hospital, part of Advocate Health Care, says that “a digital test multipurpose oscilloscope” is the most practical and time-saving piece of test equipment. He says that his reliable Fluke multimeter is the piece of test equipment he uses the most. Bharaj says that for a piece of test equipment to be prized above others, is based on “the multiple features it has, and it’s easy to set up and read capability.” A portable digital oscilloscope with built in multimeter and an electrocautery tester are on his wish list. Mike Raslau, a biomedical supervisor with Advocate Health Care, says he uses “safety analyzers and DMMs” the most. He finds the ProSim 4 Patient Simulator the most practical and time-saving piece of test equipment. Beyond portability, Raslau says, “the ability to transfer data wirelessly into our database,” is the most important feature that is sought out today. He prizes portability, lightweight and multi-parameter capabilities above other features. He says that the INCU-II Radiant Warmer and Incubator Analyzer is the piece of test equipment on his wish list. “Patient simulators have been our hot ticket item recently,” Feldmeier says, referring to test equipment that is most in-demand or most desirable. “As our department grows, the demand for these items has increased. We do a good job of utilizing the equipment that we have. The team does a good job of coordinating service to reduce the wait time for needed test equipment,” he says. Feldmeier says that the most used piece of test equipment is the electrical safety analyzer. “Our technician that travels to offsite locations prefers a ESA that includes the 12-lead ECG. Being able to
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combine test equipment into one case allows for mobility and efficiency,” Feldmeier explains. He also gives the nod to portability. “Portability is still an excellent feature in test equipment. Our biggest comment is that it’s easier to perform a lot of PMs when you get on a roll. Being able to test equipment in place and on the spot once available helps get our technicians get on a roll,” he adds. When it comes to rating certain equipment as prized above others, Feldmeier says that ease of use is high on the list. “We have done a good job of standardizing the patient care equipment at our five hospitals,” he says. “Having similar test equipment, or intuitive test equipment, makes it easier for technicians to travel between these sites. We have a dedicated team at each site, but when the need arises to have extra help at a certain location, it helps the supporting technician be productive, by being able to jump right in. Rather than have to learn a new piece of test equipment before servicing the patient care equipment,” Feldmeier adds. More specialized equipment is on his test equipment wish list. “As we continue to grow our in-house program, by adding even more specialized modalities, we are finding the need to acquire more proprietary test equipment directly from the manufacturers,” Feldmeier says. While intuitive operation is important, one of the most important components of any piece of test equipment is the instruction/user manual. Not reading the manual, before using the test device, is a recipe for problems. The irony, of course, is that it is easy to get upset with end users of medical equipment because they don’t look at the operator’s manual. Along with understanding operation, many test devices will gather some dust in-between uses. Streidl says that the piece of test equipment most in-demand or desirable can fluctuate based on need.
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“It depends on the day and what pieces of equipment are due for PM during the month. When defibs are due, then the defib analyzer is in demand, etcetera. The items that are in most demand, we have multiples of, such as safety analyzers and digital multimeters,” he says. When it comes to practicality and saving time, Streidl offers some suggestions. “Most of the test equipment we have is required to complete PM procedures per the manufacturer requirements, or to help troubleshoot machine problems. The BC Biomedical PS-2010 Patient Simulator is a compact simulator that has combination posts with snaps or openings with rollerball bearings that make it easy to check 10 lead ECG machines with any type of lead end,” he says. “The SIM Cube is very practical for use in checking patient monitors as it can simulate most of the parameters we need to check. The Fluke Sigmapace 1000 saves time when checking external pacers versus checking them with an oscilloscope,” Streidl adds. He also has a favorite ECG simulator that he uses a lot because it is compact and light, and he can hook up the leads to it quickly. “Size and ease of use make test equipment prized in general in my opinion,” Streidl says. Dennis Duck, CBET, a senior BMET with Baylor Scott and White in Grapevine, Texas says that he uses electrical safety analyzers the most and finds that patient simulators are the most practical and time-saving testing devices. Asked about which test equipment he sees as most in-demand or desirable, he says; “Those that are compact, have digital displays, and multifunctional (electrical safety analyzers, patient simulators, pressure meters, precision thermometers, etcetera).” Which test equipment would make his wish list? “An additional test lung for ventilator
NEIL FELDMEIE,
MBA, CHTM, DIRECTOR OF BIOMEDICAL ENGINEERING
ROGER STREIDL,
CBET, BIOMEDICAL EQUIPMENT SPECIALIST
GREG ALKIRE,
VICE PRESIDENT OF SALES AND MARKETING FOR PRONK TECHNOLOGIES INC.
