TechNation Magazine - December 2018

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1technation.com

Vol. 9

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

DECEMBER 2018

THE PATHWAY TO

LEADERSHIP

reach new heights in 2019

14 Company Showcase

Pronk Technologies

45 Biomed 101

Common Sense Troubleshooting

54 Roundtable

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CONTENTS

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ROUNDTABLE: TEST EQUIPMENT est equipment plays a critical role T in the maintenance and repair of medical devices. We reached out to manufacturers of test equipment for tips and asked about the latest devices and features that biomeds should look for in 2019.

Next month’s Roundtable article: Patient Monitors

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THE PATHWAY TO LEADERSHIP: REACHING NEW HEIGHTS IN 2019

Key elements for a project manager to consider are to identify the phases of the project, identify the participants and stakeholders who can make it happen, and understand the budget process and its role in the project. Here we share tips to help you reach the summit in 2019.

Next month’s Feature article: Networking: New High-Tech World of HTM

TechNation (Vol. 9, Issue #12) December 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

DECEMBER 2018

TECHNATION

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CONTENTS

INSIDE

Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley Karlee Gower Kathryn Keur EDITOR

John Wallace

EDITORIAL

Jenifer Brown K. Richard Douglas Jim Fedele Inhel Rekik Manny Roman Cindy Stephens Steven J. Yelton

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg Travis Saylor

CIRCULATION

Lisa Cover Melissa Brand

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Eddie Acosta, Business Development Manager, Colin Construction Company Manny Roman, Business Operation Manager, AMSP Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System Jim Fedele, Sr. Program Director, Clinical Engineering, BioTronics, UPMC Susquehanna Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Clinical Engineering Manager, Medstar Georgetown University Hospital

MD Publishing / TechNation Magazine 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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DECEMBER 2018

Proud supporters of

P.12 SPOTLIGHT p.12 Department of the Month: The Hawai’i Pacific Health Biomedical Engineering Department p.14 Company Showcase: Pronk Technologies p.18 MD Expo Reigns in Seattle p.20 Professional of the Month: Matthew Jones p.24 Biomed Adventures: Jumping with the best of Them P.28 p.28 p.33 p.34 p.36 p.39 p.40

INDUSTRY UPDATES News & Notes David P. Harrington Ribbon Cutting: Introducing Diversified AAMI Update Welcome to TechNation ECRI Update

P.45 p.45 p.47 p.48 p.51

THE BENCH Biomed 101 Shop Talk Tools of the Trade Webinar Wednesday

P.65 p.65 p.66 p.69 p.70 p.73

EXPERT ADVICE Career Center Ultrasound Expert The Future The Other Side Roman Review

P.74 BREAKROOM p.74 Did You Know? p.76 The Vault p.78 MedWrench: Where in the World is Ben C.? p.80 MD Expo Seattle Scrapbook p.84 Service Index p.89 Alphabetical Index p.90 Parting Shot

Like us on Facebook www.facebook.com/TechNationMag Follow us on Twitter twitter.com/TechNationMag

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SPOTLIGHT

DEPARTMENT OF THE MONTH

The Hawaii Pacific Health Biomedical Engineering Department BY K. RICHARD DOUGLAS

H

ow many biomeds would dream of working in Hawaii; with the islands’ many beaches, palm trees, tropical breezes and temperate climate?

To get an answer to that question, you may need to ask the HTM professionals in the biomedical engineering department at Hawaii Pacific Health. The team of 25 full-time and three part-time members know all about it. “We are tasked to continually identify, address and monitor medical equipment-related risks within our organization,” says Aaron Predum, director of biomedical engineering. Other members of leadership in the department include Peter Ines, manager at Kapiolani Medical Center for Women & Children; Keoki Fujinaka, supervisor at Pali Momi Medical Center; and Scott Shiraishi, manager at Straub Medical Center. The health system is based in Honolulu on the island of Oahu. The main medical centers are Kapiolani, Pali Momi, Straub and Wilcox. Hawaii Pacific Health also has more than 70 other locations spread among the Hawaiian islands. The health system’s mission is to create a healthier Hawaii. Kapiolani Medical Center for Women & Children is a 243-bed hospital located in Honolulu. It is Hawaiis only maternity, newborn and

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pediatric specialty hospital. Pali Momi Medical Center is a 118-bed medical center located in Aiea, servicing Central and West Oahu. Pali Momi offers a full range of services. Straub Medical Center is a 159-bed medical center in Honolulu. It has a network of neighborhood clinics, and a visiting specialist program that reaches throughout the state of Hawaii. Straub has more than 32 different medical specialties and is home to the Pacific region’s only multidisciplinary burn treatment center. Wilcox Medical Center in Lihue on the island of Kauai is a 72-bed medical center dedicated to providing the Kauai community with accessible, quality health care. Kauai Medical Clinic is the island’s largest clinic and its only multispecialty medical group. “Each of our Oahu hospitals has a biomedical engineer that specializes in imaging based there. They work closely to cover for one another and share on-call. Additionally, they provide on-the-job training to the nonspecialized biomeds at each site,” Predum says. “We also have recently created and filled a biomedical engineering role that specializes in cybersecurity mitigation. This individual, Timex Xayaseang, works collaboratively with IT and clinical leadership to ensure medical equipment within Hawaii Pacific Health

has been properly patched and able to connect to the network for integration,” he adds. Predum says that the department provides several services to the health system. He says that the biomedical engineers “ensure appropriate and dependable medical equipment are evaluated prior to purchase; inspect, test, and maintain medical equipment in keeping with appropriate maintenance strategies that meet all applicable regulatory requirements, and manage medical equipment risks.” “With support of our C-suite, we recently created and filled a contract administrator position in our biomedical engineering department. This individual, Tom Taylor, is tasked with judiciously evaluating, monitoring, tracking and managing all medical equipment service contracts at Hawaii Pacific Health. Tom works with our biomedical engineers, department leadership and vendors to accomplish these tasks,” Predum says. He also points out that while there is not an official integration between biomed and IT, there are wellestablished and newly created relationships that exist. “We work side-by-side on all medical equipment purchases, integrations, upgrades, mitigation, etcetera. Coming from an organization in which IT and biomed were fully integrated for 10-plus

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SPOTLIGHT

BY K. RICHARD DOUGLAS

The Hawai’i Pacific Health Biomedical Engineering Department

years, the relationships between these two critically important teams at Hawaii Pacific Health are just as, if not more, synergized,” Predum adds. PATIENT SAFETY AND CYBERSECURITY PROJECTS The biomed team has been very proactive in the area of cybersecurity and even brought their insights to the AAMI 2018 Conference and Expo through a presentation. They have been involved in a medical equipment cybersecurity management project. “After WannaCry, Petya and other hacking attacks across the world brought critical attention to the state of health care technology cybersecurity, the biomedical engineering and IT teams at Hawaii Pacific Health collaborated together to develop a comprehensive strategy and process for managing cybersecurity patches and risks for all applicable medical equipment at each hospital,” Predum says. He says that this included talking with the C-suite and having their support to hire a specialized biomed to focus on cybersecurity. “This biomed (Timex Xayaseang), myself and our information security officer (Alan Ito) presented a case study at the 2018 AAMI Conference in Long Beach, California about our challenges and solutions related to security

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

reviews, vendor communication and collaboration, inventory tracking and management, patch testing, and the updating of medical equipment and their integrated systems,” Predum says. He says that biomed has been working with the IT department over the past two years on the inclusion of medical equipment that stores PHI in their yearly security survey. “Goals are to identify gaps that need to be addressed and mitigated to ensure PHI stored on devices is protected and secure,” Predum adds. Other constructive projects have included addressing patient safety and bringing more services in-house. “Through our new contract administration management process we identified an improvement and costsavings opportunity at all Hawaii Pacific Health sites to transition the support of our medical bed, stretcher, crib and ceiling lifts from outsourced contracts to an in-house model. We told the story and the C-suite supported adding two new entry-level biomeds to implement the new in-house plan,” Predum says. He says that biomedical engineering took the lead in working across the Hawaii Pacific Health entities to create a new wireless infusion pump, drug library policy. “Its purpose is to outline the steps taken to ensure the drug library/data set

updates are wirelessly uploaded onto all the applicable infusion pumps in a timely manner. This was identified as an important patient safety initiative for the wireless infusion pumps. Teams involved in this process range from pharmacy, nursing and front-line staff, nursing leadership, supply processing, biomed and IT,” Predum adds. An exciting development outside of work has been the creation of a new biomed association. “The majority of our biomedical engineering team are official members of Hawaii’s newly created (December 2017) Hawaii Healthcare Technology Management (HiHTM) Association,” Predum says. He is the association’s current president and Peter Ines is on the board of directors. “The website is www. hihtm.com and we are passionate about providing education, training and networking opportunities to our community in Hawaii, as well as trying to use the new platform to bring back a biomedical associate’s degree program to a local university in Hawaii to better prepare for the future,” Predum says. Along with the tropical breezes and swaying palm trees in Hawaii, there is real work being done to keep medical devices working and patients safe. That is thanks to the good work being done by the Hawaii Pacific Health Biomedical Engineering Department.

DECEMBER 2018

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SPOTLIGHT

COMPANY SHOWCASE PRONK TECHNOLOGIES

P

ronk Technologies was founded in 2004 and is located in Sun Valley, California.

Greg Alkire, vice president sales and marketing, said the company has over 40 years of experience in designing, producing medical devices and biomedical test equipment. “We owe a tremendous amount of our success to the HTM community who early on expressed a desire for test equipment that was smaller, more durable and affordable. This inspired our first product, the SimCube® NIBP Simulator. The success of this product launched our mission to innovate better, more affordable solutions for biomeds,” Alkire said. Alkire shared more about Pronk Technologies in a Q&A session with TechNation.

Q

What are some advantages Pronk has over the competition?

ALKIRE: One of our core values is consistently partnering with our customers throughout the product concept phase, the R&D process and field test evaluations of our products before going to market. Identifying what is most important to biomeds is our key to success. Creative product design and innovating the smallest test equipment that can pack a punch in terms of features and durability are the cornerstone of providing products with the best warranty in the industry. We are the only company that designs

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DECEMBER 2018

products durable enough to withstand drop testing from 3 feet onto a hard surface 50 times.

Q

What are Pronk’s core competencies?

ALKIRE: We differentiate ourselves in a number of areas. First, we focus on product areas where engineering innovation can revolutionize the biomed work experience. Pronk focuses on providing exactly what biomeds want in a small, ruggedized package. Second, we keep our products affordable so that any biomed, whether part of a large organization or running his/her own business, can have their own set of equipment. Third, we are committed to high-quality production that results in an extremely low rate of repairs and a high rate of repeat customers.

introduced DataSnap 2.0 for FlowTrax. DataSnap enables a user to capture infusion pump testing data to trend performance over any period of time. No renewals or license fees.

Q

What is on the horizon for Pronk?

ALKIRE: With the volume of medical devices a biomedical engineer has to support, making it easier to capture test results and store them in their CMMS, is more important than ever. Safe-T Sim Electrical Safety Analyzer functions via Bluetooth with our App on a smartphone, tablet or PC to automatically generate test reports, eliminating the need to manually track units tested or the test results. The test report can then be easily transferred to the CMMS software.

Q

Q

ALKIRE: The new Safe-T Sim™ Electrical Safety Analyzer with one-touch automated safety testing improves the efficiency of safety testing and provides the ability to tailor the testing to match testing protocols. Our second generation FT-2 FlowTrax ® Infusion Pump Analyzer really speeds up the testing by having an industry-best measurement resolution of 0.8ul. This provides faster, more accurate measurements. We also offer software products without the hassles of a customer needing to purchase an annual license contract. For instance, we recently

ALKIRE: Jim Loeffler manages the biomedical engineering responsibilities at International Aid, a great organization that provides health products and medical equipment used by hundreds of ministries and humanitarian organizations working in over 60 countries. On a Friday, he received an emergency call that a mission hospital in Kenya was experiencing inconsistent NIBP readings that neither the manufacturer nor an onsite biomed were able to diagnose. The issue had been impacting patient care for over six months, and

What are you most excited about right now?

Can you share a time that Pronk “saved the day” for a customer?

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

“ I needed your SimCube…to run the tests with accurate repeatability in front of the medical staff which allowed me to build their confidence in the monitors.” Jim Loeffler, International Aid Jim needed to travel to the hospital. He contacted Pronk as he did not have the test equipment on hand. We expedited him a loaner SimCube Simulator and on Monday, after more than 24 hours of travel, Jim identified the root cause was a simple cuff-related problem. Jim said, “I am reporting that my trip was a success. The hospital is now using their new monitors and getting reliable and repeatable results. And you were a big part of it. I needed your SimCube to not only diagnose the problem, but [also] the ability to run the tests with accurate repeatability in front of the medical staff which allowed me to build their confidence in the monitors. You helped turn a huge fiasco into something positive. Proper test equipment is essential to ensure the best patient care in any setting, whether in a little community hospital in rural America, or a mission hospital

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

Top left, Jim Loeffler providing service in Kenya. Top right, Pronk’s new automated safety analyzer. Above, Pronk production team in Sun Valley, CA.

on the other side of the globe. And Pronk Technologies is my go-to in any situation.” It is being able to support biomedical engineers that really encourages us to strive to produce the best tools possible.

Q

Can you describe your company’s facility?

ALKIRE: We take a lot of pride in being able to manufacture our products here in California as its key to ensure the highest level of quality. Our manufacturing team is a diverse group of talent including an engineering group that focuses on improving and automating our test processes to maximize efficiency. We take an all-hands-on-deck approach to quality, where every member is empowered to raise any issues to improve the quality of the products and services we provide.

Q

How does Pronk design and introduce a new product to the market?

ALKIRE: Our design team includes individuals from all departments, as well as customers we partner with and the process is quite extensive. For example, when developing the new Safe-T Sim, we spent 18 months working with a limited release to key accounts that put the product through trials in the field, using the device every day. With their feedback, we made a number of improvements to the design. In parallel, we performed durability and drop testing to be sure the product would hold up to the demands of the field. Every product must pass all these steps before we will begin marketing it. FOR MORE INFORMATION visit www.pronktech.com DECEMBER 2018

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SPOTLIGHT

MD EXPO REIGNS IN SEATTLE BY JOHN WALLACE

“T

he first day was explosive. I ran out of material to give out. This is a great conference,” Maull Biomedical President and CEO Steve Maull said about the MD Expo held in Seattle.

