TechNation April 2019 by MD Publishing

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ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

APRIL 2019

SHRINKING POOL Recruit & Retain Amid Retirements

14 Company Showcase

Edge Biomed

36 Ribbon Cutting

Medcise

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Endoscopes

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CONTENTS

FEATURED

SHRINKING POOL Recruit & Retain Amid Retirements

ROUNDTABLE: ENDOSCOPES echNation asks those in the know T to share the latest advances in endoscopes. We also share tips on how to purchase endoscope, how to store them and how to educate personnel how to properly handle these important devices. Next month’s Roundtable article: Tubes/Bulbs

SHRINKING POOL: RECRUIT & RETAIN AMIND RETIREMENTS

The “problem” for the HTM field has been on the horizon for some time; how do you replace legions of tenured, experienced, retiring biomeds? We take a look at different approaches and strategies that leadership is taking to locate sources for trained technicians, as well as retain existing talent and provide career opportunities.

ext month’s Feature article: N Got a Spare? Parts Sourcing Remains a Challenge

TechNation (Vol. 10, Issue #4) April 2019 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. ©2019

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2019

TECHNATION

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

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Cover Melissa Brand

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

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 â&#x20AC;¢ Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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APRIL 2019

Proud supporters of

P.12 SPOTLIGHT p.12 Professional of the Month: Joshua Virnoche p.14 Company Showcase: Edge Biomed p.18 Department of the Month: Iredell Health System Healthcare Technology Management Department p.20 Biomed Adventures: Changing Lives P.25 p.25 p.30 p.32 p.34 p.36 p.38

INDUSTRY UPDATES News & Notes AAMI Update ECRI Update In Memoriam: George Hryshchuk Ribbon Cutting: Medcise Welcome to the TechNation Community

P.41 p.41 p.44 p.47 p.48

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

P.62 p.62 p.64 p.66 p.68 p.71 p.73

EXPERT ADVICE Career Center 20/20 Imaging Insights Cybersecurity: Beware of Trojan Horses The Future The Other Side Roman Review

P.76 BREAKROOM p.76 Did You Know? p.79 The Vault p.82 MedWrench: Where in the World is Ben C.? p.81 Cart Contest p.86 Service Index p.91 Scrapbook: Indiana Biomedical Society p.93 Alphabetical Index p.94 Flashback: MD Expo 2003

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Joshua Virnoche, MBA, CHTM, CBET Living the Authentic Leadership Model BY K. RICHARD DOUGLAS

ometimes, it takes the observation of a family member, committed to their job, to spark an idea for a career path. With a lot of work, in HTM, that career path can lead to a director position.

That career path was in the cards for Joshua Virnoche, MBA, CHTM, CBET, director of clinical engineering at JPS Health Network in Fort Worth, Texas. “When I was growing up, I had an uncle, Scot Virnoche, who served in the United States Air Force (USAF). Ultimately, he became a biomedical technician. Some of my earliest memories are traveling with my father to pick him up from Sheppard Air Force base on the weekends,” Virnoche remembers. “As I got older, I struggled with the same thing all people do. I didn’t know what I wanted to do with my life, or what I wanted to be when I grew up. At that time, I had decided that college wasn’t exactly for me, so I enlisted in the Army,” he says. His father suggested that he look into the BMET program in the military. So, he put that as one of his top choices. “Unfortunately, when I got to MEPS,

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APRIL 2019

the recruiters told me they didn’t have the MOS (military occupation specialty) available for me, but gave me some other options. As I was beginning to work through the paperwork to enlist as an active duty journalist, a master sergeant ran through the area yelling to stop. He found a BMET position for me, but it was as a reservist. Because I wanted to be in this career field, I decided to take the reserve option,” Virnoche says. And that’s where he started, working as a biomed in the Army Reserve. “My first civilian job was as a biomedical tech for Renal Ventures Dialysis. From there, I moved to Cook Children’s Medical Center, and held positions as Biomedical Equipment Tech 1, was promoted to a Tech 2, and then to medical imaging,” Virnoche says. He says that while at Cook Children’s, he completed his bachelor of science and started working on his MBA. “I decided, at that point, that I was ready to pursue leadership, and began looking to expand there. I was eventually offered a position as a manager of clinical engineering at John Peter Smith (JPS) Hospital, aka Tarrant County Hospital in Fort Worth, Texas.

I’ve been employed at JPS for five years and was recently promoted to director, clinical engineering, which is my current position,” Virnoche says. BUILDING AND GROWING A TEAM Virnoche’s tenure in the field has not been without challenges. Most of those challenges became learning experiences. “During my time at Cook Children’s, we were in a constant state of construction. I was fortunate enough to take part in that. We built almost one-million additional square feet of in and out patient areas, and the clinical engineering department took lead in installing the vast majority of general medical equipment. I truly believe my involvement and time working on this project molded me and taught me more about the field than I can ever say,” Virnoche says. He says that the part of his career that he is most proud of, to this point, is his work with his current organization. “When I arrived, we had six technicians for an academic medical center with 25,000-plus medical devices. We relied heavily on service agreements to maintain equipment, many times on equipment that is easily in-housed,” he says.

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SPOTLIGHT

BY K. RICHARD DOUGLAS

Virnoche’s tenure in the field has not been without challenges. Most of those challenges became learning experiences. “With the support of my vice president, we began to change the way the organization viewed the department. We agreed that for every dollar I could cut from service contracts, is a dollar I could spend on staffing. I immediately began hiring, and spent the entirety of the next year hiring technicians. I had identified the ‘low hanging fruit’ of service contracts to cut, and as I brought people on board, began eliminating them,” Virnoche says. Ultimately, by the end of that fiscal year, he had achieved double the savings that had been initially projected. “Fast forward to today, and we have a department of 24. Myself, a supervisor, two database coordinators, three biomedical team leads, one imaging team lead, six biomedical specialists and 10 technicians. My budget is roughly half of what it was when we began this project, and we’ve had two perfect TJC inspections and one perfect CMS inspection,” Virnoche says. “We handle nearly all medical devices in house, and really only depend on service agreements for lab equipment and imaging equipment. Ideally, over the next few years, we will begin to focus on first call/shared service on those items too,” he adds. Away from work, Virnoche loves to play video games to unwind after work. He also enjoys baseball and football. “I have two sons; Jaden is seven and Jack is four. I’ve been married for almost nine years to my wife, Jessica,” he says. Virnoche says he would describe himself as someone incredibly passionate about biomed. “My decision to pursue leadership was because I felt like I could affect change in our career field much more

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

from the top than as a technician. I want to be one of the driving factors that allows our field to expand, and for people to begin appreciating how much we really bring to the table,” he says. As a CE director, he is fiercely loyal to his staff and will go to bat for them any day of the week. “At the same time, I empower them to make decisions on their own, and ensure they’re in the spotlight when they succeed. I love developing my staff and work on development plans with all of them on an annual basis. I help mentor and guide them so that they can achieve what they want to out of their career,” he says. “I abide by the Authentic Leadership model, where I garner a level of trust between my staff and me, and they understand that I will always be honest with them and guide them in the best way for themselves and the department,” he adds. At the same time, he says that he holds them accountable for their actions when they succeed and when they fail. “I work my very best to make sure my team knows failure happens, and when it does, we will look back, review the failure point, and make adjustments so that it doesn’t happen again,” he says. “My family is the most important thing in my life, and I try and make sure our staff knows that when they work on medical equipment, they work on it like it will be used on themselves, their friends and their family. Because as a county level 1 trauma center, there is the potential it can, and everyone we help is somebody’s family member. I’ve been guided by that sentiment my entire career, work on it like it’s going to save your family. It’ll rarely steer you wrong,” Virnoche says.

FAVORITE BOOK: “To Kill a Mockingbird” I have a 7th edition print, and it’s one of my favorite possessions. “Peter Pan” is my other favorite book. FAVORITE MOVIES: “Gladiator” “Bull Durham” “For Love of the Game” “A Knights Tale” “Peter Pan” “The Secret Life of Walter Mitty” FAVORITE FOOD: Sour candy HIDDEN TALENT: “Many years ago, I was a pretty good baseball player and pitched in college for two years before enlisting in the Army.” FAVORITE PART OF BEING A BIOMED/DIRECTOR? “I love the people and the relationship building. I enjoy the constant technology change. I really enjoy the constant change management aspect of leadership. You have to kind of mix all the tools in your tool belt to be successful, and then you have to sell your team members on it, to get the buy in. It’s kind of a unique mixture of skillsets.” WHAT’S ON MY DESK? A calendar, a notebook and pen, computer (for emails), coffee (a lot of coffee), AAMI’s Cybersecurity Guide for HTM Professionals

APRIL 2019

TECHNATION

SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE E

dge Biomedical’s team of professionals has over 175 years of experience in the biomedical field. They use their experience and proprietary tools, such as eBioTrack, to assist in managing equipment and staff. All of Edge Biomedical’s efforts and its culture focus on serving customers for life.

Many companies claim superior customer service and give lip service to customers “getting what they want,” but that is not the case at Edge Biomedical. CEO Matthew Spencer says, “we live this focus on the customer. Biomedical service is often an afterthought, and usually is associated with a problem or inconvenience. That is why we started Edge Biomedical … to solve problems. Your problem is why we have a job, and we are grateful for the opportunity to solve it.” In an exclusive interview with Spencer he shared more information about the company he founded and how it sets itself apart from the competition. Q: Can you share a little bit about your company’s history and how you achieved success? Spencer: We recognized that most non-hospital medical facilities had no asset management tool for their equipment and inconsistent biomedical service. Q: What are some advantages that your company has over the competition? Spencer: Our proprietary, web-based asset management tool, eBioTrack, provides access to all inventory reports, service history and much more. eBioTrack is a game-changing software program specific to Edge Biomedical. Whether you are tracking 14

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APRIL 2019

equipment compliance or the tasks of your staff, eBioTrack keeps you organized with an easy-to-read dashboard. eBioTrack is the tool that manages your equipment. With your busy schedule and multiple responsibilities, you need a reliable resource that allows you to see all your equipment, and its status, in one place. eBioTrack allows you to set up multiple sites and different points of Matthew Spencer contact. In Edge Biomedical CEO addition to managing all your medical equipment, eBioTrack can be used to monitor fire extinguisher dates, oil changes or even employee training schedules. eBioTrack is an essential part of our world-class service to our customers. The software is also available as a standalone tool for those organizations who might not need our service, but definitely need eBiotrack’s management capabilities. Edge also has a large footprint of technicians, stretching from San Antonio, Texas to Manchester, New Hampshire. These technicians follow Edge’s industry-specific processes and procedures.

Q: Can you explain your company’s core competencies and unique selling points? Spencer: Edge Biomedical focuses on equipment compliance through annual inspections and asset management tools. eBioTrack is cloud-based and backed up multiple times daily. In addition to these tools, Edge’s technicians are constantly training to add new competencies to their existing skills. Our large footprint of employee-technicians allows Edge to serve customers with locations outside the HQ’s immediate vicinity. Q: What product or service that your company offers are you most excited about right now? Spencer: We love the way that eBioTrack is constantly evolving, based on the suggestions and requests from our customers and technicians. The program looks completely different now than when we first started; and it will continue to improve every year going forward. The two biggest service areas we are excited about are sterilization and ultrasound. Both of these areas are absolutely essential for a facility to operate. Q: What is on the horizon for your company? How will it evolve in the coming years? Spencer: Edge looks forward to having a national footprint within the next five years. There is so much consolidation in the health care sector, and we do not see that trend slowing. Practices and clinics are merging and being acquired constantly, and we are seeing our existing customer base expand into neighboring regions. As groups seek more efficiencies in growth, the challenge of managing equipment fleets will only worsen. WWW.1TECHNATION.COM

SPOTLIGHT

Q: Can you share some company success stories with our readers – one time that you “saved the day” for a customer. Spencer: As busy as health care facilities are with their day-to-day activities, equipment maintenance usually is an afterthought. There have been many cases where a facility has an upcoming inspection by a governing body, like Joint Commission or a state board of health, and their equipment is not current on inspections and/or their records are not accurate and accessible. Edge has been able to pool our resources on many occasions to complete full inspections and be present to assist with any document requests for inspections and service history. Q: Can you describe your company’s facility? Spencer: Edge has multiple facilities across our 12 markets, where our technicians complete depot work, ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

house loaner devices and provide customer support. Q: Can you highlight any recent changes to your company, inventory, services, etc.? Spencer: Edge is in growth mode and has opened up Pittsburgh, Hartford, San Antonio and Jacksonville in the last year. Our 2019 plans call for opening up Chicago, Los Angeles, New York and a few other surprises. The previous year also included factory training at B. Braun, Carefusion, Steris, SciCan, Tuttnauer, Midmark and on several models of ultrasound. Q: What is your company’s mission statement, or if you don’t have a specific one, what is most important to you about the way you do business? Spencer: Be the coolest biomedical service company in the industry. This means winning the trust and confidence of our customers and vendors, while

being a partner that our accounts want to partner with. Biomed tends to be an afterthought, albeit a very important afterthought. If we are doing our job, the customer can focus on providing the best care for the patient. We don’t want to simply be wrench-turners. We want to provide tools and support for our partners that provide a unique and personal service to those in need. Q: Is there anything else you want readers to know about your company? Spencer: Edge invests a tremendous amount of time and effort developing our culture. We respect our employees and go out of our way to recognize their efforts. Our greatest assets are here not for a job, but for a career in an important field with a truly different company. We always focus on the health of our “work family.” For more information, visit www.edgebiomed.com. APRIL 2019

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SPOTLIGHT

DEPARTMENT OF THE MONTH Iredell Health System Healthcare Technology Management Department BY K. RICHARD DOUGLAS

tatesville, North Carolina is a city in Iredell County. It was established around the time that the Constitution was being ratified. Iredell Memorial Hospital is the largest and only nonprofit hospital in Iredell County and is located in Statesville. It is a 247bed hospital and employs approximately 1,600 people.

The hospital has been in operation since 1954. With additional facilities, the hospital is part of the Iredell Health System. In addition to the hospital the health system includes the Iredell Physician Network, which is comprised of 18 clinics, offices and family care centers throughout Iredell, Alexander and Davie counties. The health system’s Healthcare Technology Management Department is a contracted service provided by Crothall Healthcare HTS, a Division of Compass One Healthcare. The HTM team consists of Director Sterling Brown, CBET; Codi Nelson, CBET (BMET III and team lead); Barry Heffner, CBET (BMET III); Charles “Chuck” Braswell, CBET (BMET II); and John “Brad” Bennett (ISE II). Bennett is currently studying for the

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CRES exam. Brown and Nelson are currently studying for the CHTM exam. Heffner is pursuing a degree in networking at the local community college and Braswell is the Crothall Southwest Regional CEIT designee. The HTM department is responsible for asset management of almost 5,000 devices. According to Brown, the team prides itself on being able to maintain nearly all of the medical devices in-house. The only service contracts in place at Iredell are for high-end imaging (CT, MRI, linear accelerator). The hospital manages those contracts, but the HTM department oversees the service and maintains the maintenance documentation. Data collection is accomplished through a dedicated system. “Crothall Healthcare utilizes Maintenance Connection (called Team Trace within Crothall HTS) as its CMMS. All technicians are issued laptop computers and most documentation is done in real time while out on the floor,” Brown says. A PROFESSIONAL SHOP The team plays an integral role in the capital acquisition process and has been

active in a shop renovation. “The HTM department, although a contracted service, has proven itself to be an integral and vital component of the mission at Iredell Health System. Every medical device purchased at Iredell must first be approved for use by the HTM department. The department plays an active role on the capital equipment planning committee. We facilitate the quotes and ensure that the devices will meet the requirements/ needs of the clinical and medical staff at the hospital,” Brown says. Brown notes that they are in the process of upgrading the patient monitoring system at the hospital. “We are working very closely with the vendor to ensure that the project stays on track and that the scope of the project is adhered to. The scope includes replacing the backbone of the system – network hardware, switches, computers, servers, racks, cabling, etcetera – as well as upgrading the software that runs the system,” he says. Brown adds that this includes new patient monitors, telemetry transmitters and the associated components. “Another project, that is closer to our hearts, is the renovation of the biomed shop. When Crothall assumed

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SPOTLIGHT

Techs work on equipment in the shop at Iredell Health System.