JACK BARRETT,
NATIONAL BUSINESS DEVELOPMENT DECEMBER 2017
TECHNATION
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COVER STORY
testing, a second phototachometer, an additional electrical safety analyzer, an additional patient simulator, a replacement NIBP tester, and a replacement ESU analyzer,” Duck says. He says that test equipment that offers “accuracy/precision, portability and purchase cost,” are prized above others. The SlimSim, SimCube and OxSim from Pronk Technologies and the 232D Fluke electrical safety analyzer are the pieces of test equipment used the most by Michael Howell, a senior biomedical technician with ProHealth Care in Wisconsin. Howell feels that the SlimSim and OxSim from Pronk Technologies, the Certifier FA plus from TSI and the DPM3 from Fluke Biomedical are the most practical and time saving. He agrees with Duck regarding features and says; “Portability is very important, especially if the device can test/simulate multiple parameters and it is easy to use.” On his wish list are the ProSim 8 and Impulse 7000. MANUFACTURERS/SUPPLIERS PERSPECTIVE Some well-known vendors see the features/benefits equation much the same as their customers do. The makers of test equipment are driving improvements in the usefulness of these devices. “Portability remains important especially for the smaller ISOs, when a quick test is needed on-site, in a hospital room or OR. At the same time, having stand-alone operation has gained attention as well for easy data capture. Advantage is amount of equipment, e.g., computer, one has to carry on site,” says Jack Barrett, national business development manager at Rigel Medical. Barrett says that the qualities that make one test device prized are “ease of use, simple operation, functionality.” From the east coast to the west coast, those providing test equipment see the world through the HTM
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world’s eyes. Greg Alkire, vice president of sales and marketing for Pronk Technologies Inc., agrees that portability is important. “Clinical engineering departments now have more responsibilities, including supporting multiple facilities and remote clinics, so having portable test equipment is incredibly important. The industry is also facing challenges caused by inadequate staff to manage the workload, so test equipment is being scrutinized for gaining efficiencies as a vehicle to bridge that gap. Test equipment companies,
and were not as noticeable, such as improvements in accuracy and precision of various measurements such as pressure and flow. New features have reflected innovations in medical devices. Lastly, capturing electronic test records with connectivity to computers, tablets and CMMS systems is becoming more prevalent with some devices that provide measurement values,” he adds. What does he believe makes a particular piece of test equipment prized above others? “Test equipment designed small enough to be handheld with easy user
“ Clinical engineering departments now have more responsibilities, including supporting multiple facilities and remote clinics, so having portable test equipment is incredibly important.” Alkire
focused on the needs of HTM community, are striving to respond with new design solutions that help drive efficiency,” he says. What has changed with test equipment in recent years? “Old standby products driven to obsolesce with new cost-effective alternatives being available,” Barrett says. “Test automation is becoming popular with performance analyzers, internal memory for capturing test results.” Alkire says that competition has helped spur change. “In the last 10 years, some changes in test equipment design occurred abruptly due to new companies emerging into the market, driving these devices to be much smaller than what was available at the time,” Alkire says. “Others happened more gradually
interfaces that provide maximum flexibility to the users are prized above all others,” Alkire says. “Being able to rapidly answer a service call with the tools needed to identify and fix a problem, without being forced to push a big cart of equipment to a department on the fourth-floor is ideal, enabling the HTM community to be flexible and to allow for a faster response time,” he adds. With the accelerating pace of technology, one thing can be certain for the HTM community; makers of test equipment will have something that makes their job easier just around the corner.
For more information about test equipment, read the Roundtable article in this issue of TechNation.
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EXPERT ADVICE
BY JENIFER BROWN
CAREER CENTER
Ten Techniques for Technical Interviews
A
n in-person interview is a professional business transaction where you are the salesperson and the product! No successful sales professional ever “closed the deal” without preparation!
RULE #1
TAKE A DEEP BREATH AND RELAX • Your resume, reference sheet, and portfolio (briefcase) are completed and organized. • You look sharp, polished and professional in your business suit. • You have researched the company/ hospital and are abreast of the industry and its technology. • You feel confident and in control of the situation. NOTE: Do not forget to turn off cellphones, tablets, etc. to ensure NO distractions.
RULE #2
TAKE THE INITIATIVE When entering a room for an interview, make the first move to introduce yourself with your hand outstretched for a firm handshake. (Your handshake should be firm whether meeting with a male or female). This body language demonstrates you are enthusiastic about being there and interested in the company and the position. It also demonstrates confidence and integrity.
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RULE #3
MAINTAIN DIRECT EYE CONTACT Eye contact should be maintained throughout the interview; however, looking away to gather a thought is normal. Eye contact demonstrates confidence, honesty, interest level and enthusiasm.
RULE #4
ADAPT YOUR STYLE TO THE INTERVIEW TYPE When interviewing with human resources, your technical responses can be stated in general terms. However, when interviewing with a technical manager be as technically detailed as possible. Human resources normally looks for personality behavioral traits to see if you would fit in the organization. Although that is also a concern for technical managers, they tend to focus on whether or not you can handle the position technically.
RULE #5
KEEP RESPONSES RELATED Always keep answers related to the topic, not to what you might feel is important in your background. Many times job candidates go off on tangents that have nothing to do with the position.
RULE #6
BACK UP YOUR RESPONSE WITH AN EXAMPLE About 90 percent of the candidates respond to a question without backing up their statements. Use examples to
JENIFER BROWN CEO and Founder of Health Tech Talent Management
add credibility and to help the interviewer visualize your capabilities. Your examples should be directly related to the position for which you are applying.
RULE #7
KEEP IT POSITIVE If you are asked why you left a company, always explain your departure in a positive manner. Negativity makes interviewers uncomfortable and concerned that you might be the same with them.
RULE #8
NEVER BRING UP MONEY/BENEFITS Discussions about money or benefits should not take place until a verbal offer has been made. They may feel you are more concerned about the money or benefits than the opportunity or that you could be too
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easily enticed to change companies if a better offer came along. Interviewers who bring up money and benefits during the interview (especially the first) are probably screening you to see if your expectations are in line with the budget allocated for the position or if you are realistic about your experience or background. Never name a dollar figure; doing so at this early stage rarely helps you and could actually take you out of the running altogether. Most candidates say an amount that is either too high or lower than what the offer will be.
