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ICE FEATURES
OCTOBER 2019
“ Our employees are some of the most dedicated people I’ve ever come in contact with.” – John Bell
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Taking it to the People: Mobile Mammography Services Bring Breast Care to Vulnerable Communities
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Mobile mammography services bring breast care to vulnerable communities in rural areas and in big cities, including the Big Apple. The very presence of a mobile mammography unit can remove barriers to screening that are self-imposed by patients.
Professional of the Month: William Lankford, CBET William Lankford, CBET, is an imaging specialist in the healthcare technology management department at WVU Medicine. He says “working in the imaging field has been challenging and enjoyable; I would encourage anyone to follow in my footsteps.” Page 20
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ADVANCING THE IMAGING PROFESSIONAL
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33 Solutions Guide 34 Tools of the Trade
45 Imaging Matters 46 Summit Imaging 48 Daniel Bobinski 53 Photo Contest 54 Index
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IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY First U.S. Facility Installs Adopt Mobilett Elara Max UCHealth Greeley Hospital of Greeley, Colorado, recently became the first health care facility in the United States to adopt the Mobilett Elara Max, a mobile X-ray system from Siemens Healthineers that enables comprehensive IT security as well as secure system integration into the hospital’s IT environment. UCHealth Greeley has installed two Mobilett Elara Max systems: a standard model and a pediatric-friendly version featuring a giraffe design. In addition to a security package that helps facilities cope with cyber threats and virtual workstation technology that permits bedside access to patient information, the Mobilett Elara Max has an ergonomic design complete with an antimicrobial coating and fully integrated cables for an unobstructed front view that enables smooth, safe maneuverability. The system also provides 180-degree lateral
arm movement that maximizes positioning options. “UCHealth Greeley Hospital is proud to acquire these Mobilett Elara Max mobile X-ray systems, which are exceptionally user-friendly for our technologists, in addition to offering improved screen sensitivity and several new line and tube settings,” said Melody Pierson, RT(R), CRA, manager of imaging services, UCHealth Greeley Hospital. “Siemens Healthineers is pleased to provide UCHealth Greeley Hospital with the first Mobilett Elara Max systems in the United States, arming them with advanced cybersecurity features as well as virtual workstation technology that digitalizes health care by allowing the technologist to remain at the patient’s bedside,” said Niral Patel, vice president of X-ray products and women’s health, Siemens Healthineers North America. •
MITA Congratulates Lisa Spellman on Appointment The Medical Imaging & Technology Alliance (MITA) has applauded the appointment of Lisa Spellman, MBA, AStd, to the Society for Standards Professionals (SES) 2019 Board of Directors where she will serve as education council director. Spellman is the general-secretary for the Digital Communications in Medicine (DICOM) for the Medical Imaging Technology Association (MITA). In this role, she provides strategic leadership and operations management for DICOM stakeholders worldwide. She is also the SES education committee chair and serves on the United States National Committee (USNC/ANSI) for Rules & Procedures and Finance committees. “Lisa is a leader who delivers real value to MITA members through her work with DICOM,” said Patrick Hope, MITA executive director. “We congratulate her and know she’ll bring a wealth of expertise to the entire standards community.” WWW.THEICECOMMUNITY.COM
Spellman has more than 15 years of experience in international standards development working directly with hundreds of SDOs, subject matter experts, vendors, governments, health ministries, NGOs and other related entities in the development of Standards. SES is a not-for-profit professional membership society dedicated to furthering the knowledge and use of standards and standardization. It also manages the world’s only certification program for standards professionals and provides a neutral forum where standards users and developers can come together to address mutual issues, opportunities and interests in ways that work to the benefit of everyone involved with, or affected by, standards. SES Members are primarily involved in the development, application, and use of company, government, national, regional, and international standards. • ICEMAGAZINE
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FLUOROspeed X1 RF System Receives FDA 510(k) Shimadzu Medical Systems USA (SMS), a subsidiary of Shimadzu Corporation, has announced FDA 510(k) clearance for the FLUOROspeed X1, patient side conventional RF table system. The FLUOROspeed X1 is a conventional RF table system offering high image quality and a multitude of features that improve work flow and operator efficiencies which contributes to lower cost of care. As the newest U.S. based product in the FLUOROspeed series, the FLUOROspeed X1 with its 665-pound static patient weight and 500-pound all motion weight, easily performs bariatric and routine daily fluoroscopic and radiographic exams. “The X1 is an outstanding RF system offering a cost-effective balance of functionality to support a wide range of general RF applications, such as chest, abdomen or extremities along with upper GIs, modified swallows and even joint injections,” says Charles Cassudakis, director of radiographic and RF modalities for SMS. “An ambidextrous control handle for the imaging deck along with fingertip access to APR’s, image recording functions and site-specific programmable function buttons, are all standard on the new X1 RF system, all improving room workflow.” Jim Mekker, product director for SMS emphasizes that, “The X1 was designed and built from years of collecting user feedback specifically from and for the U.S. marketplace and the result is a remarkable, user-friendly and highly effective RF system with exclusive features like a park anywhere imaging deck. Additionally, the X1 is built with Shimadzu’s world renown durability and reliability. This system belongs in every X-Ray department nationwide.” The FLUOROspeed X1 conventional RF system, designed with patient side table controls for the operator, is practically priced and comes equipped with a 17”x17” dynamic digital X-ray detector (FPD) in the table bucky allowing it to be used for fluoroscopy as well as radiographic exams. With its 31.5-inch aperture opening between table top and deck, the X1 is the ideal digital RF system providing access for imaging patients in wheelchairs, yet it can fit in smaller rooms where space is limited. Furthermore, by adding a second X-ray tube on an overhead rail, the system functionality and versatility of the room increases exponentially. The FLUOROspeed X1 received FDA 510(k) clearance in August and is available for sale throughout the U.S. •
RSNA Announces Global Learning Centers Program The Radiological Society of North America (RSNA) is launching a new RSNA Global Learning Centers (GLC) program beginning in 2020. By partnering with established radiology departments based in low- or middle-income countries to create the learning centers, RSNA aims to improve radiology education and patient care around the world. “The Global Learning Centers program offers a unique opportunity to develop a tailored education program, based on the specific needs and requirements of the host community,” said Umar Mahmood, M.D., Ph.D., RSNA board liaison for international affairs. “We will be able to tap into a wealth of RSNA resources and provide a team of dedicated volunteers to create a comprehensive, dynamic curriculum for the GLC.” Over a three-year period, a team of RSNA members will work with the GLC to develop a customized educational plan including a curriculum with hands-on training, didactic lectures, conferences, online courses and other education offerings. Based on the needs of the applicant institution, equipment and technical assistance will also be provided. It is anticipated that one GLC will be selected each year, with a maximum of three centers in operation simultaneously. RSNA is soliciting applications from radiology departments from eligible countries to apply to be a GLC and for RSNA members to join a team to work with GLC starting in 2020.To be considered as a GLC, applicant institutions: • Must be a university or hospital • Must be located in countries eligible to receive discounted RSNA dues • Must demonstrate a need for radiology education and resources • Must have an established radiology department (staffed with at least one radiologist) • Must have a team lead who will serve as a primary contact with English fluency Eligible institutions can apply online. Applications to be a GLC beginning in 2020 will be accepted until November 1, 2019. The RSNA Committee for International Radiology Education (CIRE) will review applications and communicate results in December 2019. • For more information, visit RSNA.org/GLC.
For more information, visit www.shimadzu-usa.com. 10
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ADVANCING THE IMAGING PROFESSIONAL
news FDA Issues Guidance on Diagnostic Ultrasound Systems, Transducers
‘X-Ray that Moves’ Wins Innovation Award
The FDA has released a final guidance that 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, manufacturers 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. For more information or to view the final guidance, visit https://www.fda.gov/regulatory-information/search-fda-guidance-documents/marketing-clearance-diagnostic-ultrasound-systems-and-transducers. •
Konica Minolta Healthcare Americas Inc. announced that Dynamic Digital Radiography (DDR), the company’s “X-ray that Moves” technology, won the inaugural Innovation Award at the 2019 annual meeting of the AHRA: Association for Medical Imaging Management. DDR is an enhanced X-ray technology that produces images that depict motion and can be fully annotated with diagrams to help radiologists provide more detailed clinical findings. AHRA launched an Innovation Showcase at the meeting to highlight the most groundbreaking technologies and services being exhibited. Fourteen new products were featured for all AHRA members to vote on the most innovative solution. “We are honored to receive the first ever Innovation Award and thank the AHRA and its members for this recognition. The award further validates what we’ve learned from our ongoing clinical studies: that Dynamic Digital Radiography has significant
potential to impact the diagnosis and management of pulmonary diseases and orthopedic conditions,” says Kirsten Doerfert, senior vice president marketing, Konica Minolta Healthcare. “Receiving the Innovation Award exemplifies what can be accomplished through innovation and re-imagining the capabilities of digital radiography. This transformative technology will enhance the clinician’s ability to make better decisions sooner and do more with less.” DDR enables clinicians to observe the dynamic interaction of anatomical structures, such as tissue and bone, with physiological changes over time. Konica Minolta launched DDR for pulmonary applications at this year’s AHRA meeting, in collaboration with Shimadzu Medical Systems USA. This collaborative partnership will accelerate commercialization in the U.S. • For more information, visit www. konicaminolta.com/medicalusa.
