ADVANCING THE IMAGING PROFESSIONAL
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ICE FEATURES
May 2019
“ As an industry, we are afraid to collect certain data, to really disclose the things that are going on, because we’re afraid we’re going to get benchmarked against somebody else, and our jobs are on the line.” -Jim Fedele
32 Empowered Management To say that hospital decision-makers are inundated with data is an understatement. Analytics are used to justify any change in thinking at every level of management, from purchasing to servicing to staffing and beyond. Any department head will also tell you that the value of that information only goes as far as the meaning you can extrapolate from it. So, how are leaders to know which information is most useful, and under what circumstances?
rofessional P 18 Spotlight In high school, Donald Barker worked on HVAC systems. Next, he spent six years in the U.S. Navy working on a guided missile destroyer. Today, he is a senior imaging service engineer with “over 40 years of knowledge in the imaging field.”
Department of the Month:
Laurie Schachtner, Ph.D., MBA, FACHE, CRA, RT(R)(M) and her team at AMITA Health Saint Joseph Hospital Medical Imaging utilize imaging equipment that includes five CT, two MR, one LINAC, 10 rad rooms, eight C-arms, five portables and seven ultrasound units. The staff stays up to date on the operation of equipment and clinical knowledge via training. Page 20
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ADVANCING THE IMAGING PROFESSIONAL
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ICE DEPARTMENTS
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May 2019
20 Department Spotlight
24 C-arm Gallery 29 Solutions Guide 31 Tools of the Trade
MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 Phone: 800-906-3373 Fax: 770-632-9090
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ICE Magazine (Vol. 3, Issue #5) May 2019 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. Š 2019
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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY Esaote Introduces MyLabX8 to Expand Ultrasound Product Line Esaote announced the launch of the MyLabX8 – a high-performance and versatile ultrasound platform to support hospitals and clinics facing today’s challenges – at the 2019 European Congress of Radiology. Based on the recently introduced ULTRA technology platform, the product profile includes a limitless approach to ultrasound imaging and high-quality patient care. “The new MyLabX8 is designed to be a reliable partner in the daily clinical routine,” said Luca Bombino, head of ultrasound global marketing at Esaote. “We leveraged scalable technology to completely renew our ultrasound product line, and migrate premium performance and features to more affordable systems,
without compromising clinical confidence, throughput and reliability.” Esaote has always invested in workflow-oriented design. The MyLab9, its flagship ultrasound product, has many solutions in common with the new MyLabX8, including the control panel design and exam time reduction and automation. The MyLabX8 and the MyLab ultrasound product lines include a wide range of cutting-edge technologies, such as Virtual Navigator fusion imaging, QElaXto shearwave elastography, very high-frequency microV QPack, and exam automation tools like eScan, eDoppler and zero-click advanced functions. •
FDA Clears Mobilett Elara Max for Enhancements in Mobile X-ray Imaging The U.S. Food and Drug Administration (FDA) has cleared the Mobilett Elara Max mobile X-ray system from Siemens Healthineers, with features that enable comprehensive IT security as well as secure system integration into the hospital’s IT environment for anytime access to patient data. The system also has an improved design that includes an antimicrobial coating. The comprehensive security package of the Mobilett Elara Max helps health care
facilities handle cyber threats, while its virtual workstation technology provides access to necessary patient information directly at the bedside. The system’s ergonomic design has an antimicrobial coating and fully integrated cables for an unobstructed front view that allows for smooth, safe maneuverability. Additionally, the system delivers 180-degree lateral arm movement that maximizes positioning options to provide customers with robust imaging power for diagnostic confidence.
“Siemens Healthineers is pleased to offer the Mobilett Elara Max, a mobile X-ray system with advanced cybersecurity features that provide state-of-the-art patient data protection,” said Scott Watson, vice president of X-ray products, Siemens Healthineers North America. “The system’s virtual workstation digitalizes health care by allowing technologists to access important patient information right at the bedside rather than return to the radiology department.” •
Aquilion ONE/GENESIS Edition and Aquilion Prime SP Deliver Precise Imaging Capabilities From November 2011 to June 2013, approximately 12,200 patients underwent transcatheter aortic valve replacement (TAVR) across 299 hospitals in the U.S. As the number of interventional procedures continues to grow, the Aquilion ONE/GENESIS Edition and Aquilion Prime SP from Canon Medical Systems USA Inc. offer scan modes to help plan minimally invasive structural heart procedures effectively and efficiently. To improve workflow for advanced CTA scans while reducing radiation dose, the systems offer Volumetric Scan Mode that enables providers to acquire anatomical and functional data in a single heartbeat, as well as three phase Variable Helical Pitch (vHP3), which automatically changes
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from an ECG-gated to a non-ECG-gated acquisition during a single helical scan. They are part of Canon Medical’s suite of Collaborative Imaging tools which deliver clarity and confidence when supporting diagnoses and planning interventional cardiac treatments. Collaborative Imaging provides a complete, integrated solution that helps medical practitioners address structural heart disease at every stage in the process – from evaluation to treatment, offering a wide range of intelligent scanning features and analysis for confident diagnosis and treatment. • For more information, visit us.medical.canon.
ADVANCING THE IMAGING PROFESSIONAL
National Mobile X-Ray Acquires MMDS Mobile X-Ray National Mobile X-Ray LLC, headquartered in Lakeway, Texas, announced the acquisition of MMDS Mobile X-Ray. The acquisition bolsters National Mobile X-Ray’s presence in North Carolina and positions the company to further expand into the southeastern United States. Financial terms of the transaction were not announced. National Mobile X-Ray is a leading provider of mobile X-ray, ultrasound and EKG services. With its unique approach of uniting the nation’s mobile imaging providers on a single operating platform, NMXR has a nationwide reach that can offer its multi-state customers the benefits and convenience of partnering with a national company while ensuring that all individual facilities receive the personal touch and service of a hometown provider. MMDS Mobile X-Ray offers a wide variety of mobile radiology and ancillary services to skilled nursing facilities, ALFs, correctional facilities and home health organizations. MMDS, based in Asheville, North Carolina, began operating in western North Carolina in 2006 and expanded its reach statewide in early 2012. With this acquisition, MMDS customers can expect to continue receiving the high levels of service to which they are accustomed. They will also begin receiving additional benefits and services as a result of the National Mobile X-Ray platform, such as hassle-free EMR integrations, a JCAHO-accredited radiology group with the fast turnaround times and a wide variety of high-quality analytical reports to assist with QA and oversight of utilization. •
Hitachi Healthcare’s New CT scan Hitachi Healthcare presented diagnostic imaging solutions at the 2019 European Society of Radiology (ECR) in Vienna, Austria. Imaging solutions presented included Hitachi’s new CT scan, the SCENARIA View, the new high field MRI system, the ECHELON Smart Plus, and SynergyDrive suite. SCENARIA View is an all new design that raises the bar for versatility and affordability in the CT industry’s largest market of 64/128-slice CTs. SCENARIA View enhances patient comfort with an open design allowing to both accommodate the largest of patients and precise clinical targeting to feature high dose reduction. The broad range of choices for clinical applications will meet the individual provider’s needs as well. ECHELON Smart Plus is a next level 1.5T conventional superconductive MRI system, featuring state-of-the-art technology and enhanced productivity with uncompromised diagnostic value. Echelon Smart Plus also enhances patient comfort featuring very quiet examination, as well as professionals’ needs with Hitachi’s latest SynergyDrive technologies. SynergyDrive represents comprehensive hardware and software that is designed to streamline operations for examinations for MRI, and CT modalities. It comprehensively addresses the bottlenecks in the MRI and CT scanning process from start to finish – from patient registration to post-processing and image sharing. It gives value to radiologists, technologists, department administrators and patients. “SCENARIA View changes the view of CT examinations. It combines all of Hitachi’s experience and expertise in a remarkable new product providing an unmatched combination of speed, comfort and quality. ECHELON Smart Plus consistently falls in Hitachi social innovation with its new workflow concepts designed for efficient and simple operations of coil setting, patient positioning and high speed, high clinical value imaging.” said Jean-Luc Budillon, president and COO of Hitachi Medical Systems Europe. • WWW.IMAGINGIGLOO.COM
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Philips Expands Radiology Solutions Offering
Innovatus Imaging Bridges Gap Between Academics, Business For years, Dennis Wulf, CEO of Innovatus Imaging, has been building and leading successful businesses for ultrasound probe repair from Tulsa, Oklahoma. He is also informing the future by providing his years of tactical and scientific insights with sonography students at a local university. The Ultrasound School program operated by Innovatus Imaging is designed to help students have a hands-on experience in the real world, in real time, to more fully understand the critical nature and equipment issues associated with managing imaging device inventory which is essential to treating patients. In addition, Ted Lucidi, clinical specialist and customer experience lead for Innovatus Imaging, has been teaching biomedical engineering technology students at Pennsylvania State University for the past 18 years, preparing them for careers as service engineers, both field-based and in-house, a position critical to enabling hospitals and clinics to maintain equipment uptime and quality which results in accurate and timely diagnoses. Wulf and Lucidi shared insights from both Innovatus’ Ultrasound School and Lucidi’s medical equipment service course with attendees at MD Expo in Houston on April 13. Wulf discussed engineering elements of sustainable probe repairs, design standards and regulations critical for biomeds to understand, and Lucidi followed with insights on how to manage short and long-term costs for probe inventories. Additionally, they helped attendees test their probe knowledge about proper functionality of specific elements, failure modes and how to assess damage that can result in clinical compromise throughout the interactive session. “While we build our curriculum for our Ultrasound School around current issues and technologies students need to know, we find that current professionals are also in need of this knowledge,” says Wulf. “It is critical that professionals in our industry never quit learning as best practices for repair methodologies, inventory management and device maintenance change frequently. Educating the present and the future will always be a top priority for Innovatus Imaging.” • For more information about Innovatus Imaging’s Ultrasound School, or a post-event summary of the MD Expo session, “Getting Schooled in Ultrasound Operations,” email Ted.Lucidi@innovatusimaging.com. 10