RULE #9
WHEN IT’S YOUR TURN, SPEAK UP At the end of an interview, they will usually ask if you have any questions. On a psychological level, the interviewer
has put the ball in your court and given you an opportunity to ask specific questions. This is your chance to mention your related achievements or experiences that might not have come up.
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EXPERT ADVICE
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B
eing able to troubleshoot diagnostic ultrasound systems successfully not only requires electrical knowledge and basic troubleshooting skills, but also requires understanding exactly what it is you are seeing when looking at an ultrasound image. The very first time I ever saw an ultrasound image, it simply looked like a grey blob on the screen. Understanding what a good image looks like compared to a poor image is vital in troubleshooting. The ability to properly scan yourself and visualize different anatomical structures is necessary to be able to diagnose difficult problems. It will also impress the sonographer and gain their confidence that you know how to scan yourself properly.
Understanding what is meant by “my images don’t look good” requires some detective work along with good scanning ability.
5.
Finally, keep in mind that if you have an inexperienced sonographer, you may want to check to make sure they are picking the correct preset for the type of study they are performing. They may have accidently picked the wrong preset for a specific study.
1.
You may hear descriptions like grainy or wormy to describe the image. Ask specific questions. Is it only the 2D image or do the color doppler and pw doppler displays look poor?
2.
Is the image poor on one specific probe? Probes are one of the highest failure items on an ultrasound system, always try to rule out the probe as quickly as possible – this will save you time and a lot of headaches.
DOUG KEENEN,
FIELD SERVICE ENGINEER
3.
Don’t forget about the probe connector ports. There could be a piece of dust blocking the contacts on pinless connectors or damaged contacts on standard connectors. Also, check to make sure the probe is tightly seated on the probe connectors.
4.
Pick up a probe and start scanning yourself in front of the sonographer
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TECHNATION DECEMBER 2017 64 TECHNATION DECEMBER 2017
and ask him/her to point out exactly what they are experiencing as being poor image quality. If you both are unable to see it at that moment, ask to see a previous study that shows the problem – this is critical for you to determine what is happening, for intermittent issues.
So, if you need to get more proficient at scanning yourself, plan on spending at least an extra 15 minutes every time you are doing a PM or evaluating a service issue to scan yourself. Learn how to visualize your carotid artery, thyroid, liver and kidneys. Properly scanning your heart can be challenging as well. Don’t be afraid to ask your ultrasound technologists for some help in scanning yourself. They usually will be more than happy to help you, time permitting, and it will be well worth it because they will have more confidence in your abilities to troubleshoot image quality issues. For ultrasound tips and tricks and technical videos, visit www.conquestimaging.com or call Conquest Imaging 24/7/365 at 866-900-9404
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65 65
EXPERT ADVICE
BY JOHN NOBLITT
THE FUTURE
We Want You: Part II, III and IV, etc.
I
n the September 2017 Issue of TechNation the cover story by K. Richard Douglas is a must read for anyone in the HTM profession. This article once again highlights areas in the HTM field regarding the aging population of HTM professionals and where their replacements are coming from.
Douglas states in the article that 76 million baby boomers have begun to retire and will continue to retire in the next few years. This mass exodus of skilled labor from the workforce will create a void in many professions and the HTM profession will not be immune to the struggles this labor shortage will create. Douglas further states in the article that an estimated 20 to 25 percent of the entire HTM field will retire in the next 10 years. I can’t verify those numbers off the top of my head, but I must agree with him on this point as I am one of those who hopefully will be retired. Most everyone I know who got into the field when I did, (early 1980s) are talking about how much more time until retirement. The individuals that have carried the HTM torch for a long time now rightfully deserve their retirement, but the question is who is going to carry the torch forward from here? This article has many different perspectives about this crisis, from Barb Christie, Ph.D., and Roger Bowles, Ed.D., both highly regarded educators in the HTM field and Rodney Nolen a biomedical engineering manager. Each of these individuals comments on their perspective of a crisis that is fast approaching the HTM industry. For schools, partnering with employers is a way to help facilitate quality trained technicians and is a great idea. However,
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in my experience, the employers are so busy doing the business at hand that there is little time for collaborating with educational institutions on a continuous basis. However, when there is little to no involvement from employers to educational institutions you may end up with a graduate that is categorized as Rodney Nolen mentioned in the article as “repair humans” and not biomeds. Another suggestion was for manufacturers to be more involved with donations of newer technologies to educational facilities. This again has proven problematic for me as these “donations” effect the bottom line in financial reports so it’s difficult for a manager to make such donations of capital equipment. We educators do receive donations from many different sources and are very grateful for the opportunities for our students to get their hands on medical equipment. Rarely would donations to biomedical programs be considered “new” technologies. Personally, I find that these older technology units for students to work on are great ways to get past the fear of working on medical equipment and to sharpen mechanical skills while reinforcing the theory behind the technology. The suggestions and recommendations that were given in the article, in my opinion, are only the very first step in a long journey to find the
JOHN NOBLITT M.A.ED., CBET
next generation of HTM professionals. One thing that resonated with me – which both educators mentioned – is “word of mouth” advertising. This is where classically I have gotten my very best students. This is when a HTM professional explains to interested individuals what they do, and spark interest in the student and to the point where they seek out a career in the HTM industry. This is where each and every HTM professional can help with the future of the HTM industry. I’ve mentioned it many times before, but every HTM professional should tell a member of their church or their child’s baseball team or to any person searching for a great career opportunity. You would not only be doing a favor for the HTM community, but also to the person getting into this fabulous career field. The last point I would like to highlight, that was mentioned in the article by Giovanna Taylor of St. Petersburg College, is the ability for
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they are training. This educational situation is manageable but in my opinion the lead instructor in a biomedical program needs to have some hands-on experience working in the field. It is my hope for the future that all HTM professionals will get the next generation of technicians excited about the field and encourage them to get the training they need for a very rewarding career. For the next generation of HTM educators, I hope some young HTM professionals will realize the future opportunities and persue a higher degree in engineering or education and bring their expertise and passion about the HTM industry to the next generation of HTM professionals.