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news Tampa General Uses AI to Improve Care Tampa General Hospital launched a high-tech “mission control” clinical command center which uses artificial intelligence and predictive analytics to improve and better coordinate patient care at a lower cost. The hospital’s new center is called CareComm and has been developed in partnership with GE Healthcare. It features 20 artificial intelligence apps, video walls with 38 large screens, 32 work stations, multiple computer systems and a multi-disciplinary clinical team that includes doctors, nurses and allied health professionals. CareComm staff use these resources to predict the needs of patients and team members before they arise. With CareComm, Tampa General can anticipate potential roadblocks and issues in the care process, ensuring that rooms, equipment and medical professionals will be available for patients as soon as they’re needed. The center will improve quality while decreasing costs, said John Couris, president and CEO of Tampa General Hospital. “CareComm is a huge step in our journey to become the safest and most innovative academic health system in the country,”
Couris said. “We’re grateful to our physicians, nurses, staff and our GE Healthcare partners for helping us leverage technology to drive quality up and costs down. This means better care and lower costs for patients.” •
ENCORE Orian MR Upgrade Brings Latest Technology to Existing Customers Health care providers are challenged to offer the best possible patient care while lowering costs. Canon Medical Systems USA Inc. is helping to provide solutions for its customers with the launch of the ENCORE Orian MR upgrade program. The program enables users of Canon Medical’s MR systems, including the Vantage and Atlas, to upgrade their system to Canon Medical’s brand new MR, the Vantage Orian 1.5T, with significantly less downtime and a lower cost than purchasing a new system. With the ENCORE Orian MR upgrade, Canon Medical customers now have access to the Orian hardware and digital software platform that can help improve workflow and deliver clinical confidence. The upgrade includes an all-new detachable, dockable table option enabling preparation outside the scan room, enhancing workflow and allowing medical staff to respond to patient requirements quickly and easily. It also includes a re-designed digital gantry interface which displays important patient-related and coil information, allowing technologists to ensure a proper, complete setup without leaving the patient’s side. The Orian also includes the EasyTech software package, featuring: • NeuroLine+ to achieve outstanding scan consistency for all brain exams • SpineLine with its auto-locator functionality allows providers
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to plan spine studies quickly and easily and sagittal and coronal locators to set double-oblique slices, enhancing the reproducibility of follow-up exams • SUREVOI Knee to support the accurate alignment of the knee to the iso-center which reduces artifact-related re-scans, and KneeLine+ to improve reproducibility and image quality The all-new system enhancements come in addition to the existing patient-friendly MRI features Canon Medical offers, including the 71cm wide bore patient aperture, an optional MR Theater feature delivering an in-bore immersive virtual experience to encourage patients to relax and stay still, enabling clinicians to produce stable, high-quality imaging, along with Pianissimo technology, which significantly reduces the noise in and around the MRI environment, making exams even more comfortable and easier to complete. “The ENCORE Orian MR upgrade program gives existing customers access to the newest innovations in diagnostic technology to extend the life of their systems without the construction costs of a new installation,” said Jonathan Furuyama, managing director, MR business unit, Canon Medical Systems USA Inc. “Canon Medical is committed to our customers and to providing them with the technology they need to ensure they can provide optimal care for their patients.” ICE
ADVANCING THE IMAGING PROFESSIONAL
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• Lead Lined Cabinets • Radiation Barriers • Modular Booths/Walls • Lead Curtains • Lead Bricks • Sheet Lead • Borated Polyethylene • Leaded Glass & Acrylic • Lead Lined Storage Containers • X-Ray Rooms Design & Construction • In-House Design Assist Team
Innovatus Imaging Posts Record Growth
Innovatus Imaging Chairman Dennis Wulf recently announced record growth in service volume and revenue generated by the company’s Ultrasound Center of Excellence in Tulsa, Oklahoma. This growth is due to securing multiple contracts with independent distributor networks, imaging facilities, and securing new volume from existing customers for repair services for standard, TEE and 3D/4D and ultrasound probes. “Our volume for probe repair has grown exponentially under the leadership of Jonathan Hoffman, our general manager, who develops and executes operational processes for optimized efficiencies and quality outcomes,” said Wulf. “We are honored with the trust our clients, new and old, have and continue to put in us to deliver the 1.800.381.5335 | sales@marshield.com | www.MarShield.com loaners they need and the outcomes they expect.” ISO 2001- 2015, CAN/CSA Z299.2-85 CERTIFIED QUALITY MANAGEMENT SYSTEM Hoffman has been overseeing the day-to-day operations of the Tulsa Center of Excellence for probe repair since 2018. Under his direction, the company has substantially expanded its daily output, testing and repairing hundreds of makes and models of ultrasound probes. Overall the company has seen exponential growth since January 2019, putting out more volume per capita than ever, and with best in class outcomes. In other company news, Innovatus Imaging announced its RapidRepair program for Philips X8-2t TEE probes. This program is an extension of the company’s exclusive RapidRepair program for the Philips X7-2t, expanding the methodologies and processes for the X8. Few ultrasound probe repair companies have capabilities for the Philips X8-2t, and none other than Innovatus Imaging offers a proprietary program enabling them to get these complex, high-demand probes back in the hands of imaging professionals when a repair is needed in 3-5 days. “RapidRepair for the X8 is really game changing,“ says Matt Tomory. “Most facilities are coming up on the one-year warranty expiration and many facilities struggle with how Specializing in Philips, Picker/Marconi, Specializing in Siemens, Philips, Picker/Marconi, MRI & CT Systems Siemens, MRI & CT Systems to effectively manage costly replacements versus repairs when they fail. They also cannot afford to have them out of 512.477.1500 512.477.1500 operation for more than a few days. A RapidRepair process that gets probes evaluated, repaired, tested and returned in info@keimedparts.com info@keimedparts.com as little as five days is key to maintaining workflow, patient www.keimedparts.com www.keimedparts.com care and the financial bottom line.” •
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Philips Debuts Innovations at ESC 2019 Royal Philips showcased its latest cardiac care innovations at the ESC Congress 2019. At the congress, Philips showcased Release 5.0 of its EPIQ CVx cardiology platform for the first time in Europe. The platform includes automated applications for 2D assessment of the heart, as well as robust 3D right ventricle volume and ejection fraction measurements. Philips also announced that it is collaborating with digital health company LindaCare to combine the company’s OnePulse cloudbased solution for the remote monitoring of patients with cardiac implantable electronic devices (CIEDs) with the Philips IntelliSpace Cardiovascular informatics platform. “Monitoring and follow-up of cardiac arrhythmia patients with CIEDs can be often complex, with data trapped in different silos that need to be reviewed individually,” said Calum Cunningham, business leader for enterprise diagnostic informatics at Philips. “LindaCare’s innovative OnePulse solution consolidates this data, and by incorporating OnePulse into our IntelliSpace Cardiovascular platform, caregivers can see this additional information as part of the broader cardiovascular history of each patient, allowing them to make the most appropriate treatment decisions for each patient.” Philips IntelliSpace Cardiovascular is a web-based image and workflow management platform which streamlines the workflow of cardiology departments and across hospitals by consolidating multi-modality images and data and enabling access to an open ecosystem of cardiovascular software applications. The seamless combination of IntelliSpace Cardiovascular with LindaCare’s OnePulse solution allows clinicians to more easily access data from their patients’ CIEDs remotely. This results in a more seamless overall workflow, including alert man14
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agement and triaging, supporting more proactive care. Philips is also introducing a new module on IntelliSpace Cardiovascular which complements the remote monitoring workflow by automating, standardizing and streamlining reporting for patients with CIEDs during hospital visits. Both the OnePulse interface and the new module will be available on the platform later this year. At the ESC Congress 2019, Philips also highlighted the new advanced automation capabilities available on the EPIQ CVx cardiology ultrasound platform. By incorporating advanced automation, there is less variability between scans, leading to confident treatment decisions which benefits patients. The AutoStrain LV application uses advanced Automatic View Recognition technology to identify the different views of the heart, providing exceptional visualization and analysis of left ventricular function – extremely important diag-
nostic information for patients at risk of developing cardiovascular disease. Also new are the AutoStrain LA and AutoStrain RV applications, which automate the measurement of left atrial and right ventricular longitudinal strain respectively. By creating reliable and reproducible strain measurements for the left ventricle, left atrium and right ventricle, the AutoStrain LV, LA and RV applications support clinicians treating patients with atrial fibrillation, arrhythmia and other complex heart conditions. In other news, Philips has completed the previously announced acquisition of Carestream Health Inc.’s Healthcare Information Systems (HCIS) business in 26 of the 38 countries in which it operates. Carestream HCIS’s cloud-enabled enterprise imaging platform will expand Philips’ current enterprise diagnostic informatics solutions, including productivity enhancement, imaging data management, and advanced visualization and analysis. • ADVANCING THE IMAGING PROFESSIONAL
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PEOPLE ON THE MOVE By Matt Skoufalos
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Paramit Corporation of Morgan Hill, California named Bruce Richardson as president of its product development group. Richardson has 30 years of extensive experience in the medical and biotech industries. Named on 37 patents, he held a variety of executive and senior management positions. In 2007, Richardson founded Accel Biotech LLC., and the firm was acquired by Ximedica in 2016. Innovatus Imaging of Pittsburgh, Pennsylvania named Dave Johnson its CEO, replacing founder Dennis Wulf, who will now serve as chairman of the board. Johnson most recently served as CEO of Joerns Healthcare; he was a team leader in the development of Stryker’s acute care and ICU beds, ER and EMS stretchers; ConMed’s GI/endosurgery products and Invacare’s power rehab, continuing care and personal care line.
