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hat Chat with with Chat ourour with experts experts our live experts live at at InnovatusImaging.com live InnovatusImaging.com at InnovatusImaging.com mail email us us at email at TedL@innovatusimaging.com TedL@innovatusimaging.com us at TedL@innovatusimaging.com Centers of Excellence for Ultrasound and r or call call usorus at call at 844-687-5100 844-687-5100 us at 844-687-5100 MRI Coil Repair, Design and Manufacturing
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SEPTEMBER 2019
“ All those pieces should create a retrospective view as to where are we today, where are we planning for the future, and what do we put in place to accommodate for the future – or don’t get in the way of what we want to do for the future.” – Tobias Gilk
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Safe Spaces in the Imaging Suite: Designing for Patient, Staff Protection
When you think of the safest and most dangerous areas in the hospital, would you believe they could be the same place? If not,
epartment D 26 Spotlight Peterson Regional Medical Center
it might be time to adjust your thinking about imaging safety. In an MR suite, there’s no ionizing radiation because the device doesn’t require it to operate. However, the forces generated by a high-powered magnet can be just as dangerous.
Radiology Department consists of a hospital-based department and an ambulatory care center imaging department. The team keeps current with the newest advances through several training
Company Showcase: MRIequip
Founded in 2002, the partners of MRIequip collectively set out to develop and bring quality medical equipment and accessories to the high-risk area of MRI suites to promote safety. The company has achieved success by partnering with its customers and listening to their specific needs. Page 18
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approaches. It also consults with colleagues and stakeholders to make capital purchase decisions.
ADVANCING THE IMAGING PROFESSIONAL
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9 Imaging News
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29 MRI Spotlight
42 Career Center
20 People on the Move
26 Department Spotlight
30 MRI Gallery
22 Webinar Wednesday
34 Solutions Guide 36 Tools of the Trade
45 AHRA Recap 46 AI Insights 49 Imaging Matters 50 Daniel Bobinski 52 AHRA Scrapbook 54 Index
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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY Award-Winning Agfa DR 800 Showcased at AHRA The Agfa DR 800 was on display at the 2019 AHRA Annual Meeting and Exposition. It is a multipurpose digital radiography solution that delivers radiography, fluoroscopy and advanced clinical applications in a single investment. Agfa announced earlier this year that it received Frost & Sullivan’s 2019 award for New Product Innovation Leader in the Global Multipurpose Digital Radiography Systems Market. The award further highlights the value proposition of Agfa’s DR systems, which “revolves around maximizing patient care quality and safety, while still optimizing total cost of ownership (TCO) and return on investment (ROI).” Previously, Frost & Sullivan recognized the strong overall performance of Agfa’s comprehensive DR portfolio with the North American Product Leadership Award for Digital Radiography in 2016. This newest award distinguishes Agfa’s DR 800 multipurpose digital imaging system. The prestigious recognition is based on Frost & Sullivan’s extensive and ongoing analysis of the multipurpose DR systems market. The award report describes how technology previously kept static and dynamic (fluoroscopy) imaging separate, due in part to different detector material optimization, which allowed either the use of lowdose beams for real-time imaging or of stronger X-ray beams for single-shot imaging. Newer technologies, including Cesium Iodide (CsI), however, enable static and dynamic imaging to be brought together. Frost & Sullivan recognizes that, with the innovative DR 800, Agfa has tapped into this new opportunity. The 3-in-1 system enables clinicians to perform general radiography and a full range of fluoroscopy examinations in one integrated, versatile imaging room, without a separate investment in fluoroscopy. The award also highlights that the MUSICA Dynamic Multi-Scale Image Contrast Amplification processing further strengthens the value-driven proposition of the DR 800 in digital radiography. •
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ImageCare LLC Installs First Intelli-C in U.S. CMS Imaging Inc. announced the first clinical installation in the United States of an Intelli-C at ImageCare LLC. “The Intelli-C, which is distributed nationally by Alpha Imaging LLC, is a multipurpose tilting C fluoroscopic imaging system that offers true versatile imaging explicitly designed to accommodate the needs of busy health care facilities, imaging centers or hospitals,” according to a news release. “The Intelli-C now offers ImageCare LLC the extended ability to provide their patients low-dose, high-quality images for procedures ranging from radiographic, serial and fluoroscopic X-ray procedures all on one system.” “We have been working with the Intelli-C for a few months now. It provides all that I need in my practice of diagnostic and interventional radiology. The configuration allows me to perform interventional procedures, gastrointestinal procedures, pain management applications and orthopedic interventions, with low-dose radiation, without compromise in image quality. Even at low pulse rate fluoroscopy, there is excellent visualization of target structures,” said Timothy P. Close, M.D. “If an imaging center or small hospital has only one fluoroscopy or procedure room, they should have this equipment. In a busy hospital setting, this room provides flexibility and a broad spectrum of applications to complement diagnostic and therapeutic procedures.” •
MarShield Announces New White Paper “Shielding Solutions You Can Look Through: Leaded Glass and Leaded Acrylic” is the title of a white paper available on the MarShield website, marshield.com. Shielding Technician Paul Rochus compares and contrasts leaded glass and acrylic in the white paper. It also includes information about material composition, gamma attenuation and lead equivalences, clarity and durability. “Two common and reliable solutions to provide safe shielding; lead X-ray glass or clear lead acrylic,” Rochus noted in the white paper. “Both materials are used in a variety of applications, from windows in NDT rooms, to small windows on tungsten vial shields.” • For more information, visit marshield.com.
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news Siteman Cancer Center Receives Accelerator for Proton Therapy System Mevion Medical Systems has delivered an accelerator for a second Mevion proton therapy system to the S. Lee Kling Proton Therapy Center at Siteman Cancer Center, based at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri. “The addition of the second proton therapy system will feature Mevion’s HYPERSCAN Pencil Beam Scanning (PBS) technology, coupled with the industry’s only proton multi-leaf collimator, the Adaptive Aperture. This powerful duo improves on older scanning technologies by delivering conformal fields of therapeutic radiation to tumors faster and with more precision – making it the most advanced form of PBS available today,” according to a news release. In addition, the new proton therapy system will feature the latest imaging modalities with a ceiling rail-mounted, cone-beam CT system and an integrated Siemens Somatom diagnostic CT system. With these new capabilities, Washington University physicians and scientists at Siteman will research new approaches to adaptive re-planning and hypofrac-
tionation, aiming to advance the field of proton therapy. Siteman and the Mevion Advanced Development team are currently collaborating on research studies into ultra-high dose rate, or “FLASH,” treatment modalities on Mevion systems. In 2013, Washington University physicians at Siteman Cancer Center treated the
first patient in the world using a Mevion compact proton therapy system. Siteman treats adult cancer patients with proton therapy and partners with St. Louis Children’s Hospital, also located on the Washington University Medical Campus, to treat pediatric cancer patients. •
Grants Help Advance Innovations in Health Care For the past 12 years, Canon Medical Systems USA Inc. has partnered with AHRA: The Association for Medical Imaging Management in support of the Putting Patients First program, awarding grants dedicated to improving patient care and developing best imaging practices in the areas of CT, MR, ultrasound, X-ray and vascular. This collaboration seeks to advance patient care, safety and cybersecurity in imaging through grants that fund programs, trainings and seminars at IDN/hospital systems, local hospitals and imaging centers. In 2019, eight (8) grants will be awarded according to the following categories: • Six (6) grants of up to $7,500 each will be awarded to single-site hospitals and imaging centers. • Two (2) grants focusing on diagnostic imaging
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• Two (2) grants focusing on pediatric imaging • One (1) grant focusing on MSK • One (1) grant focusing on oncology imaging • Two (2) grants up to $10,000 each will be awarded to an Integrated Delivery Network (IDN). “For over a decade, Canon Medical has provided $685,000 to the Putting Patients First program which has made possible more than 70 grants focused on bringing a wide range of innovations in diagnostic imaging to help advance patient care,” said Angelic Bush, CRA, FAHRA, past president, AHRA: The Association for Medical Imaging Management. “Today, cost burdens in the health care industry make the need for a grant program like Putting Patients First more important than ever to help continue
to drive change and improvement in the health care industry.” Putting Patients First applicants are judged on their program plan and ability to share best practices. The applicants’ programs should address one or more of the following: • Reducing radiation and/or contrast dose • Reducing the need for sedation • Improving communication with patients regarding the process • Improving patient comfort • Improving the overall clinical pathway All eligible facilities are encouraged to apply by completing an application at www.ahra.org/PatientsFirstProgram. The deadline to apply is October 21, 2019, and the winners, selected by the AHRA, will be announced in January 2020. •
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Fujifilm Sonosite, Partners Healthcare Team Up FUJIFILM SonoSite Inc. has announced the launch of a strategic relationship with Partners HealthCare to apply artificial intelligence to improve the utility and functionality of portable ultrasound. The two organizations will collaborate to enhance ultrasound technology with AI to enable clinicians to perform scans at the point-of-care, further expanding the accessibility of this technology for clinicians and their patients. The collaboration will be executed through the MGH & BWH Center for Clinical Data Science and leverage the extensive data assets, computational infrastructure and clinical expertise of the Partners HealthCare system. “Allowing for even greater integration of ultrasound into our health care delivery system requires smarter machines,” said Keith Dreyer, DO, PhD, FACR, FSIIM, chief data science officer, Partners HealthCare.