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Royal Philips is expanding its radiology solutions portfolio with innovative teleradiology services, aimed at addressing the increasing shortage of radiologists, as well as the pressing need to improve access to precision diagnoses. Philips’ new telehealth services will build on its cloud-based radiology informatics portfolio of Picture Archiving and Communication Systems (PACS) and Vendor Neutral Archive (VNA) solutions, combined with advanced analytics, visualization and workflow applications, to now also include advanced teleradiology viewing and reporting capabilities, on-call radiologist services and related exam workflow enhancement applications. Teleradiology involves the remote interpretation of patient images from medical imaging exams, such as CT, MR, and X-ray exams, by radiologists without needing them to be in the same location as the patient. It includes remotely storing, retrieving, viewing and analyzing medical images by clinical experts anywhere, so that patients can receive optimal treatment via their local caregivers, wherever they are. The global teleradiology market is among the fastest growing segments in the radiology and the clinical services outsourcing market, and is expected to be a sizable part of the imaging interpretation market within the next few years. “As health systems worldwide struggle with the ever increasing costs and shortage of care providers, teleradiology will be a key enabler to optimally use the available resources, and support radiology departments to improve the speed and accuracy of image interpretation,” said Sham Sokka, business leader of radiology solutions at Philips. “We see imaging as a system and deliver innovation to support the needs of all the people behind the images by seamlessly integrating technology and data. Our new teleradiology services address a pressing need, while providing a strong platform for Philips’ future growth in the telehealth market.” Philips already provides the IT infrastructure for advanced telehealth solutions to improve collaboration among clinical care teams, and HealthSuite Digital Platform, a digital framework that connects consumers, patients and health care providers in a cloud-based ecosystem of devices, apps and tools. Philips’ new teleradiology services build on the recent acquisition of the teleradiology platform of U.S.-based Direct Radiology, that Philips plans to scale to support radiologists globally. This complements Philips’ organic innovation initiatives to expand its radiology solutions portfolio. The direct radiology business currently provides services for more than 300 hospitals, imaging centers, mobile imaging services and doctors’ offices across the U.S.
ADVANCING THE IMAGING PROFESSIONAL
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Siemens Healthineers Debuts Cardiovascular Edition of SOMATOM go.Top CT System During the 68th Annual Scientific Session & Expo of the American College of Cardiology, Siemens Healthineers introduced the SOMATOM go.Top Cardiovascular Edition, a new version of its established computed tomography (CT) system designed to deliver personalized patient dose control in all types of routine cardiovascular imaging. The 128-slice scanner offers outpatient cardiology offices as well as hospitals access to not just coronary CT angiography (CCTA), but also advanced tests, including the HeartFlow FFRCT Analysis. The system’s unique tablet-based mobile workflow simplifies and streamlines cardiac image acquisition. It also enables the technologist to remain with the patient to help ensure comfort and calm – key factors for a successful cardiac exam. The CARE kV feature automatically selects the optimal kV setting for each
patient with the precision of 10 kV increments, for personalized reduced radiation dose control as well as improved contrast enhancement. The system also has a fast native temporal resolution required for optimal visualization of coronary arteries. The HeartFlow FFRCT Analysis, a personalized cardiac test developed by HeartFlow Inc., enables clinicians to better evaluate the impact a blockage has on blood flow and determine the best treatment for patients. GO technologies help reduce workflow inconsistences and variabilities that can result in poor image quality. For example, the Check&GO algorithm helps identify problems associated with anatomical coverage and contrast media distribution as they occur. • For more information, visit www.siemens-healthineers.com.
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news CS Medical Completes Study CS Medical announced the successful completion of a study on the effectiveness of the TD 100 automated TEE probe disinfector, when used with either TD-5 or TD-8 high-level disinfectant, to remove human papillomavirus (HPV) from TEE probes. The study was conducted at the request of its Canadian customers as well as new regulations being reviewed by the Canadian Ministry of Health. The concern over HPV transmission has primarily focused in the transvaginal market place over the last decade. In recent months, the Canadian Health Authority has taken steps to include TEE probes as a potential patient risk. CS Medical, while working closely with a leading U.S. state university, successfully completed studies on both the TD-5 and TD-8 when used in the TD 100. The state university laboratory has been at the forefront of research and many consider this laboratory the leading
authority in the study of HPV 16 and 18. “Today’s news is reassuring in that the TD 100 has been, for over a decade, a valuable tool in the fight to reduce HAIs. Our science team at CS Medical worked closely with both the Canadian customer and university laboratory team to answer the call for more assurance in our product abilities. This continues to show CS Medical’s commitment to support our customers and the health care community in finding solutions to the hard problems that face our health care system,” said CS Medical President, Mark Leath. “We are committed to continuing our efforts to work with health care professionals and other professional organizations in the reduction of HAIs and increase awareness for a better and safer health care system.″ •
Carestream Health To Sell its Healthcare IT Business To Philips Carestream Health has signed an agreement with Royal Philips to sell its healthcare information systems (HCIS) business to Philips. Carestream’s HCIS business unit provides imaging IT solutions to multi-site hospitals, radiology services providers, imaging centers and specialty medical clinics around the world. The business has developed strong customer relationships in attractive, highgrowth health care segments and is positioned for continued growth and success. As a result of this acquisition, Philips’ expanded healthcare IT business will feature Carestream’s enterprise imaging platform – including VNA, diagnostic and enterprise viewers, multimedia reporting, workflow
orchestrator and clinical, operational and business analytics tools – as part of its broad portfolio. Carestream will retain its medical imaging, dental and industrial films, non-destructive testing, and precision coating businesses which are not impacted by the sale. Following receipt of all regulatory and applicable government approvals, input from works councils and unions, and meeting all pre-conditions, the two companies will work toward closing the sale in the second half of this year and will continue to operate independently until closing. Additional terms of the transaction were not disclosed. •
Varex Imaging to Acquire Direct Conversion Varex Imaging Corporation has entered into an agreement to acquire at least 90 percent of the outstanding shares of common stock of Direct Conversion AB (publ). Stockholm-based Direct Conversion, also known by its Ajat and XCounter brands, is a leading manufacturer and marketer of linear array digital detectors utilizing direct conversion and photon counting technology. The aggregate purchase price is 75 million Euros for 100 percent of the outstanding shares, subject to customary adjustments, of which 10 million Euros will be paid in either Varex common stock or cash on the first anniversary of closing. The company plans to fund the consideration using available cash and debt under its existing credit facility. The transaction is expected to be completed in 12
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the third quarter of the current fiscal year. “Upon closing, this acquisition will expand our product portfolio to include new linear array digital detectors along with a revenue stream from these products for certain medical, dental and industrial applications. It is expected that the current applications will widen our addressable market for digital detector products by approximately $200 million over the coming years, with additional addressable market expansion potential of up to $500 million by replacing current CT detectors with photon counting technology in the future,” said Sunny Sanyal, chief executive officer of Varex Imaging Corporation. The X-ray imaging industry has been working on photon counting technologies because detectors built with this technology
can significantly improve image quality while using lower dose and performing more precise material discrimination. Direct Conversion has successfully commercialized linear array digital detectors for certain medical and industrial applications and is expected to continue to work on applying this technology to additional applications, including medical CT detectors. Spencer Gunn, chief executive officer of Direct Conversion AB said, “We are excited to be joining Varex at this point in the growth and expansion of our digital detector array products. This transaction is expected to accelerate the adoption of this technology in the marketplace utilizing Varex’s position as one of the leading providers of digital detectors and its global distribution channels.” • ADVANCING THE IMAGING PROFESSIONAL
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PEOPLE ON THE MOVE By Matt Skoufalos
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Millstone Medical of Fall River, Massachusetts named Richard Worthen its executive vice president of sales and business development. Worthen was previously vice president of North American sales at Clozex Medical Inc.
