ICE Magazine - August 2019

ADVANCING THE IMAGING PROFESSIONAL

AUGUST 2019 | VOL.3 NO.8 | THEICECOMMUNITY.COM

Do it for the Children

Designing Medical Devices for Pediatric Patients Page 32

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Do it for the Children – Designing Medical Devices for Pediatric Patients

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ICE DEPARTMENTS

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AUGUST 2019

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10 Imaging News

18 Professional Spotlight

23 RIS and PACS Spotlight

36 Career Center

14 Webinar Wednesday

20 Department Spotlight

24 RIS and PACS Gallery

17 People on the Move

30 Tools of the Trade

39 Imaging Matters 40 Daniel Bobinski 45 Photo Contest 46 Index

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ICE Magazine (Vol. 3, Issue #8) August 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.

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ADVANCING THE IMAGING PROFESSIONAL

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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY Hologic Enters into Exclusive Negotiations to Acquire SuperSonic Imagine FDA Clears DCNN Image Reconstruction Technology for CT Canon Medical Systems USA Inc. has received 510(k) clearance on its new deep convolutional neural network (DCNN) image reconstruction technology, ushering in a new era for CT. Canon Medical’s Advanced Intelligent Clear-IQ Engine (AiCE) uses a deep learning algorithm to differentiate signal from noise so that it can suppress noise while enhancing signal.

The algorithm forges a new frontier for CT image reconstruction with its ability to learn from the high image quality of Model Based Iterative Reconstruction (MBIR) to reconstruct CT images with improved spatial resolution (compared to AIDR 3D), 3-5x times faster than traditional MBIR. With AiCE’s deep learning approach, thousands of features learned during training help to differentiate signal from noise for improved resolution. AiCE applies a pretrained DCNN to enhance spatial resolution while simultaneously reducing noise with reconstruction speeds fast enough for busy clinical environments.

“Our AiCE technology utilizes a next generation approach to CT image reconstruction, further proving Canon Medical’s leadership and commitment to innovation in diagnostic imaging,” said Dominic Smith, senior director, CT, PET/CT, and MR business units, Canon Medical Systems USA. “This technology doesn’t just meet our customers’ evolving needs, it exceeds them, opening doors to clearer, more precise images to help optimize patient care.” • 10

ICEMAGAZINE | AUGUST 2019

Hologic Inc. has made a binding offer to acquire (directly or through an affiliate) SuperSonic Imagine, a France-based innovator in cart-based ultrasound products, and that it has entered into an exclusive negotiation agreement with the company and its main shareholders toward that end.

“Like our previous acquisitions of Faxitron and Focal, acquiring SuperSonic Imagine will strengthen our strategy to provide comprehensive screening, interventional and surgical solutions across the continuum of breast health care,” Hologic’s Pete Valenti said.

“Ultrasound is becoming increasingly important in diagnosing breast cancer, and we believe SuperSonic Imagine offers superior technology that translates into better clinical outcomes for breast cancer patients, as well as for patients with liver and prostate disease.”

Under the terms of the binding offer, Hologic has agreed to acquire SuperSonic Imagine’s outstanding shares at a price of €1.50 per share. This price corresponds to approximately $39 million for all outstanding shares, or approximately $42 million assuming all outstanding warrants and options with an exercise price lower than €1.50 are exercised. In addition, Hologic would make available funds to repay SuperSonic Imagine’s net debt in an amount not to exceed $43 million, equating to a maximum enterprise value of $85 million.

The completion of this tender offer is subject to the French Financial Markets Authority’s clearance decision on the

proposed tender offer and, particularly, on its financial terms.

Acquiring SuperSonic Imagine will enable Hologic to enter the $450 million cart-based global breast ultrasound market, which has been growing at a high single-digit rate as the technology is increasingly being used as an adjunct to mammography in women with dense breast tissue. SuperSonic Imagine’s products will complement Viera, the wireless, handheld ultrasound scanner that Hologic is commercializing through a development and distribution agreement with Clarius Mobile Health.

“SuperSonic Imagine provides bestin-class ultrasound technology that is strategically important to the long-term growth of our breast health business,” said Steve MacMillan, Hologic’s chairman, president and chief executive officer. “The transaction is consistent with our capital deployment goals and will be accretive to our revenue growth rate.”

SuperSonic Imagine generated approximately $29 million of revenue in calendar 2018. Less than 15% of this revenue came from the United States, Hologic’s largest market, providing an opportunity for future growth. The acquisition is estimated to be less than 1 percent dilutive to Hologic’s non-GAAP earnings per share in fiscal 2020. • ADVANCING THE IMAGING PROFESSIONAL

THE WORLD MOVES FAST. WE MOVE FASTER.™

626 Holdings LLC has acquired The JDIS Group.

In business since 2009 and based in Anaheim, California, The JDIS Group is a provider of parts, equipment sales, service and specialty services (magnet solutions, equipment install/de- install, mobile services) for multi-vendor imaging systems, nationwide.

“626 is solid in all aspects of MR, CT and PETCT service, but this transaction immediately makes us comprehensive experts in these additional areas. We are now able to deliver the same responsiveness and quality we deliver on the East Coast through 626 and Walsh Imaging to the West Coast. We could not be more

excited about our future with JDIS and this is just the beginning,” stated Philip Revien, CEO of 626.

Founded by Phil Revien and Michael Fischer in 2014, 626 has more than 60 engineers nationwide and offers maintenance on all medical imaging equipment. With a focus on quality workmanship and exceptional customer service, 626 is committed to providing its clients and partners with unprecedented access to stress-free solutions.

“There were several strategic paths we could have taken with JDIS, but after spending time planning optimal next

steps with Phil and Michael, the path was clear. The best decision was an alliance with 626 and we could not be more excited about the future. Coming together will create a uniquely positioned value proposition for our customers,” said Burke Whitney, president of The JDIS Group. “We are excited about the opportunity to be a part of the 626 team, their amazing culture, and what the combined companies will bring to the industry.”

For more information, visit www. weare626.com.

Philips Extends Advanced Automation Capabilities on EPIQ CVx, EPIQ CVxi Royal Philips has announced new advanced automation capabilities on its EPIQ CVx and EPIQ CVxi cardiac ultrasound systems. With Release 5.0, both the EPIQ CVx and EPIQ CVxi now include automated applications for 2D assessment of the heart, as well as robust 3D right ventricle volume and ejection fraction measurements.

Together, the new applications provide clinicians with the means to confidently evaluate the heart’s function, increasing diagnostic confidence for patients with pulmonary hypertension, congenital heart disease, coronary disease and heart failure.

“The complexity of cardiac exams can be a barrier to accessing high-quality care.

Philips is addressing this by leveraging Artificial Intelligence to make echo exams easier, faster and more reproducible,” said David Handler, general manager of cardiac ultrasound at Philips. “By incorWWW.THEICECOMMUNITY.COM

porating advanced automation, there is less variability between scans, leading to accurate treatment decisions which benefits patients. The new release of EPIQ CVx is a major step forward, reducing the number of touches of the system by 21% in each exam, which is equivalent to more than 400 exams each year.”

The AutoStrain LV application uses advanced Automatic View Recognition technology to identify the different views of the heart, providing exceptional visualization and analysis of left ventricular function – extremely important diagnostic information for patients at risk of developing cardiovascular disease. Also available are AutoStrain LA and AutoStrain RV, applications which automate the measurement of left atrial and right ventricular longitudinal strain respectively. By creating reliable and reproducible strain measurements for the left ventricle, left atrium and right ventricle, the AutoStrain LV, LA and RV applications support clinicians treating patients with atrial

fibrillation, arrhythmia and other complex heart conditions.