“In emergency settings, the efficiency and cost-effectiveness of portable ultrasound makes it a critical companion to other imaging modalities.” The first project under the collaboration will target some of the more complex emergency medicine procedures using AI enabled portable ultrasound. Andrew Liteplo, MD, MGH department of emergency medicine, explains, “If we build scanners that can be used by non-expert users both inside and outside the hospital, we can likely reduce the time delay between trauma and diagnosis, which will translate to more rapid interventions and improved outcomes.” Diku Mandavia, MD, FACEP, FRCPC, senior vice president and chief medical officer of FUJIFILM SonoSite emphasizes, “This collaboration is really focused on embedding AI in portable ultrasound with
the goal of automating the segmentation of organ boundaries, measurement of anatomic features and calculation of physiological parameters – the type of automation that will allow us to increase the accessibility of this critical technology while still delivering high diagnostic value.” Both parties agree that high fidelity, affordable medical imaging could have an impact on a global scale, particularly in the developing world, where access to care is a fundamental challenge. As an important diagnostic tool in the fields of obstetrics and emergency medicine, increased accessibility to, and utilization of, point-of-care ultrasound holds substantial promise. Through the collaboration, the collective clinical and technical expertise of the organizations will be harnessed to advance the field of point-of-care ultrasound. •
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RadSource Imaging Technologies Named Fujifilm Distributor Canon Medical Showcases Alphenix Platform The Alphenix platform was showcased in front of thousands of health care providers at Premier Inc.’s 2019 Breakthroughs Conference and Exhibition on June 18. Canon Medical’s Alphenix family of interventional systems was debuted during the conference’s 11th annual Innovation Celebration, an event recognizing advancements in health care and highlighting suppliers dedicated to furthering innovation and improving patient outcomes in the industry. “Canon Medical shares Premier’s commitment to providing valuable products to our alliance members that are high-quality and cost-effective,” said David A. Hargraves, senior vice president of supply chain, Premier. “These innovations can truly benefit providers in our shared work to transform health care.” “Clinicians and other health system members of Premier selected the Alphenix platform to be showcased at the Innovation Celebration due to its uniqueness, ability to have an impact on unmet clinical needs and potential to improve patient care,” according to a news release. “The innovative line of interventional systems delivers images with clarity and precision and combines industry-leading dose op-
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timization technologies, enhanced workflow and a new set of features to provide patients with accurate and fast imaging.” “The Alphenix Biplane and Alphenix Core + systems within the family also include an all-new Hi-Def Detector (High-Definition Flat Panel Detector) with the highest image resolution in the market to help clinicians see finer details during complex interventional procedures such as stent positioning and stent apposition, wire and catheter navigation through the stent struts, and observation of coil deployment,” according to the release. The West Virginia University (WVU) Heart and Vascular Institute is the first hospital in the country to acquire the Alphenix 4D CT from Canon Medical Systems USA Inc. “The system offers an innovative angiography configuration to expand capabilities in interventional procedures and help advance patient care in the community. The configuration pairs the Alphenix Sky + C-arm and Hybrid Catheterization Tilt/ Cradle Table for interventional procedures with the Aquilion ONE/GENESIS Edition CT system, allowing clinicians to efficiently plan, treat and verify in a single clinical setting,” according to a news release. •
FUJIFILM Medical Systems U.S.A. Inc. has announced that RadSource Imaging Technologies will become the exclusive distributor for the ASPIRE Cristalle with Digital Breast Tomosynthesis (DBT) mammography unit in Missouri, Oklahoma, Kansas, Iowa and Nebraska. Under the agreement, Fujifilm has granted RadSource Imaging Technologies the rights to sell, service and support Fujifilm’s breast imaging solutions. To date, 10 ASPIRE Cristalle with DBT mammography units have been purchased by Radsource Imaging Technologies. “Fujifilm’s ASPIRE Cristalle with DBT combines state-of-the-art, Hexagonal Close Pattern (HCP) capture technology and intelligent image processing, optimizing dose and contrast based on individual breast composition. The result is low dose and fast acquisition of exceptional images for all breast types,” according to a news release. “In addition, patients can experience a noticeable improvement in comfort during procedures with Fujifilm’s patented, flexible comfort paddle design, which provides gentle and even compression that is designed to adapt to patient curves.” •
ADVANCING THE IMAGING PROFESSIONAL
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Konica Minolta, Shimadzu Bring Dynamic Digital Radiography to U.S. Konica Minolta Healthcare Americas Inc. along with Shimadzu Medical Systems USA announced a collaborative agreement that will accelerate the commercialization of Dynamic Digital Radiography (DDR) in the U.S. health care market. Konica Minolta Inc. and Shimadzu Corporation collaborated on the development of DDR incorporating Konica Minolta’s new advanced image processing and Shimadzu’s RADspeed Pro radiographic imaging system. The companies will co-market the DDR technology in the U.S. market. DDR is an enhanced X-ray technology that enables clinicians to analyze and quantify the dynamic interaction of anatomical structures with physiological changes over time to enhance diagnostic capability and efficacy. In clinical studies conducted by the Icahn School of Medicine at Mount Sinai in New York, DDR has been shown to provide a more comprehensive assessment of pulmonary function and pulmonary mechanics than a conventional chest X-ray, as well
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as visualization of respiratory kinesiology. In a poster presented at the American Thoracic Society 2019 annual meeting, Mary M. O’Sullivan, MD, associate professor of pulmonary medicine, and Stephen I. Zink, radiologist and assistant clinical professor of diagnostic, molecular and interventional radiology, both at the Icahn School of Medicine at Mount Sinai, reported that DDR delivers a contextual understanding of dyspnea and other pathophysiologic abnormalities, and provides an earlier and more comprehensive understanding of the etiology of dyspnea. Of 16 diaphragm abnormalities identified, six were minimally or non-visible on the chest radiograph while the remaining 10 were better defined. Two cases of chronic obstructive pulmonary disease (COPD) not seen on the chest radiograph were detected using DDR. Prior studies by Mount Sinai concluded that DDR may be a clinically relevant option to assess COPD severity in the acute setting, and for patients unable
to perform pulmonary function testing. “Shimadzu has long been a valued partner of Konica Minolta with an exceptional reputation for providing high-quality radiography systems and we look forward to continuing the relationship as we bring DDR to the U.S. market,” says Guillermo Sander, director of marketing, digital radiography, Konica Minolta Healthcare. “Based on the clinical data provided by Mount Sinai and several academic hospitals in Japan, we believe that DDR may have an immediate impact in the diagnosis and management of patients with pulmonary diseases. By joining forces with Shimadzu, we strive to accelerate clinical acceptance of this novel technology that may increase the quality and accuracy of diagnosis and reduce the need for additional tests.” Konica Minolta Healthcare and Shimadzu introduced DDR on the RADSpeed Pro at the 2019 AHRA Annual Meeting and Exposition. •
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$25 Million Gift to Expand Resources at CHLA While wishing to remain anonymous, a generous donor has provided $25 million to Children’s Hospital Los Angeles (CHLA) to support the expansion of the CHLA Neurological Institute and the hospital’s capacity in interventional radiology. “This truly transformative gift comes at a time when demand is growing quickly – particularly among underserved children in Southern California – both for pediatric neurological care as well as interventional radiology’s broad range of minimally invasive procedures,” says CHLA President and CEO Paul S. Viviano. “I am beyond grateful for the generosity of this gift, one of the largest single donations in the hospital’s history, and one that invests in healthier futures for the infants, children and youth we serve.” A portion of the gift will help fund the creation of a new multidisciplinary neurological institute outpatient center. When open, it will be one of only a handful of clinical hubs nationwide where all team members vital to treating neurological
conditions – neurologists, neurosurgeons, developmental pediatricians, geneticists, nurses, psychiatrists, social workers and more – will work in one centralized location. The project includes the remodeling and creation of: • 35 patient exam rooms • Five electroencephalogram (EEG) rooms • Four consultation rooms • Two nurses’ stations • A dedicated playroom for neurology patients By 2022, CHLA’s Neurological Institute is projected to care for more than 31,000 patients a year. The new outpatient center aims to guide families as seamlessly as possible from diagnosis to treatment, from surgery to rehabilitation, for neurological conditions including brain tumors, epilepsy, neuromuscular disorders, craniofacial issues, strokes and more. The other component of the gift will enhance CHLA’s interventional radiology,
or IR, capacity through purchase of new technology and an overhaul of existing diagnostic and treatment space. IR, the fastest growing modality within CHLA’s Department of Radiology and Imaging, uses advanced imaging equipment to diagnose and treat a range of conditions – including tumors and cardiovascular anomalies – with less invasive yet more precise procedures. IR patient volume at CHLA has increased more than 30% annually, with the hospital providing more than 3,800 procedures over the past year. “Expanding IR is critical to allowing CHLA to meet growing patient volume while also facilitating research to improve patient care for future generations,” says Alexandra Carter, CHLA senior vice president and chief development officer. “This considerable contribution will significantly advance CHLA’s vision of providing each patient and family with care that is timely, personalized, multidisciplinary and family-centered.” •
FDA Releases Ultrasound Guidance, Seeks Feedback The U.S. Food and Drug Administration (FDA) recently issued a final guidance document regarding the marketing clearance and use of diagnostic ultrasound systems and transducers. This guidance document supersedes the guidance entitled “Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers” dated September 9, 2008. This guidance document provides detailed recommendations for manufacturers seeking marketing clearance of diagnostic ultrasound systems and transducers. In addition to outlining regulatory approaches for certain diagnostic ultrasound devices, this guidance document describes the types of modifications to a diagnostic ultrasound device for which FDA does not intend to enforce the requirement for a new premarket notification (510(k)). As before, manufac-
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turers who submit 510(k)s and receive marketing clearance will continue to be exempt from the Electronic Product Radiation Control (EPRC) reporting requirements in 21 CFR 1002.12, for diagnostic ultrasound devices, as described in the notice to industry entitled “Exemption from Reporting under 21 CFR 1002” dated February 24, 1986. FDA’s guidance documents, including this guidance, do not establish legally enforceable responsibilities. Instead, guidances describe the agency’s current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word “should” in the FDA guidance means that something is suggested or recommended, but not required. The guidance document includes the following:
• Recommendations on what should be included in a premarket 510(k) application for diagnostic ultrasound systems and transducers • The kinds of modifications to a diagnostic ultrasound device for which a new premarket 510(k) application is unnecessary • A new transducer element integrity check that applies to all the ultrasound devices covered in the guidance Electronic comments and suggestions my be submitted online at https://www. regulations.gov. Submit written comments to the Dockets Management Staff, Food and Drug Administration, 5630 Fishers Lane, Room 1061, (HFA-305), Rockville, MD 20852. Identify all comments with the docket number FDA-2017-D-5372. Comments may not be acted upon by the FDA until the document is next revised or updated. •
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LENDING A HELPING HAND AT EVERY STEP.
626 Holdings Inc. Donates $25,000 to Salah Foundation Children’s Hospital NICU 626 Holdings Inc., an imaging service solutions company, has made a $25,000 donation to the Neonatal Intensive Care Unit (NICU) at Salah Foundation Children’s Hospital at Broward Health Medical Center in Fort Lauderdale, Florida. A room in the NICU will be named after the company and the donation will go toward supporting the programs and services of the hospital. The official room dedication occurred on June 26, a date very special to company founders Philip Revien and Michael Fischer. It was on June 26, 2012, that Revien, CEO of 626, and Fischer, CFO, first met in the maternity ward of a South Florida hospital, the day each of their sons were born. The vision for 626 (a tribute to their sons’ birth dates) was also born that day along with their passion for improving patient care. “Improving patient experience, is extremely important to our team at 626,” says Revien. “We feel fortunate to be able to give back.” According to the Centers for Disease Control and Prevention, nearly 10% of babies born in the U.S. are born prematurely. These babies typically need specialized equipment and dedicated teams because they are critically ill. According to Fischer, giving back is an integral part of the company. “We have made volunteering and financially contributing to charities a part of our corporate culture, from the day we founded 626, Phil and I committed ourselves to helping our community,” he said. “We greatly appreciate the generosity of 626 and the commitment Michael and Phil have shown to our most fragile patients,” said Traci Allyn Shur, president of the Broward Health Foundation. “Our children’s hospital would not be the state-of-the-art facility it is today without contributions from our community.” •
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New Stanford Hospital Receives Temporary Certificate of Occupancy After more than a decade of planning, design and construction, the new 824,000-square-foot Stanford Hospital in Palo Alto reached a major milestone in July, receiving a Temporary Certificate of Occupancy. This milestone marks the final leg of construction on the new Stanford Hospital before it opens for patient care this fall. “Our new hospital will be a place for firsts. New discoveries will be made here. New procedures will be performed. And through this remarkable state-of-the-art facility, we will be able to revolutionize the way that patient care is delivered at Stanford,” said Stanford Health Care President and CEO David Entwistle. “It’s wonderful to see our vision for the future of patient care coming to life, and I am grateful to our exceptional team who helped us reach this point.” Once completed, the new facility will accommodate the latest advances in medical technology, increase capacity, revolutionize the treatment of rare, complex diseases, meet new seismic safety requirements and transform the way patient care is delivered in the community. “More than 5.5 million construction work hours have been completed on the hospital from 135 trades and specialties to date,” said Bert Hurlbut, vice president of construction for the new Stanford Hospital. “This milestone triggers many transitions, the most noticeable being that hard hats and safety gear will no longer be needed in most areas of the building.” While minor finishing work continues, Stanford Health Care will now begin the extensive operational training and preparation necessary to license a brand-new hospital facility where Stanford Medicine’s life-saving treatment and care will occur.