MD Expo – the growing must-attend conference for HTM professionals – continues to attract the top businesses, educators and biomeds from throughout the United States. MD Expo Seattle also drew internationally with individuals from Europe, Asia and Canada in attendance. It was the first visit to the Pacific Northwest for MD Expo, which is directed by MD Publishing and linked with the company’s TechNation magazine, and it most likely will not be the last. Support from the Washington State Biomedical Association and the Oregon Biomedical Association provided a strong base as more than 700 people stopped by the event’s registration desk to pick up credentials. HealthMed 360 President Robert Dakessian said he was impressed with the conference. He attended previous MD Expo events with a different company but had a new perspective this year. “MD Expo is a place where you can, in real time, get to know the landscape of the industry with the latest and greatest offerings from vendors within the industry,” Dakessian said. He said the Welcome Reception,

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1

“ MD Expo is a place where you can, in real time, get to know the landscape of the industry with the latest and greatest offerings from vendors within the industry.” Robert Dakessian, HealthMed 360 President sponsored by Select Biomedical and MedWrench, presented a great opportunity to connect with acquaintances after five years away from the HTM world. The Happy Hour, sponsored by AIV, on the second day of the conference was another great opportunity to re-establish connections with colleagues and add new experts to one’s list of contacts. The top-flight education was a

highlight for many attendees with sessions covering a wide range of pertinent topics, including ultrasound, reporting techniques, cybersecurity, leadership, management and more. Kelly Proctor, from DNV-GL Healthcare, added to the educational opportunities with his keynote address, “Understanding the Physical Environment Standards.” The keynote was made possible thanks to a sponsorship from Sodexo.

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SPOTLIGHT

2

3

4

5

1. The addition of the exhibit hall raffle allowed attendees the opportunity to win great prizes. 2. The MD Expo Welcome Reception, sponsored by Select Biomedical and MedWrench, provided a great opportunity for networking among HTM peers. 3. Maull Biomedical President and CEO Steve Maull talks with an attendee in the MD Expo exhibit hall. 4. Gerald Zion presents a class on test instrument calibration at the MD Expo in Seattle, Washington. 5. The MD Expo Finale Party at Tavern Hall, sponsored by Summit Imaging, capped off another successful conference.

The action in the exhibit hall continued on day two of MD Expo with more valuable interactions and a second consecutive day of raffle prize drawings, including one sponsored by Asimily. RPI President Ira Lapides, a frequent exhibitor at MD Expo, gave the Seattle conference a positive review. “The first day was awesome. We had great traffic Saturday and meaningful conversations with customers and potential clients,” Lapides said shortly before the exhibit hall opened on day two of the conference. “It was as good as we’ve ever had. We like the exhibit hall, the

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

hotel, the location and the MD Expo staff has been excellent also.” Several other companies exhibiting at MD Expo Seattle also reported excellent quality and quantity when asked about exhibit hall traffic. “The conference has been awesome,” Edna Johnson from Fluke Biomedical said. “Traffic has been great. We had some really good leads with some decision makers.” “We have had a lot of good leads, a lot of serious prospects,” Vivek Sundaram from Glassbeam said. “We should continue to [exhibit] every year. There are definitely good quality attendees with decision makers and directors.”

The MD Expo Finale Party at Tavern Hall, sponsored by Summit Imaging, capped off another successful conference with delicious food and an open bar. Attendees and exhibitors networked and shared their thoughts on hot topics and the future of HTM. MD Publishing will continue to offer conferences for HTM professionals in 2019 with the annual ICE conference slated for February 17-19 in Clearwater, Florida. The spring version of MD Expo will be held April 10-13 in Houston, Texas. Perioperative professionals are invited to attend the OR Today Live Surgical Conference in Las Vegas on August 18-20.

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Matthew Jones

Finding the Problem, Before it’s a Problem BY K. RICHARD DOUGLAS

T

here may be a few forks in the career road that leads to the biomed department, and after arriving, there might still be an additional one. That was the experience for one clinical engineer in Utah who started out in Alabama in an entirely different field.

Matthew “Mat” Jones, a CE system cybersecurity analyst in the clinical engineering department for Intermountain Healthcare in Midvale, Utah, has just such a story. “I worked nearly a decade in northeast Alabama in the automotive manufacturing industry. I started from ground level, on the assembly line, building the same parts over and over. Eventually, I was given the opportunity to learn other roles in the Final Assembly Department, which led to a position in Quality Assurance. Although, I was in an entry-level position in Quality, I was able to learn the importance of compliance, standardization and documentation control,” Jones remembers. He says that at the time, he had finished his Green Belt in Six Sigma and was able to assist the company in achieving ISO 9001 standardization.

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“I eventually gravitated to an automation engineering position, where I maintained welding robots and an automated powder-coat paint line. I was given a second opportunity to work with Quality when the company needed to gain ISO/TS 16949 technical specification, in order to bid on new contracts. I found a great interest in the continuous improvement methodology and, I knew I wanted to work in a fast-paced technology field,” Jones says. After reading an article about surgical robots, he learned that health care technologists were in low supply. “I decided to change professions [and] I moved to Salt Lake City, where I had seen an increase in biomedical research. I started at a homecare repair depot, cleaning equipment and, at night, I went to community college taking a year of human anatomy and physiology,” Jones says. At the homecare repair depot, Jones worked as an equipment processing tech, performed oxygen trans fill and assisted in a wheelchair shop. “It wasn’t until I joined the team at Intermountain Medical Center, that I was able to dig in deeper. As a clinical engineer, I have had opportunities to work in a wide variety of clinical

departments and serve as technical lead on multiple large projects,” he says. On the training front, after Jones accepted the position with Intermountain, he finished his training in Six Sigma as a Black Belt and certifications in Lean Healthcare. “Once I knew I wanted to continue to improve healthcare technology, I started a degree in health care administration,” he says. “I have received multiple certifications in radiation security and safety, along with several vendor-specific training programs.” One of those projects was the installation and upgrading of Intermountain Healthcare’s electronic medical records (EMR) to the design telemetry control room. “My experience with many of the clinical systems and interfacing of medical devices to the EMR, is why I have such a passion for medical device cybersecurity. I found my career in clinical engineering very rewarding because I knew I was supporting those that could save lives. And now as a clinical engineering cybersecurity specialist, I am [able] to support those same professionals before they know there is a problem,” Jones says.

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BY K. RICHARD DOUGLAS

SPOTLIGHT

FAVORITE BOOK: “All Over but the Shoutin’” by Rick Bragg and almost all of John Grisham’s novels.

PROJECTS, HOBBIES AND FAMILY Jones has been able to tackle some projects with other team members and engage in some interesting hobbies while away from work. “When Intermountain Medical Center needed to upgrade the physiological/ telemetry system, it was like changing the tires without stopping the car. By strategically replacing certain departments first, we were able to run two systems at the same time. The legacy system was running in pseudo-ring topology, while the new system was being installed on star topology. This reduced the overall downtime, and patient safety concerns. When working at a large trauma center, many projects require several million dollars to implement; I found that focusing on saving money where you can, will add up quickly,” Jones says. He says that one of his favorite projects was designing a tele control room. All of the PCs were remoted in a data closet with each workstation consisting of four PCs and each tele tech monitoring up to 48 patients. “I enjoy all types of crafts, from woodworking to machine shop. I try to find ways to use techniques from one craft that can be used with another,” Jones says. “And this is how I found one of my passions, aquaponics, which is the combination of aquaculture and hydroponics. I started keeping an aquarium for ornamental purposes, where the science involved in maintaining an enclosed ecosystem, is what I find enjoyable. So, it was natural for me to find an extended ecosystem of aquaponics which combines raising marine life for food (aquaculture), and growing vegetables in water (hydroponics) in a closed loop system, really exciting,” Jones adds. Born and raised in northeast Alabama, the youngest of four, Jones currently lives in Salt Lake City, Utah with his wife of eight years.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

FAVORITE MOVIE: Anything from the Disney’s Marvel Cinematic Universe, especially the three Avengers team-ups. FAVORITE FOOD: Momma’s jambalaya and Southern cornbread. HIDDEN TALENT: “I’m really good at putting together LEGO kits. Most of the boxes say five to six years, but I can generally finish them in couple of hours.” FAVORITE PART OF BEING A BIOMED/CE SYSTEM CYBERSECURITY ANALYST? “When I was biomed tech and maintained medical devices, I found the work very rewarding, knowing that we are supporting those that have the training to save lives. Now that I working as a clinical engineer cybersecurity specialist, I have the opportunity to collaborate with others in the field to build standards to prevent problems related to cybersecurity before anyone is aware of the threat.” WHAT’S ON MY BENCH? • Chewing gum • Headphones • Notepad • White board

DECEMBER 2018

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SPOTLIGHT

BIOMED ADVENTURES Jumping with the Best of Them BY K. RICHARD DOUGLAS

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any people would look at you sideways if you suggested that they dive out of an airplane at 13,000 feet. That might just happen to encroach on a few phobias. What might be worse is jumping out of that aircraft and then taking the time to think about how to safely and accurately coordinate your jump with several other people. You’re not just thinking about deploying your parachute but actually considering other critical steps before that.

Since 1959, a group of expert skydivers with the U.S. Army have done just that; they have jumped out of aircraft and achieved incredible coordinated demonstrations of artistry around the world. They are known as the Golden Knights, a Department of Defense aerial demonstration team made up of approximately 89 men and women. Staff Sergeant (SSG) David Echeverry, BMET is the Non-Commissioned Officer In Charge (NCOIC)/shop foreman at Munson Army Health Center in Fort Leavenworth, Kansas. Echeverry can speak with some level of confidence about what it is like to be a Golden Knight. He was jumping out of planes before ever jumping into malfunctioning medical equipment diagnosis. “I joined the Army National Guard in December 2002 during my junior year of high school because it was the only branch of service with the option for me to go to the infantry and I could start training with my unit while still in high school,” Echeverry says. “I completed basic training during my summer vacation between my junior and senior year; once I graduated from high school, I attended the Infantry Advanced Individual Training (AIT) at the same location as my basic training; Fort 24

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Staff Sergeant (SSG) David Echeverry, BMET is the Non-Commissioned Officer In Charge (NCOIC)/shop foreman at Munson Army Health Center

Benning, Georgia,” he adds. Echeverry says that he saw the Golden Knights for the first time during the Fort Lauderdale Air and Sea Show when he was a freshman in high school. “I looked back at my parents and said ‘that’s what I want to be when I grow up, that’s going to be me,’ and my parents looked back at me and said that I could do anything I set my mind to; I just had to work hard at it and never let anyone tell me I couldn’t do it,” Echeverry says. He spent eight years in the infantry, during which time, he was deployed for one year to Afghanistan, before making it onto the Golden Knights. “I attended the Golden Knights Assessment and Selection (GKAS) in 2008 and a few weeks into it I tore my meniscus and could not keep up with the pace and jumps. I was invited to come back again and had the opportunity to attend in 2010 where I was one of the eight graduating candidates and was ‘Knighted.’ The Golden Knights Assessment and Selection is held annually; it is eight-10 weeks long with no defined end date,” Echeverry says.

He says that you must have a clean military and civilian record, military and civilian references, good evaluation reports, and a minimum of 100 freefall jumps – just to name a few of the requirements – to be considered for attending GKAS. “The training is fast paced, and mentally and physically exhausting with a strong emphasis on how you react under extreme pressure and stress. As members of a demonstration team, you travel 180-220 days a year and ‘live in a glass house’ where you can be constantly in the spotlight and you must have the ability to conform to various situations and represent the U.S. Army and yourself in a good way,” Echeverry says. Echeverry says that you can teach a monkey how to fly a parachute and just about land on target, but you can’t teach it how to be a good person, and that’s what the team looks for in its candidates; the right person for the job is not always the best skydiver. He says that they can build upon their skills once on the team. THE KNIGHTED LIFE The experience of being a Golden Knight is unique and structured. “The Golden Knights is unlike any other organization I have been a part of; it is essentially a large family with a great sense of pride and a love for everything they do. The team consists of about 89 men and women from all walks of life who serve on one of the five sections of the team: demonstration team, competition team, tandem team, aviation section and administrative support section,” he says. Echeverry says that of the total team of men and women that make up the Golden Knights, about half of them make up the jumpers to each of the sections with many of the administrative support section being former jumpers now serving in a different capacity. WWW.1TECHNATION.COM


SPOTLIGHT

BY K. RICHARD DOUGLAS

“As a demonstrator, we did a lot of traveling, however the team does its best to ensure that when we are home, we spend sufficient time with our families and loved ones; many sacrifices and compromises have to be made, but at the end of the day we did our best to ensure our family’s needs were being fulfilled,” he says. “At the beginning of a jump day, or prior to any show jump, each team has a huddle and reads off the team’s jumping ‘safety brief,’ and usually a ‘dirt dive’ (dry run on the ground of what is expected to be performed in the air) is conducted prior to each jump. Upon taking off, each demo team has its own chants/cheers that everyone takes part of and yells out when the planes wheels leave the ground. If there are press riders on the plane, the team ensures there is always someone sitting next to them and engaged in conversation or answering any questions they may have,” Echeverry adds. He says that prior to jumping, most jumpers have individual personalized handshakes with each other (kind of like a secret handshake), and a handshake is something that is developed between two teammates that relates to an event that took place between them (such as an inside joke) and converted into a handshake. “Most jumpers are extremely superstitious and stick to their specific routines. For example I always sat on the left side of the aircraft and my buddy always sat next to me to my left; it seemed every time I sat on the other side of the plane, something would go wrong such as landing in the wrong place or having a hard landing and twisting an ankle,” Echeverry says. “Every jump is unique in its own way, so even after over 1,800 jumps, I would still get nervous on some jumps,” he adds. Echeverry is the recipient of the prestigious Soldier’s Medal. A dangerous emergency during a jump, that could have killed him and a colleague, was averted through quick thinking on the part of both soldiers in 2013. He graduated from the Army’s BMET school as the Honor Graduate of his class. “[I] was fortunate enough to be afforded the opportunity to take some of ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

the advanced courses at the schoolhouse immediately after. The advanced courses I took were: CT, computer-based medical systems (CBMS), and the BMET management course,” he says. “I took up my position and started working at the end of July and hit the ground running. So far it has been great and along with my supervisor and mentor, we feel we have knocked out many things on the management agenda in a short period of time in order for our shop to run more effectively and efficiently, providing the clinic with better and faster service,” Echeverry adds. What advice does he offer to anyone contemplating taking their first parachute jump? “Do it,” he says emphatically. “Statistically speaking, it is safer than driving a car and most of the injuries suffered in the sport are usually by experienced jumpers who jump much smaller parachutes. Google search ‘skydiving near me’ and you may be

pleasantly surprised to find a dropzone near you. Doing a tandem jump you will be safely secured to a tandem master who also does not want to get hurt or injured, therefore you should be in great hands,” Echeverry says. He says that the best way he can describe the feeling of skydiving is a feeling of absolute freedom that you cannot experience elsewhere, and that feeling alone offsets any possible downsides to the sport that you may be thinking of. “As a skydiver, I would venture to say that about half, if not more, of the skydivers I know or have met have some form of a fear of heights. Jumping from 10,00012,500 feet, you do not have the depth perception, and that helps taking that first step out of the plane easier,” he says. If you happen to be in a biomed shop in Fort Leavenworth, Kansas, and you overhear someone claim to have been on an elite parachuting demonstration team, don’t feel like you’re falling for a story; it’s legit. DECEMBER 2018