The 3D Auto RV application segments, identifies the borders of and aligns the views of the right ventricle, enabling clinicians to carry out the quantification and check the measurements quickly. These new applications expand on the advanced automation applications already available on the EPIQ CVx platform, including Dynamic HeartModel, which provides a clear vision of the heart’s chambers and how well they are pumping blood – specifically on the left side, where heart failure often begins. A recent study of Dynamic HeartModel published in the European Heart Journal – Cardiovascular Imaging concluded that “the automated algorithm can quickly measure dynamic left ventricle and left atrial volumes and accurately analyze ejection/filling parameters.”

The new release also adds diagnostic capabilities to the EPIC CVxi. Tailored for use in the interventional lab, the system can now also be used in the echo lab. • ICEMAGAZINE

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news

MANAGE YOUR RISK & LOWER YOUR COST OF CT OWNERSHIP. MITA Testifies at HHS Public Meeting

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• Grant provisional coverage to new technologies which have FDA clearance/approval; and • Assign an appropriate New Technology Ambulatory Payment Classification (APC) within 30 days of FDA clearance or approval.

“New technologies that are approved by the FDA but not reimbursed by CMS face a classic ‘Catch 22,’ ” said Carol. “They are approved but not covered by Medicare – forcing patients to pay out of pocket. As a result, the procedure’s use is hindered, and the amount of clinical data needed for Medicare coverage can’t be generated. This disconnect between the FDA and CMS leaves innovative and proven technology in the laboratory and not in the clinic where patients can benefit from it.”

Carol shared with the panel the example of “partial gland prostate ablation” procedure as a case study on how innovative technology can languish between FDA approval and CMS reimbursement.

The FDA-authorized procedure uses ultrasound to target diseased regions, treat those regions by thermally ablating targeted tissue and then tracks the impact of treatment using advanced signal processing tools. The result is the destruction of cancer while sparing healthy tissue and limited to no compromise in quality of life for the patient.

Lack of Medicare reimburse-

ment, Carol noted, means patients must pay for the treatment out of pocket and the high-cost is a high barrier to overcome that limits access for many. Limited access and utilization also make it difficult to collect sufficient data needed to convince CMS to initiate a coverage decision. The result, in this case, is that a minimally invasive, cost-effective treatment is unavailable to many patients who would benefit.

“By initiating this process, the administration is taking an important first step toward bridging the divide between the FDA and CMS,” Carol said.

“I applaud HHS for recognizing how patients can benefit from spurring clinical innovation and hope our recommendations rooted in transparency, collaboration and accountability can assist the agency as it pursues these important goals.”

The Medical Imaging & Technology Alliance (MITA), a division of NEMA, is a collective voice of medical imaging equipment manufacturers, innovators and product developers. It represents companies whose sales comprise more than 90 percent of the global market for advanced medical imaging technology. ICE

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The Medical Imaging & Technology Alliance (MITA) affirmed its view that the U.S. Centers for Medicare and Medicaid Services (CMS) should grant provisional coverage to new technologies that have Food and Drug Administration (FDA) approval for two years to validate the reasonableness and necessity of these innovations and obtain stakeholders to collect sufficient data to determine an appropriate reimbursement payment.

At a public hearing convened by the Department of Health and Human Services (HHS) to assist in developing “programs and procedures for assessing and accelerating the pace of the clinical innovation enterprise throughout the United States,” Dr. Mark Carol, CEO of SonaCare based in Charlotte, North Carolina and Chair of MITA’s Focused Ultrasound Section, laid out four recommendations to improve patient access to innovative technologies and to help prevent a technology from languishing or disappearing all together from marketplace: • Make the coverage process more transparent, accountable, predictable and collaborative; • Use available alternate resources, including externally collected data, to make determinations of “reasonable and necessary;”

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WEBINAR WEDNESDAY Presenters Cover Hot Topics Staff Report

T

he webinar “Predicting the Future: RTI Detector Development with Monte Carlo Simulations” was sponsored by RTI. Attendees were eligible to receive 1 credit from the ACI. The webinar was presented by RTI Physicist Petty Cartemo, PhD. RTI uses Monte Carlo simulations as a tool in the development of products and mathematical models for the measurement of key values such as HVL, kV and dose.

Petty briefly discussed the physics and technical details needed for the theoretical description of radiation properties. She also described how the RTI research and development group utilizes data simulation tools. An example of a current product was also presented to demonstrate the effectiveness of Monte Carlo simulations.

Attendees shared why they attended the webinar.

“Our department is starting to move into first response for X-ray, I want to be there. Definitely worth my time,” said V. Jacobson, biomedical technician.

“Keeping myself updated on industry trends. As always very informative webinar,” said R. Mesropyan, CBET. “I always gain knowledge from Webinar Wednesday,” said D. Pilkilton, BMET II. “Interested in the topic. I don’t specialize in X-ray, but I would like to see if it is 14

ICEMAGAZINE | AUGUST 2019

“ I learned a lot about optional and recommended quality control practices for ultrasound and will be implementing some in my institution.”

The webinar featured CyberMDX Vice President of Business Development Safi Oranski. He explained how imaging service professionals can break down silos within healthcare delivery organizations (HDO) using data and analytics from medical devices and other connected IoT assets.

Oranski also explored how medical device insights provide a wealth of operational and security intelligence – benefiting imaging service, HTM, IT and IS departments. He shared best-in-class use cases from hospitals to illustrate system-wide benefits. Attendees gained knowledge on how multiple departments can benefit.

CyberMDX sponsored the webinar that drew 153 attendees to the live presentation and more HTM professionals have watched a recording of the session to gain a valuable education credit.

Attendees were quick to share how much new information they received from the webinar.

Ultrasound Accreditation The webinar “Clinical Engineers’ Critical Role in Ultrasound Accreditation – Why It Matters To Departments and YOU!” was sponsored by Innovatus Imaging.

The 60-minute webinar was presented

by Matt Tomory and Ted Lucidi of Innovatus Imaging. Accreditation is one of the most critical aspects of imaging facility operations, yet many clinical engineers are unaware of where their facilities stand and what they personally are responsible for on a day-to-day compliance basis.

What you don’t know could be impacting your operational and diagnostic efficiencies. This educational session created awareness of the imortant role clinical engineers play and how they can fulfill that role efficiently and effectively.

Beyond understanding the purposes and objective of accreditation, attendees learned the following: • Testing criteria that each board requires relative to ultrasound image quality.

• Performing common tests using several transducer models.

ADVANCING THE IMAGING PROFESSIONAL

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– P. Baxter, leader radiation safety and quality control. a direction I would like to pursue,” said J. Bareis, BMET II. “Interested in nuclear physics research and development applied to radiation detection devices. Yes, it was worth my time.

Great job on the presentation,” said R. Carl, cardiovascular and nuclear medical services manager.

“I am always fascinated by the science behind the equipment. Math and physics play a big role in the development of biomedical equipment. Simulations in research and development help us define and fine tune materials that are used in production. It also helps before testing and verification begins,” said H. Martin, clinical engineer.

Secure Your Clinical Network The recent Webinar Wednesday presentation “Automate, Optimize and Secure Your Clinical Network” was eligible for 1 credit from the ACI.

“I learned there needs to be more planning on our part to keep up with industry trends,” said Clinical Engineer M. Mappes.

“It was a great topic considering what is happening now with cyber attacks,” shared G. Dickerson, healthcare technician lead.

“It contained a lot of good information on HTM and IT,” according to J. Damasco, biomedical technician.

“I really wish my department manager could have watched. A lot of good information regarding utilization, etc,” said J. Arford, BMET.

• Assessing transducer performance in the field per the various boards’ requirements.