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educational facilities to find qualified instructors. Many of the technicians in the HTM field have an associate’s degree from a community college or a military background in biomed. This educational level is very appropriate for entry level HTM opportunities, but this level will not work for an accredited college faculty member. Most accrediting agencies require a master’s degree and 18 hours in the field of study to teach in a discipline. This creates an entire new set of problems as schools are forced to fill positions with faculty members who may not have the experience of working in the HTM field. I know of a college who has to have outside guest speakers to instruct students about the industry for which
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BMDI Support and Strategy
H
ow do you support biomedical device integration (BMDI)? How involved are you in the overall strategy? Meaningful use – which is the use of EMR to improve quality, efficiency and safety of health care – has led more and more medical devices to integrate with the EMR. Now, every hospital is catching up and integrating more and more devices to support this initiative. This allows clinicians to spend more time providing care rather than charting. The ability of integrating vitals from every single medical device at the bedside, as well as alarms, while prioritizing the information sent to the caregiver is not very far away. Soon enough, electronic records will always be available to clinicians regardless of where the patient received a treatment.
How are we as HTM departments preparing for this? Are we aware of our organization’s BMDI strategy and the impact it might have on the operation of our department? Have we looked at the skills our department needs to develop? What has been our interaction with IT? Supporting BMDI varies from one health care organization to another. For the most part, the way this solution is supported has to go through a maturity process as you get all parties involved in BMDI to get acclimated with their roles and the list of issues they might run into. IT can be the first line of support or that may be the responsibility of clinical engineering. The support model where IT is the first line of support has the advantage of not adding any workload to your HTM department. The only time that requires heavy intervention from biomed is during daylight savings or testing of new devices. Some networked devices, such as patient monitors, will get the time automatically from the hospital’s time server while others need to be updated manually. This model doesn’t bring any issues with off-hour calls since the IT helpdesk is usually 24 hours. However, it means that the HTM department is less involved in the overall BMDI strategy. This could lead to less interaction
between CE and IT and risk the purchase of non-compatible devices or deploying devices before they are tested by the BMDI team. Certain organizations choose to put clinical engineering as the first line of support. In this support model, the HTM department will mostly be responsible for the connectivity hardware (gateway, connectivity engine and device adapters). This support model has the advantage of having CE involved in the BMDI strategy. They will not be seen as a break-and-fix department but rather as a technology department that can support equipment and systems. The off-hours support might be an issue since most clinical engineering departments are not 24/7, but having someone on call and any intervention that requires clinical engineering to be on site will be delayed. This will have an impact on the operational budget and will increase your overtime. Ideally, this additional workload should be planned from the beginning of the project. Another challenge will be the skills that your department has. You will need to do an assessment of what classes they need and the skills they need to develop. They will also need to gain an understanding of the BMDI workflow and understand the procedure when they need to pass the call
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INHEL REKIK Clinical Engineering Manager
to the application team or the networking team. With training, clinicians start recognizing who to call minimizing the number of false positive calls that clinical engineering receives. Some HTM departments will add read only access to EMR server and gateways allowing them to easily identify issues remotely and escalate them to the correct team. Learning basic EMR application functionalities can also help HTM professionals solve user-related issues. Regardless of their involvement in supporting this integrated solution, HTM professionals need to learn as much as they can about BMDI by getting engaged, networking with others in the industry and sharing ideas and participate in the roadmap discussion of their organization. They should focus on building a solid collaboration with all IT departments. As the scope of the systems we support expand, one can ask the question: “Should we become a 24-hours department?” – Inhel Rekik, MS, is the clinical engineering manager at Medstar Georgetown University Hospital.
DECEMBER 2017
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EXPERT ADVICE
BY DAVID SCOTT
BEYOND CERTIFICATION I
recently attended the MD Expo in Orlando Florida. Like all the other MD Expos I have attended it was well organized, fun and informative. I attended several of the educational opportunities and visited the exhibit hall. I learned a few new things which I would like to share.
