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BIG DATA ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL
NOVEMBER 2018
IT’S KIND OF A BIG DEAL
14 Company Showcase
Rigel Medical
24 Company Showcase
626 Holdings
52 Roundtable
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CONTENTS
FEATURED
52
ROUNDTABLE: DIGITAL RADIOGRAPHY (DR)
dvances in technology continue to A evolve medical imaging and create more options for clinicians. One imaging modality that continues to provide valuable insights to health care professionals is digital radiography (DR). We quizzed a few insiders to find out the latest on DR and what HTM pros can expect in the future.
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BIG DATA: IT’S KIND OF A BIG DEAL I n the HTM department, the ability to pull data and scrutinize it allows for many tasks to be completed. The goals of using big data include cost savings, efficiency, positive patient outcomes and reduced downtime. The ways that extrapolated data can do this in the HTM department are many.
Next month’s Feature article: New Year Resolution: Plan to be a Leader in 2019
Next month’s Roundtable article: Test Equipment
TechNation (Vol. 9, Issue #11) November 2018 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.
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
NOVEMBER 2018
TECHNATION
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VICE PRESIDENT
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CIRCULATION
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Departments P.12 SPOTLIGHT p.12 Professional of the Month: Clarice Holden p.14 Company Showcase: Rigel Medical p.18 Department of the Month: The VA Long Beach Healthcare System Biomedical Engineering Department p.22 Biomed Adventures: The Fast Break before HTM p.24 Company Showcase: 626 Holdings P.27 p.27 p.34 p.36 p.38 p.40
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SPOTLIGHT
PROFESSIONAL OF THE MONTH
Clarice Holden, Committed to the Mission BY K. RICHARD DOUGLAS
T
he U.S. Department of Veterans Affairs depends on people who are committed to their mission of helping veterans and their families to address health concerns. It is testament to repaying those who have rendered their service to the nation.
One of the VA’s many health care systems that provide medical services to veterans is located in Dallas, Texas. The chief biomedical engineer at that facility is Clarice Holden. She is responsible for a critical care team, a networking team and an imaging team. Holden knew what career field she wanted to enter from a surprisingly early age. “I was in sixth grade when I learned about biomedical engineering as a potential college major. I had always wanted to be involved in medicine – and as soon as I understood that biomedical engineering was the fusion of modern medicine and modern technology, I was enthralled,” Holden remembers. She applied to schools based on whether they offered biomedical engineering as a major and picked Tulane University. “While at school, I attended a presentation about working as a biomedical engineer in a hospital setting, for the Department of Veterans Affairs. I thought it sounded like an
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interesting job – so I joined the biomedical engineering department at the Temple, Texas Veterans Affairs (VA) hospital when I graduated,” Holden says. Her formal on-the-job training started as a technical career field (TCF) biomedical engineer intern at the Temple, Texas VA hospital in July 2012. “The TCF program is a two-year program that pairs a novel biomedical engineer with an experienced preceptor,” she says. “The intern is expected to work at their primary hospital for around 18 months, then transfer to a vacancy somewhere at another VA hospital, generally speaking (some interns remain at their primary hospital),” Holden adds. She points out that the interns are “interns” in name only: they work full time, earn the same benefits as other government employees, and carry out assignments similar to staff biomedical engineers. “Interns are allocated around $10,000 a year for travel and training outside the hospital. These funds enabled me to attend several conferences, as well as specific education courses (including HL7/ DICOM and CompTIA),” Holden says. Holden’s training included several good mentors along the way. “In Temple, I was very lucky to be learning from Paul Canaris (who has
had a dynasty of interns over several years), Scott Hornsby (a Navy veteran who has the mission at heart and the know-how to operate the shop, overseeing the maintenance of the $60 million medical equipment inventory), and Lucas Marsh, the staff engineer who went on to become the director of the Charleston VA Healthcare Technology Management Department,” Holden says. She says that because of her experience at Temple, she was prepared to take on the role of a staff supervisor at the VA Greater Los Angeles Healthcare System, working for Arif Subhan. “I transferred from Temple to Los Angeles 19 months into my internship, and completed the last few months at the larger, more complex hospital,” she says. Moving up through the VA system did not come without challenges. “A special challenge I have encountered is navigating the hiring process at the Los Angeles facility. We had worked to bring on and provide promotion opportunities to our biomedical technicians, but due to administrative delays, we were not going to be able to provide those opportunities on time,” Holden says. “So, trying to think outside the box, I wrote up justifications for details for our vacant promotion positions. A detail is a temporary assignment anywhere from 30 to 120 days, in which an employee leaves
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SPOTLIGHT
FAVORITE MOVIE: “The Hobbit” by J.R.R. Tolkien FAVORITE MOVIE: “The Lord of the Rings: The Two Towers” FAVORITE FOOD: Bread (French, Ciabatta, Sourdough, Flauta, especially) HIDDEN TALENT: I can play the baritone and alto saxophones. FAVORITE PART OF BEING A BIOMED: “The daily adventure – how each day can be unpredictable and exciting.” WHAT’S ON MY BENCH? A picture of my shop from Greater Los Angeles, coffee, latest TechNation and AAMI magazines, Moleskin notebook, and iPhone (access to emails, calendars, and a camera).
Clarice Holden their current position and takes on the roles and responsibilities of a vacant one (details can be lateral or promotions). Details require much less red tape to get going,” she adds. She explains that those details were approved, interested staff members applied and were able to secure the higher-level positions until the additional administrative documentation came through. Since 2012, Holden has served on a special VA team – the documentation of services advisory board. “Our goal has been to develop and implement specific work action coding for all the work performed in VA biomedical engineering shops around the country,” she says. “We also developed business rules for the application of those codes (for example, minimum time to record, and only one work action code per work
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
order). This work has standardized the data from biomedical engineering sections across the VA, allowing for greater analysis and comparisons of different biomedical engineering sections,” Holden adds. MISSION FOCUSED When not working, Holden’s favorite place to spend leisure time is the great outdoors. “I enjoy spending time with my family outdoors and just around the house. Hiking, running and camping are some of my favorite hobbies. In recent years I hiked the 18-mile Yosemite Half-Dome trail in California and ran the Disneyland ‘Dumbo Double Dare’ race (a 10k and half-marathon on consecutive days),” she says. Her husband is an electrical engineer and they have two children; a son, two-years old and daughter, who is twomonths old. All of her hardwork on the job has not gone unnoticed. Holden has
received recognition for her efforts in recent years. She received the VA Central Texas Extra Mile Award in 2014, was a VA Biomedical Engineer of the Year honoree in 2017 (runner-up to that year’s awardee) and won the AAMI Young Professional Award in 2018. She makes it clear that her mission as a chief biomedical engineer aligns perfectly with the VA’s mission. “I would like the readers of TechNation to know that I am committed to the mission of the Department of Veterans Affairs, to ‘Care for him who shall have bourne the battle, and his widow, and his orphan.’ This is a quote from Abraham Lincoln’s second inaugural address, and something I committed to memory when I first started at the hospital in Temple. I am very happy and proud to serve America’s veterans; they are my co-workers, friends and heroes,” she says. Just like the VA, Holden’s mission as an HTM professional, could not be more honorable.
NOVEMBER 2018
TECHNATION
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SPOTLIGHT
COMPANY SHOWCASE Rigel Medical
R
igel Medical joined Seaward Group in 1997 and its U.S. headquarters in Tampa, Florida, were established in 2008. “Our number one priority is keeping people safe, and we’ve been doing that across the world for more than three decades as a global leader in electrical test and maintenance Jack Barrett solutions, including PAT, high National Business voltage, solar and biomedical Development Manager testing equipment. When Rigel joined Seaward, it was a case of the best becoming even better. The parent company’s history of electrical safety testing proved synergistic with the Rigel brand,” said Jack Barrett, National Business Development Manager, Rigel Medical (part of the Seaward Group). “We believe that while our products have their own individual competitive strengths, our people are the foundation for our success.” Barrett shared more about the company via a Q&A session earlier. Q: What are some advantages Rigel has over the competition? Barrett: Our level of service is second to none. We offer help and support before, during and after the purchase process. Our deliveries are fast and efficient with the vast majority of customers receiving their equipment within a week. The combination of performance, support and training gives us a competitive advantage. This is our value proposition to our customers.
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
Continual innovation and understanding what customers want and need is helping Rigel to grow and succeed. The company doubled it’s premises in 2016 to cope with demand.
Q: What are some challenges that your company faced last year? How were you able to overcome them? Barrett: The Tampa facility has enjoyed a tremendous growth curve over the past few years. In 2016, we doubled our company’s premises to cope with the inventory demands and we wanted to be able to maintain the high level of support to our growing customer base. In order to assist in customer pre- and post-sales support, we installed a state-of-the-art video studio for conducting training webinars. Our customers can view real-time product operation and follow along using equipment at their site. The feedback has been fantastic and our customers love this capability. It is fast and efficient, plus being able to record the session gives them an ongoing training tool for refresher or new employees. With any double digit growth comes the
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
challenge of ensuring you can maintain the pace so that standards never dip. To answer that challenge, we have grown our team and welcomed new personnel. Q: Can you explain the core competencies and unique selling points? Barrett: Seaward’s core competency is electrical test equipment and Rigel’s is the biomedical segment of testing equipment. Technological advantages in one product segment often provide advantages in other product platforms too. Test data availability, storage and traceability are among the features most appreciated by our customers. Another strength of Rigel is the educational information we provide. Along with technical guides, we often conduct webinars and seminars for biomedical associations and colleges. These presentations have minimal sales influence but are truly educational in nature.
Q: What product are you most excited about right now? Barrett: It’s pretty hard to select just one. The SafeTest safety analyzers are becoming increasingly popular due to their simplicity and look and feel. Our ESU analyzer, the Uni-Therm, has been a best seller for some time and continues to win over customers with its performance capabilities and test automation. Q: What is on the horizon for the company? Barrett: Continued product development and innovation. The world is becoming more demanding and our equipment will be designed with that in mind, to keep pace with those changes and lead the field in terms of innovation in electrical testing equipment. We will have new products and product capability ready for market next year.
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
Rigel Medical joined Seaward Group in 1997 and its U.S. headquarters in Tampa, Florida, were established in 2008.
And, as the business continues on its growth trajectory, there will be continued opportunities for both current and new personnel.
and repair shop, inventory and sales staff. All of our products are manufactured in our main UK facility in the northeast of England.
was responsible for technical customer support and their calibration needs. She now brings that superb customer service to us at Rigel.
Q: Can you share some company success stories?
Q: Can you highlight any recent changes?
Q: What is most important to you about the way you do business?
Barrett: A new customer had just taken delivery of several new ESU generators and it was paramount they have them tested and operational immediately. In parallel, they had also purchased our Uni-Therm for testing the new generators. On the day it arrived, we provided them with test sequences, conducted an online training webinar for them and got them comfortable and confident with the test process. We work in a very dynamic environment and this level of customer care is what makes Rigel such a great company. In this case, our speed, flexibility and capability saved the day and allowed the generators to be placed into service in the OR. Q: Can describe the company’s facility? Barrett: Our Tampa satellite office houses product specific technical support personnel, a calibration lab
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Barrett: Probably our biggest achievement recently was the addition of our video studio and the corresponding impact on customer support. Even though we knew the studio would be well-received, the feedback has been tremendous. Q: Please tell me about your employees. Barrett: In particular I’d like to mention two recent additions to the team who are already making an impact: Brittany and Amber. They joined the Rigel Medical team to assist and accelerate our North American expansion. Brittany Schmidke has spent 15 years in consultative sales positions serving the medical market and she is now a vital part of the team based at our Tampa headquarters. Amber Spangenberg works remotely from a home office and joins us after a successful career with Spectrum Technologies – Transcat, where she
Barrett: Our company values are to ensure we have “delighted customers, engaged staff and that we operate within a dynamic environment.” We believe that if our employees have these values in their minds we will succeed. It seems to be working – as we provide outstanding products and superb service which we believe helps us to deliver premium value to our customers. Q: Is there anything else you want readers to know about your company? Barrett: Even though it seems obvious for a technology-based company, Rigel’s ability to be forward-thinking and to continually innovate is vital. This along with our approach of really listening to and understanding what our customers want, and need, is helping us to grow and succeed.
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SPOTLIGHT
DEPARTMENT OF THE MONTH The VA Long Beach Healthcare System Biomedical Engineering Department BY K. RICHARD DOUGLAS
I
n a major city like Los Angeles, caring for our veterans is a big job. Named after a Korean War veteran, who won the Congressional Medal of Honor, the Tibor Rubin VA Medical Center exemplifies that mission.
Up until 2016, the facility was simply known as the Department of Veterans Affairs Long Beach Medical Center. It was renamed for the Holocaust survivor, POW and war hero through congressional legislation. The medical center serves thousands of veterans in the Greater Los Angeles area and Orange County, where it provides comprehensive health care. Part of the VA Long Beach Healthcare System, the system also includes five communitybased outpatient clinics (CBOCs ) located in Anaheim, Cabrillo, Santa Ana, Santa Fe Springs and Laguna Hills. The 421-bed medical center and affiliated facilities would not be able to serve veterans without the services of a well-trained biomedical engineering department. “The biomedical engineering department at VA Long Beach Healthcare System currently has a total of 12 full-time employees; nine biomedical equipment support specialists (BESS) staff members and two biomedical engineers,” says the department’s Chief Biomedical Engineer Anita Veizaj, M.S. Veizaj says that the biomedical engineering department falls under Engineering Services.
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“The biomedical engineering department services all the inpatient and outpatient clinical areas both on site at the main Tibor Rubin VA Medical Center and at five off site community-based outpatient clinics (CBOCs),” Veizaj says. “The scope of the biomedical engineering department, as part of Healthcare Technology Management, is to provide consultative services for overall medical equipment management, continuous education for clinical staff, management of recalls and safety alerts for medical devices, and to advise clinical and administrative staff on medical equipment including existing and emerging technology, long-term sustainability, compatibility and safety,” she adds. She says that in fiscal year 2019, the department will be growing by an additional 50 percent. “Our department will soon consist of 23 staff members. We are also re-structuring our department by adding two new lead Biomedical Equipment Support Specialists, two new Imaging Biomedical Equipment Support Specialists, adding on call service and an evening shift to ensure 24/7 biomedical engineering coverage for our veterans,” Veizaj says. The team makes the determination of the need for a maintenance contract during the pre-purchase technology assessment phase. “The service contracts are managed and monitored by our current administrative staff, the Program
Support Assistant Janice Rowell. Rowell reviews and tracks periods of performance to ensure that all of the medical equipment contracts are submitted efficiently to prevent any lapse in contract coverage,” Veizaj says. “The Contracting Officer Representative’s (COR) duties are shared among the biomedical equipment support specialists and the biomedical engineers. The major responsibilities and duties of the COR are to manage the activities of the work conducted by the contractor and overall contract performance,” she adds. Data collection is achieved through a proprietary system that works in conjunction with other VA health systems. “VHA has a corporate data warehouse (CDW) that leverages data from every VA Medical Center. The CDW collects data from the individual Veterans Health Information Systems and Technology Architecture (VistA),” Veizaj says. She says that engineering service utilizes a homegrown database application within VistA, called Automated Engineering Management System/Medical Equipment Reporting System (AEMS/MERS). The AEMS/ MERS database is used for engineering work order processing and electronic medical equipment inventory management. LEADERSHIP AND RESPONSIVENESS Beyond the more routine duties of the team is a project to further solidify a
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SPOTLIGHT
The VA Long Beach Healthcare System Biomedical Engineering Department
secure system. One project the group is involved with for their facility is a VA pilot project for a new cybersecurity system for networked medical devices. “This project involves the implementation of a system that can re-use our network infrastructure while providing visibility of our current network and moreover reducing cybersecurity risks. Due to the ongoing pilot phase, we cannot disclose any additional information but we are very excited that our facility was selected to be the pilot site,” Veizaj says. “Our department has facilitated the Spinal Cord Injury center by installing specialized junction boxes which enable the autonome systems connected to patient beds,” she adds. Veizaj says that adding these junction boxes will allow for the ability to promptly address all technical issues without compromising patients to be relocated from one bed to another. “A process improvement, we have developed and implemented in our facility, is the standardization of the incoming inspection process for new medical equipment delivered at our facility,” Veizaj says.