• Acquiring and assembling the Quality Control data required for accreditation.

• Affordable tips to reduce operational costs while maintaining accreditation standards.

The presentation received positive feedback with a rating of 4 on a scale of 1 to 5 with 5 being the best possible rating.

Attendees provided feedback to the question, “How well did the content that was delivered match what you were promised when you registered?”

“Excellent presentation of what was promised. Very educational and helpful,” said P. Collett, biomed team leader.

“Excellent and covered more than I expected,” Biomed K. Baber said.

“Excellent, very well delivered, exceeded my expectations,” said J. Dipad, biomed equipment specialist.

“Yes, I learned a lot about optional and recommended quality control practices for ultrasound and will be implementing some in my institution,” said P. Baxter, leader radiation safety and quality control.

“Excellent, A lot of information in little time but was directed to the important items,” said A. Negron.

Parts Management The Nuvolo-sponsored webinar “The Future of HTM Parts Management” continued the success of the Webinar Wednesday series. The attendees, who were eligible for 1 credit from the ACI, gave the session a thumbs up.

The webinar featured Nuvolo Vice President of Product Marketing Ben Per-

son. He discussed and demonstrated how Nuvolo can help with parts management in a CMMS system. As part of driving cost and process efficiencies for an organization – by being able to locate, order, track, receive and install parts for your medical devices – Nuvolo demonstrated its PartsSource and GE Parts ordering capabilities in a CMMS along with parts and stockroom management.

After the webinar, attendees shared their thoughts.

“Great, very informative insight about the future of parts management” Biomed M. Barry said.

“Really informative and very interesting. Great webinar,” said D. Warner, CE Tech III. “Interesting, good tips for making order in our job, which is such a difficult task to achieve,” Biomedical Engineer M. Nacu said.

“A great way to earn CE credits, while learning something new,” said J. Poe, national manager parts procurement. ICE For more information, including upcoming webinars and recordings of previous sessions, visit WebinarWednesday.Live.

A special thank you to the companies that sponsored the recent webinars.

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ZRG Medical of Oceanside, California added marketing administrator Emily McGowan. McGowan has five years of graphic design for print and digital media.

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Innovatus Imaging of Pittsburgh, Pennsylvania promoted Jason Brownley to operations manager of its MRI Center of Excellence, Amanda Hoover to group lead of customer care, and added support staff Patrick Carr and Greg Raleigh. Brownley was most recently group lead overseeing MRI technicial staff; Hoover joined Innovatus after having worked in the automotive industry. Carr joined the company when it was known as MEDRAD, and has been a service engineer and service manager for the radiography service team. Raleigh, a former U.S. Army biomed, joins Innovatus after years of field service experience with Renovo Solutions, Merry X-ray and GE.

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ADVANCING THE IMAGING PROFESSIONAL

held both roles since September 2016. Ryu succeeds outgoing president-CEO David Feinberg, and becomes the seventh CEO in the 104-year history of Geisinger. Ryu has been president of integrated care delivery for Humana, was CMO at the University of Illinois Hospital & Health Sciences System in Chicago, and has held various leadership roles at Kaiser-Permanente, the Centers for Medicare and Medicaid Services (CMS), and the Department of Veterans Affairs.

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Irvine, California-based Kareo named David Justus its CFO and Scott Maxwell and David Cozzens to its board of directors. Prior to joining Kareo, Justus has been CFO of Avetta and of The Retail Equation. Maxwell is senior managing director of OpenView Venture Partners; Cozzens previously was CEO of Telogis, has been vice president of operations for Novell, and vice president of consulting at Cambridge Technology Partners.

MolecularMatch of Houston, Texas named Eric Pulaski its president. Pulaski has 30 years of technology and software experience. He most recently was CEO of SmartVault Corporation, which he co-founded and sold to Reckon Ltd. in 2016. Pulaski was also cofounder and CEO of BindView, which was sold to Symantec; he also has founded and led similar organizations like RedFlag Software and Lightbulb Technology Partners.

Healthcare Management Administrators (HMA) of Bellevue, Washington named Lindsay Harris to the PacMed community board, effective immediately. Harris is the HMA Chief Client Officer, and has previously worked at Premera Blue Cross, Mathematica Policy Research, and the Agency for Healthcare Research & Quality at the Department of Health and Human Services in Washington, D.C.

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Analytical Wizards of Edison, New Jersey added Mike Steward as its principal and chief digital officer and Kurt Mueller as chief marketing officer. Prior to joining Analytical Wizards, Steward was vice president of analytics at Indegene. Mueller previously served as an executive-level consultant and advisor to several companies and startups in the greater Philadelphia region.

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N8 Medical of Dublin, Ohio named Marc Rohman its CEO and a board member. Rohman previously worked at Scios Inc., and has also spent a decade at Biocodex of France.

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Geisinger of Danville, Pennsylvania removed the interim tag from acting president-CEO Jaewon Ryu, who’s

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New York, New York-based Pfizer will add Jeff Settleman as senior vice president and group head of oncology research and development. Settleman joined Pfizer on July 1 from Calico Life Sciences, where he was a distinguished principal investigator and head of oncology research.

Prior to Calico, Settleman led discovery oncology at Genentech. Robert T. Abraham, who has led the oncology research and development group at Pfizer since 2011, will retire at the end of 2019. ICE

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Jessica Chambers, MHA, RT(R)(CT): Submitting Every Goal

S

t. Charles, Missouri has been on the map since the late 18th century. It was Missouri’s first state capital and is a short drive from St. Louis.

SSM Health St. Joseph Hospital is a provider of health care services to the people of St. Charles. The hospital is part of SSM Health, a Catholic not-for-profit health system serving communities across the Midwest.

Jessica Chambers, MHA, RT(R)(CT), is the director of Imaging, Vascular Lab/Procedure, Neurodiagnostics and Pain at SSM St. Joseph Hospital in St. Charles.

It may have been the experience, several times, of laying under an X-ray machine that piqued her interest to find out what it is all about.

“I was a wild child growing up; by time I was finished with elementary school, I had already broken multiple bones, had multiple stitches and was a pretty frequent flyer in the emergency room,” Chambers says.

“I knew at a young age I wanted to work in health care. After attending a year of college, I decided to follow in a family tradition and joined the Air Force. It was when I was reading the job descriptions at the recruiters office that ‘diagnostic imaging’ stood out as something that I would enjoy doing, so I picked the job and signed the dotted line to do this profession as I served my country,” Chambers says.

Chambers attended phase one training 18

ICEMAGAZINE | AUGUST 2019

– mostly the didactic part of schooling – at Sheppard Air Force Base in Wichita Falls, Texas. She then went to Nellis Air Force Base in Las Vegas to complete phase II of training, which she says, was “basically your clinical.”

“After working as an X-ray tech for about three years, I then received on-thejob training in CT at my first duty assignment at Travis Air Force Base in Fairfield, California. I then separated from the Air Force in 2007, and further advanced my career by utilizing my GI bill to obtain my bachelor’s and then [a] Master of Health Administration. This gave me the skill set to advance my career into a leadership role, where I currently am the director of imaging and network CT consultant for the St. Louis Region of SSM,” Chambers says.

Her journey in imaging led her to working as a general radiology technologist. Working the night shift, Chambers says that the night techs had to learn basic non-contract CT, since there wasn’t a nighttime CT tech available. She says that she fell in love with CT and applied for a position working with this modality.

“Upon making the rank of staff sergeant, I was granted an interim noncommissioned officer in charge (NCOIC) for the CT department, and this is when I learned the basic skills of leadership, as I managed the CT department for a little less than a year. I then separated from the Air Force

and was hired on as the CT supervisor at SSM DePaul Hospital in St. Louis. I led this team for about two and a half years, when I was promoted to assistant team leader and began to lead the entire diagnostic imaging department,” Chambers says.