Members of the Iredell Health System HTM Department include (from left to right) Director Sterling Brown, Charles “Chuck” Braswell, Codi Nelson, Barry Heffner and John “Brad” Bennett.

the responsibility for the HTM program at Iredell in October 2016, the physical appearance of the shop was typical of what we have come to expect in most shops (usually located in the basement, next to the boiler room or morgue),” Brown says. The furniture and workbenches were cast offs and hand-me-downs that the techs had scrounged from the discard pile on the loading dock. “Our shop is actually inside the hospital engineering shop. We have a small slice of the main plant operations shop. In the last two years, we have totally renovated the technician workbenches, storage cabinets, tool cabinets and my desk. This has proven to be a huge morale booster, the shop looks very professional, and the techs take personal pride in maintaining it that way,” Brown says. He says that last year, during Healthcare Technology Management Week, they held an open house for the clinical and medical staff at Iredell that was a tremendous success. “The majority of the staff had no idea where we were located and what the shop looked like. We received numerous comments on the appearance of the shop

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

as well as the stations we had set up – incoming inspections, electrical safety testing demonstration, infusion pump performance verification and defibrillator performance verification; to name a few,” Brown says. Brown says that Crothall Healthcare is also a sponsor of the Iredell Memorial Community Golf Classic, which benefits the Iredell Memorial Hospital Institute for Nursing Excellence and Innovation. This organization assists nurses with educational endeavors, specialty certifications and nursing leadership development. The HTM team has also contributed to help all of the health system’s employees with access to useful information. “When Iredell Health initiated its ‘Moving Forward Together’ initiative to boost staff morale and improve employee satisfaction, the biomed technicians were integral in the process. We volunteered to be part of the focus groups (employee communication, employee appreciation/recognition and employee feedback),” Brown says. He says that the Communication Group developed a new employee interface called I Connect. It is a

Iredell Memorial Hospital is a 247-bed facility in North Carolina.

web-based portal for accessing all of the hospital’s intranet sites from any computer or smartphone/device. “The Employee Recognition Group developed a reward system based on points that can be awarded for going above and beyond. These points can be redeemed for merchandise from the Company Store. The feedback group recommended open employee forums that allow employees and hospital admin the opportunity to have open and honest dialogue concerning issues at the hospital,” Brown adds. When not helping out colleagues or performing maintenance or repairs, the team members are involved in the state biomed community. “All the techs are members of the North Carolina Biomedical Association (NCBA). Codi and I are members of the Association for the Advancement of Medical Instrumentation (AMMI). Codi Nelson is a past president and board member of the NCBA and is currently serving as media coordinator. He is also on the AAMI Awards Board,” Brown says. A small, dedicated HTM team keeps every medical device running well in Iredell County, North Carolina.

APRIL 2019

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SPOTLIGHT

BIOMED ADVENTURES Changing Lives BY K. RICHARD DOUGLAS

“

ay it forward” has become a familiar phrase in the American vernacular. Showing some kindness or doing a good deed is especially appreciated in a world that displays a good amount of greed, narcissism and often seems void of empathy. There are people who need a safety net, a helping hand or some encouragement. They just need one opportunity to improve their lives.

Some people answer God’s calling to show love and compassion to their fellow humans. It is those human qualities that can often provide a helping-hand when others can use it. Nathan “Nate” Cinefro is a biomedical engineer at the Cincinnati VA Medical Center. There was a point where Cinefro realized that he and his wife, Jessica, had the resources and the drive to answer this call and provide safe, affordable housing to single mothers and their families in the Cincinnati area. The answer to that calling was when St. Margaret’s House became a reality. “God has blessed us with a stable upbringing, loving families and the means to provide for the family we are creating. For those that are less fortunate, the stresses that come with the instability in a home life impacts the development of the child as they grow up into adults. Hamilton County, where Cincinnati is located, experiences a high poverty rate among children,” Cinefro says. “The factors leading to childhood poverty are numerous and mostly outside of my control. Yet it is within my power to use the talents God has given me to help one of the factors impacting these children; housing,” Cinefro says.

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He says that the impact of providing safe and affordable housing for these mothers transforms their lives. “They are able to move beyond crisis mode, and move up their hierarchy of needs to begin working toward longterm goals. The habits, patterns and lifestyle choices of poverty were not created overnight,” Cinefro says. Cinefro says that for some of these mothers their issues were created over generations and it takes time for them to establish different habits that lead to a new lifestyle. “For one of our mothers, this has meant finally going back to school, but in her case, she attends classes for a semester and then takes a break and then goes back for another semester. The stability in housing continues to facilitate this pursuit of higher education,” Cinefro adds. The home that is at the foundation of St. Margaret’s house was originally built in 1900 as a single-family home. Subsequent renovations converted the house to a three-family dwelling. When Cinefro and his wife purchased the home in 2014, it had already fallen into a state of disrepair. He worked the first year to renovate and update the house. The definition of “affordable housing” is housing that does not require a family to spend more than 30 percent of its income on housing and utility costs. St. Margaret’s house is designed to meet that standard. Cinefro quotes a housing affordability study done in his county that said that for every 100 of the lowest income households, there are only 28 units affordable and available. The need for affordable housing is very real.

A VIABLE BUSINESS MODEL Cinefro says that one aspect that he strongly wanted to incorporate into the house was the sustainability of the business model. “The goal of the house was that the rents the mothers pay are sufficient to cover the expenses of the property. Yes, of course, it still took the initial financial capital we invested in the mission. But now, St. Margaret’s house is able to run without operational donations. Our dream was to show that if you remove the profit from the operation you can still provide good affordable housing,” he says. He says that for their efforts, they get something that is far more valuable than money. “We have relationships and transformational life encounters that change and shape us to become better servants of God, opening ourselves up to His plan for our lives. I would like to share a couple of grace-filled moments from our time with St. Margaret’s house,” Cinefro explains. “The first time was the day our first mother moved into the building. She had very few possessions and very little food. But she was happy because she had a home. The food they did have was a loaf of bread and jalapeños. They toasted the bread in the oven and all sat down on the floor in the living room enjoying jalapeño sandwiches ... and they were deeply happy. It shows me the strength and the spirit that God has given us when we turn to Him in gratitude for the blessings in our lives. Focusing on, and enjoying the simple pleasures, we begin to see the deeper meaning and purpose of humanity,” Cinefro says.

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SPOTLIGHT

Nathan “Nate” Cinefro is a biomedical engineer at the Cincinnati VA Medical Center who created St. Margaret’s House to help those in need by providing safe and affordable housing to single mothers.

He says that the second story is about a picnic they had in the backyard. “The kids were running, playing on the swings and slide. The mothers were sharing stories about their kids’ current milestones. We gathered around makeshift tables and as I looked around at the meal. I saw the fellowship across races – black, white and Hispanic – and companionship in shared struggle. People moving beyond the aspects that divide us and instead sharing the joy of being with others,” Cinefro says. He says that it has been an honor and a gift to be included in the lives of these mothers. “Is the road always easy? No. Is the joy always there? No; but this is life and we are called to live life to the fullest. How do we fill up our lives? We are the ones who choose what to fill our lives

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with. I’m thankful that these mothers have chosen to be a part of my life,” Cinefro adds. With all he does with St. Margaret’s house, Cinefro also has his main vocation with the VA. He is involved with implementing healthcare technology, including clinical information systems, imaging modalities and PACS. He has been selected as the 2018 honoree BME of the year for the VHA and presented his VISN virtualization project at the 2018 VHA HTM conference. He holds a bachelor of science in BME from Marquette

University and an MBA in information systems from Tennessee Tech University. He is also a busy family man with his wife and five kids and he can be seen biking around town in Norwood, Ohio. For some of the single moms in Cincinnati, he and his wife are also a Godsend. The first house is not the end of the story though. Cinefro and his wife have purchased a second property. It is a two-family structure and they have already remodeled one of the units and are at work on the second one. The first unit is already occupied by a mother, so their ministry is now helping four single moms.

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STAFF REPORTS

NEWS & NOTES

Updates from the HTM Industry AVANTE HEALTH SOLUTIONS OPENS N.C. LOCATION

Avante Health Solutions has announced the completion of its new offices in Concord, N.C. Located just outside of Charlotte, the new building was completed earlier this year and will house Avante Diagnostic Imaging, Avante Ultrasound and Avante Oncology Services. The new Avante Health Solutions location measures approximately 158,000 square feet, providing expanded space for each Avante division and fostering a collaborative work environment. “Our new Concord location will further unify the Avante Health Solutions family of companies and bring together the efficiencies and expertise of our various imaging specialties,” said Steve Inacker, Avante’s president and chief operating officer. In addition to increased space, the new location will feature upgraded, state-of-the-art staging and service bays for cath/angio, CT, ultrasound and LINAC systems as well as expanded offices to house each division’s growing administrative and sales staffs. Avante Diagnostic Imaging will be the first company to relocate to the new building, with moving previously announced to commence in January 2019. Formerly known as Transtate Equipment Company, Avante Diagnostic Imaging is currently based in Concord. The new building is located just minutes away from its current campus. The new Avante Health Solutions offices will be located at 1040 Derita Road, Suite A, Concord, NC 28027. •

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COMMONSPIRIT HEALTH LAUNCHES AS NEW HEALTH SYSTEM Dignity Health and Catholic Health Initiatives (CHI) have come together as CommonSpirit Health, creating a new nonprofit Catholic health system focused on advancing health for all people and serving communities in 21 states. The $29 billion system operates more than 700 care sites and 142 hospitals, as well as research programs, virtual care services, home health programs and living communities. CommonSpirit Health also supports a range of community health programs to create healthier communities and address the root causes of poor health such as access to quality care and health equity, affordable housing, safe neighborhoods and a healthy environment. The new organization is built on the legacy of 17 congregations of women who founded health ministries to serve people most in need. Today, it is supported by approximately 150,000 employees and 25,000 physicians and advanced practice clinicians. Catholic Health Initiatives CEO Kevin E. Lofton and Dignity Health President and CEO Lloyd H. Dean will both serve as CEOs in the Office of the CEO for the new health system. CHI and Dignity Health previously announced that the new ministry will retain the names of local facilities and services in the communities where they are located. •

THE INTERMED GROUP ACQUIRES HORIZON CSA LLC The InterMed Group announced the acquisition of Horizon CSA LLC, a Mooresville, North Carolina-based provider of clinical engineering solutions for biomedical and imaging services at health care organizations. “Horizon is known for its unique approach to assessing then managing clients’ total costs for medical equipment servicing and administration and has built a reputation for quality that consistently generates the highest customer satisfaction ratings,” according to a press release. Horizon services include: biomedical equipment repair and maintenance services; clinical engineering services; imaging equipment repair and maintenance services; life-cycle management; inventory audit; service contract review; technology management; and clinical equipment planning and assessment. It is anticipated that Horizon’s operations will be quickly, and seamlessly, integrated enabling its customers to take advantage of InterMed’s broad array of modality services. In turn, InterMed will be able to offer a new best-in-class HTM program called “New Horizons,” a direct product of the integration of these two companies’ cultures. In other news, the InterMed Group announced that Dan Harrison has joined the company as chief growth and development officer. Harrison is a seasoned sales executive with over 40 years of experience in the Healthcare Technology Management industry. •

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ECRI INSTITUTE RECEIVES $2.4 MILLION GRANT ECRI Institute announces a $2.4 million grant from the Gordon and Betty Moore Foundation to ensure that the health care community has free access to trustworthy clinical practice guidelines. The ECRI Guidelines Trust is available to the public at no cost through this grant. Medical professionals rely on expertly vetted clinical practice guidelines to support safe and effective patient care. Since its launch in November, more than 4,000 clinicians, medical librarians and academic researchers from 60 countries around the world have registered for free public access. ECRI already has over 700 guidelines represented on the site through collaboration with developers whose guidelines meet ECRI’s inclusion criteria. The Guidelines Trust currently contains expertly vetted briefs, TRUST Scorecards and links to full-text guidelines. “To help providers apply high standards of clinical excellence, we designed our TRUST Scorecards with a 5-star rating system that makes it easy to see how the guidelines comply with Institute of Medicine standards,” says Karen M. Schoelles, MD, SM,

FACP, vice president for clinical excellence and safety at ECRI Institute. “This goes beyond the rigor and transparency that we had provided in the National Guideline Clearinghouse.” Guidelines from nearly 60 developers, medical specialty societies, and other healthcare organizations are already included at the site, which will continue to grow. ECRI’s strict conflict-ofinterest policies ensure evaluations are unbiased, fact-based, and free from industry influence. ECRI Institute developed the Guidelines Trust after substantial federal funding cuts forced the shutdown of the National Guideline Clearinghouse (NGC), which ECRI Institute developed and maintained for 20 years. The next phase of the Guidelines Trust will feature advanced search capabilities, an enhanced user interface, and support for guideline implementation and decision-making. • For information and to register for free, visit guidelines.ecri.org or e-mail guidelines@ecri.org.

GBIS KICKS OFF 2019

HCA HEALTHCARE COMPLETES PURCHASE OF MISSION HEALTH

The GBIS Board of Directors and Trustees met January 26, 2019 at Central Georgia Technical College in Macon, Georgia to formulate plans for 2019. Dave Wiedman was elected to the board of directors. He is the chief commercial officer for Vizzia Technologies, a successful entrepreneur and healthcare IT executive. Board member Nikhil Shirke presented favorable survey results indicating improved satisfaction with the 2018 conference from vendors and attendees. Plans are underway to improve benefits for the members at large while also increasing membership and expanding business opportunities. Hands-on classes are being developed and a 2019 conference is being planned for August. The GBIS and its’ members currently support select charities, scholarships and workshops. Members are encouraged to contact any GBIS board member or trustee with ideas, suggestions or comments, as member input drives the type of activities and events. •

HCA Healthcare has completed the purchase of Mission Health, a six-hospital system in Asheville and western North Carolina, for approximately $1.5 billion. “The team at Mission Health has been nationally recognized for providing high-quality patient care, and we’re excited that they’ve joined HCA Healthcare,” said Sam Hazen, CEO of HCA Healthcare. “We’re looking forward to investing in western North Carolina and helping ensure Mission Health’s 133-year tradition of caring for communities throughout the region continues for many years.” Mission Health, recognized as one of the nation’s top 15 health systems by IBM Watson Health in six of the past seven years, is now a new operating division of HCA Healthcare. Benefits and highlights of the transaction include the following commitments: • H CA Healthcare will build a 120-bed inpatient behavioral health hospital in Asheville. • H CA Healthcare will build a new replacement hospital for Angel Medical Center in Franklin, N.C. • H CA Healthcare will complete the new state-of-the-art Mission Hospital for Advanced Medicine in Asheville. • I n addition to the new behavioral health hospital, replacement hospital and new tower, HCA Healthcare will invest $232 million in capital in Mission Health facilities. • H CA Healthcare will create a $25 million Innovation Fund focused on improving healthcare service delivery and spurring economic development. • M ission Health will adopt HCA Healthcare’s more expansive charity care policy. HCA Healthcare is providing assurances that certain healthcare services will be maintained. HCA Healthcare and Mission Health entered into exclusive discussions March 21, 2018 and signed a definitive agreement August 31, 2018. The North Carolina Attorney General’s Office approved the transaction January 16, 2019. The acquisition brings HCA Healthcare’s total number of hospitals to 185. •

For more information about joining GBIS please visit www.gbisonline.org or contact Horace Hunter at gbisexecutive@gmail.com.