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The Atlanta, Georgia-based North Highland added Amy Andersen as vice president. Andersen is the founder of Andersen Health Advisors, and previously held executive and leadership positions with IBM, Philips Healthcare, Booz Allen Hamilton, and Kaiser Permanente. Andersen began her career in healthcare policy and regulatory affairs in Washington, D.C. She is an advisory board member of Lightning Bolt Solutions and a board member of Mount Holyoke College Alumnae Association.
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The American Osteopathic Association (AOA) of Chicago, Illionis, has named Kevin Klauer its CEO. Klauer joins AOA from TeamHealth, where he was chief medical officer for hospital-based services, chief risk officer and executive director for the patient safety organization. Klauer also is a clinical assistant professor at Michigan State University College of Osteopathic Medicine and at the University of Tennessee Health Science Center College of Medicine.
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Fresenius Medical Care of Waltham, Massachusetts named Frank Maddux as global chief medical officer (CMO), Robert Kossmann as CMO for North America, and expanded the role of Fresenius Kidney Care CMO Jeffrey Hymes to include senior vice president of clinical and scientific affairs for Fresenius Medical Care North America. Maddux is a physician, IT entrepreneur and health care executive with 30 years of experience who has been
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working for Fresenius Medical Care since 2009. Before joining Fresenius in 2014, Kossmann practiced nephrology in Santa Fe, New Mexico for 20 years. Hymes has more than 30 years of experience in leading medical operations in both nephrology practices and multiple dialysis organizations.
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Nevro Corp. of Redwood City, California named D. Keith Grossman its president-CEO and a member of its board of directors, succeeding Rami Elghandour. Elizabeth Weatherman and Kevin O’Boyle were also named as new directors, as director Ali Behbahani resigned.
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Health System Advisors of Minneapolis, Minnesota named Kate Lovrien its managing director.
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Kumanu of Ann Arbor, Michigan named Paul M. Meister to its board of directors. Meister was most recently president of MacAndrews & Forbes Incorporated, and has been chairman and CEO of inVentiv Health (now Syneos Health) and chairman of the board at Thermo Fisher Scientific. He also co-founded Liberty Lane Partners and Perspecta Trust.
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XSurgical of Cambridge, Massachusetts has named Michele Marzola chair of its board of directors. Marzola is the co-founder and CEO at Interceptin srl, and has been general manager of IBM Global Services (Milan and Paris), principal of Booz, Allen & Hamilton; and a consultant with Bain & Co. in London. He is also chairman of the board at O.R.P.E. d.o.o., a director at Green Bone Ortho srl and Winegrid S.A., and a partner at DeBere Capital Partners.
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The Tacoma, Washington-based Swenson Healthcare added Sara Walden as
its chief nursing officer and Dahan Pham as its CFO. Walden has spent the past six years with Life Care Centers of America, most recently as the director of nursing at Life Care Center in Port Orchard, Washington. Pham has had senior financial leadership experience at Kiel Mortgage, SEFNCO Communications, and Cascadia International.
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3M of St. Paul, Minnesota has realigned its structure and made a number of new executive appointments. Michael Vale, executive vice president of the health care business group is now executive vice president of its safety & industrial business group. Ashish Khandpur, executive vice president of the electronics & energy business group, is now executive vice president of the transportation & electronics business group. Mojdeh Poul, executive vice president of the safety & graphics business group, is now executive vice president of the health care business group. Senior Vice President of Business Development and Marketing-Sales Paul Keel is now executive vice president of the consumer business group. Vice President of Research & Development and Commercialization, Industrial Business Group Denise Rutherford is now senior vice president of corporate affairs. Stephen Shafer, vice president of the greater China area, is now senior vice president of business development and marketing-sales.
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21st Century Oncology (21CO) of Fort Myers, Florida added Drs. Mohammad Jahanzeb, Raja Mudad, Edgardo S. Santos, Neil Nagovski, and Simon Abi Aad. Jahanzeb, a professor of clinical medicine at the University of Miami and medical director of its Sylvester Deerfield campus, will lead the 21CO Florida Precision Oncology practice. Mudad is an assistant professor of clinical medicine at
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the University of Miami and medical director of the chemotherapy treatment units at the Sylvester Comprehensive Cancer Center, where he also serves as co-chief medical informatics officer and associate director of the hematology/oncology fellowship program. Santos is medical director of cancer research at the Lynn Cancer Institute at Boca Raton Regional Hospital, a clinical affiliate associate professor at Florida Atlantic University, a board member at the Florida American Society of Clinical Oncology (FLASCO), and chair of the publication committee of the International Association of the Study of Lung Cancer (IASCL). Nagovski is board-certified in medical oncology, hematology and internal medicine, and has been in practice for more than 20 years. Aad is board-certified in internal medicine and medical oncology/hematology.
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DRS Imaging Services of Springfield, New Jersey added Jeff Russo as executive vice president of sales and marketing. Russo joins the company from DocuWare.
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Novant Health of Charlotte, North Carolina named Ann Caulkins senior vice president of Novant Health and president of the Novant Health Foundation.
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Women’s Care Florida of Tampa, Florida added Bethany Kieley as its COO. Kieley joins the company from ProHealth Physicians of Farmington, Connecticut. Kieley has a master’s degree in business administration from Plymouth State University. Women’s Care Florida also promoted Justin Wagoner to medical director of its pathology lab. Wagoner previously served as director of clinical pathology at the Bay Pines VA Medical Center in St. Petersburg, Florida. He is board-certified in anatomic pathology and clinical pathology by the American Board of Pathology.
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Le Bonheur Children’s Hospital of Memphis, Tennessee named Michael Wiggins its next president, succeeding the retiring Meri Armour on April 8, 2019. Wiggins joins Le Bonheur from Children’s Health in Dallas, Texas, where he was senior vice president of clinical operations and the northern market and administrator of Children’s Medical Center Plano. Wiggins has an MBA from the University of Alabama and is a fellow of the American College of Healthcare Executives (FACHE).
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WEBINAR WEDNESDAY Free Webinars Deliver Helpful Insights
T
he free webinars, many eligible for 1 credit from the ACI, continue to deliver helpful insights to attendees. The most recent webinars focused on X-ray preventative maintenance and repair, cybersecurity and regulatory compliance. Each webinar was well attended and received positive feedback. Experts Share X-ray PM, Repair Insights Webinar Wednesday delivered insights for HTM professionals with the presentation “Controlling the Clock in X-ray Preventative Maintenance” by RTI Electronics AB Global Product Manager Fredrik Brorson. Attendees are also eligible to pick up 1 credit from the ACI. In the webinar, which was sponsored by RTI, Brorson discussed how HTM professionals can be more efficient and productive in maintaining and repairing X-ray assets in today’s highly regulated environment. He discussed the effect tight budgets are having on health care facilities and the pressure it places on imaging service departments to maximize the uptime of imaging equipment. He talked about the desire for a faster response and shorter service time in today’s health care environment. In regards to the efficient servicing of imaging equipment, Brorson suggested the utilization of the best resources available. He said key elements to consider are a fast response time, intimate knowledge of the equipment history, the physical environment of the device, in-depth technical knowledge and more. The webinar concluded with a question-and-answer session. 16
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More than 200 people attended the live webinar and more have watched it online. At the conclusion of the live presentation, a survey sent to attendees captured positive feedback. “Informative webinar. This one was more on point and relative to the future of this facility,” said R. McInally, CBET. “This was a good seminar. Very insightful and informative. The speaker is very knowledgeable and his presentation was clear and concise,” shared K. Ongchango, CBET. “Was an informative experience with many useful takeaways,” S. Honeywell, Operations & Quality Manager, said. “This was a very informative webinar. This is a great tool and skill for in-house trained biomed professionals to assist in keeping equipment up, assisting with diagnostics, reducing downtime and cost. Thank you for having this presentation,” said B. Hayes, CBET. Cybersecurity, AEM Knowledge Shared The Webinar Wednesday presentation “The Simple Guide to MedTech Security” was sponsored by CyberMDX and attendees were eligible to receive 1 credit from the ACI. Safi Oranski, vice president of business development at CyberMDX, explored the nature of health care cyber threats and how they have impacted the current landscape of medical technologies and connectivity vulnerabilities. He talked about the convergence of cybersecurity and MedTech, then expound on the need, the complicating factors, and the routes to better protected medical devices. Attendees where shown a five-step method-
ology to comprehensively secure medical technology. More than 200 people attended the live presentation and even more have viewed a recording online. Those present for the live presentation gave positive feedback in a post-webinar survey. “It was nice to have an honest approach toward securing your network. He was straight forward in identifying all the risks at hand, but he also gave us a road map for regaining control of our network through small steps in a coordinated effort toward security,” explained P. Garon, Biomedical Technical Specialist. “The webinars keep getting better and better. This one was very timely,” shared C. Nanney, National Quality Manager. “A fantastic presentation on cybersecurity, one of the most important subjects of the future of health care,” said B. Baxter-Brown, BMET. “This was the best presentation by far in all of the webinars I have attended so far in explaining how complex cybersecurity can be. It was well presented and gave me a much clearer understanding of this matter,” said B. Hayes, CBET Site Lead. “Very informative webinar. Brought up some interesting points I hadn’t thought of before,” said P. Dorsey, BMET. Regulatory Compliance, Effective Maintenance Management A recent Webinar Wednesday session titled “oneSOURCE Document Site and Interface with EQ2’s HEMS CMMS Makes Maintaining Regulatory Compliance and Achieving Effective Maintenance Management Easier” was eligible for 1 credit from the ACI. Presented by Lindsay Frkovich-Nelson, ADVANCING THE IMAGING PROFESSIONAL
Vice President of Sales & Marketing at oneSOURCE Document Site; Rich Sable, Product Manager at EQ2; and Vishal Malhotra, Chief Technology Officer at EQ2, the webinar was designed to help attendees understand how having service manuals and all other item documentation right at the point of service saves the biomed time and effort. The ease of documenting performance levels and staying in compliance with documentation was another point made in the webinar. It is required that a hospital have documents from the manufacturer to show why it went to AEM. The webinar discussed how a hospital can use the HEMS AEM module to manage the program day to day, while using the oneSOURCE HTM Service Document Database to maintain the appropriate documentation. Almost 300 people attended the live presentation and provided positive reviews via a post-webinar survey. The webinar was sponsored by oneSOURCE and EQ2. “This Webinar Wednesday gave me insightful information I can start applying today,” said J. Haroldson, Business Contractor CMMS. “Update your skills with Webinar Wednesdays,” said R. Slater, Medical Electronics Technician. “This is my first webinar and thought it was very informative on the usage of the program. I hope our surgical center considers this product,” C. Pettiford, CRCST, said. “Excellent presentation which was well worth the time spent attending,” J. Kocurek, Director of Clinical Engineering, said. “The presentation had relevant information and it was informative. The WWW.IMAGINGIGLOO.COM
topics were explored in as much detail as possible within the allotted time,” said J. Huerta, Principal Consultant. The overall series also continues to receive rave reviews. “Very accessible learning from a wide range of speakers, keep up the good work,” E. Stone, Principal Clinical Engineer, said. “Webinar Wednesdays provide education on a wide variety of topics that are invaluable to the HTM field. They provide exposure to a variety of companies and products to further your organization. Highly recommended,” D. Page, Biomedical Equipment Technician, said. “Webinar Wednesday is a good series that brings various applications into my view that I would not otherwise know about,” said S. Strzalkowski, Metrology Professional. As Medical Electronics Technician R. Slated said, “Upgrade your knowledge with Webinar Wednesdays!” ICE For more information about Webinar Wednesday, including upcoming presentations and a video library of previous sessions, visit WebinarWednesday.Live.