I have talked about the CBET test changing in previous articles. While at the MD Expo, I attended an interesting class by Sherrie Schulte from AAMI Credentials Institute (ACI). She presented the changes for the 2018 CBET Exam. All three exams remain at 165 questions. CBET Content Topic Anatomy and Physiology Public (employee, patient, visitor) Safety in the Healthcare Facility Fundamentals of Electricity and Electronics Healthcare Technology and Function Healthcare Technology Problem Solving Healthcare Information Technology
2017 12% 15%
2018 12% 15%
13% 25% 25% 10%
10% 25% 25% 10%
As expected the content of each topic is staying the same but the amount of focus or the number of questions in each topic is changing somewhat. The changes involve Fundamentals of Electricity and Electronics and Healthcare Information Technology. The other percentages stay the same from 2017 to 2018. Bigger changes came in the CLES test. CLES Content Topic Anatomy and Physiology Biology and Chemistry Safety in the Healthcare Facility Fundamentals of Electricity and Electronics Healthcare Technology and Function Healthcare Technology Problem Solving
2017 12% n/a 15% 13% 25% 25%
2018 n/a 10% 12% 10% 20% 30%
Healthcare Information Technology
10%
18%
As you can see there is a new topic added and one taken out completely. The new topic is Biology and Chemistry. There are also major changes in the percentages of questions asked in each category.
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DAVID SCOTT CABMET Study Group Organizer, Children’s Hospital Colorado
The CRES test keeps the same content topics but the percentages change significantly. CRES Content Topic Anatomy and Physiology Public (employee, patient, visitor) Safety in the Healthcare Facility Fundamentals of Electricity and Electronics Healthcare Technology and Function Healthcare Technology Problem Solving Healthcare Information Technology
2017 12% 15%
2018 10% 10%
13% 25% 25% 10%
10% 25% 25% 20%
While I was attending the class I was thinking to myself, “How would this change how a person studies and prepares for certification?” I concluded that it wouldn’t change much except for maybe studying a little more Healthcare IT Content. The new outline is quite a bit different than the old outline. Go to the AAMI website (www.aami.org) and check out the handbook. The 2018 content is already in the handbook. If you are renewing your certification in 2018 you will be using the new CEU system for renewal “points” now called Continuing Education Units or CEUs. Which, in my opinion, it is much easier and better to accumulate the needed 30 CEUs over a three-year renewal period. I’m looking forward to the next MD Expo in Nashville, Tennessee. I’m sure it will be very well organized, fun and informative just like all the other ones have been. There will also be new opportunities to learn and earn CEUs.
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BY JEFF NIEDERHAUSEN
TECH KNOWLEDGE Beyond The Wrench
I
t’s just another routine day in the biomed shop and suddenly the phone rings. It’s an imaging director fired up because the CT crashed and revenue is going out the door. You tell them you will be right up. Then you wipe your hands on your scrubs after finishing up a breakfast sandwich, and head up to radiology, thinking, “I better fix this or I am going to get chewed on for the next hour!”
Does this sound familiar or close to something you have experienced? Have you ever sat and thought of a life beyond repairing equipment? Many were drawn to this profession for the integral working on machines and being able to be a health care professional, without the many years of medical school and the large debit that goes with it. We could be in the health care arena, and affect patients’ lives in a positive way by making sure the medical equipment attached to them is working as expected and the best it can. For some, this is the pinnacle of their professional career and they could not be happier. For others, this solid foundation can open doors and lead to a greater experience in the patient care world.
JEFF NIEDERHAUSEN Chief Finanacial Officer, Tech Knowledge
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Everyone should take any opportunity presented to them, not only for career growth, but for personal growth too I have been in this field for over 20 years and have seen biomed techs just like you rise to become powerful people within their health systems, facilities or companies. Biomed techs have become vice presidents in large health systems, department heads in hospitals, powerful and effective managers, and everything else in between. Every one of these people I have seen or personally knew started out just like most you, a bench tech. When they started out sitting at their benches, taking equipment apart and cleaning it, they never thought that one day, they would be running the whole program or calling the shots. However, something clicked inside of them over time and opportunities opened up before them, making them want to expand in their professional careers. We all know that not everyone is made for taking the reins and being the leader or the vice president. I have been in many biomed shops across this great country of ours, and I have seen the ones who have that spark and others
where they are perfectly content to be the busy bee fixing equipment daily and there is absolutely nothing wrong with that. We recently promoted a technician at one of our sites to the director of the program. At first, many thought he couldn’t do it, so he was passed over. After a little time passed and candidates just were not clicking, we decided to bring this technician back in the picture for being the director. We wanted to proceed and the client agreed. No one has ever looked back. Now people simply say, “Why did we wait?” He had that spark and that drive to lead the program. He has already taken the program to a new level and the customer couldn’t be happier. Everyone should take any opportunity presented to them, not only for career growth, but for personal growth too. The more we’re open, the more of a valued asset we become for our employer. The more we open up, the more we become a marketable commodity in the marketplace too. When training opportunities arise, don’t brush it off. Be
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full time, married with three little children, and was able to go back and get my bachelor’s degree many years ago. Even now, with my busy schedule for work, I am in the midst of going back and working on my master’s degree. I bring this up to illustrate that anyone can do this if you put forth the effort and time. It is hard and can be difficult, but ultimately the payoff will be worth it. Like the people I mentioned earlier who were biomed techs just like you who thought bigger and used every opportunity they had to educate and better themselves to advance their careers. With biomed as their background, they had the solid foundation to understanding health care and patients coming first. They had the biomed experience to fall back on when things got tough and they knew how to fix things and make them happen. They were proud biomed techs who become leaders in the health care industry and moved beyond the wrench of fixing equipment.