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INDUSTRY UPDATES

ZALUZNEY JOINS PARTSSOURCE PartsSource has selected supply chain logistics and optimization expert Joseph Zaluzney to lead its fast-growing commercial organization, according to a news release. Zaluzney joins PartsSource as senior vice president and chief revenue officer after 20 years at the global health care services and supply company Owens & Minor, Joseph Zaluzney where he was the senior vice president of global business development responsible for development and execution of enterprise wide distribution and solution strategies on behalf of medical suppliers and IDNs. Zaluzney previously was senior vice president of commercial services, leading a team of 400 professionals who supported 2,000 hospitals’ supply chain needs. Before joining Owens & Minor, Zaluzney was chief supply chain officer for Mary Washington Healthcare in

Fredericksburg, Virginia. In his newly created executive position, Zaluzney will lead PartsSource’s expanding commercial portfolio that includes 1,200 PartsSource Pro hospitals, 3,300 hospital clients, 15,000 clinical sites across the U.S., government, GPO and ISO member hospitals. “In 2018, PartsSource added over 700 hospitals to PartsSource Pro, our software-enabled managed services program for hospitals and ISOs to improve supply chain costs, team productivity and product quality. Joe joins our rapidly growing company that will benefit from his three decades of work serving the health care ecosystem,” said Philip Settimi, M.D., president and CEO of PartsSource. “His vast supply chain experience complements our executive leadership team to support recently onboarded client success at HCA, Mayo Clinic, Advocate Aurora Health, Mercy, Memorial Sloan Kettering, Intermountain Health, University of Michigan and many more who are seeking enterprise pricing, product and purchased service standardization.” •

PROBO MEDICAL LLC ACQUIRES TRISONICS INC. Probo Medical, one of the fastest-growing companies in medical equipment sales and repair and a portfolio company of Varsity Healthcare Partners, announced the acquisition of Trisonics Inc., which will expand its presence in the ultrasound industry. With the acquisition of Trisonics, Probo Medical will have an extensive ultrasound service division to complement its current ultrasound equipment sales and refurbishment departments. Trisonics is located in Harrisburg, Pennsylvania. Established in 2014 and headquartered in Indiana, Probo Medical has quickly become one of the U.S.’s largest resellers of new and refurbished ultrasound equipment. Probo’s family

of companies includes ultrasound probe operations in Indiana and Oklahoma, ultrasound system sales through its MedCorp office in Tampa, Florida, and expands service and sales by Trisonics throughout the eastern United States. Trisonics will continue to operate under its current name, with the same tenured service team providing for its customers. Now with more than 120 employees, four locations and strong capital backing, Probo is looking to continue to expand through acquisition within the industry. •

INTERSTATE BATTERIES OFFERS INFUSION PUMP REPLACEMENT BATTERY Interstate Batteries now offers an alternative to the OEM Sapphire Infusion Pump battery 16354-01, providing customers with the same OEM quality performance at a lower cost and nationwide service. Currently available for local delivery from nearly 200 Interstate All Battery Centers, Interstate’s quality management process meets ISO 13485:2016 standards, and they are FDA registered. In addition to offering OEM-quality replacement batteries, Interstate’s network of All Battery Centers provides medical facilities with a complete battery program that includes local delivery, recycling services and expedited shipping to meet all of their power needs. “Our customers asked for an alternative to purchasing

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

OEM, and we felt they deserved another high-quality option with the service they expect from Interstate,” said Nate White, director of supply chain, Interstate All Battery Center. “Our new Sapphire Infusion Pump replacement battery is just one example of how we continue to seek new ways to deliver the most trustworthy products and services.” The Sapphire Infusion Pump replacement battery joins Interstate’s offering of medical battery applications, including monitors, defibrillators, respirators, ventilators, OR tables and more. •

APRIL 2019

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STAFF REPORT

PRONK TECHNOLOGIES INC. HIRES RICK WALSTON Pronk Technologies Inc. has announced the addition of Product Specialist Rick Walston. “Walston comes to the company with a history of commitment to the Healthcare Technology Management community, having spent five years in the U.S. Army as a biomedical engineer and then 20+ years managing multiple Adventist Health facilities during which time he was instrumental in building a remarkable biomed program virtually from the ground up,”

according to a press release. At the end of his tenure with Adventist Health, Walston was responsible for managing operating budgets of $13 million and an inventory of over $80 million. Rick’s role with Pronk will be multi-faceted including conducting technical presentations, guiding us toward the future as we continue to increase our focus on tools for the HTM community that have a big impact on improving work flow and efficiencies,” the press release states. • For more information, visit www.pronktech.com.

STORAGECRAFT PROTECTS HEALTH CARE ORGANIZATIONS The widely standardized use of electronic health records and medical imaging, plus the growth in data intensive health applications such as wearable technologies and telemedicine, are catapulting even small health care organizations into the petabyte era. To help health care organizations immunize themselves against the resulting triple threat of spiraling data costs, system downtime and loss of data integrity, StorageCraft has introduced StorageCraft for Healthcare, a converged scale-out primary and secondary data platform with integrated data protection. StorageCraft worked with health care solution partners to optimize its recently introduced OneXafe solution – the industry’s first converged data platform for both primary and secondary data, and data protection – for the specific

requirements of health care environments. “A one-two punch of data-hungry advances in medical technologies and growing data compliance regulations poses a significant challenge for our IT systems and budgets. StorageCraft presented the means to solve our data challenges of today – and the means to simply and cost-efficiently scale in the future,” Lake Chelan Community Hospital CIO Ross Hurd said. “We now have an easy-to-manage and exceptionally well-protected data environment in a single solution, that meets our needs for remote replication, file serving data protection, continuous data protection and even protects us from possible exposure to ransomware.” •

TECHNICAL PROSPECTS ANNOUNCES NEW VICE PRESIDENT OF SALES Technical Prospects has added Steve Green to the position of vice president of sales. Green comes to Technical Prospects with years of experience in sales, sales management and training in several industries, most extensively in the health care industry. In his previous experience, Green has been able to excel in building an aftermarket distribution network that expanded business worldwide by designing and implementing a distributor, dealer and manufacturer sales representative network. Prior to joining Technical Prospects, Green also operated his own medical device distributorship covering a large geographic range with several products in addition to managing more than 80 sales representatives throughout North America. •

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BY AAMI

AAMI UPDATE

Artificial Intelligence to take Center Stage at the AAMI Exchange BY AAMI

ook no further than this year’s AAMI Exchange – the name for AAMI’s growing and reimagined Annual Conference & Expo – for evidence that the artificial intelligence (AI) revolution is in full swing.

The Exchange will feature a variety of AI-related content, ranging from hands-on exhibitions on the Expo Floor to the following education sessions: • Healthcare AI: Not as Scary as You’d Think • Reduce Costs and Downtime with AI-Enabled Predictive Maintenance • Data Analytics, Artificial Intelligence, Predictive Modeling and HTM • Artificial Intelligence in Ultrasound Imaging: Yesterday, Today, and Tomorrow • Using AI with CMMS for Capital Equipment Planning “The 2019 education program will deliver an immersive and interactive learning environment for professionals in a variety of health technology-related fields at all experience levels,” said Sherrie Schulte, CAE, AAMI’s senior director of certification and meetings. “These sessions will provide the cutting-edge solutions and forward-thinking insights attendees need to meet the challenges they encounter on a daily basis and those they will face in the future.” Join your colleagues at the AAMI Exchange, June 7-10, in Cleveland, OH, to learn how AI is reshaping healthcare. To register, visit www.aami.org/2019registration. AAMI ESTABLISHES FELLOWS PROGRAM TO RECOGNIZE ‘EXTRAORDINARY INDIVIDUALS’ For more than five decades, AAMI members have led the way in developing, managing and safeguarding effective health technology. To recognize those who have provided substantial service and contributions to AAMI and the health technology industry as a whole, AAMI has established the AAMI Fellow Program. “The AAMI Fellow Program recognizes truly extraordinary individuals who have made a distinctive mark

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in the health technology field,” said Rob Jensen, president and CEO of AAMI. “Their work, like AAMI’s mission, touches many different relevant areas such as standards development, healthcare technology management, education and certification, and special domains like quality assurance, sterilization and cybersecurity. An AAMI Fellow embodies the level of achievement and principles that we can all emulate in our health technology careers.” AAMI Fellows will be selected based on the depth and breadth of their accomplishments in seven core areas: professional experience, education, technical contributions, presentations and publications, professional participation, certification, and awards and honors, as well as their response to an essay question. The AAMI Fellow Selection Committee received nominations for its first class of fellows in March and will make its selection by April 12. Decisions are considered final for one year from the submission date, after which an applicant may reapply. All Fellows will receive a certificate and pin and will be recognized at the AAMI Exchange, in publications and on social media. More information about the AAMI Fellow Program is available at www.aami.org/Fellow. AAMI WELCOMES NEW SENIOR VICE PRESIDENT OF EDUCATION AAMI has turned to a business leader with 20 years of leadership experience in learning and organizational effectiveness as its new senior vice president of education. In early February, Robert Burroughs, founder of the Northern Virginia-based learning services company Trainingwerx, took the reins of AAMI’s educational portfolio, which includes industry training courses for medical device manufacturers, certifications for healthcare technology management and sterilization professionals and the AAMI Exchange, the association’s growing and revamped annual conference. “It is a very exciting time to join the AAMI team,” Burroughs said. “The next decade will bring both tremendous opportunity and tremendous disruption to the health

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technology industry, and AAMI can play a critical role in driving positive healthcare technology outcomes. I’m thrilled to help support such an important mission.” AAMI President and CEO Rob Jensen spoke highly of Burroughs’ experience and vision, which separated him from a field of nearly 200 applicants. “Robert brings broad and deep experience in professional education programs, learning technologies and e-learning/media production as well as proficiency in management, strategic planning, and sales,” Jensen said. “He is knowledgeable, engaging and eager to learn more about AAMI’s mission, members and current education offerings. We are excited to welcome him to the team.”

Burroughs earned dual bachelor’s degrees in economics and art/art history from Rice University and studied motion picture and television production at the University of Southern California’s Graduate School of CinemaTelevision. However, he has spent the past two decades finding new ways to drive individual and organizational performance. Prior to starting his own learning services company, Burroughs was vice president at Learnsomething, a Xerox Company, where he was responsible for the learning management systems business unit; was a principal and co-founder of Genesys Solutions, a boutique consulting firm focused on strategic execution; and director of client services for the full-service

eLearning company Quisic. Burroughs says he is looking forward to “getting to know and work with so many talented professionals, both at AAMI and in our larger community of stakeholders” and plans to spend his first few months doing what he has promoted throughout his career – learning. “There are so many good things happening at AAMI that my first task will simply be to wrap my head around them all,” Burroughs said. “That will mean spending lots of time with staff from across the AAMI organization and getting out into the field with our members. I can’t wait to hear from them what opportunities they see for AAMI to have a greater impact.”

Doctor is Selling Selling medical equipment is a centerpiece of our business. We purchase medical equipment that is no longer being used from hospitals, surgery centers and third-party providers. We then offer it for resale at significant savings and provide comprehensive support documentation on everything we sell.

The Doctor is in, and Selling. Selling@MedicalEquipDoc.com

2749 East Regal Park Drive • Anaheim, California 92806 • 800-285-9918 • medicalequipdoc.com

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BY ECRI

ECRI UPDATE

ECRI Laboratory Notebook Testing Med/Surg and Critical Care Hospital Beds

icture a traffic jam in a parking garage: Navigating the aisles requires some careful maneuvering when a lot of vehicles are present in a confined space.

A similar experience was observed in ECRI Institute’s main testing lab a few months ago, as Ismael Cordero jockeyed electric hospital beds from one spot to another. Cordero, a senior project engineer in ECRI Institute’s Health Devices Group, was the project lead for the nonprofit organization’s recent testing of hospital beds. The studies focused specifically on models designed for use in med/surg applications and those intended for use in critical care areas. With up to 10 hospital beds occupying the lab at any one time, the job did indeed require some careful maneuvering, as each bed was shuttled from one lab to another for various aspects of the testing. ECRI Institute published its ratings for med/surg and critical care beds in December and January, respectively. BED COMPONENTS AND FEATURES The features available on a bed model will vary depending on the intended application; but, as ECRI Institute’s Cordero notes: “Most models are highly configurable. If there’s a feature that you want, you may just need to ask the manufacturer for it.” The trend is toward “smart beds” that communicate information to caregivers to improve care or enhance patient safety. For example, some beds offer verbal safety alerts, such as a voice command stating “brake not set”; or the bed might offer visual safety projections, such as a status icon projected onto the floor to alert caregivers when the bed-exit alarm is deactivated. Such features may be of particular interest in med/surg areas, where the degree of patient movement and alertness can vary widely. Regardless of the intended application, most electric beds marketed today consist of five major components:

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APRIL 2019

1. The bed frame. The bed frame holds a patient support surface or mattress, which may be integrated with the frame or available as a separate component. The platform on which the mattress rests can be raised or lowered to provide a comfortable working height and to facilitate ingress and egress from the bed. Electric motors allow the bed’s height and position to be adjusted without the need for manual force, reducing both time and strain. The mattress platform is typically divided into three or four segments that allow the bed to be positioned in various ways for patient comfort, for performing procedures, and for therapeutic purposes. In some critical care beds, the frame can rotate laterally to facilitate turning the patient for cleaning or for conducting procedures. Removable headboards and footboards facilitate access to patients for certain procedures, and movable and latchable siderails facilitate patient ingress and egress and protect patients from falls. The bed frame may also include features like integrated scales, motorized drives for transport, a braking and steering system, and a battery backup that can be used during transport or in the event of a power failure to change bed height and positioning. 2. Bed motors. In most beds, separate motors are present to adjust the height and tilt of the bed and to move the head and knee sections. In some beds, additional motors adjust the bed frame length and the elevation of the foot section. Most current beds require constant pressure on the positioning controls to provide continuous motor movement. This critical safety feature helps prevent accidental entrapment and harm. Some beds additionally have a motor and a drivetrain that can be engaged to help propel the bed during transports. 3. Patient controls. Patient controls typically include adjustment of the height of the head and knee sections, and a nurse call button. Additional controls may include activation of reading lights and room lights and operation of the TV. The controls may be embedded on the siderail or available on a pendant.

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4. Caregiver controls. These include controls for all bed positions and for patient lockout. They are typically located in the siderails on the side facing away from the patient, or at the foot of the bed. For bed frames with integrated powered therapy surfaces, the caregiver controls allow control of the surface. Like patient controls, caregiver bed-raising and position controls are usually of the momentary-contact type. 5. Alarm and status system. Beds can include alarms and visual indicators for conditions such as bed-exit, siderail positions, head-of-bed angle less than 30°, bed height, brake activation, and under-bed obstructions. Bed status and alarm conditions are typically transmitted through the nurse call system for central monitoring. Bed-exit alarms can be set to different levels of sensitivity for patient movement, from minor movements to fully exiting the bed. Many bed-exit alarms can be temporarily paused to reduce nuisance alarms while the patient is being repositioned; after the pause, the alarm is automatically re-armed. Some bed-exit alarms will reset automatically if the patient stops moving and returns to normal rest position within a certain time period. Many new beds have visual bed status indicator bars at the foot of the bed for easy identification of the bed status by the caregiver. FINDINGS AND DIFFERENTIATING FACTORS All the models that ECRI Institute tested for its recent evaluations performed acceptably. However, the models did differ in ways that could affect their appropriateness for particular healthcare facilities. Following are four areas where ECRI’s testing revealed factors that should be considered when making bed purchasing decisions. 1. Operation at the bed’s maximum rated weight capacity. Testers distributed sand bags on the bed surface to reach the bed’s manufacturer-stated safe working load (SWL). The bed was then operated to determine whether it could perform all movements, positions,

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and functions at that weight. “All beds ultimately passed the test,” noted Cordero, “but a few did struggle with some positions at the SWL.” 2. Transport on an incline. ECRI constructed a 5-degree ramp to test the beds’ braking systems and to measure the force required to push each bed up a typical incline that might be encountered in a hospital. All brake systems worked as expected. However, all the beds required excessive force to initiate and to sustain movement up the ramp when not using a motorized drive. For facilities that include ramps, ECRI Institute recommends bed models that incorporate a motorized drive. 3. Motor noise. Loud bed motors can disrupt a patient’s rest; thus, ECRI Institute’s test protocol involves measuring the noise levels associated with bed operation. The organization’s findings confirm that new motor technology has made the beds very quiet. One of the models tested, however, did not meet ECRI’s noise criterion. 4. Battery-powered operation. We tested the functionality of the beds while operating on battery power, as would be the case during transport or in the event of a power outage. Half of the beds retained full functionality when operating on battery power, while the other half lost some functionality. Hospitals need to be aware of which functions will and will not be available if operation on battery power will be required. This article is adapted from ECRI Institute’s “Evaluation Background: Electric Beds for Medical/Surgical Units” (Health Devices 2018 Dec 28) and “Evaluation Background: Electric Beds for Critical Care Units” (Health Devices 2019 Jan 30). The complete articles—including model-specific test results and product ratings, along with additional guidance for purchasing and using these types of beds—are available to members of ECRI Institute’s Health Devices System and associated programs. To learn more about membership, visit www.ecri. org/HealthDevices, 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 JOHN WALLACE

IN MEMORIAM Industry Will Miss ‘Amazing Man’ BY JOHN WALLACE

eorge Hryshchuk Jr., 53 suddenly passed away on Saturday, February 2, 2019. He will be terribly missed by family, friends and the industry he served as a longtime member of the Advanced Ultrasound Electronics (AUE) team.