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“It’s quite an extraordinary process to bring a new hospital like this online,” said Helen Wilmot, vice president of facilities services & planning. “More than 4,000 physicians, nurses, staff and volunteers will undergo rigorous training this summer to familiarize themselves with the new hospital before it opens to patient care this fall.” Designed by the internationally recognized firm Rafael Viñoly Architects, the new Stanford Hospital sets a global standard for patient care. The new hospital blends a human-centered approach to care with a razor-sharp focus on integrating technological advancements into every aspect of medical care delivery. Four acres of gardens, original art and sweeping views share the spotlight with state-of-the-art interventional operating and imaging suites, digitally driven patient rooms and access to a premier team of specialists from across Stanford Medicine. “Through the new Stanford Hospital, we are taking an important step forward in realizing our vision of Precision Health: to predict, prevent, and cure disease — precisely,” said Lloyd Minor, M.D., dean, Stanford University School of Medicine. “In every aspect of its design, our new facility enables us to provide high-tech, high-touch care to our patients and bring the latest biomedical advances to the bedside.” The new hospital is scheduled to open this fall. The community will be invited to tour the building as part of its Community Open House on September 14 and 15. • For more information, visit www.stanfordhealthcares.com.
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news
Samsung Announces iQuia Samsung has announced iQuia, a new digital radiography (DR) platform. At the core of the iQuia platform lineup is the newly upgraded detector, aptly named iQuia Detector, which was showcased during its launch at AHRA 2019. “The detectors will be applied to the
premium ceiling DR and mobile systems, iQuia GC85A and iQuia GM85, to enhance workflow and user experience between the systems. Offered in two sizes, 14”x17” (S4335-AW) and 17”x17” (S4343-AW), the iQuia Detector bolsters improved performance in many key areas,” accord-
Alliance Aims to Transform Care Delivery Siemens Healthineers and the University of Missouri System (UM System), including all four universities, and University of Missouri Health Care (MU Health Care), have established the Alliance for Precision Health that will leverage their joint expertise to transform health care delivery, promote education in the fields of technology and engineering, and develop groundbreaking research initiatives. The strategic alliance focuses on four key pillars: health care delivery, education and workforce development, health care innovation, and research and collaboration to improve the quality of care for patients in Missouri and around the world. “A global pioneer in medical technology, Siemens Healthineers will ensure the UM System’s four universities and MU Health Care have access to the latest innovations in diagnostic and therapeutic equipment, educational and training resources, and digital health solutions through a 10-year value partnerships agreement,” according to a news release. “Through the agreement, Siemens Healthineers will combine its strength in medical technology management and digitalization into a future-proof solution for the UM System that gener-
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ates long-term benefits. The UM System will, in turn, employ these resources to deliver high-quality care, collaborate with Siemens Healthineers on joint innovation research projects, and enhance opportunities for students by offering refreshed educational curricula and mentorship programs.” This alliance will support the research, educational and clinical care goals of the new statewide NextGen Precision Health Initiative, the UM System’s highest priority. That initiative positions Missouri on the leading edge of health care breakthroughs, focusing on treatments for diseases including cancer, Alzheimer’s and cardiovascular disease, among many other illnesses that plague Missourians and patients around the world. The effort will be anchored by the NextGen Precision Health Institute at the University of Missouri’s flagship institution in Columbia, Mo., where world-class researchers from all four UM System universities and industry partners will work together to accelerate life-saving treatments from bench to bedside. • For more information, visit allianceforprecisionhealth.org.
ing to a news release. “Additionally, the introduction of SMART Center by iQuia, an enterprise-level quality and asset monitoring solution that continuously aggregates multiple Samsung DR devices’ data into one easy-to-use platform, will enhance DR technology across affiliated products.” •
Magnetic Insight Announces Corporate Headquarters Expansion Magnetic Insight, suppliers of research and diagnostic imaging solutions, announces the completion of their move into a new facility in Alameda, California, to support corporate growth, manufacturing and research and development infrastructure. The 22,000 square-foot facility provides increased manufacturing capacity for magnetic particle imaging (MPI) systems while enabling new product development and operations. The facility includes a laboratory, a clean room, a demonstration experience space, a manufacturing floor and a warehouse to support the increasing demand for MPI products. “Our new site provides the space and environment to accommodate our growing team as we continue to develop leading edge innovation for the life science industry. The island of Alameda is an ideal setting to attract talent from nearby communities, which include Berkeley, San Francisco and Silicon Valley,” says Anna Christensen, president and CEO for Magnetic Insight. “The addition of laboratories to our internal resources will also allow us to expand areas including supporting cell therapies, nanotechnology tools and onsite customer demonstrations.” ICE
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company showcase
C O M PA N Y S H O W C A S E
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ounded in 2002, the partners of MRIequip collectively set out to develop and bring quality medical equipment and accessories to the high-risk area of MRI suites to promote safety. The company has achieved success by partnering with its customers and listening to their specific needs.
“I know there have been multiple times we have helped customers out that would otherwise have ordered from a competitor, but after speaking with our customer service team, they chose to order from MRIequip. They enjoyed the dedication our employees have to the customers. Our customer service is what has made us stand out above the rest, time and time again! We will do whatever we can to help a customer. Our employees go above and beyond every day,” MRIequip President and CEO Erich Schulz says. Schulz shared more about the company in a recent Q&A session with ICE magazine. Q: What are some advantages that your company has over the competition? Schulz: Prior to starting MRIequip in 2002, the partners owned a medical manufacturing company. A hidden secret most of our customers don’t know is that with our custom upholstery and wood working shop we also manufacture custom upholstered items including cushions; stretcher/gurney pads; flat upholstery; and custom cushions for our furniture line as well as provide 18
ICEMAGAZINE | SEPTEMBER 2019
adaptive seating for physically challenged individuals. We offer not only custom manufacturing, but custom-tailored equipment. Our history in manufacturing allowed our team to join forces, sometimes with multiple manufacturers, to feature just one product. With this history and knowledge, we were able to start MRIequip in 2002. Securing deals with manufacturers since the early 1980s has allowed MRIequip to continue to offer MR safe and MR conditional products found for the MRI suite. Q: What are some challenges that your company faced last year? Schulz: Our biggest challenge is keeping up with today’s ever-changing technology and creating MR safe and MR conditional products that the facilities we work with are looking for to help in the MR environment. In this industry safety is always first, and hospitals are always looking for new and innovative products to make the MRI experience more efficient for everyone. Everyone has new ideas; our goal is to make them safe for the MR environment. Working with our engineers, we redesign and recreate new products
every year to make partially metallic products non-magnetic and MR safe or MR conditional. Q: Please explain your company’s core competencies and unique selling points. Schulz: MRIequip.com was built on the notion that we always fix; always upgrade with new technology and our most unique selling point is attributed to our ability to modify a product and make it more user friendly; increasing safety and comfort. Our customer care
MRIequip President and CEO
Erich Schulz ADVANCING THE IMAGING PROFESSIONAL
company showcase
Checking for magnetism
staff are the liaisons from the customer to the engineers available to our team. Q: What product or service that your company offers are you most excited about right now? Schulz: We’re most excited about our newest stretcher. Our newly redesigned non-ferrous stretcher with wrap around rails will pass non-ferromagnetic detection systems and add safety with a full wrap around rail system. With the help of Children’s Mercy Hospital, this design is the first of its kind to the niche MRI environment. We’ve also recently added an MRI adjustable height stretcher that allows you to raise or lower the stretcher to the height of a hospital bed or MRI table. Q: What is on the horizon? Schulz: At MRIequip, our goals are always set high. In addition to working on three more products, that we hope to introduce by the year 2022, we are also working with MRI safety professionals to bring safety to the forefront of conversations. We are also working with Kopp Development to develop products that pass through non-ferromagnetic detection systems.
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Q: Have there been any recent changes to your company? Schulz: The most current change is the redesign of our ecommerce website. We challenged the marketing team to make the most user-friendly platform to the MRI industry. It’s both appealing and full of educational detail to help with decision making. With the growth of our facility, we are stocking more product than ever before. Having items in stock is crucial to our customers. Recent changes to our inventory include the addition of our newly redesigned non-ferrous stretcher with wrap around rails that will pass non-ferromagnetic detection systems and adds safety with a full wrap around rail system. Our new MRI Breast Coil Carts have been tested to be MR conditional to 10.5 Tesla. The carts are designed to be the same height as the MRI table for easy transfer of the breast coil. They provide for immediate access to coils and supplies improving efficiency in the MRI Suite. We have also introduced the new Exclusive MRI Wireless Patient Monitoring Dual Camera System to the market this year with many benefits proving useful
in the MRI room. Its many benefits include monitoring every patient safely, including pediatric patients, sedated patients, MRI pacemaker patients and all patients receiving Gadolinium contrast. The system records and documents high-risk patients during the scan, reduces liability risk and lawsuits, reduces repeated exams and assures claustrophobic patients that they are monitored during the scan. The system features multiple-devices viewing simultaneously, HDMI output, added storage methods and 1080P live viewing with a sleek monitor design, authentic smart camera realization with friendly menu, easy to set up schedule and record at your fingertips. Q: Is there anything else you want readers to know about your company? Schulz: I want our current and prospective customers to know that when you pick up the phone and reach our team members, we are here to listen. We are here to fulfill your needs. No suggestions are too modest to share. We can’t change what we don’t know needs change. ICE For more information, visit mriequip.com. ICEMAGAZINE
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news
PEOPLE ON THE MOVE By Matt Skoufalos
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Oncology Analytics has named David Fusari as chief technology officer (CTO). Fusari was most recently CTO and co-founder of TriNetX, and had been CTO at Ability Network and Sentillion. Sentillion was acquired by Microsoft, where Fusari was an executive and principal architect in its health solutions group.
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Intervention Insights has named Chet Burrell as executive chairman. Burrell is the founder and managing member of Silavon Healthcare Holdings; he has been the president/CEO of three different Blue Cross/Blue Shield plans and CEO or chair of a number of for-profit health care technology companies.
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Health Care Service Corporation (HCSC) of Chicago, Illinois saw President and CEO Paula Steiner, who led the organization since 2016, depart the company. HCSC board member and former energy executive David J. Lesar will serve as interim CEO until Steiner’s replacement is named. Maurice Smith, who has been with the company for 20-plus years, most recently as president of Blue Cross and Blue Shield of Illinois, has been named president of HCSC.
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Advocate Aurora Health of Downers Grove, Illinois named Jim Skogsbergh its sole president and CEO; Skogsbergh had jointly run the company as co-president and co-CEO with Nick Turkal since the system was formed in April 2018 through the merger of Advocate Health Care and Aurora Health Care.