LENDING A HELPING HAND AT EVERY STEP.
Diagnostic Solutions is a customer service based parts provider that specializes in all imaging modalities and manufacturers. Created to offer hospitals and ISO’s a cost effective and time saving solution for ordering imaging replacement parts, equipment moves, ultrasound probe repair and on-site service.
Contact us today, we are confident you will see us as THE Parts Solution! A special thank you to the companies that sponsored these recent webinars.
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330.296.9729 ICEMAGAZINE
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people By K. Richard Douglas
PROFESSIONAL SPOTLIGHT Donald Barker, senior imaging service engineer: Imaging Veteran
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n Augusta, Georgia, the oldest and largest hospital is University Hospital. It is part of the University Health Care System. The hospital opened its doors originally in 1818 before going through several incarnations that led to its current location in 1970. Today, the hospital campus includes the Heart and Vascular Institute and office buildings. It serves 25 counties. The health system also includes University Hospital Summerville, as well as multiple ancillary clinics. Maintaining and repairing University Health’s 10,000 pieces of medical equipment is the Novant Clinical Engineering Management Program (CEMP). Donald Barker is a senior imaging service engineer in the Novant CEMP department at University Hospital. In Barker’s ICE professional spotlight nomination, it was stated that he had “over 40 years of knowledge in the imaging field” and that he “single-handedly supported a 580-bed facility, 25-bed clinic and various care centers for one and a half years on his own,” referring to the imaging equipment. He started out learning how to work on HVAC systems which is where he became familiar with hand and power tools. “When I graduated high school, I worked in heating and air conditioning doing installations. This is where I learned to use tools and, because of this, when I 18
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applied to the Navy, I scored high on the entrance exam and was granted a six-year obligation enlistment in electronics,” Barker says. “Six years in the U.S. Navy working on a guided missile destroyer with three deployments” provided Barker with plenty of electronics training and experience. “I worked on the air search radar system,” he says. While necessity is the mother of invention, it is also the incentive for putting bread on the table. That is how Barker ended up servicing imaging equipment. “[I] was laid off from [my] previous profession in 1986 in the oil and gas industry. I was looking for a new profession and Siemens Medical took a chance on me. [I] Loved the work and have been servicing imaging equipment ever since,” he says. Despite considering another avenue, the health care sector became the destination for him. “My father-in-law recommended I go with medical electronics rather than Rockwell International as a metrologist working on hell fire missiles,” Barker adds. “I applied with Siemens Medical Systems in August 1986 and was accepted in January 1987 to work at New Hanover Medical Center in Wilmington, North Carolina. For the first year, I was in training since I had no previous experience in imaging service. Over the next eight years
with Siemens, I learned many valuable lessons and tricks of the trade. But I learn something new every day,” Barker says. “While I was with Siemens, they trained me in the basics and 22 other training classes over a nine-year period of time including cath labs, special labs, fluoro rad rooms, portables and mammography,” Barker says. “Since leaving Siemens Medical, I have worked as a third party with Premier CTS, Aramark CTS, Masterplan and back to Aramark, and now with Novant Health. Currently, I have 32 years of experience in the imaging profession and 49 years in electronics,” Barker adds. During his time at Aramark and Masterplan, he also received training from ReMedPar on GE Advantx 1, Advantx E and Innova 4100 and training from RSTI on GE Essential Mammography. “I had always been a field service engineer until I started working at Novant Health, where I am an in-house engineer. All the long drives were causing me to question my ability to continue field service or to go in-house, so I accepted the position here at University Hospital in Augusta, Georgia,” he says. Today, Barker takes care of more than 300 imaging systems. Holding down the Fort Along the way, with all of the experience ADVANCING THE IMAGING PROFESSIONAL
people Favorite part of being an imaging professional? “Fixing the equipment and meeting people.”
In 1978, a 26-year-old Donald Barker is seen holding a wallaby in MacKay, Australia. of maintaining and repairing imaging systems, there have been a few challenges. “While I was with Masterplan, the most challenging projects were maintaining five hospitals in the Dallas area and the many trips outside of my normal work areas to service equipment that I was not specifically trained on. In all cases, the problems were resolved through perseverance,” Barker says. “While at Novant, I maintained and managed over 250 systems for two years with minimal assistance, until I received a co-worker, and now we have increased our equipment base to over 300 systems with 14 vascular labs, five CTs, four MRIs, eight nuclear medicine units, six mammography units, 11 portable X-ray, 12 C-arms, several digital radiographic panel units and work stations. There are many support equipment (items) as well,” he adds. The hard work has generated some recognition. “I was most outstanding recruit in boot camp. [I] received a commendation for excellent service while on deployment in the Indian Ocean. I have received, while at Novant, an outstanding service award in 2017,” Barker says. WWW.IMAGINGIGLOO.COM
Away from work, Barker enjoys simple pleasures and used to be active in sports. “I like listening to music and watching movies. I used to play softball, tennis and basketball, until I tore my ACL and medial collateral ligaments playing softball. I also build furniture for pleasure,” he says. “I like making furniture as a hobby – assisting my wife with her soap making.” Also, away from work, he is a grandpa. “My wife and I met, while I was in the Navy and my wife was in the Army, on a blind date and have been together now for 45 years and we have two sons with five grandchildren.” Asked what readers should know about him, Barker refers to his longevity in the profession. “I am a friendly individual that can get along with almost anyone I meet. A lot of your readers probably have heard about me or already know me. I have been around and have talked with many people in the imaging profession,” he says. As a military and imaging veteran, Barker has served his country and community well. No doubt, there are readers who will recognize his name. ICE
GET TO KNOW THE PRO Favorite book The Outlander series Favorite movie “The Long Kiss Goodnight” Favorite food A well-cooked roast Hidden talent Bizarre sense of humor What’s on my bench? • A bin with chocolate mini bars • Computer with music to listen to • Coffee • Breakfast
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people By K. Richard Douglas
DEPARTMENT SPOTLIGHT AMITA Health Saint Joseph Hospital Medical Imaging
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ith nine and a half million people, the Chicagoland area is the third largest metropolitan area in the United States. Two local acute care hospitals that provide health care services to this population are AMITA Health Mercy Medical Center in Aurora, a 292-bed full-service facility with a Level II Trauma Center, and AMITA Health Saint Joseph Hospital Elgin, which is a full-service 184-bed hospital with a Level II Trauma Center. The hospital recently added a four-story bed tower, containing all private rooms, to better serve patients. Saint Joseph Hospital also includes the Meadows Regional Cancer Care Center; a 25,000-square-foot, state-ofthe-art facility. The cancer center offers 64-slice CT scanning, image-guided radiation therapy (IGRT) and intensity modulated radiation therapy (IMRT). The technicians and specialists who operate the many imaging systems at these facilities are part of AMITA Health Saint Joseph Hospital Medical Imaging. “I am the current imaging director for two hospitals who are part of a large health care system – AMITA Health within the Chicago area – which is part of the Ascension Health System. AMITA has over 19 hospitals within the Chicagoland area,” says Laurie Schachtner, 20
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Ph.D., MBA, FACHE, CRA, RT(R)(M). “There are a total of approximately 90 associates that I am directly/indirectly responsible for between the two hospitals at this time,” Schachtner says. “This is comprised mostly of the modality technologists, front desk associates/ tech aids and two FTEs of imaging nurses.” “At both of the hospitals we have: CT, MRI, nuclear medicine, radiology and ultrasound. I am also over the Cancer Center, which includes a linear accelerator and a 4D CT unit for simulation,” Schachtner adds. Imaging equipment includes five CT, two MR, one LINAC, 10 rad rooms, eight C-arms, five portables and seven ultrasound units. The staff stays up to date on the operation of equipment and clinical knowledge via training. “We train our staff via the OEM vendors when we purchase new clinical equipment (or have software upgrades). The clinical staff are also required to maintain their clinical licenses by completing their continual education hours (per their respective licensed accreditation professions). Nuclear medicine is different than radiography – so each modality has specific criteria,” Schachtner says.
