ADVANCING THE IMAGING PROFESSIONAL
DECEMBER 2018 VOL.2 NO.12 THEICECOMMUNITY.COM
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contents
ICE FEATURES
December 2018
“ Even though we are nonprofit, we have to spend
Wish List 34 A Radiology Manager's Wish List At the end of every fiscal year, imaging centers and health systems start making difficult choices about capital planning and budgeting for the future. Those resources are always judiciously meted out. However, it seems as if there’s never enough to go around for all the institutional needs that exist. We asked radiology managers and directors at a handful of sites across the country to share what is on their wish list for 2019.
money to put in high-quality equipment.”
Product Focus:
29 Contrast Injectors Contrast injector systems are medical devices that use contrast media to enhance the visibility of complex body structures such as body fluids, tissues, arteries and veins. The diagnosis is conducted with the help of many imaging procedures such as computed tomogra-
Department Spotlight:
phy (CT), magnetic resonance imaging
NewYork-Presbyterian Imaging Service Team
injector system market is expected to
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(MRI) and angiography. The contrast reach new highs in the near future.
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contents
ICE DEPARTMENTS
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December 2018
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news
people
products
insight
10 ICE2019 Preview
24 Department Spotlight
38 Careers Now
12 Imaging News
26 Professional Spotlight
29 Contrast Injector Spotlight
21 Webinar Wednesday
30 Contrast Injector Gallery
22 People on the Move
32 Tools of the Trade
40 Imaging Matters 42 Daniel Bobinski 45 Photo Contest 46 Index
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ICE Magazine (Vol. 2, Issue #12) December 2018 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2018
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ICE2019 IMAGING CONFERENCE & EXPO FEBRUARY 17-19, 2019 • TAMPA/CLEARWATER
ICE 2019 SET FOR SUNSHINE STATE S
ave the date, ICE 2019 will be held February 17-19, 2019 just steps from the Gulf of Mexico in sunny Florida. The Imaging Conference and Expo (ICE) continues to evolve to meet the needs of imaging service professionals, engineers and administrators throughout the United States. The conference, presented by ICE magazine and parent company MD Publishing, is headed to the Sunshine State in 2019. ICE 2019 in the Tampa/Clearwater area boasts many of the same elements that made ICE stand out to attendees and exhibitors the past four years, including top-notch educational offerings, high-quality networking events and an exhibit hall filled with the latest technology, equipment, parts and service solutions. The educational sessions include a Training Track and a Management Track in 2019. The education at ICE 2019 also features a CRES prep course and super sessions. MD Publishing Founder and President John Krieg is excited about the growth of this annual event and promises a continued focus on creating a quality experience for attendees and exhibitors. “ICE offers valuable continuing education certification from ASRT, and keeping in line with our successful conferences of the past, offers world-class presentations and instructors,” Krieg said. The same formula that has powered MD Publishing’s MD Expo to amazing heights is being used to guarantee access to those who work in the imaging realm. There will be complimentary admission for all hospital employees, who will get to experience the same warm hospitality and first-rate production they have come to expect from previous events. “Whether it’s valuable continuing education, productive networking or the exclusive exhibit hall, attendees will have the perfect opportunity to enhance their careers and spend time with colleagues,” Krieg added. Those in attendance at ICE 2018 were quick to state that they would recommend that their peers attend future ICE events. 10
ICEMAGAZINE | DECEMBER 2018
“I would let my colleagues know that the ICE conference is a diverse meeting that allows HTM leaders and technologists to hear the issues that concern our medical imaging peers,” said Christopher Nowak, CBET, CHP, CSCS, corporate director, Universal Health Services Inc. “Some HTM professionals get caught up in all of the technical aspects of our roles as fix-it personnel and forget about all of the implications surrounding our actions in the repair and maintenance of medical imaging technology. The patient care aspects, the financial reimbursement aspects and the technology needs are often overlooked by HTM professionals. The ICE meeting allows HTM professionals to make the connection between our professional activities managing and servicing medical imaging devices and the needs of our medical imaging peers.” “HTM professionals should place the ICE conference on their calendar for attendance. The value of your time and the costs to attend are reimbursed through the knowledge and camaraderie gained at the meeting,” he added.
ADVANCING THE IMAGING PROFESSIONAL
RE W GIS W W. TRA AT TIO TE ND N OP ICE EN .CO ! M
“A really good opportunity to learn about what’s going on in our field right now. Huge networking opportunities … just plain enjoyable and fun and at the same time a truly productive use of time,” Imaging Specialist Nick Trageser said. “Do it! Absolutely worthwhile and a great time.” “A great opportunity to gain insight from industry peers and leaders from around the country,” Adventist Health Regional Director Rick Walston said. “A lot of information about the imaging field is given to each and every individual,” VA Imaging Engineer Marshall Misouria said. “There are many education classes that will answer any questions that you have,” ProHealth Care’s Joe DuPont said. “A meeting place for like minded imaging service businessmen and engineers to meet, network and plan for the future in the industry,” said Cory Williams from UT Southwestern-Clements University Hospital. ICE18 Leadership Summit + Reverse Expo As one of 18-plus handpicked imaging leaders, you will have the rare opportunity to network with the best and brightest in the industry, gaining invaluable knowledge that will help you and your department grow and prosper. There will be several exciting networking events, including the ICE18 Talks where you can learn and share innovative and creative ideas. The event’s grand finale is the Reverse Expo, which provides brief one-on-one introductions with vendors who will share product information that will assist with equipment and service needs. WWW.THEICECOMMUNITY.COM
Confirmed ICE18 participants include the following: • Nuclear Medicine/Radiation Safety Manager at Naval Hospital Jacksonville • Imaging Manager at Presence Saint Joseph Medical Center • Corporate Director of Healthcare Technology Management at Universal Health Services Inc. • Director of Imaging Services and Dean of the School of Radiologic Technology at Regional West Medical Center • Director of Non-Invasive Cardiology at Northeast Georgia Health System, • Chief Operations Officer/Technologist Diagnostic Imaging Services at Puget Sound Health Care System • Advanced Imaging Manager at University of Maryland Medical Center • Director Eastern Region Healthcare Technology Management at Mercy Hospital St. Louis • Clinical Engineering Supervisor at Christiana Care Health System • Manager, Medical Imaging at Holy Cross Germantown Those present in 2018 encourage others to join them in 2019. “ICE18 was great! Networking is always the best, being able to discuss challenges with other directors, etc. is beneficial. I have been coming to this for years and I love seeing more imaging directors here,” Director of Imaging Jessica Chambers said. “Go! Find a way to get approved to go and reap the benefits of it.” ICE For more information about ICE 2019, visit AttendICE.com. ICEMAGAZINE
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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY GE Healthcare Introduces Invenia ABUS 2.0 GE Healthcare has launched the Invenia Automated Breast Ultrasound (ABUS) 2.0 in the United States. This device is the only FDA-approved ultrasound supplemental breast screening technology, specifically designed for detecting cancer in dense breast tissue. “We are committed to informing patients about breast density, and offering supplemental screening options,” said Sophia Roumanis, M.D., section head of breast imaging and intervention, Beaumont Breast Care Center, Dearborn. “We are thrilled to add this advanced ultrasound technology to our breast cancer screening program, which allows better visibility of dense breast tissue during breast cancer screenings.” Launched in 2014, Invenia ABUS has been installed at hundreds of facilities around the world. The new Invenia ABUS 2.0 builds on its predecessor to enhance the exam experience for operators and patients, including new features that further customize the exam based on the patient’s body. •
Ultra Solutions Joins Avante Health Solutions Avante Health Solutions has announced that Ultra Solutions has joined its family of companies. Avante President Steve Inacker said Ultra Solutions further strengthens Avante’s overall reach and capabilities in ultrasound. “We are incredibly excited to have Ultra Solutions join the Avante Health Solutions family,” Inacker said. “Given the experience of the management team, the quality and effectiveness of the operating model, and the strength of the customer and supplier relationships, we are extremely confident that Ultra Solutions will immediately provide accelerated growth within the Avante Ultrasound platform.” As part of Avante Ultrasound, Global Medical Imaging (GMI) and Ultra Solutions have an expanded national footprint with facilities on the east and west coastS. The new partnership creates a global independent ultrasound solutions provider with expanded service and repair capabilities, as well as an extensive inventory of parts, probes and ultrasound systems.
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Ultra Solutions President Sterling Peloso said he is excited about the opportunities the new partnership will create. “As a company, our focus and mission is to provide worldclass quality products and outstanding customer service,” Peloso said. “Joining the Avante team will provide unlimited opportunities to grow our business and provide a complete suite of products and services to our customers that is unmatched in the health care industry.” Ultra Solutions is the newest member of Avante Health Solutions. • For more information, visit www.avantehs.com.