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Shield Diagnostics of San Jose, California appointed David Esposito to its board of directors. Esposito is CEO of ONL Therapeutics, the former CEO of Armune BioScience, and has been president of Phadia US Inc.
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Varian of Palo Alto, California named Phil Febbo, chief medical officer at Illumina, to its board of directors. Febbo has held his current position with Illumina since 2018. He previously served as CMO of Genomic Health, was a professor of medicine and urology at the University of California, San Francisco (UCSF), and currently serves on the board of the American College of Medical Genetics and Genomics Foundation.
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MCRA of Washington, D.C. named Tonya N. Dowd its vice president of reimbursement, health economics and market access. Dowd most recently was global franchise director, healthcare economics and market access at Johnson & Johnson Medical Devices. She has 25 years of reimbursement and market access experience and holds an MPH from the University of California Los Angeles.
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The Aurora-based Children’s Hospital Colorado added Luis De La Torre as assistant director of its international center for colorectal and urogenital care. De La Torre has more than 30 years of experience in pediatric colorectal surgery and urogenital medicine, and joins the hospital from the Children’s Hospital of Pittsburgh of UPMC. Technical Prospects of Appleton, Wisconsin has added imaging support engineer and technical trainer Joseph Sam as a trainer and member of its 24x7 customer support team. Sam has more than 15 years of field service and support experience in the diagnostic imaging industry, with additional specialization in Siemens MRI/CT and extensive knowledge in multivendor systems.
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The Medical Imaging & Technology Alliance (MITA) of Washington, D.C. saw Lisa Spellman, its general-secretary for the Digital Communications in Medicine (DICOM) appointed to the Society for Standards Professionals (SES) 2019 Board of Directors, where she will serve as education council director. Spellman is also the SES Education Committee Chair and serves on the United States National Committee (USNC/ANSI) for Rules & Procedures and Finance Committees.
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Banner Health of Phoenix, Arizona has appointed Peter Nakaji as physician executive of neurosurgery at Banner Health, physician executive director of the Banner–University Medicine Neuroscience Institute, and chair of the department of neurosurgery at Banner for the University of Arizona College of Medicine–Phoenix. Nakaji joins Banner from Barrow Brain and Spine, where he has practiced for 15 years. He has also served for nearly a decade as the director of the neurosurgery residency program at Barrow Neurological Institute. ICE
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news
INSIGHTFUL SESSIONS Benefit Rookies and Experts By John Wallace
T
he 2019 Webinar Wednesday Series eclipsed the 5,000 attendee mark in August with an average of 351 registrations per session. The series continues to deliver expert knowledge and continuing education on a wide variety of relevant topics. Attendees from a range of experience levels have viewed live and recorded presentations to earn continuing education credits. Strategic Planning The Webinar Wednesday presentation “Strategic Technology Planning – Process and Leading Practices” sponsored by MedWrench was a hit with attendees. “Strategic Technology Planning – Process and Leading Practices” was also eligible for 1 credit from the ACI. Carol Davis-Smith, CCE, FACCE, AAMIF, president of Carol Davis-Smith & Associates LLC delivered insightful knowledge in the session. Davis-Smith clarified what strategic technology planning is and is not. She reviewed the process and the supporting resources and explored how to initiate or enhance the strategic technology planning process within an organization. In a post-webinar survey, attendees
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“ Exceptionally good information. Wellorganized slides that were fantastic. This very much encapsulated how strategic planning should be done. I would love to see the presentation again to absorb more information.” – K. Hutton, principal were asked “How useful was the information presented in today’s webinar?” “I found this webinar very helpful. I am new to leadership and we had been trying to achieve the relationships spoken about in this webinar. The information got me even more motivated and excited to start up the conversations again,” Supervisor C. Haschke said. “Exceptionally good information. Well-organized slides that were fantastic. This very much encapsulated how strategic planning should be done. I was quite impressed with the scoring system and the process versus list. I would love to see the presentation again to absorb more information that it provided,” said K. Hutton, principal.
“This was probably the most useful Webinar Wednesday I’ve attended yet. I can see how the information presented could be overwhelming for younger technicians, but I found it very informative and comprehensive,” shared Director E. Oates. “Carol did a great job covering pertinent areas of strategic technology planning and the long-term importance of doing it effectively, especially as more medical devices become integrated into electronic medical records,” said Senior BMET D. Duck. “We are looking to improve our capital equipment planning strategy, and the content of this presentation will be helpful for our organization during this process improvement initiative,” Clinical Engineer M. Kopecki said.
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Patient Flow and Safety The Webinar Wednesday presentation “Clinical Engineering’s Role in Patient Flow and Safety” held July 31 was eligible for 1 credit from the ACI. The session was sponsored by Universal Medical (UMRi). In the 60-minute webinar, Craig Diener, senior product manager at Universal Medical, and Craig Snodgrass, national service manager at Universal Medical, discussed patient flow and safety and how the clinical engineering department can affect it. The duo also covered clinical applications and technical support, identifying the system type and configuration, as well as parts identification, shopping and installation. In a post-webinar survey, attendees were asked “What information did you learn during today’s webinar that you can apply to your role?” The responses included praise for the presentation. “I was enlightened by the fact some parts vendors offer an hour phone tech support with part sales to answer replacement related questions and may also have service manuals and tech tips,” J. Cozadd said. “That as a support person you are directly involved in patient care and therefore should take every measure possible to ensure patient safety,” said E. Stone, principal clinical engineer.
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“ I was enlightened by the fact some parts vendors offer an hour phone tech support with part sales to answer replacement related questions and may also have service manuals and tech tips.” – J. Cozadd Cybersecurity Roundtable The recent cybersecurity roundtable webinar helped imaging service professionals power up to the next level with great insights and helpful tips. 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 health care. Webinar Wednesday reached out to these experts to share more information about challenges, recent developments, health care-specific threats and more. Almost 200 people attended the live presentation. They were asked “How did today’s webinar meet your expectations?” in a post-webinar survey. “I liked how three different companies shared there different strategies for addressing network security,” said J. Cozadd. “Today’s webinar provided a good overview of medical IoT security concerns and how to monitor, track and document
associated actions,” said L. Riley, 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. ICE For more information about the Webinar Wednesday series, including a calendar of upcoming presentations and recordings of previous webinars, 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 William Lankford, CBET: Imaging Service to Pottery
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n the state of West Virginia, residents can get their health care needs and emergency hospital visits attended to by the West Virginia University Health System. WVU Medicine includes its flagship hospital, J.W. Ruby Memorial, and nine other hospitals. J.W. Ruby Memorial Hospital was named in honor of the late J.W. Ruby. Ruby’s late wife, Hazel Ruby McQuain, donated $8 million toward the construction of the hospital. Ruby started life as a farm boy in the early 1920s and worked his way up in the plating department of a company in Ohio. After relocating to Morgantown, West Virginia, he was put in charge of the Sterling Faucet plant. By the end of the war, he owned it. He later branched out into several business ventures. It was this success that later allowed his wife to make the sizable donation for the new hospital. Other hospitals in the system include Berkeley Medical Center in Martinsburg; Braxton County Memorial Hospital in Gassaway; Camden Clark Medical Center in Parkersburg; Jefferson Medical Center in Ranson; Potomac Valley Hospital in Keyser; Reynolds Memorial Hospital in Glen Dale; St. Joseph’s Hospital in Buckhannon; Summersville Regional Medical Center in Summersville and United Hospital Center in Bridgeport. William Lankford, CBET, is a biomedical
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Away from work, William Lankford enjoys pottery and motorcycle trips with his wife.
and imaging specialist in the healthcare technology management department at WVU Medicine. However, he had his sights set on a different kind of imaging in the beginning. “After high school, I went to art school for a year; I enjoyed photography but realized I didn’t want to do it as a job. After that I worked as a machinist for a couple years and decided I needed something more. I visited my local high school guidance counselor and he told me of a new associate degree program at Penn State that dealt with taking care of medical equipment. The next year, I started at Penn State and graduated with degrees in biomedical equipment technology and electrical engineering technology,” Lankford says. He says that in his second year of col-
lege, he was working part-time at a local community hospital where he also did his internship. “I was hired full time right after graduation. Shortly thereafter, I was contacted by West Virginia University to see if I would be interested in working there to help start a new department that was being created to support a new hospital, Ruby Memorial, which was in the planning stage of being built,” Lankford says. Lankford says that after the hospital was completed, he worked there for a couple of years as a biomed tech 2. “I was offered a job as a field engineer for a laboratory instrumentation company. I enjoyed working for the laboratory company, but I was starting a family and the travel was just too difficult. A position opened back at West Virginia University
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GET TO KNOW THE PRO Favorite book Anything by Clive Cussler, Lee Child or Stuart Woods. Easy reading “junk food for the mind.” Favorite movie “Deadpool” Favorite food Anything cooked on my Big Green Egg Hidden talent Pottery What’s on my bench? My computer monitors, coffee cup; lots of caffeine, green tea mints and Post-it reminders.
hospitals and I have been here ever since. When I was hired, I returned as a biomed tech 3,” he says. “About four years ago, I was offered a position in the radiology department as a senior tech working on imaging equipment. That position was recently absorbed back into the healthcare technology management department where I presently work as a biomedical specialist,” Lankford adds. The position in the radiology department came about after radiology approached the biomedical engineering director looking for assistance in supporting their one-man department. “I volunteered for the position, which started at 1/2 FTE with the other half supporting my assigned departments in biomed. After a couple years of this, the radiology department offered me an opportunity to join them full time,” Lankford says. Training has been an ongoing commitment for Lankford. “Since starting my career, I have attended 46 training schools on a variety of equipment from patient monitoring through multiple imaging devices,” Lankford adds.