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INDUSTRY UPDATES

STAFF REPORTS

NEWS & NOTES

Updates from the HTM Industry GLASSBEAM AND MONNIT INK PARTNERSHIP AGREEMENT Glassbeam, 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. “Maintaining the uptime of expensive health care equipment is of paramount importance to health care providers; patient care and safety are prioritized, and providers avoid financial setbacks,” said Brad Walters, CEO of Monnit. “Using Monnit sensors to provide environmental telemetry data for Glassbeam’s continuously increasing data set will dramatically improve providers’ ability to implement predictive maintenance and increase equipment performance.” Previously, CLEAN Blueprint was primarily focused on collecting, assimilating and analyzing machine logs from complex equipment such as MRI and CTs. The new capability will monitor external environmental factors that can impact proper functioning of medical imaging assets. 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 incredible value by alerting staff on

impending failures within operating imaging machines. This addition will translate into higher machine uptime, lower maintenance costs and overall superior patient care. “External factors surrounding machine maintenance are often overlooked,” said Puneet Pandit, CEO and founder of Glassbeam. “Knowing critical environmental factors such as humidity, room temperature and equipment water flow can impact the performance of medical equipment and when addressed, can help prevent machine failure. By integrating environmental telemetry data with machine logs, Glassbeam has moved one step closer to its vision of providing a 360-degree view on medical imaging machines’ performance and uptime. This is especially important for providers who have facilities with unreliable infrastructure or mobile units in remote locations.” • For more information, visit www.glassbeam.com.

MULTIMEDICAL SYSTEMS EXPANDS INTO WASHINGTON MultiMedical Systems LLC. (MMS), a subsidiary of the Innovation Institute, will begin providing biomedical repair and periodic maintenance services in the state of Washington, beginning January 1, 2019. “MultiMedical Systems was established in 1996 with the goal of providing the most comprehensive medical equipment maintenance services in the industry. Over the years, MMS has come to recognize the importance of customer service, and we at MMS pride ourselves in providing the best in the industry,” according to a press release from MMS. “We are very excited about our growth and ability to provide additional services to the communities in the 28

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Washington area.” Mike McRoberts, senior vice president, business development stated on the Washington expansion. MMS will be providing the following solutions: • Medical Device – Repair and Maintenance • Medical Device – Depot Repair (ship moveable device) • Endoscope Repair • Infusion Pump – Annual Periodic Maintenance Solution • On-Demand Biomedical Staffing Support – Short and Long Term • For more information, visit multimedicalsystems.com

WWW.1TECHNATION.COM


INDUSTRY UPDATES

ACCRUENT LAUNCHES CMMS INTEGRATION WITH GE HEALTHCARE PORTAL Accruent offers the first computerized maintenance management system (CMMS) to offer integrated ordering with GE Healthcare’s Service Shop portal. This portal enables healthcare technology management (HTM) professionals to search, access and order parts, accessories and supplies for many of GE Healthcare’s devices. Accruent’s HTM solution now further increases the operational efficiency of hospitals and clinics through an integrated workflow and interface. This purchasing integration provides instant access to more than 80,000 of GE Healthcare’s parts and accessories, real-time pricing, up-todate inventory information and documentation resources. “Automating the procurement workflow process within the HTM CMMS reduces errors and saves time for our customers, so they can focus on providing the best care for their patients,” said Rob Reilly, vice president & GM, U.S. and Canada Service, GE Healthcare. Accruent offers CMMS-generated work orders to maintain or repair GE Healthcare equipment, and the CMMS gives HTM pros direct access to GE Healthcare’s Service Shop to

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

request replacement parts immediately. Then, managers and supervisors are prompted automatically to review and grant purchasing approvals within the CMMS, and buyers can complete the purchasing workflow connected to their ERP – all within a single integrated system. “Accruent’s mission is to improve every experience when a customer interacts with their physical resources, and with our GE Healthcare integration we are removing the complexity of ordering parts to deliver a quick and easy experience within a B2B environment that customers have come to expect in consumer purchases,” Accruent CEO John Borgerding said. “Every minute that our customers spend managing all these collective steps is lost productivity that can be refocused on supporting their organization’s mission.” With this integrated ordering process, procuring GE Healthcare parts and accessories to maintain and repair health care equipment is done with a single sign-on using streamlined order workflows and a unified process. Accruent’s CMMS integration with GE Healthcare’s Service Shop portal is available immediately. •

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INDUSTRY UPDATES

STAFF REPORTS

BAYLOR SCOTT & WHITE HEALTH, MEMORIAL HERMANN HEALTH SYSTEM PLAN COMBINED HEALTH SYSTEM The boards of Baylor Scott & White Health and Memorial Hermann Health System have signed a letter of intent to merge into a combined system to further strengthen communities, advance the health of Texans and transform the delivery of health care. This proposed combined health system is positioned to become a national model for integrated, consumer-centric, cost-effective care, according to a press release. “This is about two mission-driven organizations – both committed to making safe, high-quality health care more convenient and affordable – building something transformative together,” said Jim Hinton, CEO, Baylor Scott & White Health. “We must lead the change in our industry, while insisting we continue to fulfill our unwavering commitments to meeting the needs of all Texans.” The health systems serve more than 30 Texas counties, employing more than 73,000 across the state. Both have strong ties to the academic medical community, and together will be positioned to expand those affiliations to advance medical training and research programs, while continuing to attract and retain the very best talent. “Together, we believe we will be able to accelerate our commitments to make care more consumer centric; grow our capabilities to manage the health of populations; and bend the unsustainable health care cost curve in the state,” said Chuck Stokes, president and CEO, Memorial Hermann. “Through this combined system, we have a unique opportunity to reinvent healthcare and make a profound difference in the lives of millions of Texans.” A unified board will be comprised of an equal number of appointees from both organizations. Ross McKnight, the current chair of the Baylor Scott & White Holdings Board of Trustees, will serve as the first chair of the proposed combined system’s board. A vice chair, selected by the Memorial Hermann Health System Board of Directors, will be named prior to closing and will become chair at the end of McKnight’s two-year term. Jim Hinton, CEO of Baylor Scott & White Health, will be the CEO of the proposed combined system and will be joined in the proposed office of the CEO by Chuck Stokes, president and CEO of Memorial Hermann and Pete McCanna, president of Baylor Scott & White Health. Other members of the executive leadership team will be comprised of leaders from both Baylor Scott & White Health and Memorial Hermann. The proposed combined system will have executive and support staff based in Austin, Dallas, Houston and Temple. The proposed combined system will have a new name to be determined before closing; however, Baylor Scott & White Health and Memorial Hermann will continue to operate under their strong, highly regarded brands in their respective service areas. Together, the two systems include 68 hospital campuses, more than 1,100 care delivery sites, nearly 14,000 employed, independent and academic physicians and two health plans; and they currently record nearly 10 million patient encounters annually. •

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ZINGBOX, FIRST HEALTH ADVISORY SOLUTIONS DEVELOP PARTNERSHIP Zingbox and First Health Advisory Solutions (First) have announced a strategic partnership to provide a comprehensive security and operations solution for connected health care assets. The unified approach, managing the ever-increasing reliance on the Internet of Medical Things (IoMT), will relieve health care delivery organizations of operational and technical challenges to identifying, securing and maintaining all types of connected assets. The combined offering, IoMT Guardian, will leverage Zingbox’s health care analytics platform for real-time protection of hospitals and their environment by inventorying all connected medical devices, onboarding new devices, securing against ransomware/malware, and optimizing device utilization. In concert with the Zingbox platform, First’s IoMT services provide customers with a holistic, managed solution that will address asset governance, legacy device security strategies and lifecycle management, as well as rapid response to threats. “The health care industry faces a growing challenge in securing their connected medical devices. From accurate inventory and real-time security protection to gaining operational insights, they face a daunting task,” said Xu Zou, CEO and co-founder of Zingbox. “We are excited to partner with First Health Advisory Solutions to bring together the most widely deployed healthcare IoT analytics platform and industryproven services for assessment, policy enforcement and other managed services.” “IoMT Guardian will foster collaboration and clarity device ownership in previously ambiguous areas of responsibility. Our comprehensive solution with Zingbox addresses both the technical and operational blind spots many organizations are facing today with connected assets, including policy navigation, patching strategy, network design and clinical engineering involvement. We are proud to be a partner of Zingbox, as our successful co-engagements have shown immediate value in managing risk,” said Carter Groome, co-founder and CEO of First. •

WWW.1TECHNATION.COM


INDUSTRY UPDATES

We ONLY use OEM Parts!

ECHONOUS SHOWCASED AI STATION AT MD EXPO EchoNous, a developer of intelligent medical tools, is applying the emerging field of artificial intelligence (AI) with the extreme miniaturization of ultrasound to solve common everyday problems in health care. During the MD Expo 2018, October 5-7 in Seattle, EchoNous provided biomedical engineers and managers hands-on demonstrations of the EchoNous Vein – a new, ultrasound-based tool designed to improve first-time peripheral IV (PIV) placement, and Uscan – the industry’s first AI-driven bladder tool. These intelligent medical tools are part of EchoNous’ nursing platform, the recently released AI Station – an innovative docking system designed for the modern hospital. “Throughout our design process we’ve collaborated with biomed managers to understand and innovate towards their everyday needs,” said Kevin Goodwin, CEO of EchoNous. “By creating a platform for our current and future intelligent tools, we hope to help biomed departments reduce their hard costs by addressing the overflow of medical devices at the bedside, while eliminating the need for preventative maintenance.” The AI Station was created by reimagining every component of the nursing dock based on first-hand direct input from biomedical engineers and clinicians. Key design elements include probe cords docked in an “inner channel” to prevent snagging and tripping, and feature materials such as chemically resistant anodized aluminum and Tritan plastic to optimize durability and cleanability while maintaining a low weight for ease of maneuvering. Biomeds at MD Expo also saw demonstrations of the EchoNous Vein, which was designed to provide an immediate and clear image of veins using just two-button controls. As part of the company’s commitment to device uptime, the tool comes with EchoNous’ standard 5-year product warranty and customer service, providing one of the industry’s lowest cost of ownership. •

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

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.

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INDUSTRY UPDATES

STAFF REPORT

DAVID P. HARRINGTON 1941-2018 HTM Professional Set Strong Example

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ongtime HTM professional and advocate David P. Harrington died on September 27, 2018 at the age of 77. His peers remember him as a man who loved to teach and help others.

Harrington worked in medical engineering at New England Medical Center for many years, taught biomedical engineering at the Franklin Institute for two decades as well as at Wentworth, MIT, Tufts and Boston University, according to an obituary published in the Milford Daily News. “He was also very involved in the biomedical community, locally, nationally and internationally, had published over 100 articles and had worked with Mother Teresa while in India,” according to the newspaper. He is remembered by his colleagues and peers as a dedicated professional who shared his knowledge via his writings and years as an instructor. “Dave was a dedicated member of the HTM community, sharing his vast experience and wit in everything that he touched, including the articles I remember reading in the ACCE News! He will be greatly missed,” Huntington Hospital Director of Clinical Technology Izabella Gieras, MS, MBA, CCE, FACCE, said. “I met Dave in 1991 when we were both on the faculty of the first ACCE/

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

WHO/PAHO Advanced Clinical Engineering Workshop in Boston for about 50 clinical engineers from all over the world,” recalls Frank Painter, Healthcare Technology Consultant and University of Connecticut professor. “Dave loved to teach and had been all over the world teaching about medical equipment technology, maintenance and management. He spent quite a bit of time working with a medical equipment refurbishing company who sent containers of refurbished medical equipment to hospitals in countries with few resources. On one of the trips Dave got to work with Mother Teresa at the hospital she established in India.”

active in ACCE, being a regular contributor to the ACCE News for longer than any other member. It seemed that Dave rarely missed a meeting of the New England Society of Clinical Engineering, even as recently as the NESCE 2018 spring meeting Dave came to encourage and speak with as many members as he could. Dave was active and visible in the profession his whole life. This is the thing that impressed me the most about Dave Harrington.” In short, Dave Harrington was the real deal. “Dr. Harrington was a real role model. He was an active participant, a prolific writer, a dedicated educator, a

“ Dave was a dedicated member of the HTM community, sharing his vast experience and wit in everything that he touched.” Izabella Gieras Painter, who is also a past-president of the American College of Clinical Engineering (ACCE), said Harrington found many ways to give back to his profession. “Dave was active on so many levels in the clinical engineering profession. He was an outstanding director of clinical engineering at Tufts Medical Center in the Boston area. He was

true professional and a very nice person who gave of himself to the end. There are few who worked for others as much as Dave did,” Painter added. “He will be missed.” The family asks that, in lieu of flowers, donations be made in his memory to the Medway Fire & EMS Association, 44 Milford Street, Medway, MA 02053.

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INDUSTRY UPDATES

STAFF REPORT

RIBBON CUTTING Diversified Medical Innovation Group

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ecognizing the broad array of technology solutions Diversified was providing to hospitals including audio-visual integration, collaboration, digital signage, electronic security, IT infrastructure and experiential walls, coupled with the need for vendor-neutral, vintage-agnostic OR, hybrid and interventional procedure suite integration solutions, its executive leadership team created a division that focused exclusively on the medical market. As a result, Diversified secured a team of medical subject matter experts and formed the Medical Innovation Group.