ADVANCING THE IMAGING PROFESSIONAL
news
Lumitron HyperVIEW Platform Celebrated At an exclusive event held at University of California, Irvine (UCI) Applied Innovation Center, Lumitron Technologies Inc. celebrated its arrival in the university’s Research Park and introduced the HyperVIEW system. Lumitron’s laser-based, X-ray technology will boast imaging capabilities beyond current medical standards to reach Superman® resolutions and have the unique ability to produce single color X-rays that enable cellular-level identification and treatment of disease. The HyperVIEW platform utilizes a proprietary X-ray technology conceived and developed at the Lawrence Livermore National
Laboratory (LLNL). Professor Chris Barty of UCI, former CTO of LLNL’s National Ignition Facility and Photon Science Directorate, home of the world’s largest laser system, has overseen the establishment of Lumitron’s commercial endeavor in Irvine, California, and is now shepherding the company’s development of the patents he helped create. Lumitron holds exclusive commercial development rights. According to Barty, the HyperVIEW technology presents the potential to create the first true theranostics machine capable of unprecedented imaging detail and cellular level treatment, simultaneously. •
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Adoption of Carestream’s Vue Cloud Continues to Grow in U.S. Carestream Health, a global leader in medical imaging systems and healthcare IT solutions, will install its Carestream Clinical Collaboration Platform at Guadalupe Regional Medical Center in Seguin, Texas. Carestream’s Vue Platform will provide a comprehensive enterprise imaging solution to improve efficiencies for image review and collaboration. The hospital has opted to have its new enterprise imaging solution delivered under Carestream Health’s Vue Cloud Service with monthly charges. This service model allows users to access the workflows, images and reports they need – anytime, anywhere – and collaborate seamlessly for more efficient, effective patient care while Carestream proactively manages the technology. In addition to providing PACS and archiving capabilities, the agreement includes advanced visualization, multimedia enhanced reporting, integrated voice recognition, analytics and other features. •
Acertara Upgrades ISO 13485:2016 Certification Acertara has achieved ISO 13485:2016 certification for medical device and quality management systems, upgraded from the ISO 13485:2003 certificate. This certification closely aligns with FDA regulatory guidelines and is an international standard that outlines the requirements for a quality management system specific to the medical device industry. ISO 13485:2016 is an internationally recognized quality standard intended to provide a quality framework focused on the consistent design, development, servicing and sale of medical devices that are safe and effective for their intended purposes. To be certified, organizations must demonstrate an ability to provide medical devices and related services that consistently meet customer expectations and regulatory requirements. “This certification is further evidence of our unwavering commitment to quality and ensures every Acertara customer
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– from a hospital probe repair customer to an OEM who purchases complex test equipment – receives products and services that adhere to the highest standards for safety, product performance and reliability,” said G. Wayne Moore, CEO of Acertara. “With a focus on maintaining a world-class quality management system and as one of the few privately owned companies in our market space, Acertara is an organization that customers can confidently rely on in a shifting competitive landscape.” • For more information, visit www.acertaralabs.com.
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GE Healthcare Establishes Procedures for Testing Safety of TEE probe GE Healthcare and BC Group International Inc. have announced that a new procedure for testing the safety of TEE ultrasound probes has been established. Ken O’Day, vice president of sales and marketing for BC Group said, “Testing TEE probes for electrical leakage has always been a recommended procedure and effective December 2015 the Intersocietal Accreditation Commission (IAC) Standards and Guidelines for Adult Echocardiography Accreditation went into effect.” GE Healthcare’s Daniel Vignet, headed up a team of engineers who performed the testing and established the leakage limits as well as the additional procedure for testing the GE TEE probes. “Historically the electrical leakage testing for ultrasound probes was performed by the biomedical or clinical engineering department on a scheduled basis,” stated O’Day. “With the IAC regulations, the responsibility for testing the probes has shifted to the ultrasound or cardiology departments, since the test now needs to be performed after every usage. Although the testing requirement is designed for patient safety, a side benefit is the detection of small problems with the TEE probes before major damage occurs.” The new recommended guideline just established by the GE engineering group will now take the testing one step further to include the deflection controls as well as testing for leakage caused by bite holes, damage or other breaks in the sheath of the TEE probes. All TEE probes need to be tested for electrical leakage, however the GE ultrasound probe models 6VT-D, 6Tc and the 6Tc-RS will require the new additional testing. •
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FDA Clears MAGNETOM Sola 1.5T MRI Scanner The Food and Drug Administration (FDA) has cleared the MAGNETOM Sola, a 1.5 Tesla magnetic resonance imaging (MRI) scanner from Siemens Healthineers that brings BioMatrix technology to the 1.5T market. This technology addresses patient anatomical and physiological differences, as well as differences in how users set up and conduct MRI exams, to increase productivity and decrease rescans for improved efficiency and patient satisfaction. With the MAGNETOM Sola, Siemens Healthineers is expanding precision medicine and transforming the delivery of patient care. The MAGNETOM Sola helps health care providers perform a full range of routine and complex MRI exams while accelerating workflow and delivering consistent results across all patient types. BioMatrix Sensors save setup time and inform the correct exam strategy. Respiratory Sensors in the patient table eliminate the need for navigators with respiratory-triggered sequences. A new Kinetic Sensor, an in-bore camera system, enables technologists to visually monitor the patient’s face. BioMatrix Tuners improve the quality and reproducibility of head, neck and spine imaging using distortion-mitigating software and hardware. BioMatrix Interfaces utilize artificial intelligence and body models to expedite patient positioning and deliver consistent, reproducible results.
The scanner architecture offers extremely high performance in an open, 70-cm bore. Larger body regions can be covered in one step with a full 50x50x50 cm field of view. Ultra-lightweight, anatomy-adaptive coils improve patient comfort while delivering high signal-to-noise ratio with up to 204 RF channels. New software enables faster scanning to benefit patients and the facility. MultiSlice TSE reduces routine musculoskeletal scan times by up to 46 percent. Compressed Sensing not only makes cardiac and dynamic liver exams faster but also
enables imaging of patients who cannot reliably hold their breath. Combined with Dot workflow engines and Tim 4G technology, the software accelerates scanning from positioning to post-processing with continual quality control of image data. The result is increased productivity and consistency across patients and exams. A cardiovascular edition of the MAGNETOM Sola – which includes high-performance hardware and software such as Compressed Sensing Cardiac Cine, MyoMaps, and the Cardiac Dot engine – is also available. •
Conquest Imaging Announces In-House Probe Repair at MD Expo Conquest Imaging has announced in-house probe repair, conducted in its Fishers, Indiana repair lab. Under the direction of Senior Director of Technical Operations Bob Broschart, the repair lab is fully operational, performing quality transducer repair, with less than 2 percent failure rates. SIMPLIFY, Conquest’s repair program announced last year, will now deliver in-house repair for standard, 3D/4D and TEE probes. Bringing probe repair in-house, has empowered Conquest to offer lower than market probe repair prices, additional probe repair options, faster turn-around times, and 50 percent off a hospital’s first probe repair. The program continues to deliver free evaluations, loaners, Probe 360 (swap), and straight repairs.
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The expansion into probe repair is part of Conquest Imaging’s ongoing effort to strategically build and expand the company. With the lab’s Because Quality Matters completion, efficiencies are streamISO 9001:2015 CERTIFIED lined, and repair costs reduced. Adhering to Conquest’s Quality Assurance 360 standards, their new probe repair lab administers the quality management system that allows Conquest to offer a six-month warranty on standard probe repairs. • For more information, visit conquestimaging.com.