In 2001, George became AUE’s first employee where he assisted his brother, John, to grow the company to what it is today. He was a firm believer in outstanding customer service and he had a unique ability to motivate others to meet his own high standards no matter how difficult a challenge might be. “George was the first employee hired by Advanced Ultrasound Electronics, shortly after John founded the company in 2001,” said AUE Director of Service and International Operations Jim Carr. “He was responsible for building much of the foundation the company stands on today. His knowledge of the industry, his incredible memory for part numbers, and his knowledge about compatibility of parts were a huge asset for AUE. He helped train many technicians, logistics folks, salespeople and the people that are developing the AUE model at AUE Ltd. in the UK. His passion for customer service was a shining example for all of us, which we will carry for the rest of our lives!” “I will always remember the way George would light up a room,” Carr added. “He had a huge, warm smile that came easily because he was happy almost all the time. It could make a person meeting him for the first time feel like he was a lifelong friend. And it was sincere, because George would literally give a stranger the shirt off his back if asked. He could get frustrated at times, especially if we didn’t live up to his high standards for customer service. Even when he was urging you on with something like helping a customer solve a seemingly impossible technical challenge, he did it in a supportive way, usually imitating a line from one of the many movies he had memorized. I still hear him saying, ‘C’mon, Jim. You can do it! You ‘da man!’ ” John Hryshchuk said his brother was friendly and outgoing to everyone. “George loved his work and treated everyone like family, and he genuinely enjoyed helping everyone. It didn’t matter if he made the sale or not, he wanted the customer to get the correct information on the part or probe,” he said. “George was a person who wore his heart on his sleeve, loved his work and his life. It’s rare to find a person you can only say good things about,” John Hryshchuk added.

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In his many years with AUE, George became a friendly face at industry trade shows where he represented the GEORGE HRYSHCHUK JR. company. His positive outlook 1965-2019 and friendly words were among the characteristics for which he was best known. “I had the pleasure of knowing and working with George for as long as I can remember. What really stood out was the way he smiled and always had a positive outlook on life. He always had a fantastic life experience to share, and I always looked forward to seeing him. He was truly one of a kind and the industry will sorely miss his kind and gentle spirit. Rest in peace George,” MD Publishing Founder and President John Krieg said. MD Publishing Vice President Kristin Leavoy remembers seeing George at several conferences and industry events. “George was a fixture at the MD Expo. He had been representing AUE at conferences since the company was founded, and you could always count on him for a smile and a kind word. He’d usually throw in a funny story about his shenanigans back home in Oklahoma which always made for a good laugh as well,” she said. “He will be sorely missed by the TechNation family.” His interactions within the industry were just one way that George continued to grow professionally. The interactions were also an avenue he used to share his knowledge with others. “One of the ways he gained knowledge of the ‘real world of imaging technicians’ was his membership and support of many HTM organizations. And, using that knowledge and experience, George helped many others in this industry. We are astounded and grateful for all the emails, texts and phone calls we have received at AUE from people telling us how much George meant to them in their lives and careers,” Carr said. People from throughout the industry were quick to share their thoughts and memories on a LinkedIn memorial page as well as on a Tribute Page created by Moore Funeral Home. “The last time George and I spoke at one of our trade shows, I told him he looked great. He said he was doing the best he could and his girlfriend was telling him he needed new clothes. We had a wonderful time and laughed and told stories. I always looked forward to talking to him. He loved his work, family and loved doing what we all do – taking care of patients with the products and services in the health care industry,” wrote Michele Shahbandeh of Integrity Biomedical Services. “George you are a one of a kind soul and I feel truly blessed to

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INDUSTRY UPDATES have known you. Gone far, far too young ... you will be missed so much,” wrote Kimberly Rowland from Tri-Imaging Solutions. Janice Courtois, CBET, at Mayo Clinic wrote, “Very sad news. I would search out George at the many vendor fairs over the years. He was a knowledgeable resource in the ultrasound modality, and he had a great sense of humor!” April Lebo from Trisonics Inc. echoed what many wrote and thought upon hearing of George’s passing. “George was an amazing man and will be sorely missed! The industry will not be the same without him,” Lebo wrote on LinkedIn. “So sorry for your loss John and Hryshchuk family. George always made us laugh. He had the softest heart and was always a pleasure to talk to. He will be missed. May his legacy and spirit always be alive at AUE,” SONO Ultrasound Wipes President and CEO Arman Semerjian shared. Daniel Pierce, MV ultrasound trainer at Philips Healthcare, is another who referenced George’s kindness and caring nature. “George was an amazing person with a warm kind heart. Always a big smile and time to talk. He genuinely cared about people. I miss him and am thankful I knew him,” Pierce wrote. Robert J. Steele, director of service solutions at Agiliti, wrote, “Our industry is sadder and a little smaller today. Condolences to the entire AUE team and George’s family and friends.” A memorial service was held February 7, 2019 at Moore’s Southlawn Chapel in Tulsa, Oklahoma. In lieu of flowers, the family suggests contributions be made in George’s memory to John 3:16 Mission, 575 North 39th West Ave, Tulsa, OK 74127; or Coffee Bunker, 6365 E. 41st, Tulsa, OK 74135; or www.semperfifund.org.

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RIBBON CUTTING Medcise

ataBank has been working within the health care industry since 1975, maintaining patient records with a strong focus on data management. The continued success of DataBank is a testament to its leadership and employees. They ensure the company continues to grow and adapt. From humble beginnings, DataBank has taken the time to develop its own content management products and has partnered with the largest electronic content management (ECM) companies in the industry. Looking at present day, the needs of health care enterprises have changed. DataBank opted to offer products and services in a more digital and technical landscape. As a company, it has always kept its eyes and ears on the health care industry. Feedback from existing clients and experts in the field enabled DataBank to expand its solution set and geographic reach. As the needs of health care providers become less and less linear, they no longer look for a vendor to provide them with a single solution set to solve one problem, especially as data management needs become more diverse and expand beyond the traditional four-walls of a hospital. Medcise was born to offer wider solution sets to meet those needs. To better serve North American health systems, it refocused its efforts into health care solutions, deepening the products and services DataBank offers. By just focusing on one solution, it did the industry a disservice. By offering a wider breadth of health care offerings under one umbrella (the Medcise brand), DataBank is able to provide hospitals with a more targeted approach and specialized solutions to meet unique pain points. Q: WHAT IS THE MAIN FOCUS OF MEDCISE? A: The main focus of Medcise is to offer a solution to North American health systems that allows them to manage the

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disparate part of patient information in an ever-increasingly distributed environment (i.e., physicians’ practices, home health, etc). ECM technologies adopted

Jordan Bires National Healthcare Practice Director DataBank IMX by the industry, by and large, have done a great job of making us a more digital society from a HIM-standpoint. However, from DataBank’s perspective, there’s still an acknowledgement of the fact that there are aspects of those records that are hard to manage. Medcise aims to provide two critical pillars of support to health care providers. First, the option of many different “on-ramps” allows health systems to have a variety of patient-data capture tools.

MEDCISE Contact: Jordan Bires National Healthcare Practice Director DataBank IMX Email: jbires@databankimx.com Website: www.databankimx.com Phone: 1 (800) 873-9426

The second pillar is to then get that patient information into a platform where it can be quickly and accurately classified to the degree that a clinician or caregiver requires, all within an aggressive turnaround time. Q: CAN YOU PLEASE TELL US A LITTLE ABOUT THE SERVICES MEDCISE OFFERS? A: Our first step and guiding principle is to talk to potential customers about their own unique needs and using this information to stack available technologies and solutions that address those main points. The solutions that Medcise offers include, but are not limited to, point-of-care scanning and indexing models (in support of HIMSS Stage 7), remote capture and scanning services, data indexing and classification, image and data quality assurance services, traditional digital conversion (paper-to-digital) and data migration services (digital-to-digital). Q: HOW DOES MEDCISE STAND OUT IN THE INDUSTRY? A: When I look at Medcise, I believe it stands out in the industry in a couple of ways. Primarily, it does not expect health systems to fit inside a preconceived notion of what the perfect solution looks like. We are not forcing them to fit into any

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the medical product support network “MedWrench connects a wide range of biomed engineers, helping them to share knowledge and experiences.” –Fadi Ali, RSS

processes or standards that may not be best for them or does not fit their unique needs. Secondly, Medcise allows health providers the opportunity to take advantage of world-class technologies, all while maintaining a low footprint to their overhead and/or IT infrastructure. Additionally, DataBank has an array of facilities across the country that can support the processing and delivering of data, regardless of where a health system is located or in what time zone they are in. Lastly, we are proud to say that Medcise is a technology-enabled service that allows us to compliment the right solution that targets a health care enterprise’s individual challenges; where some competitors may lead with a specific technology, we lead with what is best for the customer. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT MEDCISE TO ACHIEVE IN THE NEAR FUTURE? A: If you look around health care right now, there are big grassroots companies all hopping on the bandwagon of making the industry more efficient. Everyone is acknowledging that health care cannot continue to grow, from a cost-perspective view, at the pace that is it is currently developing. Clinicians need to continue to provide high-quality care and to deliver it as efficiently as possible. When you look at the services Medcise offers, we align nicely with those two initiatives. We are helping to collect and classify information so that it gets to a central place for easy physician access and doing so at a very predictable cost model. What DataBank wants to do with Medcise is to take the competencies that we have developed over nearly 50 years of working in this space and align them with the nation-wide goals of our health care systems. We do not want to be a brand that is selling a product to the industry, we want to be a brand that helps health care providers meet their own initiatives and overall increase the quality of patient care.

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BIOMED 101 The Goal of Goals BY DALLAS SUTTON

s a rule, at that certain time of the year (depending on your organization’s evaluation cycle), we all get the opportunity to reflect on goals. Whether it be the previous year’s or the upcoming year’s goals we tend to have a love/hate relationship with them. This is most likely because they are generally imposed on rather than proposed by the individual – but why is that?

First, let’s take a minute to describe what we are talking about here. The Webster definition of “goal” is “the end toward which effort is made.” Oxford similarly defines a goal as the object of a person’s ambitions or effort; and aim or desired result. Now when we consider the development of goals, there are often two types. There are departmental goals which are, more often than not, some form of a regulatory or corporate compliance requirement. These tend to trickle down to the individual from some form of performance improvement goal established by the Environment of Care Committee as a method of ensuring regulatory requirements are met. This may find its way to into a Department Goal of 100% PM Completion, but that’s not really a goal is it? It’s a requirement, and if you have to set your goals to meet regulatory requirements that’s like saying “My goal this year is to do my job.” You’re not really stretching yourself. I’m not saying there is anything wrong with corporate or departmental goals, but look at the Oxford definition above – where is the ambition in meeting regulatory requirements? So, when considering departmental goals, which aren’t necessarily super fun things to do,

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consider those things outside of what you are expected to accomplish. A goal is something that should force growth, personally and professionally, and in the case of departmental goals, this should reflect team growth and cohesion. But, departmental goals are not the focus of this article – that was free for nothin’. That brings us to our second type of goal – individual or personal. As I reflect back on my interaction with personal goals over the years, most often they were assigned by leadership for the express purpose of meeting some corporate or regulatory requirement. I had no vested interest in completing, let alone exceeding, the goal other than to check the box before the end of the year. Now before all the hate mail starts, I’m in leadership at my organization and am just as guilty as the next leader in making up a few last-minute goals to assign to every single team member – and I mean that every member received exactly the same goal. This of course is fruitless, turning what could be a good goal for an individual into a nuisance departmental goal that may have no applicability to the rest of the team. Here is where we made a change. For starters an individual goal should be individualized – developed specifically for each individual member of the team – one per customer. I can hear it now – “Hey, wait, I have 18 technicians to write on, that’s gonna take a lot of time.” – Yes, yes, it is, but are you truly interested in the real growth and maturity of your individual team members? Truth be told, it took a couple of months to get to the point of writing down a goal for the coming year, but once I explain what took place, I hope you will be willing to invest the time.

Dallas T. Sutton Jr., CRES Clinical Engineering Supervisor, WakeMed Clinical Engineering. The best part about this whole process is that, as a leader, I didn’t have to write the goals. That’s what made them individual – we simply provided a criterion that each team member would use to create personalized goals for the coming year. The criteria went out via email about 80 days prior to the due date and contained the following requirements: • Each technician should develop an individual goal that is impactful to shop operations. • The impact should be measurable in a cost or labor hour savings, but the result should directly affect the time it takes to accomplish a task or an improvement in patient safety. • This can be a new visual control, process, procedure or an improvement to an existing item • To determine a goal the technician must utilize one of the following: Waste Wheel 5S Idea Form • Once determined, the goal must be approved by the department supervisor or director. • Once an idea has been approved, the

APRIL 2019

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technician must utilize at least one of the following to document the evaluation and improvement process: PDSA Form Takt Time Calculation Worksheet Detailed Time Observation Form and Time Observation Form Value Stream Map • In addition to the documentation above there should be an accompanying policy/process/ flowchart/visual aid that will be used to communicate the win to the rest of the team. • If your goal requires physical signage and/or the procurement reassignment of tools/equipment/parts or material, that will need to be documented as well. • Once completed, you will be required to present your win to the team. Include why the project was selected The time invested in the project The tools used to complete the project The financial impact of the project The impact to the patient The finished product • Throughout the process, leadership will be available to provide guidance on the use of the tools above or offer suggestion in navigating roadblocks. • As we progress through the year, there will be one-on-one sessions to gauge your progression toward goal and to offer feedback. • You will be expected to allocate 1-2 hours per week toward accomplishing your goal. This gives you between 36 and 72 hours to invest in completing your goal. If you have a particularly in-depth goal, additional time can be allocated, but the end result of this task should demonstrate that you spent at least 36 hours on it (i.e. quality of work is a factor). • This goal will represent 25% of your annual evaluation. The first thing many will key in on is the use of Lean/Six Sigma Process Improvement Tools. This element was

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APRIL 2019

incorporated to support our organization’s journey to a Lean Healthcare environment. Over the past couple of years there have been several training events that brought some familiarity to some tools, and simply introduced others, but we thought this to be a great opportunity to incorporate these into the team’s daily activity and provide for individual growth. The second thing some will notice is that we are not telling the team what to focus on, but instead allowing them the autonomy to impact something that they have a personal interest in. What’s great about it is that we don’t really care what it is, because, according to the established criteria, we will either save money or time or have a safer environment when they are done. By allowing the individual to pick their goal, you end up with automatic buy-in and an accompanying level of pride in knowing that they are directly responsible for the success or failure. So, we issued the directive, and it being a new experience for the team, there were some initial grumblings, but not near as much as we expected. Once we affirmed that we as a leadership team are fully engaged in their success and are relying on them to pick a goal that they want to accomplish as opposed to force feeding some inconsequential departmental goal, the ideas started to flow. About three weeks after dropping the initial bombshell, we followed up with a meeting invite to each individual team member. This would be their opportunity to tell us the direction they are trying to go, and our opportunity to refine their ideas, however slightly, to meet the program’s objective. Inevitably, we had a team member or two that, as opposed to shooting for the moon, chose to shoot for a low hanging branch, but after a quick recalibration, everyone was headed in the right direction. We were completely amazed at the level of sophistication and complexity that some of these projects

aspired to. For the most part, during the initial interviews, all that was needed was a little push to have the team member develop a plan to sustain the gains that they projected – other than that, most were well thought out and very impactful to overall operations. Over the remaining few weeks, another email was sent out, this time containing the format in which we needed them to be entered into their performance evaluation. Quite simply: title, description and expected outcome. Just a short synopsis of their plan and how we would know if they accomplished it. Once received, we simply cut and pasted them into their goals for the coming year. They will be evaluated on what they said they were going to accomplish. They own the process and the success when accomplished. To give you an idea of some of the goals presented, here are a few as entered into the performance evaluation system: • Title: Vendor Service Evaluation Description: Establish new metrics with which to illustrate clinical engineering’s expectations and service vendors’ effort to meet these expectations. Our desired goal is to clearly communicate and illustrate our service expectations for all suppliers regarding access to service resources associated with equipment purchased by the organization. Expected Outcome: This will be a long-term metric that should provide clear visibility to the performance of vendors against their own stated deliverables as well as each other. This has the potential to dramatically increase the effectiveness of clinical engineering as well as the entire in-house clinical engineering industry and future purchase negotiations. • Title: Automation of Clinical Alarms Reporting

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Â&#x192;Â&#x192; Description: Automation of the collection of clinical alarms data would eliminate the human error factors as well as speed up the process of creating such reports. There are many different processes to automate, but this project will focus on automating the transfer of data from the 10 server monthly reports into one main spreadsheet. Â&#x192;Â&#x192; Expected Outcome: Time to complete quarterly reporting should be reduced by 90% to 2 hours per quarter. Seventy-two labor hours saved per year plus this eliminates human error to almost zero. This is an ambitious goal but should be achievable if as much of the process is automated as possible. The only quarterly changes to the code would be adding sections for each new file (10 per month, 30 per quarter).