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Flatwater kayaking is one of William Lankford’s hobbies. Knowing Your Inventory When Lankford started in radiology, the database was little more than a handwritten notebook. Because of his efforts, it now includes a complete inventory of over 80 X-ray devices, including extensive service histories in the CMMS. “When I started in radiology four years ago, there wasn’t a complete inventory of imaging equipment, and what little information there was; it wasn’t in a database,” he says. “I spent a lot of time adding devices into the biomed CMMS database. I added equipment and contacted vendors to inquire about service performed in the past. I data-mined their service reports and added that information to the CMMS database so we had an accurate service history for most devices. This was very helpful during our last Joint Commission review,” Landford adds. Away from the workplace, Lankford enjoys two-wheeled travel and creating pottery. “I have many outside interests, including traveling on our Harley Road King with my wife, flatwater kayaking, multiple home improvement projects and supporting the local sports teams. My main
hobby, and potentially my retirement job, is wheel throwing pottery,” he says. His family is very accomplished and he is justifiably proud. “My wife of 34 years, Colleen; she is the director of Christian Help, in Morgantown. My daughter Jessica graduated with three engineering degrees and is an instructor with the Naval Nuclear Propulsion Training Command in Charleston, South Carolina. My son Kris has a master’s degree in safety management engineering and is a safety manager with Black and Veatch telecom division in Columbus, Ohio,” Lankford says. Lankford says that he is just an average guy who made a lucky career choice. “Working at WVU Medicine has been great. Working in the imaging field has been challenging and enjoyable; I would encourage anyone to follow in my footsteps,” he says. For now, Lankford will make certain that the imaging devices at WVU Medicine work well; in the future, it may be a pottery wheel that needs attention. ICE
Favorite part of being an imaging professional? “The people I work with; I like coming to work most days.” ICEMAGAZINE
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people By K. Richard Douglas
DEPARTMENT SPOTLIGHT UAB Health System Department of Radiology Service Department
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cademic teaching hospitals play a special role in health care. They are more likely to be level 1 trauma centers, more likely to have pediatric ICUs and more likely to have burn care units. They provide a significant portion of hospital charity care. When the topic of academic teaching hospitals comes up, the first thought of many are the hospitals in the northeast, like Georgetown or Harvard. Indeed, one of the nation’s best is in Birmingham, Alabama. The University of Alabama at Birmingham (UAB) Health System is a top-ranked teaching hospital. It is a part of the University of Alabama School of Medicine. Established in 1945, UAB Hospital is the centerpiece of the UAB Health System. “The clinical engineering staff at UAB Health System is a part of the physics and engineering group in the department of radiology. We have nine physicists, six service engineers, and two quality control staff. Our service engineers and quality control staff have a combined 175 years of experience maintaining radiology imaging equipment. All are dedicated to radiology imaging,” says Johnny Watkins, chief equipment engineer in the department of radiology. The imaging team services most equipment including diagnostic X-ray, CT,
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PET/CT, MRI, PET/MRI, vascular imaging, nuclear medicine, ultrasound and mammography. “The overall scope of our department includes assistance in the selection of new equipment, planning and installation, physicist surveys of new equipment installed and maintenance during the life of the equipment,” Watkins says. “Biomed and imaging use the same administrative resources, but are free-standing,” he adds. Watkins says that his group supports 1,157 beds and that the hospital is one of the 20 largest hospitals in the U.S. and the third-largest public hospital in the U.S. “Our equipment includes 11 MRIs, one PET/MRI, 16 CT systems, two PET/CT systems, 12 nuclear medicine systems, 38 radiographic and fluoro rooms, 10 mammography systems, 17 vascular labs, 18 portable X-ray units and 34 C-arms. We support and manage all facilities except the Kirklin Clinic at Acton Road,” Watkins says. “We are OEM-trained in all modalities and operate on the model of ‘first call’ within the major modalities. Smaller equipment, such as C-arms; we go ‘at risk.’ We have no equipment managed 100 percent by the OEM,” Watkins says. He says that the only equipment they do not service is oncology/therapy equipment because they have their own physi-
cist and make decisions independently. Training is a key element of the department’s preparation. “For the major modalities, we receive training from the OEM in their training facilities. It is, however, becoming more popular to have onsite training if possible,” Watkins says. “Imaging equipment purchasing decisions are made collectively by our team leaders within the modality. This includes technologists, service engineers, physicists and administration. Physics and engineering do play a large role in planning and construction. We also have construction engineers within UAB that facilitate most large projects; also, a collective effort,” Watkins says. “As the chief engineer, I work closely with our department for sourcing and procurements to negotiate service contracts. Most of the parts we use are covered by service contract but I do source parts and have several third-party vendors I work with locally. Most user training is done by the manufacturer,” he adds. Improving the Budget with Internal Resources The team has focused on metrics that improve the patient experience and look for any weak links. “Within the last couple of years, we
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Medical Imaging Equipment Tech II Timothy O’Hara services a GE Healthcare Optima NM/CT 640 nuclear imaging machine. Photo Credit: University of Alabama at Birmingham
have been focused beyond the statistics of looking at numbers for equipment downtime and repair time. As in-house engineers, we can take a deeper look at how the particular downtime affected our patients. For example, was the patient moved to another room? Was the exam canceled? Was contrast used? Answering these questions can tell us if another imaging system is justified or a different back-up plan is needed,” Watkins says. He says that they also monitor and log each service call by the type of failure the system experienced. “Was it a software problem, mechanical trouble, defective component or maybe user error? We find monitoring these failure trends increases awareness we would not normally see in the larger scheme of things,” he adds. The team has also done its share to improve the bottom line and make the best use of resources.
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“Getting the most use from our equipment solves a lot of problems within our department and financially for the UAB Health System. Refurbishing older equipment to a quality standard, and making sure everything is updated to manufacturers’ specifications, extends the life of equipment,” Watkins says. He says that as in-house engineers, they have an opportunity to save critical dollars for the institution and perform at a high level with experience and continued training. “In the past, we’ve been able to completely refurbish portable X-ray systems with new components and skin to a like-new condition. Converting some of our older C-arms, from CRT displays to flat panel, has also made a significant improvement in image quality to extend the life for a few more years. Our department physicists test quality parameters on a yearly basis that helps us maintain a
high quality of imaging in every modality. Maintaining this level of image quality certainly reduces the user perception that equipment should be replaced sooner than later,” Watkins says. Watkins says that the team has also been able to move equipment to different facilities, which solves a lot of financial challenges. “With so many facilities, there always seems to be an opportunity to replace older equipment with newer technology and in better condition within the institution. When you have a view of all facilities, items like portable X-ray, C-arms, radiographic rooms and ultrasound system re-purposed properly can save significant capital dollars,” Watkins adds. When it comes to the crème-de-lacrème of America’s hospitals, the UAB health system, its extensive imaging capabilities and top-notch service engineers are hard to beat. ICE
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PRODUCT SPOTLIGHT Breast Imaging Market Growth Continues
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ccording to a new market research report published by Meticulous Research, the global breast imaging market is expected to grow at a compound annual growth rate (CAGR) of 8.2% from 2019 to 2024. The report states that the market will reach $5.13 billion by 2024. “Previously, breast imaging was done using X-ray film, analog or other traditional mammograms; however, these products used to come with drawbacks such as inability to examine dense breast tissue, longer procedure for viewing mammogram, ability to capture only two images of each breast, and less allowance to undergo mammographic examination for woman over age 40,” according to a press release. “Thus, to overcome these drawbacks, digital mammography came into existence. These digital systems are able to capture tiny calcium deposits which may lead to cancer or any abnormality, with low dosage. Moreover, digital files can be easily enhanced and shared to clinicians at any locations. Most of the women aged 40 years and above prefer to undergo routine mammographic examinations as it is covered by health insurance in most of the countries. Though, there is emergence of digital mammography, not all systems are able to detect abnormalities in dense breast tissue.” WWW.THEICECOMMUNITY.COM
“Therefore, researchers developed new technology called tomosynthesis, which can accurately determine breast cancer from dense breast tissue. Moreover, this technology reduces the patient recall rate up to 30%. Similarly, this technology has comparatively low cost because of less false positive and false negative errors,” the release adds. “Such advancements in the breast imaging technology and growing awareness about the timely diagnosis of the disease for better care in women are driving the growth of breast imaging market.” In addition, rising prevalence and incidence of breast cancer, increasing funding in R&D for breast cancer treatments, and an aging population further drives the growth of the overall breast imaging market, according to the report. The breast imaging market is primarily segmented on the basis of technology, end user and geography. On the basis of technology, the overall breast imaging market is mainly categorized into two segments – ionizing technology and non-ionizing technology. “On the basis of technology, ionizing technology is estimated to command the largest share of the overall breast imaging market in 2019,” according to the release. “On the other hand, non-ionizing technology is expected to grow at
the highest CAGR, owing to advantages such as enhanced safety, accurate detection of breast tumor location and higher sensitivity for smaller breast lesions in dense-breast women.” Geographically, the global breast imaging market is segmented into North America, Europe, Asia-Pacific, Latin America, and Middle East and Africa. With an accelerated economic growth in many countries and a growing government focus on health care, Asia-Pacific breast imaging market is expected to grow at the highest CAGR from 2019 to 2024. In addition, a rising incidence and prevalence of breast tumors, increasing health insurance penetration and an aging population are further expected to drive the growth of the breast imaging market in this region. The release states that the global breast imaging market is dominated by Hologic Inc., GE Healthcare and Siemens Healthcare GmbH. Some additional companies operating in the global breast imaging market are Carestream Health Inc., Koninklijke Philips N.V., FUJIFILM Holdings America Corporation, Canon Medical Systems Corporation and Hitachi Medical Systems. ICE
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Canon Medical System Aplio a-series Canon Medical System’s recently launched Aplio a-series delivers high performance for multiple clinical uses, including breast imaging, at an affordable price point. The a-series is a feature-rich solution that can be configured with a range of breast transducers. Featuring MicroPure technology, the a-series is equipped to improve visualization of microcalcifications in breast tissue, a potential marker for malignancy. Through non-invasive and qualitative assessment, the a-series’ elastography suite provides a visual representation of the elasticity of breast lesions following manual compressions. 3D Shear Wave technology within the elastography suite supports more confident visualization of lesions.