The department’s leadership also plays a role in the capital purchase process. “At the time of capital approval and purchasing; the biomed leader signs-off on the capital request. They are in the loop so they can negotiate for additional training from the vendor and/ or decide which kind of service level agreement they will decide to participate in with the OEM,” she says. She adds that she is directly involved when it comes to negotiating for the equipment itself; although for the service portion, the system’s biomed leader negotiates that portion of the transaction. This way each department’s needs are vetted by the respective leader prior to issuing a purchase order. Shared Knowledge Through collaborative work, those in the imaging group work to provide continuous improvements and learning opportunities to their colleagues and staff. “We have a radiology council – which is led by a system vice president – where all imaging leaders meet (via Skype) monthly to discuss imaging improvements or issues that we are working on together as a system,” Schachtner says. ADVANCING THE IMAGING PROFESSIONAL
people
AMITA Health Saint Joseph Hospital Medical Imaging provides quality care to the Chicagoland area.
“There are four various imaging leaders who lead, report and present on four key areas on behalf of radiology for the system: stewardship, patient experience, growth, and quality and safety. This team also includes the medical director radiologist from each hospital as well,” she says. Schachtner says that they invite various subject matter experts ad hoc in order to provide current information if and when a topic of interest is needed. Some examples she shared are insurance verification, central scheduling and IT. “This forum fosters important information and processes so we can communicate and improve together as a clinical department within a larger system,” Schachtner explains. The department has also been proactive in problem solving and helping colleagues throughout the system. Schachtner says that the radiology council has helped identify system opportunities that may have otherwise been considered to be a local issue. One WWW.IMAGINGIGLOO.COM
example was a technologist staffing shortage issue. This enabled the group to work at the system level, with corporate human resources, in order to perform a market analysis to investigate the pay range relative to the market. She shared the best practice ‘Imaging Order Exam Change’ across the system that can be utilized when a patient’s procedure is changed at the time of clinical service. This can happen when tech and patient history inquiry discloses the appropriate procedure needs to be changed – after conferring with the radiologist for approval. An example for a change would be a CT without contrast [pre-approved]; being changed to CT with and without contrast. Once the change has been learned, the CT tech will fill out a form and fax it to Insurance Verification for a “stat approval” — so it will not be denied. The radiology council also serves as the forum where they standardize contrast products and supplies in order to best leverage standardization and
manage costs without compromising on quality. Away from the workplace, department members continue expanding their knowledge. “Our imaging department (along with many Chicago imaging departments) are attending the College of Imaging Administrators – which has a local twoday continuing educational event that grants continuing educational credits for the two days of attendance. There are varied imaging topics that are presented. The topics are proposed to the board and approved for presentation. Many imaging leaders meet monthly to plan for this annual event. We work with vendors and imaging leaders for presentations,” Schachtner says. Patients in the Chicago area, who require diagnostic imaging, are in experienced hands when they utilize the imaging services at AMITA Health Mercy Medical Center in Aurora or AMITA Health Saint Joseph Hospital Elgin. ICE
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the medical product support network “An excellent resource. It’s my first stop when I have a question or need information. An asset to any technician’s toolbox.” –Mark Cooper, Legacy Medical Imaging
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“MedWrench connects a wide range of biomed engineers, helping them to share knowledge and experiences.” –Fadi Ali, RSS
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PRODUCT SPOTLIGHT Surgeries Power C-arm Market Growth
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C-arm is a medical imaging tool with a C-shaped arm that attaches the X-ray source and X-ray detector to each other. These devices offer high-resolution X-ray images in real-time, thereby permitting medical professionals to observe progress at any point during the operation and promptly make required alterations. The growth of innovative C-arms has broadened their application area, adding considerably to the growth of the global fluoroscopy and mobile C-arms market, according to Market Data Forecast. In the present world, imaging systems are a vital technology in every hospital. Experts in fields such as surgery, orthopedics, neurology, urology and cardiology utilize C-arms for intraoperative imaging. The North America C-arm market was worth $1.4 billion in 2018 and estimated to be growing at a compound annual growth rate (CAGR) of 3.78 percent, to reach $1.68 billion by 2023, according to Market Data Forecast. The growth of the North America C-arm market is mainly due to factors such as rising awareness regarding interventional surgeries, increasing implementation of minimally intrusive surgeries, growing demand for superior imaging technology and for C–Arms in cardiology and vascular surgery, according to Market Data Forecast. The research group also suggests that an increasing emphasis on the transportability of C-arms has created a market opportunity for companies manufacturing mini C-arms. However, factors such as growing utilization of refurbished devices, increasing cost concerns and the low substitution rates of C-arm systems are obstructing the growth of the market in this region, according to Market Data Forecast. In 2015, North America led the global WWW.IMAGINGIGLOO.COM
C-arm market in terms of both value and capacity, according to Market Data Forecast. “The market in this region is projected to grow strongly during the forecast period due to various factors such as growing awareness about medical imaging tools, financial strength to procure expensive devices and adoption of advanced products,” according to Market Data Forecast. “The market is highly consolidated due to the high prices of equipment and a huge amount of capital is required for the entry of a new company into the market. This has led to a formidable competition among prominent market players. The major companies dominating the C-Arms market in this region are GE Healthcare Inc., Varian Medical Systems Inc., Philips Healthcare, Siemens AG, Toshiba Corp., Hologic corp., Omega Medical Imaging Inc., BMI Biomedical International, Hitachi Ltd., DMS Health Technologies, ATON GmbH, Medonica Co Ltd., Gemss Co Ltd. and Shimadzu Corp.” The growing importance of medical imaging in the global health care industry is helping to boost the market for fluoroscopes and C-arms, according to a report by BCC Research. fluoroscopes and C-arms are medical imaging systems that are based on X-ray technology that can produce real-time dynamic images. The global market is estimated to be worth $2.7 billion in 2022, reaching a CAGR of 3.8 percent, according to the report “Fluoroscopy and C-arms: Technologies and Global Markets.” The market for cardiovascular applications is driven mainly by the growing number of interventional heart procedures, especially minimally invasive surgeries. The increasing dependence on advanced mobile C-arms for these cardiovascular applications has caused a positive impact on the market.