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Arizona-based Phoenix Children’s Hospital has named Rajeev Bhatia chief of its pulmonology division. Bhatia joins Phoenix Children’s from Akron Children’s Hospital of Ohio, where he spent eight years, most recently as medical director of the clinical exercise physiology lab in the Robert T. Stone Respiratory Center.
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ViewRay has named Gail Wilensky to its board of directors. She has been a White House senior adviser on health and welfare and was the first chair of the Medicare Payment Advisory Commission. Wilensky is also a director for Quest Diagnostics, United Health Group, the Geisinger Health System Foundation, and is on the Board of Regents of the Uniformed Services University of the Health Sciences (USUHS).
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MaxQ AI of Andover, Massachusetts named Tom Neufelder as its new chief technology officer. Neufelder most recently was senior vice president and innovation leader at Philips Healthcare.
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Memorial Hermann Health System of Houston, Texas has named David L. Callender its president and CEO, effective September 1, 2019. Callender has been president of the University of Texas Medical Branch (UTMB Health) since 2007. He succeeds outgoing president and CEO Charles Stokes.
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Avenda Health of Santa Monica, California added Michael S. Klein as chairman and CEO of iCAD and Simon Stertzer as a medical advisor. Klein has nearly 40 years of commercial leadership experience in medtech, pharma and health care. Stertzer, has spent his career improving treatment modalities in cardiovascular disease; he is professor emeritus at Stanford University.
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Sheppard Pratt Health System of Baltimore, Maryland named Todd Peters its vice president and chief medical officer, succeeding the retiring Robert Roca, who spent 25 years of service to the health system. Peters joined Sheppard Pratt in July 2018 and served as its medical director of child and adolescent services and chief medical
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news When MRI, When CT MRI, CT Parts are Needed Parts are Needed
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information officer (CMIO). Before joining Sheppard Pratt, he was the inpatient medical director and assistant CMIO for the Vanderbilt University Medical Center.
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The New York, New York-based Montefiore Health System and Albert Einstein College of Medicine named Michael deCastro Cabana physician-in-chief at ChilKEI MEDPARTS KEI MEDPARTS dren’s Hospital at Montefiore (CHAM) and university chair MRI & CT Equipment MRI & CT Equipment of pediatrics at Montefiore and Einstein. Cabana is currently Knowledge, Experience, Knowledge, IntegrityExperience, Integrity a professor of pediatrics and epidemiology and biostatistics at the University of California, San Francisco (UCSF), where he also is chief of general pediatrics and teaches at the Philip R. Lee Institute for Health Policy Studies. He will join Montefiore and Einstein on September 9.
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The Pancreatic Cancer Action Network (PanCAN) of Manhattan Beach, California, named Andrew Lowy, professor of surgery and chief of surgical oncology at the University of California San Diego School of Medicine, to chair its Scientific and Medical Advisory Board (SMAB). Margaret A. Tempero, director of the UCSF pancreas center and professor of medicine at the University of California, San Francisco, is the new chair-elect.
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Hartford HealthCare of Hartford, Connecticut has named Jeffrey A. Flaks its president and CEO effective September 1. Flaks, a 15-year member of the organization, succeeds the retiring Elliot Joseph. ICE
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ICEMAGAZINE
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news
WEBINAR WEDNESDAY Cybersecurity, Product Development Explored Staff Report
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he Webinar Wednesday series continues to deliver insights and advice to imaging service professionals around the globe. Thus far in 2019, the Webinar Wednesday series boasts more than 4,000 attendees. Cybersecurity Roundtable Delivers The recent Cybersecurity Roundtable webinar helped professionals power up to the next level with great insights and helpful tips. It also provided 1 credit from the ACI. The webinar was sponsored by Medigate, Cynerio and Nuvolo. The panel of speakers included Simeon Utubor, director/pre-sales engineering at Medigate; Leon Lerman, co-founder and CEO of Cynerio and Ben Person, vice president of product marketing at Nuvolo. Cybersecurity continues to be an important and hot topic in today’s world, especially in health care. Webinar Wednesday reached out to these experts to share more information about challenges, recent developments, threats specific to the health care industry and more. Almost 200 people attended the live presentation and they were asked “How
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“ It was good to see different companies present together on the same topic and goal. It makes it so that you can see the strength of each product in comparison to others at the same time.” – A. Todd, CET 4 did today’s webinar meet your expectations?” in a post-webinar survey. “Provided some very basic concepts to consider about cybersecurity as we research replacing our current CMMS program,” said R. Hinds, BMET II. “I liked how three different companies shared there different strategies
for addressing network security,” said Biomed J. Cazadd. “It was interesting to get three varied, yet associated opinions,” shared C. Callista, CBET. “Each presenter was very knowledgeable of their product, presented pertinent material regarding their product and did a great job at answering the questions submitted by the attendees,” Senior BMET D. Duck said. “Continues to let me know what the industry is doing for medical equipment security,” Senior Biomed R. Faut said. “Today’s webinar provided a good overview of Medical IoT security concerns and how to monitor, track and document associated actions,” said L. Riley, biomedical systems analyst. “It was good to see different companies present together on the same topic and goal. It makes it so that you can see the strength of each product in comparison to others at the same time,” shared A. Todd, CET 4. “Good overview of what tools are becoming available to help us manage medical equipment and cybersecurity issues,” Director of Biomedical Services M. Bishop said.
ADVANCING THE IMAGING PROFESSIONAL
news
Simulations Help Develop Products The Webinar Wednesday session “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, Ph.D. 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. Cartemo 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. About 100 attendees were on hand for the live presentation. Several more HTM professionals have viewed a recording of the webinar online. Attendees shared why they attended the webinar and if it was worth their time in a post-webinar survey. “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.
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“ 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.” – H. Martin, clinical engineer “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 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. “It was definitely worth it. It was a great refresher on the physiology of the X-ray detector,” said F. McVean, business process manager. “I am always fascinated by the science behind the equipment. Math and physics play a big role in the development of biomedical equipment. Simula-
tions 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. “I attended to learn more about an area with which I am not familiar. It was worth my time,” said M. Swanson, biomed. ICE For more information about Webinar Wednesday, visit WebinarWednesday.Live.
A special thank you to the companies that sponsored the recent webinars.
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people By K. Richard Douglas
PROFESSIONAL SPOTLIGHT Matthew Frank, CBET: To Go Far; Go Together
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edford, Oregon is a medical hub in the Rogue Valley. The city is the fourth largest metro area in Oregon and is in an area that offers some of the best recreation in Southern Oregon. One reason the city is the medical hub of the area is because it is home to the Providence Medford Medical Center. One member of the medical center’s imaging service team is Matthew Frank, CBET, clinical imaging engineer. Frank had his sights set on a career as a clinician until he discovered the work done by those who maintain medical equipment. “In high school, I had the opportunity to participate in a health occupation internship at a local hospital in Medford, Oregon. For a short time, I thought a career on the clinical side of health care was the direction I wanted my life to follow. Life, however, does not follow a straight line and during my internship, while rounding in the operating room, I met a member of the biomedical team,” Franks says. “At that time, my thoughts about health care were singular, either you were in technology or health care but not both. After meeting the biomedical team, I realized there was a career path that included both clinical and technology. Over the next few months of the program, I found myself rounding more with the clinical engineers instead of the OR and ER staff where I was scheduled. This did 24
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put me in a fair amount of trouble with the instructor of the program, but I did not care as I had found a career that I truly enjoyed and that my talents applied specifically,” he says. He enrolled at a technical college in Phoenix, Arizona and received a degree in computer electronics. After graduation, he applied and was hired by a third-party service company in Gilbert, Arizona. “This was in the late ’90s and formal biomedical training was in its infancy. Like most at that time, my formal training consisted of a six-month training period with a senior technician, on-the-job training (OJT), and manufacturer training schools,” Frank says. “Once I entered into the imaging world, I was able to plan a more formalized approach. When we started our imaging service department, we partnered with RSTI for their phased training. This served two functions; to provide the basic knowledge needed to understand the fundamentals of medical imaging, and met the perquisite requirements that most manufacturers have before attending modality specific training. After attending RSTI, I scheduled vendor-specific modality training over the next five years for X-ray, cath lab, fluoro, CT and O-arm,” Frank says. After working for a third-party service provider for several years, he was promoted to a service manager position. He managed
10 service technicians and support staff. He was in this position for five years until he and his family decided to move back home to the Medford area. “I accepted a position at Providence Medford Medical Center as a BMET II in 2008. After a short time, I was asked to join the imaging team as a clinical imaging engineer. I am still serving in this role today, along with a project management emphasis,” Frank says. “During this time, our organization was realizing the cost of service and contract responsibility. To help combat these costs, myself and a co-worker were asked to start the imaging program for the Southern Oregon region. We were tasked with implementing this program over a five-year period which must include radiation oncology, CT, cath lab, X-ray/fluoro and ultrasound. This was no small task. This involved contract negotiation with our vendors, cooperation and trust from every imaging department and a financial commitment from administration,” Frank adds. Family and Team Work Frank enjoys playing a blues or getting out on two wheels when not on the job. “I am a guitar guy and love the blues. When I have the opportunity, you can find me in my music room working on songs. I am also a motorcycle enthusiast. Street bikes or dirt bikes; I do not have a preference. Although I will drop most things, if ADVANCING THE IMAGING PROFESSIONAL
people
GET TO KNOW THE PRO Favorite book Fiction: “Lord of the Rings” by J.R.R Tolkien Non-fiction: “Biography of Benjamin Franklin” by Walter Isaacson
Favorite part of being an imaging professional?
Favorite movie “Miracle” Story of the 1980 Olympic Hockey team
and knowledge needed to perform the functions of an
Favorite food Anything Italian
equipment we maintain most clinical diagnosis and treatment
Hidden talent I am a pretty good at juggling. I was very popular at my kids’ birthday parties.
of the hospitals and clinics we serve, but also the communities
What’s on my bench? • Photos of my family are #1. (Even if they need to be updated). • I always have a notepad by my phone. I am a little old school and believe that conversations are crucial for understanding of tone and concept. However, the downside is no documentation on a phone call. Got to have an organized phone record. • I keep a small toolkit next to my desk which works for about 90% of the calls I respond to. No need to lug a big tool box everywhere. • I always keep a list of my goals for the year in a place I see every day. • And finally, coffee. Some days more than others, but always coffee.
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“I think everyone in the imaging field would agree that the best part of the job is performing a task that not too many people are capable of doing. The complexity of the systems imaging specialist is highly rewarding. Not only for personal satisfaction of a job well done, but knowing that without the would be impossible. What we do is critical to the functioning in which we live. For me, this is the best and most fulfilling part of the job.”
