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CONTENTS
FEATURED
56
HE ROUNDTABLE: CMMS T A computer maintenance management system (CMMS) is a valuable tool that biomeds use to maintain medical equipment. TechNation invited several experts to participate in this month’s roundtable article on CMMS. The goal is to provide insights into the latest technology and features available to the HTM community. Next month’s Roundtable article: X-Ray
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LEADERSHIP IN TRAINING There is a point in many people’s lives where they decide that it is time to reach new heights in their personal lives or career. Some are salespeople looking for new ideas to increase sales and others are looking for the best path to a promotion. HTM professionals have a variety of methods to help prepare for advancement and leadership roles.
Next month’s Feature article: What EXACTLY is AEM?
TechNation (Vol. 10, Issue #10) October 2019 is published monthly by MD Publishing, 1015 Tyrone Rd., Bldg. 100, Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Bldg. 100, Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2019
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
OCTOBER 2019
TECHNATION
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CONTENTS
INSIDE
Departments
PUBLISHER
John M. Krieg
VICE PRESIDENT
Kristin Leavoy
ACCOUNT EXECUTIVES
Jayme McKelvey Megan Cabot
ART DEPARTMENT Jonathan Riley Karlee Gower Amanda Purser EDITOR
John Wallace
EDITORIAL
Roger Bowles Jenifer Brown K. Richard Douglas Jim Fedele Joe Fishel Inhel Rekik Manny Roman Cindy Stephens Steven J. Yelton
DIGITAL SERVICES
Cindy Galindo Kennedy Krieg Erin Register
CIRCULATION
Lisa Lisle Melissa Brand
WEBINARS
Linda Hasluem
ACCOUNTING
Diane Costea
EDITORIAL BOARD
Manny Roman, Business Operation Manager, AMSP Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System Jim Fedele, Sr. Program Director, Clinical Engineering, BioTronics, UPMC Susquehanna Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Clinical Engineering Manager, Medstar Georgetown University Hospital
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P.14 SPOTLIGHT p.14 Company Showcase: Nuvolo p.18 Professional of the Month: Tim Cordes, CBET p.22 Company Showcase: Asset Services p.24 Department of the Month: The Portneuf Medical Center Biomedical Engineering Department p.28 Company Showcase: Midmark RTLS p.30 Biomed Adventures: Hiking for Wishes P.35 p.35 p.42 p.44 p.47
INDUSTRY UPDATES News and Notes: Updates from the HTM Industry ECRI Institute Update AAMI Update Welcome to TechNation
P.48 p.48 p.50 p.53 p.54
THE BENCH Biomed 101 Webinar Wednesday Tools of the Trade Shop Talk
P.69 EXPERT ADVICE p.69 Career Center p.70 Ultrasound Image Quality Troubleshooting Tips p.73 Cybersecurity p.74 Benefits of ISO p.76 The Future p.78 20/20 Imaging Insights p.81 The Other Side p.83 Roman Review P.86 BREAKROOM p.86 Did You Know? p.88 The Vault p.90 NCBA 2019 Scrapbook p.92 Where in the World is Ben C.? p.98 Flashback p.94 Service Index p.97 Alphabetical Index Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE T
he HTM field has changed substantially over the past two decades. Not only has medical equipment become more sophisticated, and interconnected, but the processes and technology used to maintain that equipment has evolved rapidly as well. One HTM professional has been there pretty much all the way, from the ground floor to senior management, Heidi Horn. Horn has earned a reputation as a transformational HTM leader, most recently as the head of the HTM department at SSM Health. Horn has also been an active member of the Association for the Advancement of Medical Instrumentation (AAMI), including serving as a member of the board of directors and chair-elect of AAMI’s Technology Management Council (TMC). And recently, Horn received AAMI’s HTM Leadership Award and is an inaugural member of the AAMI Fellow program.
Q: HOW DID YOU FIND YOUR WAY INTO THE HTM FIELD? A: It wasn’t the traditional way. In 1998, I was looking for a new job in marketing or sales. Back then, job hunting was still done by looking for open positions in the newspaper. I came across a “want ad” at SSM Health looking for a Business Development Manager to sell clinical equipment maintenance services to non-SSM facilities. I applied and miraculously got the job, considering I knew nothing at the time about health care or clinical equipment. Over the years, I learned a lot and
took on more and more operational responsibilities. In 2007, I was promoted to vice president over the health system’s entire health care technology management program. Q: HOW HAVE YOU SEEN THE FIELD CHANGE IN YOUR TWO DECADES IN HTM? A: When I started in the field 20 years ago, the primary responsibility of the biomed department (as it was called back then) was to maintain clinical equipment and ensure regulatory compliance. Over the years – as the hospitals’ needs grew – so did HTM’s responsibilities. We
In June of this year, Horn joined innovative HTM software maker Nuvolo (nuvolo.com) as its vice president of global healthcare enablement. We caught up with Horn recently to learn more about her career path and her new role with Nuvolo.
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SPOTLIGHT
HEIDI HORN NUVOLO VICE PRESIDENT OF GLOBAL HEALTHCARE ENABLEMENT
began to take on responsibility for clinical device integration, service contract management, equipment planning and purchasing, device cybersecurity, device analytics, etc. Many of these responsibilities require skill sets other than being a good technician and so new job descriptions have been added to the HTM department. I’ve also noticed the gap between traditional biomed shops and sophisticated HTM departments widen. Q: WHEN YOU WERE RUNNING THE HTM OPERATION AT SSM, WHAT KINDS OF ISSUES KEPT YOU UP AT NIGHT? A: There were a lot of issues that kept me up at night – I would worry if we were ready for the Joint Commission; How do I control costs when the manufacturers keep increasing theirs? Where do I find the staff to fill open critical positions? How do I make sure my team has the training they need? Why is that employee not pulling their weight? How do I make sure HTM is involved in all clinical equipment-related discussions and adds value to the organization? Q: WHAT DO YOU SEE AS THE MOST PRESSING CHALLENGES THAT WILL CONFRONT YOUR HTM COLLEAGUES IN THE NEXT COUPLE YEARS? OVER THE NEXT 5 TO 10 YEARS? A: The ever-increasing pressure on hospitals to lower their costs is not going away anytime soon.
Unfortunately, if the HTM department hasn’t made an effort to demonstrate their value to the C-suite, they will likely be one of the first departments faced with budget cuts. The C-suite sees value in the HTM department when it demonstrates it can provide service and expertise better than any other department or vendor can and at a lower cost. However, knowing your department is doing a great job and proving it are two very different things. The challenge will be to have the data and analytics to prove your department’s value and make sure the C-suite sees it on a regular basis and understands it. Those analytics also will become more and more important in controlling costs. Q: WHAT BROUGHT YOU TO NUVOLO? A: I loved being part of the health system’s HTM department, but when the time came to decide what I wanted to do in the next phase of my career, I knew I wanted to expand my horizons and try something different. I had been in contact with Tom Stanford, the CEO at Nuvolo, for several years and really liked him and admired his belief in his company. We had also signed a contract with Nuvolo to implement its HTM software at our hospitals, and I was very impressed with Nuvolo’s innovative product and its support during our implementation. So when I found out that they were creating this position, I told Tom right away that I wanted to apply for it.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Q: CAN YOU TELL US MORE ABOUT YOUR ROLE AT NUVOLO? A: I am so excited to be in this role. It leverages all of my skills and health care knowledge gained over the past 20 years to enable Nuvolo staff and partners to provide products and service that meet and exceed their health care clients’ needs and expectations, as well as ensure our health care clients have the tools, training and support they need to optimize our products. I am working very closely with the product development teams to fine tune the product so that it is aligned with HTM’s needs. I am talking with the sales teams to make sure they understand the needs of the HTM department and the culture. I also get to work with the implementation teams and customer success teams to ensure they understand what support HTM needs. Recently, I’ve been
OCTOBER 2019
TECHNATION
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
working very closely with the curriculum and training teams to give them the information they need to develop comprehensive curriculum, certification and training programs for our employees, partners and clients. Finally, I have several client visits scheduled to get feedback from them on what they like and what we can improve on. In the very near future, I will be organizing a client user’s group to enable the sharing of best practices and provide a forum for feedback. Needless to say, I have been very busy and enjoying my new job immensely. Q: YOU’VE “CHOSEN” NUVOLO TWICE. ONCE AS A VENDOR AND NOW AS A FULL-TIME EMPLOYEE. WHAT APPEALS TO YOU ABOUT THE COMPANY’S PRODUCTS VERSUS SOME OF THE OTHER CMMS VENDORS OUT THERE? A: It really comes down to the company’s innovative culture and desire to be the best in the industry.
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Nuvolo technically delivers a CMMS, but their product offers so much more than what a traditional CMMS provides. The other companies in this space have been around for two decades, so they’re built on very old technology, and their organizations reflect an inflexible mindset that’s mirrored in their products. Nuvolo’s solution adapts to the customer, not the other way around. As I mentioned earlier, reporting is so important for HTM leaders, not only to document compliance, but also to demonstrate the department’s value to the C-suite. Nuvolo’s flexible and user-generated reporting eliminates the old need to go back to the CMMS vendor for every new report. Those are just a couple examples, but overall, it’s about the modern architecture and modern approach to software design and delivery, and a commitment to deliver best-in-class products.
ABOUT NUVOLO Nuvolo (nuvolo.com) is the world’s leading, cloud-based Connected Workplace company, built on the NOW Platform. We are transforming full lifecycle service management for asset intensive industries, including health care, life sciences, financial services, retail, oil and gas and manufacturing. Nuvolo is the largest and fastest-growing ServiceNow independent software vendor globally. The company is headquartered in Paramus, New Jersey with a global workforce located throughout the U.S., Europe and India. Questions about Nuvolo can be directed to sales@nuvolo.com. You can reach Heidi Horn directly at Heidi.Horn@nuvolo.com.
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Clinical engineers have been forced to operate with non-integrated, legacy CMMS software products, spreadsheets, and paper-based tools.
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SPOTLIGHT
PROFESSIONAL OF THE MONTH Tim Cordes, CBET: Maintenance to OR Supervisor BY K. RICHARD DOUGLAS
A
career in biomed does not always begin with an emphasis on medical devices. Sometimes, it can start with a lot of maintenance tasks that have little to do with medical equipment. In the end, such a start can serve to boost a person’s experience and confidence.
Tim Cordes, CBET, perioperative clinical engineering supervisor for the University of Kansas Health System, is an example of just such a start. “I originally began my career in electronics in the manufacturing industry, but after a couple of lay-offs and boredom of working on the same thing day in and out, I began to look outside manufacturing,” Cordes remembers. “A local hospital was looking for an ‘Electronics Technician’ and I thought; why not. My first year, I learned how to run a jackhammer, some light plumbing, replaced a multitude of bathroom call cords, cleaned dialysis machines and, eventually, calibrated more than a few ‘bouncing-ball’ patient monitors,” Cordes says. “As you might have guessed, a lot of those first biomed departments began under the direction of the maintenance department. I did figure out I really liked going on service calls to the floors as you never were sure of what problem you might encounter,” he adds. Cordes graduated from an electronics technology certificate
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program through a local technical school in the early 1980s. “After a few years in various electronics jobs, I landed at a local hospital as a BMET I and took biomedical instrumentation and lab classes at a local community college that offered a BMET program. I found a medical terminology class being offered to the medical records staff and signed up for that class. It wasn’t long after that a few of us started our own study group and with the help of the BMET program instructor I became a CBET in the late nineties,” he says. His other experience came from on-the-job training, OEM technical classes and multiple leadership, team building and communication skills training through various employers. “As a director, we used interns from the community college’s BMET program to evaluate technicians that were frequently hired by us. I truly believe on-site internships are a key to developing BMETs at that point in time and even more so now,” Cordes says. Cordes’ area of expertise is the operating room. “I really started my ‘real’ BMET job in the operating room, primarily setting up video arthroscopic procedures and, after some training, responding to issues with anesthesia machines and eventually almost everything within the OR,” he says. “I found that I really enjoy the
FAVORITE BOOK
“The Hound of the Baskervilles” or any of the Sherlock Holmes mysteries by Sir Arthur Conan Doyle.
FAVORITE MOVIE
“The Return of the Pink Panther” or “Blazing Saddles;” kind of a toss up.
FAVORITE FOOD
Patty’s chicken spedini with homemade alfredo sauce.
HIDDEN TALENT
Still waiting for it to develop; hoped it was golf but sadly, not so much.
FAVORITE PART OF BEING A BIOMED
“Early on, I found out what I liked the most was the pace and challenge of solving issues, equipment or otherwise, in the OR. The gratification received is great, but I think what truly makes a BMET enjoy this area of service, is not the hero syndrome, but the satisfaction of utilizing, conscious or not, several of the qualities of Servant Leadership. Those qualities don’t always have to be geared only toward leading, they work just as well in everyday interactions.”
WHAT’S ON MY BENCH?
“Our group, being assigned specifically in the OR, mostly share all the benches, tools, etcetera. That said, we are well supported by our leadership and have all the routine meters, testers, simulators, service phones, well stocked parts carts and especially training we need. I prefer to think of us as ‘guerilla warfare’ BMETs where we’re always taking our ‘knowledge tools’ to the front line, or in this case, point of care. Although I personally never leave the shop without two small pocket screwdrivers, a pen and paper; obviously an old school BMET. By the way, my locker has several months of TechNation, my lunchtime friend.”
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SPOTLIGHT
challenge and pace of the operating room. Currently, I’m part of a group of five BMETs — three CBETs — that live in the ORs with the primary responsibility of maintaining over 100 anesthesia machines. A major portion of our daily duties is to facilitate any service needs within those ORs. Our system does an average of over 130 surgeries every day, and being a teaching institution, we have many rotations of student CRNAs, residents,
anesthesia and surgical techs, not to mention hundreds of OR nurses, and support personnel,” Cordes adds. He says that their philosophy is that they will own any problem occurring in the OR; IT, temperature, color of the walls, etcetera. “We can’t always fix everything, but we certainly can facilitate the resolve and we want the nursing and support staff concentrated on caring for our patients,” Cordes says.
Proud parents at Devin’s Army boot camp graduation.
“ I found that I really enjoy the challenge and pace of the operating room. A major portion of our daily duties is to facilitate any service needs within those ORs.” EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
REPLACING THE RETIRING BABY BOOMERS Helping to direct new biomeds into the field to repopulate the outflows is one of Cordes’ goals. “Currently, I’ve been working in conjunction with our local biomed association – the Healthcare Technology Management Association of the Mid-West (HTMA-MW) – a local community college and an electronics technology technical school to create an BMET degree program using the electronics technology classes at the community college coupled with the BMET online classes through the technical college,” Cordes says. He says that the concept, not unlike what so many others are doing, is to get electronics technology students interested in BMET careers and a path to get started. “This has been done with the assistance of several area biomed directors as the internship part of the program will fall on us to implement. The effort is really starting to come to fruition and we hope to begin promoting the program to starting electronics technology/high school students this fall,” Cordes says. Cordes says this is a win-win-win situation because the BMET technical school has more facilities where it can send students for internships, the community college has little expense relating to a new offering and, hopefully, there are more “qualified” BMETs in the Kansas City metro area. Away from work, Cordes is married to his wife Patty, who is enjoying retirement after 35 years in the insurance industry. The family includes two Shih Tzus; Shyloh and Sophie. “Our son, Army PFC Specialist Devin, with his wife Morgan, [are] currently stationed at Ft. Bliss in El Paso Texas,” Cordes says. Apparently, starting in maintenance can result in lifelong benefits that lead to important biomed work. Thousands of OR patients can attest to that.
OCTOBER 2019
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE Asset Services Inc.
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sset Services Inc. is based in Kansas City and has been in business for over 25 years. Asset Services performs fixed asset and equipment inventories primarily for health care, education, and information technology clients, on a national and international level. They serve a unique niche in the health care industry focusing specifically on wall-to-wall, on-site physical inventories to support and provide initial data for existing or new computerized maintenance management systems (CMMS).
conferences. Asset Services is unique, because we strictly perform on-site physical equipment inventories. Our inventory specialists look behind every door of the hospital or clinic to locate equipment. We collect information including location, description, manufacturer, model, serial number and PM due date. This information is used to validate or populate the data in our clients’ CMMS applications.
The focus of specific services in the aforementioned industries provides trained and experienced employees the skills to handle the sensitivity of these environments. Asset Services has achieved strong growth since their initial commitment to focus on equipment inventories in healthcare, education and IT industries. The company has been named one of the fastest growing companies in the Kansas City area three of the last four years. Asset Services Vice President of Sales and Marketing Tim Michener recently shared more information about the company via a question-and-answer session.