Life Lessons from the Martial Arts Away from work, Chambers is an expert grappler and knows how to submit an opponent.

“I hold a purple belt in Brazilian Jiu Jitsu. I train with Gracie Barra. I actually was the first female to achieve this rank at my gym, which was a pretty awesome compliment for me. I not only train, but compete; this is what helps keep everything in perspective,” she says.

Chambers says that although she has won many gold, silver and bronze medals, she has lost just as many matches as she has won.

“Training in Jiu Jitsu is something I did to stay active and fit, but it has become so much more than that for me. It, honestly, probably helps me in the way I tackle projects and goals at work too. One saying that has stuck with me is that you never lose in Jiu Jitsu; you learn, maybe you made a mistake and got submitted, but you learned not to make that mistake again,” Chambers says.

She says that this has carried over into her career, where she might take a little ADVANCING THE IMAGING PROFESSIONAL

Favorite part of being an imaging professional?

“Knowing that is more than ‘taking pictures,’ though the things we discover with these ‘pictures’ are sometimes not the greatest news for people. Without us, there would be no diagnosis, so we are sort of the Google of the hospital. Come to us and we can give you answers.”

GET TO KNOW THE PRO Favorite book Growing up I read every V.C. Andrews novel.

Favorite movie All the Pitch Perfect movies.

Favorite food A good street taco!

Hidden talent I can touch my nose with my tongue.

What’s on my bench?

• Pictures of my family – when stress is high looking at these can always put a smile on my face.

• My LA Dodgers cup full of water – I drink a ton of water each day.

• My cellphone – unfortunately today people expect immediate responses, phone calls aren’t always the way people ask for things so I’m typically getting requests or information via text each day.

• Twizzlers – these are my weakness; people know this and supply me with them daily.

• My notebook – I’m a list maker. I make a daily list and mark things off when I complete them.

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more risk when trying to identify opportunities and achieve goals.

“It’s not so crushing if I don’t meet the goal. I just maybe need to approach it differently and try again,” she says.

Chambers says that her family are die-hard Dodgers fans and that she grew up in Southern California. All three of her children have Dodgers-related names.

“I have three children; Brooklyn, Ebbet, and Raleigh. Brooklyn is 15 and going into her sophomore year of high school.

Thanks to her training in Jiu Jitsu, she wrestled on the varsity team last year as a freshman and had an amazing year. Ebbet

is going into seventh grade and Raleigh is going into fifth grade. They too train in Jiu Jitsu and I anticipate they will follow in their sister’s footsteps and wrestle in high school,” Chambers says.

Chambers says that she is in leadership because she genuinely cares about improving outcomes and assisting employees in career advancement. In addition to this, she also won an innovation award at her hospital.

With a competitive nature and the philosophy of learning from every experience, Chambers is bound to lead her imaging department to great things. ICE ICEMAGAZINE

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people

people

By K. Richard Douglas

DEPARTMENT SPOTLIGHT Advanced Imaging

O

ne Florida city, that sits north of Orlando and inland from coastal Daytona Beach, is Orange City.

It is considered a part of the Deltona-Daytona Beach-Ormond Beach metropolitan area, which had a total population of 590,289 in 2010. Orange City sits in Volusia County.

Area attractions include Blue Spring State Park and nature cruises on the St. Johns River are popular. Visitors can also observe some of the area’s manatee.

Those visiting the area can fly into Daytona Beach Regional Airport, which is 21 miles away.

With such a large population base in the area, diagnostic imaging is a necessary service. One stand-alone service provider that fills that need is Advanced Imaging.

The imaging center offers several medical imaging and radiology services to patients. The center also offers an accommodating schedule.

“We are a locally owned outpatient imaging center that opened in 2012. We happily have over 20,000 annual studies with a staff of 21 including two radiologists, five techs covering four modalities,” says Josh Laberee, the imaging center’s owner and administrator.

The center offers several modalities and is a fully digital site incorporating MRI, CT, ultrasound and X-ray.

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“We proudly average 90 patients a day; 18 MRI, 18 CT, 20 ultrasound and 35 X-rays. We have five techs on staff daily staggered between 6 a.m. and 7 p.m., Monday to Friday. Saturdays, we run MRI and ultrasound only from 8 a.m. to 2 p.m.

This is all done at our one location with all new state-of-the-art equipment,” Laberee says.

There are also three board-certified and fellowship-trained radiologists.

Advanced Imaging is accredited by the American College of Radiology (ACR).

Staff technologists perform every type of imaging study except for mammography. “We, by choice, do not focus on breast imaging. This is due to us being a smaller, one-location center,” Laberee explains.

It is easy for primary care providers and others to refer patients to the center because of its accommodating hours and payment options.

“We are proud to offer all 93 of Central Florida’s insurances. This allows us to treat everyone like family and rest-assured you are covered for any exam that you or your family may need. We are also proud of the ACR center of excellence accreditation we have received, making us a prepared provider in our community and with our network of insurance carriers and health systems,” Laberee says.

Accessibility is Key The business has realized much success and growth in its short history. Laberee attributes much of that to the many ways the center accommodates the local community and the sense of family among the staff.

“Growing from five employees, and only doing 3,800 studies in 2012, we closed 2018 with 21 employees and did over 20,000 studies. All of this accomplished while maintaining only one original location. How did we do it? I think one word defines our success: accessibility. We are open 72 hours during the week, but like Chick-fil-A, never on Sunday,” he says.

“During that time, our amazing staff focuses on efficient and compassionate patient care. From assisting referring providers with insurance authorizations to providing transportation for our patients, we are willing to do whatever it takes to make our center unlike any other,” Laberee says.

He says that internally, the success is accomplished by allowing all employees to have access to an abundance of resources and benefits not common at small imaging centers.

“From monthly bonuses, paid benefits, employer-provided lunches; we share everything together like one big family. As a locally owned business, I feel it’s essential

to have a blend of staying small but also being able to offer benefits like a Fortune 500 company,” Laberee adds.

Because imaging technologists can never be too well trained, the staff at Advanced Imaging, along with support staff, share knowledge and constantly train.

“We are providing constant contributing education at every level. Utilizing a team-centric approach, we have all members of the staff focused on constantly educating each other on the best in practice standards. From our radiologists being board certified teaching providers, to all front desk being certified trainers with our EMR/PM system, no detail is overlooked,” Laberee says Laberee says that every department in the office has a constant opportunity for continuing education.

“From our entire staff being CPR certi-

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fied, to our quarterly staff team-building outings, we are always doing something to continue our education. We are proud members of associations in both the professional and charitable communities ranging from the ACR to the American Cancer Society,” he says.

Keeping things running efficiently and tackling challenges that come up on a dayto-day basis is a hallmark of a successful business. Advanced Imaging has found a way to address these challenges.

“Teamwork here is the key. We have a team in place that is family. The team up front, that answers phones and checks in patients, constantly communicates to the techs of any order changes, a patient has special needs, etcetera. The same approach is taken in the back. If an exam is done without contrast, it’s communicated

through email to the whole team so nothing is missed. Working in an environment where your opinion is valued, respected and listened to, allows everyone to be able to give their input. It’s how we make progress every day and sets us apart from our competition,” Laberee says.