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FUJIFILM Medical Systems U.S.A. Inc. ASPIRE Cristalle FUJIFILM Medical Systems U.S.A. Inc. presents its latest advancement in digital mammography, the ASPIRE Cristalle with digital breast tomosynthesis (DBT) option and state-of-the-art dose-saving Hexagonal Close Pattern (HCP) image capture technology for exceptional image quality for all breast types. It is now available with new imaging software tools including Tomosynthesis Biopsy, S-View, Iterative Super-resolution Reconstruction (ISR), and Tomosynthesis Spot – innovative tools designed with the aim to meet the challenges of delivering exceptional image detail. The ASPIRE Cristalle is engineered with a focus on the patient experience helping ensure patients receive noticeably improved comfort with Fujifilm’s patented Comfort Paddle. For more information, visit www.fujimed.com.
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GE Healthcare SenoBright HD Performed as a follow-up to inconclusive mammography and ultrasound, SenoBright HD Contrast Enhanced Spectral Mammography (CESM) from GE Healthcare highlights areas of unusual blood flow patterns – all in a simple and quick procedure. CESM offers a high level of confidence for clinicians and patients, as it delivers clear image quality. The high specificity of SenoBright HD can help reduce the number of unnecessary biopsies and surgeries.1 The exam can be performed in less than seven minutes2 – using the same mammography equipment, in the same room, with the same staff. The next generation of SenoBright HD CESM is now available with Senographe Pristina, GE Healthcare’s latest mammography system. 1. Tardivel et al, Added Value of Contrast-Enhanced Spectral Mammography in Post-Screening Assessment; The Breast Journal, 2016 1–9; © 2016 Wiley Periodicals, Inc., 1075- 122X/16 2. Daniaux et al. Arch Gynecol Obstet, 2015
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Hologic Inc. SmartCurve Breast Stabilization The SmartCurve Breast Stabilization system from Hologic Inc. is clinically proven to deliver a more comfortable mammogram without compromising image quality, workflow or dose. It features a curved compression surface that mirrors the shape of a woman’s breast to reduce pinching and allow uniform compression over the entire breast, while its processing software is designed to take the geometry of the curved surface into account so the resulting images have the same appearance as images taken using standard compression. The SmartCurve system is available exclusively with Hologic’s Genius 3D Mammography exam, which is FDA approved as superior to conventional 2D mammography for all women, including those with dense breasts.
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KUBTEC Mozart Specimen Tomosynthesis System The Mozart System from KUBTEC is the only intraoperative specimen imaging system to use tomosynthesis to give the most accurate three dimensional images of excised specimens during breast cancer surgery. Clinical studies indicate that the Mozart Specimen Tomosynthesis System gives breast surgeons and radiologists the clearest view of their surgical margins and enable a reduction in post operative re-excisions of up to 50%. The high specificity of the technology can significantly reduce the requirement for routine cavity margin shaves, resulting in an increased preservation of healthy breast tissue.
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Philips Anatomical Intelligence for Breast The Philips Anatomical Intelligence for Breast (AI Breast) feature is a powerful software that allows for visual mapping of a patient’s anatomy for documenting full coverage during breast examinations with superb image quality. AI Breast enhances reproducibility and streamlines workflow while preserving image quality during a breast exam. The anatomical intelligence can automatically annotate scanned anatomy, with minimal user interaction, to give clinicians confidence while documenting full coverage of the breast during the acquisition phase. AI Breast is part of the Philips Ultimate Ultrasound Solution for Breast Assessment, that provides clinicians with a solution that brings together high-quality imaging with complementary clinical tools tailored for breast ultrasound exams.
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Siemens Healthineers MAMMOMAT Revelation The MAMMOMAT Revelation mammography platform from Siemens Healthineers is engineered to make the difference in early breast cancer detection, workflow, dose and patient comfort. HD Breast Tomosynthesis offers the widest image acquisition angle available at 50 degrees, resulting in the industry’s highest in-plane resolution for improved separation of overlapping breast tissue, and 3D imagequality, improving diagnostic confidence and aiding in earlier cancer detection. HD Breast Biopsy enables one-click targeting of suspicious areas with a +/- 1mm accuracy. The InSpect integrated specimen imaging tool permits imaging and real-time review of biopsy samples at the technologist workstation to improve biopsy workflow, shorten compression time and reduce patient discomfort. Also, the MAMMOMAT Revelation is the first platform to offer automated breast density measurement during a mammogram for immediate, personalized risk stratification and more personalized care.
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SOLUTIONS GUIDE Mammography
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As a word-class leader in medical imaging technology since 1982, AMPRONIX delivers customer-centric solutions tailored to meet the unique needs of your medical environment. We develop, distribute, and service medical imaging peripherals: diagnostic and surgical displays, medical grade recorders, signal converters, ultrasound machines and more. We have sold products in over 130 countries so we are able to provide you with the best price possible. Call Ampronix today for sales, service, or repair.
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International X-Ray Brokers 25 Conant Drive Brockton, MA 02301 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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RSTI/Radiological Service Training Institute SEE Anne Morrison-Registrar OUR AD 30745 Solon Rd. P. 15 Solon, OH 44139 Toll-Free: 833-229-7784 Phone: 440-349-4700 Fax: 440-349-2053 Email: registration@rsti-training.com Website: www.rsti-training.com Engineered for Learning; RSTI is the industry leader in basic, multi-vendor and product specific diagnostic imaging service training. Our educational programs focus on the repair and maintenance of today’s high-tech diagnostic imaging systems. RSTI’s training center is equipped with over 45 fully functional imaging systems to ensure RSTI students have unmatched hands-on learning opportunities to support their classroom education.
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Technical Prospects, LLC SEE 1000 South County Road CB OUR AD P. 35 Appleton, WI 54914 Toll-Free: 877-604-6583 Phone: 920-757-6583 Fax: 920-757-6591 Email: parts@technicalprospects.com Website: www.technicalprospects.com With over 20 years of experience with Siemens medical imaging parts, training and support, Technical Prospects is an industry expert. Technical Prospects has a DOA rate lower than OEM repaired parts. Providing quality-tested-parts at a cost-savings is a priority to ensure customers get their equipment up and running quickly.
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Summit Imaging, Inc. 15000 Woodinville-Redmond Road NE Building B, Suite 800 Woodinville, WA 98072 Phone: 866-586-3744 Fax: 866-586-3740 Email: Info@mysummitimaging.com Website: www.mysummitimaging.com Summit Imaging is an Ultrasound & Mammography equipment support organization that can quickly address specific technical needs based on a foundation of outstanding rapid customer service. Our philosophy is simple: make our customers heroes.
Varex Imaging Corporation 1678 Pioneer Road Salt Lake City, Utah 84104 Phone: 801-972-5000 Website: varexinfo.com/SIS
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At Varex Imaging, we aren’t just a supplier to our customers. We aim to be an extension of their teams; a partner in their success; a solution to their problem. Our goal is to help our customers become world-class system suppliers by strengthening their competitiveness and enabling them to bring products to market faster. Our rich history spans 65+ years of dedication to the imaging industry. Our knowledge, our people, and our innovation make us who we are. At Varex Imaging, we are Solutions in Sight™.