ADVANCING THE IMAGING PROFESSIONAL
news CS Medical Offers TPorter System CS Medical has released its TEE Complete Care system. TPorter is engineered to aide health care professionals to promote the proper care of TEE ultrasound probes. TPorter, a uniquely designed transportation device, provides a safe and secure method to move TEE probes throughout a health care facility. The TPorter system provides a standardized approach for reprocessing of TEE probes between patient uses and minimizes the potential for costly damage. The transportation device has custom designed compartments that hold the TEE probe securely in place while allowing the inclusion of necessary accessories to promote good point of use cleaning and proper labeling of the TEE ultrasound probe’s status. The accessories are placed in TPorter to allow quick and simple pre-high-level disinfection care while giving clear, visual identification of the clean or soiled status of the TEE probe. TPorter provides a standardized approach to the handling and transporting of delicate TEE probes. This will elevate staff confidence, minimize probe damage and reduce the potential of an improperly reprocessed TEE probe from contacting a patient. TPorter will help to minimize instances of damage while promoting a standardized solution to proper TEE probe reprocessing. “TPorter is the product that our customers have been asking the industry to provide for years. I am excited that CS Medical is able to provide more than just a transportation device, but a complete system to improve probe transportation while creating a standardized approach for the critical early stage of TEE Probe reprocessing, the point-of-use cleaning,” CS Medical’s President Mark Leath stated. •
YOUR IMAGE IS OUR FOCUS Every time I have utilized your services, they have exceeded anything I have experienced from other vendors. Whether its Parts, Tech Support or Service, nowhere else compares.” PA R T S . S E R V I C E . T R A I N I N G . T E C H S U P P O R T. 245 W Roosevelt Road Building 7 Unit 47, West Chicago, IL 60185
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Fujifilm Enters U.S. CT Market FUJIFILM Medical Systems U.S.A. Inc., a provider of diagnostic imaging and medical informatics solutions, has introduced the FCT Embrace. Powered by Analogic, the FCT Embrace is the world’s first 85cm wide bore computed tomography (CT) imaging unit with 64 or 128 slice configurations. Optimized for oncology and radiology applications, the FCT Embrace, combined with other oncology solutions, offers enhanced and efficient CT simulation with radiotherapy treatment planning capa-
bilities. The unveiling at booth #3063 during the 2018 American Society for Radiation Oncology (ASTRO) Annual Meeting marks Fujifilm’s entry into the CT market, expanding its diagnostic imaging product portfolio. The new FCT Embrace provides imaging capabilities on an easy-to-use, standardized platform for radiology and oncology. Designed to improve accuracy throughout the entire oncology care cycle, the 85 cm bore optimally matches the rotational arc of the linear accelera-
tor – offering easy and precise positioning options for simulation and treatment planning. This solution allows oncology patients to be imaged in their optimal treatment position at the full clinical image quality afforded by 64 slice or greater systems for the first time; maintaining the accuracy requirements radiation oncology demands without compromising diagnostic image quality. • For more information, visit: www.fujimed.com.
Varian Introduces New ProBeam 360° Proton Therapy System Varian has announced its new single-room proton therapy system, ProBeam 360°. With a 30 percent smaller footprint than the previous system, ProBeam 360° offers uncompromised clinical capabilities while reducing vault construction costs by approximately 25 percent. The new system has a 360-degree rotating gantry, the most powerful particle accelerator available today to treat cancer, iterative conebeam CT imaging and high-definition pencil-beam scanning technology. The system can also provide clinicians a viable path to potential next-generation treatments such as Flash therapy. The 360-degree rotating gantry of ProBeam 360° enables efficient Intensity Modulated Proton Therapy (IMPT), and faster treatment times by minimizing patient repositioning and re-imaging and allowing high-quality cone beam CT (CBCT) imaging from almost any angle. RapidScan technology, available on the ProBeam 360°, simplifies the process of motion management
by delivering each field in a single breath-hold. This capability increases the number of patients who can comply with breath-hold treatments like lung SBRT. Additionally, Varian’s high-definition pencil-beam scanning technology gives clinicians the ability to deliver the dose precisely within the contours of the tumor to minimize dose to healthy tissue. When combined with iterative CBCT, the ProBeam 360° system enables adaptive precision radiation therapy during the course of treatment, helping to make it an even more precise form of proton therapy. • For more information, visit www.varian.com/probeam360.
Technical Prospects Announces 2019 Training Schedule Technical Prospects has announced its training class schedule for 2019. The modality-specific courses feature topics covering computed tomography, fluoroscopy, radiography and more. Imaging engineers and technicians will expand their Siemens medical imaging equipment skills and knowledge base through hands-on labs and structured lessons led by Technical Prospects’ experienced instructors. Courses are offered online and in person at Technical Prospect’s state-of-the-art facility. New in 2019, online courses will be available at any time, and in-person classes can be coordinated on custom dates for classes of three or more students. Technical Prospects will
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TECHNICAL
PROSPECTS
Experts in Siemens Medical Imaging
also introduce a Siemens Multix Fusion radiography course. This class will focus exclusively on the Multix Fusion system with an emphasis on the tube overhead, table, wall stand, RF 80 generator, flat panel digital detector and imaging system. • For more information visit TechnicalProspects.com.
ADVANCING THE IMAGING PROFESSIONAL
Innovatus Imaging Launches Mobile App for Imaging Service Pros Innovatus Imaging has launched Innovatus Imaging Mobile, a mobile application that allows imaging service teams to set up diagnoses and repair services for ultrasound probes and MRI coils anywhere they have phone service. “This new app is available for free at both the Apple and Android app stores and will work seamlessly, providing imaging service professionals the power to exceed expectations without missing a beat,” according to a press release. “It’s no secret that the speed of repairs is mission critical,” said Cam Conklin, vice president of global sales and marketing for Innovatus Imaging. “Oftentimes delays happen when imaging service professionals are out of the office and can’t get online or get stuck holding for customer service for a supplier. This app is designed to eliminate both of these issues by enabling anyone to get diagnostic and repair orders in the queue wherever they have mobile phone service.” According to the release, users of the Innovatus mobile app will be able to: • View sample photos of damaged products to better describe the issue • Ability to upload photos of damaged parts of ultrasound probes and MRI coils • Request a loaner • Chat live with an Innovatus team member • Arrange for service in seconds “By giving imaging service professionals the ability to get equipment in a diagnostic and repair queue from anywhere anytime, we are pleased to simplify their jobs and make it easier to provide access to critical medical devices for clinicians and patients when they need them most,” said Conklin. •
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RaySearch, Canon Medical Enter Collaboration Agreement – EXPERIENCED –
RaySearch Laboratories AB and Canon Medical Systems Corporation have entered into a collaboration agreement to facilitate a close integration between RaySearch’s advanced software products RayStation and RayCare, and Canon Medical’s imaging systems and advanced visualization solutions. While RayStation provides treatment planning functionalities, the oncology information system RayCare and its imaging archiving and communication system, RayPACS, provides image management and workflow tools. The collaboration, that will generate products that will initially be launched in the U.S. market, is expected to enable a more efficient workflow in the process of virtual simulation. By using radiotherapy imaging and planning tools, clinicians will be assisted in deciding how and where patients should be treated, determining the size and location of the tumor, planning the direction of radiotherapy beams and calculating appropriate iso-center locations. RayStation Simulation provides functionality for virtual simulation including patient modeling, isocenter placement, export to patient marking systems and beam design. The functionality has been part of RaySearch’s comprehensive treatment planning system for more than two years. The oncology information system RayCare was released by RaySearch last year and it provides the image management and the necessary workflow for performing virtual simulation tasks. RayStation Simulation and RayCare will provide a fully integrated workspace and a comprehensive toolbox together with Canon Medical’s imaging technologies. This tightly integrated solution will simplify the workflow and assist treatment planners to design the best radiotherapy treatment plan for the patient. •
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ULTRASOUND REPAIR
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news
WEBINAR WEDNESDAY Free Sessions Deliver CE Credits
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he immensely popular Webinar Wednesday series of free educational presentations, many of which are approved for 1 CE credit from the ACI, has amassed 7,163 registrations in 2018 with an average of 231 attendees per webinar! The series remained popular in September and October! Gamma Camera Presentation Empowers Attendees The “Gamma Camera and Correction Fundamentals” webinar sponsored by Universal Medical (UMRi) was a hit with biomeds and imaging service professionals. The 60-minute webinar featured Mike Hill, training support manager and IT manager at Universal Medical. He provided an understanding of basic gamma camera detector imaging and the effects of various calibrations. Attendees praised the session in a post-webinar survey. “Even after attending nuc med classes at two OEMs , this was by far the best theory explanation I have heard,” said P. Jenne, radiology equipment specialist. “Very informational, the speaker did a nice job of flowing through the material to be covered,” said R. Wagner, radiology technician. “I’m beginning a new role in nuclear medicine and the Webinar Wednesday series has given me a distinct advantage before even attending my first training course. I’m able to get a head start and have the advantage of having new resources for assistance during my training through attending the webinars. This is a huge advantage for new techs or those of WWW.THEICECOMMUNITY.COM
us that have been around a while and have just started down a new path,” said P. Garcia, field service specialist. “This was a great webinar! Very informative and educational, breaking down the concepts with great illustrations,” said L. Kosir, instructor/program head. “I work around nuc med but not on the equipment so this was very helpful in my understanding of the technology behind it,” said P. Dorsey, biomed technician. “Excellent presentation as always,” said C. Nanney, director of clinical engineering. “Very informative, sometimes I wish it was a two-hour event,” said R. Pray, biomed. HTM Explores ‘Leveraging Data’ The Webinar Wednesday session “Leveraging Data, Adding Value” was another presentation to receive high marks from attendees. The webinar, sponsored by Oxford Instruments Healthcare, featured John Garrett, a director of clinical engineering for Catholic Health Initiatives. Garrett discussed how using data already being collected can help a hospital make better decisions regarding service and equipment. He explored the various benefits of applying the basics of big data to practical application in the day-today operations of a medical center. The reviews from a post-webinar survey shows the presentation was a hit! “This is good information on knowing the real costs of equipment. It gives me knowledge of how our department sets up service and costs of service,” said H. Martin, CBET. “This was one of the more informative webinars I’ve attended and included infor-
mation I can use today, thank you,” Lead Biomedical Technician D. Mathews said. “This webinar was helpful in understanding what management is looking at when they are making the decisions to not stock parts, PM kits all the way up to how they make the decisions to go with a contract or not. I see the need for better education for the technicians on their data entry,” said C. Davis-Ryan, CBET. “It (the webinar) was very relevant to what I was trying to accomplish and helped me make definite strides into modifying my data analytics experience to the health care field. It helped understand the KPIs and how to harness them,” said S. Gundavarapu, business analyst. “I’ve attended a lot of Webinar Wednesdays and it’s always an exciting time because I know I’ll learn something to make me a better BMET and a better instructor, because some of these things I can apply to my job and to what I share with my students,” BMET Instructor J. Seriosa said. ICE For more information, including recordings of these and other sessions, visit WebinarWednesday.Live.