Major players within this market, according to BCC Research, include GE Healthcare, Philips Healthcare, Siemens Healthineers, Shimadzu Scientific Instruments Inc., Toshiba Medical Systems Corp. and Ziehm Imaging Inc. A separate report also predicts sustained growth in the C-arm market. A July 2018 report on the future of the C-arm market by Market Research Engine forecasts continued growth. It also includes a detailed study of global and regional markets within the global C-arm market and provides reasons for variations in the growth of the industry in certain regions. The global C-arm market is expected to exceed more than $3.46 billion by 2022 at a CAGR of 3.82 percent in the given forecast period, according to the Market Research Engine report. The increasing adoption of mobile C-arms in hybrid ORs is expected to drive the growth of the global market, according to Research and Markets. “The latest mobile C-arms feature 3D navigation aid and image processing software to improve quality and system capabilities. The analysts have predicted that the surgical imaging devices market will register a CAGR of more than 4 percent by 2022,” according to Research and Markets. Commenting on the report, an analyst from the research team said: “The latest trend gaining momentum in the market is the increasing adoption of mobile C-arms in hybrid ORs.” According to the report, one of the major drivers for this market is the increase in the prevalence of chronic diseases. Further, the report states that one of the major factors hindering the growth of this market is the high costs of surgical imaging devices. ICE ICEMAGAZINE
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products
Canon Medical Alphenix 4D CT Canon Medical Systems USA Inc. has introduced an angiography configuration featuring its Alphenix Sky+ C-arm and Hybrid Catheterization Tilt/Cradle Table for interventional procedures with its Aquilion ONE/GENESIS Edition CT system. The new pairing, called the Alphenix 4D CT, allows clinicians to efficiently plan, treat and verify in a single clinical setting. The flexible hybrid system enables flexibility with innovative C-arm flip, right or left lateral flexibility, speed and full body 3D imaging capability. The Alphenix Sky+ offers revolutionary ImagingRite technology to generate a 3D image anytime, anywhere. •
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Siemens Healthineers Cios Spin The Cios Spin mobile C-arm from Siemens Healthineers provides precise 3D computed tomography (CT)-like imaging for orthopedic, trauma and spine surgery to enable intraoperative quality assurance. Capable of integrating seamlessly into the clinical routine, the system offers versatility to support both 2D and 3D imaging for a wide variety of procedures, including vascular imaging. NaviLink 3D digital navigation permits easy-touse connectivity to surgical navigation. The Cios Spin has flat panel detector technology and is available with a range of optional software packages. Its high generator power facilitates imaging of large patients and dense anatomy for precise clinical evaluation of images. •
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products
Ziehm Imaging Vision RFD Hybrid Edition The Ziehm Vision RFD Hybrid Edition is the first fully motorized mobile C-arm for the hybrid OR. The system is a space- and cost-saving alternative to fix installed systems for highly demanding cardiovascular procedures. Lower purchase and installation costs result in a faster return on investment. The powerful 25 kW monoblock generator and advanced cooling technologies guarantee higher performance levels.. •
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ADVANCING THE IMAGING PROFESSIONAL
products
GE Healthcare OEC Elite CFD OEC Elite CFD is the first premium mobile C-arm offering both a 31 cm and 21 cm CMOS flat panel detector, which is designed to produce high-image quality at a low dose. The OEC Elite CFD produces crisp, detailed images, enabling better confidence by allowing surgeons to see greater differentiation between a patient’s anatomy. It features imaging tools such Digital Pen for planning and drawing on an image and Live Zoom, with ability zoom up to 4x and then fluoro or Cine on an area of interest. Beyond high-quality imaging, the OEC Elite C-arm’s streamlined design is intended to provide surgeons with more control and maneuverability in the OR with a 4K Ultra-HD 32-inch display mounted on an articulating arm for easy positioning and an entirely new ergonomically designed C-arm called Ergo C, which provides great range of motion and flexible positioning around the patient. •
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products
Philips Azurion with FlexArm The Philips Azurion with FlexArm is designed to set a new standard for patient imaging and positioning flexibility for image-guided procedures. Azurion with FlexArm includes a set of innovations that makes it easier for the clinician to perform imaging across the whole patient in both 2D and 3D. The design provides flexibility and intuitive control. Powered by a unique smart kinematic engine, the system moves on eight different axes, all controlled with its single ‘Axsys’ controller. Simulation tests with clinicians have demonstrated the system’s potential to significantly reduce the repositioning of the patient, staff and equipment to improve access for minimally invasive procedures, including those that enter the body through the patient’s wrist (‘radial access’), and to reduce the risk of unintentional pulling of wires and tubes, as well as significant time savings1. The system is ideally suited for hybrid ORs that cater to multiple specialties in one room, such as a combination of surgical and endovascular procedures. • 1
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Uselab simulation test with 17 clinicians.
ICEMAGAZINE | MAY 2019
ADVANCING THE IMAGING PROFESSIONAL
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Solutions Guide SOLUTIONS Need companiesGUIDE C-Arm SEE OUR AD P. 17
Brandywine Imaging, Inc. SEE 201 W. Cedar Street OUR AD Kennett Square, PA 19348 P. 30 Phone: 610 444-5553 Fax: 610 444-5571 Website: www.brandywineimaging.com Brandywine Imaging offers a variety of X-ray imaging equipment to meet your facility’s needs. Our goal is to improve our national presence as a provider of healthcare imaging products. Currently, we have equipment installations across the country. We also serve our customer’s through our online catalog, where we are continually adding products. Items include X-ray film, pre-owned items we have in stock, new X-ray related accessories and much more. In addition, Brandywine is a founding member of the AMSP (Association of Medical Service Providers) allowing us a network of service providers across the country as well as access to equipment we may not offer directly.
Diagnostic Solutions 4075 Karg Industrial Parkway, Ste A Kent, OH 44240 Phone: 330-296-XRAY (9729) Fax: 330-296-2555 Email: sales@diagnostic-solutions.com Website: www.diagnostic-solutions.com Diagnostic Solutions is a customer service based parts provider that specializes in all imaging modalities and manufacturers. Created to offer hospitals and ISOs a cost-effective and time-saving solution for ordering imaging replacement parts. We are confident you will see Diagnostic Solutions as THE Parts Solution.
Shop multiple vendors in a single online marketplace.
RSTI/Radiological Service Training Institute 30745 Solon Rd. SEE OUR AD Solon, OH 44139 P. 2 Toll-Free: 833-229-7784 Phone: 440-349-4700 Fax: 440-349-2053 Email: registration@rsti-training.com Website: www.rsti-training.com Engineered for Learning; RSTI is the industry leader in basic, multi-vendor and product specific diagnostic imaging service training. Our educational programs focus on the repair and maintenance of today’s hightech diagnostic imaging systems. RSTI’s training center is equipped with over 45 fully functional imaging systems to ensure RSTI students have unmatched hands-on learning opportunities to support their classroom education.
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TOOLS OF THE TRADE CS Medical TD 100 TEE Probe Disinfector
T
he TD 100 delivers high-level disinfection to TEE probes in 5 minutes. The TD 100 disinfects each TEE probe with high-level disinfectant and provides printed verification upon completion of a successful disinfection cycle. Microprocessor-controlled, the TD 100 is simple to use for any health care professional reprocessing a used TEE ultrasound probe. The TD 100 reduces the amount of stress and the potential for damage to TEE probes. The system was designed with every aspect of the TEE probe taken into consideration. The control handset is held securely within the TD 100, while strain and stress are minimized from the cable and electronic pack adapter with a specially designed hanger and mounts for both. Additionally, the height to insert the TEE probe distal tip and shaft is 38 inches, giving less potential of hitting and damaging the distal tip during insertion into the TD 100. ICE
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ADVANCING THE IMAGING PROFESSIONAL
o say that hospital decision-makers are inundated with data is an understatement. Analytics are used to justify any change in thinking at every level of management, from purchasing to servicing to staffing and beyond. But any department head will also tell you that the value of that information only goes as far as the meaning you can extrapolate from it. So, how are leaders to know which information is most useful, and under what circumstances? Do better data make a better manager? And, in the case of imaging services, which are both revenue drivers and cost centers, how does the applicability of that information empower those in the driver’s seat to best set the course for the winding road ahead? Nicole Walton-Trujillo, ultrasound manager for Desert Radiology of Las Vegas, Nevada believes that one of the best ways to determine which data are useful is to connect her departmental operations with the strategic plans of her enterprise. Walton-Trujillo describes “a line that goes between the C-suite and the strategic plan” as offering the clearest guidance for her teams. “You should always look at your company’s three-to-five-year plan,” she said. “In the end, you as a leader are responsible for facilitating it. What’s the company plan, these are the benchmarks, and then what are you doing to meet that bullet point? What are you doing, what are you looking at, so it aligns?” To that end, Walton-Trujillo has created an internal scorecard, updated monthly, that charts “anything I can access that I can quantify,” she said, from technology to patient volumes to staffing hours to service. “I have a whole section for quality under biomed – every machine, every minute it was down, how many patients it affected in every modality every month,” she said. Foremost, Walton-Trujillo said that creating internal metrics for downtime accounting WWW.IMAGINGIGLOO.COM
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EMPOWERED MANAGEMENT not only “keeps my service provider and me speaking the same language,” but has helped her build the case for changes to staffing and resource allocation with her supervisors. “We have a service provider, and our definition of downtime is not the same,” she said. “My definition is the second it went down to the second it’s back in patient use.”
date patients.’ They can justify me being able to give somebody a job [because it means being] able to treat more patients a month.” “It’s all about building that foundation of communication and managing it well,” Walton-Trujillo said. “More often than not, when I go to those quarterly meetings with my service provider, they expect it. Now they say, ‘Do our numbers match?
clinical engineering at the Williamsport, Pennsylvania-based BioTronics, is another firm believer that “those who have the data control their own destiny.” But like Walton-Trujillo, he believes that applying that data to make meaningful comparisons is everything. “Looking at the process, you have to find out where to start,” Fedele said. “What’s broken that creates this situation?”