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TOOLS OF THE TRADE Radcal Accu-Gold Touch for X-Ray QA
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he Accu-Gold Touch Series is Radcal’s newest line of stand-alone X-ray test instruments. These measurement systems incorporate a large capacitive for a bright and straightforward user experience. In addition, the Accu-Gold Touch provides access to the full lineup of Accu-Gold sensors. The Accu-Gold Touch provides the accuracy and reliability you’ve come to expect from Radcal in an economical package. Alternatively, the Accu-Gold Touch Professional Series provides wired and wireless computer interfaces. Using the Accu-Gold Windows application, users are able to access a rich set of advanced capabilities such as automated Excel-based reporting and waveform analysis. Current Accu-Gold system users can explore the Accu-Gold Touch conversion option. ICE
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TAKING IT TO THE PEOPLE Mobile Mammography Services Bring Breast Care to Vulnerable Communities By Matt Skoufalos
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The Texas-based nonprofit The Rose provides breast health options to those in need throughout rural Texas.
hroughout the United States, health care, like many other resources, is unevenly distributed. In eastern Tennessee, at the foothills of the Appalachian Mountains, that truth is plainly spelled out in some of the most needy communities in the state. There, surgical oncologist John Bell has worked to drive down the disproportionate incidence of advancedstage diseases among residents of the region, a staggering fact that manifested itself in epidemiological data he first explored 25 years ago. Bell runs the University of Tennessee Medical Center (UTMC) Cancer Institute Breast Health Outreach Program (BHOP), a community outreach health initiative that he said sprang from a conversation with the then-director of the UTMC pastoral care program, the Reverend George Dobbler. “Since he was clergy, and we live in the Bible Belt, we thought the best way to start this program was through the churches, where people generally listen to what the pastor has to say,” Bell said. “I began to look at different counties that touched our service area, and identified some that we thought were not meeting, from a statistical
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cover story point of view, anticipated numbers of new cases.” With financial backing from cosmetics companies Avon and Revlon, Bell launched the BHOP mobile mammography service in two east Tennessee counties. Today, it serves about 20 of them with a combination of health education and cancer screening services. With the help of community outreach organizations, BHOP seeks opportunities to deliver those services to some of the people least likely, for reasons of time and financial resources, to get them. Their common barriers to access are financial, emotional and, often, physical. “The education level here is not generally what you’re going to find in an more ‘sophisticated’ urban area,” Bell said. “You’re going to find a high percentage of working-poor women, who don’t have the means, time, or knowledge to get to an imaging facility – if they’re trying to go to a facility – and then they often have to overcome their initial fears.”
staff that supports this program. It’s a full, comprehensive service.” Many women most in need of breast cancer screenings can’t take time off work to schedule a mammogram. This includes shift workers and single parents upon whom households depend financially. Given a cancer diagnosis, many also wouldn’t be able to take time off work to receive appropriate treatment. So they avoid mammography for fear of discovering a problem. “I think it boils down to one word: fear. They are afraid of what they’re going to find out,” Bell said. “They’re afraid of what treatment they might have to undergo because there’s still a lot of antiquated thoughts in some of these rural areas,” he said. “They think about the side-effects of treatment, and it’s hard for them to understand that the diagnosis of breast cancer is not a death sentence; that early diagnosis leads to care. Treatment options have come so far that surgery is not mutilating; oral anti-cancer agents have minimal-to-no side effects and allow people to continue to work and care for their families while they’re being treated.” “It’s overcoming this fear of what they might find and talking them off the ledge that leads them to obtain the education and screening that can be life-saving,” Bell said. More than talking women off the ledge, however, BHOP has made a noticeable dent in the number of cancers that otherwise wouldn’t have been detected among a population least equipped, resource-wise, to face the disease. In its early days as a two-county pilot project, BHOP screened 60 women and found two cancers. Of those cases, many were in their advanced stages. After 25 years, “it’s pretty rare that we find anybody that’s beyond a Stage I or II,” Bell said. Since 2002, BHOP has averaged approximately 2,200 mobile mammograms per year, with 2018, in which 3,548 mobile studies were conducted, its busiest yet. Anywhere between 6 and 10 percent of those studies are the first mammograms patients have ever undergone – about 200
“ OUR EMPLOYEES ARE SOME OF THE MOST DEDICATED PEOPLE I’VE EVER COME IN CONTACT WITH.” JOHN BELL
In addition to its dedicated technical and medical staff, BHOP breast health educators are versed in early warning signs of breast cancer and self-examination techniques. They can teach patients how to identify breast abnormalities, and they provide didactic, hands-on education that Bell described as better than “throwing some brochures on a table” at a health fair. “Our employees are some of the most dedicated people I’ve ever come in contact with,” he said. “What they do and what they give up, being ready to teach a class at 6 a.m. after these women get off the night shift … I cannot say enough about the
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per year, Bell said – and many of the women screened today are return customers, which demonstrates the need for those services. At the heart of the mobile program is a 3D tomography system. Bell estimates the mobile units have traveled about a quarterof-a-million miles since 2005. Soon, the 3D equipment will be transferred to a new vehicle, “and we’re going to keep working,” he said. Operating with a state-of-the-art diagnostic tool offers a multitude of benefits, Bell said. It enables BHOP screeners to find cancers earlier and yields better-quality images, reducing the rate of callbacks, lowering the cost of performing the studies, and offering a higher likelihood of detecting multiple tumors. It’s kept in tip-top shape by a dedicated service staff, Bell said. “We QA that piece of equipment every time we roll it out, we digitally transmit those images back to our home center, and the images are read within 24 to 48 hours,” he said. In the event that a study reveals the need for follow-up, BHOP nurse navigators “reach out to each patient and make sure they don’t fall through the cracks,” Bell said. “In the final analysis, all the program is trying to do is to provide a service to women that are otherwise underserved, hoping to find breast cancers early and save lives,” Bell said. Similar to the efforts undertaken by BHOP, Texas-based nonprofit The Rose has been working to improve awareness of breast cancer and access to diagnostic screening tools since 1986. Headquartered out of Houston, The Rose focuses on delivering breast imaging services to women who lack the ability to pay for those services, especially those living in rural communities. Chief Operating Officer Bernice Joseph estimates that its mobile mammography program, which has been operating since 2006, performs anywhere from 8,500 to 10,000 mammograms a year, backed in part by state funds and those from independent foundations, like the Susan G. Komen Foundation. The Rose started out with a small van containing portable imaging equipment; today, the organization operates a fleet of 40-foot coaches equipped with mobile mammography systems on par with those in its fixed-site, ACR-accredited breast centers
ADVANCING THE IMAGING PROFESSIONAL
cover story The University of Tennessee Medical Center (UTMC) Cancer Institute Breast Health Outreach Program (BHOP) conducted more than 3,500 studies in 2018.
of excellence. Onboard counselors provide a network of additional support services, from clinical education to follow-up services, for the women screened at The Rose outreach events. Today, of the 40,000 patients seen annually by the agency, roughly a quarter of them are screened through its mobile mammography program. “We believe that all women, regardless of whether they are insured or uninsured, should have access to 3D imaging,” Joseph said. Jessica Duckworth, The Rose’s director of imaging and mobile services, estimates that its mobile units cover a geographic area of more than 30,000 square miles in a 40-county radius. It’s not uncommon for the mobile coach and its staff to spend six hours a day on the road, out and back, to communities where 3D mammography and computeraided cancer detection systems may otherwise be inaccessible to locals. When using such high-end technology to deliver high-stakes screenings, “one of the first and foremost things you have to be able to do is create trust,” Joseph said. Just like with BHOP, a lot of that work is done through a network of partners on the ground. Community organizations – federally qualified health centers, charity clinics,
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physician’s offices, United Way chapters, employers – not only help drive attendance on the days the vehicle is in town, but they also identify which patients might need help covering the cost of the studies. “Here we are driving up from the big city of Houston,” Joseph said. “We have the funding to be able to provide those services at no cost to the patient, but what we need is a community partner to get the women there.” “We also find people who want to support us by helping us fund that uninsured care,” she said. “If [Duckworth] finds something on that screened mammogram, we can take the patients back to our centers.” “It doesn’t help to tell an uninsured woman we saw something that needs more study,” Joseph said. “We have a place for her to get that care.” In the future, Joseph anticipates forming additional clinical partnerships with practitioners who can provide other health screening services “that many women may never have the opportunity to take advantage of,” from gynecological care to mental health; even genetic counseling. “We talk to a lot of different organizations about what they think might work in their community, but our biggest challenge is what do they think they might need, and how do
we improve the health of the community,” she said. “For us, the evaluating process is just as important as the screening process.” Economically vulnerable women don’t only exist in rural areas, as Laurie Margolies, chief of breast imaging for Mount Sinai Health Systems, can attest. In 2016, when the New York State Department of Health and Health Research Inc. announced a multi-million-dollar funding opportunity to create six mobile mammography vans, Margolies drafted a winning proposal on behalf of Mount Sinai Hospital. In October 2018, the health system rolled out its mobile mammography program (MMP); inside a year, it’s connected with 1,600 patients and identified six cancers that may have otherwise gone undiagnosed. “We go out, five or six days a week,” Margolies said; “to every borough of New York City at least once a month.” “In the urban areas, just like in the rural areas, there are many barriers to health care access, and screening mammography is one of those areas that can be greatly impacted by bringing a mobile mammography van to an area,” she said. The Mount Sinai MMP van is equipped with the same high-quality imaging equipment the organization uses in its
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Photos courtesty Mount Sinai Health System
Mount Sinai Health Systems brings easy access to breast health to all five New York City boroughs.
“IN THE URBAN AREAS, JUST LIKE IN THE RURAL AREAS, THERE ARE MANY BARRIERS TO HEALTH cancer screening services. CARE ACCESS.” Those community connections
fixed site, a Hologic 3Dimensions mammography system. A team of drivers, technologists and patient navigators offers a complete suite of services for women seen through the service, and Margolies oversees 14 radiologists who interpret the studies the MMP generates. Mount Sinai coordinates follow-up services for patients whose mammograms show a need for further investigation. “It reaches people who are distressed or unable to access care otherwise, and in a very cost-efficient way,” Margolies said. The cost of an annual mammogram typically is covered by health insurance, and CDC grants administered by the New York state cancer services program are available to help those patients who are uninsured. The MMP “really addresses some of the patients’ needs by not having to travel, by not having to make an appointment or have a prescription, and without concern for their insurance status, for the most part,” Margolies said. As in other mobile mammography programs, Mount Sinai’s leverages partnerships with community organizations to identify vulnerable audiences that otherwise might not have access to breast 40
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bridge service providers and the populations they support, and also help acclimate patients to the MMP who have never participated in a mobile health care screening. “Allowing the mobile bus to be partnered with people they trust, be it a health care facility, a religious organization or a community center, really helps patients who may have a distrust of the whole medical health care infrastructure to overcome that and get the necessary screening,” Margolies said. “Community organizations have been incredibly grateful that this service is available for their constituents,” she said. “Sometimes people are a little bit hesitant to get their medical care on a mobile unit, but once they’ve done it, the research shows that they are uniformly very happy with the care they’ve received.” Vitally, the MMP has helped individual patients who were reluctant to be
LAURIE MARGOLIES
screened for breast health, or who had dismissed mammography as unnecessary because they had no family history of breast cancer. Unfortunately, as Margolies noted, most breast cancer patients have no family history of the disease. “They were very afraid, but they are incredibly grateful that things are caught,” she said. Perhaps most importantly, Margolies said, the very presence of a mobile mammography unit can remove barriers to screening that are self-imposed by patients. “One woman knew that she needed a mammogram, and her doctor was telling her to get one, and when the bus was in front of her, she didn’t have any excuse any more,” she said. “It’s invaluable to the patient, and in health care, helping patients is our goal.” ICE
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CAREER CENTER
Written by Cindy Stephens Stephens International Recruiting Inc.