With a 25-year history of providing cutting-edge solutions and exceptional service, Diversified has emerged as a leading global technology solutions partner. Its reputation and strategic growth has enabled Diversified to align with some of the most innovative companies in the medical marketplace and, through acquisition, enrich its offerings, capabilities and expertise to clients and, ultimately, to the patients in their care. Q: WHAT IS THE MISSION OF DIVERSIFIED’S MEDICAL INNOVATION GROUP? A: Our mission is to leverage our medical team’s expert knowledge of the market with Diversified’s access to best-of-breed technology and core competencies in technology integration. We also strive to create and deliver 34

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Steve Plaugher Senior Vice President, Medical Innovation Group solutions that provide health care professionals and institutions with clinical integration solutions and workflow optimization tools that complement their existing assets and infrastructure, while providing interoperability with new and emerging technologies. Q: CAN YOU TELL US A LITTLE ABOUT THE SERVICES DIVERSIFIED’S MEDICAL INNOVATION GROUP OFFERS? A: We provide vendor-neutral, vintageagnostic integration solutions for operating rooms, hybrid and interventional procedure suites and workflow optimization, situational awareness and collaboration tools for the perioperative, imaging departments and supporting departments. Q: HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Our experience tells us not one

DIVERSIFIED MEDICAL INNOVATION GROUP Website: diversifiedus.com/medicalinnovation-group Contact: Steve Plaugher, Senior Vice President Phone: 972-409-0900 Email: splaugher@diversifiedus.com

medical device company makes the best product for every application; and it is widely accepted that integrating operating rooms helps to improve safety and efficiency. These truths, coupled with an understanding that we, as a medical device supplier must be an active and ongoing contributor to helping hospitals control capital and operating costs are the genesis for our vendor-neutral, vintage-agnostic, IT-based procedure suite integration architecture. Our integration approach provides a venue for helping hospitals to leverage and maximize the value of their existing assets while enabling the ability to have complete flexibility when selecting and investing in new best-of-breed medical devices. To facilitate a lower total cost of ownership, we leverage an IT service model as our goal is to empower HTM professionals to be highly effective first responders by supporting them with 24/7/365 backup support. WWW.1TECHNATION.COM


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INDUSTRY UPDATES

BY AAMI

AAMI UPDATE AAMI EXPANDS GLOBAL PORTFOLIO With two new agreements, AAMI is taking a more active international role in training and education for the health technology community. In India, AAMI has a Memorandum of Understanding with the Indian Biomedical Skill Consortium to enhance the professional development of biomedical engineers and healthcare technologists through education programs and certifications. The partnership is an integral part of a major publicprivate initiative to spur the healthcare technology industry in India. The government there is funding a massive industrial park dedicated to medical equipment, devices, and products, from R&D to manufacturing to talent development, according to AAMI’s Brad Schoener, vice president of innovation. “The idea is to develop R&D capabilities linked to manufacturing facilities linked to government purchasers and regulators,” said Schoener. “They expect to attract over 250 medical device manufacturers in the next two years.” In Singapore, AAMI is collaborating with the Singapore Manufacturing Federation (SMF) to deliver educational programs, certifications, and events for the Singapore medical device industry. SMF, a nonprofit organization established in 1932, champions Singapore manufacturing. With more than 3,000 corporate members, SMF has strong links with the nation’s government. “AAMI is encouraged by the strong support of Singapore’s government, their medical device manufacturing community, and by the Singapore Manufacturing Federation,” Schoener said. “AAMI is looking forward to a strong and mutually beneficial relationship.” The Statement of Intent between the two organizations calls for “promoting increased technical and educational ties between U.S. and Singaporean companies.” The agreement also calls for promotion of several “priority sectors,” including standards for medical technology and innovative startups in the industry.

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TOP INNOVATION STRATEGIST, FUTURIST TO HEADLINE AAMI EXCHANGE Nicholas Webb, a top innovation strategist, futurist, award-winning inventor, and bestselling author, will help to kick off the new AAMI Exchange this June, serving as the opening Main Stage speaker. The Exchange is the name for AAMI’s growing and revamped Annual Conference & Expo. Webb, CEO of Lassen Innovation, works with Fortune 500 companies throughout the world to help them lead their industries in innovation, strategy, and customer experience (CX) design. In health care, Webb speaks to audiences across the entire health care ecosystem on the future of health care in the face of changes driven by the Affordable Care Act, the consumerization of patients, and the impact that disruptive innovation is having on both clinical and business models. Webb helps organizations understand and, most importantly, be relevant in the fast-moving and hyperconnected future. In his recent body of research, he discovered the four key trends that will determine the success of any enterprise, from entrepreneurial startups to Fortune 500 companies. He helps his clients and audiences understand the trajectory of change so that they can take the insights from his talk and apply it in their business to ensure their relevance in the future. Webb has been awarded more than 45 patents by the U.S. Patent and Trademark Office for breakthrough technologies, ranging from one of the world’s smallest medical implants to state-of-the-art wearable technologies. His most recent book, “What Customers Crave,” is used by top brands to design their CX and innovation strategies. To learn more about the AAMI Exchange and to register, visit www.aami.org/aamiexchange. AAMI PUBLISHES SECOND EDITION OF HTM BENCHMARKING GUIDE The second edition of the “HTM Benchmarking Guide,” authored by four long-time AAMI members, applies lessons learned from AAMI’s HTM Benchmarking Task Force. This includes a new emphasis on “the importance of appropriately allocating corporate-level HTM expenses to individual

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Physician’s Resource Network

facilities within a multiple-facility system,” according to the preface. “Systems are the new norm.” Another new focus is “the need to distinguish (a) equipment maintenance expenses from (b) engineering and project-related expenses,” according to the preface. “The latter category is where HTM is growing.”Finally, to supplement the long list of metrics from AAMI’s online Benchmarking Solution, which has been decommissioned, the authors propose refinements in the definitions of a short list of key performance benchmarks. The authors of the updated “HTM Benchmarking Guide” are Ted Cohen, clinical engineering consultant and retired manager of clinical engineering at the University of California, Davis, Medical Center; Frank Painter, adjunct professor of biomedical engineering, University of Connecticut; Matt Baretich, president and CEO of Baretich Engineering; and David Braeutigam, president of Braeutigam Enterprises LLC. This guide is available to download at no cost at www.aami.org/BenchmarkingGuide.

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INDUSTRY UPDATES

BY ECRI

ECRI UPDATE

Cyber Threats Top ECRI Institute’s 2019 Health Technology Hazards

F

or the second year in a row, cyber threats top ECRI Institute’s annual Top 10 list of health technology hazards. Last year, the organization addressed the risks from ransomware and other malware, broadly examining the challenges that health care organizations face. For this year’s list, ECRI focused more narrowly on one key area of vulnerability: systems that allow remote access to a health care organization’s network.

Each year, ECRI Institute produces its “Top 10 Health Technology Hazards” report to help hospitals direct their time and energy toward technology management activities that can have the greatest impact on patient safety. The list identifies 10 topics that warrant priority attention. The accompanying report, available to the organization’s members, details practical steps that health care organizations can implement to reduce the risks. It’s little surprise that cybersecurity remains at the top of the priority list for 2019. A successful attack can have far-reaching effects, potentially disrupting health care operations and putting patients at risk. REMOTE ACCESS: A KEY VULNERABILITY Many networked devices and systems incorporate remote access functionality. This capability allows off-site clinicians to access clinical data, for instance, and it allows vendors to troubleshoot systems installed at the facility. While intended for legitimate business needs such as these, remote access systems can instead be exploited for illegitimate purposes. Hackers target unmaintained and vulnerable remote access systems to infiltrate an organization’s network. Once they gain access, attackers can move to other connected devices or systems, installing malware, stealing data or rendering it unusable, or hijacking computing resources for malicious purposes. For instance, the SamSam hacking group has exploited remote desktop protocol (RDP) connections to gain entry into organizations’ networks for the purposes of spreading ransomware – malicious software programs that encrypt a

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system’s data, rendering it inaccessible and thereby crippling the system until a ransom is paid. Hospitals, EHR vendors and laboratory testing companies are among the many organizations that have been affected by such attacks. Published reports place the cumulative costs to affected organizations in the millions of dollars. “Remote access hacks have increasingly become the attack vector of choice,” notes Chad Waters, senior cybersecurity engineer in ECRI Institute’s Health Devices Group, “but damage can extend well beyond the point of attack.” The infamous 2013 Target hack provides a case in point: Stolen credentials from an HVAC vendor reportedly provided the entry point for the attack that ultimately exposed the payment and personal information for millions of the retailer’s customers. Failing to configure a network with proper security controls – such as the use of VLANs and network segregation, when appropriate – can leave remote access systems vulnerable to attack. Other risky practices include granting requestors a higher level of access than is required for the task to be performed, or neglecting to terminate the requestor’s access once the task is completed. CYBERSECURITY AS A PATIENT SAFETY CONCERN “In the health care environment, cybersecurity threats are not just a business consideration, they are a critical patient safety concern,” stresses Juuso Leinonen, a senior project engineer in ECRI Institute’s Health Devices Group. “A successful attack can profoundly impact an organization’s ability to provide effective patient care.” Indeed, the consequences of an attack can be widespread: Systems that administer patient care may become inoperative. Data dictating patient care may be altered or unavailable. Systems that support health care operations – such as financial, scheduling or communications systems – may be taken offline. All of these can affect an organization’s ability to deliver timely patient care, creating the potential for harm. Additionally, protected health information (PHI) or other confidential data that is stored on an affected system could be accessed by, and potentially distributed to, unauthorized parties.

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JOIN OUR TEAM ECRI INSTITUTE’S RECOMMENDATION: BE PROACTIVE ECRI Institute recommends that organizations take the following steps to strengthen their defenses against remote access attacks: Take inventory of all remote access systems deployed within your organization. Know which systems allow remote access, or that initiate remote access from the inside, and validate the business purpose for any remote connection. Implement policies to approve and govern remote access. Select a limited number of standard remote access methods that will accommodate the majority of use cases. When the needs of a specific project cannot be addressed using one of the organization’s standard remote access options, audit the security of the proposed method and clearly document the internal and external stakeholders for the project, as well the maintenance plan. Adhere to recommended cybersecurity practices. Examples include: keeping all remote access systems and all security infrastructure maintained and patched, logging all access and security events, deploying two-factor or multifactor authentication to protect against compromised passwords or brute-force attacks, isolating remotely accessible systems from the rest of the network, locking down outbound traffic on firewalls, and changing default passwords on vendor devices. ECRI Institute’s full report details these and other protective measures. “It’s vitally important that you identify, protect, and monitor all means of remote access,” advises Waters. “The bad guys are looking for your organization’s remote access vulnerabilities. You need to look for them too … and find them first.” Stay tuned for the next issue of TechNation, where more hazards from the list are uncovered. This article supplements ECRI Institute’s 2019 Top 10 Health Technology Hazards report. An Executive Brief of the report can be downloaded from ECRI Institute as a free public service. The full 2019 Top 10 Health Technology Hazards Solutions Kit, which includes detailed problem descriptions and recommendations for addressing the hazards, requires membership in ECRI Institute programs. For more information, visit www.ecri.org/2019Hazards, or contact ECRI Institute by telephone at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

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BY PHILLIP HOWELL

BIOMED 101

Common Sense Troubleshooting BY PHILLIP HOWELL

T

he Gerber cloth-cutting machine was doing some very intermittent and strange things. “It has to be the microprocessor (CPU),” I told my supervisor. He just laughed and went about troubleshooting the problem. The year was 1983 and I was studying electronics in the evenings while working as an industrial maintenance technician. I had just started studying microprocessors in class and I was, as you might expect, fascinated with the then cutting-edge technology. Little did I know, the CPU was one of the least likely causes of such a problem. As it turns out, there were several small pieces of wire floating around inside a three-inch cannon plug. That day I came to understand that faults occurring in high-tech devices most often have low-tech solutions.

That lesson has served me well in the 30-plus years that I have worked as a BMET. Most service requests have simple solutions. Experienced troubleshooters know that they can isolate the cause of many problems with a few quick observations. Does it turn on? Does the device have a power indicator? Is the indicator lit? Does the device have a battery and is the battery charged? Do the accessories look worn? In general nursing areas, these few questions will help you determine the cause of 90 percent of reported problems. It is important to know something about the user reporting the problem. If the user is someone that you deal with frequently, you should have a good feel for their level of knowledge of their equipment. Some users know the tools of their trade forward and backwards. Some people are just button pushers. They know they can expect a certain result if they select a certain button. If that does not work for them, then they ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

are lost for answers. Do not let their lack of technical savvy bother you. Hey, they are the reason that you have a job! Always begin by asking the user what they observed. Ask enough questions to make sure that you are getting a clear picture of the situation. Some answers should be taken with a grain of salt. At the very least, your questions communicate to the user that you are concerned with their problems. There are going to be times that you find yourself facing an irate user. Remember, they are your customer. Listen to their complaint and do not interrupt them. Be careful not to contradict them. Allow them to vent their concerns. Most importantly, ask the right questions. This shows that you are serious about addressing their complaints. They may complain that the device was sent down before for the same problem. In such a case, make sure that you dig a little deeper. Every biomed tech knows that a huge percent of devices that we are asked to repair just show up in the shop. They may or may not come with notes. The note may not give contact name and/or phone number. If there is a description of the problem it may be something like “it is broke”, “it don’t work”, “please fix” or any number of other less than helpful descriptions. As a skilled technician, you may take such situations as a chance to shine even though it is unlikely that anyone will notice. It is virtually impossible to know that you have fixed the problem if you do not know what the problem was to begin with. Give due diligence to identifying and correcting any problems that you may observe. Visually inspect the device. Many times, you may find several obvious problems such as cracked covers or frayed cords. Sadly, you may find and fix problems, none of which was the original problem. Always perform a thorough performance check before returning the device to service.

PHILLIP HOWELL

Most medical device repairs can be troubleshot rather easily, but that is not always the case. Some problems will leave you scratching your head. Remember that you are not expected to have all the answers but you should know where to find the answers. If you have co-workers that may have more experience with that type of device, be sure to pick their brain. As they say, two heads are better than one. There are also BMET listservers where you can draw on the experience of other technicians. You should also check the service manual. Many device manufacturers provide very detailed troubleshooting guides that can be very helpful. In addition, be sure to utilize the manufacturers’ technical support line. These professionals are often able to help you diagnose the problem quickly. However, I do not recommend calling tech support first. If you are to grow in your troubleshooting skills, then you must challenge yourself to figure it out on your own. Biomedical equipment technicians are a unique breed. The vast variety of technologies that they are expected to understand is rarely surpassed by other technical professionals. If you have entered the biomedical field, then you most likely have the basic skills needed to be a good troubleshooter. Just combine your skill with a little common sense and you will find success in your chosen profession. Philip Howell is a BMET III at Tallahassee Memorial Healthcare where he is employed by Aramark Healthcare Technologies. DECEMBER 2018

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STAFF REPORTS

SHOP TALK PHYSIO-CONTROL LIFEPAK 12

FUJIFILM FCR XG1

Q:

Q:

This thing is a dinosaur, but before we trash it has anyone seen this: We put a set of fully charged batteries in it, battery one discharges until it dies and the unit does not switch over to battery two. When we pull out one, the unit switches to battery 2. The weird thing is, if you put one back in after all this, it tries to run off one for a minute and it switches to two. Is this normal?