A special thank you to the companies that sponsored this month’s webinars.
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news
PEOPLE ON THE MOVE
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By Matt Skoufalos
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Innovatus Imaging recently promoted Cam Conklin to vice president of global sales and marketing. He will oversee customer experiences, sales and marketing programs for all of Innovatus Imaging’s service and product offerings. These include ultrasound probe and transducer repair, MRI coil repair and radiography equipment systems and field service. Prior experience includes global sales and customer service positions at Bayer Healthcare, MEDRAD and Healthpoint.
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Acupath Laboratories added Hillel Kahane as its chief medical officer and director of uropathology. Kahane was most recently medical director of Bostwick Labs and has been executive medical director of Dianon Pathology (LabCorp).
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EpiVax Oncology has named Dominique Bridon its chief technology officer and added Dan Adams to its board of directors. Bridon was most recently CEO of Biodesy, and previously served as chief development officer at Nuritas. He has been a director for Neuronax and Enobia (acquired by Alexion), and a member of the Scientific Advisory Board of Biosortia and Syntaxin (acquired by Ipsen).
business lead for diagnostic imaging for Great Britain and Ireland. She has also been the company’s MR business manager for Great Britain and Ireland, and is a former MR radiologic technologist who started with Siemens in 2001 as an MR application specialist.
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Talis Biomedical has added Jane Schwebke, professor of medicine at the University of Alabama at Birmingham, to its scientific advisory board. Schwebke, a practicing physician of more than 20 years, is also a consultant to the Jefferson County Department of Health STD clinic.
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UW Medicine and Seattle Children’s Hospital named Dr. Leslie R. Walker-Harding chair of the University of Washington School of Medicine Department of Pediatrics, associate dean for the University of Washington School of Medicine, and senior vice president-chief academic officer for Seattle Children’s Hospital, effective February 15, 2019. Walker-Harding is currently a professor and chair of the department of pediatrics at the Milton S. Hershey Medical Center, as well as medical director and pediatrician-in-chief at Penn State Children’s Hospital, both in Hershey, Pennsylvania.
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Berkeley Research Group added Orlando Alvarez Jr. as a managing director in its Healthcare Performance Improvement (HPI) practice, and was most recently chief strategy officer at Cleveland Clinic Florida. Siemens Healthineers North America has named Jane Kilkenny vice president of its U.S magnetic resonance (MR) business management. Kilkenny was previously the country
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ICEMAGAZINE | DECEMBER 2018
Varian has named Kolleen T. Kennedy, formerly president of Varian Oncology Systems, its president of Proton Solutions. Chris Toth, Varian’s former president of global commercial and field operations, succeeds Kennedy as the new president of Varian Oncology Systems. BD (Becton, Dickinson and Company) has added COO to the responsibilities of BD president Tom Polen. The company has not had a chief operating officer since 2016.
ADVANCING THE IMAGING PROFESSIONAL
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ViewRay Inc. of Cleveland, Ohio named James Alecxih its chief commercial officer. Alecxih was most recently vice president of worldwide sales at Nevro, and spent 14 years at Intuitive Surgical.
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Alpha Source Group of Milwaukee, Wisconsin has promoted COO Rich Springer to president, effective immediately. Springer has been the Alpha Source COO since 2016.
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PartsSource of Cleveland, Ohio has named David Brennan its vice president and general manager of service. Brennan most recently led the GE Healthcare global on-demand parts & services ecommerce business.
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Positron Corporation named Adel Abdullah as its president and member of its board of directors, and promoted Aaron Hargrave, a certified nuclear medicine technologist and its director of clinical applications, as vice president.
ice is The Conference for
Imaging Service Professionals
Find weekly installments at theicecommunity.com
VIEW EDUCATION AND REGISTER TODAY! WWW.AT T EN D I C E.CO M
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people By K. Richard Douglas
DEPARTMENT SPOTLIGHT NewYork-Presbyterian Imaging Service Team
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ewYork-Presbyterian Hospital in New York City is ranked number one in the New York metropolitan area by U.S. News and World Report. The health system is comprised of four main divisions, including NewYork-Presbyterian Hospital, NewYork-Presbyterian Regional Hospital Network, NewYork-Presbyterian Physician Services and NewYork-Presbyterian Community and Population Health. NewYork-Presbyterian is also affiliated with the Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine. NewYork-Presbyterian Enterprise consists of 10 institutions. The core hospitals are Columbia, Weill Cornell, Allen, Lawrence, Lower Manhattan, CHONY and Westchester. The regionals consist of Brooklyn Methodist, Hudson Valley and Queens. NewYork-Presbyterian’s biomed department is made up of 72 members and the imaging team includes another 15. The hospitals include 2,600 beds, 16 MRIs, 23 CTs, 140 portables and 40 special procedure labs. “The director of biomed reports to the vice president of IT (CTO),” says Christopher Schaefer, manager of diagnostic imaging. “Reporting to the director are four departments (general biomed, imaging, planning and performance excel24
ICEMAGAZINE | DECEMBER 2018
lence [policy]). General biomed is comprised of a union team (40 at Columbia campus) and a non-union team (32 at Cornell campus). Imaging is comprised of a union team (eight at Columbia campus) and a non-union team (seven at Cornell campus). The planning team (five) and policy team (four) round out the biomed department that supports over 140,000 pieces of equipment,” Schaefer says. The department currently services magnetic resonance, computerized tomography, nuclear medicine, X-ray, rad fluoro and portables, ultrasound, mammography and special procedures (EP Labs/Cath Labs). There are a few devices the department does not currently service. “NewYork-Presbyterian imaging pays for the vendor service agreements for radiation oncology (linacs, simulators), but the radiology/oncology department has their own vendor-trained engineers,” Schaefer says. With a large inventory of cutting edge technology, how does the team keep abreast of training? “We employ, whenever possible, shared service agreements with the OEMs, where our imaging team provides first call and PMs on the covered equipment,” Schaefer says. “The OEM training for the engineers to qualify is funded by full-service
“Complying with our need to put patients first, enhancing our shared service program to the point that GE co-authored a white paper with New York-Presbyterian on the subject, was a major step forward.” agreement discounts and annually renewable training dollar pools. Backups are preliminarily trained through onthe-job training working with the primary engineers. Regardless, the hospital’s CIO is very supportive of training,” he adds. The imaging group is also involved when it comes to buying equipment. “The imaging team signs off on all equipment purchases and capital requisitions, as ultimately we are responsible to maintain, whether by managing vendor or in-house team or a combination of both,” Schaefer says. He says that the imaging specialists attend planning meetings and are involved with the imaging equipment clinical acceptance process. ADVANCING THE IMAGING PROFESSIONAL
people
The NewYork-Presbyterian Imaging Service Team maintains a variety of devices including x-ray, MRI, CT and ultrasound.