Q: Why is a physical inventory of medical equipment important? A: Health care organizations are required to maintain medical equipment at a high level; knowing what equipment is physically on hand is critical. Many health care organizations fail to keep an accurate inventory of their equipment and the information in the asset management system becomes out of date, with records of equipment that is no longer in service (a condition called bloat). Many organizations have experienced upwards of 35% bloat, meaning more than 35% of the equipment on their ledger no longer physically exists in the facility. To maintain an accurate asset management system, a health care organization needs a physical inventory to identify the equipment actually in service.
Q: Can you describe what Asset Services does? A: Good question, as it is the first question we get at MD Expo and AAMI
Q: Who typically needs your services? A: Typically, three types of organizations require our services. 1. Health care organizations: Hospitals
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Tim Michener Vice President of Sales and Marketing
and health care organizations realize that their equipment records are out of date or inaccurate. This is typically recognized when engineering or maintenance attempts to perform preventive maintenance or inspections of equipment and the equipment is unable to be located over multiple cycles. Equipment is often discarded without proper notification. For organizations seeking to attain or maintain CMS accreditation, it is imperative to perform an equipment inventory as one of their first steps. 2. CMMS software firms: CMMS firms understand the CMMS application is only as good as the data it is populated with. They also understand it is critical to perform
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SPOTLIGHT
Asset Services Inventory Specialists performing a physical inventory of the Radiology Clinic.
an inventory ensuring the data is accurate at “go live”. 3. Clinical engineering management firms: When a hospital makes the decision to outsource clinical engineering management to a CE management firm, these organizations need to have an accurate understanding of not only the amount of equipment they will be required to maintain, but also the specific make and model of each piece of equipment. This information is critical in identifying the resources needed to staff the clinical engineering department. Q: Who performs the physical inventory, do you use biomed technicians? A: There is a high demand for biomed technicians, and they are already overbooked handling the responsibilities that require their core skills. Asset Services inventory specialists are trained and experienced in the identification of medical equipment, and experienced in operating in sensitive environments.
They are full-time, bonded, credentialled and dedicated to equipment inventories. We like to say our personnel have a good bedside manner and understand working amongst people in a high-stress environment. Q: What are the biggest challenges for a healthcare organization needing an equipment inventory? A: Planning, finding resources and the consistency of the information collected. Organizations must identify the specific equipment classes to be included, who will perform the inventory, what tools will be used, the time frame to complete the inventory and how the process will be communicated to the stakeholders. Determining which professional staff will be reassigned from their existing responsibilities to complete the inventory. Without using committed resources, the duration can run into perpetuity. Employees who do not perform equipment inventories full-time will be
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
inconsistent in their data collection. The more untrained resources that are assigned to the task will compound the number of inconsistencies. Ensuring the information is recorded in a consistent manner is critical for the final results. Fortunately, for our clients, we handle all these challenges for them. Q: Can you share a little about the company’s history? A: After starting out as a regional fixed asset inventory firm, Asset Services made a concerted effort to focus strictly on health care, education and IT inventories. Focusing in these specific areas requires a high-caliber professional team of specialists. Our specialty in these areas allows us to provide clients with exceptional service at a cost-effective value. This specialization has resulted in Asset Services becoming the “go-to resource” for hospital equipment inventories. For more information, visit AssetServices.com.
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SPOTLIGHT
The members of the Portneuf Medical Center Biomedical Engineering Department are, from left to right, David Jones, BMET III, Shawn Conner, BMET I, Timothy May, ISE III, and Robert Milward, CHTM.
DEPARTMENT OF THE MONTH
The Portneuf Medical Center Biomedical Engineering Department BY K. RICHARD DOUGLAS
T
he Idaho cities of Pocatello and Chubbuck are about four miles apart. Pocatello is the county seat of Bannock County, as well as the largest city in the county. It is referred to as the “Gate City” because it sits at the western entrance to the Portneuf Canyon.
Offering views of this part of southeast Idaho is the Portneuf Medical Center. “The new Portneuf Medical Campus, opened in 2011, and sits on the hilltop with breathtaking views of the beautiful scenery of Pocatello and Chubbuck, Idaho,” says Robert Milward, CHTM, director of clinical technology management. Since 1907, the Portneuf Medical Center, an acute care facility, has served the health care needs of Eastern Idaho. The campus is approximately 403,000 square feet and the private rooms do offer incredible views. The facility is accredited by The Joint Commission. The Portneuf Medical Center Biomedical Engineering Department is a full-service shop with one director, two biomedical engineering technicians and one imaging service engineer. The department is
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supervised by Sodexo Clinical Technology Management. In addition to Milward, the department includes David Jones, BMET III; Shawn Conner, BMET I; and Timothy May, ISE II. “We offer a unique approach to service contracts management. Every service contract is individually managed and evaluated to make sure the hospital is receiving the best value. We work with many of the OEMs, independent service providers and in-house talent to take a holistic approach to contract management,” Milward says. He says that being situated in Idaho has its inherent set of challenges with regards to parts deliverability, so at the forefront of every contract decision is the ability to service equipment in a timely, effective manner that meets the needs of the patients. The small biomed team offers their individual areas of specialty to achieve maximum coverage. “Dave Jones is our jack-of-all-trades. Having worked at Portneuf Medical Center for the last 13 years, he has played a part in the repairs and maintenance of almost every one of the 4,600 assets at this facility,” Milward says.
“His area of expertise is ventilators, but he is exceptionally skilled in the realm of GE patient monitors and networking systems as well as cell saver autotransfusion units and many more,” he adds. Milward says that Timothy May is their imaging service engineer with more than two decades of experience in the imaging field. He is the first onsite imaging engineer at Portneuf Medical Center. “Having worked for multiple major imaging companies such as GE and Philips, he brings a wealth of knowledge to Sodexo and Portneuf with his ability to support multiple modalities across multiple vendors,” Milward says. “We primarily service 90 percent of the biomedical inventory in-house, as well 65 percent of the imaging department. We service everything from ventilators to cell washers and ultrasounds and X-ray equipment. Our BMETS are very skilled and only send equipment out when they absolutely have no other choice,” Milward says. Milward says that data collection occurs organically on a daily basis. “The inventory has been combed through multiple times and is incredibly
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SPOTLIGHT accurate. Each time a device comes through the biomed doors, its asset record is reviewed for accurate, actionable data. Monthly reviews and periodic training ensure accountability and best practices with regard to data collection are in place. When data anomalies are found, the technicians have the autonomy to make necessary updates to reflect any changes or deviations in the current database,” he says. TAKING OWNERSHIP Working with colleagues in other departments, the team addressed a need to better utilize infusion pumps. “We recently coordinated the implementation of a process improvement to better utilize IV pumps in the facility. Infusion pumps were a hot commodity to come by and capital requests and work orders for additional pumps were starting to roll in,” Milward says. He says that previously, infusion pumps were cleaned after each use by clinicians within the departments where the pumps were being utilized. A utilization assessment was completed and determined that the hospital had enough pumps to cover the need. However, the facility’s utilization process needed tweaking. “We partnered with the hospital’s materials management department, environmental services and the sterile processing department to create a progression where, upon patient discharge, environmental services placed the pumps in a centralized pick up location. Sterile processing would pick up the equipment, clean and deliver to materials management. Materials management would then deliver the IV pumps back to the floors in a
designated, clean location,” Milward explains. “Now, each floor has a designated par-level and resource to contact when equipment levels become low. Materials management will prioritize equipment needs based on hospital needs ensuring that every clinician has the equipment they need, when they need it,” Milward adds. The Portneuf Medical Center Biomedical Engineering Department has also committed to help solve problems by taking ownership of an issue and seeing it through to resolution. “In 2016, we decided for every issue, we were going to do everything we could to help and to be a part of the solution. This means that with every issue, and every work order we come across, we are going to do everything we can to see it gets resolved. As a biomed department, our job is to be problem solvers,” Milward says. He says that most of the time, his team can solve the issue. “Sometimes we can’t, but it’s our responsibility to ensure proper handoff to the correct resource. For example, if biomed receives an IT work order by mistake, we submit the IT ticket for the customer, call them back with their IT ticket number, and follow up later to make sure the issue is resolved. Closing the loop through effective communication, every step of the way, is how we become the solution for every problem,” Milward adds. It is that commitment that makes the Portneuf Medical Center Biomedical Engineering Department an invaluable resource to patients and clinicians in southeast Idaho.
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COMPANY SHOWCASE Midmark RTLS
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n 2013, Billings Clinic implemented the Midmark RTLS Wired Sensory Network in patient care areas for nurse call automation – an application that requires precise, room-level location accuracy. When the hospital looked to expand RTLS for asset tracking, they wanted to leverage the existing system, yet expanding the sensory network across the entire hospital and eight ancillary buildings was a daunting proposition. To reduce costs, Billings Clinic turned to Midmark RTLS Wi-Fi locating to track the general location of assets campus-wide.
RTLS enables staff to easily locate and manage equipment to improve biomedical and nursing team efficiency.
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LEVERAGING DUAL-LOCATING PLATFORM TO LOCATE MOBILE EQUIPMENT ACROSS 56-ACRE CAMPUS “When we first considered expanding our RTLS to track mobile equipment,” explains Tim Killmer, Billings Clinic information systems analyst, “we thought it would be hard to justify the cost of covering a large campus. However, we also knew staff were spending time searching for equipment – time that could have been spent on direct patient care or other value-added activities.”1 As Killmer explains, “We wanted to know where our equipment was going. Sometimes, a piece of equipment would move from one building to another, ending up in a basement.” Killmer isn’t alone in his sentiments. Health care institutions across the nation struggle with the needless time staff spend trying to locate equipment. Compounding the issue are costs associated with underutilized assets, which often sit idle 60% of each day because they can’t be found.2 EXISTING INFRASTRUCTURE JUSTIFIES BUSINESS CASE FOR ASSET TRACKING SOLUTION In 2013, Billings Clinic installed the Midmark RTLS Wired Sensory Network and Nurse Call Automation solution in
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SPOTLIGHT
HEAR TIM KILLMER SPEAK AT MD EXPO 2019
patient rooms, hallways and nursing desks of its four-story hospital. “Our nurses were very happy with the automated cancelling of call alarms,” Killmer says. Busy caregivers were able to focus on the immediate needs of the patient rather than pressing the call cancel button, saving valuable time while automatically documenting the response. “Nurses liked how easy it was to find coworkers and wanted the same to be said for finding mobile assets,” Killmer says. In March 2017, Billings Clinic added the Asset Tracking + Management solution, building on its existing RTLS infrastructure. Killmer explains, “We leveraged our investment in the Nurse Call Automation implementation, then used the Wi-Fi network to cover the rest of the campus.”2 By tagging assets with Wi-Fi Asset Tags, which also contain infrared (IR) technology, caregivers can precisely locate mobile equipment within patient care areas where the IR sensory network is installed. Ancillary areas without IR sensors rely on the existing Cisco network, which conveys general asset location as determined by Wi-Fi access points. According to Killmer, “In our patient care areas, they need precise locating that the IR sensors provide. For other areas,
knowing the general location of an item is fine. Having that combination gives us exactly what we need, and the cost was more in line with what we could allocate.” PAR-LEVEL MANAGEMENT ENSURES ASSET AVAILABILITY Billings Clinic is also using RTLS to manage periodic automatic replenishment (PAR) levels on care units. By tracking the number of devices on each unit, Midmark RTLS keeps staff informed before shortages occur. “Our infusion center manager receives an automated alert when infusion pumps are low,” says Killmer, “enabling her to proactively request more pumps, before patients arrive.” Most care units at Billings Clinic manage inventory in this way. Killmer adds, “If one unit needs equipment, they review the RTLS software to determine which unit has a surplus of equipment that they can borrow from.” Prior to implementing the Asset Tracking + Management solution, nurses were hesitant to give up pumps because they felt they might run short when they needed them later. Now, the PAR system helps care units see when they have extra equipment they can share with other units. As a bonus, pumps have not had to be
INSTALLATION HIGHLIGHTS • Asset Tracking + Management • Nurse Call Automation • Wired Sensory Network + Wi-Fi Locating • 304-bed hospital + trauma center • 8 ancillary buildings • 56-acre campus • 1,400 assets
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
“Mixing it Up: Combining Accurate and Zonal Location for Campus-wide RTLS” Speaker: Timothy Killmer, Information Systems Analyst IV Billings Clinic When: Saturday, October 19 11:15AM-12:30PM More Info: mdexposhow.com/education
rented to keep up with misperceived demand. PREVENTIVE BED MAINTENANCE COMPLETED IN 1/3 THE TIME Before the asset management solution, the biomedical team would begin the preventive bed maintenance process on unoccupied beds, leaving the occupied beds for later. On rounds two and three of the PM initiative, they often found that the previously occupied beds had moved, yet they didn’t know where. “With Midmark RTLS in place, we know exactly where the beds are and whether or not they are in need of maintenance service,” shares Killmer. “What used to take three months to complete now takes one month.”2 PLANNING FOR THE FUTURE “More people are starting to see how we can use different applications on the same sensory network. We’re looking at other ways to become more efficient,” Killmer says. As Billings Clinic explores leveraging their RTLS infrastructure, they are building on a solid foundation of success. “We are helping achieve our health system’s vision of providing the best clinical quality, patient safety, service and value,” Killmer adds. REFERENCES 1. Healthcare-Informatics.com, “RTLS for Asset Tracking: From Luxury to Necessity,” March 28, 2018. http://www.healthcare-informatics.com/ article/rtls-asset-tracking-luxury-necessity. 2. “Managing Assets with Versus:” Timothy D. Killmer, Information Systems Analyst IV, Billings Clinic, 2017 VUE Versus User Group Experience.
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SPOTLIGHT
BIOMED ADVENTURES Hiking for Wishes BY K. RICHARD DOUGLAS
I
t is not uncommon for a doctor to suggest walking to a patient as a good form of exercise. The human body has acclimated itself to walking. It’s as much about getting out and moving, as it is maintaining the muscles that support the knees. Many people elevate this activity to get more cardiovascular benefit and take on running or jogging.
For those who want to add in attractive surroundings to their walking or running, many people choose to run or walk out in nature. There are trails for this purpose in federal, state and local parks across the country. One of those hikers, who enjoys being out in nature, is James Kerner, CBET. Kerner works with ERP International LLC as a civilian contractor for the U.S. Army Medical Materiel Agency (USAMMA) in Fort Bragg, North Carolina. “I started running early in my life and eventually learned the art of running during my 21-year military career. Running had become a daily ritual to relieve stress; starting my days early in the morning running three to five miles before work and sometimes after work. After suffering several lower back problems, running was no longer an activity that I was able to do anymore. I needed to find a ‘passion’ that would satisfy my desire for being outside while allowing me to push myself to the limits,” Kerner says. He says that in 2016, he stated hiking after reading an article about the
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James Kerner is pictured with TrailBlaze Challenge team member Tyra.
Appalachian Trail. “I instantly was drawn to the love of being in the woods; experiencing the beauty that you can only find on a trail. Hiking allows me to be active, outside, and push myself to the limits without pounding my body like running was doing. When I am asked what has pushed me the most, I always compare these two
achievements: In 2009 I ran the 26.2-mile Boston Marathon in Tallil, Iraq. In 2018, I tackled the terrain of the Sauratown Trail and completed the Make-A-Wish Foundation 26.5 TrailBlaze challenge. In the end, the 26.5-mile hike was definitely harder,” Kerner says. Kerner says that he prepares for long hikes by studying the trail(s) that he’ll
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SPOTLIGHT
James Kerner takes a selfie during a hike to Cape Fear River on the Campbell Creek Loop Trail in Raven Rock State Park.
be hiking and also tries to find landmarks or points of interest either on or near the trails. “It’s amazing what is hidden within local, state and federal land that you can see on trails. On some trails, you can actually piece moments of time back together and see the remains of old houses and communities,” Kerner says. “A few days before distance hikes I start to hydrate and increase my electrolyte levels by adding NUUN tablets to my drinks. The night before the hike I carb up with pasta or pizza and stretch a lot. The morning of distance hikes I continue to stretch, hydrate and drink a large healthy vitamin packed smoothie to jumpstart my energy levels,” he adds. Kerner says the greatest thing about hiking is that you can start out for relatively no money. “Most people have everything they need around the house; all that is needed to start out hiking is a pair of shoes, a backpack, and a bottle of water. As you increase your interest and skill level, you can slowly upgrade and/or add to your equipment in very affordable ways. The best advice or tip that I can give others about hiking is to take time to slow down, breath, enjoy the scenery and hit a trail,” Kerner says.