A:

Sounds like the power supply or the battery pcb.

A:

I have always observed that a LifePak 12 on a base charger and using the larger SLA batteries does charge one battery and use one battery at a time. I would suspect that the batteries still have much useable capacity when the discharge battery alert comes up because the battery charger base may stay on battery one.

When I put in a patient and click “Start Study” nothing happens with the reader. The light to insert cassette doesn’t light up. It acts like the computer is not communicating with the reader. If I put a cassette in and turn power off and on to reader, it cycles and then the “remove cassette light” comes on, but no image appears on display. I bought this unit used with no cable to reader. I assume it is supposed to be a CAT5 cable? Is there a way to make the software communicate with reader or to check that it is online with reader?

A:

The reader and PC need a crossover cable to talk or u can put them both on the same network.

TOSHIBA XARIO

Q:

Does this equipment have a touchscreen calibration function? This one is more than 2 cm in error. Do you have this option on the service screen “menu, maintenace, ctrl + shft + next”?

A:

Yes, there is a touchscreen calibration function in the service menu. You will need the license string for 2018 and the password to be able to get there, (I have them if you need it). Once you are in the Test Tool Diagnostic screen, you will see on the right side Panel/TCS: press on the Execute button and do the TCS tests.

A:

Here is the string and password we use for our Toshiba Aplio and Xario for this year, plus the procedure to enter them. FEBCD0A154A8FC --- EE1461 ----- expires end of 2018 -- make sure you put the number 0 and not the letter O in the string License key activation: Press MENU on panel --- select Maintenance then press CTRL + SHIFT + press right trackball button. Then, enter 14-digit license key and 6-digit password. Check the Set as Default box and click on OK.

A:

Also, check the reader configuration because sometimes it falls back to initial 172.16.1.10. Login with a laptop “telnet” directly to the reader and check/set correct IP-addresses and RU-name. (7 software utility; 1 display current config: check; 0; 2 temp setting, input new temp setting; 0; reboot).

A:

If necessary, I can send you a procedure on how to connect a laptop and use telnet. It is very easy and takes no more than 5 minutes. By the way, I always use a straight RJ45-cable CAT5 for this purpose (we live in 2018 and most PCs are autosensing), but of course feel free to try the cross-cable.

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.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

DECEMBER 2018

TECHNATION

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THE BENCH

STAFF REPORT

TOOLS OF THE TRADE MedWrench My Bench

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edWrench.com is a resource and sharing network for users of medical equipment. You can get answers, find information and read what others think about the equipment they use. It is free to join and easy to keep informed. You simply bookmark your favorite communities (equipment, categories or manufacturers) to your “My Bench” area and you are given an intelligent feed of information from other professionals as they help each other solve problems. Your “My Bench” page can help you: • Manage the equipment you’ve bookmarked and adjust how you are notified about new information. • See what other professionals in your discipline are using and discussing. • Ask questions and get answers about your equipment. You can provide answers too! • Talk to industry experts and manufacturers directly about issues that concern you. • Contribute to the community by providing accurate information about medical equipment. • Connect with other medical equipment professionals and find out how they use their equipment effectively. For more information, visit medwrench.com.

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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 was popular again 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 ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

training through attending the webinars. This is a huge advantage for new techs or those of 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 always look forward to and enjoy Webinar Wednesday, as I always learn something new.”

RTLS SESSION PROVIDES NEW INSIGHTS The webinar “Getting Real Time Operational Improvement from Real Time Location Systems” sponsored by Sonitor drew a crowd. In the 60-minute webinar, Paul Schulz, healthcare consulting manager at Eide Bailly, discussed the benefits of utilizing real time location systems (RTLS). RTLS have expanded from simple location information into workflow analysis helping to improve care processes. Becoming data driven is a call health systems are striving to achieve and RTLS are a tool many are seeking out. In his presentation, Schulz looked at how business intelligence features linked with RTLS are providing health care organizations information they did not have just a couple of years ago. The presentation was well received with an abundance of positive reviews collected via a post-webinar survey. “The webinar on RTLS was very up to date and useful. The uses of RTLS that were talked about in the webinar are possible process game changers,” said Clinical Engineer L. Velasquez. “Clear, concise information – that’s what Webinar Wednesday is all about,” shared L. Stephens, senior biomedical technician.

“Good information on RTLS. I can see how having location data on devices, patients and staff would generate useful data for optimizing processes,” Biomed F. Rosen said. “Excellent and extremely relevant, lots of valuable data and facts presented clearly and concisely,” said T. Todro, consultant.

G. Havens Manager of Biomedical Engineering

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-to-day operations of a medical center. The reviews from a post-webinar survey show the presentation was hit! “This is good information on knowing the real costs of equipment. It gives me knowledge of how our DECEMBER 2018

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AFFORD

NEXT GEN

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 information 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. WEBINAR WEDNESDAY ROCKS “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. Others agree in regards to the overall Webinar Wednesday series. “I always look forward to and enjoy Webinar Wednesday, as I always learn something new,” Manager of Biomedical Engineering G. Havens said. “The Webinar Wednesday series has been providing me with important information concerning the why, how and what is being used as health care and health care technology management is constantly moving forward. I am receiving the information about the various products on the market now as compared to what was just beginning when I found this career path that I love and it continues to get better. Things 52

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aren’t always perfect, but that is what helps in the advancement of this technology,” Biomed A. Hale said. “Great series, good information and a great way to accumulate CEUs,” said M. Mortensen, CBET. “With the wide range of topics covered by the Webinar Wednesday series, over time, you’ll find something that gives you insight into an unfamiliar or unknown aspect of the profession,” shared A. Sours, BMET. “The weekly webinars are one of the best things that have helped me throughout the year within my field. The information that is provided on these courses is fabulous,” said J. Perez, MSET. “Webinar Wednesday continues to deliver again and again,” said J. Sellers, Biomed. “Being a lead biomed and working toward being a manager, these basic webinars on how different equipment works are very helpful to understanding equipment I have not been trained on,” said M. LaPlante, lead biomed. “Webinar Wednesday is very informative, and a humongous asset to biomeds everywhere,” said T. Wood, HTM Manager.

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ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

DECEMBER 2018

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ROUNDTABLE

STAFF REPORT

ROUNDTABLE Test Equipment

Test equipment plays a critical role in the maintenance and repair of medical devices. Healthcare Technology Management professionals, a.k.a. biomeds, depend on test equipment on a daily basis. TechNation magazine reached out to manufacturers of test equipment to find out what they feel is important when it comes to the devices they make. We also asked about the latest and greatest devices and features that biomeds should look for in 2019. Participants in this roundtable discussion include: Pronk Technologies Vice President Sales and Marketing Greg Alkire, Southeastern Biomedical’s Boyd Campbell, Physicians Resource Network (PRN) Vice President Robert Gaw, BC Group International Inc. Vice President Sales and Marketing Ken O’Day and Capital Medical Resources LLC Owner Lee Ann Purtell. Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK IN A TEST EQUIPMENT MANUFACTURER? Greg Alkire

Campbell: Accuracy and reliability. You want the confidence that the test device you are using has a calibration standard of the highest quality which includes not just the longevity of the device but also the accuracy and reliability needed. Our goal is always patient safety and in order to assure we are doing all we can we need that confidence in our test devices. Gaw: Accuracy, portability and warranty/long-term upkeep. O’Day: Quality and documentation! Anyone can manufacture a device, put a label on it and sell it. How does the end user know how it was designed, manufactured and calibrated unless there is a formal quality program to back up the claims? Large OEMs would never purchase a product from a company unless they conducted their own audit or they can be reassured by

TECHNATION

Lee Ann Purtell Purtell: It’s important to work with a test equipment manufacturer who provides efficacy data on the devices they sell and support, as well as an established calibration program. Having accurate testing and measurement is essential, in not only the manufacture of equipment, but also when it comes to effective lifecycle management. It’s important to ensure that the testing devices can be used in conjunction with any Joint Commission requirements for managing equipment. Q: WHAT ARE THE BASIC TEST EQUIPMENT DEVICES EVERY HTM PROFESSIONAL NEEDS?

Alkire: Consumers want products or services from an organization that provides high quality at the best value. Just as important to customers is an organization that values them, going above and beyond to make sure they are satisfied with the product.

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documentation that the producer has a quality program in place. Most end users do not have the resources to do the investigating of each supplier, but it is easy to ask for certifications that show an outside independent certifying body has conducted the review for them. End users should ask for the manufactures various ISO certifications, accreditations and FDA inspections.

DECEMBER 2018

Alkire: Every technician should have a full complement of the basic tools and test equipment. These should range from the basic hand tools and meters to more specialized test equipment like safety analyzers, simulators, etc. Purchasing devices that are durable and easy to use will aid in their ability to work as efficiently as possible. Likewise, products that are rugged, handheld and portable serve the needs of biomeds. Campbell: This really depends on what devices a technician is servicing. I recommend a technician review their inventory list of medical devices and then determine the needs. While there are standard items such as safety analyzers there are also different options that may be needed depending on the devices being tested. Gaw: Patient monitor simulators, ESU analyzers and electrical safety check units. O’Day: This is difficult to answer. The basic list would depend on the type of facility and the duties of that particular professional. For an individual doing general HTM support, it

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ROUNDTABLE

would be helpful to have available a DMM, safety analyzer, defibrillator analyzer, ESU analyzer, multiparameter simulator, pressure meter, infusion pump analyzer and a metric and standard tool kit. This should cover most of the routine items. Now there are specialty devices that not every professional needs, but the facility will need to support those devices. This list is endless but would include test devices for imaging (CT, MRI, mammo, radiology and ultrasound), anesthesia and physical therapy. Purtell: There’s a wide-array of testing devices available to biomeds as it relates to the complex electronic equipment they test and service. However, biomed departments managing surgical and endoscopic devices often are limited in technology specifically for endoscopic equipment. In these cases, we advise the following basic endoscopic testing equipment: endoscopic light testing meter, scope image quality tester, electrosurgical continuity tester, lumen inspection device, leak testers for flexible endoscopes and a digital microscope. Q: WHAT ARE SOME OF THE NEWEST TEST EQUIPMENT PRODUCTS HTM PROFESSIONALS MAY WANT TO CONSIDER PURCHASING AND WHY? Alkire: We introduced the BMET Pack PRO, a custom carrying case that enables technicians to carry all their test equipment, including all accessories, in one portable pack. It even has enough space for their laptop or tablet. This makes it even easier to carry all Pronk products. Boyd: One of the newest devices on the market is the Fluke Biomedical VT900 and VT 650 line of gas flow analyzers for the general biomedical technician while the radiology engineers should check out the new One QA software for the Raysafe X2 Radiation Quality Assurance devices. Alkire: ESU analyzers. Most current model ESUs have higher accuracy requirements and they should have a unit that can meet their needs Ken O’Day O’Day: Medical device manufactures are constantly introducing new products that address the changing needs of the medical community. Many of the legacy test devices are no longer capable of addressing the advancements in the devices they are testing. Some testing hasn’t changed in years and a new or old test device will suffice. (DMM is a good example, a volt is a volt and an ohm is an ohm.) Electrosurgery, anesthesia and imaging are good examples of fields where old testers will no longer do an adequate job of testing these devices and they should be replaced. It is always

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

good to purchase a tester that has an upgrade path to help soften the blow of constant changes in requirements. Purtell: The McGan Technology MM513 insulation tester is an affordable device for testing the integrity of laparoscopic insulation. The unit is portable, rechargeable, and there are no additional consumables, such as disposable wands, to purchase. Small diameter, flexible MicroFlex Lumen Inspection scopes are great tools for visualizing lumens in equipment such as flexible endoscopes, shavers and instrumentation. Some manufactures recommend lumen inspection in their IFUs, and there are both fiberoptic and video models in the marketplace. Q: WHAT ARE SOME FEATURES TEST EQUIPMENT SHOULD HAVE? Alkire: Clearly, having the features to perform the task required is basic, but just as important is having a product that is durable and easy to use. Some test equipment products have lots of features but users find it complex and timeconsuming to set up and use. Biomedical engineers want to focus on the medical device to be serviced and not on complex test equipment that complicates the task at hand. So, we believe that the comprehensive features of a product in terms of ease of use, durability and warranty are vital. Campbell: This is really dependent on the usage and what the task is at hand. If you are a field technician portability is an important thing to consider, but for an in-house engineer that is working in more of a critical care environment an all-in-one solution may work best. One feature that is not considered is that of customer service. While it is not something that is built into a device you need the assurance there is someone you can reach out to as needed. This may be via telephone or it may be there is someone available to come on-site to assist you with your needs whether it be technical or for training.

Robert Gaw

Gaw: CMMS software interfaces and portability. O’Day: Budgets for the HTM field are never adequate to cover the wants, wishes and needs of the department. To get the best value for the dollar spent it is important to look for things that will save you money and time. Some features that could help address this are automation, connectivity to CMMS software, report generation, flexibility (multiparameter in one device) and quick and easy to use. Purtell: Any device that allows for portability, as well as interfacing with hospital hardware and software, is important

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ROUNDTABLE

STAFF REPORT

today. Being able to capture data, images, etc., and provide a record of testing, will further support documentation requirements by Joint Commission and are a good communication tool for staff and when communicating with repair vendors. Manufacturers and distributors should also be able to provide technical support and assist in service and calibration. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT TEST EQUIPMENT GOING INTO 2019? Alkire: This is an exciting time for medical test equipment. We are focused on advances in portability and automation of testing, including generating automated test reports and developing solutions that minimize the manual processes a biomedical engineer has to deal with. Honestly, there are a number of options in test equipment out there for a biomedical engineer to choose from, so look closely at companies that are continuing to change the paradigm in terms of developing test equipment that makes biomeds’ jobs easier and more efficient. Boyd Campbell Campbell: The test equipment market is changing rapidly with new technologies to meet the specifications you require, as new

medical devices emerge. There are also devices and software available to assist in making your job easier and more time effective. In today’s market, we are all challenged to do more with less so technicians need to stay abreast of these changes and a great way to do that is by attending trade shows where you can see all the latest technology offered. Gaw: I think it is important to emphasize the importance of properly testing and calibrating newer ESU units and to make sure you have the proper analyzer that is within manufacturer specs. O’Day: Since this field is changing so fast, it is important to look for devices that can properly test your current medical device inventory, but also have an upgrade path so you are not required to replace the entire test device when new steps, limits or features are added. Does your test equipment allow you to do software upgrades in the field and at no cost? If new features are added, can your device be sent in for an upgrade or do you throw it away and start over? Purtell: Utilizing testing equipment goes beyond simple inspection when something is wrong. Consider utilizing your test and inspection protocol for new product evaluations, routine preventive maintenance, life-cycle management, pre- and post-repair validation, staff communication, vendor communication and documentation for Joint Commission and other regulatory directives.

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THE PATHWAY TO

LEADERSHIP

reach new heights in 2019

Every year, the people with the best of intentions, make plans for the coming year and then they throw in the towel early. At least, that is what the statistics suggest in many studies. They plan to spend more time with family, or get a better job, or buy their dream car or get more sleep, and somewhere along the line, they get distracted. Sometime around new year, the local news will invariably run a story about the leading New Year’s resolutions and what percentage of people actually achieve that promise to themselves. The weight loss and

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working out resolution explains why health clubs continuously sell memberships; most people give up within six months. The irony is that achieving goals is usually in a person’s best interests. Attaining goals is the difference between the most successful people and those who just dream about better things. The fact is that many people set their eyes on a target in the new year and then lose their direction, get lost in the process or forget about the goal and move on to something else. Without a roadmap, a written set of instructions or a well-constructed plan, the

opportunity to achieve goals and accomplish projects is fruitless and frustrating. Motivational speaker Greg Reid once said; “A dream written down with a date becomes a goal, a goal broken down into steps becomes a plan, a plan backed by action makes your dreams come true.” Bringing dreams to reality requires setting goals, writing them down with concise steps and accomplishing each step. That allows you to achieve your dreams. In the same way that weight loss requires a number of systematic steps and lifestyle changes, taking on work-related projects

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“ The past several years, I cannot think of a week where we were not working on a project, let alone multiple projects.” Doug Dreps, Mercy Health requires a methodical approach. While it’s possible to dive into a project head-first and hope the stars align and things fall into place, the likelihood of success is marginalized. Projects require a plan. This holds true for the HTM department, where projects present themselves from time to time. Some of the key elements for the project manager to consider are to identify the phases of the project, identify the participants and stakeholders who can make it happen, and understand the budget process and its role in the project. As is the case with goal-setting, a project requires that a number of goals and timelines are identified. The project leader must also identify what tasks need to be completed and which team member is responsible for that task? What will the completion of each task require from a budgetary perspective and what timeline will be assigned to each task? All stakeholders must agree on the project’s scope, methodologies, expectations and deliverables. Keep good documentation of all those who buy into every phase of the project in case of future disputes. As with all goals, break up the big tasks into manageable segments. With many of the changes implemented in hospitals in recent years, and increased use of sophisticated technology, the need for managing projects has become greater than ever before. “The past several years, I cannot think of a week where we were not working on a project, let alone multiple projects,” says Doug Dreps, MBA, director of eastern regional operations, healthcare technology management for Mercy Health. “Integration of vitals into electronic medical records and images into PACs is ever increasing and makes up for 30 percent of my team’s time. Any technology that is new, and we plan to put on our IT network, must go through a new technology process. Part of this process is a manufacturer

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

passing our cybersecurity,” he says. Dreps says that his team is working on over 20 new technology projects with more being added monthly. “Some of these projects, for onboarding equipment and clearance to connect to our network, can take up to six months for clearance. Dealing with Windows XP and now Windows 7 obsolescence are other projects that, in the past with non-networked devices, we were not concerned,” Dreps adds. “I know some organizations have made positions for project manager(s) to be part of the healthcare technology department. We are looking at adding some of these positions. I made myself part of the Mercy Project Team, just so I could list a project if

any other profession. One cannot gauge the success of an implementation without establishing a thorough project plan and tracking time and costs. With the growing HTM/IT dependencies, the nature of projects is becoming more complex, which in turn benefits from approaching projects in a structured manner,” says Ali Youssef, PMP CPHIMS CWNE #133, principal mobility architect in the information technology department at Henry Ford Health System in Detroit. Youssef holds the PMP certification, which is considered the gold standard for project management professionals Youssef says that the project initiation process group is perhaps the most critical. This is where the project charter is identified, and the overall idea of the project is scrutinized and is shown to be feasible and valid. “The project charter serves as the foundation for authorizing the project. In addition, the project scope is documented

“ Project management principles are as relevant in the HTM space as they are in any other profession.” Ali Youssef, Henry Ford Health System needed, so our IT co-workers could log time against it,” he says. Dreps explains that a simple but proven effective process he instituted was hanging a 3’ x 5’ white board with 15 slots to list all the projects that are ongoing. “This is an in-your-face reminder to make sure something does not fall off my radar. Often, we wait on others for information, so a project could go stagnant for a while. It has proven to me to be effective and I highly recommend it for a New Year’s resolution,” Dreps says.

Project Steps for HTM

Developing a plan to tackle and complete a project in the HTM department requires methodical planning and precise execution, just like projects anywhere else. Knowing the phases of a project provide an outline for ushering it to completion. “Project management principles are as relevant in the HTM space as they are in

during the initialization process. The planning process involves redefining objectives in more depth and ensuring that all of the appropriate stakeholders are included or at least made aware of the project,” he says. He says that planning entails creating a detailed work breakdown structure to ensure that each task is subdivided into measurable deliverables. Perhaps more importantly, planning also involves developing a schedule and a budget for the project as well as a risk plan. “Once the project planning package is completed and signed off on, project execution kicks off. Project execution involves coordinating people and resources to complete the steps outlined during the planning process. This includes building the project team and ensuring that they have the appropriate skills. Project stakeholders need to be kept abreast and up to date during the execution process,” Youssef says.

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T H E PAT H WAY TO L E A D E RS H I P reach new heights in 2019

Then, there is the process of executing the project. Youssef says that issues generally arise during project execution, and this gives rise to monitoring and controlling activities. “This group consists of processes performed to identify potential issues and implement corrective action. Scope creep often occurs in projects and being able to identify and correct it is a major part of project monitoring and control. Ultimately, the goal is to ensure that the project is on track from a timing as well as a budgeting standpoint,” he says. Youssef says that closing out a project properly ensures that administrative and contractual procedures are followed. In addition, it is paramount to receive formal project acceptance signoff and to address the ongoing maintenance needs for the project effort. “Identifying the appropriate stakeholders is crucial to the success of a project. Equally important is the notion of identifying an executive sponsor and champion. If key stakeholders are not included, this can result in unnecessary delays and potentially a halt to the project. For example, if a new patient monitoring platform is selected for use in a hospital, without input from nursing, they may not be willing to use the new technology until they are comfortable with it which could take some time,” he says. Finally, he says that the project budgeting framework can be divided into three areas; namely cost estimating, cost budgeting, and cost control. “Cost estimating involves approximating the cost of hardware, software, and resources to complete the project. Cost budgeting is a more in depth breakdown of the costs of individual activities in the project plan. Cost control includes monitoring cost performance to identify and understand variances from the baseline costs,” Youssef says.

Medical device acquisition planning

While there are some very methodical steps to take when tackling a project in the HTM department, the same logical or disciplined thinking can be brought

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to capital purchases. “Medical device acquisition planning will be one of the dominant issues of the next decade,” says Stephen L. Grimes, FACCE, FHIMSS, FAIMBE, managing partner and principal consultant at Strategic Healthcare Technology Associates LLC in Swampscott, Massachusetts. “Organizations must adopt a strategic approach. They should not

He says that the risks include compromise to technologies on which providers have become increasingly dependent and the acquisition of costly technologies that do not fully meet needs (leading to underutilized or abandoned devices). “Health care organizations must look to become more strategic in their technology acquisitions. They need to recognize that new acquisitions now

“ Health care organizations must look to become more strategic in their technology acquisitions. Stephen L. Grimes, Strategic Healthcare Technology Associates acquire and deploy significant or substantially new healthcare technologies without first giving appropriate consideration to the strategic, clinical, safety, operational, and financial implications of that acquisition,” Grimes says. He says that health care organizations have come to depend on technology as a key member of the hospital team and their ability to deliver care is severely compromised when that technology is not ready and available. “Medical devices have become increasingly ubiquitous, complex, and capable. Examples include: robotics, telemedicine/telehealth, 3D imaging and printing, micro/nano technologies, clinical decision support (CDS) systems, artificial intelligence (AI) and augmented reality (AR),” he says. Grimes says that the prevalence and sophistication of the technology requires health care organizations to focus on acquiring the most appropriate technology for the patient care services they provide and the environment in which they provide them. “Access to more capable technology comes at both a financial cost and increased risk. Costs (product of quantity and average unit cost) of deployed medical devices are growing making up a substantial portion of the increase in U.S. health care costs,” Grimes says.

go into a connected environment where the typical medical device no longer operates in isolation but more often must connect and work well with other technology systems,” Grimes says. He says that corresponding to their impact on patient care, their level of technical integration, and their need for support, the deployment of many new healthcare technologies can easily have a ripple effect on a wide range of an organization’s clinical, support, and business operations. “They must adopt processes that involves acquisition and deployment planning, integration and subsequent evaluation of the effectiveness of those processes to ensure the right decisions are being made for the right reasons,” Grimes adds. In 2019, when the opportunity to undertake a project, big or small, presents itself, you will be ready. Through careful goal setting and the steps outlined by a certified PMP, the road to implementation and successful completion will be an easier one. The same goes for acquisition planning. With any project, the best approach involves having a plan and working it. Entering any project or acquisition without a clearly defined strategy can lead to disaster. Planning with a structured set of steps and goals will spell success.

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EXPERT ADVICE

BY JENIFER BROWN

CAREER CENTER

Customer Service Skills Still The Key To Success BY JENIFER BROWN

T

here are certain customer service skills that every employee should master if they are working directly with customers. Without them, you run the risk of finding your business in an embarrassing customer service trainwreck. You could also lose customers as your service continues to let your client or your employer down.

Here are some specific skills that every support employee should demonstrate when interacting with clients/customers: PATIENCE Not only is patience important to customers, who often reach out for support when they are confused and frustrated, but it’s also important to the business at large. Be sure to take the time to truly figure out what they want. Great service beats fast service every time. ATTENTIVENESS The ability to really listen to customers is crucial for providing great service. Not only is it important to pay attention to individual customer interactions (watching

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

the language/terms that they use to describe their problems), but it’s also important to be mindful and attentive to the feedback that you receive at large. CLEAR COMMUNICATION SKILLS Make sure you’re getting to the problem at hand quickly; customers don’t need your life story or to hear about how your day is going. You need to be cautious about how some of your communication habits translate to customers. It’s better to err on the side of caution whenever you find yourself questioning a situation. EQUIPMENT KNOWLEDGE Knowing the equipment that you support inside and out is mission critical for anyone in service. Having that solid knowledge foundation not only ensures you’ve got the best tricks up your sleeve to help customers navigate even the most complex situations, it also helps you build understanding about their experience so that you can become their strongest advocate. POSITIVE LANGUAGE Language is a very important part of persuasion, and people (especially

JENIFER BROWN CEO and Founder of Health Tech Talent Management

customers) create perceptions about you and your company based off of the language that you use. Small changes that employ “positive language” can greatly affect how the customer hears you. TENACITY A great work ethic and a willingness to do what needs to be done (and not take shortcuts) is a key skill when providing the kind of service that people talk about. The memorable customer service stories out there (many of which had a huge impact on the business) were created by a single employee who refused to just do the “status quo” when it came to helping someone out. CLOSING ABILITY Being able to close with a customer means being able to end the conversation with confirmed satisfaction and with the customer feeling that everything has been taken care of (or will be). Be sure to take the time to confirm with customers that each and every issue they had has been entirely resolved.

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EXPERT ADVICE

BY MICHAEL DAVIS

Sponsored by Because Quality Matters ISO 9001:2015 CERTIFIED

ULTRASOUND EXPERT Power Surges and Your System BY MICHAEL DAVIS

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t’s that time of year again. The time storms can become a biomed’s worst nightmare.

Power outages are very hard on hospital equipment, but when the power comes back on is even worse. The sudden surge that comes along with the power is more than enough to damage any system. The cause is not the voltages themselves, but the current that is sent. While many of the larger systems in a hospital are equipped with large surge suppressors, ultrasound systems are usually not. The power surge has been known to damage the main power circuit at a minimum. This can range from a blown fuse to an entire AC assembly damaged. The best way to prevent damage to a system is to disconnect it form the source. The majority of ultrasound systems have circuit breakers. When an ultrasound system is not in use, it is best to switch the circuit breaker off. If your system does not have a circuit breaker, you will want to unplug the system from the electrical outlet. This is especially true with portable units. Portables rely on their internal power supplies more than the power brick, so a surge can do a lot more damage to these systems. Better to be safe and keep them unplugged. Another way to protect systems is to

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install a medical grade surge suppressor inline with the power cord. While these are not inexpensive, they are worth every penny. A high-quality surge suppressor can withstand a lightning strike. What happens if the damage has already been done? With many systems, there are fuses located in the AC tray that can be blown. While some are replacable, many are hard-wired to the board and the entire assembly needs to be replaced. Even if the AC tray is defective, you will still want to check the rest of the system. Please do not assume that the AC tray was able to protect the system. A perfect example is an issue we had with a GE Vivid 7. The customer had a massive power surge and it caused the system to fail to power up. We replaced the AC tray and we got the system to show a standby light but it would not power up. We replaced the front-end power supply and still had the same issue. After replacing most of the system we were able to determine that both the AC tray and the FEPS were damaged and when we replaced one, it caused the other to fail. We had to replace both parts at the same time. As always, the best scenario is to be prepared. So, let’s do all we can to protect our systems from the coming season.

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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INDUSTRY EXPERT ADVICE UPDATES

BY JOHN NOBLITT

THE FUTURE

Help Replenish the HTM Ranks BY JOHN NOBLITT

I

n recent articles I’ve written much about the state of biomedical equipment technology programs and the need to replace the growing number of HTM personnel who are aging out of this career field. In each of these articles I have asked for your help in replenishing the ranks by asking everyone to help advise potential candidates about this career field. Many of the students in the BMET program at Caldwell Community College come into the program because they know an uncle or neighbor or friend etc. who has a job in the field. These students usually do very well in the program and advance to a very rewarding career. However, this may not be enough to keep many programs viable.

I have concluded a more proactive stance must be taken to ensure we can replenish the ranks in the HTM career field. AAMI has once again shown its leadership capabilities with efforts to attract potential students into this career field and continues to promote the field in many different ways. A recent USA Today, supplement entitled “Careers in Healthcare” included AAMI-contributed information about the HTM career field. It shines a light on this career field and the many opportunities it has to offer. Here is the link to the article, please share with

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

potential students you may know. http://www.educationandcareernews. com/learning-tools/as-healthtechnology-grows-so-do-careeropportunities. I have shared the information about the inverse relationship of the economy and school enrollment in past articles. This is evident in the age of students I have seen in the BMET program in the past two years, which is much younger. When it is difficult to find employment opportunities many people will return to school to gain more skills for a better career. This is the population of students that have sustained many biomedical programs, the career changers. Currently, with generally good job availability, these older students are not returning to school for more education and the potential for a better job. So, where do community colleges find the next wave of students to fill the classrooms? You guessed it, the local high schools. This past August at the North Carolina Biomedical Association (NCBA) annual symposium I was elected to the board of directors for another term. It is my intention to try to get our state organization more involved with mentoring more high school students about the career opportunities in this exciting field. I would also encourage other state organizations to take a lead in this effort.

JOHN NOBLITT M.A.ED., CBET

In North Carolina, many schools have a health occupations education pathway to expose students to careers in health care. This pathway even has a section entitled “Biomedical Technology” but, it has nothing to do with BMET or HTM as managing healthcare technology. Recently, I spoke with a high school biomedical technology teacher and she knew nothing of the career field in HTM as a biomedical technician. I am scheduled to visit with these students to expose them to the BMET field as we know of it. I am anticipating a great response from many of these health occupations students when I enlighten them about this new facet of opportunities in health care. Next month the NCBA holds its annual board retreat to plan the next year of events for the organization. I hope to share my vision of getting the state organization more involved with recruiting solid candidates to fill the shoes of so many talented individuals who will be retiring soon. Wish me luck as I begin this endeavor to replenish the ranks. I will report back in my next article about progress and road blocks I run into.

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EXPERT ADVICE

BY JIM FEDELE

THE OTHER SIDE Buyer Beware: Used Equipment Purchase Gone Bad BY JIM FEDELE

I

have always been an advocate for purchasing refurbished medical equipment. It provides options when there is an unplanned need due to equipment failure, expanded service or budget overruns. Until lately, we have never had an issue with an equipment purchase. A recent experience has taught me a few things that I feel compelled to share in hopes my readers don’t make the same mistake.

We have used refurbished equipment many times to replace aging equipment. About two years ago, we were building out a new physician office suite and due to some unforeseen construction costs the project was tracking to be woefully over budget. I contacted our refurbished equipment dealer and he quoted the equipment for us and saved us over $200,000 which helped get the project budget back on track. We have also used refurbished equipment to replace equipment that cannot be repaired, because parts aren’t available. We frequently purchase refurbished NIBP monitors as my customers never seem to have enough. My experience has been that used equipment is a viable alternative to new equipment in many cases. Given the amount of used equipment we have purchased, we have not had too many issues with the equipment. We have occasionally had equipment that needed to be serviced but the dealer we use always stands behind the products he sells and does

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whatever it takes to solve the problem. I think most reputable companies do the same. We typically only use one company as we have a good relationship and they are a trusted partner. My issue started with a call from one of my technicians about a unit he sent to the manufacturer for repair. He was having trouble getting it to connect to our network and the manufacturer recommended he send it in to get the software updated. Everything seemed to be going as planned, except when my tech called for a status update, the company said that the unit was their loaner. Which meant they weren’t going to send it back. At this point I needed information, so I started digging. What I found was the unit was refurbished, purchased by the physician’s office before we took over their equipment maintenance. When we added the unit to our inventory we weren’t given any purchasing information which is not uncommon in situations like this. Therefore, we were unaware that the unit was refurbished. I contacted the physician to find out who sold him the unit so I could contact them about the situation and decide how to proceed. My first contact with the reseller was not very good, the reseller went into defense mode. He claimed that the unit he sold us was not the same serial number as the unit we had. He actually implied that someone removed his company sticker and stuck it on the unit. He then

JIM FEDELE, CBET Director of Clinical Engineering for Susquehanna Health Systems

continued to send me a sales document that had a serial number on it but not the one we had. Since my team did not check the unit in when it first came in (over a year ago) I could not verify one way or the other that we received the unit he stated. All I knew was we would not have restickered a unit with a refurbishers company on it just to place ownership on them. In my mind this situation really is a problem with the OEM; did they really lose track of their loaner? Had they already contacted the original owner of the unit and charged them for the loaner? I decided I should call the reseller– utilizing email wasn’t getting it done for me and sometimes people say things in email that can be misinterpreted. When I spoke to the reseller the conversation was a lot better than the email exchange we had been having. He admitted that he himself did not verify the serial number on the unit, he used the documents the seller provided him to issue the number. Therefore, he was not 100 percent certain of the serial number. At the end of the conversation, he told me he had contacted the original owner of the unit to find out what they knew. This situation is still going on. I have spoken to the CEO of the OEM

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and the reseller. We are trying to work something out. The original owner of the unit has stated that he had a loaner in his possession at one time, but was certain he returned it. All I can say is, “Ugh!” We have finally coerced the OEM to send us a loaner so we can continue to treat patients until the situation gets resolved. My point in writing this is so others may use this experience as an educational moment. As I stated, utilizing refurbished equipment can solve a lot of problems. However I recommend that you ensure that the reseller is reputable and actually refurbishes the equipment not just brokering the equipment. When the equipment comes in, you should thoroughly check it and verify that the serial number matches the sales receipt. Something our physician’s office did not do. If they had it would have avoided this entire situation. I still love the company I regularly use as I seldom have problems with them. However, this situation reminds me that there are others out there that require a little more due diligence before purchasing from them. 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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ROMAN REVIEW Attitude: The Cure for Age BY MANNY ROMAN

M

y body, and likely my mind, is getting old. I was reminded of this on a recent trip where there was much mounting and dismounting of a rather tall vehicle as we visited multiple wineries in Oregon. Possibly the many wine tastings had a slight influence also.

Every time that I am reminded that I am no longer 35 by an event or my wife, I also realize that my mentality is still that of a 35-year old. It isn’t that I have not matured, it is that my attitude is in control of my feelings and emotions. I realize that getting old and being old are not the same situation. Getting old causes us to realize that we are not as, well, anything as we used to be. We begin to notice unusual pains, creaks, mental fog and weariness. Getting old is a slow process of realization, acceptance and complacency. Acceptance that all things are inevitable and that there is little to be done to prevent and alter the path one is on. The path leads toward old and the eventual demise. Getting old is in fact an unavoidable path, and for most people much better than the alternative. Even the most fit of you is already on that path. Unless science comes up with some miraculous cure for getting old, you are on your way.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

Being old is relatively avoidable. Being old is a choice. Being old is an attitude and attitude is a choice. The late Stephen Covey in “The Seven Habits of Highly Effective People” states that we have response ability. That is we have the ability to respond how we choose to respond to all things, people and situations. If your response to getting old is that you are old, then you are. If your response is that you are not so old, then you will not be. Attitude can make us happy or unhappy, successful or unsuccessful, not so old or old. Attitude can even minimize aches and pains. Attitude molds who we are, what we are and how others perceive us. Attitude determines how others perceive us because we control how we present ourselves. You have probably heard me say that if perception is reality, and presentation controls perception, then presentation is everything. Whether we realize it or not, our attitude is on our sleeve for all to see and is evident in how we present ourselves and thus, how others perceive us. Often, when I tell people my age, they express a genuine surprise because I don’t really act my age, even though I do look it. My attitude is that of a younger, maybe less wise, much better looking individual. I tell people that I don’t mind being old because it justifies

MANNY ROMAN, CRES AMSP Business Operation Manager

me looking as I do. So why am I bothering you with this stuff? I am suggesting that even though we are all on the path toward old age, how we deal with that and life in general is entirely up to each individual. You can choose to respond in a negative way or in a positive way. You can go ahead and get old or you can choose to embrace your enhanced wisdom, the greater respect given to you and your newly found freedom to act crazy. Wake up every morning determined to have a great day. Perform an attitude check as soon as possible when you awake. Don’t be among those who spend their day looking to be offended or antagonized. Find good and pleasure in everything possible. Your attitude is in fact your choice. I know that I rambled, however, that is one of the benefits of age. People accept and sometimes listen to old people’s ramblings. Also, sometimes there is wisdom in those ramblings. (Not the case here, I’m just trying to meet a commitment to write something.) Actually my wonderful wife, Ruth, doesn’t mind my ramblings. As the James Gang song says, she just turns her pretty head and walks away.

DECEMBER 2018

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BREAKROOM

DID YOU KNOW? Science Matters

Where our feelngs are located We experience feelings every moment we are conscious, and a Finnish study of 1,000 people plotted out how 100 subjective feelings map into five major categories. All are connected with strong bodily sensations.

How they mapped feelings Not at all

HUNGER

Extremely

How much does it affect your mind? Not at all

Extremely

Cognitive (mind) functions Somatic (body) states Illnesses

3 Feelings and the body People located each feeling: Blank body used in questionnaire

How pleasant does it feel? Very unpleasant

Positive emotions Negative emotions

1 Basic dimensions People answered for each feeling: How much do you feel it in your body?

The five major kinds of feelings

How one person plotted a feeling

Very pleasant

2 Mental feeling space People were asked to locate how each feeling resembles others: Craving Disgust Pain Seeing Craving Tasting Vomiting

Panic

Anxiety

Sneezing Reasoning Love

Hunger

Craving

Arousal

Pleasure

Source: Lauri Nummenmaa of the University of Turku (Finland)

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DECEMBER 2018

Statistical consensus of many people’s answers

Small figures at top and bottom show how some feelings are experienced Graphic: Helen Lee McComas, Tribune News Service

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BREAKROOM

SCRAPBOOK MD EXPO SEATTLE 1. TechNation Editor John Wallace speaks with Laura Lewis, CBET from Honolulu, Hawaii at the MD Expo Happy Hour. 2. Kevin Melvin presented on volumetric diffusive respiration. 3. Maull Biomedical Training’s Steve Maull speaks with an attendee inside the exhibit hall. 4. A jazz quartet entertained attendees at the welcome reception sponsored by Select Biomedical and MedWrench.

14-15. Several attendees took home great prizes thanks to the new exhibit hall raffle.

01

16. The Exhibit hall offered a great venue for networking. 17. The party at the Tavern Hall sponsored by Summit Imaging capped off a successful MD Expo. 18. The Women of HTM networking happy hour was well received 02

5. Jim Rickenr from Conquest Imaging shares knowledge about ultrasound probes and portables. 6. Avante Health Solutions was well represented in the Exhibit Hall. 7. Attendees enjoyed gourmet food, drink and networking during the welcome reception.

03

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07

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8. The happy hour, sponsored by AIV, was the perfect end to a busy day in the exhibit hall. 9. Representatives from Fluke Biomedical interact with attendees. 10. Kyle Grozelle presents at one of MD Expo’s many ACI-approved educational sessions. 11. DNV-GL Healthcare’s Kelly Proctor delivered the keynote address sponsored by Sodexo. 12. Twhe AIV team sponsored the happy hour. 13. Exhibitors and attendees alike enjoyed the welcome reception.

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BREAKROOM

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ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com

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RepairMED 855-813-8100 • www.repairmed.net

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Retrieve Medical Equipment 330-963-0277 • retrievemedicalequipment.com

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A.M. Bickford 800-795-3062 • www.ambickford.com

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Gopher Medical 844-246-7437 • gophermedical.com

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RepairMED 855-813-8100 • www.repairmed.net

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SPBS, Inc (800) 713-2396 • www.spbs.com/

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Soma Technology, Inc 1-800-438-7662 • www.somatechnology.com

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Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com

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SPBS, Inc (800) 713-2396 • www.spbs.com/

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USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

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Asset Management Asset Services 913-383-2738 • www.assetservices.com

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ISS Solutions 800-752-2290 • ISSsolutions.com

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Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com

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PartsSource 877-497-6412 • www.partssource.com/shop

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Technical Prospects 877-604-6583 • technicalprospects.com/

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Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com

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Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com

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Gopher Medical 844-246-7437 • gophermedical.com

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Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/

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Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/

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Technical Prospects 877-604-6583 • technicalprospects.com/

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Cardiology

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ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com

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BC Group International, Inc 314-638-3800 • www.BCGroupStore.com

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Biomedical Repair & Consulting Services, Inc. 844-656-9418 • www.brcsrepair.com

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Crothall Healthcare Technology Solutions (800) 447-4476 • www.crothall.com

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D.A. Surgical 800-261-9953 • www.da-surgical.com

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Health Tech Talent Management, Inc. 757-563-0448 • www.HealthTechTM.com

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iMed Biomedical 817-378-4613 • www.imedbiomedical.com

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InterMed Group 386-462-5220 • www.intermed1.com

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ISS Solutions 800-752-2290 • ISSsolutions.com

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Master Medical Equipment 866-468-9558 • masterfitmedical.com

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Medical Equipment Doctor, INC. 800-285-9918 • www.medicalequipdoc.com

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Multimedical Systems 888-532-8056 • multimedicalsystems.com

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Soaring Hearts Inc 855-438-7744 • www.soaringheartsinc.com

626 Holdings 800-516-0990 • weare626.com

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Technical Prospects 877-604-6583 • technicalprospects.com/

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CMMS Nuvolo 844-468-8656 • eam.nuvolo.com/clinical

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Computed Tomography Altima Diagnostic Imaging Solutions 844-548-4540 • www.altimadis.com

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Exclusive Medical Solutions 866.676.3671 • emedicalsol.com

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Injector Support and Service 888-667-1062 • www.injectorsupport.com

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Retrieve Medical Equipment 330-963-0277 • retrievemedicalequipment.com

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RSTI 800-229-7784 • www.rsti-training.com

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AIV 888-656-0755 • aiv-inc.com

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Injector Support and Service 888-667-1062 • www.injectorsupport.com

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Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