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the person who steps up and gladly trains on a new modality. Don’t be the person who refuses and grumbles about travel! Accept the challenge! Whenever seminars are offered, take them. I would recommend taking any business seminars that are offered to you. Even though you may not be in the “business world,” there are many good and valuable tools that you could learn, not only for today, but for the future. Things like Microsoft Excel, Word, and even PowerPoint are good to learn in this day and age. Yes, techs need to do a spreadsheet every once in a while! Conflict management, dealing with difficult people, good communications are other subjects I would recommend checking out as you grow professionally. The last big piece is school. Never be afraid to go back to school to get that degree you thought about getting. Many companies have tuition assistance that you should be able to tap into. Take it from someone who has done it. I worked
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EXPERT ADVICE
BY MANNY ROMAN, CRES
ROMAN REVIEW Procrastination is a Good Thing
I
have been writing the Roman Review for a very long time. Each month I am required to come up with something witty, enlightening, entertaining, etc. Sometimes I succeed and I get nice feedback.
Most of the time I have no idea what I will write about until past my deadline. I procrastinate. Then I have to scramble to keep from irritating the editor too much. TechNation editor, John Wallace, has learned to move my deadline up in an attempt to get me done on time. I have learned that the line is not as dead as it appears and I move it back. I have always been a procrastinator. I put off doing almost everything until the very last minute or later. I have found that I work better under the pressure of expiring time constraints. My focus is sharper and clearer. This drives some people mad, my lovely wife Ruth for example. Procrastination is good. It is the art of putting things off for a later time. Procrastination is always leaving for tomorrow what we don’t feel like doing today. With practice you get over the anxiety caused by putting important things off. So why do people procrastinate? Sometimes the task is unpleasant. Sometimes we just don’t want to do it. We may expect it to be a difficult process to complete, requiring extra effort. Sometimes we hesitate to engage the task due to a lack of confidence in our ability to complete it properly. Sometimes it just is an irritation we wish to avoid. Sometimes it is fear of failure. Good procrastination is not a sign of laziness. It is a purposeful manner of organizing work to be done. No matter the reason for procrastinating, there is value in putting things off if we do it right. As an example, I was avoiding writing this
“Good procrastination is not a sign of laziness. It is a purposeful manner of organizing work to be done.” column until after the deadline. So, I put my mind’s back burner to work on coming up with what to write. Then, I began to complete other tasks that I had been avoiding. I cleaned out the garage, a very unpleasant task. I rinsed down the driveway and other areas in the back yard. Here in Las Vegas, we get many windy days which leave a thin coat of dust on everything as well as moving each neighbor’s stuff from one yard to another. I have one neighbor who vacuums the small rocks that take the place of grass in his yard every single day. I imagine that he does not know what procrastination is.
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MANNY ROMAN, CRES AMSP Business Operation Manager
So, my point is that procrastination is a good thing because in the process of avoiding one task, we can justify getting others done. Procrastination can get a great deal of other productive work completed. Also, sometimes, not doing something for a while allows us time to determine if the task needs to be done at all. This will avoid the “Do something even if it’s wrong” mentality because of unrealistic time constraints. We are taught to generate a to-do list, prioritize the items and only work on priority one items. That is a great thing for non-procrastinators. I believe that the to-do list should not be prioritized until the time for completion of an item is very close. Until then, work on whatever you wish and you will be happier. If you are the type who worries about not getting things done, I suggest you procrastinate the worrying until later when it is more productive. Well, now that I got this column out of the way, only two days late, I think I will procrastinate the next item on the list until next week.
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THE VAULT
D
o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-December-2017. Good luck!
NOVEMBER PHOTO Otoscope, Ophthalmoscope Set. Submitted by Adam Unsworth, BMET I, Clinical Engineering Schneck Medical Center, Seymour Indiana.
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NCBA SCRAPBOOK The 2017 NCBA Annual Conference was held at the Arrowwood Resort in Alexandria, Minnesota on September 20-22. The North Central Biomedical Association has always featured HTM’s most common issues and hot topics. This year’s spotlights were medical device cybersecurity with a panel presentation. As it has always been, the NCBA featured The Joint Commission updates. Herman McKenzie from The Joint Commission presented on the new EPs and discussed the topic. Another key point was a focus on non-technical topics such as communication. The conference was a great place to meet new people and know what others are doing in the HTM departments throughout Minnesota, South Dakota, North Dakota and Iowa. 1
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MD EXPO SCRAPBOOK For more than a decade, MD Expo has set the bar for biomedical, clinical engineering and HTM conferences. MD Expo provides endless avenues for professional knowledge, a chance to develop valuable relationships and career advancement. Attendees gain extensive knowledge with ACI (AAMI Credentials Institute) accredited educational seminars, as well as the opportunity to participate in signature networking events. The next MD Expo will be held in Nashville this April. Find out more at MDExpoShow.com 1. MD Expo Orlando featured a
5. Speaker David Domanski chats with
8. Delicious food and an open bar
9. HTM professionals learn more
packed exhibit hall that overflowed
attendees. HTM professionals share
provided a great way for attendees
about a product inside the exhibit hall.
into the foyer where exhibitors fea-
knowledge throughout the MD Expo in
and exhibitors to network at the
tured their products and services on
classrooms, the exhibit hall, at network-
Poolside Bash to cap off MD Expo
tabletop displays.
ing events and even during casual
Orlando.
2. Networking at signature MD Expo
10. Matt Tomory presents a class to an attentive group at MD Expo Orlando.
connections made at the host hotel.
events like the Poolside Bash are one
6. Jim Rickner provides examples
of the reasons the event is so popular.
and some hands-on training during his class at MD Expo.