“Equipment contracts are overseen by a combination of legal, procurement and imaging. Being responsible for the maintenance of the imaging equipment, we have developed our own parts sourcing when vendors are not obligated by contract,” Schaefer adds. He adds that the team has negotiated operational training pools with the major vendors (separate from technical training pools) to be implemented at their discretion. “Being affiliated with two reputable medical schools – Cornell and Columbia – our imaging equipment tends to be more of the latest and greatest,” Schaefer says. “OEM service contracts are more applicable (for us) then third-party. In-house members of the imaging team are fully vendor trained on magnetic resonance, computerized tomography, nuclear medicine, X-ray, rad fluoro and portables, ultrasound and special procedures (EP labs/ cath labs). Whenever equipment is upgraded, different training is employed to maintain competency,” he adds. WWW.THEICECOMMUNITY.COM
Leadership in Fastest Response Time A big focus of the imaging team has been to find ways to maximize equipment up-time beyond the industry standard. The imaging team has taken a leadership position in faster response times and minimizing patient inconvenience. “Most recently, the shared service project (GE, Siemens, Philips and Carestream) took up most of our spare time. Currently, we are working on expanding that so that the expertise of our imaging specialists can be available to all 10 NewYork-Presbyterian locations on-demand via equipment remote access, with only one imaging engineer at each of the eight locations not supported by an in-house imaging team. The imaging teams are involved with joint effort research projects between GE, Philips and Siemens,” Schaefer says. Schaefer adds that being affiliated with two teaching institutions, NewYork-Presbyterian is being exposed to new clinicians and doctors annually. OEMs typically perform operational training the first year new equipment is installed, leaving it up to the hospital to train new employees. By negoti-
ating training pools into the service agreements with the vendor, all students can be exposed to encompassing imaging training every year. “Complying with our need to put patients first, enhancing our shared service program to the point that GE co-authored a white paper with NewYork-Presbyterian on the subject, was a major step forward,” he says. “Typically when a problem occurs on a major imaging device, the patient has to be moved due to the industry standard of a vendor two- to four-hour response time,” Schaefer adds. He says that with shared service, the patient does not necessarily have to be moved, the two- to four-hour response downtime is minimized. He also says that out-of-contract overtime costs can be reduced, full-service contract cost is reduced with no down side and there is more flexibility in scheduling PMs on high-usage equipment. The NewYork-Presbyterian imaging team is leading the way in strategically planned imaging service. ICE ICEMAGAZINE
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people By K. Richard Douglas
PROFESSIONAL SPOTLIGHT Arthur "Art" Larson: Making a Difference
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o one has ever serviced an imaging device without first getting some type of training; whether that be through the manufacturer, a third-party provider, in-house or from a mentor. Without quality training, there would be nobody to service the many thousands of MRI, CT, X-ray or ultrasound devices. Each modality requires a special skill set. Thankfully, just as there are those who choose to work as imaging service engineers, there are those devoted to training imaging service professionals to do the job right. One of those people, who has had a profound impact over many years, is Art Larson, MBA, general manager of Global Services Training and Documentation for GE Healthcare. With a quarter of the HTM workforce expected to retire during the next decade, Larson’s experience and focus on technology in teaching, will play an important role in meeting that challenge. Larson uses a variety of techniques to share his knowledge, including augmented reality (AR) and virtual reality (VR) training sessions. A world of experience will leave an enormous vacuum as many baby boomers retire from the imaging service profession. These new training methods will help prepare a new generation. Larson has been with GE Healthcare for 35 years. He has held a number of positions within the company that include 14 years in engineering roles, four years as Six Sigma/sales operations leader and 17 years in various service leadership roles. 26
ICEMAGAZINE | DECEMBER 2018
“Each new role gave me more experiences into the life of our customer, our industry and our business. This is an amazing responsibility we have within imaging, and our biomed area, to serve our population’s health needs,” he says. While not many people consider imaging service training as a profession when starting out, it was an interest in teaching and the process of learning that first motivated Larson. “I’ve actually thought of myself as a teacher for most of my adult life. My various roles and mentoring roles have helped shape my understanding of learning and the importance of a balanced approach to learning/doing/evaluating to improve yourself. My current role is a perfect fit for all of the experiences I have had within GE Healthcare,” Larson says. “I began my career at GE Healthcare (GE Medical Systems) in 1983 right out of college as a CT software engineer. I fell in love with our technology and the ability to be a part of something that truly would help our health,” he adds. Larson went on to earn his MBA after five years with GE.
“I’ve actually thought of myself as a teacher for most of my adult life. My various roles and mentoring roles have helped shape my understanding of learning and the importance of a balanced approach to learning/doing/evaluating to improve yourself." -ART LARSON
Understand How Trainees Learn The retirement of a whole generation of HTM professionals and imaging specialists has required a shift in focus for training. Larson has watched this event play out and has adopted his training approach to address it. He says that it is important to understand how to best approach those you are teaching. He says that you then teach them the way that they learn. “We are seeing a significant change in our population of field engineers. Our experts of 30-40 years are retiring in waves and we are replacing them with younger ADVANCING THE IMAGING PROFESSIONAL
people
Favorite part of being an imaging professional? “Interacting with some of the most brilliant people on the planet. I have 180+ imaging and biomed professionals here each week for training. Spending time with these amazing people energizes me every day.” Top: Art Larson observes a student participate in a VR training session. Bottom left: When not at work, Art likes helping the community as a volunteer. Here he is seen working with Samaritan's Purse. Bottom right: Art, left, enjoys cycling on the back roads of Wisconsin and hopes to one day cycle across America.
engineers that learn and experience their work in different ways,” he says. Larson says that with the new generation of imaging engineers, it is absolutely critical that the approach to training meets both their learning needs and the needs of his customers. “Our industry is retiring in significant numbers over the next five years. We have to use technology (AR, VR) to combat the loss of experience and increase the instant learning/guidance of our field engineers. This is an industry concern and we are helping to lead the transition for our GE team as well as our customer teams,” Larson says. Larson finds some time to steal away from the rigors of training the next generation of imaging service professionals and get outdoors for some enjoyment. “I enjoy spending time on the back roads of Wisconsin cycling and playing on some great golf courses for relaxation. Some day I hope to ride across the USA to raise money for a favorite charity,” he says. His family includes his wife Connie of 34 years, two grown daughters and a beautiful two-year-old granddaughter. WWW.THEICECOMMUNITY.COM
Larson also brings his experience as a parent to a good cause. “I mentor a young man from Milwaukee in the Big Brothers Big Sisters of Milwaukee. We have been together for two years and hope to see him through high school and into college,” he says. However, Larson never loses sight of the importance of having well-trained imaging engineers to maintain diagnostic equipment crucial to health care. “I feel very privileged to be part of an industry that has so much to provide to our population. We, as providers of health care products and services, have a tremendous responsibility to provide the best solutions for our customers and be an active part in the improvement of precision health, so our family, our neighbors and our global fellow man can live healthy lives for the moments that matter,” Larson says. “I thank God each day for the opportunity to serve our GE team to be the best they can be for this mission. I take pride in knowing that in some, small way; we are making a difference.” ICE
GET TO KNOW THE PRO Favorite book “This is your Brain on Music” by Daniel Levitin Favorite movie “Hoosiers” Favorite food Roast Beef with Gravy and Mashed Potatoes Hidden talent Trumpet player – first career choice was to be in a major symphony orchestra What’s on my bench? The books “The Five Dysfunctions of a Team” by Patrick Lencioni and “Together is Better” by Simon Sinek. Teamwork and collaboration are fundamental requirements for our business. It’s always helpful to be reminded of what is important.
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Happy Holidays from us to you.