Imaging is key to diagnosis, and accommodating the patient, during a stressful time, is key to getting through a necessary procedure. The professional staff at Advanced Imaging offers both and helps promote the imaging profession’s reputation of compassion and care. This imaging business also shows that having an approach that focuses on teamwork and cooperation results in successful growth and positive recognition. In the end, this approach serves the people of this central Florida community. ICE ICEMAGAZINE

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ccording to a MarketsandMarket report, vendor neutral archive (VNA) and PACS are regarded as two important markets in the medical image management industry. VNAs enable the acquisition, management and storage of images while streamlining the communication between multiple vendor PACS. A Market Watch press release reports that the global departmental PACS market is expected to exceed more than $5.05 billion by 2024.

Zion Market Research has published a new report regarding the PACS and RIS market. According to the report, the global PACS and RIS market was valued at $2.6 billion in 2017 and is expected to reach $4.3 billion by 2024, growing at a CAGR of around 7.3% between 2018 and 2024.

Information technology, such as Radiology Information Systems (RIS) and Picture Archiving and Communications Systems (PACS), is now being utilized for various health care applications. Cost-effective implementation of both PACS and RIS applications is possible owing to its shift to the PC environment. PACS is currently the preferred method of diagnostic image distribution. Today, PACS is not limited to radiology applications. It is also WWW.THEICECOMMUNITY.COM

being used in the fields of dermatology, pathology, ophthalmology, cardiology and other telemedicine areas. The heart of PACS is image acquisition from whatever unit generates the diagnostic image to the proper display of that image whenever required. RIS has several applications, such as providing registration, scheduling, incident reporting, quality assurance, file folder management, material management, teaching file management, human and technical resource management, and billing functions.

RIS is a software system network used to manage medical images and the data associated with it. It is particularly beneficial for tracking billing information and radiology imaging orders. It is often used in amalgamation with PACS for record-keeping, billing, and managing image archives.

PACS is used for hoarding, recovering, presenting, and allocating images produced by multiple medical hardware modalities, like CT scan, X-ray, ultrasound machines, and MRI. Digital Imaging and Communications in Medicine (DICOM) is the universal format used for storage and transfer of PACS images. Scanned documents and other non-image data can be incorporated in various formats, like PDF, after they have been

summarized in DICOM. PACS comprises four main components: imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and X-ray plain film (PF), a safe network to transfer patient information, archives for storing and retrieving images and reports, and workstations to interpret and review images.

Increasing adoption of health information technology (HIT), growing use of diagnostic imaging, development strategies incorporated by the leading players to develop highly advanced PACS and RIS platforms, and rising use of RIS and PACS for a thorough assessment of patient health are the prime factors responsible for the growth of PACS and RIS market.

Untapped market and increasing government funding for research and development are also expected to generate new opportunities in the forecast timeframe.

However, the high software cost is one of the roadblocks in the development of PACS and RIS market.

Some key players operating in the PACS and RIS market are GE Healthcare, Fujifilm Holdings Corporation, Agfa Healthcare, Allscripts Healthcare Solutions Inc., Philips Healthcare, Siemens Healthineers and McKesson Corporation. ICE ICEMAGAZINE

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ADVANCING THE IMAGING PROFESSIONAL

The Change Healthcare Enterprise Viewer aggregates data from disparate sources to present the entire care team with meaningfully aligned clinical imaging content. The scalable enterprise viewing platform provides all clinical specialties with the precise data they need within their existing workflow – improving operational efficiency. Referring physicians and care team members have immediate access to the patient’s complete clinical history, with images presented in the ideal clinical state based on the member’s function. The viewer provides deep insight into the patient’s condition, helping the care team efficiently detect patterns, make diagnoses and determine the most appropriate treatment plan.

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Fujifilm Synapse PACS

GE Healthcare Centricity PACS with Centricity Universal Viewer

Fujifilm’s Synapse PACS enables comprehensive and secure radiology, cardiology and enterprise imaging data management by displaying organizational datasets with server-side technology to the diagnostic display – on demand and as needed. The server-side platform strengthens expanding imaging infrastructures while minimizing overall support and preparing for an AI-driven future. REiLI,* Fujifilm’s global medical imaging and informatics AI platform, will serve as the intelligent layer between AI imaging analytics engines and AI-enabled applications in Synapse PACS, allowing these solutions to co-exist on a single platform, which spurs collaboration in development of these key technologies.

GE Healthcare continues to drive innovation by providing radiologists and clinicians with solutions for image viewing, editing and evaluation of patient conditions that lead to quick diagnoses and enhanced outcomes in patient care. Centricity PACS with Centricity Universal Viewer is a next generation Picture Archiving and Communication System that delivers enhanced diagnostic speed and confidence. With intelligent tools that act as intelligent clinical assistants and a unified, web-based diagnostic viewer designed to keep diagnosticians in the workflow, Centricity PACS improves productivity and increases access to patient data to help enhance diagnostic confidence.

*Fujifilm’s artificial intelligence software is a work in progress and is not yet commercially available in the United States.

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syngo.plaza is the smart PACS for reading and reporting of all types of cases, from routine to complex. It brings intuitive routine reading through embedded 3D+ combined with automation tools and opens up powerful storage capacities, enabling vendor-neutral archiving across an enterprise. syngo.plaza Web Clients permit authorized users to view images and reports through a local area network or through the internet. This allows direct online exchange of images and reports between the requesting physician and the radiology department. syngo.plaza also offers efficient breast reading that enables display of conventional and Tomosynthesis (DBT) images, allows reporting in line with BI-RADS classification, and display of different VOI LUTs.

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*syngo.plaza VB30 is not yet commercially available in all countries. Due to regulatory reasons its future availability cannot be guaranteed. Please contact your local Siemens organization for further details.

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cover story

Do it for the Children Designing Medical Devices for Pediatric Patients

By Matt Skoufalos

F

or more than 30 years, surgeon Alvin Crawford worked to help thousands of children with pediatric orthopedic conditions and spinal deformities correct congenital issues and reach their growth potential. He’s the founding director of the spine center that bears his name at Cincinnati Children’s Hospital Medical Center, a professor emeritus at the University of Cincinnati College of Medicine, and an innovator in surgical techniques and implantable medical devices that serve a pediatric population.

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Working in this area of expertise for so long has given Crawford an authoritative perspective on the distinct and specific needs of designing technology for use by pediatric patients, as well as allowing him to witness the unfolding of those plans along a decades-long timeline as he follows his patients to skeletal maturity. Designing for children, Crawford said, is contingent upon a handful of particular needs, most of them centered on the fact that unlike adult patients, they grow and change. That means designing “for their current as well as their potential sizes.”

“In pediatrics, it’s a continuous learning process; almost all kids present to you differently,” he said.

“The most important difference between the adult and the child is that you can’t injure their potential to grow. You’re trying to pre-empt any particular danger ADVANCING THE IMAGING PROFESSIONAL

that could occur to the child as they’re being treated; you want to see how their growth and development continues. It’s not a one-size-fits-all.”

Far from being a one-size-fits-all approach, many medical devices that are commonly used in the treatment of children may be custom-developed because an out-of-box solution simply doesn’t exist. In some instances, physicians are required to modify existing products for use by children; in others, they may be called upon to develop custom solutions to congenital issues that are specific to the cases they see.

Managing hip, foot, and spine issues WWW.THEICECOMMUNITY.COM

to help children develop along a normal timeline has led Crawford to contribute to the design of devices that are adjustable over 10 to 15 years; skeletal maturity is about 13, 14 in girls and up to 17 in boys, he said. He’s seen patients on a much longer timeline than many other health care specialists might; has seen them transition through different developmental phases in their lives. Some of that is because he’s done the bulk of his work in the same general geographic area for much of his career, and “[being] in one place for a long time [has] given me the opportunity to see things that one wouldn’t normally,” Crawford said.

But it’s also given him the opportunity to evolve his approach to treatment and care of pediatric patients because he’s learned from them as they’ve grown. Another of the biggest takeaways after years of designing for kids: the safety factor “is altogether different” for children than adults.