3. Attendees and exhibitors take a break and enjoy a complimentary
7. Amy Hobbs greets an attendee at
lunch inside the exhibit hall.
USOC’s booth inside the exhibit hall.
4. HTM professionals relish the opportunity to meet with vendors and see the latest technology.
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INDEX
SERVICE INDEX TRAINING
Technical Prospects 877-604-6583 • www.technicalprospects. com/
A.M. Bickford 800-795-3062 • www.ambickford.com
6
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
59
P P
J2S Medical 844-342-5527 • www.j2smedical.com
67
Batteries PartsSource 877-497-6412 • www.partssource.com/ shop
4
P
Biomedical BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
BC
Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com
32
P P
D.A. Surgical 800-261-9953 • www.da-surgical.com
32
P
iMed Biomedical 817-378-4613 • www.imedbiomedical.com
65
P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
79
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
26
P P
24
P
P
P
AllParts Medical 866-507-4793 • www.allpartsmedical.com
43
P
P
Injector Support and Service 888-667-1062 • www.injectorsupport.com
73
P
JDIS Group 800-974-9729 • www.jdis.com
60
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
63
P P
RSTI 800-229-7784 • www.rsti-training.com
40
P P P
RTI Electronics 800-222-7537 • www.rtigroup.com
63
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P P P
The Intuitive Biomedical Solution Inc 1-866-499-3966 • www.tibscorp.com
65
P P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P P
Injector Support and Service 888-667-1062 • www.injectorsupport.com
73
P P
Maull Biomedical Training 440-724-7511 • www. maullbiomedicaltraining.com
36
P
Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
39
P P P
JDIS Group 800-974-9729 • www.jdis.com
60
P P
24
P
Contrast Media Injectors
C-Arm Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
Computed Tomography
Auction/Liquidation
P
Diagnostic Imaging
Calibration Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa. com
3
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
51
P P
Endoscopy
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
7
P P
Cadmet 800-543-7282 • www.cadmet.com
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
TECHNATION
SERVICE
Cardiovascular
Anesthesia
84
PARTS
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
DECEMBER 2017
WWW.1TECHNATION.COM
INDEX
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
79
Monitors
P
P P P P
Hand Switches inRayParts.com 417-597-4702 • www.minxrad.com
36
P P
Imaging JDIS Group 800-974-9729 • www.jdis.com
60
P P
Infection Control Healthmark Industries 800-521-6224 • HMARK.COM
Select BioMedical 866-559-3500 • www.selectpos.com
53
P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
21
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
BMES 888-828-2637 • www.bmesco.com
IBC
P
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
59
P P
JDIS Group 800-974-9729 • www.jdis.com
60
P P
KEI Med Parts 512-477-1500 • www.keimedparts.com
63
P P
PartsSource 877-497-6412 • www.partssource.com/ shop
4
P P P
2
P P P
Fluke Biomedical 800-850-4608 • www.flukebiomedical.com
47
P
J2S Medical 844-342-5527 • www.j2smedical.com
67
MedWrench 866-989-7057 • www.MedWrench.com
77
Webinar Wednesday 800-906-3373 • www.1technation.com/ webinars
46
Monitors/CRTs
MRI 37
Infusion Pumps Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions. com
TRAINING
67
SERVICE
J2S Medical 844-342-5527 • www.j2smedical.com
PARTS
37
Company Info
AD PAGE
Healthmark Industries 800-521-6224 • HMARK.COM
TRAINING
67
SERVICE
Capital Medical Resources 614-657-7780 • www. capitalmedicalresources.com
PARTS
AD PAGE
Company Info
14
P P
Infusion Therapy
Nuclear Medicine
FOBI 888-231-3624 • www.FOBI.us
31
P P
Global Medical Imaging 800-958-9986 • www.gmi3.com
J2S Medical 844-342-5527 • www.j2smedical.com
67
P P
Online Resource
Select BioMedical 866-559-3500 • www.selectpos.com
53
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
59
P P
Labratory Ozark Biomedical 800-457-7576 • www.ozarkbiomedical.com
74
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
RSTI 800-229-7784 • www.rsti-training.com
40
P P P
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
P
PACS FOBI 888-231-3624 • www.FOBI.us
31
DECEMBER 2017
P P
TECHNATION
85
INDEX
SERVICE INDEX
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
26 74
RSTI 800-229-7784 • www.rsti-training.com
40
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
Stephens International Recruiting Inc. 870-431-5485 • www.bmets-usa.com/
BMES 888-828-2637 • www.bmesco.com
IBC
P P
Replacment Parts
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions. com
14
P P
J2S Medical 844-342-5527 • www.j2smedical.com
67
Pacific Medical 800-449-5328 • www.pacificmedicalsupply. com
8
PartsSource 877-497-6412 • www.partssource.com/ shop
4
P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
79
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
P
TRAINING
65
SERVICE
The Intuitive Biomedical Solution Inc 1-866-499-3966 • www.tibscorp.com
PARTS
Patient Monitoring
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
CONTINUED
P P
Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
39
P P P
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
61
P
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