HIKING FOR A GREAT CAUSE The Make-A-Wish Foundation works to bring some happiness to children diagnosed with critical illnesses by granting that child’s wish. The organization has granted the wishes of more than 315,000 children since 1980. Kerner recognized the good work the organization does and how his pastime could raise funds for it. “Two friends of mine had children with life-changing critical illnesses and I followed their stories on Facebook. After donating money to their causes, I began to look for other ways that I could help children who are fighting for their lives,” he says. “My search led me to the Eastern North Carolina Make-A-Wish Foundation Trailblaze Challenge, a 26.5-mile endurance hike where participants can tackle the terrain of the Sauratown Trail in one amazing day! After more research and my desire for helping children faced with illnesses, I decided to participate in the fundraiser and raised close to $3,000. Currently, I am registered to be a TrailBlaze lead on future hikes,” Kerner says. CAREER PATH Kerner has been a biomed since 1998 after graduating from the U.S. Army Medical Equipment and Optical School
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
in Aurora, Colorado. “Shortly after my graduation, I moved to the Fort Bragg, North Carolina area and began working at Womack Army Medical Center. In 2011, after an exciting and rewarding 21-year career, I decided to end my active and reserve military career and retired from the U.S. Army Reserves. As a BMET, I became AAMI CBET certified in 2010 and was considered a subject matter expert (SME) in imaging, being trained in radiology, CT and MRI,” Kerner says. He is currently a BMET 4 Maintenance Readiness Officer-Medical for USAMMA and works as a link between the Medical Maintenance Operations Division and the medical operational forces (field medical maintenance assets) of the U.S. Army. “In short, I am a medical maintenance analyst that provides technical support and guidance between USAMMA at the national level and medical maintenance field units at corps level and below. We are not considered a third-party entity, but a direct contractor with the U.S. Army embedded directly with active and civilian assets,” Kerner adds. To children, who are uplifted because their wish is granted, he is also a source of funding for those wishes and a trailblazer.
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College of BIOMEDICAL EQUIPMENT TECHNOLOGY Building the Healthcare Technology Workforce of the Future
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INDUSTRY UPDATES
NEWS & NOTES
Updates from the HTM Industry STAFF REPORTS
CYNERGISTEK SEES INCREASED DEMAND FOR MEDICAL DEVICE SECURITY SERVICES CynergisTek Inc. has experienced significant market demand with Medical Device Security Service customer wins at leading health systems since launching the service in late 2018. Sixty percent of the contracts were existing Compliance Assist Partner Program (CAPP) clients that expanded their relationship with CynergisTek to add ongoing Medical Device Security Service engagements. In a recent survey, nearly one-third of health care executives reported that medical device security is one of the top five cyber risks facing health care today, however the majority also reported not having an effective (or any) strategy in place to assess the risks posed by medical devices. This is often due to the organization’s lack of internal resources, leaving the cyber threat to hospital operations and patient safety at an all-time high. It is for this reason that multiple leading health systems, including Banner Health, one of the largest nonprofit health care systems in the U.S., and Gwinnett Medical Center, one of the largest health care networks in Atlanta and nationally recognized for clinical excellence, have turned to CynergisTek’s Medical Device Security Service to help address security vulnerabilities by developing and managing a security strategy around its devices. “CynergisTek has been a valuable resource for us, helping to ensure our medical devices are protected from security threats,” said Priyanka Upendra, Quality & Compliance Program Director, Technology Management/ENTECH at Banner Health. “A fundamental benefit to the Medical Device
Security Service is having a team of skilled professionals that act as the liaison between our Banner teams, delivering seamless coordination, collaboration and communication. It also serves as an extra set of eyes to oversee critical, constantly evolving elements in our health care operations.” CynergisTek’s Medical Device Managed Services address the security of the entire medical device lifecycle, including policy development, pre-acquisition procedures, implementation and security control setup, identifying and reporting vulnerabilities and coordinating remediation in conjunction with the device maintenance schedule. CynergisTek’s team of security experts act as advisors, providing a comprehensive view of the system and a systematic approach to address issues or concerns during any part of the lifecycle process, whether that be alerts of a critical recall or performing risk assessments of the device and manufacturer during vendor selection. CynergisTek offers a comprehensive set of medical device services to ensure security best practices for the planning, implementation, and ongoing maintenance of an organization’s biomedical device lifecycle management program. From device acquisition to retirement, CynergisTek’s managed service program provides services to support program implementation and optimization activities as well as ongoing support to ensure a continued focus on addressing new biomedical device vulnerabilities and risks as they are discovered. •
MEDIGATE WINS GOLD IN INTERNET OF THINGS CATEGORY Medigate announced that Network Products Guide, an IT industry technology research and advisory guide, has named Medigate a Gold winner in the 14th annual 2019 IT World Awards in the best product, service, upgrade or innovations category for Internet of Things (IoT). Medigate was honored for its unique medical device security and asset management platform, which addresses both clinical IoT and general IoT devices. Medigate enables accurate and comprehensive device discovery, contextual and behavioral anomaly detection and
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
clinical policy enforcement for health care organizations’ entire clinical networks. “Medigate has deep expertise in both cybersecurity and health care, and we’ve capitalized on this to take a distinctive approach to identifying and securing medical and IoT devices,” said Jonathan Langer, CEO of Medigate. “This award further validates our approach to helping healthcare organizations protect everything on their network and overcome the security threats that the industry is facing today.” •
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INDUSTRY UPDATES October 17-19, 2019 • Baltimore
CAREER INSTITUTE OF TECHNOLOGY RENAMED COLLEGE OF BIOMEDICAL EQUIPMENT TECHNOLOGY
MD EXPO PRE-APPROVED FOR UP TO 9.5 CEUS
Following re-accreditation by the Accrediting Council for Continuing Education and Training (ACCET) and approval by the Texas Higher Education Coordinating Board (THECB) and the Texas Workforce Commission (TWC), the Career Institute of Technology has been renamed the College of Biomedical Equipment Technology, a veteran-owned and operated online college. “The decision to change the name of the college was driven by our efforts to better align with our mission and purpose,” said school director Richard Gonzales. “The College of Biomedical Equipment Technology’s mission is to provide Healthcare Technology Management (HTM) education, training and career services consistent with the evolving needs of employers in the health care industry.” The college is also announcing the addition of two instructors. Frauke Steinmeier, M.A. education, is joining the college with more than 10 years of teaching experience at the University of Luxemburg, the University of Texas at San Antonio, and in public education. She is also a Department of State Fulbright Scholar and a Department of Homeland Security SFS Scholar with an emphasis on cybersecurity. Frauke joins College of Biomedical Equipment Technology from Northeast Independent School District in San Antonio, Texas, where she served as a foreign language teacher and activities director. The College of Biomedical Equipment Technology also announced the addition of Brent Isham as its lead math and electronics instructor. He possesses more than 15 years’ experience in education and brings an unsurpassed passion for education and the HTM industry. He earned a bachelor of science in mathematics from the University of Texas at San Antonio and an associate of applied science degree in electronics engineering from ITT Technical Institute. • For more information, visit www.cbet.edu.
The 2019 MD Expo to be held October 17-19 in Baltimore, Maryland, has been preapproved for a total of 9.5 CEUs. “Please feel free to inform all attendees that this course has been preapproved and if they are claiming it on their ACI journals, it will be accepted for a maximum of 9.5 CEUs,” Martin “M.J.” McLaughlin, program manager certification, AAMI, wrote in an email. MD Expo is a well-known conference that has served the HTM community for almost 20 years by providing world-class educational sessions, top-flight networking opportunities and an exhibit hall filled with the latest technology, service and equipment options. It also provides opportunities for meaningful interactions with HTM thought leaders and peers from around the nation. MD Expo strives to provide healthcare technology management professionals with a unique, intimate and rewarding conference second to none. For three eventful days, clinical engineers, biomedical technicians, directors and managers, procurement/asset managers and others responsible for medical technology will gather in a one-of-a-kind warm and welcoming environment to network with peers, learn the latest technologies and advances in HTM. • For more information, visit MDExpoShow.com.
IMT ANALYTICS AG INVESTS IN IOT PROJECT IMT Analytics AG reports that it will invest in the future in the business field of Internet of Things (IoT), additionally to the further development of the ventilator testers. This project will improve patient therapies. In the second quarter, sales rose to $4.4 million. The sales of test equipment and the number of measuring instrument calibrations according to the ISO 17025 standard increased as well. IMT Analytics invests continuously in the further development of its measuring devices for testing ventilators and anesthesia machines. The modern device platform enables automatic, regular software updates via a WLAN connection. The user then can upload measurement data to a dropbox as test reports, which simplifies the work and makes it more efficient and reliable. IMT Analytics AG also plans to invest in a new business
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segment and currently develops IoT devices that transmit data from medical devices into a cloud. These are then evaluated and made available to clinical users anonymously. The goal of this technology is to improve the medical care of patients. A first test system will be put into operation in Switzerland in 2020. •
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REPORT: NEARLY A THIRD OF HEALTH CARE EMPLOYEES NEVER RECEIVED CYBERSECURITY TRAINING A new report from Kaspersky finds employees of health care organizations in the U.S. and Canada are lacking cybersecurity education and awareness in three main areas including regulation, policy and training. Of these key areas, the most alarming statistic found that nearly a third of respondents in North America (32%) said that they had never received cybersecurity training from their workplace but think they should have. The report, “Cyber Pulse: The State of Cybersecurity in Healthcare – Part 2,” uncovers several key findings that directly correlate to the increasing number of hacking and IT related incidents occurring in healthcare organizations across North America. When surveying respondents on health care regulations, the main findings concluded that there is an obvious lack of awareness of federal regulations in the U.S. and Canada in place to keep patient information safe and secure. According to the report, nearly a fifth of U.S. respondents (18%) reported they did not know what the HIPAA security rule meant. In Canada, nearly half of respondents (49%) said they didn’t know if Canadian PHI needed to stay in Canada. “The results of the survey show that knowledge of regulatory requirements is missing or too low,” said Matthew Fisher, chair of Health Law Group and partner for Mirick O’Connell. “In working with many clients and talking with others across the health care industry, the results are not surprising given the number of erroneous statements made about regulatory requirements and the misuse of regulations as the reason not to engage in an action that is actually permissible. The lack of awareness creates unnecessary risks.” In addition to gaining insights on regulations, health care policy proved to be an area where health care professionals are also lacking in awareness as well as education. Over a fifth of respondents (21%) in North America admitted that they were not aware of the cybersecurity policy at their workplace. When breaking down the results by region, just over a third (34%) of respondents in the U.S. and just over a quarter (27%) of respondents in Canada said they were aware of the cybersecurity policy at their workplace but have only reviewed it once. The survey also evaluated respondents on the level of cybersecurity training they received in their workplace. According to the findings, there is a dramatic need and desire from employees for increased cybersecurity training in their organizations. Nearly 1 in 5 respondents (19%) said there needed to be more cybersecurity training by their organization. When comparing the results by region, over 24% of respondents in the U.S. noted they had never received cybersecurity training but should have, compared to 41% of respondents in Canada when asked the same question. This quantitative study was conducted by research firm Opinion Matters via an online survey targeting 1,758 employees in a variety of roles ranging from doctors and surgeons, to admin and IT staff working at healthcare organizations in North America. •
COME GROW WITH US
Build Your Career at Crothall Healthcare Technology Solutions Career opportunities abound when you are part of a growing Team. Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years. With growth comes new jobs and new opportunities.
Come see why Crothall has earned Modern Healthcare’s Best Places to Work six years in a row.
ISN’T IT TIME FOR YOU TO FIND OUT MORE? Come grow with us. Please contact: Glenn Garrett Talent Acquisition Recruiter Glenn.garrett@compass-usa.com
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INDUSTRY UPDATES
INNOVATUS IMAGING ANNOUNCES LEADERSHIP CHANGE
REPORT: MEDICAL EQUIPMENT MAINTENANCE MARKET TO REACH $12.6 BILLION
Innovatus Imaging recently announced the addition of Dave Johnson, a seasoned executive for medical device and health care companies, to its leadership team. Johnson joins as CEO, replacing Dennis Wulf, founder, who will now serve as chairman of the board. Johnson comes to Innovatus Imaging at a time of record growth and will help to manage the company’s recent growth in probe and MRI coil repair volume, and lead expansion into other medical device markets. He will be located in the company’s MRI Center of Excellence in Pittsburgh, Pennsylvania. Johnson has served on the Innovatus Imaging Board of Directors since October 2018. “We are pleased for Dave Johnson to join Innovatus Imaging and apply his proven leadership to achieve greater efficiencies and growth while maintaining the high value already delivered to our customers,” says Wulf. “I look forward to blending our leadership vision and expertise to further Innovatus Imaging as the thought and technology leader in the imaging and medical device industries and achieve our future business and financial goals as we continue to diversify into the medical device markets.” Johnson most recently served as CEO of Joerns Healthcare, a medical products and services company targeting post-acute care needs. He has led multinational services for global brands operating in North/South America, Europe and Asia, and has managed more than 3,000 employees across 12 international locations. He has a strong track record for improving operational systems while increasing revenue and profitability for both public and equity backed organizations. He brings more than 20 years of demonstrated leadership and tangible results to the Innovatus Imaging team. In addition to serving as CEO, Johnson will serve as the Operating Partner for Healthcare for Resilience Capital, a private equity firm with interests in Innovatus Imaging. •
The U.S. medical equipment maintenance market is expected to reach $12.6 billion by 2024, this growth is primarily ascribed to the rising health care expenditure as a percentage of gross domestic product (GDP), large pool of installed medical devices in hospitals and diagnostic centers, and huge presence of OEMs as well as medical equipment maintenance service providers in the country. On the basis of equipment type, the U.S. medical equipment maintenance market has been categorized into imaging, electromedical, life support, surgical, dental equipment and endoscopes. Among these, imaging equipment is expected to be the fastest growing category, advancing at a CAGR of 10.1% during the forecast period. The high cost of imaging equipment compared to other medical equipment; and increasing adoption of imaging modalities, such as X-ray, computed tomography (CT) and ultrasound for clinical applications are the key factors contributing to the growth of this category in the U.S. On the basis of type of modality, the imaging equipment maintenance market has been further categorized into advanced and primary imaging modalities. Advanced imaging modalities are in high demand in the U.S., since most of the health care settings in the country invest and incorporate these imaging modalities, such as CT and magnetic resonance imaging (MRI) rather than primary imaging modalities. Furthermore, increasing adoption of equipment with advanced imaging modalities creates high demand for their maintenance. Based on service type, the U.S. medical equipment maintenance market has been classified into preventive, corrective and operational services. Of these, the preventive category is predicted to lead the U.S. market, both in terms of size and growth, during the forecast period. This growth can be attributed to the increasing adoption of the annual maintenance cost (AMC) policies by hospitals and other end users in the country, due to various benefits associated with these policies. On the basis of service provider, the U.S. medical equipment maintenance market is categorized into original equipment manufacturers (OEMs), independent service organizations (ISOs) and in-house maintenance. Among these, OEMs was the highest revenue generating category in the U.S. market, with more than 72.6% contribution in 2018. This category is further classified as multi-vendor and single-vendor OEMs. On the basis of end user, the market has been categorized into public-sector and private-sector organizations. Privatesector organizations as an end-user category is expected to be the faster growing category in the U.S. medical equipment maintenance market, registering a CAGR of more than 10 % during the forecast period. •
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NUVOLO APPOINTS HEIDI HORN TO GLOBAL ENABLEMENT LEADERSHIP ROLE Nuvolo has announced the appointment of health care industry veteran Heidi Horn to the position of vice president, global enablement-healthcare. “Horn brings deep expertise in healthcare technology management (HTM) and clinical engineering operations, holding a variety of executive leadership and strategy roles throughout her 20-plus year career,” according to a news release. “Horn is well-known in the HTM community for her transformational work leading the HTM department at SSM Health for more than a decade. Heidi also has deep roots in the health care industry with extensive involvement with the Association for the Advancement of Medical Instrumentation (AAMI), including serving as a member of the board of directors and chair-elect of AAMI’s Technology Management Council (TMC). Horn recently received AAMI’s HTM Leadership Award and is an
inaugural member of the AAMI Fellow program.” “Heidi’s experience will be an important asset as we continue to scale our health care business, replace legacy CMMS and create a better work experience for our HTM customers,” Nuvolo CEO Tom Stanford said. “Her deep industry experience, understanding of the everyday needs of the hospital and commitment to teamwork are important attributes she brings to our organization. Heidi will contribute to and help grow Nuvolo’s culture, making this appointment a great fit for our company. We’re thrilled to have her leading our global enablement team’s health care initiatives and look forward to her many contributions as we continue to grow and expand globally.” • For more information, visit www.nuvolo.com.