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Maull Biomedical Training 440-724-7511 • maullbiomedicaltraining.com

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FOBI 888-231-3624 • www.FOBI.us

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Master Medical Equipment 866-468-9558 • masterfitmedical.com

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RepairMED 855-813-8100 • www.repairmed.net

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Select BioMedical 866-559-3500 • www.selectpos.com

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Soma Technolgoy, Inc 1-800-438-7662 • www.somatechnology.com

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USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

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Cyber Security InterMed Group 386-462-5220 • www.intermed1.com

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Avante Health Solutions avantehs.com

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InterMed Group 386-462-5220 • www.intermed1.com

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Retrieve Medical Equipment 330-963-0277 • retrievemedicalequipment.com

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Diagnostic Imaging

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Endoscopy Capital Medical Resources 614-657-7780 •capitalmedicalresources.com

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Healthmark Industries 800-521-6224 • HMARK.COM

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Multimedical Systems 888-532-8056 • multimedicalsystems.com

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PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

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Gas Monitors Biomedical Repair & Consulting Services, Inc. 844-656-9418 • www.brcsrepair.com

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P P

General ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com

59

Imaging 626 Holdings 800-516-0990 • weare626.com

17

Health Tech Talent Management, Inc. 757-563-0448 • www.HealthTechTM.com

53

P

Infection Control Healthmark Industries 800-521-6224 • HMARK.COM

P

IV Pumps

IV

IV

IV

IV

SPBS, Inc (800) 713-2396 • www.spbs.com/

75

P

Ozark Biomedical 800-457-7576 • www.ozarkbiomedical.com

59

P P

SPBS, Inc (800) 713-2396 • www.spbs.com/

75

P

Ampronix, Inc. 800-400-7972 • www.ampronix.com

4

P P

Exclusive Medical Solutions 866.676.3671 • emedicalsol.com

27

P

RSTI 800-229-7784 • www.rsti-training.com

77

P P P

Select BioMedical 866-559-3500 • www.selectpos.com

31

P

Soma Technolgoy, Inc 1-800-438-7662 • www.somatechnology.com

72

Labratory

Fetal Monitoring Multimedical Systems 888-532-8056 • multimedicalsystems.com

TRAINING

SERVICE

PARTS

P P P

Company Info

AD PAGE

TRAINING

SERVICE

83

PARTS

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

AD PAGE

Company Info

38

Infusion Pumps

Mammography

Monitors

Monitors/CRTs Ampronix, Inc. 800-400-7972 • www.ampronix.com

4

P P

BMES 888-828-2637 • www.bmesco.com

46

P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P

USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

7

P P

AIV 888-656-0755 • aiv-inc.com

26

P P

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

68

P P

Altima Diagnostic Imaging Solutions 844-548-4540 • www.altimadis.com

37

P P

Master Medical Equipment 866-468-9558 • masterfitmedical.com

27

P P

Exclusive Medical Solutions 866.676.3671 • emedicalsol.com

27

P P

Multimedical Systems 888-532-8056 • multimedicalsystems.com

6

P

PartsSource 877-497-6412 • www.partssource.com/shop

23

P P P

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

MRI

DECEMBER 2018

TECHNATION

85


TRAINING

SERVICE

PARTS

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

Power System Components

Nuclear Medicine Global Medical Imaging 800-958-9986 • www.gmi3.com

2

P P P

Universal Medical 1-888-239-3510 • www.uni-med.com

50

P P P

Interpower 800-662-2290 • www.interpower.com

35

P P P

Radiology

Online Resource

Ampronix, Inc. 800-400-7972 • www.ampronix.com

4

Adel Lawrence Associates 866-252-5621 • www.adel-lawrence.com

88

Holden Battery Services, LLC 800-594-9257 • www.x-raybatteries.com

87

MedWrench 866-989-7057 • www.MedWrench.com

88

RSTI 800-229-7784 • www.rsti-training.com

77

P P P

Webinar Wednesday 800-906-3373 • webinarwednesday.live

78

Soma Technolgoy, Inc 1-800-438-7662 • www.somatechnology.com

72

P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P P P

P

Oxygen Blender FOBI 888-231-3624 • www.FOBI.us

87

P P

Recruiting

PACS RSTI 800-229-7784 • www.rsti-training.com

P

77

Patient Monitoring

Adel Lawrence Associates 866-252-5621 • www.adel-lawrence.com

88

Health Tech Talent Management, Inc. 757-563-0448 • www.HealthTechTM.com

53

Stephens International Recruiting Inc. 870-431-5485 • www.bmets-usa.com/

72

AIV 888-656-0755 • aiv-inc.com

26

P P

Ampronix, Inc. 800-400-7972 • www.ampronix.com

4

P P

Avante Health Solutions avantehs.com

32

P P

BETA Biomed Services 800-315-7551 • www.betabiomed.com/

67

P P

Avante Health Solutions avantehs.com

32

Biomedical Repair & Consulting Services, Inc. 844-656-9418 • www.brcsrepair.com

44

P P

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

68

P

BMES 888-828-2637 • www.bmesco.com

46

P P

Technical Life Care Medical Co. 800-989-8949 • www.technicallifecare.com

29

P

Gopher Medical 844-246-7437 • gophermedical.com

11

P P

Master Medical Equipment 866-468-9558 • masterfitmedical.com

27

Pacific Medical 800-449-5328 • pacificmedicalsupply.com

49, 71

P P

PartsSource 877-497-6412 • www.partssource.com/shop

23

P

ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com

45

RepairMED 855-813-8100 • www.repairmed.net

71

P

PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

37

Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/ Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/ USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

Refurbish AIV 888-656-0755 • aiv-inc.com

Rental/Leasing

Repair ALCO Sales & Service Co. 800-323-4282 • www.alcosales.com

59

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

68

P P

ISS Solutions 800-752-2290 • ISSsolutions.com

41

P

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

68

P P

Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com

16

P

P P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P

43

P P

Respiratory

63

P P

A.M. Bickford 800-795-3062 • www.ambickford.com

57

P

P P

FOBI 888-231-3624 • www.FOBI.us

87

P P

7

P P

Replacement Parts

P P

Software

Portable X-ray Technical Prospects 877-604-6583 • technicalprospects.com/

86

TECHNATION

26

DECEMBER 2018

46

P

P

Nuvolo 844-468-8656 • eam.nuvolo.com/clinical

91

WWW.1TECHNATION.COM


Capital Medical Resources 614-657-7780 •capitalmedicalresources.com

89

Healthmark Industries 800-521-6224 • HMARK.COM

38

P

TRAINING

Surgical

SERVICE

P

75

PARTS

SPBS, Inc (800) 713-2396 • www.spbs.com/

Company Info

AD PAGE

Sterilizers

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

ReNew Biomedical 844-425-0987 • www.ReNewBiomedical.com

45

RepairMED 855-813-8100 • www.repairmed.net

71

P

Southwestern Biomedical Electronics, Inc. 800-880-7231 • www.swbiomed.com/

63

P P

USOC Bio-Medical Services 855-888-8762 • www.usocmedical.com

7

P P

P P

Test Equipment

Telemetry AIV 888-656-0755 • aiv-inc.com

26

Biomedical Repair & Consulting Services, Inc. 844-656-9418 • www.brcsrepair.com

44

P P

BMES 888-828-2637 • www.bmesco.com

46

P P

Elite Biomedical Solutions 855-291-6701 • elitebiomedicalsolutions.com

68

P P

Gopher Medical 844-246-7437 • gophermedical.com

11

P P

Master Medical Equipment 866-468-9558 • masterfitmedical.com

27

Multimedical Systems 888-532-8056 • multimedicalsystems.com

6

P

Pacific Medical 800-449-5328 • pacificmedicalsupply.com

49, 71

P

P P

P P

A.M. Bickford 800-795-3062 • www.ambickford.com

57

BC Group International, Inc 314-638-3800 • www.BCGroupStore.com

92

P P

PRN/ Physician's Resource Network 508-679-6185 • www.prnwebsite.com

37

P P

Pronk Technologies, Inc. 800-609-9802 • www.pronktech.com

5,

14-15

Radcal Corporation 800-423-7169 • www.radcal.com

39

Rigel Medical, Seaward Group 813-886-2775 • www.seaward-groupusa.com

3

Southeastern Biomedical, Inc 828-396-6010 • sebiomedical.com/

43

P P

Easily access thousands of biomedical products, accessories and services at FobiMed.com

HOLDEN BATTERY SERVICES

From our family to yours we wish you a joyous holiday and a happy new year!

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www.x-raybatteries.com DECEMBER 2018

TECHNATION

87


TRAINING

SERVICE

PARTS

AD PAGE

Company Info Training COM E GR O W W I TH U S Build Your Career at Crothall Healthcare Technology Solutions HOW FAR CAN YOU GO? Career opportunities abound when you are part of a growing team. Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years. With growth comes new jobs and new opportunities.

Come see why Crothall has earned Modern Healthcare’s Best Places to Work four years in a row.

Come grow with us. Please contact: Theresa Howell, Talent Acquisition Manager Theresa.howell@compass-usa.com

CROTHALL.COM

Adel Lawrence Associates 866-252-5621 • www.adel-lawrence.com

88

ECRI Institute 1-610-825-6000. • www.ecri.org

42

P

RSTI 800-229-7784 • www.rsti-training.com

77

P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

83

P

Universal Medical 1-888-239-3510 • www.uni-med.com

50

P

PartsSource 877-497-6412 • www.partssource.com/shop

23

P P P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

83

P P

4

P P

Tubes/Bulbs

Ultrasound Ampronix, Inc. medwrench 800-400-7972 • www.ampronix.com ATS Laboratories atslaboratories@yahoo-com •atslaboratories-phantoms.com

GET THE

POSITION YOU DESERVE Nationwide Opportunities •Biomedical

•Tech Support

•Medical Imaging

•Management

•Field Support

•Instructors

•In-house

•Service Sales

Adel-Lawrence Assoc., Inc. CALL LARRY RADZELY 866-252-5621 info@alajobs.com | www.adel-lawrence.com

88

TECHNATION

DECEMBER 2018

P

41

Avante Health Solutions avantehs.com

32

P P

Conquest Imaging 866-900-9404 • www.conquestimaging.com

8

P P P

Exclusive Medical Solutions 866.676.3671 • emedicalsol.com

27

P P

Global Medical Imaging 800-958-9986 • www.gmi3.com

2

P P P

ISS Solutions 800-752-2290 • ISSsolutions.com

41

P

Retrieve Medical Equipment 330-963-0277 • retrievemedicalequipment.com

52

Trisonics 877-876-6427 • www.trisonics.com

75

P P

75

P

Ventilators SPBS, Inc (800) 713-2396 • www.spbs.com/

X-Ray Engineering Services, KCS Inc 888-364-7782x11 • www.eng-services.com

16

P

Exclusive Medical Solutions 866.676.3671 • emedicalsol.com

27

P P

Holden Battery Services, LLC 800-594-9257 • www.x-raybatteries.com

87

Retrieve Medical Equipment 330-963-0277 • retrievemedicalequipment.com

52

RSTI 800-229-7784 • www.rsti-training.com

77

P P P

Technical Prospects 877-604-6583 • technicalprospects.com/

46

P

Tri-Imaging Solutions 855-401-4888 • www.triimaging.com

83

P P P

P WWW.1TECHNATION.COM


ALPHABETICAL INDEX 626 Holdings....................................... 17

ISS Solutions........................................ 41

A.M. Bickford....................................... 57

Master Medical Equipment.................. 27

Adel Lawrence Associates.................... 88

Maull Biomedical Training.................... 44

AIV...................................................... 26

Medical Equipment Doctor, INC........... 22

ALCO Sales & Service Co...................... 59

MedWrench......................................... 78

Altima Diagnostic Imaging Solutions..... 37

Multimedical Systems............................ 6

Ampronix, Inc........................................ 4

Nuvolo................................................. 91

Asset Services..................................... 89

Ozark Biomedical................................. 59

ATS Laboratories.................................. 41

Pacific Medical ............................. 49, 71

Avante Health Solutions....................... 32

PartsSource......................................... 23

BC Group International, Inc.................. 92

PRN/ Physician’s Resource Network.... 37

BETA Biomed Services......................... 67

Pronk Technologies, Inc. ............5, 14-15

Biomedical Repair & Consulting Services....... 44

Radcal Corporation.............................. 39

BMES.................................................. 46

ReNew Biomedical.............................. 53

Capital Medical Resources................... 89

RepairMED.......................................... 71

Conquest Imaging.................................. 8

Retrieve Medical Equipment ............... 52

Crothall Healthcare Technology Solutions... 88

Rigel Medical, Seaward Group................ 3

D.A. Surgical........................................ 56

RSTI.................................................... 77

ECRI Institute....................................... 42

Select BioMedical................................ 31

Elite Biomedical Solutions.................... 68

Soaring Hearts Inc............................... 75

Engineering Services, KCS Inc.............. 16

Soma Technolgoy, Inc.......................... 72

Exclusive Medical Solutions................. 27

Southeastern Biomedical, Inc.............. 43

FOBI.................................................... 87

Southwestern Biomedical Electronics .....63

Global Medical Imaging.......................... 2

SPBS, Inc............................................ 75

Gopher Medical................................... 11

Stephens International Recruiting Inc... 72

Health Tech Talent Management, Inc... 53

Technical Life Care Medical Co............. 29

Healthmark Industries......................... 38

Technical Prospects............................ 46

Holden Battery Services, LLC............... 87

Tri-Imaging Solutions........................... 83

iMed Biomedical.................................. 58

Trisonics.............................................. 75

Injector Support and Service................ 67

Universal Medical................................ 50

InterMed Group................................... 64

USOC Bio-Medical Services................... 7

Interpower........................................... 35

Webinar Wednesday............................ 82

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

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TECHNATION

89


BREAKROOM

PARTING SHOT

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90

TECHNATION

DECEMBER 2018

WWW.1TECHNATION.COM


nuvolo

YOUR CMMS ALTERNATIVE Is your CMMS solution from Accruent, AIMS or Medimizer in CODE BLUE? A Modern Hospital Needs a Modern Platform.

A HEALTHY HTM PLATFORM SHOULD HAVE THE FOLLOWING 3 Capital Planning & Forecasting

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FINANCIAL

OPERATIONS

3 Supplier Management

3 Safety and Recall Integration

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3 Contract & Warrenty Management

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NEW IPA-3400 Infusion Pump Analyzer The High Accuracy, Easy-to-Use System with Full Touch Screen Control of All Processes         

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