A.M. Bickford 800-795-3062 • www.ambickford.com
6
P
P P
FOBI 888-231-3624 • www.FOBI.us
31
P P
51
P P
J2S Medical 844-342-5527 • www.j2smedical.com
67
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
7
P P
Surgical
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
21
P P
67
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
59
P P
Capital Medical Resources 614-657-7780 • www. capitalmedicalresources.com Healthmark Industries 800-521-6224 • HMARK.COM
37
P P P P
Respiratory
Portable X-ray inRayParts.com 417-597-4702 • www.minxrad.com
Telemetry 36
P P
Power System Components Technical Prospects 877-604-6583 • www.technicalprospects. com/
P
24
P
P
Radiology
BMES 888-828-2637 • www.bmesco.com
IBC
P P
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions. com
14
P P
J2S Medical 844-342-5527 • www.j2smedical.com
67
8
P
Interpower 800-662-2290 • www.interpower.com
25
P
Pacific Medical 800-449-5328 • www.pacificmedicalsupply. com
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
7
P P
RSTI 800-229-7784 • www.rsti-training.com
40
P P P
Tenacore Holdings, Inc 800-297-2241 • www.tenacore.com
21
P P
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
59
P P
86
TECHNATION
DECEMBER 2017
WWW.1TECHNATION.COM
INDEX
BC
Fluke Biomedical 800-850-4608 • www.flukebiomedical.com
47
IMT Medical 181-750-6699 • www.imtmedical.com
1820
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
79
Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com
5
Radcal Corporation 800-423-7169 • www.radcal.com
73
Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa. com
3
RTI Electronics 800-222-7537 • www.rtigroup.com
63
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
51
TRAINING
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
SERVICE
6
PARTS
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
Test Equipment A.M. Bickford 800-795-3062 • www.ambickford.com
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
68
P P
Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
39
P P P
AllParts Medical 866-507-4793 • www.allpartsmedical.com
43
P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
15
P P
ATS Laboratories atslaboratories@yahoo-com • www. atslaboratories-phantoms.com/
65
P
Conquest Imaging 866-900-9404 • www.conquestimaging. com
11
P P P
Global Medical Imaging 800-958-9986 • www.gmi3.com
2
P P P
J2S Medical 844-342-5527 • www.j2smedical.com
67
Ultrasound
P P P P P
P
X-Ray
P P
Training Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
39
P P P
ECRI Institute 1-610-825-6000. • www.ecri.org
52
P
Fluke Biomedical 800-850-4608 • www.flukebiomedical.com
47
P
RSTI 800-229-7784 • www.rsti-training.com
40
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P
AllParts Medical 866-507-4793 • www.allpartsmedical.com
43
P
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
61
P
RSTI 800-229-7784 • www.rsti-training.com
40
P P P
RTI Electronics 800-222-7537 • www.rtigroup.com
63
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
68
P P P
P
P
Tubes/Bulbs Cadmet 800-543-7282 • www.cadmet.com
24
P
PartsSource 877-497-6412 • www.partssource.com/ shop
4
P P P
Technical Prospects 877-604-6583 • www.technicalprospects. com/
24
P
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
DECEMBER 2017
TECHNATION
87
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INDEX
ALPHABETICAL INDEX A.M. Bickford…………………………… 6
Global Medical Imaging………………… 2
Radcal Corporation……………………
73
Advanced Ultrasound Electronics, Inc.…39
Healthmark Industries………………
37
Rigel Medical, Seaward Group………… 3
AllParts Medical………………………
43
iMed Biomedical………………………
65
RSTI……………………………………
40
Ampronix, Inc.…………………………
15
IMT Medical……………………… 18-20
RTI Electronics………………………
63
ATS Laboratories………………………
65
Injector Support and Service…………
73
Select BioMedical……………………
53
BC Group International, Inc………… BC
inRayParts.com………………………
36
Sodexo CTM…………………………
26
BMES………………………………… IBC
Interpower……………………………
25
Southeastern Biomedical, Inc………
51
Cadmet………………………………
24
J2S Medical…………………………
67
Southwestern Biomedical Electronics, Inc.… 7
Capital Medical Resources……………
67
JDIS Group……………………………
60
Stephens International Recruiting Inc.… 74
Conquest Imaging……………………
11
KEI Med Parts…………………………
63
Technical Prospects…………………
24
Crothall Healthcare Technology Solutions… 32
Maull Biomedical Training……………
36
Tenacore Holdings, Inc………………
21
D.A. Surgical…………………………
32
MedWrench…………………………
77
The Intuitive Biomedical Solution Inc… 65
ECRI Institute…………………………
52
Ozark Biomedical……………………
74
Tri-Imaging Solutions…………………
68
Elite Biomedical Solutions……………
14
Pacific Medical ………………………… 8
Trisonics………………………………
77
Engineering Services, KCS Inc………
61
PartsSource…………………………… 4
USOC Bio-Medical Services…………
59
Fluke Biomedical……………………
47
PRN/ Physician’s Resource Network… 79
Webinar Wednesday…………………
46
FOBI…………………………………
31
Pronk Technologies, Inc. ……………… 5
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TECHNATION
89
BREAKROOM
THE BEST TIME TO PLANT A TREE WAS 20 YEARS AGO. THE SECOND BEST TIME IS NOW. –CHINESE PROVERB
90
TECHNATION
DECEMBER 2017
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THE BLACK PIRANHA: EASY AND FAST X-RAY QUALITY CONTROL RTI Black Piranha Features:
All-in-one multifunction X-ray meter
Can measure on scanning beams as well as tomosynthesis
Built-in energy compensation
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