“Children like to experiment,” Crawford said; “they like to do stuff. You can’t have a device that hurts them when they get out of the bounds that you put them into. Whether it’s radiologic or mechanical, there has to be automatic safeguards so that if a child starts to manipulate it, it shuts off.”

Manufacturers will stress-test devices in consultation with clinicians, but their repetitive and mechanical external approaches are meant to simulate conditions that are sometimes very different than those inside the human body. (Even models generated from simulations with animal models have their own safety constraints, Crawford said.) However, as children grow and develop, updating implanted devices accordingly used to require multiple surgeries in the same areas of the body, exposing children to the risks of infection and repetitive stresses on growing tissue. Innovations that have shown promise in limiting complications from surgery include implantable devices that can be externally adjusted once installed.

“Nothing is easy, but in terms of the spine, we put devices like growing rods for scoliosis,” Crawford said. “Getting underneath the skin repeatedly, you can let bacteria in, making it subject to infections and wear and tear, whereas a magnetically controlled growing rod for spinal deformity is a tremendous advance.

In a scoliosis patient, you can perform the definitive procedure when they reach skeletal maturity.”

Of course, as Crawford points out, “there’s nothing that a kid can’t destroy, and that’s why it’s important to image them.” Designing technologies that are able to be scanned safely to monitor children’s growth is a key consideration; this can mean working with a variety of materials that can stand up to the “potential ICEMAGAZINE

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effects of the child wanting to be a normal child; running, playing, and so forth” as well as those of routine diagnostic scans, he said.

“What’s required of imaging is making sure we can follow [growth], and imaging is the only way we can do it,” Crawford said. “We can do it with ultrasound to decrease [the impact of ionizing] radiation as much as possible.”

When designing for imaging patients, the principal focus for medical device manufacturers is creating technology that relies upon the lowest possible radiation dose without sacrificing image quality.

But when those patients are children, different considerations come into play.

Some technologies are designed to keep them comfortable — and, most importantly, still — during imaging procedures. Virtual reality (VR) units can help soothe a young patient, and environmental controls for adjusting the sensory experience of an imaging study can, too.

Other approaches are centered on accelerating the speed of a procedure, limiting the amount of time a child is asked to sit for a study and therefore the occurrence of motion artifacts. Some advances in the sensitivity of non-ionizing systems, like ultrasound, are showing greater detail in infant vascular systems. And the revolution in 3D printing technology is allowing surgery pre-planning and custom modeling to take much of the guesswork out of incredibly complicated procedures.

But for all those improvements, said Mario Pistilli, Director of Imaging and Imaging Research at Children’s Hospital of Los Angeles, there’s still a major concern: how to pay for them.

“It’s unpalatable to talk about money,” Pistilli said; “the fact is, we have to be able to survive. They’re injecting cash to get [these technologies] developed on the front end, but if it’s not reimbursed on the back end, it doesn’t help. You can’t adopt everything that doesn’t pay, so you have to be very smart in how you do that.”

Asking billing codes to catch up with emerging technologies is a tall order; as Pistilli said, “If there’s not reimburse34

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“ T hey’re injecting cash to get [these

these devices themselves.”

“Kids are not just small adults,” Moran said. “Their anatomy is different and the structure is different; getting access to it is too.”

Pediatric patients may account for less than 10 percent of all medical device use, Moran estimated, and there’s a significant need among them for medical devices tailored to their anatomy and needs.

Without a considered approach to getting those technologies to market, however, a viable business model can be elusive.

“You can’t do the standard approach,” Moran said; “You can’t build up a big, fixed-cost structure, as you would typically. This really has to be done from an outsourced, bare-bones structure. You don’t need a full-time team to get this stuff to market.”

PediaVascular products “are in every pediatric cath lab in the U.S., and we sell direct,” Moran said. Even so, the market size is so small that the business doesn’t justify having more than himself and a part-time employee to do that work. This might be antithetical to the way traditionally built corporations operate, but the pediatric medical device market also has gained another bit of support from the U.S. Food and Drug Administration (FDA) that helps level the playing field.

In 2009, FDA established the Pediatric Device Consortia (PDC) Grants program, an offshoot of its Office of Orphan Products Development, which is mandated to “advance the evaluation and development of products (drugs, biologics, devices, or medical foods) that demonstrate promise for the diagnosis and/or treatment of rare diseases or conditions.”

Five regional consortia work with inventors who have an idea for a pediatric medical device, whether through market research, internal design work, or competitive grant awards. They contract with outside experts to support the business development and research that a larger, private corporation might provide from its own resources, and which is invaluable to smaller, developmental-stage companies. For most private enterprises, it’s a marked change in the way they’re used to dealing with FDA. Pediatric medical devices represent “a large number of needs that are not adequately met by device manufacturers for a variety of reasons,” including the cost and the risk of conducting pediatric trials for patients with significant diseases, said pediatric cardiologist Robert Levy.

Because the market won’t take on the challenge of making pediatric-specific medical devices, manufacturers are “throwing the burden on the physicians who take care of those children” to use off-label items in their work, Levy said.

Leveraging the resources of the Pennsylvania Pediatric Medical Device Consortium (PPMDC), for which Levy is the principal investigator and chair of the clinical and scientific advisory committee, helps foster the development of various kinds of pediatric devices to resolve these issues.

“The off-the-shelf equipment just isn’t there,” Levy said. “We’ve now assisted more than 100 different organizations.

Some of them have been startup companies; some have been universities trying to roll out their technology.”

Having the FDA’s official support helps a lot, he said. The PPMDC oversight committee is composed of current or former executives from throughout the medical device community, including representatives from the ADVAMED pediatric division, venture capitalists, and former regulatory experts. In the time since its inception, the agency has brought nearly 20 projects to market, and others are in trials. Five large grants are awarded annually, and five early-stage concepts are handed over to a local design group, Archimedic, which helps them flesh out the next stages.

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technologies] developed on the front end, but if it’s not reimbursed on the back end, it doesn’t help. You can’t adopt everything that doesn’t pay, so you have to be very smart in how you do that.” – Mario Pistilli ment, it’s hard to get it off the ground.”

The best hope for many emerging devices is to show the return on investment that potentially pricey innovations can yield in terms of patient throughput, customer growth, and partnerships with deep-pocketed educational or private institutions.

Entrepreneur Tim Moran of Cleveland, Ohio, is the founder of both PediaVascular, a medical device company that developed and markets FDA- and CE-approved pediatric angiography catheters, and of PediaWorks, a pro bono consulting and advocacy nonprofit that advances the research and development of additional pediatric medical technologies. In addition to putting his specialty catheters on the market, Moran is an advocate for the expansion of the field of pediatric medical devices, which he said is underserved by medical device manufacturers who don’t see enough financial potential in making products for a small patient group.

“Typically, the hurdle for a big company is a market size of a couple hundred million at a minimum,” Moran said.

“Even if a product might be profitable, they haven’t hit that revenue threshold.

For some companies, it’s a great niche business, but all the development costs are still there. If you’re not getting some sizable grant funding, you’re not going to make it.”

The biggest medical device companies typically don’t look at the pediatric space outside of the neonatal intensive care unit (NICU), Moran said, which results in the off-label use of other, FDA-approved processes; what he describes as “physicians acting like MacGuyver, manipulating

“We stay in touch with everybody,” Levy said. “We’re always reviewing other ideas of in-kind support. We have a regulatory specialist who’s under contract to us as a consultant; many of the people we talk to, we connect with him.”