I have an opportunity to get down to the sand dunes in Glamis, California,” Frank says. He says that his greatest accomplishment is his family. “My wife, Marisa, is an amazing person; I am the best version of myself when I am with her. We were married in October 2001 and, since then, have had four children; three boys and a girl. My oldest, Ethan, is a sophomore in high school and is on the Rogue Rowing team. Hudson is 12 years old, a seventh grader, and is playing on the Southern Oregon Timbers premier soccer team. Owen is 10 and is going into the fifth grade. He is on the Superior swim team. Megan is the youngest, and is going into the third-grade, and loves to play soccer with the Timbers recreational team. Needless to say, we
are very busy with sports. I am very proud of all four of them,” Frank says. He says that he has learned that personal accomplishment is never 100 percent the work of the individual. “Being successful is as much the sum of the relationships a person makes as it is personal growth. I have many accomplishments in my career and have worked extremely hard for those achievements, however, I never did it alone or without council. It is true, and I would like to share an old saying many may already know; ‘If you want to go fast go alone, if you want to go far, go together.’ I have had a core of people around me that create success no matter what the challenge may be,“ Frank says. We’re sure that his team feels the same way. ICE ICEMAGAZINE
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people By K. Richard Douglas
DEPARTMENT SPOTLIGHT Peterson Regional Medical Center Radiology Department
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erving the people of the Texas Hill Country, and sitting on a scenic 35-acre campus, the Peterson Regional Medical Center (PRMC) is an independent, not-forprofit 124-bed health care facility. It is located in Kerrville, Texas, northwest of San Antonio. Staffed with 900 full-time employees, Peterson Regional serves nine counties. “The main campus offers over 25 key service lines and departments, including an emergency department, acute rehab unit, a Texas Ten Step designated maternity unit, The Baby Place and women’s services, an intensive care unit, an expanded heart and vascular center, seven surgical suites and an award-winning center for orthopedic health for total joint replacement,” says Tracy C. Moore, RT(R)(M)(CT), CRA, radiology director at PRMC. “Peterson’s neighboring Ambulatory Care Center offers outpatient surgical services, radiology and imaging, outpatient rehabilitation and an advanced wound healing center offering two hyperbaric oxygen chambers – the only of their kind available in the region,” Moore adds. Moore manages the imaging department at the hospital and ACC. “Peterson’s roster of services also includes Peterson Hospice, Peterson Home Care, Peterson Medical Associates, Peterson’s Outreach Lab, Peterson Community Care and Peterson Urgent Care. Proudly, Peterson recently opened a new family practice clinic 26
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in Bandera to meet the growing needs of this characteristic community and has recently opened a new physical therapy clinic in Comfort, Texas,” Moore says. She says that the imaging department consists of a hospital-based department and an ambulatory care center imaging department. “Both imaging departments offer exams in X-ray, computed tomography, ultrasound, magnetic resonance imaging and nuclear medicine. In addition to these exams, the ambulatory care center also offers mammography and bone density, while the hospital offers interventional radiology. Between both departments we staff 28 full-time registered technologists, two fulltime RNs, four full-time clerical and 17 PRN employees including – two nurses, 13 techs, two clerical/RA,” Moore adds. The team keeps current with the newest advances through several training approaches. “Continuing education is accomplished in training on new equipment and procedures with the OEM as well as online classes, in-services, inviting reps to come and instruct and travel to vendor sites for new equipment training,” Moore says. She says that they are also a clinical site that supports student rotations in X-ray and ultrasound for Alamo-St. Philip’s College, College of Health Care Professionals and PIMA Medical Institute. The department consults with colleagues
and stakeholders to make capital purchase decisions. “We value input from our radiologists, technologists, nurses and performing physicians. Construction planning is accomplished with admin, maintenance, environment of care and infection control (departments),” Moore says. “Contract negotiations are accomplished by sharing quotes with our materials management director, once received she negotiates to the best pricing before we proceed,” Moore adds. Finding a Better Way Employing careful process improvement techniques, the radiology team at PRMC devised a better process for patients to pass through the procedures they have related to mammography and follow-up. “We had a special project in women’s imaging that gave us an opportunity to meet our community’s needs by improving the process by which a patient is navigated from screening to biopsy in the mammography department. We noticed we were not retaining our patients due to the time it took for them to navigate the system,” Moore says. “We used Six Sigma and lean processing to define the problem, look at all the steps from scheduling, completion of exam and follow up to create a process map from which we defined all the areas that caused delays and issues. Once this was completADVANCING THE IMAGING PROFESSIONAL
people
Members of the Peterson Regional Medical Center Radiology Department include mammography team members, from left to right, Gregoria Noonan, Maribel Cano, Jennifer Stueber, Cindy Hunter, Shannon Stolz and Paula Bess.
ed, we were able to come up with a new process we call the Pink Pathway, that allowed a patient to be seen for diagnostic imaging with results, additional imaging and a one-on-one visit with our interpreting physician to navigate that patient to a surgical appointment within that same week, often next day when warranted,” Moore explains. She says that this change in processes, along with the remodel of the women’s center and purchase of a stereotactic biopsy system, allows them to navigate the patient and biopsy, while meeting patients’ needs throughout the process. In addition to coming up with a streamlined imaging experience, the group collaborates with other departments to improve workflows and help colleagues understand roles and responsibilities. This has also been an inter-group exercise. “We utilize unit practice councils in our WWW.THEICECOMMUNITY.COM
facility to empower our staff and give them a voice in processes and share frustrations to allow improvement. Oftentimes, we will join another department to solve problems and to ensure all contributing areas have a say and share perspective. This gives us an opportunity to work through issues and build a better understanding of the workflow and approach and how one change affects other departments,” Moore says. She says that one example concerned issues with double booking exams which caused delays and frustration for techs and patients. “As a group, we shared concerns and frustrations; mapped out the processes, redefined parameters, adjusted scheduler notes and set up rotations so that the schedulers could spend some time in the imaging department to see how everything plays out in real time,” Moore says. “This gave a greater understanding of how
the scheduling of exams directly affects the performance from details of lab work, screening questions and diagnosis. They could see why everything is so important to collect. Through this process improvement, the techs were able to learn the scheduling process and ins and outs to better appreciate the number of calls taken and worked through and the limitations the schedulers are often dealt when scheduling exams. The scheduling of patients ran much smoother and we work together as a team to improve what we do,” she says. Beyond their work at Peterson’s facilities, the team members are involved in AHRA (The Association for Medical Imaging Management). “Several in our group have associations with ASRT and TSRT,” Moore adds. Imaging patients at PRMC are in good hands as they reap the benefits of constant process improvements and a caring team of professionals. ICE ICEMAGAZINE
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PRODUCT SPOTLIGHT MRI Growth Continues
S
everal reports predict continued growth of the global MRI market in the near future. A report from Grand View Research states that the “global magnetic resonance imaging market size was valued at $3.8 billion in 2018. It is anticipated to expand at a compound annual growth rate (CAGR) of 5.3% during the forecast period (2019-2026).” MRI is a preferred diagnostic tool for central nervous system disorders, tumors, spine lesions and stroke affected areas in the brain and blood vessels, according to Grand View Research. “High prevalence of these conditions is projected to drive the growth. In addition, rising geriatric population, number of chronic diseases and demand for minimally invasive or non-invasive diagnostic procedures are some other primary drivers for the MRI market,” the report states. “In addition, advancement in scanning techniques such as open MRI systems, software upgrades and superconducting magnets is fueling the growth,” it adds. “Also, development of MRI systems compatible with cardiac pacemakers is propelling the demand for these instruments. Advancements in contrast agents, for instance, the paramagnetic contrast agent, gadolinium-DTPA, is used as intravenous injection to give sharp, accurate and precise images within 20 minutes to one-hour duration.” The report mentions other factors driving continued growth and also points out obstacles for the global MRI market.
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“Advancements in medical imaging devices have enhanced the diagnosis and treatment of cardiovascular diseases and cancer among other health conditions. Rising demand for minimally invasive treatment is leading to innovation in diagnostic imaging devices. Four advancements; such as accelerating processing speed, expanding the parameters of 3D and 4D, capturing images at the right place and at the right time, and automating workflow, are expected to increase the adoption of medical imaging during the forecast period,” according to Grand View Research. “Significant increase in the number of public and private hospitals across countries such as India and China is boosting the demand for diagnostic imaging devices. Rising medical tourism coupled with government initiatives in this region is expected to boost the growth of the magnetic resonance imaging market during the forecast period.” The high cost associated with MRI systems, maintenance and servicing is challenging the growth, according to the report. Reportlinker also predicts growth despite challenges. “The global MRI market size is expected to reach an approximate value of $5.8 billion by 2026. It is projected to expand at a CAGR of 5.3% during the forecast period. Constant introduction of advanced disease diagnostic technologies is primarily boosting the growth,” according to Reportlinker. “Rapid growth of MRI sector is attributed to the rising prevalence of chronic diseases which require early diagno-
sis and timely treatment to prevent late stage complications. Also, rising number of road accidents leading to injuries and complications are augmenting the demand for this modality. The musculoskeletal and spine injuries also demand for these systems for better diagnosis using high-resolution scanning technique.” “On the other hand, high cost and requirement of qualified professionals to operate the device are some of the major factors challenging the growth of the MRI market. Moreover, prolonged life span of these devices is resulting in delayed repeat purchase and thereby hindering the market growth,” the report adds. Mordor Intelligence predicts growth in a specific area. “The neurology segment of the global MRI market holds the largest market share, and it is expected to record a CAGR of 6.7% in the coming future,” according to a Mordor Intelligence report. “The global magnetic resonance imaging market is highly competitive and consists of several major players. In terms of market share, few of the major players currently dominate the market. However, with technological advancement and quality service provision, mid-size to smaller companies are increasing their market presence by introducing new products with fewer prices. Companies, like Siemens Healthineers, GE Healthcare, Canon Medical Systems, and Philips Healthcare hold a significant market share in the global magnetic resonance imaging market,” Mordor Intelligence adds. ICE
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Canon Medical Systems MR Theater The MR Theater, available on the Vantage Galan 3T, Vantage Titan 1.5T and Orian 1.5T, projects peaceful, virtual reality images onto a dome-shaped screen inside the bore. The MR Theater gives patients a visual focal point to distract them from their MR exam and the peaceful images encourage patients to relax and stay still, enabling clinicians to produce efficient, high-quality imaging. The images also move with the patient table for a continuous display, for a truly engaging experience. Combined with Canon Medical’s exclusive Pianissimo quiet scan technology, which helps reduce acoustic noise during the MR exam, patients are able to listen to in-ear audio as the MR Theater provides continuous projections to help relax patients. By putting patients at ease, clinicians can complete MR exams quickly and capture the highquality images they need for confident diagnoses and treatment, all while increasing patient satisfaction.
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GE Healthcare SIGNA Premier The SIGNA Premier is a wide bore 3.0T magnetic resonance imaging (MRI) system that delivers a new level of performance with research-focused clinical capabilities designed particularly for neurological and oncology research and clinical work. This system is built on a platform with a short-bore, high-homogeneity magnet; powerful new gradients; a new digital RF transmit and receive architecture; and cutting-edge applications, including cloud analytics. SIGNA Premier is powered by the innovative SuperG gradient technology to improve diagnostic confidence for clinicians. The SuperG gradient coil introduces outstanding performance and superb stability, which is designed to deliver the performance of ultra-high-performance, researchclass 60 centimeter MRI system in a 70 centimeter bore MRI. When paired with the AIR Technology suite of lightweight, ultra-flexible, versatile and durable coils that conform to almost any part of the human body, the MR experience is truly transformed. Add to that intelligent applications that automate and personalize workflow, and you’ll be able to achieve industry-leading productivity and image quality.