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ADVANCING THE IMAGING PROFESSIONAL
products
PRODUCT SPOTLIGHT Contrast Injector Market Continues Surge
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ontrast injector systems are medical devices that use contrast media to enhance the visibility of complex body structures such as body fluids, tissues, arteries and veins. The diagnosis is conducted with the help of many imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRI) and angiography. The contrast injector system market was valued at $554.38 million in 2016 and is expected to reach $954.62 million by 2023, registering a CAGR of 8.1 percent during the forecast period, according to Allied Market Research. “The rise in geriatric population coupled with rapid rise in chronic diseases as well as the demand for early and minimal-invasive diagnosis are the key factors that drive the growth of the contrast injector systems market,” according to Allied Market Research. “However, the high cost of contrast injector systems and the risks associated with the use of contrast media in the injector system is projected to impede the market growth. Moreover, the increase in health care expenditure and the emergence of complex diseases in emerging economies are expected to create lucrative opportunities for key market players.” Researchers echo the forecast for continued growth. WWW.THEICECOMMUNITY.COM
“Rising demand for minimally invasive surgical procedures is a major factor expected to boost the market during the forecast period.” -GRAND VIEW RESEARCH The global contrast media injectors market is expected to reach $1.4 billion by 2025, growing at a CAGR of 5.8 percent, according to a report by Grand View Research Inc. “Rising demand for minimally invasive surgical procedures is a major factor expected to boost the market during the forecast period,” according to Grand View Research. “These devices assist surgeons in accurate insertion of contrast agents with reduced human errors, thus increasing the accuracy and efficiency of surgical procedures. They play a crucial role in Intraoperative Computed Tomography (iCT), Intraoperative Magnetic Resonance Imaging (iMRI), and interventional cardiology. Availability of advanced injector systems for diagnosis and intraoperative imaging has boosted adoption of these systems. For instance, Medrad Stellant CT injection system integrated with
Certegra Workstation provides high efficiency and accuracy in CT imaging.” “Technological advancements, such as automated contrast media injectors and double-head injectors, are also among major factors supporting the growth of the market,” the report added. “Automated contrast media injectors provide improved patient safety, accuracy and enhance image quality. Also, double-head injectors allow a large and rapid initial bolus of contrast, which is required in several imaging procedures. For instance, in cardiac CT, a fast injection is required for imaging of both sides of the ventricular septum to identify septal thickness, shunts and enlarged ventricles. Delivery of contrast media is more efficient and controlled with a dual-head injector.” As estimated in a Zion Market Research report, the global contrast injector market stood at $660 million in 2016. Witnessing a tremendous rise during the period from 2017 to 2022, the revenue in this contrast injector market is expected to reach $889.3 million by the end of the forecast period. The main products available in this contrast injector market are injector systems, consumables and accessories. Among the three, the demand for injector systems is relatively higher and the trend is anticipated to remain so over the next few years, notes the research report. ICE ICEMAGAZINE
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products
GE Healthcare SenoBright HD Following an inconclusive mammogram and ultrasound, clinicians can use SenoBright HD, a next-generation Contrast Enhanced Spectral Mammography (CESM) exam designed to aid health care providers in breast cancer diagnosis by delivering clear images for a confident and fast patient diagnosis and overall improved patient experience. It is a less expensive alternative diagnostic exam in comparison to breast MRI and is now available on the Senographe Pristina. The patient receives an iodine contrast agent to acquire a standard four-view mammogram. Using dual energy to reduce background signal, the contrast agent used with SenoBright HD highlights areas of unusual blood flow to help localize a known or suspected lesion. The contrast-enhanced mammogram provides high specificity, delivers clear image quality and reduces acquisition time by 40 percent in women with large breasts compared to GE Healthcare’s first generation CESM technology, helping to reduce the risk of patient movement during acquisition*. The entire exam typically takes less than seven minutes and the images are available immediately for a radiologist to review**. * Data on file at GE Healthcare ** Daniaux et al. Arch Gynecol Obstet, 2015
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ICEMAGAZINE | DECEMBER 2018
ADVANCING THE IMAGING PROFESSIONAL
products
SIEMENS HEALTHINEERS SOMATOM go. CT platform The SOMATOM go. CT platform – consisting of the SOMATOM go.Now, SOMATOM go.Up, SOMATOM go.All, and SOMATOM go.Top systems – was designed by Siemens Healthineers with feedback from over 500 medical professionals globally, who identified key characteristics of an ideal CT scanner. That feedback led to the development of not only key features such as the platform’s mobile, tablet-based workflow, including automated inline reconstructions, but also the gantry-mounted contrast injector arm – an alternative that addresses the cost and complexities of traditional pedestal- and ceiling-mounted injector solutions. Additionally, the SOMATOM go. CT platform’s FAST ROI (Region of Interest) feature automates detection of the aorta to help the technologist identify the optimal moment to begin contrast administration.
WWW.THEICECOMMUNITY.COM
ICEMAGAZINE
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products
TOOLS OF THE TRADE Glassbeam Clinical Engineering Analytics (CLEAN) Blueprint software
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lassbeam Inc. has announced the integration of environmental sensor data into its Clinical Engineering Analytics (CLEAN™) Blueprint software, enhancing quality and time to insights. Monnit Corporation’s ALTA IoT sensors will provide this new data. Monnit sensors monitor environmental factors, such as room temperature and humidity; when these factors deviate beyond specific ranges, they can adversely impact the performance of expensive hospital imaging equipment, such as CT scanners and MRI machines. This solution advancement will collect the environmental telemetry data such as compressor power, water inlet and outlet temperature, room humidity and temperature readings every few seconds. Combining telemetry data with machine logs into one holistic data model provides value by alerting staff on impending failures within operating imaging machines. This addition could translate into higher machine uptime, lower maintenance costs and overall superior patient care. ICE For more information, visit www.glassbeam.com.
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ICEMAGAZINE | DECEMBER 2018
ADVANCING THE IMAGING PROFESSIONAL
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A RADIOLOGY MANAGER’S
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Wish List
At the end of every fiscal year,
imaging centers and health systems start making difficult choices about capital planning and budgeting for the future. Those resources are always judiciously meted out, and yet it seems like there’s never enough to go around for all the institutional needs that exist. So we asked radiology managers and directors at a handful of sites across the country to tell us what their wishlists consist of — from staffing to technology and everything in between. Here’s what they told us... For Connie Hatcher, CT Supervisor at the Lourdes Health System in Burlington, New Jersey, a small, community hospital, the technological wishlist is short. Hatcher just wants another CT scanner. She’s working on a 16-slice unit from 2011, and “it can only do so much.” At most, Hatcher said, her department can scan 20 to 40 patients per day. But those with complicated conditions may need to be transported elsewhere, like to the Lourdes sister facility in Camden City 15 miles away. “If you get a patient from the hospital who really needs a perfusion, I have to send them in an ambulance to Michele down in Camden,” Hatcher said. “It’s not a great thing to do the imaging
at two facilities, because time is brain.” Michele is Michele Ross, the CT and 3D Imaging Supervisor for the Camden and Burlington campuses of Lourdes Health System. At Lourdes Camden, Ross oversees two CT scanners, a 256-slice unit in the emergency department for critical care patients, and a 64-slice device in the main imaging department, for biopsies. The biopsy scanner is 15 years old, which means every physician wants their studies performed on the other one. “With everything being all about turnaround time now, it becomes
an issue,” Ross said. “We are a heart hospital. We do a ton of cardiac studies, and then we get Burlington’s too, whatever they can’t do there. We’re not going to be able to keep up with our work schedule if we don’t get another scanner.” Hatcher has almost the same problem in reverse. With only one scanner at her site, the limited capacity of her
All I want is... a new CT scanner! C O N N I E H AT C H E R
LOURDES HEALTH SYSTEM, BURLINGTON, NJ
All I want is...
always like that. In my takes time to speak to the patient. You’re domain, I know what’s starting IVs, you’re calling floors, you’re going on. A lot of nurses calling radiologists. All these factors on will come down and que- both sides, it’s important. ry my techs on different “Probably the radiologists need things. There’s still room to get more involved with the care of for improvement on patients, but they’re not used to that some of the physician's either,” Ross said. “It’s hard to get our part. radiologists here to go out and educate “You’re always going to be educat- physicians on what they should order ing your nurses because you’re in con- and how they should order. People tact with them every day,” she said. don’t understand all the pieces it takes “The doctors, you teach a bunch, and to make the right study with the right then a new bunch come in. It’s an on- experience.” going thing. And the older techs know For Nicole Walton-Trujillo, Manager how to handle it, and the younger techs for Desert Radiology of Las Vegas, Nevadon’t. I’ve seen techs get steamrolled da, her biggest needs center on staffing. by ER physicians.” Walton-Trujillo is responsible for over“It’s a matter of getting the message seeing 88 employees at nine Desert Raout that what we do is important,” Ross diology sites, including a floating pool said. “They can’t do their jobs without of full-time employees who are schedus, and we can’t do ours without them.” uled at any of them on a given day. In Hatcher said that communication just a month, her primary site alone with physicians can be a challenge sees more patients (380) than do most overall, not only for those reasons, but critical access hospitals. sometimes for more practical ones— Even for someone who describes like their physical whereabouts. Those herself as “the queen of multitasking,” delays can contribute to longer patient the personnel oversight duties of her wait times, which ultimately increase position are intensely demanding. the length of studies conducted, af“I get time-off requests every day,” fecting patient satisfaction scores, and she said. “I do eight things at a time, my reimbursement rates. She would like help explaining the complexity of the job of the imaging department not only to physicians but to patients as well. “Trying to reach the ordering phyNICOLE WALTON-TRUJILLO sician to pick their DESERT RADIOLOGY, LAS VEGAS, NV brain and educate them and clarify an order can be time-consuming, and phone goes off 24-7. I have supervisors you’re waiting,” Hatcher said. “It can be at two of my sites, and they do an inlaborious, and everything is patient sat- credible job of keeping the house going isfaction today. when I’m not in it. I need the ability to “Everybody thinks that the scan is so have way more floats.” fast, but everything you need to do beWalton-Trujillo describes Las Vegas fore and after for that patient; the time as “a very well-populated small town,” does not change,” she said. “I don’t think and in addition to its general populathe public realizes it’s about safety of tion, Desert Radiology provides imaging the patient. All these things take time. It services for the NHL’s Golden Knights
a second scanner. MIC HELE ROSS LOURDES HEALTH SYSTEM
department also affects the nature of studies it can provide in a given day. “We do a fair amount of interventional, but we try to keep it to a minimum because you don’t want to tie up the machine because you only have one,” she said. “You have to use other modalities, or just do it under fluoro because the scanner’s not available. It impacts how you have to arrange your schedule.” Both Lourdes hospital sites are in the process of being sold to nearby Virtua Health of Marlton, New Jersey. Hatcher and Ross are optimistic that the merger could mean more, or newer, equipment might be made available to them soon, and not just scanners. Ross wants to streamline some of its IT processes, and migrate from a PACS-driven system to a RIS-driven system. Patient histories, requisitions, even dose-tracking functions are all managed manually, “and it’s labor-intensive,” she said. “We do a lot of things manually,” Ross said. “None of our systems work together. It’s very old-school. It takes more time, and if you forget something, it’s gone.” Oddly, that doesn’t square with some of the most frustrating presumptions both Hatcher and Ross say they encounter within their broader hospital community: that their teams are composed of low-skilled “button-pushers” who are there only to follow the orders of more knowledgeable medical staff. That’s why their wishlists would also include some way of improving inter-departmental communication and understanding of the roles and responsibilities of the imaging department as relates to caregiving and patient satisfaction. “In my 38 years, it’s gotten much better,” Ross said. “I have a great relationship with my ER department, and it wasn’t
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ICEMAGAZINE | DECEMBER 2018
All I want is... a Starbucks between the parking lot and my office.