Others can benefit from consulting with the consortium, which also supports companies’ pre-submission product meetings with FDA. PPMDC members often conference-call into those meetings to provide a pediatric perspective for the discussion. The grassroots process is a different one from which many medical devices are developed, but so far, it’s yielded encouraging dividends in a critical area of need, Levy said.

“The way the testing unfolds is not necessarily that different, but the nature of the errors is different, which means that the design implications of the errors we observe is different,” he said. “The problem that all of us have in product development is that we always think the person we’re designing for is going to be more like us than they actually are. The challenge for us is to look at it more from the point of view of the person who’s going to use the device and not let our knowledge and biases drive the information.”

When designing for children, Wilcox points out that it’s hard for adults to remember what kids don’t know; “what all of us didn’t know at a certain age.” Some-

“ T he approval process is still rigorous, but it makes it somewhat easier for companies to get into it. It’s really exciting, and I think progress is being made.” – Robert Levy

“The approval process is still rigorous, but it makes it somewhat easier for companies to get into it,” he said. “It’s really exciting, and I think progress is being made.”

As technology progresses to FDA approval, prototyping for pediatric devices increases the sample size required for adoption. Proving that use error is unlikely among pediatric patients requires studying children’s interactions with the devices as well as those of adults. The testing isn’t that different, but children tend to make different kinds of mistakes “because of all of the obvious differences between children and adults,” said Stephen Wilcox, principal of the Philadelphia, Pennsylvania-based Design Science.

Aside from children’s ability to unintentionally damage technology by using it in contraindicated ways, designing for young people means considering the developmental differences between children and adults.

times designers will struggle to explain how something works, “and sometimes the kid just won’t get it, whereas that would be rare with an adult,” he said.

That’s a clue for designers that they’ve either got to rethink the design or really restrict the age of use.

“If there are procedures, we’ve got to imagine how easy it is for a young child to remember the procedure so it’s not error-prone; particularly not in a way that it’s dangerous,” he said.

“Often an adult’s involved, so you’re really designing for children and parents, and much of the time, the parent’s are going to use [the device] in sometimes unpredictable ways, too.”

Regardless of the work that it takes to innovate pediatric-specific devices, the financial cost of doing so, or the time involved in honing it to perfection, the moral mandate to care for the most vulnerable patients is one that cannot be overlooked. ICE ICEMAGAZINE

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CAREER CENTER

Use good listening skills to ensure you

Leadership Skills Include Communication,Tech Etiquette

E

ffective Healthcare Technology Management (HTM) leaders must demonstrate excellent communication skills and practice good business etiquette, especially when it comes to cellphones, tablets and e-mail.

Today’s technology enables people to easily communicate with anyone from anywhere and at any time. However, this convenience has also caused many people to lose sight of the importance of communicating effectively in their daily business and professional lives. Our communication skills are now challenged and complicated by information overload from social media, e-mail and texting.

Yet, developing and maintaining professional communication skills and common courtesies continues to be very important today.

Effective communication is critical in business and how one communicates with others greatly affects the way they are perceived. Whether you are responding to a phone call, voicemail message or e-mail, professionalism is important. Equally significant is how soon you respond to messages. If you do not respond promptly, you may be perceived as a person lacking in professional courtesy.

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understand what is being said. By listening

LENDING A HELPING HAND AT EVERY STEP.

carefully to conversations, you catch While electronic communication is very important in daily operations, it can also lead to miscommunication and confusion. Too often, communication skills are lost when texting, e-mailing or chatting via social media. A message sent can easily be misunderstood.

The use of electronic messages can also hinder good writing skills. Many people are so used to sending text messages that they lose grammar and spelling skills. It soon carries over to business communication.

HTM leaders should maintain professional courtesies and use effective and timely communication skills daily. They should be direct and concise. No one wants to read a lengthy e-mail that loses its message amid a sea of unnecessary words.

When responding to an e-mail, ensure the message is succinct, uses appropriate grammar and spelling, and has appropriately constructed sentences and paragraphs. Nothing is worse than attempting to interpret an e-mail that runs on and on before getting to the point.

Leaders can use technological tools as an essential method for effective and efficient communication. Use of appropriate software such as spreadsheets can also assist in keeping your

details that may be missed in a text or email message. Verbal and listening skills also Written by Cindy Stephens Stephens International Recruiting Inc.

help improve relationships and demonstrate a responsive and respectful leader.

team up-to-date and informed of special projects and initiatives. However, this informal means of communication can contribute to employees feeling isolated rather than feeling like part of a team.

Therefore, it is important for leaders to engage their team and ensure they are genuinely connected without complete reliance on technology.

Great leaders successfully inspire, encourage and motivate teams with effective verbal communication skills that help articulate specific thoughts and instructions. Eye contact, voice inflections, and verbal pauses are lost in electronic messages, which can mislead a reader.

Use good listening skills to ensure you understand what is being said. By listening carefully to conversations, you catch details that may be missed in a text or e-mail message. Verbal and listening skills also help improve relationships and demonstrate a responsive and respectful leader.

The rules of common courtesy have

not changed, and it is important to respond promptly to calls, e-mails and other forms of communication demonstrating sincerity and consideration. Being busy is never a valid excuse for not responding or communicating in a timely manner. Additionally, be sure your voice-mail box is cleared out periodically. Nothing is more irritating than to return an important call only to hear the person’s “mailbox is full” or not set up for callers to leave a message.

Unfortunately, technology has created situations where many people do not use good business etiquette, manners or common sense.

Some common complaints include loud phone conversations in an office or enclosed public space, especially when near others.

Although the use of texting is an acceptable means of communication in the workplace, it can be a distraction that impacts productivity. Text messaging can be misused. Do not text or read text messages during a meeting.

Constantly checking a phone for messages is another problem. Never check messages while you are speaking with someone. Have the courtesy to give the other person your full attention.

Anyone can learn the rules of etiquette. However, business professionals know proper respect and kindness say a lot about them as a leader. Demonstrating good communication etiquette shows respect for others and makes a lasting impression. Politeness never goes out of fashion, no matter what age you are nor how busy you think you are. Don’t ever believe this doesn’t matter.

To succeed in today’s HTM workplace, use excellent communication skills, etiquette and professional courtesies to give yourself a competitive edge and stand out from others. ICE

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330.296.9729 ICEMAGAZINE

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ADVANCING THE IMAGING PROFESSIONAL

IMAGING MATTERS

Written by John Garrett Director of a Clinical Engineering Department in CHI

Covering the Topic of Covers

I

maging equipment covers have a special place in the hearts of those who service the equipment. Typically that place is in the depths where all things that one does not mention in polite company reside. It is most probable that people who design the covers for medical imaging equipment have never had to remove and replace said covers. They are usually a challenge to get on and off equipment. In recent years this has improved on some equipment, but there is a lot of equipment that has taught many a great deal about their temper and anger management.

During preventative maintenance (PM) a common instruction is to examine the unit covers. Often there is a small amount of touch up paint that came with the system to assist in hiding scratches. Yet it is not uncommon to find a minor crack near around the edge. This is often a result of difficulty replacing the cover once it is removed.

It is, unfortunately, not uncommon for a cover to be replaced with fewer screws than were removed. If a cover has 10 screws, 10 screws should be used to hold it on when it is replaced.

Common issues that make it more difficult than it already is to replace a cover include the position of the WWW.THEICECOMMUNITY.COM

“Common issues that make it more difficult than it already is to replace a cover include the position of the machine when the cover is replaced, screw receptacles slipping, or another misaligned cover.”

machine when the cover is replaced, screw receptacles slipping, or another misaligned cover.

The real issue that covers currently present is that of infection control according to the Joint Commission, DNV and, more seriously, the Centers for Medicare and Medicaid Services (CMS). A cracked cover is being seen as an infection control issue. It is serious enough to be considered a finding. No one wants CMS to have a finding.