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INDUSTRY UPDATES SURVEY: IOT-FOCUSED CYBERATTACKS ARE THE NEW NORMAL Eight in 10 organizations have experienced a cyberattack on their IoT devices in the past 12 months, according to new research by Irdeto. Of those organizations, 90% experienced an impact as a result of the cyberattack, including operational downtime and compromised customer data or end-user safety. This demonstrates the security limitations of many IoT devices and the need for organizations to think carefully about a cybersecurity strategy amidst an IoT deployment. The Irdeto Global Connected Industries Cybersecurity Survey of 700 enterprises in five countries (China, Germany, Japan, UK and U.S.) also found that organizations in transport, manufacturing and health care have suffered substantial losses due to IoT-related vulnerabilities, with the average financial impact as a result of an IoTfocused cyberattack identified as more than $330,000. With IoT in its relative infancy across these sectors, this substantial financial burden is only going to increase if action is not taken. However, it’s not all gloom and doom for these sectors. Of those surveyed, 99% agree that
a security solution should be an enabler of new business models, not just a cost. These findings suggest that the previous mindset of IoT security as an afterthought is changing. “One of the most promising results of the study found that today’s organizations in technology, transport, manufacturing and health care are thinking even more strategically about security,” said Steeve Huin, vice president of strategic partnerships, business development and marketing, Irdeto. “This is a clear indication that today’s businesses realize the value add that security can bring to their organization. From enabling new rental or subscription models in connected vehicles, to Digital Twins revolutionizing the manufacturing processes, to providing patients with even better health care, security is the enabler to successfully implementing new and future business models in today’s connected world.” • For more survey results, visit https://go.irdeto.com/ connected-industriescybersecurity-survey-report/.
TECHNICAL PROSPECTS HIRES JOSEPH SAM Technical Prospects, a leader in the medical imaging industry specializing in Siemens medical imaging parts, training and support, has added Joseph Sam, imaging support engineer and technical trainer. He will serve as a trainer for Technical Prospect’s wide array of onsite courses and will also work as a member of the 24x7 customer support team. As an imaging engineer, Sam brings 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. He has provided onsite service and support for customers throughout the United States as well as on-the-job training. “We are excited to welcome Joseph to the Technical Prospects team,” Jeremy
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Probst, Technical Prospects president and CEO, said. “We are always looking for ways to improve the medical imaging industry and, with his experience in the diagnostic imaging industry and electronics background in the United States Navy, we believe Joseph will provide superior customer service and training.” Sam will develop content for the training of internal staff and external customers for medical imaging equipment. He also joins the group of engineers who take support calls 24x7. In addition, as an imaging support engineer, Sam is responsible for ensuring medical imaging equipment follows applicable regulatory requirements and quality control standards. He will also maintain the equipment necessary to test finished product.
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ECRI UPDATE
Closing the Gap on Surgical Stapler Safety
I
nternal surgical staplers made headline news in 2019. Reports discussed the little-known FDA database housing tens of thousands of stapler-related problem reports, they provided updated statistics on patient injuries and deaths, and they covered the agency’s recent proposal to reclassify staplers as Class II devices, instead of the more lightly regulated Class I. While the technology landscape undoubtedly is changing, the need for hospitals to protect their patients remains constant.
The last thing surgeons want are complications that put patients at risk. So, when a surgeon pulls the trigger on a surgical stapler, it better work correctly – every time. Unfortunately, that’s not always the case. Surgical staplers are commonly used in high-risk surgical procedures; and misuse or malfunction of the devices can lead to serious complications, as ECRI Institute has seen during its research and accident investigations. To provide the appropriate context: The overall adverse event rate is actually quite low relative to how frequently staplers are used. Nevertheless, adverse events do occur, as problem reporting data shows; and even rare instances of preventable death warrant scrutiny. FDA’s May 2019 report Reclassification of Surgical Staplers for Internal Use summarizes 109,997 problem reports submitted for surgical staplers and staples since 2011. Of these, 412 involved deaths and 11,181 described serious injuries. By understanding how staplers work, recognizing how complications occur, and involving various stakeholders in patient safety efforts, hospitals and providers can close the gap on surgical stapler safety. STAPLER FORM AND FUNCTION Internal surgical stapler designs vary depending on whether the device is intended for open or endoscopic surgery, as well as whether it will be used just to staple tissue or to both staple and cut. (Some cutting models, for example, first seal the tissue with lines of staples then transect those lines with a cutting mechanism to separate those parts of the anatomy.) These specialized devices may be used when “removing part of an organ (i.e., resection), cutting through organs and
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tissues (i.e., transection), and creating connections between structures (i.e., anastomoses)” (FDA 2019 Reclassification of Surgical Staplers for Internal Use). Endoscopic linear cutter designs, for example, consist of a handle and shaft with jaws at the end that can be closed on the tissue of interest. The surgeon clamps onto the tissue and then fires the stapler. This action deploys rows of staples into the clamped tissue on either side of the intended cut line, followed immediately by a knife that travels down the channel in the stapler’s cut line, transecting the tissue between the symmetrical lines of deployed staples. In this way, the stapler seals the tissue on either side of the cut to prevent hemorrhage. On circular models, by comparison, the end of the staple cartridge is compressed against a circular anvil to bring two sections of tissue (i.e. bowel) together. Circular models are most commonly used for gastrointestinal (GI) anastomoses. Other designs are also available. Despite performing similar functions, stapler models – even those of the same type – can vary pretty significantly from one brand to the next. Again using endoscopic linear surgical staplers as an example, models from the two major stapler manufacturers differ in several respects, such as: • The design, selection, and color of the staple cartridges; the range of tissue thicknesses for which each cartridge is intended; and the method of cartridge installation and removal • The method of stapler head articulation • Whether the stapler must be unlocked to indicate firing readiness, and whether tissue compression is recommended before firing • The number of trigger pulls required for staple deployment and knife advancement • The method for retracting the knife and for opening the stapler jaws after firing • The number of recommended uses on a single patient before disposal These differences illustrate that experience with one stapler model does not necessarily translate into skill with another model, a fact that can have patient safety implications. COMPLICATIONS, AND WHY THEY OCCUR Bleeding or GI leaks can occur if a staple line is incomplete or
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The anvil and cartridge of a single use linear stapler reload.
does not hold. Such problems may be immediately apparent, or they may not appear until sometime later, leading to severe symptoms long after the patient has been closed up and sent for recovery. Patient harm in these events can range from no injury to fatality. ECRI investigators have found that, in most cases, the stapler actually functions as intended. The adverse consequences instead result from clamping on another instrument or clip, clamping on tissue that is too thick or too thin, or some other form of misuse. Poor staple line integrity can also occur with diseased, necrotic, or ischemic tissue. ECRI INSTITUTE RECOMMENDATIONS The FDA’s move to reclassify surgical staplers – or, more to the point, the implementation of effective special controls, such as improved device labeling, that will accompany the reclassification – should be a step forward. But this process will take time. Following are four steps that hospitals and providers can take now to improve surgical stapler safety. 1. Improve event reporting. Risk managers and patient safety professionals can improve the quality of event reports in two ways: First, update reports as new information is obtained. For example, an event that is initially classified as a stapler “malfunction” (without injury) should be updated if an associated injury manifests days later. Second, establish an investigation plan. Risk management and frontline clinicians should know what to sequester, and should implement measures such as labeling disposables according to the chronology of their use and saving loose and malformed staples. 2. Consider the user when making purchasing decisions. Supply chain, purchasing, and clinical engineering
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departments should consider user familiarity when making a large purchasing decision, such as switching an entire suite of endomechanicals from one manufacturer to another. Lack of user familiarity continues to be a contributing factor in adverse incidents. Involve the user in purchasing decisions to bring potential use issues to light before devices are placed into service. 3. Recognize risks and plan ahead. Users of these surgical staplers should appreciate the risk of immediate and serious hemorrhage in vascular applications. We encourage users to have a back-up intervention planned in case of hemorrhage. Such planning can dramatically reduce patient harm. 4. Improve user training. Ensure that surgeons are knowledgeable and experienced with the specific stapler model that will be used. Unexpected outcomes are less likely if the surgeon is knowledgeable about and experienced with the device before use. Develop appropriate training criteria for staplers with the manufacturer, including contraindications and what can go wrong, and verify that these are met before stapler use. Reclassification by FDA and the identification of special controls is a step in the right direction. But it is just a step; and FDA is just one of the stakeholders with a role to play. Manufacturers can continue to improve device designs to reduce the risks of misuse. And health care facilities can implement measures like those outlined above to prevent patient harm. What are your concerns with surgical staplers? What would you like to see improved? Write to Scott Lucas, PhD, PE, Director, Accident and Forensic Investigation, ECRI Institute at accidents@ecri.org or visit www.ecri.org. Were surgical stapler hazards included on ECRI Institute’s 2020 list of the Top 10 Health Technology Hazards? See www.ecri.org/top-ten-tech-hazards to find out.
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INDUSTRY UPDATES
AAMI UPDATE BY AAMI
AAMI ADVANCES HTM STANDARDS A major revision of a “flagship” standard and the development of a “potentially landmark” new standard for healthcare technology management (HTM) represent a new direction in standards development for AAMI. “Historically, our standards have been manufactureroriented, or sterilization-related, whether that be industrial sterilization or sterilization in hospitals,” said Patrick Bernat, director of HTM standards at AAMI, a position created about a year ago. “We’ve had very few new standards that address the use, purchase, or maintenance of the equipment in a hospital.” That’s changing. AAMI’s Medical Equipment Management (EQ) Committee is engaged in a major revision of ANSI/AAMI EQ56: Recommended practice for a medical equipment management program, and developing a new standard, AAMI EQ103, which will address a hot topic – alternate equipment management or alternative equipment maintenance (AEM). “EQ56 has been known as the flagship HTM-related standard from AAMI,” Bernat said. Last revised in 2013, the standard has been around for two decades. The revision expected to be released by the end of this year is “a pretty significant upgrade.” Scott Trevino, vice president of quality, regulatory and medical technology affairs at TRIMEDX and co-chair of the committee leading the EQ56 revision, said there is “a strong desire and a need” to incorporate quality management principles into a standard. “Frankly, it’s intrinsic to a robust healthcare technology management strategy,” he said. The EQ56 committee worked with the FDA and The Joint Commission, manufacturers and independent service organizations, and experts in quality management systems and cybersecurity, to conduct a gap analysis between the 2013 standard and current quality management principles. The committee also reviewed ISO quality management standards. The EQ committee identified six critical gaps and five secondary gaps across the patient care continuum that will be addressed in the forthcoming revision. The six critical topics are quality management, service level management, capacity
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management, information security management, service continuity and availability management, and change management. The five secondary topics are partially addressed in the existing standard, but they require additional attention. They are budgeting and accounting for services, relationship management, incident and service request management, problem management, and configuration management. The second HTM-focused standard in development deals with the support and service of medical devices. EQ103 will offer guidance on developing an AEM program, addressing maintenance strategies and activities, as well as their frequency, to help ensure the use of a consistent, quantitative, risk-based methodology in AEM development. The standard is scheduled to be published in 2020. AAMI NAMES NEW CHAIR TO AWARDS COMMITTEE Codi Nelson, CBET, team leader at Crothall Healthcare Technology Solutions (HTS), is now chair of the AAMI Awards Committee. Currently in his third consecutive year on the committee, Nelson said that “being able to intimately review what each applicant is doing in their respective careers is an exciting and inspiring process.” Nelson has served on the committee as the AAMI Awards Program has expanded. At the 2019 AAMI Exchange in Cleveland, AAMI and TRIMEDX launched the John D. Hughes Iconoclast Award, which recognizes individuals who push the boundaries of the healthcare technology management profession and demonstrate individual excellence, achievement and leadership. The AAMI Foundation & HSEA Health Systems Engineer Scholarship, which supports the adoption of a systems approach to healthcare technology, launched in 2017. AAMI is always on the lookout for areas of the industry where more recognition is deserved. “An AAMI award is an accomplishment that each winner should be honored to receive,” Nelson said. “It shows that the recipient is performing at the top level among their peers, and in most cases, also points to the individual’s rapid progression
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in their field.” Next year’s awards will be presented at the AAMI Exchange in New Orleans in June, and nominations are encouraged. “The AAMI Awards Program is designed to honor the best and brightest in the health technology industry for their innovation and commitment to patient care around the world,” said MaryJane Thomas, AAMI director of membership development. “Nominations for the awards are designed to encourage collaboration and new ideas in the health technology community to help move the industry forward,” she added. “While some awards do require the recipient be an AAMI member, it is not a universal requirement – and all are encouraged to nominate anyone worthy of these honors.” For more information, please visit www.aami.org/awards.
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TRAINING FOR HTM AAMI offers a variety of webinars and other training opportunities for members of the healthcare technology management (HTM) field. Recent webinars have covered tips on how to get HTM representation in the CHANGES NEEDED C-suite, along with another session that provided guidance on how to acquire and roll out new clinical technology.
ONFIRM THAT THEinformation FOLLOWING ARE CORRECT For more about upcoming webinars, including private training, please visit GO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR www.aami.org/training.
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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
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THE BENCH
BIOMED 101
How to Recruit and Retain BMET Career Changers, Prep for Gen Z Workforce BY KATHLEEN LICHT AND CHELSEA SCHOEN
F
or the past decade, the looming retirement crisis for BMETs has been at the forefront of the industry’s mind. It is apparent that there are multiple ways in which we need to recruit talent to sustain our field for the long term. Perhaps the key to attracting more people lies in the many different paths individuals can take to become a BMET.
Whether it be a career change, military training, or the traditional schooling route, one can find a place in this growing community of professional and skilled workers. In this article, we will discuss our unique paths to the field and offer our view on how to recruit and retain individuals in the future. TRADITIONAL CAREER PATH, MILLENNIAL I took the “traditional” path to becoming a BMET. In my experience in high school, the standard expectation for the Millennial and Z Generations is to pursue a four-year degree. In this fashion, I began on this path by pursuing more traditional science degrees, then became aware of biomedical engineering technology via an advisor at Cincinnati State Technical College. In researching the field, I realized it was a perfect fit for my interest in a wide-range of sciences, enthusiasm for patient outcomes and the realization that I wanted to find a career that would have long-term growth opportunities and be continually stimulating. – Kathleen Licht
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CAREER-CHANGER My change to a BMET career was a long journey that involved going back to school in my late twenties. I used to serve on the direct patient care side of the medical field as a State Tested Nurse Aide (STNA) who transitioned to become a phlebotomist/lab technician. My interest in the field was piqued when I interacted with BMETs in the lab where I worked. The decision to change my career was a difficult one and included thought into what the career field outlook was projected to be, diversity of the field and family considerations. – Chelsea Schoen Our paths crossed while pursing our BMET degree and we quickly developed support for each other. The excitement
options and titles that come with biomeds nowadays are as numerous as ever and show no signs of slowing. The diversity and pace of the field as well as the allure that your skills can be translated into a wide range of environments is enticing for careerchangers and new BMETs alike. Crothall Healthcare, specifically, was appealing to us due to its progressiveness being ISO 13485:2016 Quality Management System certified. We knew that we would be working in a leading-edge organization and our work would match the requirements that OEM vendors have as well. This allowed us to gain a greater perspective of the field from hospital, to manufacturer and the evolving regulatory
“ Regardless of where someone may have started on their path to becoming a biomedical technician, there is a sense of belonging because we all share the same drive to create positive outcomes in health care.” C. SCHOEN of the ever-evolving technology landscape of health care and innovations were the main attractors for both of us to the BMET field. As we reflect on our experience, we offer some suggestions on how biomed can continue to recruit and retain talented individuals into the field. • A Plethora of Possibilities – The
requirements in the industry. • Career Ladder and Staying Power – Due to the vast range of opportunities and translatable skills, the biomed field also attracts individuals through the promise of staying power. Biomed is a career that you can continue to grow in with or without formal training or advanced
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degrees. The push for professionalization from the field has also lead to a broader availability of certifications that can allow your job to feel brand new without leaving the field. • Community – The field has been cultivating a unique community that showcases its diversity in an inherently genuine way that reflects the field as a whole. The AAMI #IamHTM campaign has also showcased a wide range of individuals in many aspects of the field which allows those interested in biomed to gain a better understanding of the career and cast a broader net in recruitment. • Personal Considerations – Fulfillment in career, continuous learning and growth opportunities and family considerations are of utmost importance to professionals as they start in this career as well as during various aspects of their career. Regardless of where someone may have started on their path to becoming a biomedical technician, there is a sense of belonging because we all share the same drive to create positive outcomes in health care. Our two paths represent just a fraction of the ways BMETs are coming into the field.CHANGES We know that there are still many PROOF APPROVED NEEDED more paths to choose from as we grow in this field. Everyone’s path is different, but we are all a part of this growing and progressive CLIENT SIGN–OFF: community regardless of the path that led us here.