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
“Biomedical engineering leads the initiative of developing this incoming inspection process improvement. This interdepartmental standard works between clinicians, logistics department, IT [and] biomedical engineering,” Veizaj adds. She says that, overall, engineering service has enabled them to improve customer service while ensuring that the medical devices/systems being used in the facility are inspected thoroughly and accurately by all of the health care services and are in compliance with all local, facility and national standards. “For many years, such standard work was missing, creating a lot of challenges on the accuracy and prompt inspections of the incoming inspections for new medical devices and systems,” Veizaj says. Also, the biomedical engineering department is the lead for the VA Desert Pacific Healthcare Network – VA Integrated System Network (VISN) 22 on the accuracy, response and remediation work of hazards recalls and safety alerts that come through the National Center for Patient Safety (NCPS). “We review the recalls and alerts on the NCPS database on a daily basis, track the recall actions and work and
moreover we also work with [the] logistics team to receive weekly reminders on ensuring that our recalls are always completed on time and with 100 percent accuracy,” Veizaj says. “For over 15 months now, we have kept an overall compliance of 100 percent on the response and completion of all the Reusable Medical Devices (RMD) recalls/alerts actions coming from NCPS,” she adds. Away from work, the team members are involved in one of the country’s largest biomed associations. “The staff members of our department are members of the California Medical Instrumentation Association (CMIA), Health Information and Management Systems Society(HIMSS), American College of Clinical Engineering (ACCE), and Association for the Advancement of Medical Instrumentation (AAMI).” Veterans and their families in the Greater Los Angeles and Orange County areas can rest assured that their great health care isn’t solely the result of the clinicians they interact with, but also because of the biomedical engineering department professionals.
NOVEMBER 2018
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SPOTLIGHT
BIOMED ADVENTURES The Fast Break before HTM BY K. RICHARD DOUGLAS
W
ithin the ranks of the HTM profession, there are many who can recount the glory days. Before being biomeds, many had memorable experiences on military missions, as high school sports stars or being in the spotlight in some other way.
One of those biomeds is Marrita Porter. If you are a basketball fan from Kentucky or Ohio, you may already know her name. Today, Porter is a clinical engineering specialist in the clinical engineering department at The Ohio State University Wexner Medical Center, but at one time, she thrilled basketball fans with her athletic prowess. “I began playing basketball at the age of six. I learned how to play basketball from the boys in my neighborhood. I began playing organized basketball at a local Salvation Army Boys and Girls Club. Then, I played in middle school and then in high school. As a freshman in high school, my goal was to make the freshman team, but I ended up being great enough to play on the varsity team. I earned a starting position on the varsity team as a freshman,” she remembers. In the early to mid-1990s, Porter attended Butler Traditional High School in Louisville, Kentucky and was on the girls basketball team from 1991 to 1995. The school won regional championships in 1993 and 1994. A newspaper article from The Courier-Journal in Louisville from April of 1995 said it all; “Porter led the state this season with an astounding 77.3 shooting percentage from the floor.” The article went on to say that Porter was one of three finalists for
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Miss Basketball honors and was named the Gatorade Circle of Champions Player of the Year in Kentucky. Additionally, it said she was an AAU All-American and a finalist for the WBCA All-Star game. She helped lead her team to back-to-back Sweet Sixteens her sophomore and junior seasons. She finished her high school basketball career with 2,264 points and was the first in her school’s history to exceed 2,000 points. She was also the United States Marine Corps Kentucky Player of the Year in 1995. High school wouldn’t be the end of the basketball trail. “I was recruited by many top Division I programs across the country. I chose Ohio State because of its strong women’s basketball program and winning tradition, as well as its fan support of women’s basketball,” Porter says. “It was overwhelming at first being a student-athlete because the expectations are high. Being on the team was competitive and fun. We travelled a lot; for example, we played in Hawaii, San Francisco, Boston, Tennessee, and other great places, but the best place to play is on your own home court,” she adds. At OSU, Porter continued to display her talent as an exceptional player as a four-year letter winner, two-time first team All-Big Ten and two-time team MVP. She lead the team in field goal percentage making. 667 percent during the 1996-97 season. Serving as the team’s co-captain during 1998-1999, she was a Big Ten Player of the Week in 1999. As in high school, the list of achievements goes far beyond these. To make Porter’s story even more compelling is to consider that she accomplished so much on the court with
steel rods in both of her tibias and a screw in each knee after enduring back-to-back tibia rod stress fractures at the end of her freshman and sophomore seasons. FROM THE COURT TO THE SICU Kevin Durant once said; “I’m a basketball player. That’s what I do and what I love but that’s just not all who I am. I’m talented in a lot of different areas.” Porter moved from thrilling basketball fans to thrilling her clinician colleagues. As a clinical engineering specialist, Porter provides service to the maternal care units (labor and delivery, mother and infant), endoscopy/gastro services and the Surgical Intensive Care Unit (SICU). “I wanted to challenge myself, so I went back to school to get a technology degree. A professor recommended the biomed field to me. It was a good recommendation because I enjoy what I do. I find great satisfaction in working in the health care field. I believe that biomeds are major contributors to patient care because we maintain a hospital’s patient care equipment, ensuring that medical equipment is well-maintained and most importantly – safely operational,” she says. As a biomed, Porter enjoys installation, inspection, completing
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SPOTLIGHT
preventative maintenance (PM), repairing, calibrating, modifying biomedical equipment and health care technological support systems that adhere to health care’s standard guidelines. She also likes the opportunity to educate end users and advise health care staff members and other health care agencies on equipment maintenance,
She says that the same drive and determination that she had as an athlete has prepared her to handle the growth that’s happening within the HTM field. She understands how to meet the challenge of change. “And, in order to meet that challenge, I believe that you have to drive yourself to develop. Through athletics, I’ve learned that character
“ Through athletics, I’ve learned that character counts, you can’t hide it.” equipment operation, physiological operational principles of medical devices and safe clinical application of biomedical equipment. Did those days on the court result in any life lessons that could be applied to an HTM career? “The biomed/HTM field is constantly evolving, and in order to progress with the change, it’s important that one is focused on building their skillset and knowledge, particularly IT (Information Technology) knowledge,” Porter says.
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
counts, you can’t hide it. You either have great character or you have poor character. People with great character make great choices. People with poor character make poor choices. Sports taught me that high character sustains your greatness. Integrity promotes you. Dishonesty demotes you. I daily apply these lessons to my work in the HTM field,” Porter says. “I believe that it’s always best to strive to do what you know is right in your heart – taking short cuts will eventually be exposed. Being a Division I athlete
also taught me to develop a strong work ethic – always strive to be great by learning from others, self-study, and then apply what you have been taught. Develop yourself no matter your age,” she adds. She says that as she thinks back on her basketball career with fond memories. “Having the ability to play basketball at a high-level was a gift, and it brought me great joy, especially when you’re winning, but even when my teams didn’t win games, I still enjoyed playing the game of basketball. I believe that basketball is one of the greatest sports to play. The game is poetic, athletic, and exciting,” Porter says. Porter still finds time for basketball. “Today, I enjoy watching the game of basketball as a fan. Sometimes, when I’m in the gym shooting around, I work with young players on how to improve their game,” she says. While many will lament those old glory days, there are record and achievement pages for Butler High School and OSU that tell the story of one HTM professional’s victories on the court.
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SPOTLIGHT
THE WORLD MOVES FAST. WE MOVE FASTER.™
6
26, as a brand, was born on June 26, 2012 (6/26) when two, soon to be friends and partners from Long Island, New York met at a hospital while each’s first son was born. The company was officially launched 2-years later. 626 had an original focus on performing time and material service work for medical imaging parts suppliers, which led into contractual service agreements with imaging centers, OEMs and ISOs throughout the United States. 626 is currently one of the fastest growing service providers in our space. 626 Holdings CEO Phil Revien recently shared more about the company with TechNation. Q: What are some advantages that 626 has over the competition?
Phil Revien, CEO
Revien: We are a virtual one-stop shop for imaging service. We can be such a comprehensive solution provider because of our talented people and our technology. While many in the space offer a point solution (e.g. best GE CT service in the state), we offer a turn-key product regardless of manufacturer, modality or region. Q: What are some challenges that the company faced last year? How were you able to overcome them? Revien: Growth brings problems; fun problems, but problems. Recruiting and retaining best-in-breed engineers will always be a challenge. Readiness for growth; having the right engineer in the right place is a challenge. We have met the challenge by building a culture based on family and customer focus. We believe we are the employer of choice for talent. We also acquired Walsh Imaging in November 2017 which was instrumental in improving our service capabilities for our customers in the Northeast. Q: Can you explain 626’s core competencies and unique selling points?
Michael Fischer, CFO
Revien: 626’s core competency is imaging service delivery, 24/7/365. We are highly differentiated as we do all modalities and all manufacturers with a simple call or click. While we operate 24/7/365, we do not charge a premium for after-hours or holidays. We also do much of our PM work after-hours so as to not affect patient throughput. We operate with a patient first mentality. Q: What product or service are you most excited about right now? Revien: We have developed, and will soon commercialize, an exciting software and service for remote diagnoses and virtual service, cross-modality; cross-manufacturer.
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SPECIAL ADVERTISING SECTION
Your Uptime. Our Obsession. Q: What is on the horizon for 626? How will it evolve in the coming years? Revien: We are refreshing our brand as we reposition the company from service, to software and service. We are also in acquisition mode. We are seeking great individuals to add to our team that will enhance the customer experience. Also, we are seeking companies we can partner with to improve our service delivery ability and market share. Q: Please share some company success stories with our readers – one time that you “saved the day” for a customer. Revien: In February 2018, a Fort Lauderdale imaging center, owned by Akumin, was struck by a vehicle. The accident toppled the lone MRI in the facility. 626 was called at 7 a.m. and we deployed our CTO and a top engineer to the site. Our team arrived at 8:30 a.m. and had the system put back together and scanning patients by 1 p.m.
vices and building long-lasting customer relationships. Our number one goal is that every service event is completed with the highest quality workmanship and exceptional customer service. Your complete satisfaction is our obsession. 626 does not aspire to make a living, we aspire to make a difference. Q: Is there anything else you want readers to know about your company? Revien: 626 is very involved in the community and in charitable giving. Partner Michael Fischer started Drops of Hope in 2006. Drops of Hope has a primary project with Rooms of Hope. Rooms of Hope is dedicated to enhancing the healing process of chronically ill children by providing positive and imaginative bedroom environments. It gives special attention to the medical, physical and emotional needs of each child by adding special touches that personalize their room and fulfill their dreams!
Q: Please tell us a little about the 626 facility. Revien: 626 relocated our corporate headquarters to Delray Beach, Florida this July. The 12,000-square-foot facility is a mixed-use space with an office and warehouse. We also have a sales and marketing office in Akron, Ohio and the Walsh facility in Pompton Lakes, New Jersey is 11,000 square feet of warehouse and office.
We’re here to help! To find out how 626 can build a custom imaging equipment service solution for you and the patients you serve, contact us today!
Q: Can you share any recent changes to the company? Revien: We acquired Walsh Imaging in November 2017. We hired Kevin Gill as our COO in June 2018. We are positioned well for both organic and inorganic growth.
1395 NW 17th Avenue Suites 113 & 114 Delray Beach, FL 33445
Q: What is your company’s mission statement or what is most important to you about the way you do business?
sales@WeAre626.com 800.516.0990 www.WeAre626.com
Revien: 626 thrives on providing comprehensive equipment ser-
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
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WE ARE HERE FOR LIFE
TM
MULTIMEDICAL SYSTEMS
COMPREHENSIVE EQUIPMENT REPAIR, MAINTENANCE AND SALES SOLUTIONS Since 1996, MultiMedical Systems has been a leader in the biomedical equipment service industry.
Our Services Include: Equipment Repair and Maintenance
· Supplemental Biomedical Staffing · Infusion Pump PM Projects
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Join the MultiMedical Systems Team! MMS continues to grow and we are looking for experienced General Biomedical Equipment Technicians in the Western United States! Email your resume to resume@multimedicalsystems.com
QUALITY | SERVICE | EXCELLENCE 1.888.532.8056 WWW.MULTIMEDICALSYSTEMS.COM SALESSUPPORT@MULTIMEDICALSYSTEMS.COM
INDUSTRY UPDATES
STAFF REPORTS
NEWS & NOTES
Updates from the HTM Industry
MUSC, SIEMENS HEALTHINEERS FORM STRATEGIC PARTNERSHIP The Medical University of South Carolina (MUSC) and Siemens Healthineers have formed a first-of-its-kind strategic partnership with the mutual goal of advancing the quality of health care in South Carolina. The partnership will capitalize on the coupling of MUSC’s clinical care, research and education expertise with Siemens Healthineers’ engineering innovations and workflowimprovement capabilities. “We are leveraging a longstanding relationship to reshape what we can both deliver in health care,” said David J. Cole, M.D., MUSC president. “Our nation is demanding that we address our fractured, costly and inefficient health care delivery systems. As the leading academic health sciences center in this state, MUSC’s purpose must be to drive the highest quality care for our patients at the lowest cost through commitment and partnerships. In discussions with the
Siemens Healthineers team, we discovered a high degree of alignment with these concepts, and we are very excited to have them move forward with us. Our mutual goal is to not merely provide the best care possible for just our patients; we will define the new gold standard for others to follow.” Specifically, this new agreement will focus on driving performance excellence at MUSC and generating significant clinical and value-driven innovations in focused target areas including pediatrics, cardiovascular care, radiology, and neurosciences. •
ADVANCED IMAGING SYSTEMS, DEDICATED IMAGING SOLUTIONS TO MERGE
Tennessee-based Dedicated Imaging Solutions LLC will merge with Florida-based Advanced Imaging Systems (AIS). Dedicated Imaging Solutions, a CT and MRI parts repair company in the third-party imaging marketplace, is currently operating within ISO-13485 quality standards, with full certification expected by the end of 2018. In addition to parts repair, Dedicated has geared up its proprietary X-ray tube repair protocol and recently started its in-house coil repair lab
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
with the help of AIS. Dedicated will be be able to verify full-coil functionally after repair by testing it on in-house quality assurance bays. Dedicated currently has multiple CT and MRI QA bays to ensure that all parts are repaired to OEM specifications and quality before reaching inventory. Dedicated has plans to install four additional full CT system test bays and another fully operational and shielded MRI test bay this year. AIS currently houses an expansive third-party CT and MRI parts inventory with its main focus being to provide digital imaging equipment, service and parts. AIS also specializes in and offers installation/deinstallation of imaging equipment, mobile CT/MRI upgrades, and complete turn-key project management. The merger will position AIS to expand its full-service capabilities to a national and international arena, and will
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poise Dedicated for accelerated growth as a supplier of fully refurbished, system-tested parts and equipment. “The merger between the two companies allows both AIS and Dedicated Imaging Solutions to offer replacement parts, equipment and services to customers at a price that compliments the ever-changing third-party imaging market place without sacrificing quality,” said DIS President and CEO Chad Fowlkes.