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Philips Ingenia Elition 3.0T MRI As a part of Philips’ digital MR portfolio, Ingenia Elition 3.0T MRI empowers a faster, smarter and simpler path to diagnosis. By uniting Philips’ unique dStream digital broadband technology with Compressed SENSE and 3D APT, Ingenia Elition performs exams up to 50% faster1 with no compromise in image quality and helps deliver patient-centric imaging from patient set-up to the final image. New patient sensing technology and AI-driven SmartExam analytics for the automatic planning, scanning and processing of exams also helps improve the MR workflow, from image acquisition to reading preference. 1. Using Compressed SENSE technology and compared to Philips exams without Compressed SENSE.
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Siemens Healthineers MAGNETOM Altea The MAGNETOM Altea 1.5 Tesla (1.5T) magnetic resonance (MR) scanner from Siemens Healthineers has a wide, 70-cm bore and BioMatrix patient personalization technology that includes the Select&GO Interface, which removes the need for anatomical landmarking to enable faster patient positioning. Tim 4G and Day Optimizing Throughput (Dot) automation support standardized, highly reproducible scan procedures. An optional dockable table further facilitates workflow and helps ensure patient safety. Turbo Suite customized speed applications for routine examinations of various areas of the body can reduce scan time by up to 50 percent without compromising image quality.
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SOLUTIONS GUIDE MRIs Email: chuck@medimagetec.com Website: www.medimagetec.com
Carolina Medical Parts 4310 Enterprise Drive, Suite A SEE Winston Salem, NC 27106 OUR AD P. 43 Phone: 877-267-2784 Email: sales@cmparts.com Website: www.carolinamedicalparts.com The largest independent depot level MRI Coil and Component repair company in the industry, with over 1,020 active components across 72 different platforms on 3 OEMs (GE, Siemens and Philips). With our team of dedicated professionals, with over 40 combined years’ experience, ready to handle your entire MRI Coil and Component repair needs. From our commitment to quality as evidenced by our ISO 9001:2015 certification to the daily care we put into every repair service, customers are assured they are getting the most value for their dollar and delivering the highest possible quality images to their patients. SEE OUR AD P. 15
Diagnostic Solutions 4075 Karg Industrial Pkwy, 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.
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IMES – A Division of Richardson Healthcare 8190 Regent Pkwy. SEE OUR AD Fort Mill, SC 29715 P. 11 Phone: 704-739-3597 Email: info@imesimaging.com Website: www.imesimaging.com IMES (A Division of Richardson Healthcare) is an unmatched source of QA3-tested CT replacement parts, hands-on service training and certified tubes – all backed by 24/7 support.
International X-Ray Brokers 25 Conant Dr SEE Brockton, MA 02301 OUR AD P. 35 Phone: 508-559-9441 Or Phone: 508-730-9544 Fax: 508-559-9440 Email: admin@intxray.com Website: www.internationalxraybrokers.com International X-Ray Brokers buys and sells preowned medical imaging equipment including nuclear medicine, CT, MRI, radiographic rooms with and without fluro, C-Arms, portables, laser cameras, ultrasounds and special procedure rooms.
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Medical Imaging Technologies, Inc is a dedicated nuclear medicine company offering nuclear medicine systems, upgrades, service, parts, support and accessories to hospitals, clinics and physician offices.
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We carry the highest quality MRI equipment and replacement parts at bottom line pricing. MRIequip supplies all the MRI equipment you need to start an entire MRI Suite. Specializing in Non-Magnetic Stretchers and Wheelchairs our inventory is constantly growing. We offer over 1,300 products including MRI Wheelchairs, MRI Stretchers, Laryngoscopes, Pulse Oximeters, MRI Safety, MRI Stools, MRI Furniture, MRI Anesthesia Equipment and MRI Carts.
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edWrench.com is a resource and sharing network for users of medical equipment. You can get answers, find information and read what others think about the equipment they use. It is free to join and easy to keep informed. You simply bookmark your favorite communities (equipment, categories or manufacturers) to your “My Bench” area and you are given an intelligent feed of information from other professionals as they help each other solve problems. Your “My Bench” page can help you: • • • • • •
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Safe Spaces in the Imaging Suite Designing for Patient, Staff Protection By Matt Skoufalos
W
hen you think of the safest and most dangerous areas in the hospital, would you believe they could be the same place? If not, it’s time to adjust your thinking about imaging safety, says John Posh. Posh is the director of education and MRI safety officer with ferromagnetic detection systems manufacturer MetraSens of Lisle, Illinois. Throughout his career, Posh has designed more than 20 different imaging facilities, although his exclusive focus is on magnetic resonance imaging (MRI) systems. His claim – that the MR suite holds the dubious distinction of being both the safest and most dangerous area of the hospital – is based in an understanding and healthy respect for the fundamental forces at work in the technology. Most laypeople and hospital staff are aware that a computed tomography (CT) imaging system can pose certain environmental dangers; namely, those of exposure to ionizing radiation. Much has been written, policyand practice-wise, about the pursuit of the lowest possible radiation dose required to produce an optimal imaging study at the least risk to the patient. In an MR suite, there’s no ionizing radiation because the device doesn’t require it to operate. However, Posh points out, the forces generated by a high-powered magnet can be just as deadly. “There’s no radiation; there’s nothing that can hurt you physically,” he said. “But you can walk in [with a relatively mild injury], and then be dead if something flies across the room. No one can come to your aid until they can turn off the magnetic field. It requires specialized education and training.”
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One of the most well-known examples of such an accident came in July 2001, when six-year-old Michael Colombini of Croton-on-Hudson, New York, was killed during a routine MR exam at the Westchester Medical Center. A metal oxygen tank that had been left in the imaging suite became magnetized, and flew into Colombini’s head at a rate of 20-30 feet per second, The New York Times reported. The tank crushed the boy’s skull, killing him, and resulting in a $2.9-million settlement for his family and a $22,000 fine from the New York State Health Department, according to the New York Post. Worst, Posh said, the incident caused an entirely preventable death that became a sentinel event in the history of radiology. Afterwards, the American College of Radiology (ACR) developed design guidance that designates four safety zones within MRI facilities. Each corresponds to a level of “increasing magnetic field exposure (and hence potential safety concern),” the ACR notes in its documentation. In order of increasing risk/security, they range from Zone I (the outside world, where no security controls exist), to Zone IV (the highest-security zone, in which the MR magnet itself resides, and which contains the greatest level of ferromagnetic activity). Zone II covers public-facing areas, like reception and waiting rooms, where technologists can supervise MR safety education and access to Zones III and IV can be regulated. Zone III is where patients can change and technologists can control access to Zone IV; being closer to the magnet itself, Zone III may present “fringe, gradient, or RF magnetic fields [that] are sufficiently strong to present a physical hazard to unscreened patients and personnel,” ACR notes. Patients and staff in Zone
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Photo courtesy Metrasens
III should be supervised at all times by those trained in imaging safety. Designing for safety involves a lot of consideration about the work that must be done in each of these zones, and the flow of staff and patient traffic throughout them. Posh describes what can happen when those considerations aren’t managed in the build-out of an imaging room. “A facility I went with recently had worked with an architect that was good at hospitals, but didn’t know MRI very much,” he said. “Zone III was so short that, in order to get a patient on a stretcher, you’d have to open the Zones III and IV doors. You’d have to open a corridor from a public access area to the most secure area.” “Let’s say the patient stops breathing,” Posh continued. “No resuscitation efforts are possible in Zone IV. You can’t bring in equipment or people to help you because of the magnet. The code says, run it into Zone III; do it in private. This facility has such a small Zone III that they have to run it into the hallway.” “The space is efficient, but if the design team had included anyone who’s worked in these spaces, they would never have signed off on that,” Posh said. “It’s the problem between people who know the specifications and people who’ve practically lived in the space. An architect can design your space, but when it involves a bespoke knowledge of what needs to be done in that space, you need a specialized architect.” Under such circumstances, Posh can only recommend writing workaround policies designed to overcome the limitations of the space. For facilities that are in the planning phase, he can offer additional support, much of it centered on ferromagnetic detection; i.e., finding ways to identify material containing iron, steel, nickel, or cobalt, which could adversely interact with the magnetic field of an MR device. Installed in Zone III, that detector can tell technologists whether a patient has anything from an implanted
medical device, like a pacemaker or pulse generator, to a forgotten hairpin or piece of jewelry. Even street clothing, which was once regarded as a non-issue, must be taken into consideration, Posh noted, citing synthetic fabric treatments that sometimes can cause an antenna effect. “There’s copper, silver, and some kind of other treatments that involve colloidal silver,” he said. “The problem is those things are conductive. You can heat up conductors to the point of creating a fire. It’s really basic high-school physics, but patients’ clothing is now no longer presumed to be safe.” As a secondary defense, Posh recommends installing a second metal detector before the entrance to Zone IV; one that will detect the approach of ferromagnetic metal and sound an alarm in its presence. The double redundancy can be a lifesaver not just for imaging patients, but for at-large staff who don’t frequent the imaging suite. “The way we make these spaces safer is through specific training,” Posh said. “We’re not concerned about the 20-year technologists who do this every day, and who are drilling this. The problem is all the support people who are intimately involved in what we do on a daily basis, but they don’t spend enough time down there to have the muscle memory for safety.” To that end, Posh recommends a basic level of training for everyone in the hospital – details that indicate what the magnet is, its potential risk factors,
and instructions like, “the magnet is very dangerous if you don’t know what you’re doing; stay away.” He recommends that untrained personnel be forbidden to enter a Zone III or IV area without supervision and clearance from specialized, trained imaging personnel. Architect and radiology/MRI safety consultant Tobias Gilk, senior vice president at RAD-Planning of Kansas City, Missouri and past chair of the American Board of Magnetic Resonance Safety (ABMRS), said that long-term planning during the construction of an imaging facility pays dividends not just over the lifespan of the building, but of all the generations of equipment that will be housed there. “If we look at the lives of brick-andmortar hospital buildings, they have an anticipated lifespan of 50 to 100 years,” Gilk said. “A piece of imaging equipment today has an average lifespan of 10 years. We’re going to replace that piece of equipment four times in the lifespan of that building.” When designing imaging facilities, Gilk recommends making plans that allow for the evolving clinical utilization of the space, as well as changes to its broader physical needs. As more imaging-guided procedures come online, facilities must be built to accommodate the technology required to conduct them. Switching out a space principally used for diagnostic studies to one that might perform even minimally invasive
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that speak to risk management, are continuously reviewed based on changing technologies, changing staffing and changing clinical utilization.” “All those pieces should create a retrospective view as to where are we today, where are we planning for the future, and what do we put in place to accommodate for the future – or don’t get in the way of what we want to do for the future,” Gilk said. Typically, capital projects, like a redesigned imaging suite, are driven by a push for increased capacity and subsequent revenues. But when the only consideration is the number of scanners, or how to increase the potential to perform more studies, safety issues can slide to the bottom of the list of considerations. “What are the defining features of an idealized solution?” Gilk asked. “Going through that process may map out options previously unconsidered on how to reallocate resources, or give a much better picture of how to judge new facilities against their own best-practices model instead of counting the number of scans. It’s not the only metric sites should use.” Architect Sara Ridenour, an associate principal at Ballinger of Philadelphia, Pennsylvania, said a good partner on any facilities project is one who will walk the client through goals and aspirations for their space before the design kicks off. “We start with projected patient volumes to program the space, and that’s how we determine the square footage required,” Ridenour said. “While we’re doing that, we start the Facilities Guideline Institute (FGI) code review, including life safety for patients and staff.” Next comes considerations of patient experience – how the space feels, from the outside in – which is just as much related to reimbursement as any
other aspect of the conversation about revenues. Ridenour said her firm works to create “a more serene environment” in the study room itself, while focusing equally on creating areas of respite for the comfort and safety of staff. “We look at how the environment affects healing and impacts how staff and clinicians work,” she said. “We also look at the future use of the space, because as soon as you design the perfect space, a few years later you have a new piece of equipment coming in.” Ridenour also pointed out that the scope and timing of capital projects can evolve over years, and with them,