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THE BENCH
WEBINARS
Webinar Wednesday Benefits 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 HTM topics.
Attendees from a range of experience levels have viewed live and recorded presentations to earn ACI-approved continuing education credits. AEDS AND DEFIBRILLATORS The Webinar Wednesday presentation “AEDs and Defibrillators: An Introduction, Overview and Review” was sponsored by Coro Medical. The 60-minute webinar featured Blaire Czarniecki, customer service manager at Coro Medical, and Phillip Woods, BA, NREMT-P, FP-C, account manager at Coro Medical. They discussed automated external defibrillators (AED) awareness and ongoing education. They provided an introduction, overview and review of AEDs and manual defibrillators. In a post-webinar survey, attendees were asked to share how the webinar will help them improve in their role. “When our organization switches to a new fleet of AED and defibs, we will be able to give information on what models are most tailored to their needs and the cost/benefit of the differences,”
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“ This was probably the most useful Webinar Wednesday I’ve attended yet. I found it very informative and compehensive.” E. OATES, DIRECTOR BIOMEDICAL ENGINEERING Biomedical Engineer T. Wade said. “Brings in insight for my surgery center and also ideas for me to include in discussion for the entire campus to improve our quality of care,” EVI Manager J. Jordan said. “We have over 100 AEDs at our facility, anything that pertains to this topic is beneficial,” said G. Koch, BMET III. “Excellent knowledge of AEDs and defibrillators will help me carry out proper maintenance management of them for the purpose of proper patient management,” Chief Biomedical Technologist E. Enyi said. “We are taking over inspections and maintenance of AED devices in our system and the webinar helped with this,” Lead Tech Clinical Engineering E. Bican said. 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 HTM professionals can initiate or enhance the strategic technology planning process within their organization. In a post-webinar survey, attendees 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,” Biomed 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 vs. list. I would
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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 Biomedical Engineering 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. 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. “It is important for a biomed to interact favorably with clinical staff,” shared C. Callista, CBET. “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,” Biomed 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. CYBERSECURITY ROUNDTABLE The recent cybersecurity roundtable webinar helped HTM professionals power up to the next level with great insights and helpful tips. It also provided 1 credit from the ACI. The webinar was sponsored by Medigate, Cynerio and Nuvolo. The panel of speakers included Simeon Utubor, director/pre-sales engineering at Medigate; Leon Lerman, co-founder and CEO of Cynerio and Ben Person, vice president of product marketing at Nuvolo. Cybersecurity continues to be an important and hot topic in health care, especially in the HTM community. 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
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
presentation and 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 Biomed J. Cozadd. “Each presenter was very knowledgeable of their product, presented pertinent material regarding their product and did a great job answering questions submitted by the attendees,” Senior BMET D. Duck said. “Today’s webinar provided a good overview of medical IoT security concerns and how to monitor, track and document associated actions,” said L. Riley, biomedical systems analyst. “It was good to see different companies present together on the same topic and goal. It makes it so that you can see the strength of each product in comparison to others at the same time,” shared A. Todd, CET 4. “Good overview of what tools are becoming available to help us manage medical equipment and cybersecurity issues,” Director of Biomedical Services M. Bishop said. For more information about the Webinar Wednesday series, including a calendar of upcoming presentations and recordings of previous webinars, visit WebinarWednesday.Live.
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TOOLS OF THE TRADE Soom
SOOMSAFETY Soom has introduced SoomSafety, an iOS mobile app that allows users to scan a medical device and receive instructions for use, safety and recall information directly from the device manufacturer and U.S. Food and Drug Administration (FDA). SoomSafety is the first app to utilize openFDA, open-source databases that enable developers to quickly and easily use FDA data in applications. This year alone, 26 medical device products have been recalled, affecting nearly 50 million individual devices in the United States. SoomSafety users scan the barcode on a medical device to automatically identify the device and store it in the app. The app
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
also identifies and stores implanted medical devices like artificial joints, pacemakers and heart valves by scanning the barcode on a patient’s medical device identification card. Once a device is stored, the app checks for FDA recall information, provides next steps in the event of a recall and pushes notifications if the device is ever recalled. In addition, the app displays safety and use information for each stored device. SoomSafety is available now for free in the Apple App Store. Patients, caregivers and homecare professionals can learn more about SoomSafety at www.soom.com/soomsafety.
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SHOP TALK POWERED BY
GE HEALTHCARE - OEC 9800 PLUS I am having problems with an OEC 9800 machine. The beginning of the problem was the fluoro function board got stuck during the boot-up process with only squares remaining in the C arm display. When I replaced this board with another one from a different machine it worked fine. I purchased a new board, but this one gets stuck in the boot-up process. Even the workstation is unable to finish loading software. I can’t connect via RUT because the generator won’t finish the boot-up process. I tried to erase flash but it didn’t work. Can somebody help me? I have worked with GE C arms since 2002, but with the 9000, 9400 and 9600 models.
Q:
A:
I suggest you replace the old FFB and disconnect the C arm from the workstation and make sure you can boot up the workstation in standalone mode. It is likely you will have to reload the software.
A:
Where does it stop? How many bars can you count when the software hangs up? It’s probably not a software issue. When the C arm starts and the software loads it performs a number of pre-use tests and if it sees something is mismatched like a certain checksum it will halt. So, count the number of bars it is halting at.
A:
You said you replaced the board with another board and it worked (I’m guessing from another C arm) and the new board you ordered makes it go back to the same symptoms? Check all board connections and cables and make sure the new board is the proper board version. Try swapping out boards again. GE HEALTHCARE - SERIES 2000 TREADMILL I have a problem with the device. It doesn’t function. I don’t know if it is the cable between the CPU and the device or something else.
Q:
A:
The first thing to do is confirm the problem is the treadmill: Unplug treadmill from wall. Here are the steps: 1. Disconnect the interface cable at the treadmill. 2. If the treadmill has an emergency stop, pull the phone plug out. 3. Locate the small, approximately 2 by 3/4 inch black plate held on by 2 screws and remove it. 4. Plug treadmill in with power switch in “Off” position. 5. Locate two gold pins behind black plate 6. Short out two gold pins and turn on power at same time. 7. Treadmill should run through a series of elevation and belt speed steps while calibrating. 8. If treadmill does not elevate and run belt, problem is the power board or the “Thor” board.
SHOP TALK
is compiled from MedWrench.com. Go to MedWrench.com community threads to find out how you can join and be part of the discussion.
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ROUNDTABLE
ROUNDTABLE CMMS
A
computer maintenance management system (CMMS) is a valuable tool that biomeds use to maintain medical equipment. TechNation invited several CMMS experts to participate in this month’s roundtable article on CMMS. The goal is to provide insights into the latest technology and features available to the HTM community.
Participating in the roundtable article on CMMS are Fluke Corporation Vice President of Sales and Special Projects eMaint Hannelore Fineman, oneSOURCE Biomed Expert Travis Horstman, Nuvolo Vice President of Product Marketing Ben Person and EQ2 LLC Product Manager Rich Sable. Q: HOW HAS THE USE OF A CMMS PROGRESSED IN THE HTM SPACE? HORSTMAN: As reporting procedures continue to improve, using a CMMS in the
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Travis Horstman oneSOURCE
HTM space becomes increasingly important. The advent of refined reporting processes add visibility into many different HTM responsibilities. In addition, asset tracking/procurement, work status (problematic items), fiscal planning and manpower are all important to HTM.
PERSON: The evolution of HTM departments themselves have driven the need for more powerful and integrated workplace management systems. Legacy CMMS systems could mainly track assets, maintenance history and schedule planned maintenance. Today’s HTM departments must also manage vendor service contracts, track and manage maintenance costs, oversee device cybersecurity and have data for capital planning. Legacy CMMS systems have given way to cloud-based offerings that greatly expand the flexibility and capability of the typical CMMS. The advent of mobile technology is another example, freeing the clinical engineer from paper and greatly improving productivity and reporting options. SABLE: In the past, work orders and asset management were the top concerns for HTM, but now the HTM community leaders are requiring many
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new features. For example, HTM now requires mobility solutions including non-networked applications for remote areas as well as integration to other information systems to enhance productivity. These include ServiceNow, Zingbox, oneSOURCE, PartsSource, Lawson, PeopleSoft, Glassbeam and RTLS services. Finally, managers need dashboards for at-aglance management, tools to assist with AEM and ever-evolving compliance requirements, repair parts management and robust reporting. Compared to the early days of CMMS, HTM wants advanced functionality to maintain their organization’s assets, evolving workflows and regulatory compliance.
accommodate the nature of the health care environment. And since the Joint Commission or DNV surveys are a fact of life, easily generating real-time compliance reports, as well as selfgenerating custom reports, is key to handling those periodic fire drills that everyone dreads.
Q: WHAT FACTORS SHOULD BIOMEDS CONSIDER WHEN PURCHASING OR UPGRADING A CMMS FOR THEIR FACILITY? HORSTMAN: When purchasing or upgrading a CMMS, biomeds must take into account the facility and features of the system that will be beneficial to that facility’s needs. Asset tracking, for example. If a facility purchases new equipment, health care practitioners can then track maintenance through a general time window, however, if outdated equipment is procured, tracking technology to maintain compliance by the release date is more difficult. Other factors in the decision making process include funding and the justification process for purchasing, along with the level of visibility managers believe should be placed on the facility’s CMMS. PERSON: It all starts with configurability and flexibility. Every healthcare technology management team works differently, and you want to select a system that adapts to your operations, not the other way around. Additionally, a native mobile application is par for the course nowadays and should have the ability to work offline or online to
Ben Person Nuvolo
SABLE: One factor to consider is the longevity of the CMMS vendor because this is directly related to their knowledge and experience with HTM needs and regulatory compliance. Another factor to consider is the delivery model such as SaaS or in-house servers because many IT departments will dictate the delivery model, and a vendor that offers both solutions will better meet their IT department’s needs. Also, biomeds should consider their department workflows and assess the software requirements to match their service model. Such considerations include mobility solutions, networked or non-networked operation, system integration, and support and service required for the CMMS product chosen. Finally, your CMMS budget will dictate whether the purchase is for a full system or to take the modular approach where modules are selected as needs arrive and budget becomes available.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Q: WHAT ARE SOME OF THE NEWEST FEATURES AVAILABLE? FINEMAN: Some of the newest advances in CMMS capabilities are how it connects with other industrial data sources. eMaint CMMS can connect with Fluke sensors to provide maintenance teams a complete picture of asset health. By integrating data from other sources, teams can move from calendar-based preventive maintenance efforts to more efficient predictive maintenance strategies. HORSTMAN: oneSOURCE is integrated in multiple CMMS software programs. Within the equipment record in the CMMS oneSOURCE can be accessed and automatically queried for documentation. Document results automatically populate on our search screen. The document found can be added to CMMS database on the work order or equipment record. This is very intuitive and can be accomplished with a few clicks. These features are beneficial because it provides direct access for technicians and managers to manufacturer’s documents required for maintenance and repair. Technicians can quickly and easily access the document within their software while actively providing support. Managers can verify work completed is in line with equipment manufacturer’s recommendations, thus improving efficiency and accuracy of work performed. PERSON: Robust AEM functionality is something that is moving into modern CMMS systems as the AEM implementation process standards are being further defined by leaders in the HTM community, including the automation around selection and reporting necessary to credibly justify modifying the OEM maintenance schedule of a device. I would also say that, given the threat posed by cyber bad actors, improvements in
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cybersecurity vulnerability remediation operations – and specifically automating them effectively – not only alleviates workloads but, more importantly, can reduce the risk of a cyberattack that impacts hospital operations, patient privacy or patient safety.
FINEMAN: CMMS systems that are Software-as-a-Service platforms offer the best way to keep up with technological changes. Updates are rolled out as part of the subscription, so users always have the latest technology available. HORSTMAN: By building strong relationships with clinical engineering managers and technicians, HTM professionals are then more prepared for what is needed and required of their systems. Researching these requirements then informs the HTM professionals if these features are available within a new CMMS. Customer-based development and a working knowledge of CMMS help drive innovation and forums like TechNation prove to be an excellent resource.
Rich Sable EQ2 LLC
SABLE: One new feature especially helpful for remote locations is a non-networked mobile application that allows the technician to open, update and close work orders in the field, and then syncs the data once connected again. Another new feature is our call escalation and call assignment modules which route the work orders automatically to the correct technician and continually escalates them to the next technician or manager according to the HTM department’s policy. Already interfaced/integrated with ServiceNow, ECRI, RTLS and others, we recently added oneSOURCE, Glassbeam, Lawson and PeopleSoft to meet hospital needs. Q: HOW CAN HTM PROFESSIONALS MAKE SURE THEIR CMMS KEEPS UP WITH ADVANCES IN TECHNOLOGY?
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PERSON: Like clinical devices, CMMS technology has advanced considerably in recent years, and it’s important to take an objective look at your legacy CMMS and evaluate whether it is meeting the current needs of the HTM department and hospital. It’s a direct function of the vendor and the platform on which the CMMS is built. Some technologies are simply difficult to upgrade or modify, and there’s little the vendor can do about it. Understanding the vendor’s release cadence, feature enhancement request process and, most importantly, underlying technology, is critical to preparing for what is likely to be a long-term commitment and what that means for product value and modernity. SABLE: One way to keep up with advances in technology is to choose a CMMS vendor with a proven history and proven experience in the HTM field which will guarantee that the vendor will include updates to maintain regulatory compliance and address new workflow design. Another way to ensure the HTM department has the
latest and greatest software is to purchase a support contract that includes product updates which will often have enhanced functionality based on advances in technology. This way, both service and upgrades are taken care of and this method is easier to budget than budgeting a full system upgrade in the future. Finally, it’s best to choose a vendor that attends HTM events such as AAMI Exchange and MD Expo, so their teams can keep a finger on the pulse of the HTM industry. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND USING A CMMS?
Hannelore Fineman Fluke
FINEMAN: One major pain point for leadership is adoption rates and successful implementation of new systems or workflows. Luckily, eMaint CMMS software not only offers tips and tricks to improve adoption, but our customer success managers are with you every step of the way to ensure your organization achieves their maintenance goals. HORSTMAN: When purchasing and using a CMMS, HTMs should begin the search process with needs in mind. Do they need a program that can integrate
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with older systems? Can it replace the old systems? What type of reporting would be required for their funding processes? And, the list goes on. HTMs should be aware of what programs are integrated with the system. PERSON: A relationship with a CMMS vendor is a long-term proposition. Look for a CMMS solution that is specifically focused on the health care industry. Try not to make the decision based on an immediate feature need, but rather try to project the flexibility of the platform and the vendor over the course of a 5- or 10-year relationship. Do they demonstrate an innovative culture? Does their technology make it relatively
easy or difficult to accommodate inevitable changes in your business requirements? Does the vendor focus on the future of HTM and keep pace with those trends? Those kinds of macroconsiderations are ultimately the most important areas to look at when considering a modern CMMS system. SABLE: TechNation readers should look for a CMMS vendor that has built-in intelligence that assists them in setting up their system to determine equipment type risk, assets eligible for AEM, advanced tools to maintain and document compliance, test equipment calibration, and Key Performance Indicators (KPIs). Also, it’s important
to have a budgetary figure for your new system and choose a vendor that offers a modular approach in case you need to build your system over several years. Finally, the HTM department should evaluate the condition of its current data to determine if the data needs to be cleaned up or standardized, and to examine the KPIs that your department needs to report to the C-suite. The CMMS vendor may provide services to help you accomplish these tasks. Regardless of the CMMS, the data must exist and be consistent before any meaningful reporting can be obtained from the CMMS.
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HTM
DIAGNOSTIC IMAGING
CLINICAL ENGINEERING
JUMP TEAMSTM
Leaders
Training P R E PA R I N G
in
L E A DER S I N H T M B Y
K .