Obviously, new covers can be ordered and put on the units. However, most of the covers can be repaired by an auto body shop or an independent service organization (ISO) if you just

ask. Another option may be to use auto body repair kits to repair it in house.

YouTube even has a video on how to repair things with baking soda and super glue (Cyanoacrylate). Just make sure that you have a matching paint that is designed for the material the cover is made from to finish off the repair.

Just as previously mentioned, after repairing you need to ensure that you put the cover on properly as designed. If other covers are misaligned make sure to realign them prior to installing the repaired cover. After replacing the cover, check the full range of motion to find any undue stress points that may point to more serious alignment issues. ICE ICEMAGAZINE

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insight

THREE BENEFITS OF BEING A LIFELONG LEARNER

W

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ICEMAGAZINE | AUGUST 2019

Benefit #1: You develop an increased capacity to see solutions One truth about learning is that new learning attaches itself to old learning. When pieces of knowledge enter our brains they need to find a home, so our minds look for ways to file various pieces of new data in ways that make them easy to retrieve when we need them. The academic word for this mental filing system is a “schema,” which has the same root as the word schematic. The more we learn, the larger our schema.

Put another way, when new learning connects to previous learning, we build our “mental web” of knowledge. As this web grows, so does our capacity to see relationships between and among new information. Thus, the more we learn, the more we are able to learn, and our brains have an easier job of seeing how events in “situation A” relate to events in “situation B.” When we have a growing web of knowledge, solutions to problems come easier, and that makes us more valuable in our work as well as in our personal lives.

Benefit #2: You stay connected Whether your effort is personal or professional, being purposeful to acquire new knowledge keeps you connected to your family and/or your coworkers. Perhaps you’ve heard it said that if you’re not

Benefit #3: You’re more likely to keep your mental health This is not just a comment in passing, an old wives’ tale or a theoretical possibility.

Research published in the Journal Neurology found strong evidence that, “[A]

in material that feeds your personal life as well as your professional one. That said, let’s look at some benefits for doing so.

ADVANCING THE IMAGING PROFESSIONAL

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How to strengthen your lifelong learning ability As I mentioned earlier, the fact that you’re reading this tells me you already have an inclination toward lifelong learning. If I didn’t believe that, the subtitle for this section would be, “How to be” a lifelong learner. Instead, the two words I suggest you consider for strengthening your ability are “focus” and “frequency.”

Remember our definition: “The ongoing, voluntary, and self-motivated pursuit of knowledge for either personal or professional reasons.” Therefore, the first consideration is focus. Do you want your learning to be for personal reasons, professional reasons or both?

The frequency consideration is related to the word, “ongoing.” Decide on a GRAMMARand a type of learning you think frequency

PROOF SHEET

are necessary to achieve your goals. This could range from reading “x” number of books on a topic each year to auditing classes at a university or anything in between.

You don’t have to sponge up information about everything around you. Just pick some pertinent topics and make a purposeful effort to keep learning. The benefits, as they say, are many. ICE – 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 individuals to help them achieve workplace excellence.

Reach Daniel through his website, www.MyWorkplaceExcellence.com or 208-375-7606.

WE BUY AND SELL PRE-OWNED MEDICAL IMAGING EQUIPMENT. TRIM 4.5”

hen it comes to what drives adults to learn, people tend to lean one of two ways. At one end of the spectrum are those who love to learn anything about everything. They sponge up as much information as they can on just about any topic. At the other end of the spectrum are people who rely mainly on their past experiences, trusting that the insights they’ve gleaned from their involvement in various events will be sufficient for their success.

Most of us have a middle ground preference somewhere along this continuum, but either way, distinct benefits exist for adopting a practice of lifelong continual learning.

First, let me make sure we’re on the same page by providing a definition. Then, I’ll cover a few benefits for the practice of regularly putting new information into our brains. I’ll end by offering two areas of focus for improving your lifelong learning.

I’ve looked up the definitions of lifelong learning in multiple dictionaries, and interestingly, the one I like best comes from Wikipedia. They say it’s, “The ongoing, voluntary, and self-motivated pursuit of knowledge for either personal or professional reasons.” With that, the fact that you’re reading this article is evidence enough that you’re already engaged in lifelong learning. After all, you were self-motivated enough to voluntarily start reading. And if you’re seeking a work-life balance, let’s hope you’re regularly taking

history of lifelong cognitive activity may support better cognitive performance” as one ages. Specifically, biomarkers for Alzheimer’s disease were reduced and better neuropsychological testing performance occurred in people who demonstrated a history of lifelong learning.

Stated much more simply, it’s quite likely that when it comes to our brain and the activity of learning, “If you don’t use it, Written by you lose it.”

Daniel Bobinski I want to emphasize that just keeping Workplace Consultant our brains active as we age is not enough.

Research published in the journal Psychomoving forward you’re moving backwards. logical Science showed that people who APPROVED CHANGES NEEDED Now, I’m not sure that’sPROOF exactly true.

For kept their minds active by doing things example, toss a baseball into the air.

It they’ve always done did not improve their CLIENT SIGN–OFF: goes up and then comes down, but there’s memory. It was only people who were PLEASEstops CONFIRM THAT THE FOLLOWING AREskills CORRECT that moment when the ball actually learning new that showed significant LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING before it reverses direction, so technically gains in their ability to remember things. it’s not going only up or down. Still, there’s some truth to the axiom. We can stop TRIM 2.25” learning for a while, but if we stop for too long, the world and all the people in it start passing us by.

LOOKING TO PURCHASE This truth is probably best illustrated by the speed at which knowledge is OR SELL AN MRI, PET/CT, increasing. For example, scholars have CT, OR X-RAY? calculated that in the year 1900, the total amount of knowledge in the world was NO FUR LOOK doubling about every 100 years. They also TH ER . determined that by 1945, knowledge was doubling every 25 years. Not surprisingly, with the advent of computers, the speed at which we are doubling our knowledge base is almost unbelievable. According to research from multiple sources, today the total sum of the world’s knowledge is now doubling every 13 months.

Can you see that if someone doesn’t make an effort to learn new things, conversations and careers will eventually pass them by so that such a person will have difficulty staying connected?

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SAVE THE

ARE YOU AN IMAGING LEADER?

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index

ADVERTISER INDEX International Medical Equipment & Service p. 13

Multi Diagnostic Imaging Solutions Back Cover

Summit Imaging p. 5

SOLUTIONS

Brandywine Imaging p. 16

International X-Ray Brokers p. 41

MW Imaging Corp. p. 3

Carolina Medical Parts p. 22

KEI MED Parts p. 38

Oxford Instruments Healthcare p. 2

PM Imaging Management p. 41

W7 Global 38. 30

Medical Imaging Technologies p. 31 RSTI/Radiological Service Training Institute p. 6

Webinar Wednesday p. 47

TWO WAYS TO LEARN AND EARN

MedWrench p. 44

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ADVANCING THE IMAGING PROFESSIONAL

PR

E-APPRO

In te

WEBINARWEDNESDAY.LIVE

entials

itu

IT ALL STARTS ONLINE

ed

st

MRIequip p. 22

Cr

U

E

Stephen International Recruiting Inc. p. 16

View recorded webinars in our archives and download a certificate from your computer within 1 hour.

• C

Injector Support & Service p. 13

Join your colleagues every Wednesday for our live webinar series.

•

Exclusive Medical Solutions, Inc. p. 45

MarShield p. 38

Varex Imging p. 9

ED

Diagnostic Solutions p. 37

Tri-Imaging Solutions p. 4

I

626 Holdings p. 31

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