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procedures requires considerations about infection controls at the least, “and a lot of the facilities don’t harmonize,” he said. “It is technically difficult to put a hand sink in an MR room,” Gilk said. “Most facilities’ infection control protocols say if there is potential exposure to blood product, you have to have either a sink with a drain in that room, or handsfree access to go from that room to a scrub area. A lot of facilities didn’t ask the questions about what that means we need to provide in the room – seamless flooring; washable, scrubbable surfaces, hand-washing stations – and so there’s been a bit of scope creep. Without really recognizing, we’ve modestly changed the way that we use the space over time, and before you know it, we’ve made some pretty significant changes from whatever our previous benchmark was.” Simply increasing the diversity of exams and procedures in radiology environments won’t work without giving appropriate consideration to the same in the facility planning and design process, “and appropriateness for the level of acuity and intervention,” Gilk said. Most inpatient procedures are conducted on patients who are sicker than they may have historically been, he noted; a failure to consider the way those patients interact with the equipment and environments could expose them to additional risks. “In terms of the nature of the risks presented to the patient, surgery hasn’t changed in 100 years,” Gilk said. “In imaging, the risks are relatively new because imaging is relatively new in medicine. Because they’re technologically driven, the risks are constantly evolving as the technology pushes forward.” “The way in which the equipment is designed and used, potential collateral risks to patients as acuities increase are moving targets,” he said. “It changes from facility to facility, and, within the same facility, from year to year. It’s vitally important that the structures around imaging, and the policies and procedures
leadership and technology needs similarly can change. She recommends that clients find not only firms who are technically savvy to assist them with the building and design of their spaces, but are also partners who understand the guiding principles of their clients, and who have “excellent follow-through.” “It’s one thing to plan it, but to get it built, you want to be there all the way through for the client,” Ridenour said. ICE
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insight
CAREER CENTER How to Handle Stress
S
o many people I speak with – no matter their age – are feeling anxious and stressed about work (and many times about life in general). Obviously, this can affect their on-thejob performance, no matter how hard they try to keep up appearances and productivity. How can someone in this situation handle it with their employer in a way that won’t put them at risk of a bad review or worse? Data shows that stress and anxiety are, unfortunately, alive and well in the workplace. Employees in Chicago are just one example: A recent survey by Robert Half found that Chicago workers reported their level of burnout to be 5.97 on a scale of 1 to 10 – 1 being not at all burned out, 10 being completely burned out. That’s just a bit higher than the U.S. average of 5.6, according to Michelle Reisdorf, regional vice president of Robert Half in Chicago, who says that unmanageable workload/long hours, constant interruptions/fires to put out, and career stagnation/no room for growth were top causes of burnout for Chicago workers. “If an individual is caught in a cycle of excessive stress and overexertion,
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constantly feeling anxious or other negative emotions, burnout can develop,” Reisdorf says. So what’s a stressed-out employee to do? “If you’re experiencing burnout or workplace anxiety on a regular basis, don’t suffer in silence. Many companies provide internal resources where you can seek help,” advises Reisdorf, who says checking with your HR department to see if the company offers counseling or other services is a good place to start. But what about that conversation with your manager? “If you’re working as hard as you can and still feel buried, talk to your manager. Seek advice on meeting expectations and discuss possible solutions to alleviate the pressure you’re feeling, such as adjusting deadlines or delegating,” Reisdorf explains. “Your manager can’t help you if they are not aware of the problem.” Does the idea of talking with the boss cause anxiety? If so, “take a step back and prepare,” Reisdorf says. “Think of what you’ll say and how you’ll say it – you don’t want to appear frazzled, make excuses or point fingers at
Written by Kathleen Furore others. Gather all the facts – take stock of your late nights, extra assignments and expanding responsibilities – and make a list.” Taking those steps will ensure you’ll be able to calmly explain how you’re feeling about your workload and offer potential remedies. “For instance, if working remotely would help, see if your manager is open to allowing you to work from home periodically,” Reisdorf suggests. “Another option is to request a more flexible schedule, where you can start your workday earlier or later as needed. Your manager will likely want to assist in any way possible, but it’s up to you to take the first step and ask for help.” ICE – Kathleen Furore is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@ yahoo.com.
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AHRA ROCKED THE ROCKIES By Erin Register
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ver 900 medical imaging leaders and exhibitors recently came together in Denver, Colorado to network and gain insight into the latest health care services, tools and trends. The 47th Annual AHRA Conference and Exposition was held July 21-24 at the Gaylord Rockies Resort and Convention Center. AHRA offered a wide array of opportunities for attendees, including continuing education, special events, leadership workshops and an exhibit hall. ARRT Category A Continuing Education (CE) credit was available, as well as CE credit for states with licensure for radiologic technologists. With more than 70 educational sessions, attendees were able to learn a variety of information while having fun at the same time. In addition to the continuing education opportunities, AHRA provided a Certified Radiology Administrator (CRA) Exam Workshop designed to facilitate the attendees’ study and preparation for the CRA Exam. Attendees used the course to identify their areas of strength and weakness in preparation for the actual CRA Exam. AHRA’s leadership workshops were also a great success at the conference. The fourhour, interactive workshop allowed attendees to discuss challenges facing radiology leaders and identify solutions, enhance leadership skills, invest in their individual “personal brand” and create an environment that results in staff bringing their “A” game everyday! The AHRA annual meeting and exposition also featured an exhibit hall of over 150 vendors from all over the country. The exhibit hall gave attendees an opportunity to learn more about the latest products and network with exhibitors. Also, attendees were able to participate in the 20th Annual Imaging Classic Golf Tournament, which raised money for the AHRA Education Foundation. Other activities and events included a Cultivating Accountability Workshop, a welcome reception for new members and first-time attendees and WWW.THEICECOMMUNITY.COM
“The 2019 exposition was fantastic. Being my first time attending I was very pleased with both the attendance of the event as well as the engagement members attending gave at each booth. Very impressed for a first time attender and absolutely plan to make it back annually.” - Steve Anspaugh, GE Healthcare
an AHRA “Rockin’ in the Rockies” party with lots of glam, heavy, thrash and 1980s-inspired costumes! “We received very positive feedback from attendees regarding the educational sessions,” AHRA CEO Dan Kelsey stated. “The highlights were the keynote speakers, especially the final keynote (Manley Feinburg) who compared leadership with his experience in climbing mountains and providing others with enough rope to climb.” Other highlights and big takeaways from the show included the exhibit hall and the networking. Steve Anspaugh, a program manager at GE Healthcare, noted, “My biggest takeaway was being able to engage with the senior level contacts in radiology from all the visiting hospital systems.” “The 2019 AHRA Annual Meeting and Exposition was amazing! I learned so much and was able to network with so many imaging leaders,” Mon Health Medical Center Director of Imaging Brenda DeBastiani, CRA, FAHRA, said. “I am humbled and honored to get to know, and work with, such amazing imaging leaders from all over the country and the world. I had the pleasure of speaking with a radiologist and his imaging manager from Chilé at the 2019 First Time Attendee & New Member Reception. While sharing stories and information, I learned that while our cultures are very different, our issues are the same! Imaging is such a small world,” DeBastiani added.
“This was my first AHRA conference, and I was very impressed by the overall energy surrounding the meeting,” Kelsey added. “This energy was evident in attendees, leadership and volunteers. When I was interviewing for the CEO position, many people told me to wait for the annual meeting, and I would be overwhelmed by the sense of family. I was not disappointed and was very much impressed by the number of people who truly value the relationships they have made through the AHRA and how they value the opportunity to connect annually while also receiving education they can take back to their hospital or imaging center.” AHRA also has an eye on the future. “The board placed much emphasis on hearing from our members and held multiple focus groups with members of varying longevity at the annual meeting. We will also be conducting a member survey which will also help us gauge where to place our improvement efforts. We will be refreshing and revising our strategic plan of the AHRA in the coming year, and the feedback from the annual meeting will help shape the future of the organization,” said Mario Pistilli, a member of the AHRA Board of Directors. ICE For more information about AHRA, visit www.ahra.org. ICE Editor John Wallace contributed to this article. ICEMAGAZINE
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THE FUTURE OF AI Written by Abdul Alsaadi
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here is much confusion on artificial intelligence (AI) and machine learning on how it is used in radiology departments. The noise comes from which applications to use for patient diagnostics, equipment serviceability, connecting to medical records; this has many directors scratching their heads. The focus here is on equipment serviceability. AI started back in the 1950s, but the lack of data made its capabilities nonexistent. AI’s value is tremendous when large amounts of data are available. Machine learning is a branch of AI which allows equipment to become “smart” devices by utilizing data and communication. Both AI and machine learning can be a tool utilized in hospitals, clinics and outpatient centers for better performance. With a certified engineer from MIT in artificial intelligence and machine learning, Medzon has been implementing the technology at many hospitals to unlock the full potential of equipment by harnessing the power of connected machines to produce uptimes of 99%. The radiology department plays a vital role in the hospital, when equipment is down for a couple days, while waiting for parts or to have a skilled engineer to preform repairs, this will bleed the department’s revenue and affect quality. With AI and machine learning, we can be ahead of the game by predicting equipment failure. This gives
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the hospital peace of mind regarding schedules and gives the vendor time to source a part and possibly schedule a corrective maintenance after hours or Abdul Alsaadi, Ph.D., on the weekend. CEO of Medzon Hospitals are working smarter by using AI to support radiologists resulting in fewer errors and burnout from overworking. They are also using machine learning on equipment to have better performance and to train staff on equipment usage, techniques and forecast failures. AI and machine learning will never substitute a human being, but it can be the tool that will increase efficiency, generate higher revenue and improve quality. For example, an airplane has an autopilot mode, but no one will be comfortable being on a plane without a pilot flying it. The same is to true when it comes to radiologists and staff in a hospital. Artificial intelligence and machine learning is still in the early stages regarding its power and capabilities in the health care realm. However, the capabilities will be growing rapidly as more data is collected. I believe one should embrace and learn how it can support one’s daily work. In the future, hospitals will be considered a “smart entity” which will elevate health
care resulting in better patient satisfaction. Hospitals will witness not only better performance among staff, but revenue will almost double. Additionally, hospitals will be easily connected with other hospitals worldwide. As 5G starts to integrate, a robust and faster bandwidth of Internet, AI will be a workhorse when it comes to collecting better data resulting in tremendous growth in health care. Medzon, a consultant and a solution company that has derived its platform on AI and machine learning, is the backbone for so many hospitals in the world. Hospitals are losing nearly $3.1 million a year due to equipment downtime and being out of commission. Having AI, machine learning and a MTM (medical technology management) program will significantly reduce equipment issues. Radiologists, doctors and nurses are not happy when the equipment is down. We have a bright future coming to the health care space with AI and ML for all types of medical equipment. This will make hospitals more profitable and improve the patient experience. The enormous amount of data being collected daily will have a positive impact to improve health care, including performance in radiology and the biomedical department. A note to hospitals and decision makers – do not ignore the importance of technology but be involved as AI will be the norm in the future. ICE
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ARE YOU AN IMAGING LEADER? NOW ACCEPTING APPLICATIONS! We invite you to apply for the ICE18 Leadership Summit & Reverse Expo, held in conjunction with The Imaging Conference and Expo (ICE). ICE18 members will have the rare opportunity to network with the best and brightest in the industry, gaining invaluable knowledge helping their department grow and prosper. There will be several exciting networking events, including our “ICE18 Talks” where you can learn and share innovative and creative ideas. The event’s grand finale will have you take part in the Reverse Expo, which provides brief oneon-one introductions with vendors who will share product information that will assist with equipment and service needs.