R I C H A R D
D O U G L A S
H T M L E A D E R S H I P H A S A VA R I E T Y O F M E T H O D S T O H E L P P R E PA R E T E A M M E M B E R S F O R L E A D E R S H I P R O L E S .
ale Carnagey was born in the late 1800s and was the son of a poor farmer in Missouri. He was a member of his high school debate team and enjoyed listening to public speakers. His background as the son of a poor farmer did not gain him many friends after he enrolled in college. After he adopted the speaking style of another public speaker he had observed, he became a popular public speaker and gave lessons to fellow students. After failing Latin, he was forced to leave the University of Central Missouri without graduating. He later attended acting school and taught public speaking at the YMCA in New York. Those classes were so popular with students that other YMCA branches, across the country, began offering his classes. A book followed and Carnagey later spoke to a sold-out Carnegie Hall. After that experience, he changed the spelling of his last name to Carnegie. The rest, as they say, is history. Tens of thousands of people, shopping the self-improvement shelves of their local bookstores, have benefited by reading Carnegie’s book “How to Win Friends and Influence People.” It remained on the best seller lists for a decade after its release. Carnegie’s recipe for success included showing enthusiasm during public speaking, offering honest and sincere appreciation, being a good listener, remembering people’s names, smiling, become genuinely interested in other people and making other people feel important. These are all hallmarks of leadership. Carnegie remains near the top of the list of those who have authored self-help or self-improvement books. There is a point in many people’s lives where they have an epiphany and decide that it is time to reach new heights in their personal lives or career. Some are salespeople looking for new ideas
to increase sales and others are looking for the best path to a promotion. There needs to be a roadmap to accomplish this because it often takes more than introspection. A PATH TO LEADERSHIP Within the HTM ranks, there is a career path for many who seek it. It may be getting from a BMET 1 to a BMET 3. It may be going from a manager to a director or from BMET 3 to manager. Many in HTM agree that it takes soft skills, like those taught by Carnegie, to climb the proverbial corporate ladder. HTM leadership has a variety of methods to help prepare team members for leadership roles. “I hold a weekly leadership meeting that helps groom my leaders. I share big picture topics, such as regulatory, budget, politics, staffing and team morale. They also participate in the overall planning for projects and capital. I also teach project management basics, lean and six sigma processes,” says Matt Royal, CHSP, CHFSP, CHEP, CHTM, CLSO-M, CHC, CHFM, CBET, director of biomedical engineering at Eskenazi Health in Indianapolis, Indiana. Royal says he also shares classic books such as “Who Moved My Cheese,” “The One-Minute Manager,” multiple Steven Covey titles and a book on workplace law that is put out by the American Bar Association. “There is also formal leadership training that is provided by the human resources department. This training is for new hospital leaders that trains on workplace law, payroll, etcetera. There are
Article CONTRIBUTORS LEANNE HESTER chief marketing officer, TRIMEDX
MIKE BUSDICKER clinical engineering, Intermountain Healthcare
MATT ROYAL biomedical engineering, Eskenazi Health
also classes on time management and conflict management that they are asked to attend. They also have performance metrics tied to project management and continued education. I also encourage them to purchase the CHTM study guide and discuss concepts they will see on the test,” Royal adds. Not only do in-house HTM departments offer a path and roadmap for leadership, but third-party providers can have a welldeveloped program for tomorrow’s leaders. This can include the further development of current managers. TRIMEDX is one example of this. “We offer new manager onboarding classes every other month for all newly hired or promoted leaders. This week of training includes a DISC assessment that focus on their communication and work style and how to improve the impact of their style with different team members and customers,” says LeAnne Hester, chief marketing officer at TRIMEDX. “During this week, we also conduct the ‘Six Critical Practices for Leading a Team,’ which covers developing a leader’s mindset, holding effective one-on-ones, setting up your team to achieve results, creating a culture of feedback, leading through change and managing your time and energy,” Hester adds. She says that the company also offers a leadership exploration series to all associates, team leads and supervisors who would like to pursue a leadership role. This is a four-part series that covers coaching for peak performance, delegating with purpose, resolving workplace conflict and defining a leadership journey. “The first thing I do with members of my staff is to understand their individual career goals and aspirations. Staff members with an interest in becoming a leader should have a desire to learn and grow personally and professionally. With that information, then we can determine where they want to be in three, five, seven or even 10 years,” says Mike Busdicker, CHTM, FACHE, system director of clinical engineering, Intermountain Continuum of Care at Intermountain Healthcare in Midvale, Utah. He says that the next step includes looking at their current and past experience in
leadership or supervisory roles. “This information will be used to evaluate strengths and developmental needs for each person. Once the opportunities for growth are established, then we can start to set goals and objectives in the development of traits and qualities of an effective leader. These would include establishing milestones, selection of appropriate tools, attendance at education sessions and the use of leadership training materials,” Busdicker says. Busdicker says another area of importance includes learning through doing. “This piece of the development allows individuals to put into practice the things learned from educational materials and informal coaching. This does not mean an individual should be just thrown into the water and expected to swim the leg of a triathlon. Future leaders should be provided opportunities that will take them out of their comfort zone, but not something that will substantially exceed their level of training, skill and confidence,” he says. BE PROACTIVE One of the challenges many individuals entering leadership roles face, is the discomfort of speaking before groups of people. Public speaking requires confidence and practice. There are few other areas where preparation is more important. For some people, their first public speaking experience is giving a toast at a banquet, wedding or other occasion. It was the recognition of this activity that the organization Toastmasters derived its name. Like Dale Carnegie, Toastmasters got its start at the YMCA. Ralph C. Smedley organized the first Toastmasters club in 1924. Today, many of those in HTM belong to Toastmasters International. Some HTM organizations have even had their own chapters. At one time, ARAMARK (now part of TRIMEDX) had its own Toastmasters Chapter within its Technical Resource Center in Charlotte, North Carolina. While public speaking is an important component of leadership, there are a number of other steps that a prospective leader in the HTM field can take. “Never lose your passion for the field and
your drive to do what is best for our patients and the caregivers in our organizations. Take ownership of your career aspirations and do not depend on, or allow others, to set your course,” Busdicker says. “Learn from leaders you have crossed paths with and from other leaders in the industry,” he adds. “Every leader has some unique qualities and talents. Take the good things you see and include them in your bag of tools. Learn from the bad things you encounter and do not make the same mistakes.” He suggests that those with an eye on management find a mentor. “There are tremendous leaders within the HTM industry and throughout the business world. Many of them are more than willing to mentor someone with a desire to be an effective leader. Learn as much as possible and be willing to accept constructive criticism,” Busdicker says. “Step outside of your comfort zone and raise your hand for projects or tasks inside and outside of the HTM field. Let leadership within the department and/or the organization see you as a potential solution and team player.” Busdicker says those seeking to enter leadership should look outside the HTM industry for opportunities to be involved in health care. “Over the past few years, I have become more involved with organizations like HIMSS, H-ISAC and ACHE. These organizations have provided opportunities to lead, learn from effective leaders and utilize tools to evaluate my leadership attributes,” he says. “Understand what it is you desire from your professional career and then set achievable goals with timelines in order to progress. Never stop learning, be flexible with your style, approach conflict head-on and ensure others know your career aspirations,” Busdicker adds. Hester says that TRIMEDX offers its Gateway on Leadership Development (GOLD) Program for all leaders to complete within their first six months. “This program includes a 360-degree assessment and content focused on inspiring
“THERE ARE TREMENDOUS LEADERS WITHIN THE HTM INDUSTRY AND THROUGHOUT THE BUSINESS WORLD.” – MIKE BUSDICKER
trust, creating vision, executing strategy and coaching potential. During this three-day program, participants also complete a full day on executive presentation skills and are video recorded and coached several times to ensure confidence and credibility when presenting to customers,” she says. “In addition to leadership development programs, we also have licenses for LinkedIn Learning and Franklin Covey which allows them an all-access pass to hundreds of courses and resources online,” Hester adds. PREPARED FOR THE GOOD AND THE BAD Another principle that may benefit those looking to make the leap into leadership is the concept of emotional intelligence. It postulates that if a person can understand and manage emotions, they can increase their chances of success. Some traits of this ability, applied in real life, include the ability to control your reaction to emotions. This requires focusing your thoughts and not becoming a captive to your emotions. Royal says that part of leadership training should include some exposure to the more difficult circumstances. “I think including them in the decision-making process and giving them experiences makes a big impact. They also need adversity; they need to experience tough discussions with customers and employees,” he says. “Terminations and disciplinary actions are often the toughest thing they will experience in leadership, the good news is it doesn’t happen frequently, but it is a key time to coach them through it. Overall, I teach always do the right thing for the customer, it doesn’t matter if you are working for a third-party or the hospital, that seems to be the golden rule that has always worked,” Royal says.
FUTURE HTM LEADERS Management can share their knowledge and be accepting of those who aspire to leadership roles and nurture their personal development. “Current leaders within the industry need to understand the career objectives and the desires of the people working for them. We should be more concerned about the future of our departments, institutions and companies than protecting our office or building a kingdom,” Busdicker says. He says that in a recent interview with a member of his staff, he asked, “What are your career goals?” This individual replied that at some point in their career they would like to have his job. “I did not take this as a threat, or a bad thing, but as an opportunity for me to be a mentor and help them develop. When I pressed further about their desire to fill my role, they saw it as an opportunity to grow professionally and make an impact in the health care system and to be more involved with the HTM industry,” Busdicker says. He says that his approach to help mold future leaders is to identify the career goals of each member of his staff. “This needs to be an ongoing conversation and not just a one-time interview. We need to ensure there are succession plans in place within our organization, identify personnel with the desire and potential to grow, and then implement training and development plans. As an industry we should be working together to ensure there are individuals ready to take the mantle and move the HTM field forward. We should be ready to share knowledge and help each other develop future HTM leaders,” Busdicker adds. That’s what it is all about; passing the baton with confidence. With the right skill set and insights, the next generation of HTM leadership will be well prepared and confident.
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CAREER CENTER Spot and Combat Job Burnout BY JENIFER BROWN
I
n today’s era of workplace burnout, achieving a simpatico work-life relationship seems practically out of reach. Being tired, ambivalent, stressed, cynical and overextended has become a normal part of a working professional’s life.
The General Social Survey of 2016, a nationwide survey that since 1972 has tracked the attitudes and behaviors of American society, found that 50 percent of respondents are consistently exhausted because of work, compared with 18 percent two decades ago. Occupational burnout goes beyond needing a vacation or family retreat. Many experts, psychologists and institutions, including the Centers for Disease Control and Prevention, highlight long-term and unresolvable burnout as a major health concern. Biologically we are not meant to be in a high-stress mode all the time. We think that the only way to be productive is to be in go-go-go mode. Also, it is difficult to identify burnout – which often feels like surrender or failure. COMMON WORK STRESSORS • Overcoming challenges with new software, changing atmospheres or processes • Unrealistic deadlines
• Frequent scheduling conflicts or interruptions • Unpredictable schedules • Added responsibility beyond the initial scope of one’s role while not being compensated • Interpersonal demands such as interactions with colleagues or customers These stressors can manifest in outbursts against co-workers, anger toward loved ones at home, loss of appetite and passion for things once loved, or being unable to find motivation for things that you once were able to accomplish with ease. When people begin to have this problem at work there can be absenteeism, turnover and errors. We can sometimes see difficulty with people getting along with each other or even becoming angry or aggressive. WAYS TO COMBAT WORK BURNOUT If you’re suffering from burnout at work, there are a some things you can do. • Focused breathing, which can tap into your parasympathetic nervous system, can help reduce or manage stress. • Frequent breaks, preferably fiveminute breaks for every 20 minutes spent on a single task. • A trusted mentor at work with whom
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CEO and Founder of Health Tech Talent Management you can discuss and strategize other ways to deal with work-related issues. A social network, where you have each other’s back, is a precious resource. • A hobby outside of work through which you can decompress, de-stress and dissociate from work. • Regular exercise or fitness activity works wonders and has benefits beyond stress relief. Jason Lang is the team leader of workplace health programs within the CDC. He says that aside from good diet, exercise and sleep, there’s one surefire way to combat general malaise, job dissatisfaction, low morale and burnout. “Laughter,” he said. “Find some humor in daily life.”
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EXPERT ADVICE SPONSORED BY:
ULTRASOUND IMAGE QUALITY TROUBLESHOOTING TIPS BY KEITH HAMM
W
hen my team and I are in the field on ultrasound service calls, one of the most common issues we see are artifacts in the image. These abnormalities can be frustrating for the end users and HTM professionals. They are often intermittent and can be caused by many different factors. They can also affect our customer’s ability to complete a diagnostic exam. To determine the cause of an image artifact issue, we look at three main factors: the environment, the transducer and the ultrasound system.
The environment in which the ultrasound system resides can largely affect the image quality. When addressing image artifacts in the field, be aware of your location and confirm that there are no other medical systems in close proximity. Outside interference from other medical equipment is a growing issue as more facilities start to expand their diagnostic imaging capabilities. This issue is typically easy to overcome. Simply remove the ultrasound from its current environment and relocate it to a place away from CT or MRI systems that can cause interference. Aside from the environment, malfunctions within the ultrasound equipment are the most likely source of an artifact. Image artifacts typically escape the modern test tools and error logs of current systems. Changing system variables is an easy way to work around this and troubleshoot or eliminate issues. Start by moving the transducer to another available connection on the system and look for any changes in the scan field. If you have the availability of another ultrasound system, move the transducer to another system and look to see if the
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artifact follows. If the artifact is present when the transducer is used with another connection or system, then the problem will most likely be in the ultrasound transducer. The transducer, or probe, can certainly affect image quality. The artifact could come from several key components of the probe. Inspect the probe from the scanhead to the connector, looking for any physical or diagnostic abnormalities. Beginning with the lens, check for delamination, or separation of the lens material from the crystal, by running your finger across the lens. Look for air bubbles or bunching of the material. The array or crystal is another area of focus. Check the array or crystal for physical damage and any areas of missing information within the diagnostic scan field. As the cable is often the cause of artifacts, because it houses a large number of individual wires, be sure to physically and visually inspect the length of the cable for any signs of damage. One of the most difficult areas to inspect are the wires within the cable. Carefully flex the cable from side to side over the length of the probe and look for any changes within the diagnostic scan field. Transducer connectors should also be inspected for bent, broken, damaged, missing or dirty pins or contacts. Cleaning dirty pins or contacts with a blast of air, contact cleaner or alcohol is recommended. Image artifacts can also be caused by a poor probe connection. Reseating the probe is a simple solution. If the artifact was not altered during the initial transducer test, this could point to a hardware defect within the system. Such errors could include the transducer
KEITH HAMM
Imaging Service Professional for Avante Health Solutions interface or front-end board. To confirm if the error is indeed a hardware defect, I recommend trying a different probe of the same model to see if the artifact is exclusive to the ultrasound machine itself. Most probe repair facilities have loaner probes available to help troubleshoot or repair. Image issues can also be caused by corrupted user-defined presets. To avoid this, always use factory default presets when troubleshooting. When testing ultrasound systems in the field, it’s also important to remember that image quality is subjective based on many factors including the user’s perception, skill level, custom presets, the patient’s body type and the difficulty of the procedure. Always take these variables into consideration when troubleshooting, and eliminate as many components as you can. – KEITH HAMM is an imaging service professional for Avante Health Solutions. For 24/7 technical support, call 800-958-9986 or visit www.avantehs.com/ultrasound
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CYBERSECURITY Ready for the next BlueKeep? BY JOSEPH FISHEL, CBET, MBA
W
ere you ready for BlueKeep? Are you ready for the next one? If you have been following along and making use of my suggestions and recommendations, I hope things are going well. An identified vulnerability is one scenario that you should have a developed and documented in your process or playbook of procedures. I will walk you through the steps using the techniques and processes we have been developing. This is a basic example of a vulnerability playbook. Clinical engineering and biomedical engineering have actually been doing much of this for years for recalls and device upgrades. The only difference is that these devices have an unknown factor as to what can happen, when it can happen and by whom.
Here are some basic steps using the mitigating controls that we have discussed and they should be implemented to work through a remediation. Let’s start. 1. You are notified of a new vulnerability. 2. Get all of the information you can accessing the device on the vulnerability to identify fully what the vulnerability is. Your IS/IT department may be able to assist. • What does the vulnerability affect? Does it affect operating systems, versions, applications, core components of the hard drive, etc.? • How does the vulnerability gain entry to the system? Does it use a portal, if so what is the port number? • What is the manufacturer/vendor suggesting to correct this? Turning off a port? Patching? Isolating? 3. Identify which devices are affected.