Leadership Strategies for Retaining Top Talent
S
taffing shortages have changed the focus of hiring practices and employee retention strategies. Candidates have great opportunities with many companies attempting to recruit them. Many employees won’t hesitate to leave an organization for a better opportunity. Although understanding the reasons for losing top talent is crucial, having an excellent hiring and retention policy in place is critical. Many imaging service engineers leave a job because of salary and compensation issues or for opportunities for growth. However, many factors for leaving an organization include “windshield time” and the often-extended time away from their families because of the huge service areas they cover. Work-life balance is a huge factor as well as feeling like a valued member of the organization. Other reasons for leaving include a lack of additional training or a lack of potential career progression. With the increase in demand for quality imaging service professionals and the decline in available talent for these vital positions, it is more important than ever for leaders to focus on the development and retention of top performing employees. This is especially important for a successful imaging service department. Effective employee retention strategies
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should result in attracting as well as keeping key employees who are top performers, reducing turnover and related costs of recruitment and training. Consider the value of attracting and retaining quality talent, rather than continually replacing staff because competitors have more to offer. Ensure your organization is the employer of “choice” and that it can offer more to prospective candidates than the competition. A successful retention strategy includes key factors such as a competitive salary and benefits, measurable performance objectives, effective communication processes, training and initiatives to encourage employee commitment. Tailor benefits to individual needs. Effective leadership is a major factor in employee satisfaction, motivation and retention. Leaders who focus on strategies to motivate and inspire employees to contribute to the overall success of the department and organization will strengthen their retention efforts. Leaders who are supportive and focus more on the needs and expectations of employees will find them to be more engaged and dedicated. Engaged employees have a high level of commitment, loyalty, and passion resulting in high job satisfaction and productive performance.
The first step to employee retention, ensuring new hires are the right fit for the job and the culture of the organization. On-boarding is an important part of the process so the employee understands the importance of the position and responsibilities involved. Leaders should make employees feel valued as well as competent with their new duties beginning with the first day of employment. Ongoing training and competency reviews will help reinforce individual skill sets and proficiency in the position. Imaging service engineers often enjoy sharing knowledge and skills with other imaging service staff. Therefore, it is a good strategy for leaders to encourage and provide opportunities for sharing this knowledge through in-house training programs, presentations, job sharing, etc. Recognition for hard work and successful completion of special projects is important. A simple acknowledgement of appreciation via a hand-written note, verbal appreciation in front of a group or a gift card goes a long way. Growth opportunities or a career path for imaging service engineers within the organization will provide long-term retention, too. Encourage and recognize leadership, professional development and other training within the department. Provide
ADVANCING THE IMAGING PROFESSIONAL
funds and opportunities for certification training and accessibility to accomplish the certification. Consider bonuses for completion of specific training and certification. By investing in your team and building on their skills, employees gain a sense of success and accomplishment that they can be proud of. More than ever before, salary, compensation and benefits are very important. Candidates will go with the company who has the most to offer in salary and compensation as well as the quality of the work environment. When salary and compensation are close for similar positions, candidates will consider other criteria to see which company is the best fit. An organization’s culture is critical and, in this small industry, reputations
are a big consideration, too. After all, most candidates do not want to work for a company with a bad reputation or for a company known for treating employees poorly or not providing appropriate compensation, benefits and a good work-life balance. Retaining top employees should be a major concern since other competing organizations are going to do whatever they can to hire your best talent for their open positions. If you do not retain top talent, it may impact the level of experience, skills and reliability needed for excellent customer service. It is especially important for imaging service department leaders to focus on hiring and retention strategies to retain top performing employees in today’s very competitive market. ICE
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IMAGING MATTERS
Written by John Garrett Director of a Clinical Engineering Department in CHI
Letting Go
K
nowing when to let go can be a challenge. You see it everywhere for various reasons. There are emotional attachments, the fear of something new and sometimes there are financial obligations that make it difficult. However, sometimes you just need to let go of equipment and replace it with something new. Obviously, imaging equipment is not cheap nor easy to replace. The process of deciding to replace equipment is challenging and often painful. After accessing what is available, there is the process of getting quotes, making sure that the capital is available, attempting to keep doctors and users happy or at least grudgingly satisfied with whatever is purchased. Then there is the need for room remodeling, making sure the new unit has a footprint that fits in the space available, and the dreaded interface with IT. The result of buying new equipment should be that there is improved treatment for a patient. But, an X-ray is just an X-ray, isn’t it? As equipment ages, the hospital or imaging center should be calculating depreciation of the asset. This is with all imaging modalities and medical equipment. From this calculation alone there will be a point where the equipment should be replaced. However, there are
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“There are times when a major repair will have the hospital in a situation where it is illogical to keep repairing the equipment.” times when a major repair will have the hospital in a situation where it is illogical to keep repairing the equipment. When this point is reached, the money spent repairing the equipment would be better spent as part of a new capital purchase. It drives up the hospital’s (or imaging center’s) cost to care for patients. This is not good for the company or the patient. It will contribute to worse outcomes over time. This most commonly happens when there is not a robust capital purchasing plan in place. What can be done to assist? Having a purchase price and knowing the depreciation of the equipment is a start. There are industry standards for expected life of different modalities of equipment that can be used for calculation, or your CFO can assist. Knowing what you have
spent repairing the equipment is key. This should be able to be pulled from your computerized maintenance management system (CMMS). This calculation includes the cost of any in-house labor. What downtime costs the department is an important figure in the calculation. Knowing the yearly total cost of ownership is key in proper capital planning. This includes preventive and corrective maintenance costs as well as downtime costs. Accurate documentation of these items should be a standard part of the process. This documentation allows for a CMMS to report your cost of ownership. Obviously, as equipment ages it is expected that the yearly cost increases. Working with the owner of the capital process will allow them to make the most informed decisions and plan accordingly. ICE
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SPECIAL ADVERTISING SECTION
WHAT YOU DON’T KNOW ABOUT TRANSDUCER REPAIRS COULD IMPACT PATIENT CARE Written by Carolyn T. Coffin, MPH, RDMS, RVT, RDCS and Matthew Schwartz, MFA, RDMS
E
very profession has a set of tools required for the work it performs and in health care, providers rely on durable medical equipment to perform their work tasks. There is an expectation that equipment purchased as used, or currently owned equipment that has been repaired, will function as well as new equipment purchased directly from the manufacturer. In sonography, an ultrasound system consists of several components that may need periodic maintenance, repair or replacement. Heavily used ultrasound transducers often require repairs for damaged housings, internal wiring or acoustic elements. As sonographers, our ability to provide diagnostic-quality images for our patients depends not only on technical skill but also on the exacting design and manufacture of transducers used to create diagnostic images. We assume there are governmental and institutional regulatory standards that ensure the quality of the equipment we bring into direct contact with patients. But what do you know about these quality standards, or what happens to your transducer when it is sent out for repairs? If you are supplied with a repaired or remanufactured transducer, how do you know if it has been rebuilt using the original manufacturer’s components and to the original manufacturer’s specifications? 46
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You may be surprised to learn about FDA regulatory policies for the repair or replacement of medical devices that specifically apply to ultrasound transducers. Every new transducer design to be brought to market must be filed with a 510(k) submission to the FDA to validate compliance with a wide range of standard safety measures. However, there is no provision for this filing when an ultrasound transducer has been repaired or serviced. This exposes health care facilities to counterfeit medical devices, one that contains non-validated crystals and/or cable assemblies, both critical parts to provide high-quality diagnostic images, replaced with low-quality counterfeits from those of the original equipment manufacturer (OEM).1 These counterfeit parts are installed by third-party service entities and sold to the health care facility as OEM quality, which our simple study reveals is deceptive and inaccurate. The generation of a quality image encompasses far more than just acoustic power, and the impact of diagnostic quality on patient care decision-making can have far-reaching consequences. As an initial exploration of the concept, a comparison was performed using 2 OEM transducers (L9-3 and C5-1) and 2 remanufactured transducers of the same design origin that contained non-OEM
components to determine any difference in image quality. A tissue-equivalent phantom was scanned using each of the transducers to evaluate spatial resolution and acoustic penetration. The structures imaged in the phantom were a cluster of small, echogenic pins. A volunteer’s carotid artery was scanned to evaluate color saturation and vessel filling and to demonstrate the clarity of the intima-media thickness (IMT). All automatic image processing was turned off and a vascular pre-set was used for consistency. All transducers demonstrated the penetration expected for the transducer’s frequency. The pins in the phantom were imaged with higher resolution with the OEM transducers; the same structures scanned with the transducers that contained nonOEM components appeared “smeared” without good border resolution. The IMT of the carotid artery was slightly less clear with the remanufactured transducers as well. All tested transducers adequately demonstrated the carotid filling with color, but the transducers with non-OEM components generated images with more peripheral acoustic noise that could be appreciated as “fuzzy borders.” This limited transducer evaluation demonstrated that, while penetration appeared unchanged, there is some difference in the image quality between ADVANCING THE IMAGING PROFESSIONAL
insight
Below: L9-3 transducer with non-OEM components.