â&#x20AC;˘ Title: Radiology Engineering Project Management Â&#x192;Â&#x192; Description: Develop and implement the process around the management of imaging installation projects. This is to include all aspects of installation to include: pre-procurement, PO & point of sale contracts, deinstallation & trade-in management, construction & design, delivery, vendor management, install, final inspection and clinical acceptance. Â&#x192;Â&#x192; Expected Outcome: Provide for the more efficient management of equipment installation that results in better use of resources, cost avoidance associated with rework and missteps, and a decrease in the overall time invested in the installation process.

The intention of this article is not to toot the horn of my own awesome clinical engineering team, but to hopefully encourage leaders out there to unleash the potential that may be sitting dormant in a technician among your own awesome teams. There are many different industries out there with varying degrees of innovation and motivation among their employee base, but over the past couple of years I have been privy to learn the immense potential of a biomedical equipment technician. Unfortunately, they can sometimes be stifled by leadership. Not purposefully but stifled none-the-less. As a leader, if you truly care about the success of your team both individually and corporately, give them the opportunity to shine on their own terms every so often. Good luck! Dallas T. Sutton Jr., CRES, is a clinical engineering supervisor for WakeMed Clinical Engineering.

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SHOP TALK THERMO FISHER SCIENTIFIC JOUAN B4I SERIES I have recently repaired one of our centrifuges. I changed a slow charging resistor, Q: 15VDC Voltage source and some connectors. I have given it a go at different RPM levels, it is turning, everything looked fine. Then, I got a call from the lab assistant. She is

saying that rotor turns, but we can’t separate the samples (blood). What could be the cause of this? Are there any things that I might do to fix this or is it them doing something wrong?

Perhaps it is braking too fast, causing the separated fluids to re-mix. Check the braking function/setting. Or maybe, if it is taking longer to get up to speed, they will need to increase the program time. I would recommend that you try increasing the time, as a quick possible solution. Have you checked speed calibration at the speed they are using, with the rotor they are using?

This is a speed or time problem. The lab is using a specific tube which requires a specific speed at a specific time. The lab should be able to tell you what the tube manufacturer requires to get the separation required.

How much does the centrifuge shake when going up to speed, at speed and while braking? With a swinging bucket rotor, sometimes the buckets don’t swing out or fall back down evenly. Of course this creates an imbalance situation that could remix your seperation. The usual fix for this is to remove the buckets and clean the rotor pins where the buckets sit and clean the bucket contact points where they meet the rotor. Sometimes as the rotor is stopping right at the last minute before it actually stops you might hear a squeak when the actual bucket that isn’t falling back into place with the others falls into place. I hope this helps. The other suggestions are good as well.

LEICA - CM1510 S The electrical advance and return buttons are not working. The motor runs when hotwired to a 24V supply. The cable to the motor delivers 10V. Maybe this is correct, maybe not. I suspect a problem with the microtome part talking back to the circuit board. Documents include a service manual for the CM1510, but not for the CM1510S and the board I have looks very different. I would like advice on how to check the functioning of the circuit board and how to order a replacement.

Q: A:

Could be the switch. I’ve had to replace switches on these in the past. My notes show: large coarse advance/retract switch for 1510S: 14682203001. It says $24 each 2 in 2016. I think I might have had to replace a fine advance switch at another time, but I can’t find that part number, at the moment. However, if neither the fine or coarse advance/retract switches work, you might indeed have an electronics board problem. My advice would be to send the board to a PCB repair facility to see if they can evaluate/repair it. I have had good luck having several

boards repaired, for a few hundred dollars, when the replacement boards were not available, or would cost thousands to purchase new.

Call Leica Biosystems at 800-248-0123. You’ll probably need to create an account, before you can order anything. And, knowing the part number is essential. They aren’t forthcoming with help on finding part numbers anymore.

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.

TECHNATION

APRIL 2019

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APRIL 2019

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manufacturer of specialist biomedical testing equipment has launched a free mobile phone app to help clinical engineers performing electrical safety tests in the field. Built as a companion to the Rigel 288+ electrical safety analyzer, the Downloader app allows field service engineers using the device to create and upload digital test records. Users can remotely attach their test records to a computerized maintenance management system (CMMS) or send them to a central database. The 288+ is an electrical safety analyzer designed to perform routine tests on medical electrical equipment. These tests play a vital role as they highlight faults with medical equipment in hospitals and health care facilities, picking up on issues which can compromise patient safety. The Downloader app is available to download now from Google Play and is compatible with Rigel 288+ devices.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2019

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STAFF REPORT

EXPERT SHARES VENDOR MANAGEMENT TIPS STAFF REPORT

he Webinar Wednesday series continues to bring great educational material to HTM professionals in 2019. The recent Nuvolo-sponsored webinar “The Future of Healthcare Vendor Management” provided the opportunity for attendees to earn 1 credit from the ACI.

The webinar featured Nuvolo Director of Solution Consulting Peter Goltz. He discussed and demonstrated ways that HTM organizations can manage their vendors in a modern CMMS system. He covered areas around vendor on-boarding and access to the CMMS system, vendor contract management, vendor scorecards and reporting and vendor service level management. Almost 300 biomeds from throughout the United States tuned in for the live presentation and more have viewed a recording of the session online. The attendees at the live presentation gave the webinar a 3.8 rating on a 5-point scale with 5 being the best possible score. Goltz garnered positive feedback via a post-webinar survey in which

TECHNATION

APRIL 2019

the presentation was described as “informative” and “super relevant” by attendees. “Another informative webinar that helps show the effective use of CMMS technology to manage assets,” said J. Ruiz, biomedical engineering manager. “Well done and super relevant,” shared M. Pritchett, biomedical technician. “I enjoy the way that Peter presented the use of Nuvolo to log the vendor paperwork,” explained D. Palumbo, technician. “As always, with these types of webinars there is a value to the HTM field. Great information,” said L. Clifford, area manager. “Very thorough information delivered in a convenient manner,” F. Rosen, BMET, shared. “The Wednesday Webinar series is a great way to learn of new developments in test equipment, software and medical devices,” D. Minke, BMET, said. “It’s nice to have access to such relevant biomedical-specific educational sources for free,” said J. Thielen, biomedical account manager.

“We enjoy having a scheduled time to help our technicians learn more about the industry than what experience that they get in the hospital,” said J. Walker, supervisor, clinical engineering. “I truly enjoy the Webinar Wednesday series! I am able to listen to the webinar and work on equipment at my bench. No lost work time and I’m learning something new at the same time. Look forward to the next one,” S. McClinton, CBET, said. For more information about the Webinar Wednesday series, including a schedule and recordings of previous sessions, visit WebinarWednesday.live.

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ROUNDTABLE Endoscopes

This month, TechNation takes a closer look at endoscopes thanks to industry professionals who shared their expert insights in a question-and-answer format. Participants include a duo from Mobile Instrument Service and Repair in Educator Melissa Kubach and Flexible Endoscope Repair Division Product Manager Brianne Flesher, CFER. Also participating are Healthmark Industries Senior Manager of Clinical Education, Mary Ann Drosnock, MS, FAPIC, CIC, CFER, RM (NRCM); Capital Medical Resources Director of Business Development, Rob Purtell and MultiMedical Systems Director of Surgical Services, Chyrill Sandrini. Q: WHAT ARE THE LATEST ADVANCES IN ENDOSCOPES IN THE PAST YEAR? Drosnock: My answers are framed around the reprocessing of these devices. Therefore, I feel that new sterilization systems (Sterizone VP4 System from TSO3) that are FDA-cleared to sterilize GI scopes are very exciting. As sterilization provides a higher safety margin associated with reprocessing, having FDA-cleared methods that are compatible with these scopes represent a huge advancement in patient care. Single-use disposable endoscopes and duodenoscopes with a disposable cap for the tip are two more of the latest advances in endoscope technology as they can significantly decrease the risk of infection related to improper reprocessing. Kubach and Flesher: Endomicroscopy, chromoendoscopy and targeted use of white and blue light technologies have improved diagnosis, screening and treatment of gastrointestinal disorders. The ability to utilize enhanced imaging with different wavelengths capable of penetrating and visualizing tissue beyond the mucosa has allowed a number of diseases previously requiring surgical treatment to be addressed endoscopically thus greatly impacting patient outcomes. Purtell: Image enhancements, which allow for greater visibility of blood vessels and mucosal structures, are becoming more prevalent. This allows for increased opportunity for detection, as well as more effective diagnostic support. The way the light is filtered through the image processor leads to these advanced visualization technologies. The scopes themselves have features such as zoom, adjustable insertion tubes and anatomical indicators which all contribute to more effective procedures and ease of use. Sandrini: Advancements in endoscopes are exciting including better resolution in Ultra High Definition in 4k. 4D technology

TECHNATION

APRIL 2019

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ROUNDTABLE

and LED light sources are a few of the advancements we are seeing in the industry providing better diagnostic evaluations. New advancements in ultrasound endoscopes are exciting as well as new innovations in the pipeline such as the self-propelled endoscope. Q: WHERE AND HOW SHOULD ENDOSCOPES BE STORED WHEN NOT IN USE? Drosnock: According to AORN guidelines, endoscopes should be stored in cabinet, preferably a drying cabinet, with HEPA-filtered air hooked up directly to the channels to allow for drying internally. If an active drying cabinet is not available, then the storage cabinet should at least circulate HEPA-filtered air around the scopes. If an active drying cabinet is not used, then the scope must be prepared for storage by completely drying it, internally and externally, prior to being placed into the cabinet. Drying is accomplished by wiping the outside with a non-linting cloth and flushing the internal channels with instrument quality forced air for 10 minutes. Kubach and Flesher: While there are many product variations and techniques for endoscope storage the end goal has always remained singular … protect the endoscope from damage, contamination and either facilitate drying or perpetuate the dried device with high-quality, circulated or positive pressure air. Storage cabinets should be located in a secure clean area (not a procedural area). The endoscope should be completely dried internally and externally prior to hanging with high-quality air if the cabinet does not provide or has not been retrofitted with a manufacturer approved mechanical drying device to facilitate channel drying assistance. Rob Purtell, Capital Medical Resources Purtell: Ideal storage for flexible endoscopes should be in ventilated cabinets, that assist in the drying process. The scopes will suspend from a rack vertically, allowing space for insertion tubes and light tubes to hang freely, while a filtered air exchange dries the scopes. Proper spacing will keep scopes from swinging into each other and preventing ancillary damage. If budget is a concern, there are scope cabinets or other solutions that do not have the ventilation option, but still do a great job of protecting scopes. Regardless, it’s important for scopes to hang vertically, while protecting the tubes, and distal ends, from becoming damaged. Sandrini: Endoscopes should be stored in a manner that will protect them from contamination. Hang the endoscope in a vertical position to facilitate drying in an approved storage cabinet, ventilated and dust free. Remove all caps, valves and other detachable components per manufacturer’s instructions. Never cover the distal tip of the endoscope when stored.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

Q: WHAT STEPS SHOULD BE TAKEN PRIOR TO REPAIR/SERVICE OF AN ENDOSCOPE? Drosnock: Endoscopes should be inspected for residual debris and damage after manual cleaning. If debris is found, the endoscope should be fully manually cleaned again. If damage is noted, then the endoscope should be flagged as being out-ofservice and further processed according to their repair company’s instructions. Most repair companies require full manual cleaning and either disinfection or sterilization prior to being shipped to the repair facility. A few service organizations will provide instructions on how to ship a scope that has not been fully reprocessed. That organization would then be responsible for reprocessing the scope upon receipt for repair. This is the exception not the norm and the facility should expect to incur an additional cost for that. Either way, refer to the instructions from your repair company on how they require the device to be prepared through reprocessing prior to shipment. Kubach and Flesher: There are many steps that can be taken to render an endoscope free of bioburden when sending it to service provider. These steps include following all guidelines as it pertains to safe handling of flexible endoscopes which can and should include biological indication testing after cleaning procedures have taken place. Most importantly, if for any reason an endoscope was not fully decontaminated prior to sending to a service provider, the endoscope must be properly packaged and labeled that the endoscope was not fully disinfected. When endoscopes are sent to a service provider without any indication of cleaning procedures that have taken place and an endoscope is found to be contaminated, the safety of personnel has been compromised. Purtell: Prior to facilitating service, it’s important that the scope has been fully cleaned and disinfected/sterilized. Clinical engineers can establish a protocol with the processing staff, where there is a “sign off” on damaged scopes, indicating they have been fully processed. There are also products that can be used to test the surfaces of a scope with a swab, indicating the level of organic compound on the surface. Parameters can be established and logged, in order to provide traceability. Sandrini: HTM/BMET personnel should work with the central/ sterile processing manager to learn how they are managing their endoscope reprocessing and test strip processes. Always use gloves when handling any endoscope or surgical device. A little education and teamwork can help insure patient and staff safety. Suggestion: Before handling a scope have a form that is signed stating the scope has undergone the HLD or sterilization process according OEM reprocessing guidelines.

APRIL 2019

TECHNATION

ROUNDTABLE Q: CAN YOU EXPLAIN THE IMPORTANCE OF HOLDING AN IN-SERVICE OR CLINICIAN TRAINING ON HOW TO PROPERLY HANDLE ENDOSCOPES TO PREVENT DAMAGE? Drosnock: An in-service training on proper care and handling of endoscopes and damage identification is an important step in a repair reduction program for flexible endoscopes. Since these are fragile devices subject to significant use and reprocessing, damage can occur at any step in the process. Therefore, training on how to properly care for and reprocess these devices is imperative. As damage leads to costly repairs and potentially higher contract costs, instructing staff how to prevent it can help reduce overall costs. Identification of damage at an early stage can also be an important step and one that should be taught to staff. Catching slight damage early can help reduce expense and extensive repairs later. Additionally, re-use of a scope that has damage that hasn’t been properly identified is an infection control risk. Melissa Kubach (left) and Brianne Flesher, CFER (right), Mobile Instrument Service and Repair

Kubach and Flesher: Clinicians are trained on reprocessing scopes, but many basic behaviors associated with transport and cleaning need regular reinforcement. In-service programs for safe handling of flexible endoscopes are invaluable. It is a well-known fact that 70 to 80 percent of damage incurred to flexible endoscopes is preventable. Flexible endoscopes are very delicate devices which can suffer extreme damage with even minor mishandling. These devices are extremely expensive to rebuild so the benefits of holding this training have immediate financial benefits. Not only does in-servicing hold financial benefits from a repair cost perspective but the benefits also extend to the safety of personnel that have hands on these devices. Ensuring the proper handling and reprocessing techniques are employed at all levels can reduce cross contamination in patients and personnel. Purtell: With the advancement of endoscope technology, and staff turnover in health care facilities, it’s important to stay current on equipment training. Endoscopes require careful handling, in order to contain maintenance costs, so providing in-services becomes an essential part of scope ownership. Whether it’s following the manufacturers IFU for cleaning and disinfecting, or storing properly, there are steps that can be taken to protect your investment. Periodic in-services are a great way to remind the staff of their role in preventing care and handling damages. Sandrini: Education is understanding. At MMS we have watched how endoscopes, as well as other surgical equipment has moved from the hands of central sterile to the biomedical engineering/ HTM for repair responsibilities. Unfortunately, the new responsibility came with little or no education. In-service training will help the HTM staff understand how to handle and properly care for this equipment. It will reduce repair cost and downtime. They can also learn troubleshooting techniques and learn to 52

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STAFF REPORT

identify preventable issues, so they can request in-service training for hospital staff when warranted. Rarely, the HTM staff will be the cause of the damage but they can be the warriors who identify preventable root causes. Q: HOW DO YOU DETERMINE TOTAL COST OF OWNERSHIP AND RETURN ON INVESTMENT WHEN SHOPPING FOR ENDOSCOPES? Drosnock: This is not my area of expertise. However, a facility should account for not only the traditional repair costs in the equation, but when transitioning to performing enhanced visual inspection using lighted magnification as recommended by the standards and guidelines and by potentially instituting use of a borescope for internal inspection of endoscopes, there could be an initial increase in the number of repairs because damage may be identified earlier on. After an initial adjustment period, this should stabilize. Instituting these inspection steps is an infection control risk mitigation strategy because damage may be detected earlier on potentially reducing the risk of using a scope that is not in a good condition. Kubach and Flesher: In making a scope acquisition, be sure to understand the specific features and functions required clinically to avoid paying for things you do not need. Certified pre-owned equipment can help reduce acquisition costs by half. Consider more than the acquisition cost of the scope such as resources needed for proper cleaning, reprocessing, transport and storage equipment. In addition to a budget for repairs, include a provision for routine preventative maintenance inspections. In looking at ROI, it is important to consider clinical demand for equipment so the inventory can be properly balanced with caseload. Insufficient inventory often leads to rushed reprocessing and creates wearand-tear on your equipment. Be especially attuned to repairreplacement programs from OEMs to determine if you really need to pay a premium for the service. A good repair program can often produce enough savings to help expand inventory. Purtell: Endoscopes are a significant capital investment, so it’s important for your inventory to match your caseload. Purchasing too many scopes can be wasteful, and too few scopes could limit your ability to provide services to patients. Servicing your endoscopes, also factors into total cost of ownership. If your facility historically takes good care of equipment, then transactional service may be the best option. If your scopes endure heavy use, and become damaged more frequently, then a “no fault” service contract may be more effective. This helps contain service costs and allows for more predictability. Sandrini: Cost of ownership including repair cost or service contracts can be reduced with preventive maintenance programs and trackable repair utilization. Less downtime and fewer repairs increase the ROI of the capital purchase. Educating all staff from the biomedical engineering/HTM team, reprocessing staff and the end users. Identifying preventable repairs will keep cost to a minimum. Recognize small problems before they become high-cost repairs will increase the departments ROI.