• We identified many fields to make our database searchable for this reason. • Identify the devices that are vulnerable. • Are the devices all networked or are some of them standalone? • Are the devices on a protected VLAN with access control limits? Knowing these different things and what is available can save time in dealing with a vulnerability or it may already be protected due to things that you have put in place. 4. Identify the remediation steps to be taken for the different classes of vulnerable devices. Also you can create a priority list to address the most vulnerable or temporary remediating steps such as closing a port. • This may require applying a patch. • A port may need to be turned off. • If the vulnerability is on an application, such as an Adobe product, the application may not work with an updated version so the device needs mitigating controls. • A firewall installed such as a bridge, prior to the device. This allows the network to communicate to the bridge but no further. • We had applied an ACL to the edge routers limiting what can be communicated with from the Internet so it has some protection from a direct attack (often referred to as North South or In and Out protection). • If the device was installed on a VLAN. It has both an ACL for North and South protection as well as East and West protect which protects it from devices inside the institution.
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5. Verify that the remediation was successful • This may be in conjunction with vulnerability scans by IS. 6. Track what you do for remediation. • Track what you do to each device on a work order. • You may need to create a field in your CMMS to identify that the device has been remediated. • All new devices coming in need to be identified to determine if they are susceptible and remediated if needed. 7. Did you have any Issues? • Identify where you had some issues and rework your playbook to prepare for the next time. • What could have worked better? • Do you need additional information in your database? Vulnerabilities are not going away. The Internet of Things (IoT) is becoming the norm of medical equipment as we move to put more data at the fingertips of clinicians. New algorithms and applications are being developed every day to integrate medical devices.
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EXPERT ADVICE
SPONSORED BY:
BENEFITS OF ISO BY ABDUL ALSAADI
C
ompanies are racing to get their organization ISO certified, knowing one day it might be a requirement to work in a hospital maintaining medical equipment. ISO 9001:2015 prepares companies with quality procedures to consistently provide products and services that meet customer regulatory requirements, enhance customer satisfaction and assure documentation is in place for inspections. The certification process for ISO 9001:2015 creates specific requirements for a quality management system when an organization:
a) needs to demonstrate its ability to consistently provide products and services that meet customer and applicable statutory and regulatory requirements, and b) aims to enhance customer satisfaction through the effective application of the system, including processes for improvement of the system and the assurance of conformity to customer and applicable statutory and regulatory requirements. Being ISO certified is great. It means the company or the tech working in hospitals is qualified to do the job, this gets into quality of service along with competency of candidates. ISO will be the inspector
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when it’s time to renew the certification in assuring the policies and procedures are being practiced correctly by providing strong documentation and providing constant training of staff on policy and procedures. It is difficult to guarantee that each organization will hire the right person for the right task or will utilize the resources to train individuals, this goes back to business ethics and the leader leading the organization. Hospital systems have many departments that are swamped with their own individual meetings, duties to fulfill, and quality to deliver to patients. Hospitals that are short on staff and need support will tend to hire a third-party company to help with the responsibilities in the biomedical department. The manager or director hopes that the companies have qualified staff, quality of service and are certified as a management company in assuring documentation is in place for any type of inspection. This is where the benefit of hiring a third-party vendor, who is ISO certified, is seen. ISO companies need to learn and understand the services each company is offering. To be involved with the quality and competencies of staffing is an important factor for following
Abdul Alsaadi, PH.D CEO of Medzon policy procedures and documentation. It is only half of the puzzle; the other half is making sure that the candidate working in the organization prioritizes safety in this industry. The ISO certification process is not an easy one and is monitored on a yearly basis to guarantee each company is documenting and training staff accordingly. This certification holds value. When a hospital is looking to outsource equipment maintenance it should take this into consideration and select a reliable candidate. – Abdul Alsaadi, Ph.D., is the CEO of Medzon.
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EXPERT ADVICE
THE FUTURE
Great HTM Educational Programs BY STEVEN J. YELTON
A
s educators, we are all striving to make ours the best HTM program possible. We want our program to be great! We also are generally very open to help in achieving this goal. I credit much of the success of my own program to the strength of our advisory board and both our co-op and graduate employers. Without these people, we would not have adequate laboratory facilities and obviously would not have the demand that we currently do for our graduates.
It seems that currently our programs are struggling to attract enough students to fill the needs of local employers. You have heard this again and again! You in cooperation with your advisors and employers can bolster enrollment. When an employer tells a prospective student that upon completion of a semester or two at the college there could be a co-op or internship waiting for them, there is no greater recruiting tool. Notice that as I start this column on “Great HTM Educational Programs,” I discuss advisors and employers. I feel that these groups of people working with the educators are the core and key to great HTM educational programs! I would like to take the time to revisit what we are doing to help the HTM community with attaining quality college programs which result in quality graduates that enter the workforce. I’ve written before in my column that AAMI is the lead society within the Technology Accreditation Commission of the Accreditation Board for Engineering and Technology (TACABET). In this role, AAMI helps guide TAC-ABET with items related to the
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criteria used for accrediting college healthcare technology management (HTM) and similarly named programs. These could be associate or bachelor degree programs. I serve as the chair of AAMI’s Healthcare Technology Accreditation Committee (HTAC). The HTAC makes recommendations for accrediting these health care engineering technology programs. The HTAC is comprised of educators and industry personnel. TAC-ABET approved AAMI’s first criteria for HTM engineering technology programs. Programs evaluated will be evaluated under criteria provided by AAMI. We feel that this is a great improvement of the previous criteria and are reflective of what the industry desires from college programs. Don’t forget, the HTAC in conjunction with AAMI’s various departments has been working hard to support health care engineering technology and similarly named programs with support, discounted or free AAMI memberships for students and educators, resource materials and related items. The HTAC is also looking at ways to be able to provide some sort of base level credential signifying that an HTM program meets minimum criteria based on nationwide vetting for what constitutes a quality program. We are currently investigating the possibility that this be in the form of an AAMI standard. One thing about TAC-ABET accreditation is that when a program is reviewed, much more than just the content of technical courses is considered. Everything is looked at from
Steven J. Yelton Cincinnati State Technical and Community College the credentials of faculty, quality of the learning resources center, laboratory facilities, student services and on and on. We admit that these are good things and are very important to attaining TAC-ABET accreditation. However, we also understand that not all programs meet this stringent criteria in all areas, but still want to have a quality educational opportunity for students. In order to help college programs improve their curriculum, we have numerous resources available to educators on the AAMI website. We have the core competencies document, help with career ladder and certification help to name a few. If it is determined that it makes sense for AAMI to support the development of a standard for HTM programs, we hope that every HTM program in existence will take part in this standard in some way or another. This standard could possibly be an entry-level standard for an HTM program. Our
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hope is that programs will be enhanced when they work on their quality utilizing AAMI resources and the standard. Ultimately, this may also be the launching pad for attaining TAC-ABET accreditation. This will further enhance the working relationship between AAMI, ABET, HTM programs and HTM employers. A win for everyone involved. The bottom line is that even if you don’t want TAC-ABET accreditation, there is much out there to help you. Another exciting development is the enhancement of scholarships awarded by the AAMI Foundation. The AAMI Foundation awards scholarships for HTM engineers, technicians and health systems engineers. I feel that all educators and students should take advantage of all that the AAMI Foundation has to offer. This is a largely untapped resource for HTM professionals – including educators and students. In addition to the scholarships, the AAMI Foundation
endeavors to award grants, provide various awards and, in general, strives to strengthen the knowledge of health technology professionals. AAMI is working to make the application process for all of these much easier. My hope is that all HTM professionals will take advantage of this great opportunity. – STEVEN J. YELTON, P.E., CHTM; is a senior HTM engineer for The Christ Hospital Health Network in Cincinnati, Ohio and is a professor at Cincinnati State Technical and Community College where he teaches biomedical instrumentation (HTM) courses. He is the chair-elect of AAMI’s board of directors, chair of the AAMI Foundation board of directors, past chair of AAMI’s Technology Management Council (TMC), chair of AAMI’s HTAC Committee and is a member of the Accreditation Board for Engineering and Technology (ABET), board of delegates.
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20/20 IMAGING INSIGHTS
The Secret to Extending Coil Longevity is Often Just Down the Hall BY TED LUCIDI, CBET
A
s an imaging service engineer who worked in a hospital setting for many years of my career, I know the search for reliable methodologies, partners and practices for extending the life of medical devices is a constant and endless pursuit. I also know, that in many cases, one of the best solutions is just down the hall. The people who manage your imaging department and those who actually use the equipment.
Here are some simple tips to help you help your teammates – from technologists to clinicians – lower your repair frequency, costs and maintain uptime. PARTNERING WITH END-USERS The majority of coils sent in to Innovatus Imaging for repair possess some-level of mechanical damage, which often has resulted in single or multi-point electronic failures. One of the most effective ways to increase longevity is ensure that best practices and OEM guidelines are being followed. Ben Franklin said it best, “An ounce of prevention is worth a pound of cure.” We recommend that service engineers perform, what’s called, a “care and handling assessment.” Start by partnering with the department/site manager and explain the purposes and goals are reducing failures and costs while increasing uptime. Assess when and how often the coils are visually
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inspected by technologists as well as how they are stored, transported and cleaned. Even go as far as to observe how the coil’s cables are routed during setup and how the patient is positioned and re-positioned. This can be easily performed without anyone’s notice during routine visits to the department. Follow up with the manager by requesting 15-30 minutes during a routine department meeting to review findings. Spend time discussing best practices and provide, as well as solicit, ideas for improvements to reduce damage.
Ted Lucidi Innovatus Imaging
ADDRESSING WEAR/TEAR AND ELECTRONIC FAILURES Even if best practices are employed, wear and tear, random electronic failures and unavoidable accidents will occur over time. The key to longevity, in these instances, is to select a repair provider who addresses coil failures holistically. For sustainable repairs, the entire coil (both mechanically and electronically) should be assessed versus a quick fix of a single point of failure. Over time, all cables will breakdown and become intermittent. Be sure that your provider replaces worn and damaged cables, versus splicing or repairing them. It will result in like-new performance and offer the longevity of a new coil. Consider the slogan, “pay me now or pay me later.” It is better to address all of the failures at one time versus sending a product in for repair time and time again.
DISASSEMBLY OR IN-HOUSE REPAIRS Although imaging service engineers are well-qualified and the HTM community is based on the self-service model, do not attempt to repair an MRI coil without the use of proper test equipment and proper repair and testing procedures. Improper repairs and/or repair attempts have the potential to induce patient damage, including burns. Even if your confidence and experience levels are high, do not attempt to repair an MRI coil without proper electrostatic discharge (ESD) protection. Opening the housing, oftentimes, breaks the electromagnetic shielding and increases the risk of ESD to the internal components and unseen damage and failures may occur. Employees and patients can be put at risk even if repairs are attempted in approved ESD areas.
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EXPERT ADVICE
VENDOR QUALIFICATION It can’t be stressed enough that partnering with a qualified repair provider is another key to longevity and sustainable performance. Perform a thorough analysis or vendor qualification of potential MRI coil repair providers. The third-party repair industry is currently unregulated and there is no standard of quality amongst providers. Assess if the provider is ISO 13485:2016 certified specifically for MRI coil repair. Insist on a copy of the provider’s current certificate and ensure that the scope of service includes “MRI coil repair” and not just “MRI service.” Assess the experience of the provider as well as history, capabilities, approach to repair (holistic or quick fix), loaner availability, testing processes, warranty periods and warranty rates. Cost should be one of the lower-ranked qualifiers. Consider Gabriel Bell’s 15th century quote, “You get what you pay for.” For more information and ideas, email me directly. I’ll also be sharing more tips and tactics in next month’s 20/20 Imaging Insights. – TED LUCIDI, CBET, Customer Experience and Clinical Insights for Innovatus Imaging. He may be reached via email at Ted.Lucidi@innovatusimaging.com.
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THE OTHER SIDE
When The Joint Commission Visits BY JIM FEDELE, CBET
O
ur industry has many regulatory and accrediting organizations, including the Department of Health, DNV and The Joint Commission to name a few. Meeting the requirements imposed by these organizations is part of our daily activities. However, when one of these organizations come into our facility it is always a little stressful. We recently had our Joint Commission inspection. I would like to share our experience with the survey.
Anyone who uses The Joint Commission as their accreditation body knows that their surveys are unannounced. Once in the survey window they can show up at any time to survey the hospital, this is done to encourage facilities to ensure a constant state of readiness and compliance. Our three-year anniversary date was closing in and we were expecting them any day. Our survey this year was going to include an additional campus that we added to our license. This meant they would be sending five surveyors and staying for four days. It was funny to hear the prediction on when they were coming as if someone knew the secret to their schedule. Most of us had concluded that if we made it past Tuesday in any given week our survey would not be happening that week. I had just returned from a trip to Seattle to visit my son. I had taken the red eye home Sunday night and took Monday off to recover from the travel. I reported to work Tuesday, still feeling the jetlag from the travel. I had just sat down and booted up my computer when I heard the announcement “Please Welcome the Joint Commission.” Admittedly, my heart sank followed by a burst of adrenaline as I prepared myself for the ensuing barrage of requests I would soon be getting. In no time, my phone lit up. I was getting calls
from many people looking for information. As you can imagine with five surveyors, there were many people all at once looking for information. My team and I rose to the occasion and provided information as quickly as possible. The survey team was incredibly collegial and educative, this helped everyone feel at ease and present their best self when answering questions. However, they were also very thorough. They seemed to check every nook and cranny in our facilities. At the beginning of each day, they provided a debriefing of what they found and the day’s schedule. I felt like they were really digging deep to find things. At 4 p.m. on Friday they gave us an exit report, they were very complimentary of our programs and called us a “learning organization.” We made it! Here are some of the things they focused on. Life safety guy: • Looked at every smoke door • Looked at the RPTs in OR • Looked for penetrations • Asked about process for changing the use of spaces. EOC: • Looked at annual evaluation, said plans were adequate but would like them to be more robust • Stressed the plans should be a living document, changing as things change within the facility • Looked for clutter and for med gas valves being blocked or mislabeled • Explained importance of scope, objectives and policies for EOC • Explained to us that it wasn’t required to have semiannual EOC tours, that we could decide what works for us to conduct surveys. Do a risk assessment and maybe do some areas more and some areas less. • Also liked that all work requests for
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Jim Fedele, CBET Senior Program Director, UPMC and BioTronics
equipment under OEM contract were in the CMMS • Said all medical equipment needs to be on an inventory for CMS, including IT equipment and facility equipment • Looked at sterilizer records and dialysis machine records. They looked at the overall cleanliness and condition of equipment and said all equipment should be free of adhesive residue from tape and stickers. The nurse surveyor inspected the radiology department and offsite centers. She asked to see imaging records. Both the items we fixed and items the OEM fixes. At the end of the day, our survey was pretty good. There are just a few minor things we need to report on. For me, I don’t feel nearly as nervous when they come anymore. I am getting used to talking with them. With all the facilities I manage now, there is always one “in the window” for a Joint Commission inspection.
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ROMAN REVIEW The Thief BY MANNY ROMAN, CRES
W
e were having a few cold ones with neighbors not long ago and the conversation turned to the enhancements that most of us are performing on our homes. Some are updating inside their homes and others are enhancing their outdoor spaces. Ruth and I are working on the outdoor areas.