“AS AN INDUSTRY, WE ARE AFRAID TO COLLECT CERTAIN DATA, TO REALLY DISCLOSE THE THINGS THAT ARE GOING ON, BECAUSE WE’RE AFRAID WE’RE GOING TO GET BENCHMARKED AGAINST SOMEBODY ELSE, AND OUR JOBS ARE ON THE LINE.” Charting the amount and nature of the downtime her staff experiences allows Walton-Trujillo to let executives know which factors have adversely affected patient throughput, and consequently slowed revenues or monopolized human resources that could otherwise have been differently allocated. “I could now say to my COO, ‘I need a new scanner,’ and they’re going to say, ‘Show me why,’ ” she said. “I can say, ‘Here’s my staffing, here’s the amount of overtime I had to pay to accommo-
JIM FEDELE, CBET
SENIOR PROGRAM DIRECTOR, UPMC AND BIOTRONICS 34
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-JIM FEDELE
Do I need to adjust anything?’ They know I know what I’m talking about. I have built that foundation of working with them.” Despite tracking as much metric information as she can, Walton-Trujillo believes that the only innate value it has lies in whatever insight those data can provide that’s relevant to departmental operations. Her rule of thumb: “if they’re not doing you any good, don’t track them; or if you’re tracking them and you don’t understand why, you need to keep pushing to understand why.” The data gathered in any department can also have a practical effect on staff management. “You can’t educate and guide growth if you don’t understand why you’re tracking it,” Walton-Trujillo said. She’s leveraged the data collected in her department to better inform staff via an interview style of communication, as opposed to making meetings into “a data dump.” “How many staff meetings did you go to that they gave you a packet of information, and it went to your to-be-filed pile, and you never looked at it again?” she said. “If you don’t have that knowledge behind it, then you’re just parroting data, and I can do that in an email.” Jim Fedele, senior program director of
To determine performance indicators requires identifying the problem to be addressed, whether relevant data can be collected around it, ways in which those data can be affected, and whether measuring those outcomes can influence change, Fedele said. But even some of the most commonly gathered metrics may not intuit meaningful comparisons in every circumstance. “At our level, a lot of people look at uptime as an indicator for imaging equipment,” Fedele said. “A lot of my hospitals have only one CT scanner, so when one CT scanner’s down, that’s a problem. But do we really have an ability to affect that? You can kind of gather that data, you know that the unit was down, but then it becomes these gray areas – was it completely down, or was there something that we couldn’t do? To me, gathering that as a performance indicator or as a data point is less useful because there’s so many different ways to interpret that.” The most meaningful data that are collected require the least amount of distilling, he said. If a data set requires excessive manipulation to derive the desired results, there’s a fair chance that the metric it produces won’t offer a true reflection of conditions in the department. And when outcomes are tied to those data – like
ADVANCING THE IMAGING PROFESSIONAL
people’s employment, or reimbursements – there can be natural inclinations to massage the figures, which is counterproductive to performance improvement. “Every day, we should learn,” Fedele said. “That’s what the data and the analytics should be for: to learn about what’s going on with your equipment, with your users, the environment. As an industry, we are afraid to collect certain data, to really disclose the things that are going on, because we’re afraid we’re going to get benchmarked against somebody else, and our jobs are on the line.” Another concern is when performance metrics are being driven by outside pressures, like third-party consultancies, auditing agencies or leadership goals that are out of alignment with departmental practices. Over the course of a 30-year career, Fedele estimates he’s been through a consultant’s review every three years or so. He’s seen multiple variations on performance benchmarking, and experienced the impact of self-reported data on departments of various sizes. “We went through those things to drive change internally,” he said. “Inevitably, what I found was gross variability in the data set. When I watched the outcomes from that, people generally got defensive. Right away, as soon as you have someone asking you about this data, you’re going to resist that because you’re worried about your own career.” “I’m always uncomfortable with some of the consultants that come in and say, ‘You should have five guys but you have seven,’ and you know all seven of your guys are really busy,” Fedele said. “What is it that you have to be able to do to function with five guys? A lot of times that gets pushed back on the department manager to figure it out. That’s not really fair.” Conversely, Fedele believes that if leadership embraces the intention of data collection as performance improvement and not as coded language for cost- (and job-) cutting, then that information can be much more useful for driving meaningful internal change. He also pointed to two significant institutional hurdles often overlooked in efficiency improvement: WWW.IMAGINGIGLOO.COM
namely, that a significant percentage of health care is staffed by an aging workforce, and that frequent turnover in key executive positions makes it difficult to hit goals when institutional courses are constantly shifting. “For a lot of people, this is their single career, and this is all they know,” Fedele said. “Hospitals have always been clunky because they used to be a captive audience. What we have now is consumerism and highly competitive markets; offsite centers and specialty clinics that do it better than anybody else because they think about throughput.” “As we get younger leaders in key positions, I feel like some of this change will occur as needed,” he said. “It takes longer than five years, and most of these people last three.” As decision-makers and their priorities can shift frequently, third-party resources can provide a place to seek guidance, said Bill Algee, director of imaging services at Columbus Regional Hospital in Columbus, Indiana. As president of the Association for Medical Imaging (AHRA), Algee believes that “having a place to go where you can discuss those dilemmas” can offer departmental leaders the perspective they need to recalibrate their own filters outside of the strictures of their institution. “Getting the right data out there can be difficult,” he said. “Who’s making those decisions and the different metrics you can use can be somewhat cumbersome at times. There’s a lot of different ways to get it, but making sure you’re comparing apples to apples is the biggest challenge.” General measurements like workhours per procedure or costs per procedure are common denominators in many facilities, Algee said, but some of the most useful metrics in his own hospital are specialized details that have been derived from internal process improvements, which may not always be tied to quantitative evaluations. “There’s extraneous things going on that you can’t quantify by one procedure,” Algee said. “You have to look at the
NICOLE WALTON-TRUJILLO DESERT RADIOLOGY, LAS VEGAS, NV
whole picture, and you have to listen to the story. Some of those soft skills include listening to the staff. How are we setting those expectations?” Algee also believes that facilities can hamstring their operations by trying to attach too much meaning to data as a differentiator. Evaluating his monthly metrics for cost efficiencies resulted in a report that showed Columbus Regional was “way off the national norm” for per-procedure nuclear medicine costs. At the outset, it seemed to present a budgetary problem, but a deeper dive into the data revealed that was because the institution performs cardiac PET studies that used a pricey radiopharmaceutical. “That’s a choice we’ve made because the patients are getting better studies [with the contrast agent],” Algee said. “We were about to stop doing it because our costs were so far out of whack. Could we give that up? Yes, but you’ll see that cardiac PET is getting more momentum. Part of my fear was, I can get rid of that, but if it’s a hotbed in two years, and I go back to that vendor, the costs might go up. You have to play that market.” “We’ve decided that we’re going to really hone in on that because that data helped us to drive to that,” Algee said. “What made us really look at what our cost per procedure was helped us see [that] we do have a competitive edge, [and] we’re not using it to our advantage as much as we should be.” “Those things all relate together,” Algee said. “I think sometimes we get caught looking at individual things instead of the whole spectrum. It’s trying to find that balance.” ICE ICEMAGAZINE
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ADVANCING THE IMAGING PROFESSIONAL
insight
CAREER CENTER Are CBD Oil Benefits Worth Career Risk?