ICE18 had great networking opportunities.” Brenda DeBastiani, Director of Imaging
Gave me more time with a variety of vendors I normally don’t see. Vendors were prepared with relevant materials and event was organized well. The Reverse Expo was a very good opportunity to see both sides of the imaging industry.” – Nicole Serwetnky, Parts Procurement Specialist, Advocate Health
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IMAGING MATTERS
Written by John Garrett Director of a Clinical Engineering Department in CHI
Rust, the Color of the Fall
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he infection control department has to be concerned with every part of a hospital physically as well as how things are done. They are constantly trying to reduce the risk of infection just as their name would suggest. This is done a number of ways that include introducing the latest “best practice” in a department or throughout the hospital as well as finding potential hazards that no one has thought of yet. Meet the next big enemy of infection control: RUST. The Center for Medicare and Medicaid Services (CMS) has started to look at rust in procedure rooms, as well as throughout hospitals and cite it as an infection risk. Rust anywhere in a hospital should be reported and mediated. In some cases, this requires replacement of items. Sometimes it is simply a wire bush and a cloth to clear the rust. Many incidents of rust can be mediated with various chemicals and paint products. The local auto body shop will have a number of options available for rust remediation including paints that when applied properly meet food services specifications. These paints are specifically designed for rust remediation and applications. The bigger issue is where to go find WWW.THEICECOMMUNITY.COM
“The most common occurrences of rust in an imaging room occur near the floor. Due to the nature of floor cleaning, that is where most of the rust originates.” the rust before a Joint Commission, DNV or CMS inspection. Where are the inspectors looking? What are they citing? How can someone servicing medical imaging equipment be of assistance? The most common occurrences of rust in an imaging room occur near the floor. Due to the nature of floor cleaning, that is where most of the rust originates. Feet kicking a table, a mop or floor cleaner bumping into a stand, table or floor mounting. Even on equipment that has plastic covers, you should check the screws and metal supports. Of special interest will be procedural
rooms. Rooms such as cath labs, interventional radiology and C-arms used in operating rooms need to get special and detailed attention. It is important to inspect the equipment through the full range of motion. Areas that are exposed at the extreme ends of motion are often hiding rust. Finally, while you may not be directly responsible for things like tables and overhead booms, you may want to point it out to those who are responsible for them. This is a team effort. Make sure they see the rust that you see. That will grant them the opportunity to remediate any rust before it becomes an issue with an inspection. ICE ICEMAGAZINE
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WHAT CAN WE LEARN FROM THE ‘WIZARD OF OZ?’
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t’s been about 120 years since Frank L. Baum wrote, “The Wonderful Wizard of Oz,” and about 80 years since “The Wizard of Oz” came to life on the silver screen. The film was nominated for six Oscars, and eventually spun off other movies, plays and musicals, in part because the characters of Oz are unique and we have much to learn from them. As a kid, watching “The Wizard of Oz” on TV each fall was an anticipated tradition, but today I look at the story a bit differently. The reason? Many workplace lessons can be learned by considering the different characters of Oz. Although Baum said his books were written to please children and generate income for his family, the richness of the story’s characters provide us a wealth of imagery from which we can make workplace comparisons. Before I make workplace analogies to the story’s main characters, let me start with an event near the opening of the story, the Twister. The Twister. The analogy is simple: No matter what business you’re in, storms come and go, and sometimes they’re fierce. They might be tumultuous economic conditions or a sudden rash of employee turnover. A storm could also be an out-of-the-blue event that endangers the organization in some way. The hope I want to convey is that although storms come, they also go. And, with a plan and a dedication to persevere,
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an organization can survive turbulent times. Like most residents of Kansas, the characters in “The Wizard of Oz” knew what to do when a storm came along. Likewise, your organization should have plans for what to do when trouble suddenly disrupts your business. The Wicked Witch. Think of the Wicked Witch as the type of person who wants to see you fail. They’re the bullies; the power-hungry types who get a kick out of preventing you from achieving your goals. And, just like in the movie, they often amass a group of supporters to do their bidding Wicked Witches don’t listen to reason. They’re plotters and schemers who assume they know the motives behind everyone’s actions, except they are usually wrong. Therefore, it’s best to ignore Wicked Witches as much as possible. Typically, Wicked Witches like picking fights, but dealing with them logically is usually futile. Focusing on your goals and steering clear of Wicked Witches is often your best bet, saving outright confrontation as your last option. The Wizard. Picture someone in a position of leadership who hasn’t been trained for the job and you have the Wizard. Like in the movie, Wizards rely on loud voices and pompous talk to create an illusion that they know what they’re doing. All their smoke, mirrors and flashy tricks are simply distractions to prevent you from realizing they are not qualified.
Written by Daniel Bobinski Workplace Consultant
Put another way, all their bravado is simply an attempt to intimidate anyone who might see behind the curtain. However, when a Wizard’s cover is finally blown, there’s no need to drive the person out of town. Instead, help such people learn the true requirements of their job. Your kindness in this will likely be repaid to you, and your effort will help the entire team. The Scarecrow. To me, the Scarecrow represents someone who didn’t get the training or encouragement they needed while growing up. For example, some people are raised by parents who don’t encourage them. I cringe whenever I hear parents telling a child that he or she is not good at something, or worse yet, calling a child stupid. It’s a tragedy when children on the receiving end of this kind of talk believe what they’re told. Sadly, many of these children carry these beliefs into adulthood, and it affects their self-esteem. Even more sad, bullies (Wicked Witches) often pick on Scarecrows because they are seen as easy targets. Interestingly, the Scarecrow believed he didn’t have a brain, yet he had good ideas all along. Our lesson here is to look for where Scarecrows are contributing and compliment them on their value to the team. Show them how their ideas are useful and how they save the organization time, money and effort. In other words, openly acknowledge their brain power!
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The Tin Man. Imagine someone working on the outskirts of a team, never being shown how his or her work contributes to a bigger picture. Such a person can easily become a Tin Man; rusted, and stuck, devoid of “heart.” Such a person might appear to lack passion. To revive people who’ve become like the Tin Man you must lubricate the gears of interaction. Get them more involved in team efforts, especially in planning, and encourage their participation on the team. A Tin Man’s passion can be revived! The Cowardly Lion. Cowardly Lions represent people afraid to take risks. Like Scarecrows, they may actually have the abilities to do what they don’t think they can, but their mindset tends to obscure their confidence. Therefore, when working with Cow-
ardly Lions, positively affirm them and show appreciation whenever they have an idea. Be sure to show them how potential rewards of their ideas can outweigh the risks. You might also talk about how inaction can be more painful than stepping out and trying something new. Dorothy. People like Dorothy are adept at looking for ways around the obstacles that inevitably appear. They’re also excellent at gathering a team of people to help on projects, despite any perceived weaknesses those people may have. A Dorothy is good at showing others how their participation benefits everyone on the team. In other words, Dorothy is the ultimate team builder. Her “can-do” attitude is contagious, even in the face of enormous fears and obstacles. From a workplace perspective, the
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moral of this story is to plan for the Twisters, protect yourself against Wicked Witches and help the Wizards realize that intimidation is not good leadership. Then, be like Dorothy and gather up your team, involving them and encouraging them along the way. Show them that together, people can rise above any perceived weaknesses and achieve success. 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 him through his website www.MyWorkplaceExcellence.com or 208-375-7606.
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AHRA Scrapbook
AHRA 2019 SCRAPBOOK AHRA is a professional organization representing management at all levels of hospital imaging departments, freestanding imaging centers and group practices. The annual Meeting attracts more than 1,000 medical imaging leaders, offering the opportunity to network with industry peers from across the country and gain insight into health care services, tools and trends. It also offers more than 70 educational sessions. ICE magazine was among more than 150 leading industry exhibitors and held a special happy hour where attendees and exhibitors were able to network. ICE
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AHRA Scrapbook 1. Stuart Birkinbine from Merry X-ray Corporation waits for the exhibit hall to open at the annual 2019 AHRA Annual Meeting and Exposition.
5. ICE Editor John Wallace, right, and Accountant Executive Megan Cabot answer an attendee’s questions about ICE magazine and the ICE conference.
2. Mark Curley from Richardson Electronics gives a thumbs up from the exhibit hall.
6. MD Publishing Director of Sales Jayme McKelvey speaks with VIP guests at a Happy Hour hosted by ICE magazine.
3. Injector Support and Service’s dynamic duo of Ryan and Jennifer Clarke are ready to greet attendees.
7. The educational sessions at AHRA provided great insights.
4. ICE magazine gave away a plush Chill the polar bear and a waterproof Bluetooth speaker as part of a prize pack.
8. DEXA Solutions was represented by Jason Williams and Ethan Diehlman at the 2019 AHRA event.
9. The Johns Hopkins Hospital team of Michelle L. Casler and Samantha L. Mueller presented “Navigating Change Using Data: Our Journey Building a Department Dashboard” at AHRA. 10. MD Publishing Account Executive Megan Cabot listens to AHRA attendees during the ICE happy hour. 11. Industry veteran Scott Kincaid shares information about Althea with an AHRA attendee. 12. Summit Imaging were well represented at AHRA by Account Development Coordinator Jessica Pickard, CEO and CTO Larry Nguyen and Manager of Training and Education Kyle Grozelle.
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index
ADVERTISER INDEX Adel Lawrence Associates, Inc. p. 21
Injector Support & Service p. 37
Innovatus Imaging p. 3
Brandywine Imaging p. 37
InterMed Group p. 44
KEI Medical Imaging p. 51
Medical Imaging Technologies p. 28
PM Imaging Management p. 35
MedWrench p. IBC RSTI/Radiological Service Training Institute p. 8
Carolina Medical Parts p. 43
IMES – A Division of Richardson Healthcare p. 11 Diagnostic Solutions p. 15
MRIequip p. 18-19, 28
TECHNICAL
PROSPECTS
Experts in Siemens Medical Imaging
Technical Prospects p. 13
DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS
International X-Ray Brokers p. 35
Exclusive Medical Solutions, Inc. p. 51 KEI MED Parts p. 21
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Oxford Instruments Healthcare p. 2
ICEMAGAZINE | SEPTEMBER 2019
Multi Diagnostic Imaging Solutions Back Cover
MW Imaging Corp. p. 5
SOLUTIONS
Tri-Imaging Solutions p. 4
Webinar Wednesday p. 47
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