ADVANCING THE IMAGING PROFESSIONAL
and student-athletes at the University of Nevada Las Vegas. To that end, the institution must obtain and maintain the latest equipment, and although it does just that, there’s significant wear and tear on a machine that performs a study every 15 minutes. “That’s a lot of rotation in that tube,” Walton-Trujillo said. “That tube never slows down.” She credits her service provider with being “the key that keeps us running,” by performing service and preventive maintenance after-hours so as not to interrupt patient flow. Just as important to her operations is cross-departmental communication, and if Walton-Trujillo had a wishlist, it would include development of staffers’ soft skills to better align with organizational goals. “How you communicate across departments and to your people is important,” she said. “It’s how you align the strategic roadmap of the company to the actual work that’s being done. It doesn’t matter who the employee is; the goal, the role they align back to is that five-year strategic plan.” Along those lines, Walton-Trujillo, like Ross and Hatcher, believes that more could be done to advance patient safety and priorities with patient-physician advocacy programs. She’d like to see more patient navigators sourced from an imaging background so they can understand physician orders and the studies to which they correlate. Of course, with all the emphasis on patient safety and comfort, Desert Radiology has invested in improving the patient experience, from mobile device docking stations in its waiting rooms to more comfortable furniture. Of course, in her dream of dreams, Walton-Trujillo would love to add a Starbucks “between the parking lot and my office.” “I firmly believe that a chai tea latte has saved more patients’ lives than anything else,” she said. “That caffeine keeps me moving.” For Danny Gonzales, radiology manager at Lincoln County Medical
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Center in Ruidoso, New Mexico there’s or Alamagordo, and although Lincoln not a whole lot of technology needs. County draws patients from there for its The 25-bed, critical access center is in top-flight imaging services, they’re still the process of constructing an entirely some 70 miles away. Even for Gonzales, new facility. Primarily a rural radiology who commutes from Carlsbad to work center, Lincoln County Medical Center every week, the shift in altitude from is updating all its equipment and mov- 3,200 feet to 7,000 is a commitment. ing to a completely digital radiography “I could recruit for radiographers system, bringing its MRI in-house and all day long, and I have people actubeginning to offer nuclear medicine ally waiting to come up here,” he said. services in 2019. “Our hardest-hit areas are ultrasound “Even though we are nonprof- and nuc med. We have several sonogit, we have to spend money to put in raphers, but it’s going to be a process high-quality equipment,” Gonzales to get that first nuc med hire.” said. “In 2019, our equipment’s going “We were fortunate to recruit an to be top-notch.” echo-technologist to start in January,” That new hardware will play a vital Gonzales said. “A lot of it is meeting role in the financial well-being of the their salary and benefit expectations, new facility by helping avoid reim- helping them find housing, and making bursement rate cuts as it goes 100-per- sure that our technology is up to date.” cent digital, he said. Gonzales also knows that he’s in an “I’ve been very fortunate to get enviable position as compared with what I want to upgrade our depart- other rural radiology managers. For ment,” Gonzales said. “We have a facilities that don’t have the resources 64-slice CT scanner, we’ve upgraded or wherewithal to upgrade their equipour ultrasound to the top they have ment as his has done, he emphasizes out there, and we’re going to move to clear lines of communication with totally digital in our trauma rooms.” management, clinical staff, and every“Everything’s tied to reimburse- one under his direct supervision. ment,” he said. “Once you start telling “I have meetings with ER staff, and people they’re going to lose money on tell them, ‘This is what we can do for imaging [without transitioning to DR], you,’ We’re fortunate that we have ER they wake up. We’re going to do a lot physicians who aren’t prima donnas, more angiography for stroke protocols, who will listen to you and will work and we’ve upgraded our ultrasound, with you, and who have an underwhich will help with reimbursement in standing of what we can and can’t vascular.” do,” He said. “It’s a communication Yet despite the advantages of all-new gap that we’ve been able to fill. I don’t equipment on the horizon, Gonzales’ bark orders; I believe in constructive biggest challenge is always going to be criticism. Work with me, I’ll work with hiring. The site is located in the tall pines you.” ICE of New Mexico, in a resort community of about 12,000 people that can boom to 35,000 in season. Although it’s a ski lodge in the winter and a horse farm in the summer, trying to find technologists for whom those interests are a match is a case-by-case candidate search. DANNY GONZALES The closest urban LINCOLN COUNTY MEDICAL CENTER, RUIDOSO, NM centers are Roswell
All I want is... ultrasound and nuclear medicine staff.
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insight
CAREERS NOW
Written by Kathleen Furore
What if You’ve Lost Touch with Old References?