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ROUNDTABLE Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING ENDOSCOPES? Drosnock: Keep the validated reprocessing methods in mind when purchasing scopes. Look at the IFU and see what methods the device is compatible with and what is currently available at your facility. Will new AERs (automated endoscope reprocessors) or sterilizers be required to properly reprocess that endoscope? If so, that cost would need to be factored into the equation. Also, if/ when transitioning from high-level disinfection to sterilization methods, there may be an initial increase in repairs as sterilization methods are generally harsher and can potentially damage endoscopes sooner than disinfectants. With a trend to move scopes to sterilization and often a longer turn around time for these processes, this could be a factor in the budget (more scopes needed) and even scheduling of procedures with a longer turn around time for the scopes during reprocessing. Kubach and Flesher: The key to providing excellent service to endoscope users is to understand their use of the equipment as it relates to patient care. Even though you may not directly repair the equipment yourself, it pays to understand how it clinically functions, related componentry and terminology. Help clinicians keep good records of service events to better assist with planning inventory levels and confirm you are on the repair program that

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

best suits your needs. When you see behaviors that might damage delicate equipment, politely intervene and help people understand the connection between the endoscope damage and incurred cost resulting from their actions. Purtell: Health care facilities can be very educated on their equipment purchases, as there is a lot of good information available in the marketplace. Manufacturers can often provide clinical support documents, indicating efficacy of specific technology features. Peer feedback is also valuable in evaluating equipment for purchase. Chyrill Sandrini, MultiMedical Systems Sandrini: If you have any input, steer away from repair/exchange programs. Why would you purchase a new endoscope and trade it out for a used endoscope? Do you know the history of the exchanged scope? What are the true costs associated with the repair/exchange? This program is based on a flat exchange rate at thousands of dollars per exchange. Ask yourself – “What if it was a simple repair that could have been performed in one day costing $500?” How can this affect your bottom line?

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TECHNATION

Cleveland, OH • June 7–10, 2019

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Our promise:  Deliver new opportunities to exchange ideas, expand networks, and experience new technologies to empower professionals around the world.  Engage attendees with innovative learning. The 2019 education program will deliver an immersive and interactive learning environment for professionals at all experience levels. The program will deliver tracks on cybersecurity, sterilization, global perspectives, HTM, and more.  The exhibit hall will showcase new and emerging products and technologies, an IoTXperience, and a virtual reality theater.  Confirm AAMI’s focus on year-round excellence and reinvestment in the health technology profession in the form of professional development, certification, peer-to-peer communities, and development of standards, white papers, and best practices.

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SHRINKING POOL Recruit & Retain Amid Retirements

By K. Richard Douglas

TECHNATION

APRIL 2019

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ife coach and author Tony Robbins once said; “Every problem is a gift. Without them we wouldn’t grow.” The “problem” for the HTM field has been on the horizon for some time; how do you replace legions of tenured, experienced, retiring HTM professionals? The giant 74 million-plus baby-boom generation is aging and many have already collected their gold watch.

That march toward the exit leaves a void that is both personal and challenging. Long-term relationships and on-the-job experience are two qualities that will be sorely missed. The second-nature, off-the-cuff familiarity that many of these retirees have with their facility, staff and work requirements is irreplaceable. A TechNation cover story in 2017 posed part of the challenge; “Adding to the issue is the stealth nature of the HTM profession; a profession that is so ‘behind the scenes’ that most high school students have no idea it exists and most career changers have never heard of it. At the intersection of retiring baby boomers and this obscure profession lies a challenge that needs to be addressed. How will the restocking work?” Yet, the abilities of these departing colleagues have to be replaced. Leadership must devise strategies to locate sources for trained technicians, as well as retain existing talent and provide career opportunities. “The ‘mass retirement’ issue is hitting our organization already and looks to increase as we move forward. Our site has four techs currently with tenure of eight, 10, 19 and 45 years; three will be retiring in the next five years,” says Roger Kyrouac, coordinator of clinical engineering at Advocate BroMenn Medical Center/Advocate Eureka Hospital in Normal, Illinois. “The keys for me have been hiring the right person, making them welcome, providing growth challenges, mutual

respect and developing teamwork,” he says. With the merger of two health systems at Kyrouac’s employer, there is recruiting at several locations. Kyrouac points out that the recruiting process is not always easy. This is not something that health systems can afford with an exodus of retiring technicians who require replacements. “We have been working three years to fill a new position at our site; a biomed II with imaging interest. In 2016, we settled for hiring someone who just didn’t show after two weeks and sent a thankful email. In 2017, we hired someone based on the best of two candidates and they left just short of 90 days,” Kyrouac recalls. He says that last year, they steadily escalated their recruiting efforts to include third-party recruiters, received a variety of ‘settle for’ applicants and have recently

“ The ‘mass retirement’ issue is hitting our organization already and looks to increase as we move forward.” - Roger Kyrouac

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

performed initial phone interviews on two serious contenders who will have a second interview in person. This illustrates how competitive the HTM market is at a time when talented professionals are needed to maintain the highest standards. “We are paying to fly them in from Alabama and California with an overnight hotel; we’ve never done that before. If

hired, the winner will get up to $3,000 in relocation assistance,” he adds. “Both have military training and experience in biomed and imaging, at least six years of experience, a desire to grow in imaging and a desire to find a place they can build their skills, a home and security. Based on our three-year search, this sounds too good to be true, but the phone interviews have been promising, which is why we have escalated our efforts and investment,” Kyrouac says. Compared with the past, recruiting new biomeds has been more of a challenge for managers recently, as Kyrouac illustrated. “The retirements of talented HTM professionals are certainly impacting operations at many hospitals. For me personally, I have not had any retirements from my department, although they will be occurring in about three years,” says Jim Fedele, CBET, senior program director of clinical engineering, BioTronics, at UPMC in Williamsport, Pennsylvania. “For me, since we have expanded our program to include some newly acquired hospitals, I needed to hire two people. This was harder than any time in my past, as it took a couple months to fill the positions due to the lack of qualified applicants,” Fedele says. He says that for one of the positions, he was able to find a Biomed Tech I who was eager for a job. “The other position I needed to fill was at a small remote hospital; the location certainly played a role in the difficulty finding a candidate. This position was so hard to fill we actually hired a person that did not have any biomed experience, but had military training that was related to electronics. He is actually working out quite well,” Fedele says. The endless march of technology and networking challenges has added to the prerequisite list for new hires. “We have definitely experienced difficulty in recruiting for open positions in the past few years. It is getting harder and harder to recruit new talent as we continue to grow, not only as an organization with new hospitals and new construction, but also with additional responsibilities such as

APRIL 2019

TECHNATION

SHRINKING POOL networking, asset management and cybersecurity,” says Walter Barrionuevo, CHTM CMLSO, director of clinical engineering/end-user and infrastructure services (EIS) at BayCare Health System in Florida. Proximity to a source of biomed talent seems to be a determining factor in a health system’s ability to locate replacement HTM professionals. “In the eastern part of Virginia, we can fill open positions without too much issue. We have the Naval Hospital in Portsmouth. There is almost always a clinical engineering technician who is getting out or retiring looking to stay in the area. Of course, these technicians are looking for a senior position. They are highly trained and have a good work ethic,” says Richard “Rick” Davis, CBET-E, a retired CE manager with 37 years in clinical engineering and an active member of the Virginia Biomedical Association. Davis says that ECPI University did have a clinical engineering degree at its Virginia Beach and Roanoke campuses which helped fill entry positions in those areas. He says that this training has been moved to North Carolina, so now employers must look at anyone with electronic or computer training that is looking for something challenging or different. “On the bright side, Centura College is looking into starting a clinical engineering department at its Virginia Beach campus. Members of the Virginia Biomedical Association, AAMI and others have been consulted to help start this program,” Davis says. He says that recruiting on the western side of the state can be more challenging and requires more networking. This is another conundrum for hiring managers since many are not close to the leading training programs. This requires prospective new hires to also look beyond their local area. “Competition is real; the only way to get some of the best is to focus on those who are looking to settle down and

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APRIL 2019

Recruit & Retain Amid Retirements

work in one place. Not everyone is willing to make the sacrifice of windshield time for more money; that also places a burden on family relationships,” Kyrouac points out. RESOURCEFUL WAYS TO RETAIN TALENT Part of the strategy for management is to retain valuable team members. Job satisfaction is a strong determinant in retaining the best in the HTM profession. For those seeking a career ladder, promotion opportunities lead to more contentment on the job. “Our number one focus is first to retain talented staff to reduce turnover, and then to have a program in place that offers technical and leadership training to prepare staff for future openings. Our organization has created an ‘Aspiring Leadership’ program for team members who are currently not in a leadership position, but who desire and demonstrate leadership potential. This program, which is completed after several months, prepares the team member in the skills required for future leadership roles,” Barrionuevo says. He says the next step is to have honest and frequent conversations with staff to help identify future positions needed. “Having an active succession plan in place will alleviate the need to find external candidates to fill positions being vacated due to retirement. We have not yet lost any positions to retirement, but have experienced recruiting headaches for other open positions. We have engaged our internal recruiting department to use social media and job recruiting sites to assist in filling open positions. Additionally, we have utilized temporary workers and used talent agencies when appropriate,” Barrionuevo adds.

THE BABY-BOOM CHALLENGE Accounting for nearly 75 million members of the U.S. population, the baby-boom generation is one of the largest segments of the populace. The oldest of the baby boomers began turning age 65 in 2011. They account for some of the most experienced members of the U.S.

“ Having an active succession plan in place will alleviate the need to find external candidates to fill positions being vacated due to retirement.” - Walter Barrionuevo workforce – that includes HTM. “Our industry is full of baby boomers that are retiring in record numbers. It is affecting OEMs, ISOs and in-house departments equally. Also, there aren’t the number of schools training biomeds [and] the number of candidates is smaller than any time in the past. I think these issues are going to force our industry to really change how we do things and who is doing it,” Fedele says. “The trick is going to be balancing compliance and regulation with manpower. As an industry (including OEMs) we are going to need to evaluate all our activities and decide if they are valuable and necessary activities. I am hopeful as more of our senior techs retire, we can let go of some of the practices that really don’t make sense in this day and age,” Fedele adds. THE EDUCATOR’S AND RECRUITER’S VIEW A different perspective emerges when those members of the baby-boom generation are not ready for retirement and are looking for new opportunities in the field. One full-time, third-party recruiter sees both sides of the dilemma. “It appears that many of my HTM cohorts are retiring at 65 to 67 years of age. However, candidates that come to me looking to work to an older age are

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concerned that they will not be looked at because they are in their late 50s or early 60s. Their wealth of knowledge and experience are much more valuable to an employer than a candidate that has only 10 to 15 years experience. Remind the interviewer that the 60-year-old is now comparable to a 40-year old,” says Doug Stephens, CBET, founder of Stephens International Recruiting Inc. “Mergers and acquisitions cause a great deal of concern to the employee. They often are in fear of losing their position. We like to remind the candidate that, with the current shortage of HTM personnel, they will have opportunities that may enhance their career. They should be willing to relocate to where the opportunities are with the new organization,” Stephens says. He also points to the readiness of military BMETs and the advantages of their training and availability. “The DOD biomedical training course at Fort Sam Houston trains between 400 to 440 students per year, which is the largest group of BMET graduates in the nation. People should remember that these soldiers, airmen, and sailors often will have a move, paid for by the Department of Defense,” Stephens adds. According to Stephens, the combined associate/technical and bachelor’s degree programs nationwide only turn out approximately 271 graduates annually. Worse yet, at least four of those degree programs have been partially or fully closed in recent years. That leaves a handful of structured training programs to repopulate a shrinking workforce. This means that the challenge with the mass retirement of baby boom biomeds isn’t just with employers and hiring managers, but with those tasked with training the next generation to replace them. “The impeding HTM tech shortage is a double-edged sword. Just as so many are beginning to retire from this profession, we see one of the biggest down

turns in student enrollment in the nation’s community college systems. Add that to the many BMET programs that have shut down in the past several years, and the crisis becomes more and more evident,” says John Noblitt, M.A. Ed, CBET, BMET program director at Caldwell Community College in Hudson, North Carolina and owner of a CBET certification preparation business. “Here at Caldwell, I have seen a significant increase in inquiries into new graduates from employers and recruiters. I have also seen an increase in requests to host students in an internship program,” Noblitt says.

increase student numbers here at Caldwell but also provide some much-needed exposure of the HTM field to high school students. This more traditional way to recruit students may not be enough as the high school population is shrinking in the USA so it just leaves the task that much harder to accomplish,” Noblitt adds. He suggests that more aggressive ways might be needed to explore possibilities to recruit more students into the HTM field. “Here at Caldwell, we are beginning discussions on how this might happen. We are looking at doing more online classes and put all the hands-on lab classes in one or two semesters so students

“ The impeding HTM tech shortage is a double-edged sword. Just as so many are beginning to retire from this profession, we see one of the biggest down turns in student enrollment in the nation’s community college systems.” - John Noblitt

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

He says that the problem is with such a decrease in enrollment, it’s almost impossible to expand any portion of the BMET program. “Last summer, I had a former student who is now in management for a national service company [who] said he will be needing to hire around 100 techs in the next three to five years. At the time, I had no students interested in the positions he had open because of the location. Students seem to be much pickier about the first job they will consider than in the past,” Noblitt says. He says that he has reached out to the Health Occupations Students of America (HOSA) organization to form a better relationship and hopefully be able to recruit potential candidates into an HTM/BMET program. “This is not an easy task, as so few HOSA instructors or high school guidance counselors know about the opportunities the HTM field has to offer. I’m hoping these efforts will not only

could possibly only spend four months on this campus. Another possibility is for larger hospital systems, that may need several techs, to partner with a BMET/ HTM school program and let the hospital facility provide the hands-on opportunities and have a college provide the foundational knowledge such as anatomy and physiology, electronic theory, safety and standards, medical instrumentation and other program courses,” Noblitt says. In the end, the replacement of a large percentage of the departing HTM segment becomes a push-and-pull problem. There has to be a more effective way to push more young people into the field and get them involved in training programs. The “pull” has to come from health care employers who make it clear that there is a demand for workers in this profession. “To solve this crisis, some thinking outside the box must occur,” Noblitt suggests.

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CAREER CENTER Behavioral Job Interviews BY JENIFER BROWN

ore organizations in our industry are using behavioral interviews as part of their candidate screening process. Behavioral job interview questions can push candidates past generic answers by forcing them to relay personal history. These questions are used to give you an idea of how a candidate behaves in real situations, rather than their take on how you think they should have reacted.

WHAT IS A BEHAVIORAL INTERVIEW? A behavioral interview is one in which the interviewer is focused on how candidates handled real situations in their past work experience. Candidates in a behavioral interview should use the STAR technique to answer the questions. WHAT IS THE STAR TECHNIQUE? STAR stands for: Situation, Task, Action, Result. Candidates describe the situation they were in, the task they had to accomplish, the actions they took to get it done, and the result of their work.