As we discussed the projects and their expected additional beauty and functionality, it became obvious that we admired some projects more than others. We may even have questioned the wisdom and value of some of the neighbors’ projects. Yeah, perhaps a little jealousy reared its ugly head. This is when a neighbor said, “Comparison is the thief of joy.” There was silence while we pondered the meaning of the statement. We asked where she had heard this and she replied that her granddaughter heard it in one of her classes in college. A discussion of the meaning, wisdom and cautionary intent of the phrase ensued. The phrase is attributed to Theodore Roosevelt and apparently has basis in the Bible. My interpretation is that comparing our state of being to others will likely result in unpleasant emotions. They always have more and better stuff, make more money and have betterlooking children and dogs than we do. Rather than feeling joy in where we are, we aspire to more and more. It reminds me of the story of the two gentlemen at a cocktail party. In walks That Guy that everyone admires and aspires to be. One of the two gentlemen expresses his admiration
and laments that he himself wishes to have what That Guy has. The other gentleman says, “I have something That Guy will never have.” The first gentleman looks incredulously at him and asks, “What would that be?” The reply, “Enough.” The need to compare is probably inherent and unavoidable. However, what we see depends on where we choose to sit. If we sit on the jealous and envy chair, we will be disappointed and have other negative feelings. These may affect how we view those who have the perceived more and better stuff. If we sit on the contentment chair, we will see that everyone has different needs and wants and definitions of Enough. We tend to lower ourselves and elevate others when we compare. Writer Jon Acuff says, “Don’t compare your beginning to someone else’s middle.” Don’t allow yourself to view the end result of someone else’s accomplishments with negativity toward yourself. If we make a comparison from a weakened state of emotion then we will automatically perceive the others at their best. The best way to remove comparison from the equation is to have a welldefined Enough. Know what you are working toward. Know what will make you happy and content. Plan to accomplish your goals and objectives and know when you are done. Realize that there will always be others with more and better stuff and don’t let that fact reduce your joy with your accomplishments. All that said, comparison is good if applied in the correct context. Compare your situation right now to someone way less fortunate and you
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Manny Roman, CRES AMSP Business Operation Manager
should feel gratitude. Research indicates that grateful people are happy people. The more grateful you feel the happier you will be. By simply causing yourself to be grateful for what you have and where you are in life, you will increase your happiness level. Even without that new car. This comparison to find gratitude should also cause you to feel more compassionate for those who are less fortunate. Acting on your gratitude by helping those less fortunate will also increase the feelings of gratitude and happiness. As for me, I feel fortunate to be where I am in life. I have always said, and felt, that my life has been a series of fortunate events. I am grateful for the many years of life, the wonderful industry I worked in, the multitudes of great people I have known and call friends, and especially my many years with my Saint Ruth. I have Enough. I am content with my palm tree to sit under with Saint Ruth.
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Accidents Happen. You Need Answers. When a medical device-related incident occurs in your hospital, get answers from a source you can trust. ECRI Institute’s experienced team will respond immediately with a systematic, unbiased approach to accident investigation. Get the answers your leadership demands, and your patients deserve.
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o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/ vault-october-2019. Good luck!
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SCRAPBOOK NCBA 2019
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he 41st annual Symposium of the North Carolina Biomedical Association (NCBA) was held August 13-16 at the Pinehurst Resort in Pinehurst, North Carolina. The symposium began with the third annual Mike McCoy Golf Tournament for all NCBA members and guests. Education began Wednesday followed by the opening of the exhibit hall. The day concluded with a networking event at Dugan’s Pub, which was sponsored by TechNation and MedWrench. Attendees had several opportunities to network and gain valuable information throughout the next couple of days with more education, vendor exhibits and a small final night reception. Brian Lefler and Jeremy Collins each received a President’s Award. Current NCBA President David Wilson received the President’s Gavel from former President Glenn Scales. According to Collins, who is over membership, the NCBA has grown to 423 members and 192 corporate members. “My hat is off to our membership for how they have worked together to make this association one of the top in the nation,” Wilson said.
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2. TechNation team members Jayme McKelvey and Megan Cabot pose with Kaylee McCaffrey of MedWrench in front of the iconic Carolina Hotel in Pinehurst. 3. NCBA representatives gather for the awards luncheon. Pictured from left to right are Bill Fry, Crothall Healthcare; Pete Trgovic, Dreager Medical; Codi Nelson,
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Crothall Healthcare; David Wilson, Novant Healthcare; Terry Morris, Draeger Medical; and Glenn Scales, Duke Health retired.
6. Doug Adams of Avante Health Solutions presented “Ultrasound Probe Care and Handling” to a full classroom.
4. NCBA Symposium attendees had a wide array of class topics to choose from including advanced and general BMET, imaging, IT, leadership and safety.
7. Amy Hobbs, USOC Medical’s executive director of sales and customer service, joined her team in the exhibit hall on Wednesday and Thursday.
5. Scholarship winner Allison Woolford, a BMET student from Durham Tech, (middle) is pictured with David Wilson (left) and Bill Fry (right).
8. Attendees learned about the equipment and services offered by the InterMed Group from David Fox (pictured) and other company representatives.
9. Over 100 attendees joined TechNation and MedWrench at Dugan’s Pub on Wednesday night for a networking event filled with camaraderie, fun and karaoke. 10. Linda and Mike Clotfelter represented BC Group at the NCBA Symposium.
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RepairMED www.repairmed.net • 855-813-8100
Select BioMedical www.selectpos.com • 866-559-3500
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762
12
P P
33 77 39
www.spbs.com/ • (800) 713-2396
P P
www.ozarkbiomedical.com • 800-457-7576
SPBS, Inc www.spbs.com/ • (800) 713-2396
www.usocmedical.com • 855-888-8762
Innovatus Imaging www.innovatusimaging.com • 844-687-5100 www.IMESimaging.com • 704-739-3597
KEI Med Parts
E.L. Parts
P P
7
P P
P
www.adel-lawrence.com • 866-252-5621
J2S Medical MedWrench www.MedWrench.com • 866-989-7057
Webinar Wednesday www.1technation.com/webinars • 800-906-3373
www.FOBI.us • 888-231-3624
77
P P
AIV
P P
Ampronix, Inc.
P P
Avante Health Solutions
87 33 7
P
P P P
aiv-inc.com • 888-656-0755 www.ampronix.com • 800-400-7972 avantehs.com •
BETA Biomed Services www.betabiomed.com/ • 800-315-7551
Biomedical Repair & Consulting Services, Inc. www.brcsrepair.com • 844-656-9418
BMES www.bmesco.com • 888-828-2637
P P
89
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
P
P P
49
P P
89
66 60
79
P P
12
P P
4
P P
2
P P
59
P P
72
P P
21
P P
33
www.coromed.us • 800-695-1209
Integrity Biomedical Services www.integritybiomed.com • 877-789-9903
80
80
Patient Monitoring
Coro Medical 89
P
Oxygen Blender
P P
6
75
6
www.j2smedical.com • 844-342-5527
12
79
8
Online Resource Adel Lawrence Associates
P
47
Nuclear Medicine
FOBI
Labratory Ozark Biomedical
P
P P
82
IV Pumps SPBS, Inc
USOC Bio-Medical Services
nuclearmedimaging.com • 847-421-1656
Infusion Therapy AIV
Integrity Biomedical Services
P
P P
21
www.bmesco.com • 888-828-2637
www.keimedparts.com • 512-477-1500
Infusion Pumps AIV
4
www.ampronix.com • 800-400-7972
International Medical Equipment and Service
Infection Control Healthmark Industries
Ampronix, Inc.
MRI
Imaging Health Tech Talent Management, Inc.
P P
33
www.selectpos.com • 866-559-3500
www.integritybiomed.com • 877-789-9903
Hand Switches inRayParts.com
Monitors
BMES
General ALCO Sales & Service Co.
4
Monitors/CRTs
Gas Monitors Biomedical Repair & Consulting Services, Inc.
Ampronix, Inc.
P P
82
TRAINING
Multimedical Systems
Mammography
45
Fetal Monitoring
SERVICE
www.totalscopeinc.com/ • (800) 471-2255
PARTS
Total Scope, Inc
Company Info
AD PAGE
www.prnwebsite.com • 508-679-6185
P
TRAINING
PRN/ Physician’s Resource Network
82
SERVICE
www.multimedicalsystems.com • 888-532-8056
PARTS
Multimedical Systems
AD PAGE
Company Info
J2S Medical www.j2smedical.com • 844-342-5527
Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809
P
47
P P
6
P P
45
P P
OCTOBER 2019
P
TECHNATION
95
sebiomedical.com/ • 828-396-6010
Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762
Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328
Doctors Equipment Repair www.doctorsequipmentrepair.com • 458-205-8438
Replacement Parts Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701
Engineering Services, KCS Inc
87
P P
www.eng-services.com • 888-364-7782x11
27
P P
A.M. Bickford
13
P P
FOBI
7
P P
J2S Medical
Patient Monitors
www.ambickford.com • 800-795-3062 www.FOBI.us • 888-231-3624 www.j2smedical.com • 844-342-5527
InterMed Group www.intermed1.com • 386-462-5220
P P
Midmark RTLS
40
P P
Software
www.midmark.com • 1-877-9VERSUS
EQ2
80
P P
Midmark RTLS
61
P P P
Nuvolo
Power System Components Interpower www.interpower.com • 800-662-2290
www.midmark.com • 1-877-9VERSUS eam.nuvolo.com/clinical • 844-468-8656
Phoenix Data Systems IBC
Radiology
P
www.goaims.com • 800-541-2467
www.ampronix.com • 800-400-7972
4
Recruiting
P P
mountainstatesbiomed.com • 949-887-0301
SPBS, Inc www.spbs.com/ • (800) 713-2396
Adel Lawrence Associates www.adel-lawrence.com • 866-252-5621
Health Tech Talent Management, Inc. www.HealthTechTM.com • 757-563-0448
Sodexo CTM www.sodexousa.com • 1-888-Sodexo7
Stephens International Recruiting Inc. www.bmets-usa.com/ • 870-431-5485
89
Healthmark Industries HMARK.COM • 800-521-6224
11
surgicalmicroscopes.com • 800-438-3937
67
AIV
Prescotts
12
Rental/Leasing
aiv-inc.com • 888-656-0755 avantehs.com/monitoring • 800-449-5328
Biomedical Repair & Consulting Services, Inc. www.brcsrepair.com • 844-656-9418
Avante Health Solutions avantehs.com •
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703
2 77
Repair
P
BMES www.bmesco.com • 888-828-2637
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701
Integrity Biomedical Services
ALCO Sales & Service Co. www.alcosales.com • 800-323-4282
Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328
Avante Ultrasound avantehs.com/ultrasound • 800-958-9986
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701
Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809
85 68 41 77 45
P P P P P P P P
www.integritybiomed.com • 877-789-9903
J2S Medical www.j2smedical.com • 844-342-5527
Multimedical Systems www.multimedicalsystems.com • 888-532-8056
ReNew Biomedical www.ReNewBiomedical.com • 844-425-0987
RepairMED www.repairmed.net • 855-813-8100
Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 96
TECHNATION
OCTOBER 2019
67
P
79
P P
6
28-29
72 28-29 14-17 82
39
P P
89
P
32 26
P P
12
P P
68
P P
72
P P
21
P P
77
P P
47
P P
Telemetry
Avante Patient Monitoring
aiv-inc.com • 888-656-0755
P
Surgical
75
Refurbish AIV
20
Sterilizers Mountain States Biomedical Services
Ampronix, Inc.
P P
RTLS
www.eq2llc.com • 888-312-4367
www.inrayparts.com • 417-597-4702
77
Respiratory
68
Portable X-ray inRayParts.com
TRAINING
Southeastern Biomedical, Inc
P
SERVICE
www.repairmed.net • 855-813-8100
87
PARTS
RepairMED
P P
Company Info
AD PAGE
www.ReNewBiomedical.com • 844-425-0987
TRAINING
ReNew Biomedical
45
SERVICE
www.prnwebsite.com • 508-679-6185
PARTS
PRN/ Physician’s Resource Network
AD PAGE
Company Info
6 82
P
87
P
87
P P
13
P P
7
P P
WWW.1TECHNATION.COM
TRAINING
SERVICE
PARTS
AD PAGE
Company Info Test Equipment A.M. Bickford www.ambickford.com • 800-795-3062
BC Group International, Inc www.BCGroupStore.com • 314-638-3800
PRN/ Physician’s Resource Network www.prnwebsite.com • 508-679-6185
Pronk Technologies, Inc. www.pronktech.com • 800-609-9802
Rigel Medical, Seaward Group www.seaward-groupusa.com • 813-886-2775
Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010
67 BC
P P
45
P P
5 3 27
Training Adel Lawrence Associates www.adel-lawrence.com • 866-252-5621
College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027
ECRI Institute www.ecri.org • 1-610-825-6000.
International Medical Equipment and Service www.IMESimaging.com • 704-739-3597
Tri-Imaging Solutions www.triimaging.com • 855-401-4888
P P
89 34
P
84
P
75 46
Tubes/Bulbs Cadmet www.cadmet.com • 800-543-7282
Tri-Imaging Solutions www.triimaging.com • 855-401-4888
26
P
46
P P
4
P P
Ultrasound Ampronix, Inc. www.ampronix.com • 800-400-7972
P
ATS Laboratories www.atslaboratories-phantoms.com/ • atslaboratories@yahoo-com
Avante Health Solutions avantehs.com •
Avante Ultrasound avantehs.com/ultrasound • 800-958-9986
Innovatus Imaging www.innovatusimaging.com • 844-687-5100
J2S Medical www.j2smedical.com • 844-342-5527
79 2
P P
41
P P
P
8 6
Ventilators Cardiotronix CARDIOTRONIXHEALTH.COM • (855)-4DEFIBS
Mountain States Biomedical Services mountainstatesbiomed.com • 949-887-0301
SPBS, Inc www.spbs.com/ • (800) 713-2396
25
P P
39
P P
89
X-Ray Engineering Services, KCS Inc www.eng-services.com • 888-364-7782x11
Innovatus Imaging www.innovatusimaging.com • 844-687-5100
Tri-Imaging Solutions www.triimaging.com • 855-401-4888
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
20
P
P
8 46
P P P
ALPHABETICAL INDEX A.M. Bickford.....................................................67 Adel Lawrence Associates..................................89 AIV....................................................................12 ALCO Sales & Service Co....................................85 Ampronix, Inc......................................................4 Asset Services....................................... 22-23, 55 ATS Laboratories................................................79 Avante Health Solutions.......................................2 Avante Patient Monitoring..................................68 Avante Ultrasound.............................................41 BC Group International, Inc............................... BC BETA Biomed Services.......................................59 Biomedical Repair & Consulting Services, Inc.....72 BMES................................................................21 Cadmet.............................................................26 Cardiotronix.......................................................25 College of Biomedical Equipment Technology....34 Coro Medical.....................................................33 Crothall Healthcare Technology Solutions.................37 D.A. Surgical......................................................71 Doctors Equipment Repair.................................40 E.L. Parts...........................................................49 ECRI Institute.....................................................84 Elite Biomedical Solutions..................................77 Engineering Services, KCS Inc............................20 EQ2...................................................................72 FOBI..................................................................79 Health Tech Talent Management, Inc.................75 Healthmark Industries.......................................32 iMed Biomedical................................................52 Injector Support and Service..............................49 Innovatus Imaging...............................................8 inRayParts.com.................................................80 Integrity Biomedical Services.............................47 InterMed Group.................................................61 International Medical Equipment and Service.....75 Interpower....................................................... IBC J2S Medical.........................................................6 Jet Medical Electronics Inc.................................45 KEI Med Parts....................................................80 Maull Biomedical Training..................................71 MedWrench.......................................................66 Midmark RTLS............................................. 28-29 Mountain States Biomedical Services.................39 Multimedical Systems........................................82 Nuvolo......................................................... 14-17 Ozark Biomedical...............................................80 Phoenix Data Systems........................................82 Prescotts...........................................................26 PRN/ Physician’s Resource Network..................45 Pronk Technologies, Inc. .....................................5 ReNew Biomedical............................................87 RepairMED........................................................87 Rigel Medical, Seaward Group..............................3 Select BioMedical..............................................33 Sodexo CTM......................................................11 Southeastern Biomedical, Inc............................27 Southwestern Biomedical Electronics, Inc..........13 SPBS, Inc..........................................................89 Stephens International Recruiting Inc.................67 Total Scope, Inc.................................................89 Tri-Imaging Solutions.........................................46 USOC Bio-Medical Services.................................7 Webinar Wednesday..........................................60 OCTOBER 2019
TECHNATION
97
BREAKROOM
FLASHBACK
2008 marked the first year MD Expo took to the road! With the support of the Florida Biomedical Society, MD Expo opted to take the conference to Orlando and it was met with overwhelming success!
At te n d ee s w elcom o p po r e d t he tunit y t o s pe exhib ak w it itors d h uring exhib hall h it o u rs .
ng tim e A IV, a lo av ull of lt a k s w ith T a e ff Je E xpo, sp D M f o er support d ee . an atte n
d isplaye ently d B l il r B fe f ed e y an d tems o M ahon ray sys ’ X O e . ie s il m ob M agg olution ediatric - R ay S ies of p obile X M y the ser b ely exclusiv
Med Group The finale party sponsored by The Inter band! salsa featured Jerry Galante and his 10-piece
98
TECHNATION
OCTOBER 2019
The fi n ale part y e ven featured han d -roll ed cigars !
WWW.1TECHNATION.COM
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