T
his column’s topic is recommendations. What should someone do if they’ve been out of the workforce for several years and have lost touch completely with past supervisors, some of whom are no longer with the company the job applicant worked for previously? Dawn D. Boyer, Ph.D., the CEO of D. Boyer Consulting, says not having contact information about past supervisors isn’t that big a problem in the hiring world of today. “I wouldn’t worry about trying to find supervisors – most companies looking for recommendations want those listed whom you have kept in touch with,” says Boyer, who adds that HR personnel in the hiring company now call the HR department of the last company the candidate worked for and ask for details. “Most companies now will only provide job title, dates of employment, and perhaps answer the question, ‘Would they rehire?’” she explains. “Most companies have policies in place now that forbid supervisors from providing any information about past employers anyway for fear of potential liability issues.” That said, Brie Reynolds, a senior ca38
ICEMAGAZINE | DECEMBER 2018
reer specialist at FlexJobs, says it is worth reaching out to former supervisors even if time has elapsed. Boyer and Reynolds both cite LinkedIn as a good place to head to find a boss with whom you’ve lost touch. “LinkedIn is a great platform for this. Be conversational at first, asking them how they’re doing and catching them up on your life as well – don’t immediately ask for a reference,” Reynolds suggests. “Once you’ve had some interaction with them again, you can assess if they seem open to being asked to be a reference.” And don’t just rely on previous supervisors! Expand your options, Reynolds says. “Former colleagues that you worked well with can also act as references unless a job application specifies that you must have a supervisory reference,” she says. “Also, consider people you’ve interacted with in some professional capacity during your time away from the workforce. Have you volunteered at any nonprofits where a supervisor or volunteer coordinator could speak to your abilities? If you were caring for children, did you regularly help out at their schools? And could someone there
act as a reference to your professionalism, leadership and service? Maybe you’ve taken a class or certification or been active in your community in some way. It’s OK to be creative when considering who could be a great reference for you.” If you’re currently employed and thinking of moving on, Boyer offers this advice: “The absolute best manner in which to retain sustainable recommendations is to get it in writing from the supervisor and/ or manager when leaving each company,” she says. “Ask for a letter of recommendation on company letterhead from as many co-workers, supervisors, managers or even business clients as possible as you are walking out the door.” As Boyer notes, you can use those letters as “the next best option” down the road, if you can’t reach someone whose reference you seek. ICE
Kathleen Furore is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. ADVANCING THE IMAGING PROFESSIONAL
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insight
IMAGING MATTERS The Ultimate Factor
Written by John Garrett Director of a Clinical Engineering Department in CHI
T
he CT is down. The techs are stressed, the imaging director is losing his mind, and the doctor is speaking to you in a language you are fairly certain is not Latin. What drives your decision on how to proceed with the repair of that CT? There are a number of immediate concerns. Is the hospital forced to redirect due to the malfunctioning unit? Is the hospital losing revenue while a patient's waiting to be diagnosed? But, what do all the things that have to be considered actually derive from? Patient care is the answer. Using patient care as a reason to do something has become more and more common. The ultimate reason for having the equipment is to serve patients and provide patients with care. Patient care should drive the decisions made in a hospital to ensure the best possible treatment and outcomes possible. However, using patient care as a go-to reason without serious consideration leads to a failure to achieve better outcomes and the best patient care. This is due to a narrowed focus that does not consider all of the patients, but rather a single or a few patients that are in the immediate scope of the work. When considering the need to spend resources, man hours, overtime, paying outside service, couriering in parts or any other resource the bigger picture needs to be considered. In a hospital that has two CTs that run at 90 percent capacity the actual impact on patient care will be different than a hospital that has 18 CTs that run at an average of 65 percent capacity. The hospital with the greater number of CTs might find it inconvenient to wait until first delivery the next day where the hospital with only two CTs might be forced to turn patients away. The need for a resolution to the problem for the smaller hospital justifies the expenditure of more resources than the larger hospital in the same situation. Ensuring the proper expenditure of those resources is directly related to patient care. Spending the resources necessary without wasting them is a fine line that requires a delicate balance. This line is often blurred by the heat of the moment, emotions and political positioning. By not wasting resources, the focus is on patient 40
ICEMAGAZINE | DECEMBER 2018
" Spending the resources necessary without wasting them is a fine line that requires a delicate balance." care for the long term. It ensures that the patients of the future get the best care on a continuous basis. It is the same reason that it makes sense to research parts and ensure that quality parts are purchased at the best price. By making the medical facility financially viable, it ensures that future patients can be treated. Make no mistake, repairing diagnostic imaging equipment improves the quality of life of many and saves lives. It is important work. Ensuring that it is done in the most economical way, while meeting the needs of those who are served is very important. Just make sure that in the fog of battling with a challenging repair that the real reason the work is being done is not lost. The patients of both today and tomorrow are counting on a responsible response to the problem. ICE John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine. He has worked for third-party service companies, manufacturers, sales companies and in-house imaging teams. ADVANCING THE IMAGING PROFESSIONAL
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insight
TURTLES ONLY ADVANCE WHEN THEY STICK THEIR NECK OUT
H
istory books are full of astute and insightful quotes. It’s one thing to agree with them. It’s something more to incorporate their truth into our lives. What I like about many quotes is that they reflect universal principles of success, and who in their right mind doesn’t want more of that? Many inspirational quotes include great imagery and symbolism. For example, the axiom about turtles advancing only when they stick their neck out has more symbolism than just emphasizing a need for risk. In the story of the tortoise and the hare, the tortoise is depicted as a slow-moving creature that succeeds using the principle of steadiness. I know several people who were told they would not succeed in business because they were not assertive or aggressive when it came to business. But these people operated using the turtle’s symbolism: by sticking out their necks to take calculated risks and moving steadily forward. As a result, they achieved their goals and their businesses are well-established. The turtle quote and its themes can be compared to many similar sayings, such as “no risk, no reward,” or “nothing ventured, nothing gained,” or “a journey of a thousand miles begins with a single step.” Many inspirational quotes revolve around the need for risk and just getting started, but over the years I’ve come up with my own set of truisms to help people succeed. Some of my clients have latched onto these and spread them throughout their companies, such as the organization that printed them up as posters and hung them in their company break room. Feel free to do the same. Here are a few of my favorites: 42
ICEMAGAZINE | DECEMBER 2018
Slower up front equals faster down the road. This is a most helpful phrase for Type A personalities to memorize. Those who are driven hard to succeed often see the shortest distance between two points as being a straight line, but that is not necessarily the case. When dealing with “slower moving people” (about 65 percent of the population), faster-moving people benefit greatly by knowing when to slow down and work with people in ways that create harmony, not pressure. They’re frequently surprised to find that it’s true – the end result of moving slower up front is often faster results! One Type A production manager took this to heart when interacting with his easy-going scheduling person. Over the years, he pushed her so hard that she eventually became passive-aggressive. When he decide to use the “slower up front” approach, things smoothed out in relatively short order, and she started providing him his requests without “finding” reasons to delay them. You’ll go where you’re focused. If you’ve taken a good driving course you’ve learned that your vehicle tends to go in the direction you’re looking. The same principle applies in just about every aspect of life: You will move in the direction of your focus. If you’re looking only at the trouble spots, you’re likely to stumble. But if you’re focusing on the path of actions that lead to success, you’re likely to achieve success. Acknowledgement does not equal agreement. Good communication skills include being able to acknowledge someone else’s point of view, even if you don’t agree. (There are
Written by Daniel Bobinski Workplace Consultant
several talk radio hosts I won’t listen to because they fail miserably at this). Unfortunately, many people hold the mistaken belief that acknowledging someone’s point of view is the same as agreeing. Not true! Here’s an extreme example to make my point: You may fervently believe the moon is made out of blue cheese. A wise person with good communication skills is capable of acknowledging your belief without agreeing with you. An inability to do this is a tremendous obstacle to success. I recall a company bringing me in to facilitate a conflict resolution workshop. During the exercises, one employee flatly refused to acknowledge perspectives with which he disagreed. Even when I emphasized that he didn’t have to agree, the objective was just to restate someone’s position, he flatly refused. I later learned that he didn’t last long with that company. ADVANCING THE IMAGING PROFESSIONAL
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ter being released and the manager overseeing the project expected to be fired. He went to his own manager and asked if he should clean out his desk. Instead of firing him, the senior manager replied, “We just spent several million dollars training you. Why would we want to fire you?” By the way, the principle of learning from mistakes can also be tied to another of my favorite sayings, “Good judgment comes from experience; Experience comes from bad judgment.” In closing, let me emphasize that the sayings that permeate your mind are the ones that will influence your life. With the idea that you will go where you’re focused, may I suggest you choose your thoughts carefully. After all, it was Henry Ford who (rightfully) said, “Whether you think you can or you think you can’t, you’re right.” ICE Daniel Bobinski, M.Ed. teaches teams and individuals how to use Emotional Intelligence, and his videos and blogs on that topic appear regularly at www.eqfactor.net. He’s also a best-selling author and a popular speaker at conferences and retreats. Reach him at daniel@eqfactor.net or 208-375-7606.
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Only make new mistakes. This saying goes hand-in-hand with a quote solidly attributed to Theodore Roosevelt; “The man who never makes a mistake is the man who never does anything.” I should note that half-a-dozen other people made similar statements in the 70 years prior to Roosevelt making his statement, but the idea is the same. Anyone who’s getting anything done in life is making mistakes. Unfortunately, some people keep making the same mistakes over and over. The underlying message in “only make new mistakes” is the need to learn from mistakes. Think about it. Any parent who does nothing but scold children for making mistakes is, in fact, making a huge parenting mistake. Good parents help their children learn from mistakes, or those children will likely become too afraid to “stick their necks out” and achieve success. In the same way, good managers should use workplace mistakes as opportunities for learning. As the story goes, one of IBM’s big failures was the IBM PC Jr. It was called the “Edsel of computers” due to its poor design. Despite the tremendous expense of development and promotion, the product was quickly discontinued af-
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ADVERTISER INDEX Ray-Pac® THE WORLD MOVES FAST. WE MOVE FASTER.™
Exclusive Medical Solutions, Inc. p. 39
626 Holdings p. 13
AceVision Ultrasound p. 17
Global Medical Imaging p. 33
MedWrench p. 44
Multi Diagnostic Imaging & Surgical Solutions p. 2
Ray-Pac p. BC
RSTI/ Radiological Service Training Institute p. 9
CoSPBS, Inc. p. 15
Adel Lawrence Associates, Inc. p. 45
Injector Support & Service p. 28
MW Imaging Corp. p. 5 SOLUTIONS
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Inrayparts.com p. 33
Oxford Instruments Healthcare p. 3 Universal Medical Resources p. 20
Cal Ray Inc. p. 41Services • De- installation & Relocation • NIR Affiliate Owners
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KEI Med Parts p. 45 Radiology Data p. 4
Diagnostic Solutions p. 19
Webinar Wednesday p. 47
KEI Medical Imaging Services p. 43 Radon Medical LLC p. 15
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