Above: L9-3 transducer with OEM components.
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transducers with OEM components and those with non-OEM components. The question remains, how might this difference in image quality influence patient care management? Diagnostic evidence of pathology not seen during an exam may result in unnecessary delays in a patient’s treatment. The resolution of small structures may be impacted the most. Accurately measuring the IMT, resolving small gallstones, precise imaging of the fetal heart structures and procedures involving needle guidance could be compromised by transducers that are no longer performing at the high standard of the original ultrasound system manufacturer. The cost savings of having a transducer repaired or remanufactured by a service facility that uses less-expensive, non-OEM components is not worth the loss of diagnostic confidence and the potential negative impact on patient care. ICE
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References 1. https://www.fda.gov/MedicalDevices/default.htm 2. FS Resnic, SLT Normand, Postmarketing surveillance of medical devices – filling in the gaps, New England of Medicine; March 2012; 366:875-877
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3. U.S. Food and Drug Administration, Guidance for Industry and FDA Staff - Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers - Sections 4 Through 6 and Appendix A Through H, https:// www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm089001.htm#e, accessed 3/31/19 4. U.S. Food and Drug Administration, White Paper: Evaluating Whether Activities are Servicing or Remanufacturing, https://www.fda. gov/downloads/MedicalDevices/ NewsEvents/WorkshopsConferences/UCM623972.pdf, accessed 3/31/19
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WHY PASSIONDRIVEN TEAMS ARE SO RARE H
ow’s your team doing? Is it focused and flowing, or does each day feel like a slog? My observations are that most teams today are nowhere near as effective as they could be. The reasons are many; lack of structure, lack of well-defined roles and responsibilities, and lack of communication, to name a few. But one reason overrides all the rest: a lack of passion. Passion is strongest when it exudes from a natural source, such as identifying and working within your true vocation. The ancient Roman poet and author Virgil understood this when he wrote, “Your profession is what you were put on earth to do with such passion and such intensity that it becomes spiritual in calling.” In a professional workplace, a person with such passion hopes for co-workers that share a similar mindset. After all, the passion levels of which Virgil speaks naturally give birth to deep levels of commitment, and commitment by all individuals on a team is necessary for teams to flourish. All it takes is one team player that’s not fully engaged, and the entire team suffers. One place where teams often flourish is in the military. For example, during a recent conversation with a decorated veteran on the topic of camaraderie, I was reminded of the strong team cohesion I experienced when I was a member of a military unit.
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My acquaintance and I both noted that we miss the synergy and effectiveness of strong team commitments. Even though my acquaintance now holds a prestigious executive position, his perception of most corporate leaders is that they are, “egocentric and driven by their own lust for glory rather than for the goals of the companies they lead.” Additionally, he doesn’t see many of them building strong teams. This conversation brought back vivid memories for me. Non-cohesive teams were an eye-opening befuddlement that I experienced after I left the military. Within a short time of becoming a civilian, I became acutely aware that strong team commitment rarely existed in the civilian workplace. If passionate teams are rare in the workplace, it is not for lack of trying by some. Tom Peters is one who’s done a lot of trying. Peters is a prolific writer and oft-quoted management guru, and he travels the globe trying to instill passion into the corporate world. In fact, Peters includes the word, “passion” in several of his book titles. By the way, his books are unconventionally written, but all are worth the time to read. Earlier I said that passion is strongest when it comes from a natural drive, but one must ask, “Can passion be taught? Can it be fostered?” The answer, I believe, is yes, but it takes effort. The key is to clearly spell out a
Written by Daniel Bobinski Workplace Consultant
team’s goals and objectives, and then find ways to tie those objectives to each team member’s value system. People tend to perk up and be more invested when their personal values are connected to the task at hand. That’s where the work comes in, because knowing someone’s interests and values doesn’t happen by osmosis. Team leaders must genuinely want to know the people on their team and make those connections. The problem is that some won’t. And if they don’t, why should anyone else? So perhaps you’re on a team but you’re not the team’s leader. You’re passionate about your work, but maybe your team leader isn’t. What do you do? There are two schools of thought when it comes making a change with teams. The late Peter Drucker was often referred to as the father of modern management, and his philosophy was, essentially, “Start at the top.” At the other end of the spectrum was Stephen Covey, author of the popular, “Seven Habits of Highly Effective People”. Covey’s philosophy was, “Start anywhere – just start.” I happen to agree with Covey on this one. If you think your team needs to unite more around a common cause and your team leader seems to be going through the motions, you can be the catalyst to get things going. After all, there are positional leaders and there
ADVANCING THE IMAGING PROFESSIONAL
insight are “social” leaders. All of that said, I readily acknowlIn other words, you don’t need to edge that people might not have much hold an official leadership position to interest in the work they are currently look ahead at what the team could or doing. A few years back I was facilitatshould be doing to be more effective, ing a series of management training and engage others to think about those classes for bank managers, and after I things, too. talked about creating passion-driven You also don’t need a leadership teams, one of them came to the next title to daily inspire and encourage othtraining session and stated he was ers toward the activities that will make giving notice. After 10 years with the the team more effective and efficient. company, he realized his passion was Nor do you need a leadership title to elsewhere, and he decided he was gobe dedicated and set a good example ing to shift careers and do what he was for others. passionate about. Large forest fires often start from a Also, there are people who don’t small flame, and large, thriving compaknow their true calling. Some have nies start from a basic idea. Of course, never given it much thought, and maybe you are in an official leadership perhaps others don’t want to know. For PROOF APPROVED CHANGES NEEDED role, but even if you’re not, you can still these reasons, managers and leaders be a catalyst – if you choose to do so. can have a tough time building pasCLIENT SIGN–OFF:
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sion-driven teams. Still, if you’re trying to build a passion-driven team, you’ll need to either learn about how your people are motivated and connect those motivations to the vision, or identify and recruit people who have a pre-existing, deeply held passion about the purpose of the team. Neither task is easy, but that’s why passion-driven teams are so rare. 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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ICEMAGAZINE
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index
ADVERTISER INDEX MRIequip p. 41
THE WORLD MOVES FAST. WE MOVE FASTER.™
626 Holdings p. 16
Stephens International Recruiting Inc. p. 35
IMES – A Division of Richardson Healthcare p. 11 DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS
Multi Diagnostic Imaging Solutions Back Cover
Ampronix p. 4 International X-Ray Brokers p. 43 Brandywine Imaging p. 53
TECHNICAL
MW Imaging Corp. p. 5
Technical Prospects p. 35
SOLUTIONS
Tri-Imaging Solutions p. 55
Carolina Medical Parts p. 41
Oxford Instruments Healthcare p. 2 Trisonics, Inc. p. 16
KEI Medical Imaging p. 47
PM Imaging Management p. 47 Exclusive Medical Solutions, Inc. p. 44
PROSPECTS
Experts in Siemens Medical Imaging
KEI MED Parts p. 13
Diagnostic Solutions p. 43
Summit Imaging p. 24
MarShield p. 13
Varex Imging p. 8
Ray-Pac® Ray-Pac p. 3
W7 Global p. 44
MedWrench p. 52 Injector Support & Service p. 49
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ICEMAGAZINE | OCTOBER 2019
RSTI/Radiological Service Training Institute p. 15
Webinar Wednesday p. 50
ADVANCING THE IMAGING PROFESSIONAL
WE BUILD
IMAGING ENGINEERS At Tri-Imaging Solutions, we strive to live up to our name and be a Solution for our Customers and ultimately, helping to Empower the EngineerTM
WHAT WE DO Tri-Imaging Solutions is a replacement parts, equipment, service support, and technical training company. We provide quality tested imaging parts, buy-sell-move equipment, and provide technical support. All replacement parts come with a 180-day warranty. Available 24/7/365
PARTS
Tri-Imaging’s goal is to carry the replacement parts inventory critical to supporting the imaging service engineer. We appreciate your business and support during this exciting time of strategic investment and growth.
EQUIPMENT
At Tri-Imaging, we have the equipment and connections to help you with all types of purchases, sales, installations and/or de-installations. We have experience with most all modalities, including CT, R&F and Digital Mammography.
SOLUTIONS
VISIT TRI-IMAGING’S EDUCATION CENTER IN NASHVILLE, TN
Completion of our BMET to Imaging 1 course now offers 73 CEUs from the AAMI Credentials Institute.
TRAINING
The Tri-Imaging Technical Training is a unique and intuitive training program that will prepare the service engineer to efficiently and effectively trouble shoot today’s diagnostic imaging systems.
ISO 13485:2016 Certified
VISIT WWW.TRIIMAGING.COM OR CALL 855.401.4888 (24/7/365)
Authentic. Made with Peace of Mind.
Get back to life.
GE Healthcare
CT Tubes AFFORDABLE EXCELLENCE. DELIVERED.
www.multidiagnostic.com DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS
990 E. Cedar Street Ontario, California 91761
Toll-Free: (800) 400-4549 International: (909) 591-6444 Fax: 909-591-5293