A
t the risk of bringing up a controversial subject, I feel compelled to communicate an important message to our industry population. I have personally witnessed cases where great candidates (professionally and technically) did not obtain a position because of a failed drug test. These individuals failed their drug tests because they had used CBD oil for health and/or medical reasons believing it to be perfectly OK. The following information is from my research but I suggest that each inidvidual do their own research, especially prior to using a CBD oil product! CBD (cannabidiol) is one of many active chemical compounds in the cannabis plant. CBD oil is a popular product for everything from pain control to promoting sleep. CBD is currently legal in most states and isn’t subject to the same drug laws as medical marijuana. Since it’s a dietary supplement, you can find it online, in health food and other retail stores. With the rise of CBD oil usage comes the concern about failing a drug test. Those who have tested positive did so because of the presence of THC – the psychoactive component of marijuana – even though CBD oil is often said to be THC-free and that is a statement that most people believe. As it turns out, depending on the source of the cannabis that is used to WWW.IMAGINGIGLOO.COM
Written by Jenifer Brown Health Tech Talent Management
“The following information is from my research but I suggest that each inidvidual do their own research, especially prior to using a CBD oil product!” produce the CBD oil, some products do contain traces of THC (including low-quality isolates and many full-spectrum tinctures). While some CBD oils claim to be isolates, they may be full spectrum oils and actually contain more cannabinoids (such as THC) than they claim. Also, it is important to keep in mind that these are not FDA-regulated products. Since we are on the topic of drug tests, I need to point out that the medical industry still has zero tolerance! This is even the case in states where marijuana is legal! Many health care organizations, especially direct hospitals and systems, do a full extensive 10-panel level drug test versus the 5-panel level drug test via a urine or hair follicle sample covering every type of drug! It is important to note that even the 5-panel
test can detect THC traces from CBD oil! In closing, if you are under any type of prescribed medications and need to be drug tested be sure to bring those prescriptions with you, as well as any physician notifications you may have, when interviewing for a job. However, it is important to understand that if the prescription is for medical marijuana it may not be accepted. You could be eliminated as a candidate for using prescribed medical marijuana due to the industry’s zero tolerance policy. You could also be dropped from consideration for a job because of a failed drug test caused by the use of a CBD-oil product that may claim to be free of THC. ICE
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ADVANCING THE IMAGING PROFESSIONAL
insight
IMAGING MATTERS
Written by John Garrett Director of a Clinical Engineering Department in CHI
Surviving a Survey
T
he CEO of the hospital calls your office or shop. You can hear the panic in their voice. The world is coming to an end. Nothing will ever be good again. Why? There is a surveyor from The Joint Commission, DNV, CMS or the state health department on campus. The panic or fear that the administration has is not based on anything being wrong in the hospital. The fear is of the unknown. What is the surveyor looking for and does the person hired last week know the answers to the most likely questions that will be asked of them? Of course, there is also the fear of missing documentation or outdated procedures that haunt the mind of the CEO when the surveyor steps through the door. There will always be some apprehension, but there are ways to survive a survey. The first and best technique for surviving a survey is preparation. Having a system of documenting the work performed on equipment that is thorough and in line with CMS is crucial. This is something that cannot be fixed on the day the surveyor walks into the facility. WWW.IMAGINGIGLOO.COM
Having the system is only the first step. Keeping a “clean” database is a constant effort. Having all of the equipment listed, ensuring service reports are entered in a timely manner and verifying the service reports are complete requires continual vigilance. Be fluid, flexible is too rigid. Notify your team that the surveyor, don’t call them inspectors, is on the premise and that they are a priority. The surveyors do try to cover a lot of ground in a short time, so be ready to meet requests for information and data. Making sure that they have what they need to evaluate your operation means that the inspection can be done quickly. Providing accurate information quickly and candidly lets the surveyor know you have nothing to hide. The biggest issue may be a rouge surveyor. Most surveyors have a clinical background. They are typically individuals who do not know the clinical engineering side of the equipment. They know how to operate the equipment and deal with the patient. They are often unaware of proper maintenance procedures or practices. Yet some will
insist that since they are a surveyor, and you are not, that they are right. Even when they are not. Typically all you can do is smile and nod your head. Of course you provide documentation and present why you do what you do. But brace for impact and expect that they will be sure that they are correct, even when they are not. This is where the system breaks down. If you have a rouge surveyor that steps beyond their scope or ability, the hospital can file a complaint. But typically a hospital will not a file a complaint simply because the next survey is likely to be more difficult. There is no real protection from rouge surveyors. So, have your program in place, compliant and in constant review. Then, relax and get through the survey. ICE
John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine. He has worked for third-party service companies, manufacturers, sales companies and in-house imaging teams.
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insight
DO THIS ONE DAY EACH MONTH I
f you’re in a senior management or leadership role, there’s one thing you can do that sets all kinds of positive wheels in motion. But there’s a problem. Most people in leadership roles don’t want to do it. What is this powerful but oft-avoided task? Spend a day each month or so working in the front lines of your organization. For 30 years I’ve been preaching the need for top managers, leaders and CEOs to regularly get in the trenches so they can stay in tune with how their organizations are operating from the ground up. For example, the CEO of a hospital needs to work at the admissions desk for a day and the president of McDonald’s needs to work the grill or take orders at a register. If you run an imaging lab, you could spend an entire day working alongside the radiological technologists. If you’re not certified in operating specific machines, that’s OK, you can still serve as an assistant. In each of these situations, a leader will learn the valuable subtleties about what really happens where the rubber meets the road. But wait – don’t managers and leaders have more important things to do with their time? Yes and no. We learn a lot by doing. You will learn more by talking with customers and employees face-to-face in real-time situations than you will by reading customer service or employee satisfaction surveys. Why? Because bureau40
ICEMAGAZINE | MAY 2019
cratic language often distorts reality. When leaders get in the trenches, they bypass the bureaucratic filters and learn firsthand what’s going on. The result is better leadership and management decisions. Dave B. is a friend of mine who works as a regional sales manager for a national company, and he wholeheartedly agrees that managers and executives need to get their hands dirty once in a while. Dave realized the value of this by accident. He says that after working his way through the ranks, a situation arose that required extra people at the entry levels in production. Timing was critical, and the company didn’t even have time to go through an emergency hiring process. Having started out in one of those positions many years before, Dave volunteered to help out. “Wow – what an eye opener,” he says. “It amazed me how much I’d forgotten about what our front-line workers do each day, even though I’d worked in those positions for years.” As a result of that experience, Dave now spends several days each quarter working alongside front-line employees. Interestingly, he emphasizes that he needs to spend an entire day at it. He says, “Just a few hours aren’t enough. People know you’re the boss and at first they try to make everything look good. But if I’m there a whole day or two, I get better insights into what’s really going on.” Dave says he’s also careful to stay “criti-
Written by Daniel Bobinski Workplace Consultant
cism-free,” keeping a proactive and helpful attitude. “I have to ask a lot of questions, but when they see that I’m genuinely curious and interested in making things better, I get good feedback.” Dave stumbled on the value of this practice by himself. Sadly, when I suggest to managers and leaders that they spend a full day working on the front line, they usually look at me as if I’d just asked them to swallow some goldfish. Most feel it’s beneath them or that their time is too valuable. If they only had the insights that Dave had. Thankfully, leaders exist that get it. David Neeleman was CEO of the discount airline JetBlue from 1999 to 2007, and he, too, saw the value of getting in the trenches. Neeleman would board flights with all the other passengers, and after the plane reached cruising altitude, Neeleman would get on the intercom and announce who he was, stating that he wanted to meet each passenger and get their feedback. After that, Neeleman would don a flight attendant’s apron and work the carts, getting feedback from passengers as he did. He visited with every passenger on the plane, writing down their ideas and suggestions, responding to complaints and telling people about some of the cool things JetBlue was planning in the future. Neeleman did this at least once a month, and it paid off. In 2005 he won the ADVANCING THE IMAGING PROFESSIONAL
insight
Tony Jannus Award, a recognition given addressing their concerns, things have for outstanding leadership in the commerturned around at Wal-Mart. Since Foran cial aviation industry. took over four years ago, the company has As another example, consider Greg experienced steady growth, a change from Foran, CEO of Wal-Mart’s U.S. operations. several years of declining sales before he The man regularly visits stores, and cusarrived on the scene. tomers would have no idea that he’s the As another quick example, perhaps CEO because he walks around in regular you’ve seen the TV show, Undercover Boss. Wal-Mart employee attire, complete with a I sometimes joke that they owe me some standard company name tag. royalties, as I’ve been publicly advocatA recent article in Business Insider ing this practice for decades, but that TV pointed out that Foran is so interested in show clearly demonstrates just how much learning what employees need to do their senior executives can learn when they put jobs better, he tells them to e-mail him some time in on the front lines. PROOF APPROVED NEEDED their input. In that process, ForanCHANGES learned Bottom line, when people at the top that things as little as electrical outlets are willing to go beyond a facilities tour CLIENT SIGN–OFF: not working were hindering employees’ and actually do the work that front-line productivity and impacting their morale. workers do, they will make better deciCONFIRM THAT ARE CORRECT And,PLEASE because employees see their CEO THE FOLLOWING sions in the boardroom.
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And so, if you’re a manager or leader, why not schedule a day each month or so, working where the rubber meets the road in your company? It’s my bet that you’ll learn more than you think you will, and the payoff will be greater than the investment. Daniel Bobinski, M.Ed. is a certified behavioral analyst, a best-selling author and a popular speaker at conferences and retreats. He loves working with teams and coaching individuals to help them achieve workplace excellence. Reach Daniel through his website, www. MyWorkplaceExcellence.com, or (208) 375-7606.
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index
ADVERTISER INDEX Adel Lawrence Associates, Inc. p. 45
Holland p. 30
MedWrench p. 22
RSTI/ Radiological Service Training Institute p. 2
DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS
AHRA p. 47 Injector Support & Service p. 41
KEI MED Parts p. 15
MW Imaging Corp. p. 5
Oxford Instruments Healthcare p. 3
MarShield p. 15 PM Imaging Management p. 30
Entech p. 38
46
ICEMAGAZINE | MAY 2019
PROSPECTS
Experts in Siemens Medical Imaging
InterMed Group p. 36
Diagnostic Solutions p. 17
Sodexo CTM p. 9
TECHNICAL
Brandywine Imaging p. 30
Carolina Medical Parts p. 13
Multi Diagnostic Imaging & Surgical Solutions Back Cover
Medical Imaging Technologies p. 38
Richardson Healthcare p. 11
Technical Prospects p.13
SOLUTIONS
Tri-Imaging Solutions p. 4
W7 Global p. 36
Webinar Wednesday p. 44
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