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HERE ARE SOME COMMON BEHAVIORAL INTERVIEW QUESTIONS A CANDIDATE CAN USE TO PREPARE: • Tell me about a stressful situation at work and how you handled it. • Describe a time when you disagreed with your supervisor on how to accomplish something. • Have you ever had to convince your team to do a job they were reluctant to do? • Have you ever had a deadline you were not able to meet? What happened? • Tell me about a time your co-workers had a conflict. How did you handle it? • How have you prioritized when you’re assigned multiple projects? • Tell me about a difficult work challenge you’ve had. • Talk about a time when you had to adapt to big changes at work. • How have you dealt with an angry or upset customer? • Have you ever gone above and beyond to help a customer? What did you do? • Tell me about a time when you had to fight for an idea at work. • Talk about a time where you had to make an important decision quickly. What did you decide? What were the results? • Have you ever been in a business situation that was ethically questionable? What did you do? What were the results? • Have you ever had a project that had to change drastically while it was in progress? Why? How did you do it? • Talk about a time when a co-worker was not doing their share on a project. How did you handle it? • Tell me about a major setback you’ve had. How did you deal with it? • What have you done when colleagues have been stressed out by a project? • Talk about a difficult problem you’ve had to solve. How did you solve it? • Have you ever had to defend a customer’s point of view? What did you do? • Talk about a time when you’ve had to sell an idea to your colleagues. • Tell me about a problem you solved in a creative way. 62

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Why Evidence-Based Repair(EBR) is as Critical as Evidence-Based Medicine 3 Ways EBR drives sustainability and device longevity

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ealth care clinicians using Evidence-Based Medicine (EBM) for diagnosis and treatment have been improving quality and reducing costs for years. Data-driven protocols enable clinicians to eliminate guess work and provide treatment at higher confidence levels.

The same applies to imaging device repair. When providers base repair processes on scientifically valid research, they are able to increase repair sustainability and device longevity. Yet few providers in a price-driven market have the resources to continually test and develop EBR methodologies. Doing so requires high levels of: • Clinical expertise and judgement • Valid evidence • Ability to execute efficiently and affordably Having the above requires more than a typical depot repair shop with skilled technicians. It requires engineering depth, testing and research capabilities, and leadership that understands what to test, and how to identify valid evidence around which to build best practices. Following are 3 Benefits of EvidenceBased Repair that can help you maximize your inventory and ROI goals for 2019. DATA-DRIVEN PROCESSES FOR PROBLEM RESOLUTION AND SUSTAINABLE REPAIRS Repair providers face increasing

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pressure to resolve problems quickly, yet doing so without valid data for best practices can have serious consequences. Those that engage in multiple types and levels of testing are more prepared to solve problems right the first time and achieve optimum outcomes. It’s important to ask providers what data they use to back up their practices. Is the data backed by high-level evidence from randomized controlled trials or observations from multiple time trial studies? Or low-level evidence such as personal experience and opinion? While low-level evidence can be impactful, the best evidence for building best practices and optimum outcomes comes from controlled testing and trials. With more than 150,000 successful probe repairs completed and a first-time fix rate above 95 percent, Innovatus Imaging continues to collect and apply proprietary evidence for repair methodologies for ultrasound probe, MRI coil and radiography device repairs. Ongoing testing programs help us gather evidence and identify thresholds at which efficacy diminishes further impacting our quality outcomes. ADVANCED TESTING While advanced testing capabilities are not always necessary for favorable outcomes, providers that engage in high-level testing programs can build proprietary EBR methods and provide in-depth information about your devices.

Acoustic Testing (hydrophone measurements and acoustic force balance) is a good example. Acoustic testing measures the amount of energy delivered to patients and OEMs design their probes, in conjunction with their systems, to deliver a specific level of acoustic energy to the patient. Hydrophone testing of new probes allows engineers to document baseline acoustic performance and use the data to build an acoustic profile for a given probe model. As a result, EBR can insure repaired probes perform as originally intended. ACCOUNTABILITY AND SAVINGS Documentation is another benefit of EBR. Providers can document processes, and data validating those processes, to enable end users to know precisely what they are getting from a repair and what to expect. At Innovatus’ Centers of Excellence, we conduct research and testing to identify best practices for EBR, asset management and long-term savings. Our proprietary Savings Planner is customized for clients upon EBR processes proven to extend lifecycles and enable investments and budgets to go further. As a result, we save health care providers tens of thousands of dollars annually. Mike LaBree is the Chief Technology Officer of Innovatus Imaging, and leads the Design and Manufacturing Center of Excellence in Denver, Colorado. He can be reached at MikeL@ innovatusimaging.com or 844-687-5100.

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CYBERSECURITY Beware of Trojan Horses BY JOSEPH E. FISHEL, CBET, MBA

bout 2,500 years ago, the city of Troy was protected by a high wall around the city. The invading Greeks had tried for 10 years to breach the wall with no success. As the story goes a peace offering was given in the form of a wooden horse and left outside the gate. Inside the wooden horse were 30 men. That night after the horse was moved inside the wall they emerged and opened the gates and the Greek army entered Troy and that was the end of Troy.

This happens every day in the cyber world. Viruses are brought in on computers, tablets, cellphones, thumb drives and not intentionally introduced. The Greeks (or virus) is now inside the wall. Patching and antivirus have been issues on medical devices for years and are always behind when the latest virus hits the cyber world. This makes them the most vulnerable. So, what can we do? We built a perimeter wall to prevent invaders from coming in, but how do we protect from within? The simplest way is to start with is an enterprise policy and procedures for employees. IS/IT usually has one but it doesnâ&#x20AC;&#x2122;t mention medical devices yet they have the same vulnerabilities as the IS/IT departments computers. This policy needs to prohibit the use of thumb drives, plugging in of cellphones and tablets into medical devices or hospital computers. If all employees are aware of the vulnerability you now have a higher percentage of the intrusion not coming from employees. The employees are also your eyes to prevent patients and

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APRIL 2019

visitors from doing the same. This policy needs to include accessing the Internet from a medical device. Lab and imaging devices have Internet access on them so that they can communicate with the vendor. These should not be used to go out and check personal email or surf the net. This is, in essence, opening the door to hackers and providing access to the network. There are several different approaches to protect from within and sometimes you have to use all of them to achieve your goal. Limiting what gets onto your network is one way of protecting the network. There are primarily three different ways to do this and each has its own level of protection. The lowest level is using a MAC/NAC server. The MAC address is collected from all known devices and entered onto a Network Access Controller. When a device is turned on, the MAC address is compared against a known list and if the device is found it is allowed on the hospital network. If someone gains access to the MAC address of a device they could use it to imitate the device and access your network. The second way is a bit more secure and requires PEAP and a Root Certificate to authenticate. The final way is to use PEAP and a Certified Certificate â&#x20AC;&#x201C; which usually has a license fee attached to it. Another way to protect from within is to restrict what a device talks to and what talks to it. This is done through the use of virtual LANs (VLAN) and Access Control Lists (ACL). A VLAN is any broadcast domain that is partitioned and isolated in a computer

Joseph E. Fishel, CBET, MBA HTM Manager for Sutter Health eQuip Services

network at the data link layer (OSI layer 2). LAN is an abbreviation of Local Area Network. To subdivide a network into virtual LANs, one configures a network switch or router. The IS/IT team knows how to create these and can create these for you. Some thought needs to go into how you want to segregate your VLANS. Do you divide by manufacturer or by departments? Each has its benefits. By manufacturer makes it easier to push patches out to the devices. Putting a department on a VLAN makes it easier to apply ACL as much of the communication is between the devices in the department. When an ACL is applied at this level, you can restrict it to two-way traffic, from the device to the app server and back. This prevents what is referred to as East/West traffic. If a hacker gets inside the wall to a workstation they can only talk to other devices on the VLAN that the workstation is allowed to talk to. This limits an intrusion. With virus protection on the server, you can get immediate notification should an intrusion occur and isolate the device until it can be remediated. These are electronic or network options that protect at several levels. Another way of protecting a device is the use of a firewall or a bridge. These can be between $350 to $1,000

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each. Many of us donâ&#x20AC;&#x2122;t have $3 million to replace a linear accelerator that has XP on it. So, how can you protect this at a reasonable cost? This can be done with the use of a bridge. The linear accelerator talks to the bridge and the bridge talks to the network creating a firewall. A search of the network for the linear accelerator only reveals the bridge not the linear accelerator so it is isolated from the network. There are a lot of lab analyzers that are in a similar situation and can be protected in this manner. The device is still vulnerable to thumb drives and cellphones being plugged into the HDMI port, but it is isolated from the network. When looking at this option, make sure the bridge can handle the bandwidth of the traffic to and from the device. The IS/IT team may have already identified a standard for these. Each of these different approaches has some nuances when being applied to Wireless, Static IP or DHCP devices. These need to be looked into to determine what and how this can be done with your IS/IT team. Knowing what makes up your inventory is important and how it connects will make it easier. Joseph E. Fishel, CBET, MBA, is a Healthcare Technology Systems Manager for Sutter Health eQuip Services.

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BY STEVEN J. YELTON

THE FUTURE

Using Collaboration in HTM Education? BY STEVEN J. YELTON

would like to continue discussion of educational resources that the HTM educational programs are desperately seeking. Right now, a hot topic seems to be the availability of HTM textbooks of all kinds—particularly at the technician level.

I agree with what Roger Bowles mentioned in his recent Future column entitled “Recommended Reading.” I too have seen many changes to the HTM field over the past 30 years. Programs at the college level “look” way different today than they did years ago. This “look” includes equipment in the laboratories, computer facilities that may not have been there 25 years ago and how classes are delivered and on and on. One thing that hasn’t changed much, in my opinion, is the biomedical textbook. There isn’t much financial incentive for an author to write a textbook on biomedical systems. We have a few new textbooks on the market. For instance, recently released was Barb Christe’s second edition of the biomedical instrumentation textbook “Introduction to Biomedical Instrumentation: The Technology of Patient Care“ as well as Binseng Wang’s new book, “Clinical Engineering Financial Management and Benchmarking.” I’m sure that there are other textbooks, but these are two I am familiar with. It’s great that Barb and Binseng wrote these books, but ultimately they only cover a small part of our field and we need more. Danielle McGeary, AAMI’s Vice President of Healthcare Technology

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APRIL 2019

Management, in early February posted a request in AAMI Educators AAMI Connect Group: Creation of a BMET Textbook. I wanted to mention this to help get the message out to a larger group which might find this interesting and may want to contribute. Danielle posted the following: “If AAMI developed a more BMETfocused textbook, would that be of interest to this group and would your programs use it? If AAMI did compile one, how many would you anticipate purchasing a year? Would any of you be interested in working on this project and potentially contributing to the book? Most of the feedback I received is that most HTM textbooks on the market are more focused around the clinical engineer and not so much the BMET. We also spoke of the issue around incorporating medical device specific IT/cybersecurity training into BMET educational programs since many of the courses offered at your institutions are not specific to health care.AAMI currently offers: AAMI’s Practicum for Healthcare Technology Management, which includes chapters on FMEA, CMMSs, imaging devices, DICOM, PACS. None of the responses I received actually listed anyone as using this as a resource. Is there a reason? Is it not relevant any longer? Does it need a refresh? Are you all just not aware this resource is out there?” In my opinion, the best option would be to work together to collaborate on the textbook as she asks. A similar type of book published by AAMI is entitled: “A Practicum for Healthcare Technology Management.” This book

Steven J. Yelton P.E., CHTM

has chapters written by different leaders in the HTM field who contributed based on their individual expertise. This not only produced great information from leaders in the particular specialty but also made the creation of the book a lot more manageable when spread over a large group of authors. Another area that I would like to reach out to the HTM community about is what I’ll call “remote laboratory experiences.” There are lots of opportunities for “online” content for biomedical instrumentation classes, but I feel many are lacking what I consider viable laboratory experiences. I may be a little old school, but I believe the student should be required to “touch” the equipment in the laboratory. I think computer simulation has its place, but cannot completely replace actual hands-on laboratory experiences. I have previously written about the possibility of a laboratory experience that takes place on a mentorship basis. I would also like to ask this group to help come up with an innovative way to remotely deliver laboratory experiences. I feel that in order to make HTM education adequately available to a more widespread group, a very good way to deliver labs remotely is key. Speaking of real-world experience, I am also a strong advocate of the

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internship or cooperative education component of education. I feel that this should be required for a student to graduate from any program. I like to mention this whenever I have the opportunity to reach a diverse group of HTM professionals. I feel this is not only key to any program, but it is ultimately an area that requires all of us in HTM to work together. This includes anyone who may read this column or even this magazine. If you are in a position to hire these students, you will be afforded the opportunity to have a long-term interview of prospective employees as well as shape the HTM program in which the students are enrolled. In conclusion, I would like to plant the notion of collaboration in your minds. This is how we can move forward in the HTM field.

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Steven J. Yelton, P.E., CHTM; is a senior HTM engineer for The Christ Hospital Health Network in Cincinnati, Ohio and is a professor at Cincinnati State Technical and Community College where he teaches biomedical instrumentation courses. He is the chair-elect of AAMI’s board of directors, chair of the AAMI Foundation board of directors, past chair of AAMI’s Technology Management Council (TMC), chair of AAMI’s HTAC Committee and is a member of the Accreditation Board for Engineering and Technology (ABET), board of delegates. He may be reached at steven.yelton@cincinnatistate.edu

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THE OTHER SIDE Do Your PMs Positively Impact Patient Safety and Improve Uptime? BY JIM FEDELE

enjoy analyzing data. Lately, I have been analyzing work requests to explore if the preventative maintenance (PM) actions we perform everyday actually improve patient safety and outcomes. My preliminary findings have been very interesting and support some of my intuitions about PMs.

There is no doubt in my mind that electronic equipment has become very reliable. All the advances in computer technology and semiconductors have equated to smaller, less expensive and more reliable devices. Televisions are a good example of this. When I repaired them, at my first job out of college, we had to clean tuners, adjust the oscillators and sometimes replace tubes (I know this dates me). Today’s TVs do not have any of those components and seldom need to be repaired. Actually, my solid state TV with the electronic tuner has been working flawlessly for 16 years. The best part is I never performed a PM on it! Medical equipment has not been exempt from these advances. Recalling my first years repairing medical equipment the “span” and “cal” potentiometers always required attention. Getting the adjustment just right often took a large amount of time and was incredibly frustrating. The old IVAC 200 series even prompted one of our student interns to take an unrepairable unit out to the shooting range for a fun filled afternoon of revenge. We kept that holey unit around for peace of mind for a long time. Now, however, the plastic screwdrivers or “diddlers” as

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

we called them, lay in the tool box collecting dust. Internal adjustments are almost completely gone, and seldom are outputs out of calibration. With all these improvements and changes in electronic circuitry, why is the preventative maintenance methodology still the same? Many devices have built-in diagnostics that tell the user if the unit is operating correctly. However, like drones or zombies, we go out as we always have and PM everything we can get our hands on. The difference now is that the PM is nothing more than an operational check and electrical safety check. There really is not anything “preventative” going on. I am not talking about everything; Electro-mechanical devices still benefit from regular lubrications but a large portion of the devices we manage do not have any “preventative” tasks. As I look at the data, I am trying to understand what our direct impact is to the reliability of items we PM. The majority of our repairs fall into two categories, physical damage or unpredictable electronic failure. This means that the component or board would not have been addressed during the PM tasks. Most issues are things that the user knew about, but did not report to us. What does this mean? As I think about how the “traditional” PM may be proving to be ineffective, I wonder what other opportunities exist that can truly help our customers. I think focusing on the failure of equipment and monitoring equipment use in “real life” could

Jim Fedele, CBET Director of Clinical Engineering for Susquehanna Health Systems

provide a lot of insight into how we can improve our service model. These observations could possibly illustrate training opportunities or even identify a clinical need that isn’t addressed by mindlessly doing performance checks on devices. However, these new tasks are more people related than they are equipment related. They would require consistent and constant communication with customers, which is not achieved by sitting in the shop or hiding in a corner doing PMs. This is a problem for many in our industry. I still have a lot of work to do on the data, whenever one has to rely on handwritten notes in data it takes a lot of time to distill it. However, that being said, I am excited about what my preliminary review revealed. Jim Fedele, CBET, is the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pennsylvania. He can be reached for questions and/or comments via email at info@mdpublishing.com.

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ROMAN REVIEW

Change a Mind, Change Your Approach BY MANNY ROMAN

f you want a challenge, try to get someone to change their mind about something they believe. Here is how to do it effectively.