STAFF REPORTS
The merger will also impact the European imaging marketplace. “It only makes sense to offer our parts and services to our European counterparts, because their third-party marketplace is growing so rapidly, we want to see them succeed,” AIS CEO David Band said. Dedicated will stay at its location near Nashville, Tennessee. AIS will remain in Pompano Beach, Florida. •
ARAMARK TO SELL HEALTHCARE TECHNOLOGIES BUSINESS TO TRIMEDX
Aramark has signed a definitive agreement to sell its Healthcare Technologies (HCT) business for $300 million to TRIMEDX. “Today’s action is another demonstration of the clear and focused strategy we are following that has substantially elevated our operating performance and is driving Aramark’s success,” said Eric J. Foss, chairman, president and CEO. “The divestiture of our healthcare technologies business will further focus our portfolio around our core food, facilities and uniforms businesses. I want to thank and congratulate our HCT team members for their contributions to Aramark
and wish them continued success.” Aramark’s Healthcare Technologies business, based in Charlotte, North Carolina, is a leading provider of healthcare technology services in North America, providing innovative management programs for clinical equipment at more than 500 hospital and health care facilities. The business, acquired by Aramark in 2001, has been in operation for over 45 years and employs more than 1,500 technicians, engineers and program staff. Services include maintenance and refurbishment of high-end imaging equipment. “This transaction represents the latest step in our commitment to deliver sustainable shareholder value, while also increasing our financial flexibility,” Foss added. “We will use the majority of proceeds to strengthen our balance sheet through debt reduction and will also repurchase $50 million of shares after closing of the sale.” The transaction is subject to customary closing conditions and regulatory approvals, and is expected to close in the fourth quarter of 2018. •
HEALTHMED360 ACQUIRES VECTOR MEDICAL IMAGING HealthMed360 has reported its acquisition of Vector Medical Imaging’s assets, including tools, test equipment and inventory. Also joining the HealthMed360 team is Vector President Jim Pike. He is now HealthMed’s senior computer and electronics engineer. Vector Medical Imaging is focused on the repair of high-failure/high-end diagnostic imaging replacement parts, including various CT and MRI computers, workstations, GE patient table pumps, cylinders, motors and other electro mechanical repairs for GE, Siemens and Philips parts. “The purchase of Vector Medical Imaging and Jim Pike joining the HealthMed360 team aligns with our main goal of having the leading provider of quality parts repairs, systems and services under one roof,” HealthMed360 President
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Robert Dakessian said. HealthMed360’s focus is equipment sales, installation/ deinstallation, system upgrades and refurbishment, replacement parts and in-house parts repair, cold head replacements and they have a mobile fleet for interim mobile rentals. HealthMed360 works with hospitals, imaging centers, clinics, asset management companies and independent service organizations. •
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INDUSTRY UPDATES CYBERMDX RESEARCH TEAM DISCOVERS MEDICAL DEVICE VULNERABILITIES CyberMDX, a health care cybersecurity provider, has announced that its research group has discovered two security vulnerabilities found in commonly used medical devices: Becton Dickinson (BD)’s Alaris TIVA Syringe Pump and Qualcomm Life Capsule’s Datacaptor Terminal Server (DTS). Working closely with both vendors, the vulnerabilities have been publicly disclosed via ICS-CERT. CyberMDX found a potential vulnerability in the BD Alaris TIVA syringe pump with software version 2.3.6 and below that is sold and used outside of the U.S. Through CyberMDX’s research, the team discovered that if a malicious attacker can gain access to a hospital’s network and if the Alaris TIVA syringe pump is connected to a terminal server, the attacker can perform hacks without any prior knowledge of IP addresses or location of the pump. The attack could lead to unauthorized start/stop of the pump and/or unauthorized changes in the rate of infusion. To learn more about this potential vulnerability, classified as a CVSS 9.4 (critical), refer to the ICS-CERT advisory (ICSMA-18-235-01). CyberMDX worked closely with the product security team at BD that emphasizes collaboration across the health care industry to enhance cybersecurity of medical technology and devices. More information on the vulnerability can be found on the CyberMDX website. Qualcomm Life Capsule’s Datacaptor Terminal Server (DTS) is a medical gateway device used by hospitals to connect their medical devices to the network. The gateway is typically used to connect
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
bedside devices such as monitors, respirators, anesthesia and infusion pumps. The DTS has a web management interface used for remote configuration, based on Allegrosoft RomPager. The CyberMDX research team found that interacting with the web management using the “Misfortune Cookie” vulnerability, which hands out a crafted HTTP cookie to the device, resulted in an arbitrary write to its memory. This action can be performed with no authentication and the arbitrary write may be used to login without credentials, gain administrator-level privileges on the terminal server, or simply crash them. This may result in harm to the device availability as well as the network connectivity of the serial medical devices connected to it. Although the Misfortune Cookie vulnerability has been publicly known for four years, prior to this disclosure, there was no awareness of it in this instance. After collaboration with Qualcomm Life Capsule, CyberMDX recommended users to immediately update the DTS devices to their latest firmware version to overcome the vulnerability. Qualcomm Life worked quickly to validate the vulnerability, provide a workaround and an update to the firmware, and notify customers. To learn more about this potential vulnerability, classified as a CVSS 9.8 (critical), refer to the ICS-CERT Advisory (ICSMA-18-240-01). • For more information, visit CyberMDX.com.
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STAFF REPORTS
HARRIS HEALTHCARE GROUP ACQUIRES IATRIC SYSTEMS INC. Iatric Systems Inc., a healthcare technology company dedicated to helping health care organizations enhance their IT investments, has been acquired by Harris Computer Systems through its health care group. Iatric Systems will be run as an independent business unit within Harris. Frank Fortner, a long-term Iatric Systems senior executive, has been named as executive vice president for Iatric Systems.
“This investment is a tremendous vote of confidence in our team and technology,” Fortner said. “We are pleased to become part of the Harris family of companies. This positions Iatric Systems well for continued and long-term success in line with our 28-year history of providing innovative healthcare IT solutions to hospitals and health care systems. Harris will provide an enhanced set of tools and resources to support and serve our customer community.” •
PARTSSOURCE LAUNCHES PROBE EXCHANGE PROGRAM
PartsSource now offers an ISO 13485-certified ultrasound probe exchange at a flat-rate price. “The new program simplifies the hassle of probe repair through a single automated online platform to order, track, package and exchange, while maximizing quality through a comprehensive 20-point visual and functional inspection,” according to a press release. “I don’t have to make any phone calls getting different POs for different vendors, I just go to the PartsSource website,” said PartsSource PRO customer Gene Alveshire, CRES, ultrasound engineer at Lexington Medical Center in South Carolina. “The prices are good and we always get documentation about the repairs, and that’s important to us.” “To order a reliable reconditioned probe requires only three steps through PartsSource’s curated marketplace, which
consolidates 4 million products into a single digital platform. PartsSource adds new probe models regularly and updates inventory daily to meet hospitals’ critical ultrasound demands,” according to a press release. The program, according to the release, also provides: • Reliable products from qualified experts: 20-point visual and functional inspection on all probes and ISO 13485-certified process and facility for all repair work • Wide selection of probes available online: 130+ models with daily inventory updates to meet demand • Upfront pricing: Cost savings up to 40 percent below OEM pricing • B est warranties in the industry: 6-month full warranty on standard and 3D/4D probes and 90-day warranty on all TEE probes • For more information, visit PartsSource.com.
RPI MOVES TO NEW LOCATION, LARGER BUILDING Replacement Parts Industries Inc. (RPI) – a leader in quality replacement parts for hospital, medical, laboratory and dental equipment since 1972 – has announced its relocation to Simi Valley, just north of Los Angeles, California. RPI moved into the two-story 38,000-square-foot building to accommodate its growth and expansion plans. RPI purchased the building in Simi Valley then remodeled it to allow for much larger office spaces for the customer service, product development, quality control, marketing, purchasing and accounting departments. The spacious product development lab offers double the space that its previous building would allow, with the shipping and warehouse spaces each doubling in size. This move marks an important milestone in RPI’s history. “As the health care industry experiences phenomenal growth and transformation, RPI has maintained its leadership in the industry by being innovative and making strategic moves at the right time, like this relocation. We carefully considered a number of locations for our move, and Simi Valley met all of our requirements. This move is the next phase of our ever expanding changes to our business of offering our customers quality replacement parts, excellent customer service, and knowledgeable
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technical assistance. We are proud of the solid contributions we have made to our industry and customers since we first opened our doors in 1972,” said Ira Lapides, president and CEO of RPI. “Perhaps most impressive about our relocation was the fact that we started the move on a Friday afternoon, and by Monday morning at 8 a.m. we were up-andrunning – taking and shipping orders. Many of our customers complimented us and thanked us for this. We never skipped a beat in taking care of our customers. I owe much of this to the loyalty and determination of my employees, the incredible work by our IT team, phone system and construction teams and the remarkable assistance from the city of Simi Valley and the Simi Valley Chamber of Commerce,” added Lapides. RPI is now located at 625 Cochran Street, Simi Valley, California 90365. The phone numbers (800-221-9723 and 818882-8611) and fax number (818-882-7028) remain the same. • For more information, visit www.rpiparts.com.
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INDUSTRY UPDATES
TRACE MEDICAL ANNOUNCES PARTNERSHIP WITH VGM Trace Medical, a leader in ventilation rentals based in Whitmore Lake, Michigan and Van G. Miller & Associates (VGM) based in Waterloo, Iowa, have executed an exclusive program agreement to provide ventilator rentals to the entire VGM membership of nearly 3,100 HME providers. “Aligning with industry leaders like VGM helps ensure our value proposition is available to as many providers as possible. While ventilation is often clinically necessary, the high cost and risk of ownership limit access to the products. More providers are recognizing the value of renting ventilators. Partnering with VGM allows Trace Medical to continue our growth strategy and offer our services nationally,” Trace Medical Senior Vice President Elliot Campbell said. The agreement solidifies the first program of its kind for VGM’s membership community. •
US MED-EQUIP ON INC. 5000 LIST, AGAIN US Med-Equip, a provider of medical equipment rentals, sales, service and asset management solutions, has earned a place on the Inc. 5000 list of America’s fastest growing companies – for the sixth consecutive year. Headquartered in Houston, US Med-Equip provides moveable medical equipment to the health care market, primarily to hospitals and long-term acute care centers. The company rents a wide range of moveable equipment across various clinical applications, including respiratory, infusion, monitoring and neonatal. US Med-Equip maintains a rental fleet of more than 27,000 pieces of equipment and serves its customers across 23 facilities throughout the United States. According to Inc. magazine, publisher of the annual list, tens of thousands of companies have applied over the years, but only a fraction have made the list more than once. Only six percent of the companies have made the list six times. “It’s an honor to be included among those special few companies that have achieved the Inc. 5000 for the sixth year in a row. We want to thank our employees for their unwavering dedication to client service and to patient care as they are the key of our ongoing success,” said US Med-Equip President Gurmit Bhatia. “In addition, when we started this company we committed to investing in technology that would create better solutions for our customers – and that commitment has also set us apart in our industry.” In a press release, Bhatia noted that US Med-Equip provides technology-based, value-added benefits such as RFID-tagged equipment, proactive PM management and an online customer portal that gives hospitals greater control over rental expenses. • For more information about US Med-Equip, visit usmedequip.com.
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
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REPAIRMED OFFERS A NO-HASSLE WARRANTY ON ALL REPAIRS!
RepairMed is a one-stop component-level repair depot whose services include the most comprehensive and cost effective flat rate repair pricing in the industry!
RepairMed repairs all models of these devices to component level: • Infusion Pumps Including Baxter Sigma Spectrum
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STAFF REPORTS
ZINGBOX JOINS VMWARE TECHNOLOGY ALLIANCE PARTNER PROGRAM
Zingbox, a provider of Internet of Things (IoT) analytics platform, has joined the VMware Technology Alliance Partner (TAP) program as a standard level partner. Members of the TAP program collaborate with VMware to deliver innovative solutions for virtualization and cloud computing. The diversity and depth of the TAP ecosystem provides customers with the flexibility to choose a partner with the right expertise to satisfy their unique needs. With thousands of members worldwide, the VMware TAP program includes technology partners with the shared goal to
bring the best expertise and business solutions for each unique customer environment. “We welcome Zingbox as a valued member of the VMware TAP program,” said Kristen Edwards, director, Technology Alliance Partner Program, VMware. “This membership means customers can take full advantage of a streamlined cloud infrastructure experience. By joining the program, Zingbox is working with VMware to develop technologies that can transform customers’ environments.” “We are excited to deliver a comprehensive Internet of Things security solution as a member of the VMware TAP program,” said Xu Zou, chief executive officer and cofounder of Zingbox. “Advancing the convergence of IT and OT enables organizations to adopt new processes, technologies and business models to improve operational efficiency and security.”
SAVE THE DATE April 10-13, 2019 | HOUSTON, TX
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Introducing probe exchange at repair pricing
Swap defective probes for high-quality reconditioned models No more waiting around for repairs. Just order online, receive your replacement overnight and send us back the defective probe using the provided shipping label. It’s that simple. partssource.com
• Reliable, high-quality probes pass 20-point visual and functional inspection as part of ISO 13485-certified process • Portfolio includes 130 models of Standard, 3D/4D, TEE and Endocavity probes guaranteed in stock • Upfront, flat-rate pricing with no hidden fees and a cost savings of up to 40% below OEM • Best warranties in the industry, with 6-month full warranty on Standard and 3D/4D and 90-day on all TEE probes* * Warranties do not apply to customer mishandling, misuse or abuse
INDUSTRY UPDATES
STAFF REPORTS
RIBBON CUTTING Introducing CyberMDX
F
ounded, developed and run by executives and veterans of the Israeli government’s cyber arm and leaders from the health care global industry, CyberMDX has seen the growing challenges and concerns for health care providers.
“The number of connected medical devices such as MRIs, patient monitors and infusion pumps is growing dramatically, improving patient care as well as hospital operations. By nature, these devices are the most critical assets to a hospital’s operations, connected to the heart of the IT network and its data centers,” said Amir Magner, co-founder and CEO of CyberMDX, “However, medical devices often lack very basic security controls, using legacy systems and unpatched software. They are extremely vulnerable, imposing huge security risks on a hospital’s network. The consequences of an attack are frightening, risking patient safety, operational continuity and significant financial and brand damage. Looking at the current landscape of hospitals and health care campuses, existing security solutions are insufficient and in many cases lack the very basic visibility for these devices.” The health care environment, more specifically hospitals, face unique challenges in their workflows. IT, security and clinical engineer teams are struggling to manually configure and secure thousands of medical devices. CyberMDX aims to solve this huge challenge, merging
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the expertise in cybersecurity and digital health to create a holistic solution for health care providers. CyberMDX’s state-of-art software is built based on artificial intelligence technology, medical device vulnerability research as well as defensive and offensive cyber capabilities. “We passionately believe in the significance of our work, addressing the arising threat for health care provider networks,” Magner said. “Cybersecurity for medical devices is an absolute necessity in order to enable hospitals to focus on their main and most important mission – treating and saving human lives.” Q: WHAT IS THE MAIN FOCUS OF CYBERMDX? A: CyberMDX is 100 percent focused on cybersecurity solutions for health care providers’ connected devices, detecting and preventing growing cyber threats against hospitals’ IoMT and medical devices, ensuring the operational continuity of its critical assets as well as securing patient data. Q. WHAT ARE SOME OF THE SERVICES CYBERMDX OFFERS? A: Today, the pressure on IT and security departments to rapidly deliver security solutions that support the hospital’s business needs has never been greater. Hospitals are under tremendous pressure to adopt the latest technologies to stay competitive, improve efficiencies, drive down costs and continue to
Amir Magner, CEO CYBERMDX Website: www.cybermdx.com Phone: 646-794-4160
protect patient safety. Hospitals must deploy technology that not only identifies a security problem, but also solves it from discovery and detection to risk assessment and prevention. Our network security solution, MDefend, is a non-intrusive solution, specifically designed for providing visibility and protection of hospitals’ critical assets. We are not only solving the technical
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problem of bringing visibility and safety into hospital-connected devices, but we are providing a business solution by foreseeing and preventing attacks against them. Q: HOW DOES CYBERMDX STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: CyberMDX’s solution combines an in-depth understanding of the world of cybersecurity, a hospital’s network and medical devices and is designed to provide a comprehensive solution that identifies and monitors these connected medical devices – and sheds light on hidden threats and automatically detects and monitors all devices and critical assets in clinical networks. Our technology solution is complemented with a team of research experts and white hackers who provide customers with concise and actionable risk assessments on cybersecurity for their connected medical devices and clinical assets. Recently, our research team discovered two new vulnerabilities in critical medical device equipment, with a CVSS v3 grade of 9.4 and 9.8. Working closely with the vendors and the ICS CERT to assist in closing these gaps illustrates that we are not only providing a technology solution, but leveraging our expertise to help the industry with this great challenge. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT CYBERMDX TO ACHIEVE IN THE NEAR FUTURE? A: CyberMDX plans on becoming the world’s leading cybersecurity solution for the health care sector. We are passionate about helping the health care industry overcome the growing security challenges they’ll face in the next decade by adopting new and disruptive medical technology to improve patient care.
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BY AAMI
AAMI UPDATE AAMI OPENS NOMINATIONS FOR ANNUAL AWARDS Who are your outstanding peers in healthcare technology? Now’s the time to give them a chance to shine in the spotlight. Each year, AAMI recognizes leaders and innovators who are moving the healthcare technology industry forward. AAMI needs your help! Until January 7, you can nominate yourself or other leaders in the industry for one of AAMI’s annual awards. Award winners will receive monetary prizes and a plaque commemorating their achievements. Winners will also be recognized in a celebration at the 2019 AAMI Exchange, the name for the reimagined AAMI annual conference, in Cleveland, Ohio, next June. “Professionals working in healthcare technology have many different job titles and come from a variety of backgrounds, but all work to advance the safety and effectiveness of the field. Through our AAMI and AAMI Foundation awards program, we recognize those ‘healthcare technology heroes’ who are innovating, volunteering and leading the way,” said MaryJane Thomas, director of membership development at AAMI. “We encourage you to nominate all who are working to advance the profession.” There are several types of awards:
AAMI Awards recognize achievement in patient safety and healthcare technology management (HTM) leadership • AAMI & Becton Dickinson’s Patient Safety Award recognizes outstanding achievements by health care professionals who have made a significant advancement toward the improvement of patient safety. • AAMI’s HTM Leadership Award recognizes individual excellence, achievement and leadership in the HTM profession. • AAMI & GE Healthcare’s BMET of the Year Award recognizes a BMET’s individual dedication, achievement and excellence in the field of HTM. • AAMI’s Young Professional Award is presented annually to a professional, under the age of 35, who exhibits exemplary professional accomplishments and a commitment to the health care profession. • The Spirit of AAMI Award recognizes the outstanding
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contributions of an AAMI member in volunteer efforts within the association. • AAMI’s HTM Association of the Year Award recognizes an HTM association that distinguishes itself during the course of the year through outstanding society operations and meetings as well as a commitment to elevating the HTM profession at the local level. AAMI Foundation Awards recognize an individual or group for a unique or significant contribution to the advancement of healthcare technology and systems, service, patient care or patient safety; humanitarian efforts to improve global human conditions with healthcare technology; or applied clinical engineering practices or principles to solve patient care problems or challenges. • The AAMI Foundation’s Laufman-Greatbatch Award is AAMI’s most prestigious award. Named after two pioneers in the field – Harold Laufman, MD and Wilson Greatbatch, PhD – this highly regarded award honors an individual or group that has made a unique and significant contribution to twhe advancement of healthcare technology and systems, service, patient care or patient safety. • The AAMI Foundation & ACCE’s Robert L. Morris Humanitarian Award honoring the late humanitarian Robert Morris –
recognizes individuals or organizations whose humanitarian efforts have applied healthcare technology to improving global human conditions.
• The AAMI Foundation & Institute for Technology in Health Care Clinical Solution Award honors a healthcare technology
professional (individual or group) that has applied innovative clinical engineering practices or principles to solve one or more significant clinical patient care problems or challenges facing a patient population, community or group. Standards Awards honor major contribution(s) to the development or revision of a standard and to a technical committee. • Standards Developer Award awards major contribution(s) to the development or revision of a specific standard. • AAMI Technical Committee Award recognizes an AAMI technical committee’s outstanding efforts. WWW.1TECHNATION.COM
For more information about the AAMI Awards program or to submit a
nomination, visit www.aami.org/awards. I AM HTM AAMI is celebrating the work of healthcare technology management professionals with it’s months-long #IamHTM campaign. With photos and quotes, AAMI features one professional every week on its social media platforms. Alyssa Merkle, a biomedical engineering manager at Brigham and Women’s Hospital in Boston with Aramark Healthcare was recently featured. “We are the problem solvers,” said Merkle. “Every day is a new challenge. I love thinking through ways to fix these issues with my team.” Show your pride in the profession by sharing these posts and using #IamHTM in your social media posts. PODCAST SERIES SHEDS LIGHT ON HEALTHCARE TECHNOLOGY AAMI now offers more than two dozen episodes in its awardwinning podcast series. Experts cover a variety of hot topics in these informative and engaging conversations, including AEM programs, quality management systems and software patch management. All of these podcasts are complimentary, offered to the healthcare technology community as a resource. They are available at www. aami.org/podcasts.
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STAFF REPORTS
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“MedWrench connects a wide range of biomed engineers, helping them to share knowledge and experiences.” –Fadi Ali, RSS
“MedWrench has proven to be an invaluable resource in servicing medical technology. –Sam Morgan, Kaleida Health
“An excellent resource. It’s my first stop when I have a question or need information. An asset to any technician’s toolbox.” –Mark Cooper, Legacy Medical Imaging
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INDUSTRY UPDATES
BY ECRI
ECRI UPDATE
Digital Radiography: The Essentials
G
eneral-purpose radiographic systems are used to perform routine diagnostic x-ray procedures provided by most hospitals, freestanding clinics, physician offices, and urgent care centers. More than 60% of all radiographs taken for routine examinations of the skull, respiratory organs, and skeletal system are produced by general-purpose table systems.
From traditional film-based radiography, which was virtually unchanged in many ways for almost a century since its inception in 1895, to computed radiography (CR) that debuted in 1987, to present-day digital detectors, the industry has evolved into fully digital image workflows. Digital radiographic (DR) systems use various methods to acquire electronic x-ray images, which are digitized for viewing, storage, or hard-copy printing. Digital images are available almost immediately for viewing on a monitor and can be manipulated electronically to enhance the region of interest and can be transmitted digitally to other locations. The patient positioning and imaging techniques are identical to those used in conventional radiography. A radiographic room typically includes a radiographic table, an upright stand, the x-ray system (including the generator, tube, housing, suspension system, and collimator), and at least one digital detector. X-RAY SYSTEM The x-ray generator provides the x-ray tube with the power needed to produce an x-ray beam. In current systems, high-frequency transformers are employed to modify the input voltage. X-rays are produced in the x-ray tube when a stream of electrons, accelerated to high velocities by a high-voltage supply from the x-ray generator, collides with the tube’s target anode (positive electrode). The cathode (negative electrode) contains a tungsten wire filament that provides the source of electrons when heated. Either a stationary or a rotating anode can be used in the x-ray tube. A stationary anode consists of a 2 to 3 mm thick plate of tungsten embedded in a copper block, which aids in heat dissipation. A rotating anode consists of a large tungsten or tungsten alloy disk connected to the anode assembly by a molybdenum stem. The stream of electrons from the cathode is directed against the beveled edge of the tungsten disk, which rotates at a speed of approximately 3,000 rpm (revolutions per minute) during an exposure. The focal spot, the small area of the target struck by electrons, remains fixed while the disk rotates;
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thus, the disk continuously presents a cooler surface to receive the bombarding electrons, and the heat is distributed around the disk in a broad ring. The focal-spot area for tubes with rotating anodes can be reduced to one-sixth that for tubes with stationary anodes under similar exposure conditions. To protect the patient by confining the x-ray beam and decreasing scatter radiation, x-ray beam collimators (also called beam-limiting devices) are attached to the opening in the x-ray tube housing to regulate the size and shape of the x-ray beam. As in all diagnostic radiographic systems, the primary beam should be confined to cover only the region of interest. Collimators consist of sets of lead plates (or shutters) that move as independent pairs to control beam dimensions. A lightbulb in the collimator produces a light beam that coincides with the x-ray field. In addition to showing the x-ray field configuration, the collimator’s light beam also identifies the center of the field. Both capabilities help ensure accurate localization of the x-ray beam on the patient. DIGITAL DIFFERENCES Digital systems offer a number of key advantages over conventional radiographic setups. Chiefly, the dynamic range of digital detectors is much larger than that of x-ray film: x-ray film can record exposure differences of approximately 100:1, while digital imaging receptors can record differences of approximately 10,000:1. This large dynamic range allows a wider range of exposures, decreasing the need for additional exposures and reducing radiation to the patient. Additionally, since the detector converts x-rays to a digital image, there is no need for film handling or supplies. DR differs from traditional film-based radiography from the point at which the x-rays reach the detector. The x-rays enter the patient’s body and some of them are attenuated— that is, either absorbed or scattered by the tissue they strike. The x-rays that are not attenuated pass through the patient and reach the digital detector. Several digital detector technologies exist, including phosphor plates (commonly called computed radiography [CR]) and DR detectors (also called flat panels). There are two types of digital detectors: indirect DR and direct DR systems. In the former, x-rays are captured by a scintillator (fluorescent screen) and converted to visible light. The light is transformed by a photodiode array and read out by a charge-coupled device (CCD) or thin-film transistor
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(TFT) into an electronic signal that is digitized. Indirect DR detectors include a scintillator layer (e.g., of cesium iodide [CsI]) along with a photodiode layer (e.g., an array of amorphous silicon). Direct DR detectors include an x-ray detector layer and a read-out layer. One of the most common structures in these detectors is a layer of amorphous selenium along with a TFT panel. Amorphous selenium detects x-rays through photoelectric interactions, in which electron-hole pairs are produced on exposure. These electron-hole pairs are attracted to electrodes and form a latent image that is read out from a TFT array, creating a digital signal. This process is called direct DR because no intermediate steps are required to convert x-ray photons to digital signals. Direct DR reduces the scatter that occurs while light is traversing the phosphor detectors in indirect DR, film radiography, and CR. A DR detector might be fixed in the table, tethered to the table, or portable in a wireless configuration. In the latter, the DR detector is read out right after the exposure and the image data is wirelessly sent to an image processing station to display and further process. The wireless capability means the awkwardness of a tether is eliminated and allows easier positioning; portable detectors can be positioned like cassettes, permitting views that were impossible with conventional radiography with the added benefit of immediate image previews. Purchasing a wireless detector can be the least expensive way to attain DR benefits with film-based or CR equipment; most vendors offer digital upgrades or retrofits to their older, film-based systems. Numerous models fit into a standard cassette holder and therefore can be used with any standard radiographic table. Additionally, the same wireless detectors can be used with mobile x-ray units. Image processing tools contribute to productivity by permitting technologists the ability to enhance contrast, zoom in/out, or stitch images together (e.g., long bone studies) within minutes after exposure. Radiologists can review images at bedside to determine whether additional studies are necessary. Features such as dual-energy subtraction, CAD, and orthopedic planning programs are common add-ons or standard features. The ability to integrate with digital picture archiving and communications systems (PACS) and radiology information systems (RIS) is a great advantage of DR, as these systems have become essential to the current healthcare environment. Recent U.S. legislation aimed at incentivizing healthcare providers to upgrade to DR will reduce Medicare reimbursement rates for non-DR technologies. As a result, U.S.-based facilities predominantly using film and CR will need to plan for the transition to DR or choose to absorb the financial loss.
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This article is adapted from ECRI Institute’s Healthcare Product Comparison System (HPCS), a searchable database of technology overviews and product specifications for capital medical equipment. The source article is available online to members of ECRI Institute’s HPCS; learn more at www.ecri.org/components/HPCS.
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BY ROBIN FAUT
BIOMED 101
Potentially Misleading Recall Notices from Medical Device Companies BY ROBIN FAUT
A
t the hospital where I work, we recently received a field recall for an operating room device. While I will withhold the name of the company and device, the recall was titled “Field Cybersecurity Routine Update and Patch Notice.” The title of this notice intrigued me as, to the best of my knowledge, this device has no network connection, holds no patient data, and transfers no data to any other system. I am writing this article as an objection to the potentially misleading wording of the title for this routine patch notice.
Before I get started, let me explain my position and experience. I have been a biomedical technician for over 20 years, and I was a computer systems analyst for five years before that. Beyond the associate degree needed to become a biomed tech, I hold a master’s degree in network security, as well as CBET certification and several IT certifications. As a biomed tech, I am currently working with connectivity of medical devices to networks. Now, back to the patch notice. As mentioned above, the notice uses the term “cybersecurity.” As also mentioned above, the intended device does not connect to any network or other device. It does have a disposable accessory that is often “reprocessed” by third parties and a trunk cable to that disposable which has a limited life. This being the case, how can this device have a “cybersecurity” issue? First, let me give the defense of the company and notice. I got my hands on a used disposable
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and cable for the device at end-of-life and tore them apart. I found that the cable had a chip in the plug that I assume is a use counter. (I was not able to get numbers off this chip, but it only had contacts to the main unit.) I found no reason for upgrade of cybersecurity there. I next tore apart the disposable, and I found two chips in the handle that communicate through two wires through the trunk cable to the unit. Researching the chip showed that they were “communication” CPUs with in-chip instruction sets and memory. These are intended to communicate the depression of the four buttons on the disposable handle, and here is where there is a possible defense of the notice. One CPU slaves to the other CPU, which communicates to the main unit through two wires. This means it is a serial communication that could go both ways. This communication can be encrypted to ensure single use and that the correct disposable is connected to the unit. The assumption of communications being encrypted is backed by the notice referencing a posting (ICSMA-17-332-01) on the website ICS-Cert.US-Cert.gov. It appears that the main unit has a limited memory for the encryption key used, which allows for the reprocessing of the disposables. As this is communication between a CPU chip and the main unit in a likely encrypted manner, this can be argued as “cybersecurity.” Now, let me blow holes in this. Cybersecurity is the endeavor of creating security of one’s property
(physical, electronic and intellectual) in cyberspace – or, as defined by the Oxford English Dictionary, “the state of being protected against the criminal or unauthorized use of electronic data, or the measures taken to achieve this.” “Cyberspace” is defined by the Oxford English Dictionary as “the notional environment in which communication over computer networks occurs.” Based on these definitions and concepts, what possible “cybersecurity” issues can there possibly be with this piece of equipment? It does not communicate with other devices over any kind of a network. It does not reside in “cyberspace” in any way. The only data it might collect and hold is the keys of used disposables. Any security on the programming and/or design of the unit is already out in the world and not retrievable. The disposable neither gathers nor holds data on the patient, or the notice would be for the disposables. The only plausible purpose for this notice is to do an update to the unit to prevent reprocessing of disposables (and the notice does state that reprocessed disposables will not work after the update). That leads me to believe that the only reason for using the term “cybersecurity” is to scare users into doing the update. What bothers me about the wording of the patch notice is that it appears to be essentially scaring hospitals and doctors into doing an upgrade to monopolize business. These units were purchased with the understanding that reprocessing was available. Now, the manufacturer is
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THE BENCH changing the rules and understanding of the users’ cost of ownership. If the unit was purchased with the up-front understanding that the use of reprocessed disposables was not going to be supported, it would not be an issue. However, the manufacturer originally offered reprocessing, only to later sell the reprocessing operation to another company. This is sort of like buying a maintenance program for the labor on your car and, halfway through the program, finding they no longer will use the oil you supply. Instead, they make you buy their brand, at twice the price of any other brand, by saying that the program cannot be responsible for the contaminant that other oils pick up in the environment. Let us be frank: most hospitals barely break even financially. Most of the businesses that work with hospitals have a much higher profit margin than the hospital itself. So, rather than engaging in these blind-side tactics to get more money out of the part of the medical industry that is least profitable, manufacturers should be truthful and up front about the full cost of ownership and operation of their equipment, thus allowing hospitals to plan well enough to survive and ultimately buy more equipment. – Robin Faut is a Biomedical Technician III/Device Connectivity for Olathe Health in Kansas.
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THE BENCH
STAFF REPORTS
SHOP TALK INTERMITTENT ERROR 044
Q:
I have a IE33 with intermittent error 044. Tech mentioned it also said something about cooling fan. I checked all fans and they appear to be free of debris and spinning correctly. Does anyone know what the error code mean?
A:
Years ago, I had a similar problem. The unit would give the error code and then shut down. I found that the fan and temperature regulator (contains an op-amp) had failed, I replaced the board and problem solved. To access, tilt back monitor and near front and down is this board.
A:
There are eight fans on the system – if it is a UMB style system or higher. I would look at all of them. Two for the acquisition card cage, two in the wheel wells, two for the video cards and two on the processors.
A:
If you can open the Log Browser, the ErrorLog often helps identify which fan or associated cable is causing the error.
VENT MODE MALFUNCTION
Q:
I have a 7100 that will not ventilate when switching from bag to vent mode. I have checked the microswitch on the lever and the GUI does indicate which mode it’s in. I can hear the vent engine actuating, but I get no movement from the bellows and no movement of air across the flow sensors. Thus, I get no
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waveform on the GUI. I have done all leak tests in service mode and in normal operation mode, with no leaks. I have done all calibrations and diagnostic checks in service mode with no problems. The s/w is 1.3. Any help and/or insight would be much appreciated.
A:
Please check pneumatic connections and settings for drive gas. If drive gas is absent due to leak or some other problem the machine will not ventilate.
A:
I don’t know if your machine has an aux CGO port, but if it does make sure it’s closed.
A:
Remove the drive gas check valve; it gets stuck some times. Reseat it.
A:
Exchange the ABS with working machine. Do the spanning cal and pressure limit SES tests. Check 25 PSI on drive gas reg. Check/exchange the bellow assembly and canister. If all pass, start troubleshooting the electronics control board.
CBET OR NOT?
Q:
I have been a biomed tech for roughly seven years now at various facilities. I am considering sitting for my CBET, but feel like I have not received the needed material to sit for the exam. Unfortunately, all of the facilities where I have been employed have disregarded providing any vendor specialized training or any continuing
education training for the biomed department (which in my case has been a team of less than five in each location). My questions are: 1. Is there a benefit to obtaining the CBET? My current supervisor, who has been in the industry for 30 years, says that it’s a waste of time. 2. What are some of the ways I can get current training on the material without going broke in the process or going to a university? It seems most self study guides are about five years out of date and still cost a pretty penny.
A:
At AAMI, we believe there are significant benefits to certification. While it varies by employer, many facilities consider certification when it comes to raises and promotions. A certification helps you to stand out from the crowd, gives your resume more power – and could lead to more and better career opportunities. In terms of study resources, we encourage you to review the ACI Candidate Handbook, which includes a content outline for the exam. AAMI also offers the BMET Study Guide. Various state and local associations offer study groups. We recommend reaching out to colleagues on our online HTM Discussion Group to find out what resources they have found to be helpful.
A:
Most employers cover the cost of a certification exam and renewals. In cases where a manager doesn’t have the budget to do that, there is tuition assistance available
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THE BENCH
from the employer which can be used toward the cost. I think CBET is great if you want to work as a BMET for a broader sense. The CCE through ACCE and HTCC makes more sense if you want to be a clinical engineer. Overall, I think certification has a lot of value and is professionally recognized in all organizations through the initial hiring as well as advancement to different roles.
A:
The answer to the questions about CBET varies. Some organizations want the CBET and others do not care. The study guide is sold by AAMI and I believe its less than $100. Also, our school (CIT) offers a practice exam so the student can
bmesseptembersmall.pdf
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gauge how they will score on the real exam. Being a business owner in a medical service industry, I am more concerned about the technician’s ability to perform the work. I do not think that having or not having the CBET makes a difference. My organization has a competency form in which the new hire has 60 days to become familiar with the hospital’s medical devices and test equipment. In today’s industry, I am more concerned if the technician has the ability to communicate effectively with the customer. There have been many instances where the technician repairs the equipment but forgets to communicate effectively thus creating more problems. I have hired many
technicians without a biomed degree and had them go to school as they worked for me. This gave me the ability to train them to the customized needs of the hospital. My only criteria was that they have great people skills, the ability to learn and a clean background check. There are other companies that do require a BMET certification before they will hire them. I think the CBET is overrated personally, but if any of my employees decide to get their certification, I usually give them a dollar an hour raise just for taking the initiative. SHOP TALK is compiled from MedWrench. com. Go to www.MedWrench.com community threads to find out how you can join and be part of the discussion.
2:55 PM
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THE BENCH
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SESSIONS PROVIDE QUALITY EDUCATION STAFF REPORT
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recent Rigel-sponsored presentation “ESU Performance Testing Utilizing the ERBE-USA VIO 300D” was a hit with Webinar Wednesday attendees. Those attending the live presentation were eligible for 1 CE credit from the ACI.
In the webinar, Jack Barrett, national business development manager at Rigel Medical, reviewed test criteria and standard process for various ESU performance verifications including power output, return electrode and HF leakage. He also performed an actual demonstration of tests utilizing video clips. The webinar drew 334 attendees who gave the presentation high marks with a 4.1 rating on a 5-point scale. Attendees shared positive comments in a post-webinar survey regarding the webinar. “I believe the information presented provided a learning opportunity for my team and will benefit the organization by reducing service associated expenses,” said A. Constantine, director of clinical engineering. “My first experience with the Webinar Wednesday involved the process of ESU analysis with Rigel. The instructor Jack Barrett was well prepared and informative, along with the moderator, which kept the webinar moving at the right pace for everyone’s work day while making the presentation easy to understand,” said M. Stone, biomed technician. “Great webinar, very informative. Can’t wait to get my Uniterm tester and
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use it,” said L. Elvir, biomed technician. “We currently have several ERBE ESU devices. This webinar has helped with verifying data and output results. It is great to have experienced and knowledgeable webinar hosts giving the webinars. This webinar was detailed and allows me to build on my knowledge of ERBE and other devices,” said H. Martin, clinical engineer. “This was my first Webinar Wednesday but certainly won’t be my last. Great stuff,” said D. Uptain, biomed technician. PARTS AND INVENTORY A recent Nuvolo-sponsored webinar “Automating Your Parts and Inventory for Medical Devices” was a hit with HTM professionals around the world. Nuvolo is a modern, cloud-based EAM platform that meets high standards for ease of use, performance and online and offline mobility capability for managing clinical equipment for health care providers. Those attending the live presentation were eligible for 1 CE credit from the ACI. The webinar featured Peter Goltz, senior solution consultant at Nuvolo. He showed attendees how clinical engineers are reducing their spend and saving time by automating the life cycle management of parts and inventory, starting from purchasing through decommissioning. Attendees were able to learn valuable information, including how to reduce spend by automating the purchasing of parts and inventory. He also shared how to save time by automating the documentation of parts and inventory
that are used in the field. Goltz also explained how to increase accuracy by having a real-time reflection of inventory and parts on hand. The webinar received high marks from attendees in a post-webinar survey. “This appears to be a godsend to clinical engineering. This is what we’ve been needing for years to efficiently manage medical equipment,” said M. Pritchett, biomed technician. “This was another great webinar that helped provide key information for us in the field,” said J. Ruiz, technology manager. “Presenter communicated clearly and the presentation display was intuitive, uncluttered and well designed overall,” said M. Walker, biomedical equipment specialist. “This was a great presentation, loads of useful information,” said H. Touchette, BMET. “It was interesting to learn the value of some of the tabs in our CMMS that we have not been fully utilizing as well as how the inventory information can be used,” said C. Davis-Ryan, CBET. CYBERSECURITY Cybersecurity continues to be a topic of conversation throughout the HTM world. The Webinar Wednesday session “Future of Medical Device CyberSecurity Management” sponsored by Asimily focused on this hot topic. The 274 attendees who participated in the live presentation were eligible to receive 1 CE credit from the ACI. In the webinar, Asimily co-founder and CEO Shankar Somasundaram
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provided an understanding of how one should approach medical device cybersecurity, the different aspects one should look for and how one should approach the issue of patching. The webinar was popular with attendees who provided positive comments via a post-webinar survey. “There was a lot of great information presented in a small window of time. Because it was recorded, I will be able to listen to it again so I can capture some of the information I missed. Device integration has become a focal point for my career at this time and this webinar on cybersecurity has given me a better perspective on the importance of really knowing more information about the equipment other than its purpose and if it is working within the parameters as set by the manufacturer,” Biomedical Equipment Technician A. Hale said. “This webinar was very informational and opened my eyes to new aspects of the patching/mitigation process for medical equipment. It helped me understand the relationship between IT and biomed roles in solving pertinent issues,” Biomedical Equipment Specialist S. Orfano said. The webinar series also continues to receive positive feedback from attendees. “The webinars are a great asset as I work for a nonprofit and our educational budget is minimal,” Biomed R. Greer said. “Great educational series, always enjoy content, always relevant. Thanks for providing everyone with the access for free. Great idea to do
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ROUNDTABLE
STAFF REPORT
ROUNDTABLE Digital Radiography (DR) Health care professionals continue to rely on diagnostic imaging and some would argue it is vital when it comes to obtaining quality outcomes. Advances in technology continue to evolve medical imaging and create more options for clinicians. One imaging modality that continues to provide valuable insights to health care professionals is digital radiography (DR). TechNation quizzed a few insiders to find out the latest on DR and what HTM pros can expect in the future. The three individuals sharing their insights on DR are RSTI President Dale Cover, Carestream Regional Business Director for X-ray Solutions Cheryl McCarron and Innovatus Imaging Radiography and European Operations Vice President Tracy Schrecengost. Q: WHAT ARE SOME OF THE NEWEST FEATURES IN DIGITAL RADIOGRAPHY FACILITIES SHOULD CONSIDER WHEN BUYING NEW? Dale Cover, RSTI
attacks or stolen data. Enhanced imaging software platforms should be considered since image processing algorithms continue to improve. It is important to look for DR systems that feature high-resolution images and easy-to-use software that allow the best images to be captured using the lowest dose. Additional software options can help radiologists detect subtle diseases and conditions. Schrecengost: Retrofit systems are making it affordable for hospitals and clinics of all sizes to quickly and affordably transition to digital radiography, leveling the playing field between large and small health care facilities. When purchasing retrofit systems, providers should consider workflow efficiencies. Transitioning to DR opens up a whole new world of highly efficient possibilities and provides flexibility imaging departments have not had before. Our DR retrofit systems are designed to make this transition from analog as fast and simple as possible without having to replace the entire room.
Cover: As far as hardware goes, probably the best new feature is panels with Automatic Exposure Detection (AED). Prior to AED, digital panels had to be interfaced to the X-ray system in one way or another to inform the panel when it is time to integrate the X-ray exposure and to inform the X-ray system when the digital system is ready for acquisition. Now digital panels detect when exposure begins on its own. AED panels are ideal replacements for the outgoing CR technology. On the software side, image processing continues to advance. One example would be image stitching.
Q: HOW CAN FACILITIES OVERCOME BUDGET CONSTRAINTS WHEN IT COMES TO ACQUIRING DIGITAL RADIOGRAPHY DEVICES? Cover: Retrofitting digital on to older systems would be less costly as long as the system being upgraded is a quality system that will have minimal service requirements. If a completely new system is required, then facility managers need to be aware that there are many providers and smart buying is a must. Also, be aware of the true operational requirements. They should be known and adhered to. Don’t buy options that will never be needed or used. Not only do they cost more upfront, they also add to ongoing service contract costs. When it comes to portable digital panels, a strong drop/loss prevention program is helpful.
McCarron: Cybersecurity is extremely important for all imaging systems. Facilities should look for vendors that proactively update imaging systems with the latest technology to prevent
McCarron: Retrofitting existing CR mobile units and rooms with DR detectors allows facilities to achieve the benefits of DR at a very affordable cost. In addition, Carestream detectors can
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ROUNDTABLE
be registered for use on any DRX system, enabling detector sharing for more efficient utilization and a lower investment. As an example, health care providers can use a detector in a portable system for early morning rounds and then transfer it to a DR room for use during the day. Carestream also developed its more affordable DRX Core family of detectors to address the needs of small to mid-size providers with tighter budgets and lower volumes. Schrecengost: The transition to digital does not need to blow out your budget. There are many options that are less expensive that enable facilitates to have the latest technology without the high price tag of replacing the entire room or portable system. The main thing to keep in mind is the long-term value you receive from investing in DR. If you invest now, it will pay off dividends in the near and long-term and you don’t have to buy the most expensive equipment to see those returns soon. Q: WHAT SHOULD ONE LOOK FOR IN A DIGITAL RADIOGRAPHY SERVICE PROVIDER? Cover: Competence sounds like the easy answer, but there is more involved here. Response time is very important. For a facility that has multiple systems response time is a bit less important than the small clinic that has only one. The fastest would be to have someone on staff that is capable of handling the routine issues to restore operation of the system and a service provider willing to help out over the phone. Bigger issues will still require a service visit. Cheryl McCarron, Carestream McCarron: Look for a provider that offers varied service plans and experienced technicians. Facilities with fully staffed biomed departments may only require a plan that covers parts and provides phone support. In the future, needs may change or there may be remote locations that the facility’s biomed engineers don’t cover. The same service provider should be able to offer full service when and where it is needed. Studies have shown that experienced service technicians can deliver faster diagnosis and resolution of equipment problems. This maximizes uptime and saves time and money for hospitals, imaging centers and other imaging providers. Schrecengost: Like with any imaging device purchase there are some basic requirements all partners should meet in order to provide sustainable value and a positive ROI. These include: • Flexibility – 24/7 accessibility to technical experts • ISO certification with in-house trained technical experts • Remote service and troubleshooting capabilities, to avoid delay ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
• Have a service provider with knowledge in all aspects of the product • Look for a “partner” not just a “provider.”
Q: WHAT ADVICE WOULD YOU GIVE A BIOMED INVOLVED IN THE PURCHASING OF A FACILITY’S DR DEVICES? Cover: Serviceability, survivability, versatility! Locked down systems prevent in-house access to the systems and put more pressure on managers to maintain expensive contracts. Batteries and chargers, drop force limitations, interface cabling/connectors and software/computer stability will affect the amount of time and resources required to keep these devices productive. Digital panels that can be used in any room provide freedom for the users to have multiple panels, multiple users and back-up when one or two panels require maintenance. McCarron: Biomed engineers can evaluate DR devices for reliability, suppliers’ service/support programs and cybersecurity benefits. But it is also essential to work with both radiologists and technologists to ensure that their needs are being met. Technologists need an intuitive interface that makes imaging systems easy to use. Radiologists require extremely high-resolution images that allow them to detect subtle conditions and deliver an accurate diagnosis.
Tracy Schrecengost, Innovatus Imaging
Schrecengost: To make choices that can support your facility’s short- and long-term needs, it’s important to include all key stakeholders when making decisions for imaging devices. Speak up, ask to be involved and have a seat at the table. And again, looking for overall value vs. short-term pricing perks will pay off in terms of sustainable profitability and lower cost of operations. This is critical for all imaging equipment needs, not just DR. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING DIGITAL RADIOGRAPHY? McCarron: It’s important to select a supplier that is committed to providing the same level of training for your facility’s biomeds as their own service organization. While technology is important, maintaining high service levels always requires skilled, well-trained biomed professionals. Schrecengost: When comparing systems, make sure you’re comparing apples to apples, and make sure you are buying based upon the unique needs of your facility and your patient community. Make sure you are buying a system that is easy to integrate, and easy to use. Many software and hardware systems end up being difficult to assimilate and use which can minimize your productivity and ROI.
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BIG D IT’S KIND OF A BIG DEAL
BY K. RICHARD DOUGLAS
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DATA W
e live in an information age where data on any particular subject is plentiful and, often, obtainable. Analyzing that data, can allow it to have a meaningful utility in order to combat crime, find medical solutions to disease or determining a stock to trade.
Big data can also be used by advertisers or retailers to monitor consumers’ search trends or spending habits to create targeted advertising campaigns. Predictive analytics, using crime trend data, has been used to reduce crime. The city of Memphis Police Department worked with the University of Memphis’ Department of Criminology and Criminal Justice using predictive analytics software created by IBM. The data included the characteristics of various offenders, data from patrols and incident reports, with specific information about time of day and day of the week. This data was overlaid onto charts and maps that made it useful to the police. The results helped the Memphis police department determine where to place patrols and when to do it. The use of the accumulated data, and the ability to analyze it accurately, resulted in a 75 ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
percent decrease in carjackings and a 67 percent decrease in business robberies. In health care, big data can help identify a state of deterioration in a patient and alert clinicians by identifying the onset of adverse events. Just like evidence-based medicine, that can guide a physician in a treatment regimen, big data can allow for more specific direction in care to head off a decline in health. Tests done on blood, urine or tissue samples (in vitro diagnostics) can provide data to the data sets used in the emergency department or intensive care unit, that are combined with other data derived from patient monitors and other sources. This combined data may improve patient outcomes after it is parsed by analytics software and through machine learning and presented to attending doctors. With the advent of electronic health records, more data became available to those providing treatment. Combined with real-time data from physiologic monitors and other devices that provide feedback, this data can dictate the treatment plan that a physician follows. DELVING INTO DATA IN HTM If big datasets can lead to fewer carjackings, then with the resourcefulness of those in the HTM
profession, it can certainly find application to medical device management. In the HTM department, the ability to pull data and scrutinize it allows for many tasks to be completed. The goal of using big data in the HTM department is the hope that it can promote cost savings, efficiency, positive patient outcomes and reduced downtime. The ways that extrapolated data can do this in the biomed department are many. “Data can be used in so many ways; technicians can use data to troubleshoot malfunctions which can speed up the repair process and reduce downtime. Data helps with part identification and can help the technicians find the best price on parts,” says James Swandol, BSM, CBET, manager of Healthcare Technology Management at Baylor Scott and White in McKinney, Texas, citing just a few common uses. “HTM professionals live and breathe the use of data to drive decision making. For any equipment management program, HTM departments need to know what equipment is being repaired, how much time is spent repairing it and repair costs. With this information, HTM managers can best determine how to run their departments,” says Angelique Dawkins, clinical engineer at Baylor Scott and White Health in Dallas, Texas. NOVEMBER 2018
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BIG DATA IT’S KIND OF A BIG DEAL She says to promote cost savings, they can examine return on investment for vendor service contracts and compare that to in-house repairs. If equipment is down too often, they can pull repair records to quantify that downtime. And for problem equipment, they can compare the repair and downtime cost to the cost of replacing that equipment altogether. “Meanwhile, technicians can use data to keep track of their workload. This can include their open work orders, response time to service calls, and completion percentage for preventive maintenance,” Dawkins says. In addition to tracking important metrics, scrutinizing data can help the budget and bring some science to parts selection and sourcing. “Knowledge is power for HTM professionals. Here’s why: having data on what you are spending and where provides the opportunity to find cost and time savings. Having data on the quality of your suppliers can help determine which suppliers you can most rely on and identify trends over time,” says Will Burgman, senior director of strategy and operations at PartsSource in Aurora, Ohio. “Knowing what fails and how often can impact your buying decisions to positively impact patient outcomes and better uptime,” Burgman adds. That same use of data can allow for informed decisions for capital purchases, according to Aaron Goryl, GM, Healthcare Technology Management (HTM) and On-Demand Development, U.S. and Canada at GE Healthcare. “Every HTM program, like a fingerprint, is unique which means there is no one-size-fits-all solution. Medical equipment serving high-patient throughput areas is going to impact patient outcome, hospital revenue and end-user satisfaction in a different way 58
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than that same piece of equipment with half the utilization,” he says. “Having strong data metrics that can drill down to expense and utilization of a single device allows the type of nuanced approach that both addresses downtime where it is most critical, and save cost when cost-out initiatives invite hard decisions. That same utilization and cost data empowers HTM programs to have a strong voice and evidence-based positions when it comes to capital planning,” Goryl adds. Matthew Clark, MBA, CHTM, clinical engineer in the clinical engineering department at Advocate Health Care in Downers Grove, Illinois, says that the use of data takes the guesswork out of decisions in the HTM department. “Using data is the difference between an intuitive decision and an informed decision. Intuitive decision making can work when determining a strategy, but when you create action plans, you really should have data to see if you are in the right place initially and if your actions are moving things in the right direction,” he says. Clark says that if you are going to try to identify cost savings, you need to find an area where your spending is higher than it should be and then, after you have implemented a cost-savings initiative, you should check the spend to see if you were effective. “Efficiency initiatives can be identified by looking at where a lot of maintenance time is spent. After which, you should check the same numbers to see if you reduced the time spent. With these initiatives, you also must look at other information, such as your downtime or any clinical metrics that may also be impacted by changing how the equipment is managed. By focusing on only one metric you can solve one problem while inadvertently creating another,” he says.
The availability of data can also help answer several questions for the HTM department according to Burgman. “Is my team spending time on the high-impact areas? How well is my team purchasing,” he asks. “Where can I save more by purchasing better/ smarter and are quality trade-offs in the secondary market commensurate with cost savings?” CORRELATING DATA SETS WITHIN CMMS Using existing or add-on features with CMMS can make the most of available data. Swandol says that most, if not all, CMMS databases allow for storage of documents and [that] is how data in conjunction with CMMS can help the HTM professional. “By having all the data in one place, that is easily accessible, the HTM professional is not having to go search all over the Internet or spending hours on the phone with vendors to request documents. Instead the technician has the data at their fingertips, saving time and limiting down time of equipment,” he says. “At Advocate Health Care, we have built a dashboard with our support operations department that combines different data sets to visualize trends in different areas. We are looking at the results of satisfaction surveys (patient and customer), equipment reliability, safety measures and cost measures,” Clark says. “Trends are shown to identify potential correlations between things like cost and downtime, or reliability and customer satisfaction. There is a lean A3 form that is built into the dashboard that allows action plans to be built using the collected data and show the trends as the plan is carried out. Seeing the various areas in one place so that trends can be seen side by side really gives a lot of insight into WWW.1TECHNATION.COM
whether a strategy is working or not,” he adds. Dawkins says that many CMMS have built-in reports that come with the system, but also offer the ability for HTM professionals to customize their own. These can be run on an ad-hoc basis or sent out on a recurring schedule. “Some CMMS even have the ability to create dashboards that pull data in real time. These tools allow HTM professionals to get an accurate and up-to-date picture of the state of their programs,” she adds.
“ CURRENTLY, WE USE DATASETS TO HELP DETERMINE WHAT EQUIPMENT SHOULD BE PLACED ON AN AEM PROGRAM. WE ALSO USE DATA TO FIND TRENDS WITH EQUIPMENT MALFUNCTIONS, TRACKING OPERATOR ERRORS, MISUSE OR ABNORMAL DAMAGE.”
TRENDS IN USAGE While more and more information ends up digitized and accessible, the use of big data will continue to improve the decision process for purchases, maintenance and resource allocation. “As more medical equipment is being integrated into the electronic medical record, more data is collected than ever before. We have begun to see requests to help assess how the information is collected, trended and reviewed,” Clark says. “We also see more requests to compare devices and their results as they are fed into the EMR. The variation between devices becomes more apparent when data is reviewed side by side in a collection of data. This has led to more standardization in devices used and how they are used in the clinical environment. Naturally, this standardization of devices introduces the opportunity for efficiencies in how those devices are managed,” Clark adds. Burgman says that his employer has actively utilized big data going back to 2008, which includes data on 2.5 million product requests, tracking 20-plus key attributes across each of those transactions. Making use of that data, they were able to extrapolate several findings. ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
JAMES SWANDOL, BSM, CBET “Every clinical site has opportunities for additional savings – this is likely because few are set up to handle the long tail of low-volume, low-dollar orders. Facility size or amount of spend has little to do with how well a site purchases,” he says. “ ‘Best-in-class’ HTM programs require consistent processes and real-time decision making support based on data and insight. HTMs spend the majority of their time sourcing products under $1,000. Most organizations are spending a tremendous amount of time and resources on the lowest dollar items. The sheer volume of low-dollar transactions can overwhelm manual, paper-based or otherwise inefficient processes,” Burgman adds. As a result of this data analysis, he says that reallocating HTM expertise from sourcing low-dollar, infrequent purchases to higher-value activities like fixing important equipment is the key to impact. Having the data to understand your spend, time and medical equipment quality can increase capacity without adding headcount, creates opportunity for cost savings and quality improvement and ultimately increases uptime for an organization. The use of datasets also allows for tracking equipment status and helps pinpoint training needs. “Currently, we use datasets to help determine what equipment should be placed on an AEM program. We also use data to find trends with equipment malfunctions, tracking operator errors, misuse or abnormal damage. This data helps us determine not only what training is needed for the HTM
professional but also what training clinical staff could benefit from,” Swandol says. A continuing trend will be the ability of analytics software to allow HTM departments to visualize the status of equipment and cyber threats. “Data visualization will continue to be important to HTM professionals everywhere. A CMMS (or program interfacing with the CMMS) that can provide dashboards is an asset to any department. By giving a quick visual snapshot of the state of the program, it streamlines reporting and increases operational efficiency,” Dawkins says. “Medical device cybersecurity is also a hot topic for HTM. As medical devices become more connected with health care networks, using data to prevent intrusions will become increasingly important. This data can come from monitoring devices on the network, and establishing a baseline for device activity. By analyzing this data, suspicious activity can be flagged and stopped. This promotes patient safety, protects their data and promotes device uptime,” she adds. The ability to process an accumulation of information efficiently and transform it into a meaningful format to glean knowledge, cost savings and other benefits is still in its early stages. There will be more ways to utilize datasets and more available datasets in the future. HTM departments will continue to find ways to analyze and parse data to achieve more cost savings, efficiency, positive patient outcomes and reduced downtime. NOVEMBER 2018
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EXPERT ADVICE
BY TODD RODGERS
CAREER CENTER I See Ghosts, They’re Everywhere! BY TODD RODGERS
A
few weeks back I was reading a group discussion on a human resources social media page. The topic was about candidates “ghosting” for job interviews. Ghosting refers to when an interview is scheduled and confirmed and the candidate simply doesn’t show up, doesn’t return phone calls, and doesn’t return emails. He or she vanishes, like a ghost. The best phrase to describe this is, “man, that’s messed up.” So, I have a few ideas on why ghosting happens as well as ideas on how to limit or avoid being ghosted.
Another type of ghosting is when a new hire never shows up. What gives? Who is doing the ghosting? The answer isn’t that easy. In my imagination, people who ghost should probably stand out in a crowd. They should be easily identified as looking like a slob. They are late for something but don’t know it; always scrambling, bumping into people on the sidewalk, holding a sweaty and wrinkly scrap of paper, searching for an address on the wrong street. Their work history could be a recipe for job-hopper stew. They should be obvious outcasts, the Columbo of job-seekers. But the sad fact is, they’re not. They look and usually act just like the rest of us. You might be sitting near one and not even know it. Heck, you could be one and not even know it! Full disclosure, early in my career I accepted a job and on the first day, walked in and quit; I accepted a much better job offer the night before.
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I felt awful about it. But, following my mother’s advice, I owned up to my decision and had the decency to resign in person. The people who are ghosting are nearly impossible to identify by sight. They are nearly impossible to identify, period. When they ghost, they aren’t issued a mandatory scarlet letter. They aren’t entered into a searchable database. The only people who actually know that the person is a “ghoster” is the employer left wondering what happened. And, frankly, that employer isn’t likely to go around publicly bad-mouthing the candidate because that just looks bad for the employer. So, employers are stuck with dealing with this behavior for now. Why are people suddenly ghosting? I don’t have any supporting data so you’ll just have to take this on face value. People are ghosting because jobs are easy to come by right now. Additionally, there isn’t a short-term consequence for this rude and unprofessional behavior. Since jobs are aplenty, candidates are bombarded with opportunities. That creates a false sense of long-term security that clinicians refer to as the “illusion of invincibility.” The reality is, the job market changes every few years and when it does, those ghosts suddenly disappear. Employers usually have a candidate database. And, we can search that database for evidence of historical flakiness. I can assure you that we search for people who’ve previously shown their unreliability. But, the distilled explanation for ghosting is that
TODD RODGERS Talent Acquisition Specialist for TRIMEDX
candidates are operating in a market that has a surplus of jobs. They have the luxury of picking and choosing, or ghosting. Those same candidates also mistakenly believe it will always be like this. The result is no-show-no-call for interviews and for jobs. How can an employer minimize the chances of getting ghosted? No one likes to have their time wasted. Ghosting definitely wastes time. Employers are never going to eliminate the possibility of a no-show-nocall employee. The best that one could hope for is to reduce the potential for ghosting. This is accomplished by building rapport with the candidate through motivational interview questions. It’s essential to ask and probe about what is driving a candidate. By knowing, or at least asking about, why the person is looking for a change as well as what the person is seeking in a future job, an employer invites the candidate to get some skin in the game. The candidate must disclose something and typically it’s the true drivers behind their job-seeking. With those elements on the table and explored during an interview, the candidate develops
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some emotional linkage to the possibility that true job satisfaction is available at committed to show up and work hard. your company. People like to imagine As an employer, it’s helpful to remind themselves engaged with things they like. yourself that you really only want to hire When the possibility of having a job that is people who are reliable. One of the ancillary professionally satisfying comes into view, and indirect benefits of being ghosted by a most people will pursue that opportunity job seeker is that you were able to avoid until it’s either a reality or until it’s no making a bad hire! The ghosting candidate longer available. What people will not do is revealed their flakiness before you started act like they are pursuing that thing and paying him or her. It’s frustrating that you then haphazardly abandon that pursuit. My had your hopes up on filling a vacancy on advice to employers is to always include your roster. But, I think it’s typically questions about career-change motivations. better to have a vacancy than to have a Examples are: Could you please talk about team member who doesn’t take things what is going on with your current role that seriously. So, it’s useful to look at ghosting isn’t as satisfying as you had hoped? What is as having benefits, though they come at it about what you’re doing currently that the price of your time. isn’t meeting your expectations? If you We’re never going to be able to get rid of found a really good job with a really good ghosts. They’re everywhere and it’s rare PROOF APPROVED CHANGES NEEDED employer, what are some of the positive that we can ever identify them on sight. things SIGN–OFF: that would stand out? Can you Even the best interviewers and the most CLIENT describe a few highlights of your career respected employers are going to encounter where you really CONFIRM felt like things were going a ghost from time to time.CORRECT It’s unavoidable. PLEASE THAT THE FOLLOWING ARE well? This makes a person open up and talk However, by simply asking someone about LOGO PHONE NUMBERtheir interests WEBSITE ADDRESS about what’s inside and that linkage is what early in the process, will hopefully keep them engaged and employers can stop wasting time.
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BY MICHAEL DAVIS
Sponsored by Because Quality Matters ISO 9001:2015 CERTIFIED
ULTRASOUND EXPERT Is a USB a USB? BY MICHAEL DAVIS
A
customer called me the other day regarding his GE Logiq P5. The customer had just replaced a part on the system and while testing, discovered that the printer no longer functioned. I walked the customer through the verification of the printer settings. Verifying that all the settings were correct, I asked the customer to walk me through the repair process. As we did a step-by-step recount of the entire process, I discovered that all the USB cables had to be unplugged. I began to verify where all the USB cables were connected. When we reached the printer cable, I had the customer ensure that the cable was connected to the designated port. It turns out that the cable was connected into the port next to the designated port. Once we moved the cable, the printer began to print everything that was in the queue.
What happened? Why did moving the port make a difference? Isn’t a USB a USB? While a USB port or Universal Serial Bus is designed to support any device, this is not always the case. Any device connected to a USB port requires drivers to be loaded. Because most of the systems run Windows as the OS, many drivers are pre-installed. Input devices like keyboards and mice, can use a
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generic driver. Devices like CD/DVD drives, hard drives and thumb drives can use a generic and will usually show up as the next available drive letter. Other drives, like printers, require specific drivers that must be loaded. Depending on when the ultrasound was made, they will install drivers for the most current models at that time. This means that while the system will support a Sony UP-D895 printer, it may not support a Sony UP-D897 printer. The customer’s system was running the printer before, it had the necessary driver, so why would it not work? When an operating system is installed, it configures all the USB ports. The system’s OEM will then attach hardware to the system and load all the necessary drivers. Once this process is completed, the imaging software is then loaded, and the ports are assigned. This allows the OEM to ensure that all the systems operate in the same way. When you move a printer to another port, the imaging software may not see the changes. This is especially true with older systems. I have always said to document as much information about your system as you can and verifying the location of all your USB plugs can make a big difference when it comes to how the system operates.
MICHAEL DAVIS Technical Support Specialist For ultrasound Technical Tips and Tricks visit www.conquestimaging.com, our blog section or visit our online Technical Support Video library for installation and removal instructions and much, much more. Conquest Imaging Technical Support is available 24/7/365 at 866-900-9404.
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BY ROGER A. BOWLES
THE FUTURE What Do You Know? BY ROGER A. BOWLES
S
ometimes we don’t know as much as we think we know. I mailed in my CBET certification renewal journal last week with the requisite documentation and fee, probably for about the eighth time since I achieved certification in 1993. This was the first time, however, that I’ve renewed under the new ACI guidelines. They are a bit more stringent and I’m all for it. I didn’t really take a close look at the new requirements until very recently.
Under the new requirements, an individual must earn 30 CEUs over a 3-year period. At least 15 of these CEUs must be in Category IV: Professional Development. Luckily for me, I’ve attended an AAMI Conference during this three-year period and two different ultrasound courses (thanks to GMI). This new journal emphasizes the need to be a student. As a motorcycle instructor, I am required to update my certifications every two years. And part of that renewal is to attend a professional development activity (such as a motorcycle-related conference) plus taking a motorcycle course as a student. This continuing need to be a student is absolutely necessary in all fields, in my opinion. Charles Darwin once said, “Ignorance more frequently begets confidence than does knowledge.”
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
(Maybe that is where the Darwin Awards originated). In a recent article in a non-HTM magazine, the author mentioned the Dunning-Kruger Effect. As I understand it, the Dunning-Kruger Effect basically says that people with low ability in an area frequently think they have a much higher ability than they actually do. This made perfect sense to me. Ask any 10 drivers to rate themselves from poor, below average, average, above average or excellent and my guess is that most, if not all, of them will rate themselves above average or excellent. Perhaps this is why we see so many people using the cellphone while driving. It is seemingly only dangerous for those with below average abilities. It is also evident in the classroom when students (and instructors) are genuinely shocked by a less than perfect score (or review). For most, the more we learn, the more we realize how much we don’t know and how much more there is to learn. In HTM, the need to continuously learn is obvious. As a biomed, and afterward as an instructor, I was fortunate to work with some very talented and competent individuals. They are so talented and competent that many times I question my own competency. For educators, when students do not
ROGER A. BOWLES, MS, EDD, CBET Texas State Technical College
graduate with the skills they need it means we failed. Our advisory boards keep us on track as to what should be taught, but it is up to us to decide how we do it and how well we do it. While it is really easy to place the blame on the students, “Wow, students these days are just not as bright as they used to be,” it is probably more correct to do some self-assessment and realize we could be doing a better job of teaching. So back to the ACI, the increased requirement for professional development is a good thing. Sometimes, it is a good thing to be criticized also. I realized this recently when my wife and I were talking about writing and this column came up. She said she hasn’t read any of my writings lately because “they are all basically the same.” Wow! Spouses have a unique way of calibrating people when they need it most. The fact that she is an HTM professional made it sting that much worse. On that note, I will promise to branch out a bit and change things up. Consider me calibrated.
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EXPERT ADVICE
STEVE PLAUGHER
TM
Sponsored by
WHO PAYS FOR THE COST OF NON-STANDARDIZATION?
I
read an article a couple years ago that stated standardization is one of the top 10 critical initiatives for hospital executives.
I have no doubt the executives polled in the article recognized standardization as one of several key initiatives in their mission critical requirement to reduce costs, which is undoubtedly not unique to medical technology. Recently, I had the opportunity to talk to a Program Manager for a large military aircraft supplier. Her experience involved two different military aircraft types and I couldn’t help but ask if there is any standardization between the two. After all, radar, navigation and other such systems are not unique to any particular aircraft, generically speaking. Without hesitation, she simply responded no. After a brief pause, she stated their customers are beginning to discuss standardization and, at some point, will be specifying it as a requirement in future projects. I’ll leave it up to you to ascertain who their customer is and ultimately bears the cost for nonstandardization in their products. An example of a company that has leveraged standardization as a guiding principal, Southwest Airlines makes for a good model. I believe Southwest was clearly ahead of its time when the company standardized on a single aircraft make and model type from its inception and continues this practice today. Southwest clearly recognized the savings and efficiencies that would be derived from standardizing on a single aircraft in the way of reduced spare parts inventories, lower technical support training requirements and other operational costs. 66
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By contrast, consider other major airlines and the various types of aircraft in their fleet. Then, consider the logistics challenges associated with managing a fleet of this size, with so many aircraft variations, that are moving from one location to another. SO, WHAT IS THE COST OF NONSTANDARDIZATION FOR HOSPITALS? I believe this is an incredibly difficult question to answer and I suspect standardization is viewed as an investment much like Quality was in its infancy. The difference is quality has evolved significantly over the past few decades. The American Society of Quality (ASQ) has defined the Cost of Quality, or more aptly, the Cost of Poor Quality (COPQ) as “costs associated with providing poor quality products and services.” ASQ categorizes COPQ into four cost categories each of which can have its own measures. Measuring and monitoring these key indicators drives visibility to improving product and service quality and focus on reducing costs. The costs of non-standardization does share the same benefits as COPQ, though I trust the hospital executives interviewed in the publication understand there are inherent costs associated with nonstandardization. I would also suggest they view standardization then, and now, as a monumentally complex undertaking given the complexity of their environment, the enormous supplier base and variations in technology. That said, hospital leaders have taken steps towards standardization in areas such as collaboration and IT infrastructure technology investments. Health care and industry have also co-contributed to this vital initiative by
STEVE PLAUGHER Senior Vice President, Medical Innovation Group, Diversified
developing standards such as DICOM and HL7. Going forward, hospitals have made and will continue to make, significant investments in technology. You, as Healthcare Technology Management professionals, are recognized as valuable team members and are now a critical part of capital equipment investment committees and perhaps technology councils. Your involvement in these critical initiatives is vitally important to your hospital’s mission of providing the best possible patient care at the lowest possible cost. Technology investments will be sourced from a variety of medical companies as a result of selecting the best possible solution for each application. In your due diligence process, it may be wise to include discussions with your partners about their standardization strategy as this will have a direct impact on your costs. At the end of the day, we know who ultimately pays the costs for nonstandardization. Steve Plaugher is Senior Vice President, Medical Innovation Group, Diversified. WWW.1TECHNATION.COM
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BY INHEL REKIK
TECH TIPS
Do Firewalls Protect Against Cyber Threats? BY INHEL REKIK
T
here are three networks in your organization (border network, perimeter network and internal network). The transition from one network to another is done through a network firewall. A firewall is a network security tool that controls network traffic based on a predetermined security rules. There are several generations of network firewalls.
First generation is called the packet filter. Packets can be filtered by source and destination IP, protocols, source and destination port numbers. If the packets don’t meet the set criteria they are not allowed to pass. Second generation firewalls on the other hand operate up to layer 4 (transport layer of OSI model). This is achieved by retaining information until more information is available about the packet. This type of firewall can be susceptible to DOS attacks that bombard the firewall with several packets until saturation. The most recent category is the next generation firewall which offers a deeper inspection of packets at the application layer. It includes intrusion prevention systems, user identity management integration by linking user ID to Mac addresses for reputation as well as web application firewall. The next category of firewalls is the host-based software-based firewall which is installed on the
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machine itself and controls the network traffic in and out if. A host-based firewall can be part of the operating system itself such as a Microsoft firewall that comes with a Windows-based operating system. Some security products like antimalware or Host Intrusion Detection/ Prevention Systems (HIDS/HIPS) may also come with an integrated firewall. If you have a medical device that provides an operating system or security software provided firewall, make sure you turn it on. This will add an additional layer of security on the device level. The border network is a network that faces the Internet directly via a router that provides a first layer of protection. This network feeds data to the perimeter network via a perimeter firewall. The perimeter network called the DMZ, or demilitarized zone (network), is a subnetwork that contains and exposes an organization’s external-facing services also called Internet-facing systems to an untrusted network such as the Internet. The purpose of a DMZ is to add an additional layer of security to an organization’s network. Typically, the servers in the DMZ are “sandwiched” between the externalfacing firewall and an internal-facing firewall that provides additional protection for the internal network. External-facing systems are internal systems accessible from the
INJEL REKIK MedStar Health
Internet such as cameras used by physicians to watch cases or monitor patients. HDOs typically use twofactor authentication to secure these systems and encrypted or VPN’d traffic to protect the integrity of the data stream. Any mobile device used to access these Internet-facing systems should be done through a mobile device management system called a MDM. These systems can require the device to be password protected, set the password complexity, add lock and wipes rules. The DMZ feeds data to the internal local area network (LAN) via the internal firewall. Devices placed in the internal network are not reachable from the Internet which prevents hackers from accessing internal systems from outside of the organization. A current practice in medical
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device security is to put medical devices that can’t accommodate certain security controls, e.g. regular patching and antimalware behind a network firewall and only allow the needed communication. Network firewalls provide reasonable protection against external attacks but they don’t protect against attacks that happen internally such as malware induced by an infected USB. It’s important to run an antimalware scan on the USB before you plug it into your medical equipment. For the devices that have antimalware on them, you can disable the USB auto run. Disabling USB autorun will allow you to scan the USB before opening it and prevent infection. Firewalls go hand and hand with microsegmentation. For instance, a medical device with high-risk profile can be placed in individual segments that are protected behind a firewall for an additional layer of protection. This can help prevent the internal attack from spreading to other segments. Finally, secure web gateways complement a firewall. They are used to prevent malicious web traffic from entering the organization. This protects the organization against threats originated from the Internet. Every savvy HTM professional should understand: • T he difference between border network, DMZ and Local Area Network (LAN) • T he difference between network firewall and a host-based firewall • M icrosegmentation versus VLAN • S ecure web gateways Inhel Rekik is director of health technology security at MedStar Health.
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BY JIM FEDELE
THE OTHER SIDE Do Advancements Ever Really Make Life Easier? BY JIM FEDELE
I
have a rather complicated connection to our CIO, our transformation to a larger system has turned my once solid line of reporting to a light colored dash. However we still meet as a team and individually so I am exposed to many of the IT initiatives and projects that are going on within the facility. It is breathtaking to me that there are so many things going on. Many of the projects have a common purpose, to make us more efficient. As I think about these items and the projects my team has completed lately, I am not so sure that the “efficiencies” ever actually materialized.
Technology in general is growing and improving at a feverish pace, daily advances in technology open doors to innovations we have never seen or dreamed before. In today’s world, we can connect a computer to just about anything to gather, analyze and report data. Almost daily I hear about a new product that will interface medical equipment to a computer, collect vitals and electronically upload data into a patient’s record. The promise is speed and accuracy; no longer will pen and paper be needed in your organization. However, as I look at the growth of the IT workforce and my own experiences, I wonder if all these things really save time? What I am noticing is the advancements seem to do more shifting of labor than actually saving it. It starts with the project planning, a group of stakeholders and technical folks are convened to discuss and
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implement the software. This group is never less than six people and some projects here have had more than ten. The time commitment is usually a two-hour biweekly meeting, plus homework for 90 to 120 days. The man-hours to get a project implemented can easily exceed 250 depending on the complexity. However, the largest demand and transfer of labor is in the form of technical support. We have implemented a surgical information integration program to capture vitals electronically during surgery and the recovery of patients. This system eliminates human entry errors and allows users to be more efficient and increase their focus on the patient. However, to achieve these gains, super users and a program administrator are needed to manage the system. When the system doesn’t work correctly, someone from IT or my team is called to help identify and fix problems. What I am also discovering is that problems quickly become complex because a single department/service line doesn’t own the system. We all have parts of the system, my staff is called for the medical equipment, IT hardware is called for the interface computer and IT software or super users are called when there are program problems. The OEM also complicates the issue by falsely indentifying whose problem it is when staff calls them. When I add up all the time needed to solve problems on this system, I actually think we spend more time on it then the time it took to manually document it. So, essentially, we just moved the labor to someone else. I
JIM FEDELE, CBET Director of Clinical Engineering for Susquehanna Health Systems
have other examples; our wireless temperature monitoring is another good one. Before wireless temperature monitoring, staff checked refrigerators every shift and recorded the temperature. Now, it is done automatically so they do not have to write it down. However, my staff has to assign, calibrate and replace batteries on the tags. The labor to do this is quite substantial; I would bet it is more than writing down the information. I am not advocating that these projects are not worthwhile; removing the human element from recording data improves consistency and accuracy. This translates into reliable records that improve patient care. I am just stating that advocating for these systems on the premise that they save time and labor is flawed. Another element to all of this automation is that people are slow to change. Imagine, hypothetically, spending $1 million to implement a system that is designed to do a function automatically. To remove a tedious task of writing entries or filing papers, to collect data without user intervention. Then, imagine after six months of implementation the staff is using both the old written system and the new automatic system. I have witnessed this, the staff doesn’t trust the new system, or the system doesn’t exactly address their need which causes staff to keep using the old method. Sometimes it is an interpretation of a regulatory
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requirement that also prevents people from giving up the old system. When staff continue to run both systems the workload increases and nobody wins, money is wasted and ultimately the vendor supplying the product will receive negative feedback. My purpose for writing about this is to share with you that these advancements in integration and technology may impose a labor demand on your operation. This fact is seldom pointed out by the vendors when selling systems to our customers. Most of the requests I see for these types of new products always include labor savings in their justification. However, as I have pointed out, the savings may only be within the clinical department because every system needs support. I am not suggesting we should be resisting these advances, we should be engaged and asking the question, “Who is going to support it and how much time will it take?� There is a higher success rate asking for labor before implementation than after, when your department is the only one suffering because of the workload. I think that as health care continues to be squeezed people are capitalizing on technological advancements to reduce labor and be more efficient. We need to be ready to address the labor shift that is sure to come our way. Jim Fedele, CBET, is the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/ or comments via email at info@mdpublishing.com.
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BY MANNY ROMAN
ROMAN REVIEW Twenty Conclusions BY MANNY ROMAN
I
received the Medical Dealer 2011 Lifetime Achievement award. I was humbled, pleased and proud for the recognition until someone dampened the moment by telling me that if you live long enough, someone will give you an award. That is when I realized that awards do not define someone.
What defines us as individuals is how we have answered two questions. Have we left others better for having known us? In the end, is the good we have done greater than the bad? I’m telling you this because I have been invited to present the Keynote at the Biomedical Associations of Wisconsin Annual Conference (As you read this I will have completed this honor in September.) I decided to speak on some of the wisdom that I have acquired in my long life and career in this great industry. I will present about 20 conclusions and reflections on life and business. I want to share some of these reflections with you in this column. The number one item on my list is that we are in a relationships business. Relationships are built on trust and personal reputation. Relationships are a form of bonding. We begin bonding before birth and continue bonding through nature, nurture, chance or choice. Trust is crucial in life and business. It relies on consistent behavior and begins slowly through mutual sharing of vulnerabilities. Trust takes courage, it is a personal concept, a belief and comprises many types. Trust takes time to build and is easily broken and difficult to repair. The pursuit of money is not the
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pursuit of happiness although in the end everyone is in it mostly for themselves. Define your enough. Determine what will provide happiness and comfort and strive to achieve that. Don’t blindly grasp for every last penny. You can only be brave when you are afraid or uncomfortable in the situation. Emotional courage is the foundation of integrity. If you feel a little uncomfortable when you are doing the right thing, you are doing the right thing. Find the courage to do the right thing always. We tend to judge others as we judge ourselves and it is hard to imagine that they don’t know what we know. This is why we sometimes don’t understand the actions of others. Ask for clarification and feedback always. Realize that in every head is a different world. Leadership is not management. Leadership is one life influencing another and is not about the task or the work. To be a good leader, first learn to be a good follower. Never let anyone or anything come between you and your loved ones and those important to you. Delegate for training, not to get out of work. Remember that you delegate the power, authority and accountability. The responsibility is still yours. Have well-defined and time-bound objectives, provide them and the tools to your talented people and then leave them to their work. True friends are generally few and are based on full trust. You cannot force friendships, however you can force enemies. Cherish your friends. Never stop learning. Feed your strengths not your weaknesses. To grow you must embrace change. To change you must not accept what is. Be more
MANNY ROMAN, CRES AMSP Business Operation Manager
success conscious and not so much failure conscious. Have a well-defined value system to guide you through life and decisions. This will make your actions simple. If the system allows for it do it, if not don’t do it. Never waver from the system. Break it once and it will become easier and easier to continue outside the system until your value system is no longer. Your life is based on a true story. Look in the mirror to be sure that your perception of it is also true. Ask yourself about your value system, your time, talent and tools. What are you willing to exchange for your time, who are your true friends, are you spending enough time with loved ones, when will you have enough, and many other questions to ensure that your life is a true story in your eyes also. A great question to always ask yourself is: What would I like to see happen? This ensures that you are prepared to have the emotional courage to move in the right direction. What I would like to see happen is that I have made others better for having known me. You and I would also like to see this boring dissertation of pretentious reflections come to an end.
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THE VAULT D
you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your o 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-november-2018. Good luck!
NOVEMBER PHOTO
SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing. com and you could win a $25 Amazon gift card courtesy of TechNation!
OCTOBER PHOTO EKG simulator
76
TECHNATION
NOVEMBER 2018
WWW.1TECHNATION.COM
Innovation In Healthcare CMMS for Over 30 Years
AIMS Delivers What You Need •
Easily Track & Document Your AEM Process
•
Medical Device Cybersecurity
•
Revolutionize your Reporting
•
Real-Time Digital Dashboards
•
Interface With Any Third Party Software
Your CMMS Solution with 3,000 Hospitals in 18 Countries.
Choose AIMS and You Will Never Search for Another CMMS ®
800.541.2467 www.goaims.com
We Provide Providing healthcare facilities a viable option to acquire and maintain medical equipment in
OUR SERVICES
a cost effective manner while
c o m p re h e n si v e a n d u n e qu a l l ed
• Extensive Parts Inventory
Providing services that help biomeds deliver superior patient safety and care.
maintaining superior quality. We Offer • Depot Repair Service • Loaner Equipment Available • Complete Documentation • Regulatory Compliance • Equipment Rental • Free Technical Support Contact Us Today
GE EQUIPMENT SALES, SERVICE, AND PARTS BIOMEDS HELPING BIOMEDS™
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
Call 888.310.7322 or visit www.sebiomedical.com
NOVEMBER 2018
TECHNATION
77
BREAKROOM
STAFF REPORT
BULLETIN BOARD
A
n online resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.
CONTINUING EDUCA TION
Visit www.MedWrench.c om/BulletinBoard for m ore details and to register for these upcoming classes .
SOLUT
IONS
Decembe r 17 - TriIm aging BMET To Imaging 2
Career Opportunities Company: Sterling Surgical Supply Position Title: Service Tech Description:
December 10 - STERIS Training Course - Steam Sterilizers
Follow Ben Calibrating!
- RSTI December 3 ng Nuclear ci vi er fS Principles O e Systems Medicin
ow Want to kn C. is? where Ben on Follow us Facebook nch and @MedWre ge! like our pa
78
TECHNATION
NOVEMBER 2018
Seeking a highly motivated individual to join the team as a technician (BMET) to handle preventive maintenance calls and some light repairs. They are offering competitive pay, health and dental benefit plans, 401K package and access to the company bonus plan. More info on how to apply here: http://bit.ly/SterlingSurgicalSupply
WWW.1TECHNATION.COM
BREAKROOM
WATCH US CONTINUE TO GROW MEDWRENCH REACHES 70,000 USERS!
Thank You To All The MedWrench Members Who Helped Us In This Amazing Accomplishment. We Have Surpassed 70,000 MedWrench Members! This week’s edition of the MedWrench Blog, we would like to officially announce that we have surpassed 70,000 acti ve users! Thank you to all of our MedWrench users who trust us to help get the job done. This accomplishment would not be possible without you! We finished off last year with 60,000 members , and are pleased to have gained 10,000 more users in less than a year! Thank you to all of our members who contribute to the forums, our advertisers and our gurus.
Read more here: https://www.medwrench.com/b ulletin-board/blogs
8 1 0 2 R E B M E N OV 4
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18
25
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3
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7
8
9
10
5
14
15
16
17
12
13
21
22
23
24
19
20
28
30
1
26
27
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
THANKSGIVING
Dental Implant Conference Chicago
29
Dental Implant Conference Chicago
Dental Implant Conference Chicago
NOVEMBER 2018
TECHNATION
79
51
P
Gopher Medical 844-246-7437 • gophermedical.com
11
P P
RepairMED 855-813-8100 • www.repairmed.net
31
SPBS, Inc (800) 713-2396 • www.spbs.com/
31
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
7
P P
Asset Management Asset Services 913-383-2738 • www.assetservices.com
35
Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com
29
37
PartsSource 877-497-6412 • www.partssource.com/shop
33
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
64
SPBS, Inc (800) 713-2396 • www.spbs.com/
31
P
Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com
29
P P
P
Calibration Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
1416
Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com
29
P
67
P
Gopher Medical 844-246-7437 • gophermedical.com
11
P P
InterMed Group 386-462-5220 • www.intermed1.com
55
P
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
77
P P
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
72
P P
Cardiac Monitoring
CMMS 6,
24-25
P
ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com
51
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
88
Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com
67
P P
D.A. Surgical 800-261-9953 • www.da-surgical.com
63
P
iMed Biomedical 817-378-4613 • www.imedbiomedical.com
61
P
Master Medical Equipment 866-468-9558 • masterfitmedical.com
35
Medical Equipment Doctor, INC. 800-285-9918 • www.medicalequipdoc.com
21
P P
Multimedical Systems 888-532-8056 • multimedicalsystems.com
26
P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
41
P P
ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com
45
P
Nuvolo 844-468-8656 • eam.nuvolo.com/clinical
TECHNATION
NOVEMBER 2018
3
Computed Tomography Injector Support and Service 888-667-1062 • www.injectorsupport.com
61
P
RSTI 800-229-7784 • www.rsti-training.com
17
P P P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
42
P P P
Injector Support and Service 888-667-1062 • www.injectorsupport.com
61
P P
Maull Biomedical Training 440-724-7511 • maullbiomedicaltraining.com
63
P
37
P P P
Contrast Media Injectors
Diagnostic Imaging Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
Endoscopy Healthmark Industries 800-521-6224 • HMARK.COM
80
P P
Cardiology
Biomedical 626 Holdings 800-516-0990 • weare626.com
31
Soaring Hearts Inc 855-438-7744 • www.soaringheartsinc.com
Batteries Holden Battery Services, LLC 800-594-9257 • www.x-raybatteries.com
RepairMED 855-813-8100 • www.repairmed.net
TRAINING
A.M. Bickford 800-795-3062 • www.ambickford.com
SERVICE
Anesthesia
PARTS
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
Company Info
AD PAGE
SERVICE INDEX
43
WWW.1TECHNATION.COM
41
P P
Labratory
Fetal Monitoring Multimedical Systems 888-532-8056 • multimedicalsystems.com
General ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com
51
Imaging 626 Holdings 800-516-0990 • weare626.com
75
P P
SPBS, Inc (800) 713-2396 • www.spbs.com/
31
P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
4
P P
RSTI 800-229-7784 • www.rsti-training.com
17
P P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
4
P P
BMES 888-828-2637 • www.bmesco.com
47
P
Select BioMedical 866-559-3500 • www.selectpos.com
83
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
7
P P
33
P P P
Global Medical Imaging 800-958-9986 • www.gmi3.com
2
P P P
InterMed Group 386-462-5220 • www.intermed1.com
55
P
Monitors/CRTs 6,
P
24-25
Infection Control Healthmark Industries 800-521-6224 • HMARK.COM
Ozark Biomedical 800-457-7576 • www.ozarkbiomedical.com
Mammography
P
26
TRAINING
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
SERVICE
P
PARTS
26
Company Info
AD PAGE
Multimedical Systems 888-532-8056 • multimedicalsystems.com
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
43
Infusion Pumps AIV 888-656-0755 • aiv-inc.com
69
P P
MRI
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P P
PartsSource 877-497-6412 • www.partssource.com/shop
Master Medical Equipment 866-468-9558 • masterfitmedical.com
35
P P
Nuclear Medicine
Multimedical Systems 888-532-8056 • multimedicalsystems.com
26
P
Infusion Therapy AIV 888-656-0755 • aiv-inc.com
69
P P
Online Resource
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P P
MedWrench 866-989-7057 • www.MedWrench.com
39
FOBI 888-231-3624 • www.FOBI.us
45
P P
Webinar Wednesday 800-906-3373 • 1technation.com/webinars
84
Master Medical Equipment 866-468-9558 • masterfitmedical.com
35
P P
Oxygen Blender
RepairMED 855-813-8100 • www.repairmed.net
31
Select BioMedical 866-559-3500 • www.selectpos.com
83
P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
7
P P
IV Pumps
IV
SPBS, Inc (800) 713-2396 • www.spbs.com/
31
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
FOBI 888-231-3624 • www.FOBI.us
IV
IV
P
45
P P P
PACS RSTI 800-229-7784 • www.rsti-training.com
IV
P
17
Patient Monitoring AIV 888-656-0755 • aiv-inc.com
69
P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
4
P P
BMES 888-828-2637 • www.bmesco.com
47
P P
NOVEMBER 2018
TECHNATION
81
Gopher Medical 844-246-7437 • gophermedical.com
11
P P
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P P
Master Medical Equipment 866-468-9558 • masterfitmedical.com
35
P P
Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
20
P
Pacific Medical 800-449-5328 • pacificmedicalsupply.com
71, 87
P P
Respiratory
PartsSource 877-497-6412 • www.partssource.com/shop
33
P
A.M. Bickford 800-795-3062 • www.ambickford.com
51
P
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
41
P P
FOBI 888-231-3624 • www.FOBI.us
45
P P
ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com
45
P
RepairMED 855-813-8100 • www.repairmed.net
31
P P
Nuvolo 844-468-8656 • eam.nuvolo.com/clinical
3
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
77
P P
Phoenix Data Systems 800-541-2467 • www.goaims.com
77
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
72
P P
Sterilizers
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
7
P P
SPBS, Inc (800) 713-2396 • www.spbs.com/
Radiology
Software
31
P
Surgical
Ampronix, Inc. 800-400-7972 • www.ampronix.com
4
Holden Battery Services, LLC 800-594-9257 • www.x-raybatteries.com
37
RSTI 800-229-7784 • www.rsti-training.com
17
P P
Healthmark Industries 800-521-6224 • HMARK.COM
43
Telemetry
P P P
Recruiting
AIV 888-656-0755 • aiv-inc.com
69
P P
BMES 888-828-2637 • www.bmesco.com
47
P P
Sodexo CTM 1-888-Sodexo7 • www.sodexousa.com
64
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P P
Stephens International Recruiting Inc. 870-431-5485 • www.bmets-usa.com/
75
Gopher Medical 844-246-7437 • gophermedical.com
11
P P
Master Medical Equipment 866-468-9558 • masterfitmedical.com
35
P P
Multimedical Systems 888-532-8056 • multimedicalsystems.com
26
P
Pacific Medical 800-449-5328 • pacificmedicalsupply.com
71, 87
P
Refurbish AIV 888-656-0755 • aiv-inc.com
69
Rental/Leasing Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P
ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com
45
P
Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com
29
P
RepairMED 855-813-8100 • www.repairmed.net
31
P P
Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/
72
P P
USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com
7
P P
Repair ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com
51
Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com
49
P P
Replacement Parts Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
82
TECHNATION
TRAINING
SERVICE
PARTS
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
NOVEMBER 2018
37
P P P
Test Equipment A.M. Bickford 800-795-3062 • www.ambickford.com
51
BC Group International, Inc 314-638-3800 • www.BCGroupStore.com
88
P P
WWW.1TECHNATION.COM
Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com
5
TRAINING
41
SERVICE
PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com
PARTS
AD PAGE
Company Info
We ONLY use OEM Parts!
P P
Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com
1416
Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/
77
P P
Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
37
P P P
ECRI Institute 1-610-825-6000. • www.ecri.org
54
P
RSTI 800-229-7784 • www.rsti-training.com
17
P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
42
P
PartsSource 877-497-6412 • www.partssource.com/shop
33
P P P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
42
P P
Training
Tubes/Bulbs
Ultrasound Advanced Ultrasound Electronics, Inc. 1-866-620-2831 • www.auetulsa.com
37
P P P
Ampronix, Inc. 800-400-7972 • www.ampronix.com
4
P P
Conquest Imaging 866-900-9404 • www.conquestimaging.com
8
P P P
Global Medical Imaging 800-958-9986 • www.gmi3.com
2
P P P
SPBS, Inc (800) 713-2396 • www.spbs.com/
31
P
X-Ray Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com
20
Holden Battery Services, LLC 800-594-9257 • www.x-raybatteries.com
37
InterMed Group 386-462-5220 • www.intermed1.com
55
P
RSTI 800-229-7784 • www.rsti-training.com
17
P P P
Tri-Imaging Solutions 855-401-4888 • www.triimaging.com
42
P P P
P
Providing support services and quality rebuilt equipment for over 17 years! BIOMED DEPARTMENTS… • Our technicians repair circuit boards, pump mechanisms and LCD screens at the component level. • Look to Select for BEST IN CLASS Pricing, Quality and Turnaround Time.
EQUIPMENT PURCHASERS… • We sell and rent the highest quality refurbished infusion pumps available. • We work with you to provide tailored solutions specific to your equipment needs. • Our IOT experience ensures we can help with your M2M connectivity issues.
Contact us today! www.selectbiomedical.com | 866.559.3500 Information@selectpos.com Select also buys equipment. Call us if you have surplus pumps or monitors to sell. We offer top dollar!
ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
NOVEMBER 2018
TECHNATION
83
expand your knowledge and earn CEUs
right from your desk!
Right information, right format, right time. Webinar Wednesdays are all-right!
Webinar Wednesday series is a great way to expand your education and earn CEUs in a convenient format. - D. Minke, BMET
- C. Nieland, Operations Manager
View upcoming webinars at webinarwednesday.live!
ALPHABETICAL INDEX 626 Holdings…………………… 6, 24-25
Gopher Medical………………………
11
Pronk Technologies, Inc. ……………… 5
A.M. Bickford…………………………
51
Healthmark Industries………………
43
ReNew Biomedical……………………
45
Advanced Ultrasound Electronics, Inc.…37
Holden Battery Services, LLC…………
37
RepairMED……………………………
31
AIV……………………………………
69
iMed Biomedical………………………
61
Rigel Medical, Seaward Group…… 14-16
ALCO Sales & Service Co.……………
51
Injector Support and Service…………
61
RSTI……………………………………
17
Ampronix, Inc.…………………………… 4
InterMed Group………………………
55
Select BioMedical……………………
83
Asset Services…………………………
35
Master Medical Equipment…………
35
Soaring Hearts Inc……………………
67
BC Group International, Inc…………
88
Maull Biomedical Training……………
63
Sodexo CTM…………………………
64
BMES…………………………………
47
Medical Equipment Doctor, INC.……
21
Southeastern Biomedical, Inc………
77
Conquest Imaging……………………… 8
MedWrench…………………………
39
Southwestern Biomedical Electronics, Inc.…72
Crothall Healthcare Technology Solutions…67
Multimedical Systems………………
26
SPBS, Inc……………………………
D.A. Surgical…………………………
63
Nuvolo…………………………………… 3
Stephens International Recruiting Inc.… 75
ECRI Institute…………………………
54
Ozark Biomedical……………………
75
Technical Life Care Medical Co.………
29
Elite Biomedical Solutions……………
49
Pacific Medical …………………… 71, 87
Tri-Imaging Solutions…………………
42
Engineering Services, KCS Inc………
20
PartsSource…………………………
33
USOC Bio-Medical Services…………… 7
FOBI…………………………………
45
Phoenix Data Systems………………
77
Webinar Wednesday…………………
Global Medical Imaging………………… 2
31
84
PRN/ Physician’s Resource Network… 41
SAVE THE DATE April 10-13, 2019 | HOUSTON, TX
M D E X P O S H O W. C O M ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL
NOVEMBER 2018
TECHNATION
85
BREAKROOM
PARTING SHOT
“ Our business is about technology, yes. But it’s also about operations and customer relationships.” – Michael Dell
86
TECHNATION
NOVEMBER 2018
WWW.1TECHNATION.COM
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