Do your homework. Prioritize logic and information. Make sure that you gather all the information you can find to refute their belief. Assess how to best present that information in a logical and sequential fashion to ensure that it cannot be misunderstood. Ask questions to be sure that they are following along and understand and agree with every point you are making. Make eye contact often and use body language to emphasize every major and important point. This will bring them to the logical conclusion that their initial belief was wrong and they will thank you for correcting them. The above is how most of us do it and it is proven wrong by science. Using the above is like trying to herd cats. It doesn’t work and it annoys the cats. I was just recently involved in a particularly difficult discussion regarding decision-making with neighbors. I laid out the most beautiful sequence of scientific evidence regarding the amygdala, the ladder of inference and other things about which I expound in my writings. It was among my most beautiful displays of comprehensive pomposity. The effect: the cats were annoyed. So I consoled myself by researching the Internet where all answers can be found. In a video by Taili Sharot, professor of cognitive neuroscience, and author of “The Influential Mind: What the Brain Reveals About Our Power to Change Others,” she points out how the use of functional MRI demonstrates how the brain actually works. It seems that

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

getting others to change their minds is a difficult process. We must overcome some obstacles. One giant obstacle is that we will be attempting to get someone to change a part of their belief system. That system is entrenched and fortified and should not be directly assaulted as in the above example. The brain’s confirmation bias looks for things that confirm our beliefs and actions. We are happy to see commercials that demonstrate that we are drinking the right beer. When presented with information that contradicts our beliefs, the brain will discount the information and look for flaws in it. We never liked that actor who drinks that other beer anyway. This way of doing business is actually correct in the long run. It provides a short cut to making decisions that is mostly based on experiences. Thus we do not have to reinterpret every piece of information that presents itself. However, there are those instances when the new information should cause us to re-evaluate our position. So, how do we get someone to re-evaluate and give credibility to our presentation? First, we need to understand the above discussion, which includes not attacking their belief system directly. Directly presenting contradictory information may cause them to generate a counter that will actually strengthen their belief. This is called the “boomerang effect.” Interestingly, the science shows that the smarter you are the more likely you are to “boomerang.” Don’t try to prove them wrong. Try to find some common ground. Fight the instinct to demonstrate your credibility by bombarding them with logic and data. The good doctor explains an example where parents who refused to

Manny Roman, CRES AMSP Business Operation Manager

vaccinate their children because they believed it causes autism. Using the scientific evidence that it does not cause autism would not alter their stance. Instead, pointing out that vaccines would protect their children from deadly diseases proved more effective. This argument was not contradictory to their beliefs and was compatible with the belief that we need to protect our children. This is the common ground: a presentation framed in way compatible with a common belief. There are many other obstacles to getting others to change their mind: Overcoming their present emotional state, proper us of incentives, providing the right control, enhancing curiosity, reducing threats and overcoming social concerns. Luckily for me, I am running out of space so you will have to see the video and read the book. Bottom line is that if you want to influence people to change their mind (belief system) we must modify our approach from direct attack to finding a common belief from which to work. After all, we all want to improve our influence and communication with others and we are smart, right? For me, I plan on drinking even more wine with my neighbors since that is the common ground.

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DID YOU KNOW? Science Matters Scutoid: Geometric shape with five-sided ends that can fit tightly side-by-side with other scutoids Named for its similarity to ...

Scutellum:

Rear part of an insect’s thorax, or midsection

New basic shape of life discovered Researchers have found a previously undscribed 3-dimensional geometric shape – which they dubbed a “scutoid” – that nature uses to pack cells together efficiently.

Body’s cells fit together like tiles

... but if layer is convex

Flat layers

These cells reach from the outside to the inside of a blood vessel

of tissues are often made of straight-sided cells called prisms

Cell’s surfaces have five sides Five-sided cell surface

Prism

Concave layers

are constructed of cone-like cells called frustums

Source: Luis M. Escudero of Seville University (Spain); Javier Buceta of Lehigh University; Nature Communications journal; Fauna Germanica Graphic: Helen Lee McComas, Tribune News Service

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SERVICE INDEX Entech

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RepairMED

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SPBS, Inc

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Southwestern Biomedical Electronics, Inc.

P P

www.swbiomed.com/ • 800-880-7231

Doctors Equipment Repair

www.assetservices.com • 913-383-2738

www.doctorsequipmentrepair.com • 458-205-8438

Association 54

www.aami.org • 703-525-4890

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

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BC Group International, Inc

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

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

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

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

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Multimedical Systems www.multimedicalsystems.com • 888-532-8056

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Total Scope, Inc www.totalscopeinc.com/ • (800) 471-2255

Imaging 40

www.multimedicalsystems.com • 888-532-8056

65 11

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www.brcsrepair.com • 844-656-9418

www.alcosales.com • 800-323-4282

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Mountain States Biomedical Services mountainstatesbiomed.com • 949-887-0301

Multimedical Systems 80

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

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

Webinar Wednesday www.1technation.com/webinars • 800-906-3373

FOBI www.FOBI.us • 888-231-3624

aiv-inc.com • 888-656-0755

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

Avante Health Solutions avantehs.com •

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

BMES www.bmesco.com • 888-828-2637

Coro Medical www.coromed.us • 800-695-1209

Integrity Biomedical Services www.integritybiomed.com • 877-789-9903

J2S Medical www.j2smedical.com • 844-342-5527

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

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

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

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

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

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

www.somatechnology.com • 1-800-438-7662

P P

Recruiting

Health Tech Talent Management, Inc.

www.adel-lawrence.com • 866-252-5621 www.HealthTechTM.com • 757-563-0448

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

72 87

Refurbish 70

P P

AIV

aiv-inc.com • 888-656-0755

Rental/Leasing 16

P P

Avante Health Solutions

P P

Elite Biomedical Solutions

P P

Repair

P P

www.alcosales.com • 800-323-4282

P P

avantehs.com • elitebiomedicalsolutions.com • 855-291-6703

ALCO Sales & Service Co.

P P

33 www.doctorsequipmentrepair.com • 458-205-8438

P P

Doctors Equipment Repair

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

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

P P

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

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

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

FOBI www.FOBI.us • 888-231-3624

J2S Medical

www.j2smedical.com • 844-342-5527

Software Nuvolo

Sterilizers Mountain States Biomedical Services mountainstatesbiomed.com • 949-887-0301

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

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

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

avantehs.com/monitoring • 800-449-5328

www.ampronix.com • 800-400-7972

Adel Lawrence Associates

Patient Monitors Avante Patient Monitoring

Ampronix, Inc.

Patient Monitoring AIV

P P

Radiology

Soma Technology, Inc

Oxygen Blender

Power System Components www.interpower.com • 800-662-2290

TRAINING

Medical Imaging Technologies

www.inrayparts.com • 417-597-4702

Interpower

P P

SERVICE

nuclearmedimaging.com • 847-421-1656

inRayParts.com

PARTS

Nuclear Medicine E.L. Parts

Portable X-ray

8 77

Company Info

AD PAGE

www.IMESimaging.com • 704-739-3597

TRAINING

International Medical Equipment and Service

SERVICE

www.innovatusimaging.com • 844-687-5100

PARTS

Innovatus Imaging

AD PAGE

Company Info

P P

85 APRIL 2019

TECHNATION

SERVICE INDEX CONTINUED TRAINING

SERVICE

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

Healthmark Industries HMARK.COM • 800-521-6224

Prescotts surgicalmicroscopes.com • 800-438-3937

65 46

Telemetry

P P

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

Career Institute of Technology admissions@cit-texas.com • (512) 807-8300

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

International Medical Equipment and Service www.IMESimaging.com • 704-739-3597

AIV aiv-inc.com • 888-656-0755

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

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

BMES www.bmesco.com • 888-828-2637

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

Integrity Biomedical Services www.integritybiomed.com • 877-789-9903

J2S Medical www.j2smedical.com • 844-342-5527

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

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

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

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

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

P P

Tri-Imaging Solutions

P P

Tubes/Bulbs

P P

11 92

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

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

IMT Analytics www.imtmedical.com • 181-750-6699

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

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

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

RTI Electronics www.rtigroup.com • 800-222-7537

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

APRIL 2019

P P

Test Equipment

TECHNATION

PARTS

Training

Surgical

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

77 BC

P P

61 93

P P

5 3 46 78

P P

www.triimaging.com • 855-401-4888

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

40 22

77 60

P P

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

ATS Laboratories www.atslaboratories-phantoms.com/ • atslaboratories@yahoo-com

Avante Health Solutions avantehs.com •

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

Exclusive Medical Solutions emedicalsol.com • 866.676.3671

Innovatus Imaging www.innovatusimaging.com • 844-687-5100

J2S Medical www.j2smedical.com • 844-342-5527

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

85 2

P P

8 11 92

P P

Ventilators Mountain States Biomedical Services mountainstatesbiomed.com • 949-887-0301

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

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

Exclusive Medical Solutions emedicalsol.com • 866.676.3671

Innovatus Imaging www.innovatusimaging.com • 844-687-5100

RTI Electronics www.rtigroup.com • 800-222-7537

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

P P

8 46 60

P P P

WWW.1TECHNATION.COM

BREAKROOM BREAKROOM

PARTING SHOT

SCRAPBOOK

Indiana Biomedical Society 2019 1. Herman McKenzie of The Joint Commission provided updates and details on compliance for healthcare facilities.

3. Danielle McGeary, Vice President, Healthcare Technology Management at AAMI, led a special one-day AEM Seminar and CBET exam during this yearâ&#x20AC;&#x2122;s symposium.

2. The recently elected 2019 Indiana Biomedical Society Board Members are President Susan Sowders, Vice President Jay McKinney, Treasurer Michael Shannon, Secretary Alexis Glore, and Trustee Benjamin Esslinger.

4. Pronk Technologies Vice President, Greg Alkire of Pronk Technologies leading Metrology/Tolerance/ Uncertainty of Biomedical Test Equipment to a packed classroom.

5. TechNation is always happy to brave the cold to support the Indiana Biomedical Symposium. This year TechNation hosted a special happy hour during IBS 2019, sponsored the conference badges, and networked with attendees inside the exhibit hall.

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2019

TECHNATION

Setting the Gold Standard in Ultrasound Solutions

Shop multiple vendors in a single online marketplace.

SERVICE SYSTEMS PARTS PROBES TRAINING PROBE REPAIR

Easily search 1,000s of listings...

New equipment added daily!

MEDICALDEALER.COM The Simple Way To Buy, Sell And Review

877.876.6427 | www.trisonics.com

Your Last Resort is our First Priority Trusted equipment, trusted service.

30DAY MONEY-BACK GUARANTEE

5POINT QUALITY-ASSURANCE INSPECTION

DEFIBRILLATORS, AEDS, MONITORS, ECG/EKGS, PUMPS, VENTILATORS AND MORE!

FINANCING AVAILABLE. FAST SERVICE. CERTIFIED REPAIR. FREE ESTIMATES. LOANER PROGRAM.

Sales: 866.468.9558 • www.MMEMed.com Service: 844.425.0987 • www.RenewBiomedical.com

TECHNATION

APRIL 2019

WWW.1TECHNATION.COM

ALPHABETICAL INDEX

Physician’s Resource Network

A.M. Bickford…………………………

Integrity Biomedical Services…………

AAMI…………………………………

InterMed Group………………………

Adel Lawrence Associates……………

InterMed Group ………………………

AIV……………………………………

ALCO Sales & Service Co.……………

International Medical Equipment and Service…………………………

Ampronix, Inc.…………………………… 4

Interpower……………………………

Asset Services…………………………

J2S Medical…………………………

ATS Laboratories………………………

Master Medical Equipment…………

Avante Health Solutions………………… 2

Maull Biomedical Training……………

Avante Patient Monitoring……………

Medical Equipment Doctor, INC.…… 29,31

Avante Ultrasound……………………

Medical Imaging Technologies………

BC Group International, Inc………… BC

MedWrench…………………………

Biomedical Repair & Consulting Services, Inc.………………………

Mountain States Biomedical Services… 24 63

Multimedical Systems………………

BMES…………………………………

Nuvolo…………………………………

Capital Medical Resources……………

Ozark Biomedical……………………

Career Institute of Technology………

Prescotts………………………………

Coro Medical…………………………

PRN/ Physician’s Resource Network… 93

Crothall Healthcare Technology Solutions………………

RepairMED……………………………

Doctors Equipment Repair……………

Rigel Medical, Seaward Group………… 3

E.L. Parts………………………………

RTI Electronics………………………

ECRI Institute…………………………

Select BioMedical……………………

Elite Biomedical Solutions……………

Soma Technology, Inc………………

Engineering Services, KCS Inc………… 6

Southeastern Biomedical, Inc………

Entech…………………………………

Exclusive Medical Solutions…………

Southwestern Biomedical Electronics, Inc.……………………

FOBI…………………………………

SPBS, Inc……………………………

Our equipment is tested and serviced in-house so that we can guarantee its integrity.

Pronk Technologies, Inc. ……………… 5 35

Health Tech Talent Management, Inc.… 72

Stephens International Recruiting Inc.… 87

Healthmark Industries………………

Total Scope, Inc………………………

iMed Biomedical…………………… 49,81

Tri-Imaging Solutions…………………

IMT Analytics…………………………

Trisonics………………………………

Injector Support and Service…………

USOC Bio-Medical Services…………… 7

Innovatus Imaging……………………… 8 inRayParts.com………………………

PRN is a national leader in the Sale of New, Used, and Reconditioned Medical Equipment

Webinar Wednesday…………………

PURCHASE EQUIPMENT

ONLINE!

www.PRNwebsite.com 1.800.284.0967 AUTHORIZED NORTHEAST DISTRIBUTOR OF

ADVANCING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2019

TECHNATION

BREAKROOM

FLASHBACK MD Expo 2003

st e st the la n o p dy a es u y rea b c atc h , y r d t e us M ne. e in d In t e r agazi o m th ab of r m a f t r S n e l io R ick l De a r m at edic a d info M n f a o s ue new nt i ss curre

R PI has been a lo ng-time suppor te r of M D Expo. Seen here Ira Lapi des (left), Presiden t of R PI, Inc. talks with at tend ees in the exhibit hall

Steve Campbell (left), COO of AAMI speaks with an attendee in the exhibit hall.

TECHNATION

APRIL 2019

WWW.1TECHNATION.COM

If You Need Just One, Order Just One The Interpower® solution for hospital-grade replacement cords: if you just need one, order just one. Made-to-order to your specifications, we offer both replacement cords and special orders. We have no minimum order or dollar requirements, so this empowers you to order just what you need—whether it’s 1, 5, 100, or more. We provide value-added options, such as special labeling and packaging. For example, you can mark your cords with labels that contain identifying information (e.g. Operating Room 1, ER 2, etc.). With your cords specially labeled, hopefully they will stay in the correct location. If you need to replace one, you only have to order one. Made in Iowa, we manufacture a wide selection of clear, black, and gray North American hospital-grade plugs on power cords, cord sets, and replacement cords. All Interpower manufactured cords are electrically tested for safety and carry the appropriate approvals.

Contact Customer Service for More Information •

Made in Iowa, U.S.A.

•

No minimum order or dollar requirements

•

1-week U.S. manufacturing lead-time on non-stock Interpower products

•

Same day shipments on in-stock products

•

Blanket or scheduled orders available

•

Value-added options available

•

Free technical support

Secure Connections Are Essential To help prevent accidental power interruptions, secure your cord set to a power inlet or outlet with the new Interpower Connector Lock. This design is available in two different sizes and does not require tools for use. Before selecting your connector components, you should consult the appropriate medical equipment standards for connection security requirements.

Order Online! www.interpower.com

Business Hours: 7 a.m.–6 p.m. Central Time

NEW AA-8000 Anesthetic A g e n t A n a ly z e r The AA-8000 is the latest in portable anesthetic agent analyzers. It was designed to meet the demand for a small, easy to use unit with high reliability and accuracy. Utilizing proprietary stateof-the-art digital NDIR (Non-Dispersive Infrared) Technology it provides a low cost, high function, microprocessorbased analyzer that is simple to operate while maintaining high performance and accuracy.

Measures 4 Anesthetic Agent Gases:  Sevoflurane  Isoflurane  Desflurane  Halothane

User Friendly Interface:

 One Button Agent Select  One Button Sample (Pump) Control

AA-8000

Watch a demonstrational video of the AA-8000 on our store! Just visit the AA-8000 product page at BCGroupStore.com!

BC Group is Your One-Stop Biomed Shop BC Group Can Cover all Your Biomedical Test Equipment Needs ✓ DESIGN Our in-house engineering team designs our complete line of biomedical test equipment, including the IPA-3400 and ESU-2400H. Coming soon is the newest addition to our line of test equipment, the AA-8000 Anesthetic Agent Analyzer.

✓ M A N U FA C T U R I N G We manufacture a complete line of Biomedical Test Equipment under our brand BC Biomedical. Most BC Biomedical products are offered in a series, giving you multiple options to fit your exact needs.

✓ SERVICE Our BC Service calibration laboratory is ISO 9001-2015, ANSI Z540-1 Certified and ISO/IEC 17025-2005 Accredited. We provide on-site calibration services for over hundreds of hospitals and healthcare facilities nationwide, and in-house calibration laboratory provides metrology services for some of the top U.S. and International healthcare providers.

✓ MARKETPLACE Shop over 75 different product lines, including our own line, BC Biomedical, in our BC Marketplace. You can shop online, view pricing, datasheets, videos and more at BCGroupStore.com.

Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited