ICE Magazine - November 2019

ADVANCING THE IMAGING PROFESSIONAL

NOVEMBER 2019 VOL.3 NO.11 THEICECOMMUNITY.COM

Welcome to the Machine

AI-POWERED IMAGING PROCESSES page 40

CORPORATE PROFILE

Guide to RSNA

P.18

P.8

page 46

News

P.26

People

P.31

Products

P.52

Insight

Address Service Requested MD Publishing 1015 Tyrone Rd., Ste. 120 Tyrone, GA 30290

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contents

ICE FEATURES

NOVEMBER 2019

“ It’s important that we work to understand the change management process, and ensure that the ability to regulate within the algorithm world and the FDA and European agencies keeps pace while these things are changing.”

– Greg Horne

40

Welcome to the Machine: AI-Powered Imaging Processes

epartment D 28 Spotlight

AI is finding broader applications beyond diagnostics. As the

The members of the UCSF Medical

technology continues to develop, clinicians, technologists and

Center Medical Imaging Shop

device manufacturers are working to resolve challenges around

provide service to all ultrasounds,

workflow, decision support and the broader questions of how to

diagnostic imaging (Rad, R/F, CV,

do so securely, efficiently and ethically.

IR), CT scanners, MRI systems and PET scanners to more than 20 sites in California.

Guide to RSNA The Radiological Society of North America (RSNA) Scientific Assembly and Annual Meeting is scheduled for December 1-6 at McCormick Place in Chicago. RSNA invites radiology professionals to experience the hands-on, cutting-edge technology of artificial intelligence, 3D printing and virtual reality at this year’s event, themed “See Possibilities Together.”

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ADVANCING THE IMAGING PROFESSIONAL

contents

ICE DEPARTMENTS

11

26

32

NOVEMBER 2019

57

news

people

products

insight

8 Monitor Failure Rates

26 Professional Spotlight

31 AI Spotlight

52 Career Center

11 Imaging News

28 Department Spotlight

32 AI Gallery

18 Company Showcase: Accumen

38 Tools of the Trade

66 Index

24 ICE 2020

John M. Krieg john@mdpublishing.com

58 Agiliti 63 Photo Contest

22 Webinar Wednesday

Publisher

57 Imaging Matters 60 Conflict Resolution 101

20 People on the Move

MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090

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Circulation Lisa Lisle

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ICE Magazine (Vol. 3, Issue #11) November 2019 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2019

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news

SPECIAL ADVERTISING SECTION

CATH LAB/EP LAB & HYBRID OR MONITOR FAILURE RATES SKYROCKET

By Michael Thomas

A

hospital or health care facility can be composed of dozens of departments. A catheterization lab, commonly referred to as cath lab or EP lab, is instrumentally vital to one of the busiest departments – cardiology. Hybrid operating rooms are equipped with diagnostic imaging technology to give physicians visual access to chambers and arteries of the heart. In these areas, physicians perform life-saving procedures including coronary artery bypass graft surgery, balloon angioplasty, congenital heart defect closure, stenotic heart valves and pacemaker implantations.

Although many monumental advancements have been made in the efficiency of cath labs, the dependence on X-rays for imaging has persisted through every upgrade. From purchasing analog or digital modalities to choosing a single or bi-plane system, there are endless customization possibilities. Typically, the rooms consist of an image intensifier, C-arm, X-ray tubes and several displays.

Advantageously, the digital age ushered in an era of improvements to imaging technology, which emitted less radiation and displayed visual clarity. The adoption of CRT monitors in the cath lab inherently changed how labs ran.

In the early cath labs, all information was conveyed through film. The X-rays utilized, produced high-doses of radiation and low-quality images, which were printed on 16-mm or 35-mm film. Then, radiologists spent many hours of the day in darkrooms to process images, and ample storage space was wasted holding boxes of film.

With the implementation of picture archiving and communication systems (PACS) the transition from analog to digital technology was concretized. PACS is an all-in-one

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ICEMAGAZINE | NOVEMBER 2019

program that provides electronic storage, retrieval, distribution and presentation of radiology images.

In the cath lab, there are typically four to six CRT or LCDs in use. One image is always utilized for monitoring physiological attributes like a patient’s heart rate or blood oxygen level. Following CRT displays, was the adaptation of LCD monitors. Many physicians upgraded to these monitors since they are slimmer, more portable and offer higher resolution images.

We are witnessing yet another transition in cath lab and hybrid OR monitors as many physicians are upgrading from CCFL HD displays to ultra-high-definition 4K/8MP technology. Many health care facilities have upgraded or are currently in the process of upgrading their medical displays to this resolution. These monitors provide a level of visibility previously unknown to physicians.

During critical surgeries and procedures, increased clarity and sharper details can mean the difference between saving or losing a life.

These 4K/8MP large medical-grade displays are considered to be the new “gold standard” for surgical applications allowing multiple screens to be viewed on a single monitor while taking up a minimal amount of space. When a 4K/8MP display is combined with a video manager, it can become customizable with a variety of layout options and editing tools like magnification. The design is easier to use and provides a higher resolution, making its adoption an easy choice as it facilitates precise procedures and minimally invasive surgeries.

Although the advancement of this technology has improved patient care, the transition made could prove to be detrimental and may demand considerable attention.

With four to six displays in the cath lab pre-

viously, there are preventative measures in place that guarantee a backup option should a monitor burn out. In critical imaging procedures like angioplasty, mere seconds without visibility become crucial moments, and a single display makes cath labs extremely susceptible to all the associated risks.

To solve this issue, some displays are equipped with a secondary back-up monitor that folds out, if needed. However, this is a sacrifice that presents limited visual acuity.

When this situation unravels, the entire procedure must be halted and the patient sutured up, as technicians attempt to remedy the problem.

Furthermore, any display failure amounts to an entire cath lab rendered obsolete until a replacement or repair solution is provided.

Unfortunately, the turn around time for either of those protocols can take over a week.

The Solution Work with a service and repair center that specializes in repairing legacy and current cath lab/EP lab, and hybrid OR monitors.

Most common services are preventive maintenance, LCD, backlight, reflector and power supply replacement.

Ideally, you would want to limit downtime as much as possible. Servicing and repairing the monitors can save facilities upwards of 75% on some occasions as replacing these monitors can exceed $110,000.

ICE Michael Thomas is director of business development & marketing at Ampronix. With the partnership of well-known manufacturers such as Barco, Chilin, Eizo, GE, Hitachi, OptikView, Philips, Siemens, Shimadzu, Sony and Toshiba, Ampronix has become an authorized master distributor of the medical industry’s top brands.

ADVANCING THE IMAGING PROFESSIONAL

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news

IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY RSTI Expands Training Courses Since 1985, Radiological Service Training Institute (RSTI) has provided diagnostic imaging training. With a selection of over 60 courses each year, RSTI has trained over 15,000 service professionals from over 50 different countries in radiology, mammography, CT, ultrasound, networking, PACS and DICOM. RSTI’s comprehensive training facility offers a fully engaged, hands-on training experience.

RSTI is expanding its offerings to include a principles of servicing MRI training course. The course will be divided into two, week-long phases.

Along with a strong emphasis on MRI safety, “MRI Phase 1” will include an introduction to all the major sub-systems and basic diagnostic tools of the MRI. The 17 lab sections will provide ample opportunity for the service engineer to get familiar with the system. Labs will include learning to run diagnostic scans, testing RF coils and QA procedures. An introduction to MRI physics will be utilized to underpin all these activities.

“MRI Phase 2” begins with a strong emphasis on MRI physics to enable the engineer to diagnose image artifacts like spiking, ferrous materials and RF interference. The course continues with more information about the sub-system diagnostics and preventive maintenance (PM) procedures. Nine more hands-on lab

sections round out the second week.

RSTI’s initial MRI courses are non-OEM specific making it ideal for any medical facility that requires MRI training. The training features a Siemens Avanto 1.5T system, but is compatible with any type of MRI equipment.

Lance King, with over 35 years MRI experience with Philips Healthcare, has joined RSTI to develop and deliver these courses.

As part of the systems engineering group, his projects included work on MRI specialty coils and specialty MRI systems such as the NIAD Biohazard MRI, 3T PET-MR and the 7T ultra high field system.

King finished his career at Philips as an MRI course development/ training engineer. He also has experience with regulatory institutions such as the FDA and American College of Radiology. He was a member of the NEMA technical committee for MR. RSTI is planning on expanding the MRI portfolio in 2020 by adding a “Phase 3 Advanced MRI Troubleshooting” course. A Siemens Tims MRI family course covering the Siemens Symphony Tims, Espree, Avanto and Verio is scheduled for second quarter 2020. A GE Excite and GEMS MRI family course is planned for 2020 as well. • For more information, visit rsti-training.com.

Densitas Inc. Wins Major Procurement Densitas Inc. has won a procurement of its densitas densityai software for deployment in up to 24 breast cancer screening clinics across Germany that will provide breast density measurements at point of care to identify women for supplemental breast cancer screening as part of the DIMASOS 2 Trial.

Professor Dr. Sylvia H. Heywang-Köbrunner, M.D., head of Referenzzentrum Mammographie München, internationally recognized for her pioneering work in contrast-enhanced breast MRI and modern biopsy procedures, is using densitas densityai breast density measures to establish a supplemental ultrasound

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screening protocol in the DIMASOS 2 trial.

Densitas densityai delivers fully automated, standardized and reproducible breast density assessments from standard DICOM clinical use mammograms. Results from densitas densityai are generated by two distinct algorithms that decouple the breast density assessment into quantitative and qualitative scales in alignment with the ACR BI-RADS 4th and 5th edition density classification systems. These results can be incorporated into breast cancer risk models to provide standardized and reproducible patient-specific risk estimates. •

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news

AI Algorithms Embedded On-Device Receive FDA Clearance

Varian-equipped New York Proton Therapy Center Treats First Patients

GE Healthcare announced the Food and Drug Administration’s 510(k) clearance of Critical Care Suite, an industry-first collection of artificial intelligence (AI) algorithms embedded on a mobile X-ray device.

Built in collaboration with University of California, San Francisco (UCSF), using GE Healthcare’s Edison platform, the AI algorithms help to reduce the turn-around time it can take for radiologists to review a suspected pneumothorax, a type of collapsed lung.

“X-ray – the world’s oldest form of medical imaging – just got a whole lot smarter, and soon, the rest of our offerings will too,” says Kieran Murphy, president and CEO, GE Healthcare. “GE Healthcare is leading the way in the creation of AI applications for diagnostic imaging and taking what was once a promise and turning it into a reality.

By integrating AI into every aspect of care, we will ultimately improve patient outcomes, reduce waste and inefficiencies, and eliminate costly errors. Critical Care Suite is just the beginning.”

A prioritized “STAT” X-ray can sit waiting for up to eight hours for a radiologist’s review. However, when a patient is scanned on a device with Critical Care Suite, the system automatically analyzes the images by simultaneously searching for a pneumothorax. If a pneumothorax is suspected, an alert – along with the original chest X-ray – is sent directly to the radiologist for review via picture archiving and communication systems (PACS). The technologist also receives a subsequent on-device notification to give awareness of the prioritized cases. Quality-focused AI algorithms simultaneously analyze and flag protocol and field of view errors as well as auto rotate the images on-device. Critical Care Suite and the quality algorithms were developed using GE Healthcare’s Edison platform – which helps deploy AI algorithms quickly and securely – and deployed on the company’s Optima XR240amx system.

Additionally, embedding Critical Care Suite on-device offers several benefits to radiologists and technologists. For critical findings, GE Healthcare’s algorithms are a fast and reliable way to ensure AI results are generated within seconds of image acquisition, without any dependency on connectivity or transfer speeds to produce the AI results. These results are then sent to the radiologist at the same time that the device sends the original diagnostic image, ensuring no additional processing delay. Also, automatically running quality checks on-device integrates them into the technologist’s standard workflow and enables technologist actions – such as rejections or reprocessing – to occur at the patient’s bedside and before the images are sent to PACS. •

The New York Proton Center (NYPC) has treated its first proton therapy cancer patients. Equipped with the Varian ProBeam proton therapy system, NYPC is New York state’s first proton therapy facility and is a collaboration between Memorial Sloan Kettering Cancer Center, Montefiore Health System and Mount Sinai Health System.

NYPC is expected to treat 1,400 patients annually, including most children in New York City with solid tumors, delivering the most advanced form of cancer radiation treatment currently available. Before NYPC was opened, proton therapy patients in the New York metro area were referred to out-of-state facilities.

“We are thrilled to be delivering the highest standard of treatment possible and ensuring our patients – many of them children – are receiving this advanced oncology therapy without having to travel out of the state,” said Dr. Charles B. Simone, II, FACRO, chief medical officer at the New York Proton Center. “With the state-of-the-art Varian ProBeam system, we know that our experienced team of proton therapy experts are able to provide patients with the most advanced radiation treatment modality possible.”

Proton therapy uses protons, accelerated to about two-thirds the speed of light, or more than 100,000 miles per second, to destroy cancer cells, while minimizing exposure to nearby healthy tissues. NYPC will treat pediatric and adult patients with a wide variety of conditions, including brain and spine tumors, head and neck tumors, breast cancer, lung and other thoracic cancers, gastrointestinal cancers, sarcomas, gynecologic cancers, prostate cancer, lymphomas and recurrence cancers.

“Seeing our collaboration with long-term strategic partners in radiation oncology at New York Proton Center come to fruition is a very proud moment for Varian,” said Kolleen Kennedy, president, proton solutions and chief growth officer at Varian. “This means the most advanced cancer care for patients in the greater New York area, and we are excited to build upon this strong foundation as we partner to deliver on the promise of a world without fear of cancer.” •

For more information, visit gehealthcare.com.

For more information, visit varian.com.

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ICEMAGAZINE | NOVEMBER 2019

ADVANCING THE IMAGING PROFESSIONAL

news

ProbeHunter to Develop Probe Adapters for Cephasonics BBS Medical AB from Sweden will develop and market specialized ultrasound probe/transducer adapters that will allow users of Cephasonics systems to connect a variety of different probes from other companies to the Cephasonics system. As part of the relationship, BBS Medical AB will develop and market the adapters both directly as well as through Cephasonics.

“We are proud to announce that one of the leading programmable platforms within ultrasound research, Cephasonics, enter in to a co-operation with us at BBS Medical AB from Sweden as a developer of adapters to their system. This collaboration enables all universities and OEMs to quickly get support with adapters for their ultrasound research and development platforms,” BBS Medical AB/ProbeHunter Sweden CEO Björn Segall said. “Five years ago we released ProbeHunter, the real time test system, to verify the performance of ultrasound probes (on) all brands. To the

IT’S EASY TO GET LOST AT SEA

ProbeHunter system there are today approximately 50 different adapters to test all leading brands; GE, Philips, Siemens, Samsung, Toshiba/Canon, etc. The new adapters to Cephasonics will support probes initially from Ultrasonix and over time a growing number of probes from other major ultrasound companies to be directly connected to the Cephasonics system.”

According to Randy Whiting, chief operating officer of Cephasonics, “this product will provide our users and developers a much greater array of ultrasound probes that can be used in research and development with the Cephasonics ultrasound engine. We’re very excited to work with BBS Medical and the ProbeHunter team to expand the ability of our platform to work with popular ultrasound probes.”

For more information, visit www.ProbeHunter.com.

Let RTI navigate you in the right direction with complete quality assurance solutions for all X-ray modalities and facilities.

We have “click & go” solutions for everything from basic service to specialists. Every product comes with a 24-month factory warranty which can be extended up to 10 years.

+1-800-222-7537 or +1-973-439-0242 sales.us@rtigroup.com | rtigroup.com

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news

MITA Updates Servicing and Remanufacturing White Paper

FDA Clears ARTIS icono Family of Angiography Systems The U.S. Food and Drug Administration (FDA) has cleared the ARTIS icono, a high-precision family of angiography systems from Siemens Healthineers that permit a wide range of minimally invasive procedures to be performed in a single interventional suite. The ARTIS icono biplane system is engineered for optimal utilization in neuroradiology and abdominal imaging, while the ARTIS icono floor is a floor-mounted, single-plane system for vascular, interventional cardiology, surgical and oncology procedures. Both systems in the ARTIS icono family expand the reach of precision medicine.

At its core, the ARTIS icono platform delivers the new OPTIQ image chain, which fundamentally redesigns image processing for 2D imaging. OPTIQ increases image quality across a wide range of C-arm angles and patient weights, regulating acquisition parameters to automatically achieve optimal image contrast at patient radiation doses that conform to the As Low As Reasonably Achievable (ALARA) guiding principal for radiation safety. The platform also improves the Siemens Healthineers roadmap function, which creates subtracted angiography images for easier navigation of the patient’s vascular system during subsequent fluoroscopy, allowing dose reduction during the fluoro mode.

Additionally, the ARTIS icono platform significantly enhances ease of use through Case Flows, which provide personalized workflow plans to optimize imaging parameters and system positions, in addition to displaying layouts for the entire procedure. Case Flows adapt to user needs, providing flexibility when executing certain sequences. Users can therefore standardize procedures across multiple ARTIS icono labs for improved outcomes and more consistent documentation.

The ARTIS icono biplane system is engineered for superior utilization in neurointerventions and interventional radiology, with significantly enhanced 2D and 3D imaging as well as improved visualization of difficult-to-delineate structures. • For more information, visit siemens-healthineers.us/artis-icono.

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ICEMAGAZINE | NOVEMBER 2019

The Medical Imaging & Technology Alliance (MITA) has announced the publication of a revised white paper, titled “Considerations for Remanufacturing of Medical Imaging Devices.” The paper, updated from an earlier version released in February 2019, calls on the U.S. Food and Drug Administration (FDA) to clarify the distinction between servicing and remanufacturing and offers detailed descriptions of the types of activities that would constitute either. It also recommends that organizations adopt appropriate quality management systems to define the nature and scope of the activities they are undertaking in order to ensure servicing and remanufacturing activities are properly performed, documented and regulated.

“By updating this white paper, we hope to create a resource for involved parties to ensure that third-party device servicing activities are done in a manner that protects patient health and safety and are clearly distinguished from remanufacturing,” said Dennis Durmis, head of Americas region, Bayer Healthcare and chair of the MITA Board of Directors.

The updated white paper released includes additional examples of remanufacturing and highlights resources available to entities engaged in medical imaging device servicing activities. The inventory of resources reflects the MITA perspective on best practices and includes citations of the relevant FDA regulations and guidance documents concerning device servicing and remanufacturing as well as a reference list for international and NEMA/MITA standards on the subject. • To view the updated white paper, visit tinyurl.com/MITAwhitepaper.

ADVANCING THE IMAGING PROFESSIONAL

news Philips Teams Up with PURE Royal Philips and PURE (Point-of-care Ultrasound in Resource-limited Environments), a nonprofit organization dedicated to enhancing ultrasound education and use in the developing world, have highlighted a unique tele-ultrasound mentorship program to provide much needed diagnostic ultrasound training to health workers in Rwanda. Expert training and mentorship in point-of-care ultrasound imaging supports Rwanda’s front-line primary and emergency care system and improves access to care for its citizens.

Ultrasound is considered to be one of the most important technologies to improve access to care in limited resource settings. This is particularly relevant in many practice settings across Africa. PURE has been working in Rwanda since 2011 to provide ultrasound training.

However, there are many barriers to overcome when implementing an ultrasound training program in a resource-scare setting that is thousands of miles away.

Philips Lumify with Reacts tele-ultrasound is helping PURE to breakdown some of those barriers. Leveraging the unique live-streaming tele-ultrasound capabilities of Philips’ Lumify with Reacts (a portable point-of-care ultrasound solution), the PURE mentoring program in Rwanda connects a team of Europe and U.S.-based physicians that are experts in point-of-care ultrasound with emergency medicine residents at the University Hospital of Kigali. Rwanda is helping to lead in access to universal health care coverage and in the development of emergency medicine as a specialty in East Africa. The doctors that are trained by PURE act as ultrasound ambassadors who can train primary care and emergency medical workers throughout the rest of the country and beyond.

“The Rwandese health care system has a rapidly developing emergency care infrastructure but still experiences challenges with limited rapid diagnostic capabilities, yet diagnostic imaging is essential in providing specialist-level care for the majority of acute illnesses and injuries presenting,” said Dr. Trish Henwood, president and co-founder of PURE and a specialist in emergency medicine and ultrasound.

“The goal of this new tele-ultrasound mentorship program is to get our mentors and mentees better connected, helping to greatly increase the number of physicians we can train, and sustainably develop ultrasound expertise at the point-of-care throughout Rwanda.”

“The role of point-of-care ultrasound in improving emergency medicine in Rwanda is really important. We have a limited number of radiologists that we can call on to perform scans, and as a result there is often a delay in providing care to patients,” said Dr. Vincent Ndebwanimana, emergency care physician at the University of Rwanda.

“Now I can make the emergency diagnosis myself so that I can much better fulfil my responsibility as an emergency physician.”

Philips’ Lumify with Reacts point-of-care ultrasound solution, which works in conjunction with a compatible smartphone or tablet, is the world’s first ultra-portable ultrasound device with advanced telehealth capabilities. The Reacts communications platform enables two-way audio-visual calls with live ultrasound streaming, so both parties can simultaneously view the live ultrasound image and probe positioning, while discussing and interacting at the same time. •

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Richardson Healthcare Receives CE Mark Approval for ALTA750 Richardson Healthcare, a division of Richardson Electronics Ltd., has received CE Mark approval for the ALTA750 X-ray tube. The ALTA750 is a form, fit and function replacement for the Canon/ Toshiba CXB-750D/4A. Richardson ships the tube with a new cable and heat exchanger, and offers a full warranty. The CE Mark confirms that the product meets the requirements of the European Medical Device Directive, and signals conformity to patient and user safety and device performance standards in the European Union.

“The approval also represents a significant milestone for Richardson toward the commercialization of the ALTA750, and demonstrates the commitment we have to our existing and future customers, partners and investors,” according to a press release.

“By making third-party tubes and replacement parts as well as training available to third-party service providers and in-house service teams, Richardson is helping reduce the cost of health care by providing alternatives to costly OEM service agreements.”

Richardson has been shipping the ALTA750 in the United States for more than 15 months. Richardson now stocks the ALTA750 and other replacement parts for diagnostic imaging equipment in its Amsterdam facility in The Netherlands for quick availability throughout Europe.

“We are ready to ship the ALTA750 to customers in the European Union, the wider EEA (European Economic Area), as well as other countries that recognize the CE-marking requirements,” the release states. •

FUJIFILM Sonosite Inc., AI2 Collaborate FUJIFILM SonoSite Inc. and the Allen Institute of Artificial Intelligence (AI2) Incubator, builder of AI-first startups, have announced a collaboration to interpret ultrasound images with AI, enabling new ultrasound applications and enhanced accuracy. Fujifilm SonoSite has enlisted assistance from the AI2 Incubator to deploy deep learning models on portable ultrasound products. Together, the AI2 Incubator and Fujifilm SonoSite will work to improve image analysis, allowing for the interpretation of a much wider range of ultrasound scenarios.

Within the field of medical imaging, deep learning-based techniques have brought breakthroughs across a wide range of scenarios including detecting tuberculosis (TB) in X-ray scans and diagnosing metastatic breast cancer in pathology slides. Compared to other modalities such as X-ray, CT and PET, ultrasound is more affordable, portable and does not expose patients to ionizing radiation. Ultrasound’s comparative disadvantage was traditionally its lower image quality. While great improvements have been made over the past two decades, deep learning algorithms now stand to significantly increase both the accuracy and rapid assessment ability of ultrasound technology.

“In tackling this challenge, we are pushing deep learning, computer vision and medical imaging into uncharted territory,” said Dr. Vu Ha, technical director at the AI2 Incubator. “In building new AI-based capabilities in affordable ultrasound devices, we hope to bring them to underserved markets to improve health care around the world.” •

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Hope Regional Cancer Center Earns ACR Accreditation Hope Regional Cancer Center has been awarded the three-year term of accreditation in radiation oncology as the result of a recent review by the American College of Radiology (ACR). This is the third ACR Accreditation for the Hope Regional Cancer Center (HRCC) and is the only cancer center in the Florida Panhandle to receive this accreditation. Radiation oncology (radiation therapy) is the careful use of high-energy radiation to treat cancer. A radiation oncologist may use radiation to cure cancer or to relieve a cancer patient’s pain.

The ACR seal of accreditation represents the highest level of quality and patient safety. It is awarded only to facilities meeting specific practice guidelines and technical standards developed by ACR after a peer-review evaluation by board-certified radiation oncologists and medical physicists who are experts in the field.

Patient care and treatment, patient safety, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed. The findings are reported to the ACR Committee on Radiation Oncology Accreditation, which subsequently provides the practice with a comprehensive report they can use for continuous practice improvement. •

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Screening Mammography Could Benefit Men at High Risk of Breast Cancer Selective mammography screening can provide potentially lifesaving early detection of breast cancer in men who are at high risk for the disease, according to a study published in the journal Radiology.

Breast cancer in men is a rare but often deadly disease. The American Cancer Society projects that 2,670 new cases of invasive breast cancer will be diagnosed in men in 2019, and about 500 men will die from it.

There are no formal screening guidelines for men in high-risk groups such as those who have a personal history of the disease, breast-cancer-associated genetic mutations or family members who had breast cancer. As a result, men diagnosed with breast cancer tend to have worse outcomes than women.

“Mammographic screening has helped improve the prognosis for women with breast cancer,” said study lead author Yiming Gao, M.D., from the department of radiology at New York University Langone Medical Center in New York City. “But men don’t have any formalized screening guidelines, so they are more likely to be diagnosed at a more advanced stage and often don’t do as well as women.”

There is anecdotal evidence that selective screening with mammography in men with identifiable risk factors is beneficial, but little is known as to how and to what extent breast imaging is used in this population.

In the first study of its kind, Gao and colleagues evaluated breast imaging utilization patterns and screening outcomes in 1,869 men, median age 55, who underwent mammography over a 12-year period.

Mammography helped detect a total of 2,304 breast lesions, 149 of which were biopsied. Of those, 41 (27.5 percent) proved to be malignant. The cancer detection rate of 18 per 1,000 exams in men at high risk of breast cancer was significantly higher than the average detection rate of three to five per 1,000 exams in average risk women. In addition, the cancers in men detected were at an early stage, before they had spread to the lymph nodes, improving the prognosis for survival.

In men, mammographic screening sensitivity, or the ability to detect cancer, was 100 percent, while specificity, or the ability to distinguish breast cancer from other findings, was 95 percent. This excellent performance is related to men having a relative lack of breast fibroglandular tissue that in women often masks abnormal results, the researchers said.

Personal history of breast cancer was the most significant risk factor associated with breast cancer in men. Ashkenazi Jewish ancestry, genetic mutations and first-degree family history of breast cancer were also significant factors.

Currently, the National Comprehensive Cancer Network (NCCN) does not support screening because of a lack of evidence, even in men with elevated risk. Earlier NCCN guidelines suggested consideration of baseline mammograms on an individual basis, an approach the new study results may support.

Moving forward, the researchers hope to see larger multi-institutional studies that have the statistical power to delineate more nuanced information based on different breast cancer risk factors in men.

“Rethinking our strategy toward male breast cancer diagnosis is necessary,” Gao said. “We hope these results will provide a foundation for further investigations, and potentially help pave the way to standardizing screening for certain high-risk groups of men.” ICE

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COMPANY SHOWCASE

ACCUMEN S

ince its inception in 2011, Accumen has been partnering with hospitals and health systems to drive performance improvements and provide strategic insights into many of the challenges facing healthcare delivery. Today the company serves the healthcare industry by providing performance expertise in three key areas: operational performance, clinical performance and data performance. These efforts ensure its clients achieve their cost, quality and service targets as well as enabling them to deliver excellent patient care through evidence-based data and clinical decision support capabilities. In the area of data, its clients have mountains of data flowing through their systems but are challenged on how to connect their disparate systems and facilities, ingest the needed data and most importantly turn that data into insights and actions that can add immediate value.

Accumen has generated more than $250 million in annual cost savings within its operational performance business while enabling thousands of patients to avoid unnecessary blood transfusions and lab tests. Its clinical data exchange business has paved the way for over 600 million data transactions to happen seamlessly across payers, physicians, hospitals, labs and clinics. Accumen delivers value through improvements in lab and imaging departments with core capabilities in supply chain, quality, service, consulting and lab outreach management. Its clinical offerings include patient blood utilization,

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test utilization and virtual anemia management while its data performance offerings include clinical data exchange, inoperability and order management.

“Our team has grown significantly over the past few years with team members now operating out of 31 states across the country where we can be at our client sites working side by side to understand their challenges and maximize value. In parallel, we have acquired three companies to strengthen or complement our capabilities with Chi Solutions consulting, Halfpenny Technology clinical data exchange and My Blood Health’s anemia management business. We are currently in final stages of a very exciting imaging acquisition which brings market leading capabilities in 3D post processing”, Accumen President and CEO Jeff Osborne said.

“We began our journey with a handful of talented individuals who believed healthcare performance could be improved in a significant way. Our team has grown each year with the addition of new skills, experience, styles and perspectives. This diversity of talent, coming from both inside and outside of healthcare, is what this company was built upon,” he added. “During our journey, we have developed a reputation for delivering on or exceeding our commitments to our clients and we are extremely proud to say that all of our clients remain excellent references.”

Imaging Community Exchange (ICE) magazine recently found out more about Accumen via a Q&A session with Osborne.

Jeff Osborne President and CEO of Accumen

Q:

What are some advantages that Accumen has over the competition?

Osborne: We are a company that knows how to make our clients the hero. We are a performance guide that knows the trail and more importantly knows how to make change happen at the pace and culture of the client. We don’t tell our clients how they should improve; we execute and deliver the needed results. Additionally, our service offerings have expanded significantly and now include a vast array of services and businesses addressing a large portion of operational, clinical and data needs across the healthcare industry. In the past, our offerings were mainly focused on short-term consulting and multi-year transformation engagements, whereas now they include a wide variety of consulting, technology, benchmarking, managed services, outsourcing operations and joint venture programs. healthcare clients can now purchase offerings that are configured to meet them at

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their point of need. These include solutions for a one-time need, ongoing management of critical performance operations, multiple analytics and benchmarking services, a comprehensive portfolio of technology platforms and large-scale transformation projects. Our combination of people, process and technology has vaulted us into the mix with only a few high-performing healthcare companies.

In imaging specifically, we bring decades of operational and clinical expertise to teams across the country. Hospital and health system imaging departments face considerable pressure from other providers and from the pace at which technology is advancing.

Working with our team of operational and clinical experts in this space, our clients can accelerate their capacity, build greater agility in technology adoption, and improve their work volumes to meet these ever-growing demands. Imaging experts such as Dr. James Brink (Radiologist-in-Chief at Mass General) have recently joined our Board to provide insights and experiences, making our team relevant and impactful.

Q:

What are some challenges that your company faced last year?

Osborne: We moved pretty quickly from a startup to a growth company and following our company recapitalization with Arsenal Capital Partners, our new owners, we have accelerated our growth trajectory significantly with new capital investments, acquisitions and operating partner expertise.

This business transformation was not achieved by only a few executives at the top of the company or a handful of elite, high-performing individuals but it was the result of the collective grit, sweat and grind of every single Accumen team member. We are enacting our shared vision and answering our call to action, recognizing that this is our moment to create something special that very few people have the opportunity to be part of.

Q:

Can you explain Accumen’s core competencies and unique selling points?

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Osborne: As an organization, we bring performance excellence expertise to every business relationship and treat our clients as partners. We invest in the opportunities alongside our clients. For example, our Imaging Excellence model can take either a consultative or shared savings approach, depending on the needs of that client. We adjust our offering and business models to meet the needs of our clients as our top priority. We are a performance execution company that separates ourselves from consulting groups that merely add more work for clients with suggestions, strategies and PowerPoint slides. We deliver real results.

Q:

What product or service are you most excited about right now?

Osborne: During the past six months, we have expanded our client base from hospitals and health systems to include payers, health plans, commercial labs and physicians. The additional impact and reach we can have has grown exponentially as we take the lessons learned from one area of expertise and apply best practices across this broader healthcare landscape.

We’re excited to look at the entire healthcare industry as an ecosystem and identify the levers that we can positively impact. We see imaging as an area that has tremendous impact on both the patient experience and the diagnostic continuum as more than 80% of all visits include at least one imaging exam. Optimizing operations and creating initiatives that increase efficiencies in the imaging department will help patients receive a higher quality of care overall.

Q:

What is on the horizon for Accumen?

Osborne: We’ve built a performance-based company with functional excellence that is primed to scale, support our growth and positively impact different areas of healthcare. Healthcare isn’t just an industry, it’s our families and communities that desperately needs the help of our team that has the skills, resources and passion to

have a profound impact on healthcare.

With greater operational efficiency, additional revenue streams, and cost reduction strategies in place, patient care can improve, and our industry can re-invest in itself and continue to be on the leading edge. With that re-investment, we see our work evolving to move organizations from good to great and ever better.

Q:

Can you share a success story with our readers?

Osborne: One of our clients, a health system with imaging facilities across three hospitals and 16 off-site locations, wanted to meet its community’s needs better by offering more diagnostic mammogram appointments at a broader range of times. Facing tight budget constraints, as is the case with healthcare organizations nationwide, the health system was not able to hire additional technicians to meet the demand.

That’s where Accumen’s work adds such tremendous value. Armed with data and supported with a deep knowledge of industry benchmarks and best practices, our team of experts found ways to redeploy the existing staff more effectively. As a result, this client was able to increase staff productivity and equipment utilization, adding an average of seven exams per day, increasing appointment availability by 44%, and eliminating a two-week patient backlog.

Q:

Is there anything else you want readers to know about Accumen?

Osborne: In the end, our passion grows out of our confidence that the work we do matters. We are inspired to improve operational, clinical and data performance across the healthcare industry for one simple reason – because every dollar saved, every minute spared, every unnecessary procedure avoided, makes room for one more smile, one more sigh of relief, one more moment of comfort. What we do makes life better for providers across healthcare and, ultimately, patients. ICE

ICEMAGAZINE

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PEOPLE ON THE MOVE

By Matt Skoufalos

1

The Chartis Group of Chicago, Illinois named Rob Gallo a principal of its informatics and technology practice. Prior to joining, he was a vice president at Health Systems informatics (HSi). Gallo has held other leadership roles in advisory and provider organizations, including Accenture, Deloitte, Northwestern Memorial Hospital, Cleveland Clinic Abu Dhabi and Epic. He is also a board member for the HIMSS Greater Chicago Chapter and holds an MBA from the University of Chicago.

2

MedCrypt of San Diego, California named Axel Wirth as its chief security strategist. He joined the company from Symantec, and previously held roles with Siemens, Analogic, Mitra and Agfa.

3

oneSOURCE has expanded its team with multiple new hires and promoted a long-time employee to a senior-level position to help meet the demands of its significant growth and expansion into other markets and verticals. The following individuals have been hired to join oneSOURCE: Dawn Simmerman, director of human resources and Ian Fisher, director of engineering. oneSOURCE has also appointed long-time employee Jennifer Sippel as the new vice president of operations.

4

Aetion of New York added former FDA Commissioner Scott Gottlieb to its board of directors. Gottlieb will advise the company as it expands the reach and utility of its evidence platform.

5

AMN Healthcare Services Inc. of Dallas, Texas appointed Teri G. Fontenot, CEO Emeritus of Woman’s Hospital in Baton Rouge, Louisiana, to its board of directors. Fontenot, a fellow of the American College of Healthcare Executives (FACHE), joined the hospital in

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02

05

08

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1992 as CFO and became CEO in 1996. She is on the American College of Healthcare Executives Board of Governors, and held a six-year term on the Advisory Committee on Research on Women’s Health for the National Institutes of Health.

6

Apex Physics Partners of Towson, Maryland promoted Michele F. Loscocco to president of Krueger-Gilbert Health Physics (KGHP). Loscocco joined KGHP in 2007 as a diagnostic medical physicist, and most recently was its director of technical operations as well.

Before joining KGHP, she had completed a 20-year career as a naval officer.

7

Varian of Palo Alto, California named Francis R. Facchini its chief medical officer of interventional oncology. Facchini was most recently chief medical officer and head of medical affairs for BTG Plc., had previously been global director of medical and clinical affairs for Angiodynamics Inc., and was chief medical officer of Navilyst Medical Inc.

8

Bayer of Whippany, New Jersey named Daniella Foster head of public affairs and sustainability for the consumer health division. She most recently led global corporate responsibility at the Hilton Corporation.

9

Proton Therapy Partners (PTP) of Philadelphia, Pennsylvania named Kurt Morath its vice president of operations. Morath comes to PTP from Penn Medicine in Philadelphia where he was director of operations for its department of radiation oncology.

10

Accuray Incorporated of Sunnyvale, California expanded its board of directors to nine with the

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Stanford Children’s Health of Stanford, California named Rick Majzun its vice president and COO. Most recently, Majzun was president and COO for Women & Infants Hospital in Providence, Rhode Island.

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Quest Diagnostics of Secaucus, New Jersey named Manuel O. Méndez senior vice president and chief commercial officer, effective October 7. Mendez joins Quest from QIAGEN N.V., where he was senior vice president, head of global operations and a member of the executive committee.

13

The Joint Commission of Oakbrook Terrace, Illinois named Herman McKenzie director of its department of engineering standards interpretation group.

McKenzie worked previously in facilities management and biomedical engineering roles at several health care facilities in the Chicago area. He has more than 25 years of experience in health care and an MBA from Governors State University. ICE

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WEBINAR WEDNESDAY Imaging Sessions Deliver ‘Great Information’

By John Wallace

W

ebinar Wednesday teamed up with sponsor Avante Health Solutions to deliver “great information” in “Introduction to Computed Tomography.” Avante Health Solutions Vice President of Operations-Imaging Eric Davis presented a top-notch session and attendees were eligible to earn 1 credit from the ACI. In the 60-minute webinar, Davis discussed the basics of CT including the history of computed tomography from the first generation scanners to 4th generation scanners and the advancements between each generation. He also provided a basic overview of the theory and physics that make it possible. Davis also discussed Hounsfield numbers (CT number) and the importance of them as well as the different types of applications and studies.

Davis followed up with a look at common problems and cost of ownership from a maintenance perspective.

The webinar had 252 attendees for the live presentation and more have viewed a recording of the session online. The session received an attendee rating of 4 on a 5-point scale with 5 being the best possible rating.

Attendees filled out a post-webinar survey in which they were asked, “How

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“ One of the best I’ve seen. Information was pointed, summarized and not a sales pitch.”

– T. Wade, biomedical engineer well did the content that was delivered match what you were promised when you registered?”

“The webinar was great. I am trying to get into the imaging side and this helps with the concepts,” Senior Biomedical Technician J. Vandyke said.

“One of the best I’ve seen. Information was pointed, summarized and not a sales pitch,” said T. Wade, biomedical engineer.

“This was a very good webinar for people in our business that would like to understand that workings of CT. I enjoyed it very much,” Senior Biomedical Technician G. Haungs said.

“Exceeded my expectations. Great job.

The Siemens part of me appreciated the explanation of helical scanning,” said R. Larkin, healthcare technology equipment coordinator.

“It was very good as a source of information. The other person that watched

this webinar with me has many years of experience with CT. He told me that there was good coverage of material regarding CT and, based on that compliment, it seemed to be a good webinar,” Imaging Equipment Service Technician L. Mosqueda said.

“It was exactly what I expected. An overview of the concept of CT and the dynamic of service availability options and planning,” said J. Vazquez, biomedical engineer.

“100% satisfaction,” Director E. Rangel said.

“I had no prior knowledge of so much detail involving CT. Gave some great information and not too much detail as to become confused,” shared R. Campos, BMET. “100%. Very Informative. Loved the slideshow presentation,” said E. Petrea, CBET, senior technician.

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“ The best way to stay current on new medical equipment, new tools to test that equipment and a ton of information to help you sharpen your HTM skills.”

– R. Marek, Imaging Specialist III Remote Monitoring Tips Streamline Workflow A recent Webinar Wednesday session, sponsored by Philips, featured four ultrasound experts sharing tips on how to streamline work via remote access. Those who attended the webinar “Learn How To Streamline Your Support Workflow With Remote Access To Your Philips Ultrasound Systems” are eligible for 1 credit from the ACI. The webinar’s panel of Philips experts included Stone Dupree, ultrasound technical trainer and developer; Mark Potts, senior service product manager, ultrasound; Terri Richardson, senior global product manager; and Jim Moran, North America service product manager, ultrasound. The team showed how HTM professionals can set up the Philips OmniSphere software and connect EPIQ and Affiniti ultrasound products to the Remote Technical Connect application (a part of the OmniSphere suite of applications). OmniSphere is a software-only platform that allows professionals to access and remotely control Philips ultrasound systems and their data

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from anywhere they have a connection to the network. The presentation delivered tips on how to save time and money servicing and supporting equipment.

The webinar was well attended with 127 people viewing the live presentation.

A recording of the webinar is available online and already HTM professionals from around the world have access to the insights provided by the Philips experts.

Webinar attendees were asked “How would you describe Webinar Wednesday to your colleagues?” in a post-webinar survey. The replies were positive with many commenting on the educational aspect of the series.

“A good tool for continuing education.

A good resource to gain knowledge,” said T. Ryan, CBET. “Excellent use of one hour. Learn and get credit towards recertification,” said S. Rivera, Senior BMET. “A great place to learn about new products and gain insight on the direction of our field. It is also a great way to learn and to gain back some knowledge that you may have forgotten or just haven’t done in

a long time,” Senior Biomedical Technician G. Haungs said.

“The best way to stay current on new medical equipment, new tools to test that equipment and a ton of information to help you sharpen your HTM skills,” said R. Marek, Imaging Specialist III. “Webinar Wednesday is a genuine source of up-to-date information,” Senior Biomedical Engineer N. Ramaswamy said.

“Webinar Wednesday is a great way to learn about devices we might not see on a regular basis as well as refresher learning about those devices we do see and work with on a regular basis,” said D. Duck, Senior BMET. “Webinar Wednesdays are a great opportunity to learn procedures, processes and new products that can make your job easier. And, best of all, you can do it at work. It has been a great resource,” Instructor M. Kalis said. ICE For more information about the Webinar Wednesday series, including a calendar of upcoming presentations and recordings of previous webinars, visit WebinarWednesday.Live.

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

ICEMAGAZINE

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ARIZONA TAPPED FOR ICE 2020 Imaging Conference & Expo Set for February 9-11

By John Wallace

H

undreds of imaging professionals from throughout the nation will descend on Scottsdale, Arizona for the 2020 Imaging Conference & Expo (ICE). The wildly successful conference will build on the amazing experience imaging service professionals and administrators had in 2019.

ICE 2020 is designed to live up to the high expectations of attendees and exhibitors. It is the only conference dedicated to imaging directors, radiology administrators, and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers valuable CE credits from the ASRT and ACI (pending approval) and, keeping in line with previously successful conferences, offers comprehensive educational opportunities for attendees.

ICE 2020 will feature a full slate of educational opportunities, including a CRES Prep Course and the always popular super sessions. The conference also boasts five hours of valuable exhibit hall availability where attendees can discover the latest solutions from a wide variety of industry-specific companies. A keynote address and signature networking events are can’t-miss opportunities to advance one’s knowledge and career. The ICE Leadership

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Summit and Reverse Expo are also on tap for Arizona.

Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, attendees will have the perfect opportunity to enhance their careers and spend time with colleagues. As an added incentive, ICE conference admission is complimentary for all hospital employees, imaging centers personnel, active members of the military and students.

ICE continues to be the only conference to combine leaders in imaging management with imaging engineers, providing an exclusive and unique community of key decision makers and influential imaging professionals. ICE is the perfect resource to grow and prosper, personally and professionally.

ICE is powered by ICE magazine – the monthly magazine for imaging service professionals and directors produced by MD Publishing. MD Publishing Founder and President John Krieg reported a tremendous 2019 conference and expectations are high for this year.

“ICE 2019 exceeded everyone’s wildest expectations! From the sunny beaches of Clearwater Beach, Florida, our attendance hit 300, and was made up of imaging directors and engineers from 40 states,

and combined with the exhibitors, gave us close to 500 in total attendance,” Krieg said. “From the ICE18 Leadership Summit & Reverse Expo, to the jammed packed exhibit hall, to the incredible continued education and super sessions, we heard from more than one attendee who said.

‘ICE has become THE imaging conference to attend. Where else can you combine imaging directors with service engineers and have networking, vendor interaction and powerful education!’”

“We can’t wait to build on this for ICE 2020 in Scottsdale! Look out!” Krieg added.

“The 2019 Imaging Conference & Expo was abuzz with activity. The ICE Leadership Summit which brought together over 25 imaging leaders from around the country kicked off the conference, followed by the Reverse Expo with its whirlwind speed-dating style atmosphere.

Several ICE sessions had standing-room only, and the exhibit hall provided a festive atmosphere with food, cocktails and live music,” MD Publishing Vice President Kristin Leavoy said. “We even had vendors and attendees asking when registration would be open for the 2020 conference!”

For those asking, registration is now open. Find out more about the conference and register at AttendICE.com. ICE

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Timothy Hooks, CHTM, CBET, CRES: Efficient Processes to Perfume

T

he principle and capability of an X-ray machine was all the convincing one imaging technician needed to enter the imaging service profession. It was that enlightenment that checked all the boxes for Timothy Hooks, CHTM, CBET, CRES. Hooks is an independent HTM consultant.

“What drove me to the imaging arena was partly due to a random chance meeting with an X-ray service engineer while working at my first major biomedical position at Bay Harbor Hospital. He said, ‘Yeah, I am just working on this machine that uses invisible X-rays that penetrate your body.’ Honestly, at the time, that was just the coolest thing I had ever heard of,” Hooks says.

“Also, Manny Roman visiting CMIA back around 1998, and attending his X-ray fundamentals seminar, had a tremendous effect on my interest. I didn’t realize until then, because of the track I took to get into this industry, what we could be involved with,” Hooks adds.

I continued to work on imaging equipment and general HTM equipment until I was able to obtain my CBET and later my CRES which allowed me to get my first dedicated imaging position working for Medstone International, now Healthtronics, as a field engineer covering the Northeastern United States,” Hooks says.

Hooks says that his training came via strong electronics training through the North Orange County Regional Occupational Program (NOCROP) via a college transferable

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credit course, that existed at the time, lots of self-study and lots of on-the-job and original equipment manufacturer (OEM) training. He also attended and successfully completed their Nursing Cardiac Monitor Technician program.

“Thankfully, RSTI offered the CRES program that I took along with my own personal study material. Years of continued personal study, working for multiple imaging OEM companies, on-the-job training, third-party and OEM factory schools and ergo here we are,” he says.

The positions he has held have ranged from HTM probe technician to imaging tech II and imaging tech lead. He is also a subject matter expert consultant to three law firms and a member of the AAMI ACI CHTM certification committee.

Hooks says that his areas of specialty include CT, regulatory FDA documentation, PM procedures, mentoring junior imaging employees and staying current on new and evolving HTM imaging-related regulatory requirements.

In the broader scope, Hooks says that getting into the profession served a bigger purpose.

“Indirectly there was a humanitarian aspect that I could sense would better humanity as an aspect of its ultimate purpose,” he says.

Imaging experience and leadership experience are areas where Hooks can be of benefit to others.

“As an independent HTM consultant currently, I am serving on AAMI’s ACI CHTM Certification Committee in addition to offering incident investigation services to various law firms; something like biomedical forensic engineering of sorts,” Hooks says.

“Also, I am currently actively interviewing for various positions across the country. I also provide laboratory consulting billable back to our company. We have a perfume laboratory that utilizes biomedical laboratory processes and guidelines,” he says.

Sharing a Bright Idea Asked about challenges, Hooks says that some are older, like Y2K, and others are part and parcel of the profession, like The Joint Commission constantly changing things around [and] new CMS requirements. “[I] had my LSS certification project published in AAMI’s Bright Ideas column. [I] was one of only approximately 25 at the time to be dual certified as both a CBET and CRES; was part of the first batch of 18 to be certified as a CHTM and first to be triple certified as a CHTM, CBET, CRES,” Hooks says.

He says that he did the work to get the CHTM certification because of “career marketability and I had wanted to get the CCE before they discontinued it back on, or around, 1999.”

Hooks also says that he served as a medical design judge for HOSA. HOSA is an international student organization. According to

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people

Away from work, Timothy Hooks enjoys spending time with family.

GET TO KNOW THE PRO Favorite book Bible Favorite movie Hard to choose but if you forced me perhaps my childhood favorite is “Time Bandits” Favorite food Sushi (yummy) Hidden talent Children’s book writing and looking at half-full glasses of water.

What’s on my bench?

Master of the Messy Desk placard, colognes of various types, cellphone, laptop and DMM.

Favorite part of being an imaging professional?

“Being able to complete an otherwise canceled study, helping assist in diagnosing and treating patients who need medical care and moments like these.”

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the organization’s website; “HOSA’s two-fold mission is to promote career opportunities in the health care industry and to enhance the delivery of quality health care to all people.”

He says that during his involvement, students submitted innovative health/medical designs that would provide solutions for a problem.

“During the convention, they asked if I, along with one other person from the local university, would act as a judge for the student projects,” Hooks says.

The judges had scorecards that allowed the projects to be rated on multiple metrics.

“It was definitely an experience to remember. One of the most memorable projects was a medicine bottle that would alarm when it was time to take your medicine, which was intended for people who had trouble remembering to take their medicine for whatever reason,” Hooks says.

Hooks says that there was a call for Bright Idea project submissions and he submitted his imaging project to AAMI. “My LSS project, that was published in AAMI’s BI&T and sponsored by Texas Health Resources, was submitted to Fortune Magazine as a testimony to the positive employee work environment present at Texas Health Resources,” he says.

Hooks recognized that there could be steps taken to reduce the downtime of imaging equipment. Using knowledge learned through Lean Six Sigma training, he developed his five “S’s” approach, which included “Sort, Store, Shine, Standardize, Sustain,” in order to create a more efficient process.

According to the AAMI Bright Ideas

article, the result was “decreased equipment downtime, less time looking for existing parts, less waiting on replacement supplies, and enhanced response time to routine and emergency service requests.”

When not working, Hooks like to read science-related material and the Bible, research, exercise, blog (HTMTrends.blogspot.com) or work on the fragrance decants business.

Hooks has been married to his “wonderful wife” Mae for 18 years. They have two sons; Seth and Sam. Hooks points out that an important skill in imaging service is to understand that the only thing that never changes is change itself.

Embracing that fact can be beneficial.

“This industry has definitely been going through some unique changes which would obviously present unique challenges. Whilst some of these situations seem for the better and others perhaps not so much, one thing is true and that is that we need to embrace the change to be successful,” he says.

“I guess, just like Facebook needs to keep all those content developers employed ergo the new updates that seemingly never stop rolling out, we shouldn’t be surprised that the regulatory bodies are constantly moving the target, they need to make sure we aren’t getting complacent or resting on our laurels,” Hooks adds.

He says to stay positive and keep a good attitude and things will work out.

“Remember, the ultimate goal is providing safe and reliable health care services while balancing costs; if you can embrace this then you are where you need to be mentally,” Hooks says. ICE

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people

By K. Richard Douglas

DEPARTMENT SPOTLIGHT UCSF Medical Center Medical Imaging Shop

H

ospitals are rightly honored to be recognized for top billing in various specialties by independent, third-party reviewers. It is an achievement that often reflects on internal policies and procedures that result in great metrics along with good physicians and clinical staff.

The extra effort ends up catching the attention of national publications.

The University of California San Francisco (UCSF) Medical Center is one of those recognition recipients. This year, U.S. News and World Reports awarded the institution with elite status.

According to the medical center’s website; “UCSF ranked seventh on the Best Hospitals Honor Roll and among the nation’s leading medical centers in all 15 specialties for which it was assessed.”

The medical center is a part of the University of California San Francisco, one of the country’s top universities.

“UCSF has more than 20 locations throughout San Francisco and beyond.

The original location, Parnassus Heights, is made up of a tight network of buildings covering almost six blocks and serves as headquarters for UCSF leaders. Mission Bay is a teaching, research and clinical care facility with a daily population of about 3,500 UCSF faculty, staff and students,” says Eric Smith, the medical center’s medical

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imaging shop supervisor.

He says that the UCSF Mount Zion campus is its western addition hub of specialized medical center clinics and surgery services.

“We just opened our fourth major campus; UCSF Bakar Precision Cancer Medicine Building (PCMB). This 170,000 square foot cancer hospital contains 120 rooms for exams and consultations, 47 infusion bays for chemotherapy and 19 types of imaging services. PCMB is expected to see over 700 patients a day this fall,” Smith says.

“Clinical technologies at UCSF is responsible for the diagnostic imaging throughout the facilities, leaving the research to our OEM partners. Currently, we manage and repair over 300 pieces of imaging equipment from portables and C-arms to CTs and MRIs. This does not include the 320-plus ultrasounds we service in-house,” Smith adds.

There is only one device that the team does not service.

“We have an MRI/PET scanner that was the first one ever installed in the country and is used at one of our sites. We do not service this piece due to the research studies being done on this new technology,” Smith says.

The specialized imaging team at UCSF hasn’t been around for very long.

“The imaging team component of clini-

cal technologies is a fairly new entity. Imaging now has its own cost center and budget and is a completely integrated service delivery shop within clinical technologies’ BES organization. The imaging team has over 110 years of combined imaging experience. Currently we have six engineers/technicians and are hiring an administrative assistant. Our director, Ramana Sastry, has been with UCSF for over 11 years and had the vision of expanding services at UCSF to be more patient sensitive and customer-centric,” Smith says.

Smith, himself, is credited with helping the team make great strides in bringing the program to fruition. He says that they are currently focused on building a successful imaging program.

“Clinical technologies has just recently taken on the role of servicing and managing UCSF’s imaging equipment. Our program is almost a year old at this time,” he says.

The team provides service to all ultrasounds, diagnostic imaging (Rad, R/F, CV, IR), CT scanners, MRI systems, and PET scanners.

Training comes partly through manufacturers and partly through other outside sources.

“We are able to take advantage of the OEM’s training for in-house engineers and have a substantial training budget. We have also engaged strategic third-party vendors

ADVANCING THE IMAGING PROFESSIONAL

people

ABOVE: The members of the UCSF Medical Center Medical Imaging Shop are, from left to right, Director Ramana Sastry, Imaging Supervisor Eric Smith, Doug Shearer, Peri Duke, Samson Holmes and Ron Lawrence. LEFT: Parnassus Heights is made up of a tight network of buildings covering almost six blocks and serves as headquarters for UCSF leaders. to assist with some of our training and service needs,” Smith says.

The team has a say in the capital purchase process.

“The imaging shop and clinical technologies are involved directly and indirectly with the purchase and planning for radiology and cardiology. A portion of the capital equipment spend for diagnostic imaging goes though clinical technologies, so we have a lot of input into the planning and purchasing processes,” Smith says.

He says that they do not purchase point of sale contracts at the time of purchase as a general rule; those decisions are reserved for another time to be evaluated and studied separately with the key players.

“Our capital spend is for the equipment and the servicing expense comes out of clinical technologies operations budget. We are able to negotiate training classes and

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lock in pricing at the time of the sale. This helps us plan the transition of the equipment service life from warranty to in-house PM and repair,” Smith says.

Building Value The imaging service group has shown its worth in several ways and has been involved in projects to benefit its facilities.

“Our imaging team, in conjunction with our cybersecurity team, has been involved with the networking of wired and wireless technologies within the hospital groups.

Clinical technologies has a cybersecurity officer that interfaces between clinical technologies and the IT team within the hospital to improve the safety and security of our networks. The imaging team has been beneficial in helping to secure those networks,” Smith says.

The imaging service group has also tak-

en steps to acquaint the clinical staff with the benefits of bringing servicing in-house.

“My imaging team has made significant progress in developing the ‘buy-in’ by the end users and technologists to see the advantages of going in-house at UCSF. The dedication and desire of the imaging team to work around schedules, being available 24/7 and scheduling work on the weekends as necessary, have really helped us to convince the end-user staff that we are here for them every step of the way,” Smith says.

He says that the team’s customers are now finding out that they can problem solve and repair equipment faster than the OEMs and that their insight into the use and care of the different modalities has shown its merit in including clinical technologies in conversations.

“We are proud to be such an integral part of patient care at UCSF,” Smith says. ICE

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PRODUCT SPOTLIGHT Big Gains Forecast in Health Care AI Market Staff report

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he global artificial intelligence in health care market is expected to reach $27.6 billion by 2025, according to a report by Meticulous Research.

MarketsandMarkets also predicts tremendous growth with AI in health care.

The market was estimated to be valued at $2.1 billion in 2018 and is expected to reach $36.1 billion by 2025.

Artificial intelligence (AI) is utilized by the health care industry in various applications such as patient data and risk analytics, medical imaging and diagnosis, drug discovery, precision medicine, hospital workflow management and patient management as it applies various human intelligence-based functions such as reasoning, learning and problem-solving skills on different disciplines such as biology, computer science, mathematics, linguistics, psychology and engineering.

The growth of artificial intelligence in the health care market is mainly driven by a growing demand of precision medicines, effective cost reduction in the health care expenditure and rising funding in health care artificial intelligence.

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In addition, a growing need for accurate and early diagnosis of chronic diseases and disorders further support the growth of this market. However, reluctance in adopting AI technologies among end users, lack of trust and potential risks associated with AI in health care is restricting the growth of this market to some extent.

The overall artificial intelligence in health care market is mainly segmented by product, technology, application, end user and geography. The market by product type broadly comprises software, services and hardware; whereas, the technologies analyzed are natural language processing (NLP), context aware processing, machine learning and querying method, according to Meticulous Research.

The NLP technology segment is estimated to account for the largest share of the overall artificial intelligence in health care market in 2019, mainly attributed to the rising adoption of NLP in clinical documentation and automated coding in claims submissions. Currently, the market for NLP technology in health care is in a nascent stage, dominated by legacy

vendors such as IBM Corporation and Google Inc. focusing on front-end speech recognition for computer-assisted physician documentation and back-end coding to optimize billing.

On the basis of application, the artificial intelligence in health care market is segmented into patient data and risk analytics, medical imaging and diagnosis, drug discovery, precision medicine, hospital workflow, patient management and other applications. The hospital workflow management application segment is estimated to account for the largest share of the overall artificial intelligence market in health care. The large share of this segment can be attributed to increasing implementation of machine learning, deep learning and other detailed pattern recognition algorithms that provide clinical decision support while improving the efficiency of radiologists, pathologists and other image-based diagnostics.

Moreover, the rising adoption of AI solutions in hospitals and clinics to manage the complicated work flow and customer service is also expected to support the growth of this market segment. ICE

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products

Canon Medical Advanced Intelligent Clear-IQ Engine (AiCE) Canon Medical’s Advanced Intelligent Clear-IQ Engine (AiCE) uses a deep learning algorithm to differentiate signal from noise so that it can suppress noise while enhancing signal. The algorithm forges a new frontier for CT image reconstruction with its ability to learn from the high image quality of Model Based Iterative Reconstruction (MBIR) to reconstruct CT images with improved spatial resolution, three to five times faster than traditional MBIR and low contrast detectability. With AiCE’s deep learning approach, thousands of features learned during training help to differentiate signal from noise for improved resolution. AiCE applies a pre-trained DCNN to enhance spatial resolution while simultaneously reducing noise with reconstruction speeds fast enough for busy clinical environments.

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FUJIFILM Medical Systems U.S.A. Inc. Region Recognition Under the REiLI brand, FUJIFILM Medical Systems U.S.A. Inc. is developing AI technologies that support diagnostic imaging workflow by pairing deep learning technologies with Fujifilm’s image processing heritage. Applications currently in development include, but are not limited to, Region Recognition, Computer Aided Detection and Workflow Support. Region Recognition is an AI technology used to accurately recognize and consistently extract organ regions, regardless of deviations in shape, presence or absence of disease, and imaging conditions.

Also, FUJIFILM SonoSite Inc. has announced a strategic relationship with Partners HealthCare to apply artificial intelligence (AI) to point-of-care ultrasound (POCUS) applications. The two companies will collaborate to use AI-based models that will assist clinicians in diagnosis and enhance quality of care. The collaboration will be executed through the MGH & BWH Center for Clinical Data Science and leverage the extensive data assets, computational infrastructure and clinical expertise of the Partners HealthCare system.

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GE Healthcare Critical Care Suite GE Healthcare’s Critical Care Suite is an industry-first collection of artificial intelligence (AI) algorithms embedded on a mobile X-ray device. Recently cleared by the FDA, Critical Care Suite helps radiologists prioritize critical cases with a suspected pneumothorax – a type of collapsed lung – by immediately flagging critical cases to radiologists for triage, which could drastically cut the average review time from up to eight hours1. It also offers first-of-its-kind automated AI quality check features that detect acquisition errors, flagging images for technologist review and allowing them to make corrections before they go to radiologists.

1. Rachh, Pratik et al. “Reducing STAT Portable Chest Radiograph Turnaround Times: A Pilot Study.” Current Problems in Diagnostic Radiology Vol. 47, No. 3 (n.d.): 156–60. https://www.sciencedirect.com/science/article/abs/pii/ S0363018817300312?via=ihub.

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ADVANCING THE IMAGING PROFESSIONAL

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Philips Illumeo Philips Illumeo is an imaging and informatics platform with adaptive intelligence (AI) that augments clinicians’ skills and redefines how they interact with images.

Illumeo leverages AI and analytics1 to anticipate what a radiologist needs to do next, enhancing their expertise and efficiency, helping standardize workflow and ultimately supporting variability reduction throughout the institution. Acting as an assistant, Illumeo supports interactions with imaging data comparisons and provides an integrated view of clinically relevant, case-related information from various sources. By doing so, radiologists can further improve time savings and efficiencies to provide better, more consistent care to patients.

1. Results from specific user experience are not predictive of results in other cases. Results for other users may vary.

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Siemens Healthineers AI-Rad Companion Chest CT AI-Rad Companion Chest CT, an intelligent software assistant from Siemens Healthineers, brings artificial intelligence (AI) to computed tomography (CT). The first intelligent assistant of the AI-Rad Companion platform, AI-Rad Companion Chest CT helps radiologists interpret images of the thorax (chest) quickly with desired accuracy and precision, and automatically documents these findings as structured reports.

The algorithms provide segmentation, measurement and highlighting of key anatomical structures to support quantitative and qualitative analysis. Using CT images of the chest, AI-Rad Companion Chest CT differentiates among various structures in that region – including the lungs, heart, and aorta – highlights them individually, and marks and measures potential abnormalities, such as coronary calcifications.

Based on the AI-supported analysis, AI-Rad Companion Chest CT automatically generates standardized, reproducible and quantitative reports in DICOM SC format. ICE

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The Ultrasound QA Portal provides convenient reporting features and charting features to track results. It comes pre-loaded with default testing protocols that are designed to meet the recommended practices of the American College of Radiology, the American Institute of Ultrasound in Medicine and the American Association of Physicists in Medicine. Users can easily modify it to meet their specific requirements. Use of the QA Portal Software is complimentary for any CIRS customer who owns one or more of the following phantoms; 040GSE, 054GS, ATS539 or ATS570. ICE For more information, visit www.cirsinc.com.

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Welcome to the Machine

AI-POWERED IMAGING PROCESSES

By Matt Skoufalos

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ICEMAGAZINE | NOVEMBER 2019

ADVANCING THE IMAGING PROFESSIONAL

Like many technology-based processes, much of the value of a medical imaging study is inevitably tied to the computing power behind it. That processing power aids image analysis, fusion, annotation, and retrieval, among other applications. The better the algorithm that handles that task, the more precise the results, and the more valuable the study to the health care professionals capturing and interpreting it. As those computational processes continue to evolve in complexity and variability, more sophisticated applications powered by deeper machine learning continue to emerge. But augmented or artificial intelligence systems, popularly known by the shorthand, “AI,” are finding broader applications beyond diagnostics. As the technology continues to develop, clinicians, technologists and device manufacturers are working to resolve challenges around workflow, decision support and the broader questions of how to do so securely, efficiently and ethically.

Anant Madabhushi directs the Center on Computational Imaging and Personalized Diagnostics at Case Western Reserve University. There, he works closely with radiologists, pathologists, surgeons, clinicians and cardiologists to explore medical imaging applications of machine learning beyond diagnostics. Chief among them is using the technology to identify disease prognoses and predict responses to treatment.

Madabhushi describes AI as delivering on “the promise of precision medicine.” Whereas earlier applications of machine learning to medical imaging had been focused on fine-tuning the quality of a study, this approach, called radiomics, turns on pattern recognition within massive data sets in order to identify previously hidden details about patients’ underlying disease biology.

“By the use of AI, we can start to tell about the pathways and mutations of a tumor from the analysis of a scan,” Madabhushi said. “You can start to identify patterns that are too subtle for a radiologist to discern. It’s a way to use algorithms to find biomarkers and features to tell us more about the appearance, biology and outcome of the disease.”

For example, AI-powered bulk analysis of prostate imaging can help the team at Case Western Reserve to identify patterns that help distinguish which cancers are likelier to require interventions versus those

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that can be managed by active surveillance. That intelligence helps physicians develop more effective treatment plans for their patients.

“There’s work looking at which patients really need aggressive therapy and which can avoid it,” Madabhushi said. “We can find patterns from MR and CT scans to tell us how these patients will do in the future.”

AI tools can help physicians learn not only when a lung nodule ought to be biopsied, but whether it’s likely to respond to radiation treatment, Madabhushi said. Benign nodules tend to be connected to a blood supply, whereas malignant nodules often display a twisted vasculature, which responds worse to chemotherapy and immunotherapy. Such subtle insights were gleaned through machine learning and analysis of the data captured from medical imaging studies.

“By capturing quantitative measurements, we can predict whether a tumor is malignant or benign,” Madabhushi said. “This is metaphorically and literally outside-the-box thinking” that provides a chance to dial in the appropriate treatment for some of the most vulnerable patients and a way to stave off unnecessary spending. It spares the bank accounts of those for whom expensive immunotherapy medicines won’t work, and the bodies of those for whom surgical interventions aren’t required.

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AI-POWERED IMAGING PROCESSES “Seventy to eighty percent of early-stage breast cancer patients don’t need chemotherapy,” Madabhushi said. “They can avoid that, and at the same time, avoid all the deleterious effects. Just by analyzing images of the biopsies, you can find who will benefit from the chemo just as you can find those who should avoid it.

By doing that, we’re also addressing this issue of financial toxicity.”

Pattern recognition software is contingent upon crunching immense sets of data, and curating that information securely and with respect for patient privacy is a specific part of the work. Researchers like Madabhushi are trying to connect the maximum number of clinicians and physicians on a global scale, not only to provide the greatest benefit of this information, but also to broaden the data sets they feed the machines, thereby sharpening their tools.

“One of the biggest impediments to AI is the issue of generalizability,” Madabhushi said. “Too often, we’ve heard about how an AI-trained at Hospital A doesn’t

and focusing their competitive instincts on challenge competitions that “pool together large cohorts of cases and let the best algorithm win,” Madabhushi said.

“Those efforts are difficult, but the community recognizes that this data set has to grow,” he said. “It’s creating a great deal of interest and incentivizing people to share their datasets; it’s bringing people together.”

Ge Wang, who directs the Biomedical Imaging Cluster in the Department of Biomedical Engineering at Rensselaer Polytechnical Institute in Troy, New York, said he’s optimistic for the future of radiomics. However, the underlying issues of interoperability and “interfaceability” (i.e., standardizing image formats) are the biggest and most immediate barriers to its penetration and expansion. Corporate attitudes toward proprietary information tend to treat raw data and formatting techniques as protected information; however, Wang argues that manufacturers should unlock these data in the deep learning era so that researchers can pursue what he

“It’s important that we work to understand the change management process, and ensure that the ability to regulate within the algorithm world and the FDA and European agencies keeps pace while these things are changing.”

Greg Horne, global principal for health care at the SAS Institute

work at Hospital B because it’s learned patterns specific to one institution rather than general measurements. It’s important to validate these tools in a multi-institutional, multi-site kind of way; if not, they’re not going to work in the real world.”

Developing “the gold standard data set” will require getting some of the biggest institutions with some of the most competitive agendas to collaborate. Even when spurred on by agencies like the U.S. Food and Drug Administration, creating such a multi-institutional dataset is a significant challenge, albeit one that’s ultimately necessary for the advancement of the entire field of study. The way those big hitters – private corporations, public entities, teaching institutions – have begun inviting collaboration is by helping to build large, openly accessible datasets,

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ICEMAGAZINE | NOVEMBER 2019

calls “raw-diomics.” That’s the process of going from raw data to radiomic features while bypassing the intermediate images.

“Current radiomic researchers treat images as the input, but images are reconstructed from raw data with unavoidable information loss,” Wang said. “Hence, it is desirable to work directly on CT and MR raw data for radiomics. We believe if you go from raw data, you can get more information.”

“There’s a business way to intake these critical elements and synergize the data for hidden information,” Wang said. “You can use federal learning to utilize distributed datasets while keeping the company/ hospital/patient secrets. I believe these things can be done eventually, and hopefully quickly.”

Dr. Steve Kearney, medical director

for health care, life sciences and government at the Cary, North Carolina-based SAS Institute, views AI technology as an augmented way “to help get the providers what they need,” and cloud-based computing as providing the vehicle to deliver it in a globally distributed system.

“The challenge, as we look at these types of protocols, is finding the appropriate subjects and appropriate images,” Kearney said. “We can deliver thousands or hundreds of thousands of images in the cloud environment. To then understand and leverage those kinds of protocols across multiple entities; we see this as just another augmentation of that opportunity for efficiencies.”

“We want to then leverage these great tools to allow clinicians and researchers to define what the problem is and the true best protocol is with the least amount of challenges to the system,” he said.

Among the challenges of doing so, Kearney lists understanding the diversity of algorithm models, being able to replicate them and offering transparency into their mechanics. He sees SAS as a partner in that process to help standardize the content involved in their validation, interpretation and interoperability.

“We’ve been asked to consult with all the regulatory groups, whether it’s at study sites or the universities and manufacturers themselves, to see about getting their systems in place to have multiple protocols across multiple devices,” he said. “We get a huge number of requests for assistance for AI and machine learning, and it’s one of our largest areas of investment to make sure people understand what these algorithms mean; how it impacts their patients is what we’re working toward.”

Greg Horne, global principal for health care at the SAS Institute, said that his work focuses mostly on how these technologies can be leveraged, not only to cut back on unnecessary interventions and therapies, but “how to help the radiologist do a better job.” Beyond image interpretation, he emphasized that AI can also help ease practitioner workloads “to get relevant exams back to the doctor” through more sophisticated digital records requisitions.

“We want to use AI to help pre-fetch

ADVANCING THE IMAGING PROFESSIONAL

The members of the Center for Computational Imaging and Personalized Diagnostics at Case Western Reserve University work closely with radiologists, pathologists, surgeons, clinicians and cardiologists to explore medical imaging applications of machine learning beyond diagnostics.

exams based on the clinical conditions we have today,” Horne said. “If I broke my finger 10 years ago, and I’m going to have a CT of my chest, I only want to bring back medical history that might indicate why I’m having CT for my lung nodules. AI can bring in data that’s relevant to a clinical condition, and spread that to a faster diagnosis.”

Horne also believes AI-powered technologies can help improve revenues while easing radiology workloads. Cutting down on the number of unnecessary procedures does both, particularly as the Center for Medicare and Medicaid Services (CMS) more closely ties reimbursements to diagnostic assessments and the viability of treatment protocols. The same approach is being taken worldwide.

“We’re already seeing it in other countries as well,” Horne said, “why referral is made, whether the imaging requested is the appropriate imaging, and whether that will lead to a treatment outcome in connection with that imaging.”

“I firmly believe that AI has a big future in imaging and diagnostics, but at the moment, that is centered on the work that allows people to work more efficiently,” he said. “It’s important that we work to understand the change management process, and ensure that the ability to reg-

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ulate within the algorithm world and the FDA and European agencies keeps pace while these things are changing.”

Horne said he’d like physicians to understand more about the value of AI as a component of clinical and diagnostic support rather than embracing the narrative that “AI is coming for your job.” Instead, he champions its value in supporting change management and as a counterforce against “physician burnout and clinical overload.”

Madabhushi agrees with Horne that bringing physicians around to broader adoption of AI-based tools involves help-

make the decision. AI using an MR scan is providing one part of the puzzle; the final piece is the radiologist.”

As AI is used to process and learn from broader medical imaging datasets, Madabhushi said complementarily evolving, distributed technologies like blockchain will also support decision-making, particularly around the security of health and medical information. Amid the questions of interoperability and interconnectedness that fuel machine learning, he wants decision-makers and technology developers to hold rational discussions about the ethics of AI at the intersection of health care, law and medicine.

“We want to then leverage these great tools to allow clinicians and researchers to define what the problem is and the true best protocol is with the least amount of challenges to the system,” Dr. Steve Kearney, medical director for health care, life sciences and government at the SAS Institute

ing them understand that “the algorithm is not going to be the decision-maker; it’s providing one piece of the puzzle.”

“I think the worst thing we can do is definitely think of AI as a great monster and eschew AI,” he said. “It’s part of the rubric that the physician is going to use to

“We’re starting to have deep conversations about these things,” Madabhushi said.

“We’re using AI to tease out some of these differences and do the opposite of engendering a bias. We’re trying to use this as a vehicle to create better, consistent, more accurate and unbiased models.” ICE

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RSNA

GUIDE TO RSNA: RSNA 2019 Includes Expanded AI Showcase

T

he Radiological Society of North America (RSNA) will hold its 105th Scientific Assembly and Annual Meeting (RSNA 2019) this December at McCormick Place in Chicago, Illinois. The event will start on December 1 and conclude on December 6. The meeting’s theme is “See Possibilities Together.”

At RSNA 2019, radiologists and health care professionals will get hands-on experience with cutting-edge technology, including artificial intelligence (AI), 3D printing and virtual reality. They can dive into the latest research, enhance skills at over 400 educational courses and join 50,000 attendees gathered to meet the leaders shaping tomorrow.

RSNA is a non-profit organization with over 54,000 members from 136 countries around the world. It provides high-quality educational resources, hosts the world’s largest radiology conference and publishes two peer-reviewed journals.

Attendees can choose from a variety of educational courses presented by subject matter experts from every radiology subspecialty and related fields.

Also, they can trek through the exhibit halls and talk to more than 700 vendors about their innovative products and services. The annual event also boasts plenary sessions and poster discussions that keep attendees informed about advances and techniques from a variety of subspecialties.

The RSNA website suggests enhancing one’s radiology education and clinical skills by attending a wide variety

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of scientific sessions that cover the broad scope of radiology and the unique subspecialties. It also recommends connecting with colleagues and expanding one’s network by meeting and sparking discussions with radiologists from around the world.

Attendees are also encouraged to visit the technical exhibits floor to see innovations in radiology and interact with educational exhibits designed to encourage thought-provoking discussions.

RSNA will feature an expanded AI presence at RSNA 2019 at McCormick Place in Chicago.

The RSNA annual meeting has become a must-see event for radiologists and health care professionals interested in learning about AI. The RSNA 2019 AI Showcase, sponsored by Zebra Medical Vision, offers an exciting destination for meeting attendees focused on AI. Debuting in a new, larger space on a lower level in the North Building, the showcase expansion allows RSNA to create a central hub of AI activities for RSNA attendees.

“Many RSNA meeting attendees seek out AI subject matter,” said Steve Drew, RSNA Assistant Executive Director of Scientific Assembly, Informatics and Corporate Relations. “Creating an encompassing showcase on artificial intelligence for exhibitors, educators and researchers will create a dynamic environment for our attendees.”

The one-stop AI destination provides expanded opportunities, including: • Over 100 companies focused on AI

products and solutions participating in more than 40,000 sq. ft. of exhibit space.

• AI Showcase Theater – A larger openair theater located in the center of the Showcase will host 39 20-minute vendor presentations on various AI topics throughout the week.

• RSNA Deep Learning Classroom – Previously located in the Learning Center, this popular hands-on classroom will host 14 courses for practicing radiologists to understand the ways in which AI is clinically relevant to them.

• Hands-on Classroom – A new classroom for vendors to demonstrate their products in a hands-on environment.

• Special RSNA Exhibit – RSNA will host a demonstration of emerging data technologies and the data standards that enable them in the AI Showcase area. The demonstration will show how AI and other decision support tools can be incorporated in the radiology workflow, and the structured data capture needed for these tools to work effectively.

• Network Opportunities – Dedicated, comfortable areas throughout the Showcase where attendees can network, relax and recharge.

“High interest by commercial companies and meeting attendees led to this exciting development,” said John Jaworski, CEM, Director: Meetings and Exhibition Services of RSNA. “We now have more than 100

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RSNA

AI Showcase companies participating – which is up 25 percent over 2018’s final showcase figures – and the AI Theater, Deep Learning Classroom and Hands-on Classroom will provide various educational opportunities on artificial intelligence within the Showcase.”

The RSNA 2019 AI Showcase will be located in the North Building, Level 1, Hall C. AI Showcase hours are Sunday, December 1-Wednesday, December 4, from 10 a.m. to 5 p.m., and Thursday, December 5, from 10 a.m. to 2 p.m.

RSNA 2019 continues to offer outstanding educational opportunities with six plenary sessions and more than 400 educational courses along with science sessions and the Discovery Theater. The Learning Center features a variety of information including scientific posters, education exhibits, quality improvement reports, case of the day and demonstrations. The education includes several subspecialties including

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3D printing, biomarkers/quantitative imaging, breast (imaging and interventional), cardiac radiology, chest radiology, computed tomography, emergency radiology, gastrointestinal radiology and many more.

Also, RSNA 2019 is highlighting the work of colleagues in Egypt and India.

“As part of our Egypt Presents and India Presents programs, attend sessions led by leaders in radiology from Egypt and India, learn about the Egyptian Society of Radiology and Nuclear Medicine (ESRNM) and the Indian Radiological and Imaging Association (IRIA), and explore innovations from Egyptian and Indian companies in our Technical Exhibit Halls,” the RSNA website states.

There is even a fun run to get the blood flowing and the energy level up despite the cold December temperatures. Attendees can race and support radiology research and education by participating in the RSNA 5K Fun Run.

The current floor plan and meeting program can be found on RSNA Meeting Central at http:// rsna2019.rsna.org RSNA 2019 is big, but there is still lots of other things to do in Chicago during the annual meeting. Fine dining and sightseeing are high on the list of options. The RSNA website shares more information online at tinyurl.com/ RSNAchicago.

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RSNA

Q&A WITH DR. JACKSON I

maging Community Exchange (ICE) magazine enjoyed a Q&A with RSNA President Valerie P. Jackson, M.D., ahead of the 2019 annual meeting.

Q: What are some of RSNA’s achievements that you are the most proud of as you continue to serve as president?

Jackson: RSNA continues to be a thought leader in informatics and the burgeoning field of artificial intelligence. RSNA recognizes the importance of data technology and the deep learning applications that will lend support to our specialty in the coming years.

Also, just this year, RSNA has also launched three new online journals, Radiology: Artificial Intelligence, Radiology: Cardiothoracic Imaging, and, most recently, Radiology: Imaging Cancer. These new journals are a great benefit to our members.

Lastly, I continue to be proud of our collaborative work with other societies. Whether it’s partnering with Sociedade Paulista de Radiologia e Diagnóstico por Imagem (SPR) to develop a comprehensive Jornada Paulista de Radiologia (JPR) program or creating a 3D printing data registry with ACR, RSNA believes that our societies are strongest when we work together to provide high-quality education to all our members and develop resources that allow us to deliver optimal care to our patients.

Q: Are there any causes that you feel strongly about? What is the status of these causes?

Jackson: Education is a cause that’s very close to my heart. The RSNA Research & Education Foundation continues to lead the way in funding radiology research and education initiatives. This year, the Foundation Board of Trustees approved over $5 million in grants, supporting over 100 recipients from 48 different institutions.

Q: What are some of the challenges radiologists are facing now? How can they navigate these obstacles?

Jackson: Most radiologists are now aware

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of the importance of patient-centered practice. However, the sincere desire to be patient-centered doesn’t mitigate the pressure of high caseloads and short turnaround times. In addition, we may encounter referring physicians who may not see the value in partnering with us in patient interactions.

The key to navigating these obstacles is to adjust our own perspective. If something is truly important to us, we find the time and make the effort. Instead of focusing on the challenges, we need to focus on the benefits of patient interaction, such as a greater sense of trust and a reduction in miscommunication and errors.

In the same vein, if we build value-based relationships with referring physicians, we can improve efficiency, establish our value as part of the health care team and provide better care to our patients. Everyone wins.

Q: You are an expert in the field of breast imaging. Can you share your thoughts about some of the latest advances and the future of breast imaging?

Jackson: In the last few years, tomosynthesis has established itself as a valuable screening option; we’ve seen an expansion in genetic testing; and breast density – and its associated risk – has entered the national dialogue.

One of the things we’re seeing more of in the research phase is the use of AI and deep learning to aid in the detection of early-stage cancers and assessment of breast cancer risk.

Q: Can you share the latest regarding RSNA’s continued efforts as a convener for artificial intelligence, machine learning and deep learning?

Jackson: This has been a very productive area for RSNA. Just in the past year, there have been workshops, webinars, international and North American spotlight courses, research roadmaps and a new journal dedicated to this exciting field. And, of course, RSNA 2019 will have a host of AI technologies and learning opportunities for our attendees. The AI Showcase has a new, expanded location, fea-

Valerie P. Jackson, MD RSNA President turing daily presentations in the AI Showcase Theater, the RSNA Deep Learning Classroom, a hands-on classroom, and a special RSNA exhibit on emerging data technologies.

Q: Technological advances seem to come faster and faster in every aspect of health care. What have been some of the most amazing technological advances you have seen in radiology since earning your medical degree?

Jackson: Where to begin? Radiology continues to grow by leaps and bounds. When I earned my medical degree, MRI was in its infancy. Since that time we’ve seen an explosion of new technologies from hybrid modalities like PET/CT to interventional radiology, and even the shift from film-screen to digital.

Now, of course, we have advanced visualization, 3-D printing and artificial intelligence, and biomarkers and genetic breakthroughs that fuel precision medicine.

Q: What advice would you offer radiologists who are entering the field?

Jackson: Work with your colleagues to create a culture of patient interaction. Take every opportunity to engage with your patients. Of course, I encourage you to become an RSNA member and volunteer – in little or big ways – to build your leadership skills and play a role in strengthening our specialty.

Q: Thank you for your time. Is there anything else you would like to share with our readers?

Jackson: Join us at the Radiological Society of North America Scientific Assembly and Annual Meeting, December 1-6, in Chicago. With an innovative, inspiring program and a massive exhibition showcasing the latest in imaging technology, RSNA 2019 offers a wealth of education and networking opportunities to keep imaging professionals at the top of their game.

I hope to see you there! ICE

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CAREER CENTER 10 Tips for a Video Interview

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ith today’s fast-paced environment, more and more companies are utilizing Facetime, Google Duo, GoToMeeting, Skype or other platforms for video interviews! This is a cost-effective way to interview candidates. Several companies even use this as a means for their final step in the hiring process to determine whether or not to advance to the offer stage.

However, candidates can have a misconception about the process and view the video interview as being a casual interaction. This type of interview needs to be treated just as serious as an in-person interview. Candidates must prepare for it the same as they would for an in-person interview. Since the “Hiring Manager” can actually see you, the candidate’s appearance and body language is being weighed and measured along with the verbal communication. Plus, oftentimes, a video interview will include an entire panel of interviewers mirroring what often occurs for in-person interviews.

Here are 10 tips to assist candidates when preparing for a video Interview.

• As in any interview, you need to do research on the company, organization or hospital to better align your responses to their mission, goals and culture.

• Make sure to set up and test your video interview software prior to the interview.

Make sure your computer and Internet connection meet any minimum requirements. You definitely do not want any technical issues from your end to hinder the success of the interview. NOTE: Candidates should use a computer. Do not use a

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smartphone for a video interview!

• Prior to the interview, make sure all participants have the latest copy of your resume and list of professional references. If there is also going to be a technical aspect to the interview provide them with any OEM or third-party training certifications. If too numerous, then at least provide a training list. NOTE: Be sure to have a copy of all documents on hand during the interview!

• Dress professionally – preferably in a suit (including shoes) since this is a business meeting.

Again, they can see you and are forming an impression! Doing this shows interest and enthusiasm about this opportunity and organization! Plus, this will put you in the right mental state as well as add confidence!

• If you are not introduced to everyone on the Interview; take the initiative and introduce yourself. Ask each participant to introduce themselves or ask their names, title and function within organization.

You will then have a better understanding of who is asking what question and how to answer! For example, human resources professionals normally look for personality and behavioral traits to see if you would fit into the organization and its culture. Where a technical manager may focus on whether you have the skills to do the work.

• Always keep your answers related to the question topic! Many times candidates go off on tangents that have nothing to do with the question or even the position. Be careful of “over talking” and not allowing the interviewers to make comments or

Written by Jenifer Brown Health Tech Talent Management

ask additional questions!

• Back up your responses with an example! About 90 percent of the candidates respond to a question without backing up their statements. Examples add credibility and help the interviewer visualize your capabilities. NOTE: Your examples should be directly related to the position for which you are applying.

• Keep it positive! If you are asked why you left a company, always explain your departure in a positive manner. Negativity makes interviewers uncomfortable and concerned that you might be the same with them.

• Never bring up money/benefits! Discussions about money or benefits should not take place until a verbal offer has been made. If the interviewer brings it up, they are probably screening you to see if your expectations are in line with the budget allocated for the position or if you are realistic about your experience or background.

If that is the case, just respond that you are open to discussion but never give an actual figure until the offer stage!

• At the end of an interview, they will usually ask if you have any questions. This is your chance to mention any related achievements or experience that might not have come up. After that is when you let them know your interest and then ask what the next step and timeframe will be.

Lastly, thank all of them for their time and consideration and that you look forward to hearing back from them. Follow up with a thank you note to each of the participants!

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SPECIAL ADVERTISING SECTION

SMART SOLUTIONS FOR CAPITAL PLANNING H

ospital management, from Directors of Radiology to Cath lab managers, are under so much stress, especially when equipment fails, and cases are scheduled back to back for use on patients. It’s more than rotating or pushing a patient’s schedule, it’s patient experience, revenue the hospital is losing, and much more. After repeated equipment failures due to the age of equipment, the question becomes, “Do we start working on a capital request for a purchase, or do we keep on fixing it every time?”

Unfortunately for hospitals in California it’s not that easy to just replace the equipment since OSHPD will be part of the process. It is quite a long process of construction, approvals and installation.

Some hospitals are not even allowed to replace or change a piece of equipment due to the age of the building which cannot bear/resist any modification. They start looking at options for mobile imaging

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(which can be very expensive) and the department starts bleeding; often turning into a cost center rather than being a profitable entity.

Management isn’t working smart and considering options that are available.

Imaging can become very expensive and ROI might take years before you can start being profitable. Most of the time it’s better to upgrade and modify the system to a higher revision where parts will be available for at least another decade.

With this option, it allows the hospital to plan for the replacement in a more timely manner and possibly invest in other equipment that is a higher priority for the department.

Medzon has witnessed many hospitals investing in equipment without fully understanding the current situation of the department and hospital. Management gets excited hearing from sales about the new technology and its capabilities,

Written by Abdul Alsaadi, Ph.D. CEO of Medzon

which they think this is the best solution to deliver better quality of service, technology and profit for their organization. Technology is great and Medzon is a technology driven company, but investing smart is more important for the hospital’s growth. The directors should look at the department as a whole and also consider the other departments in the hospital to make the most advantageous decision.

Maybe upgrading to older systems is a better solution than having one room that is the latest and greatest in the market.

Having old equipment does not necessarily mean that the quality of care is terrible, or the hospital is not considered state-of-the-art. Artificial Intelligence can be implemented at a minimal cost for older equipment which makes it a smart system. Investing smart is important not only to the growth of the department but also to elevating the quality of the hospital and other departments. ICE

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IMAGING MATTERS Partnerships

Y

ou will often hear a salesman talk about partnerships with a hospital or imaging center. They are all smiles and desire nothing more than to be your best friend. However, if you take the time and look at what they are selling, it is a diode agreement. (For those that missed it, that is a one-way deal.)

There might be some manufactured cost savings, but the only real beneficiary is the company that is doing the selling.

There are benefits to true partnerships. There are situations where you can form a partnership with a manufacturer. However, it seems to be the exception.

If you have read anything that I have written, you probably know that I am a fan of the Independent Service Organization (ISO). That does not mean I am against manufacturer service organizations. But the truth is that the manufacturer has a larger built in overhead and cannot be as flexible as the ISO. However, not all ISO companies are right for the job. A good deal is based upon the service strategy of the organization, the ability of in-house personnel and overall cost savings of the deals you make with a company. This is not dependent upon the deal being made with a manufacturer or ISO. Before we enter into some fairyland idea of the ISO partnerships, we should

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

“The upside to the real partnership, with a manufacturer or ISO, is that the imaging center or hospital has access to tech support, manuals, possibly hero kits with no restocking fee, and can usually lower the cost of ownership as well as reduce downtime for the equipment.� be clear about a few things. All businesses are in business to make money. This includes not-for-profit companies. There is no way that any business can exist and operate for any length of time at a loss.

However, the ISO typically has a lower overhead and can work in a manner that is more flexible than the manufacturer.

The upside to the real partnership, with a manufacturer or ISO, is that the imaging center or hospital has access to tech support, manuals, possibly hero kits with no restocking fee, and can usually lower the cost of ownership as well as reduce downtime for the equipment.

The flip side of a partnership is the in-house responsibilities of the in-house personnel. Both parties should be a full partner in the agreement. This will typically include a requirement to have someone trained on the unit. The training might be anything from first look to a

thoroughly trained individual. Obviously, the more that is done by the hospital employee, the less a partnership should cost.

A good partnership is a relationship that includes two-way communication.

Accurate feedback is how a partner can improve the deal. Both the ISO and the hospital. If there are specific issues with a refurbished part, packaging, tech support or communication a good business wants to know. A partnership requires honest, accurate and unemotional communication of issues. This interface includes areas that could be improved. It also requires the customer to be open to the same feedback. If there is a problem with the client keeping their end of the deal, they need to be open to feedback. Such a partnership will lead to a long-term reduction in the cost of service. ICE

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SPECIAL ADVERTISING SECTION

AGILITI ACQUISITION OF ZETTA MEDICAL TECHNOLOGIES ENHANCES IMAGING SERVICE EXPERTISE WITHIN NATIONWIDE HEALTHCARE TECHNOLOGY MANAGEMENT SERVICES

T

oday’s advanced medical imaging devices provide clinicians with greater confidence in the diagnosing and treating of health conditions. But as imaging needs become increasingly critical, healthcare organizations must balance the growing need for proactive upkeep and maintenance of these devices amid a diminishing pool of technical talent to manage the demand. A recent merging of two, quality-centric independent service organizations (ISOs) is a step toward addressing this mounting challenge—enabling access to flexible, imaging technicians and field engineers nationwide who are trained experts in servicing and helping optimize high-value equipment utilization.

Agiliti, Inc., a leading, nationwide provider of healthcare technology management and service solutions, recently announced the acquisition of Zetta Medical Technologies, a provider of comprehensive medical imaging equipment services. Zetta specializes in multi-vendor clinical engineering services, parts and pre-owned equipment for medical imaging modalities, including CT, MRI and PET/ CT. The company’s reputation for technical expertise and service quality has earned trusted relationships as a national service

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provider for GE, Siemens, Toshiba and Philips equipment, led by a network of OEM trained engineers who provide on-demand technical support, maintenance and remote monitoring services.

The integration of Zetta’s expertise within the Agiliti platform of clinical engineering services gives hospitals and health systems access to full-service, clinical engineering capabilities for imaging devices—on demand. “This combination helps directly address the cost-conscious, time-sensitive needs of our customers,” said Tom Leonard, CEO of Agiliti. “Hospitals and health systems can now leverage Zetta’s unmatched experience in high-end imaging, powered by the unparalleled service and logistics network operated by Agiliti across the U.S.” Beyond their complementary service offerings, both organizations share a unique commitment to quality—evidenced by their certification to ISO 13486:2016.

“Our teams share common values when it comes to our service commitment to customers,” added Leonard. “Our primary focus is always to do what is right for our customers, so that their time can be spent where it matters most—with patients.”

With demand for HTM staff in the U.S. expected to rise by roughly 10%

annually over the next decade, Agiliti is committed to helping healthcare organizations augment the technical talent gap. The addition of Zetta’s imaging expertise, along with the company’s 2016 acquisition of Radiographic Equipment Services (‘RES’), represent the continuing expansion of Agiliti’s comprehensive and customer-centered clinical engineering service offering. “Our Equipment Value Management platform provides a flexible roadmap to lower the cost and complexity of acquiring, owning and managing medical equipment. Within that framework, our clinical engineering services address the need among healthcare providers to more efficiently manage and maintain a growing and more complex range of equipment and technology. The addition of Zetta and RES reflect our commitment to invest in capabilities that help advance the clinical, financial and operational health of our customers.” said Leonard. “We continue to look for opportunities to help us better address these challenges, so that our customers can realize the full clinical and financial value of their investment in medical technologies.” ICE To learn more about the integration of Zetta and Agiliti, visit www.investors.agilitihealth. com/news-releases.

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CONFLICT RESOLUTION 101: MINIMIZING FEARS

F

ear is a useful emotion. Why? Because it keeps us alive. The fear of becoming a hood ornament keeps us from stepping into fast-moving traffic.

The fear of being struck by lightening keeps us away from tall poles during thunderstorms. And the fear of drowning leads us to learn how to swim, or at least wear lifejackets on whitewater rafting trips.

We need to recognize that fears are powerful motivators, for good or for bad.

They can help us survive, but they can also prevent us from doing things or receiving things that are good for us. For example, when we’re trying to resolve conflict with others, fears can slow things way down. In fact, I’ve been called to help in situations where people’s fears have put a halt to all discussion.

Differences Between Fears and Phobias Before I explore the role of fears in conflict resolution, I should point out that fears are different than phobias. Everyone has fears, but not everyone has phobias.

Phobias are extreme fears that are debilitating and constraining, and psychologists have identified three different ways they emerge.

1) A psychoanalytic emergence is a repressed anxiety that manifests itself, but the true source of anxiety is unrelated to the exhibited fear. In other words, part of our personality doesn’t want to deal with a particular fear, but the fear wants

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to be expressed, so it manifests itself as an extreme anxiety about something else.

2) A “learning” emergence is a normal fear that gets amplified into a debilitating anxiety through repetition or an emotional trauma. For the repetition version, think Pavlov’s dog in reverse. Instead of receiving a reward every time something happens, a person receives a punishment.

With enough repetition, a phobia emerges and the person avoids all situations where a triggering event has even the slightest chance of occurring. On the trauma side of learning, any significant emotional event can trigger a phobia. For example, getting locked for hours in a dark closet as a child can impact the child’s emotions to the point that he forever avoids all dark rooms or small spaces.

3) A biological emergence occurs when certain neurological or genetic factors magnify brain chemistry associated with a particular fear.

I mention these mainly to show the difference between fears and phobias.

Everyone has fears, which are almost always accompanied by some level of nervousness, anxiety or emotional discomfort. Not everyone has phobias, which can be thought of as fears on steroids. Phobias can cause extreme reactions, such as panic attacks, tachycardia, dizziness and nausea, even when no real threats exist. Phobias need to be helped with cognitive behavioral therapy, but the fears I’m talking about in this article

Written by Daniel Bobinski Workplace Consultant

are common to everyone and can be managed rather easily.

The Downside of Fears Now that I’ve pointed out some benefits of fears and highlighted the difference between fears and phobias, let’s look deeper at fears and how they hinder conflict resolution.

Three decades ago, my mentor and coach taught me that at least five fears impact our relationships. A few years ago, the magazine Psychology Today published a slightly different list, but I noticed that their list has a lot of overlap; the difference are mostly semantics.

And so, when working on resolving conflicts, our question needs to be, “How can I minimize these fears in me as well as in the people around me?” it’s a vital question to ask, because when we’re trying to resolve conflict with someone, fears get in the way of making progress.

The Five Universal Fears The first universal fear is criticism. Very few people like being criticized. Sometimes we know we need it so we can learn where or how to improve, but even then, most people only endure it. It’s kind of like going to the dentist. We know the result will be good for us, but we still don’t like the process. If criticism is unsolicited, it usually stings pretty bad.

The second universal fear is failure.

This is a powerful fear, because we usually

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insight

place too much weight on what other peoexperiment was stopped because half ple think of us. When that happens, or if of the babies had “given up” and died! we’re worried that others will lose interest Feeling not wanted or abandoned can be in us if we fail, we can become terrified of devastating. failure. Like many fears, the fear of failure Fourth on the list is the fear of not can be powerful enough to prevent us getting what you want. Oftentimes from starting what we know will be good people do not move forward on something for us. because they’re afraid the outcome isn’t The next fear is rejection. Human going to be what they expect. It’s different beings are wired to belong, so theCHANGES fear of from fear of failure, but again, the fear can PROOF APPROVED NEEDED rejection can run deep. By way of illustrabe so strong that a person doesn’t even tion, inSIGN–OFF: 1944, an experiment was contry.

CLIENT ducted in the U.S. to learn how newborns Last on the list is fear of losing what would respond if not given attention you have. Maybe you have something of PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT or touch. They were housed in sanitary value, whether it’s a position or a thing, LOGO PHONE NUMBERand you’re WEBSITE conditions, fed healthy food on a regular afraid of losing it.ADDRESS When this schedule and their diapers were changed fear of loss is strong, it can prevent you when needed. But, after four months the from engaging with others.

WIDTH 7”

Again, know that everybody has these fears to one degree or another. If we’re trying to resolve conflict, our job is to try to minimize these fears, not only in ourselves, but also in the people around us. This is where good listening skills come into play.

If you can help people feel heard, you will minimize these fears and improve your conflict resolutions skills. But more on how to do that in next month’s column. ICE

PROOF SHEET

– Daniel Bobinski, M.Ed. is a certified behavioral analyst, a best-selling author and a popular speaker at conferences and retreats. He loves working with teams and SPELLING individuals to help themGRAMMAR achieve workplace excellence. Reach Daniel through his website, www.MyWorkplaceExcellence.com.

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SUBMIT YOU R N O MIN AT IO N S FO R

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1993 degree also received , he join partne got a n mo ,” Bryant ndo in y side kind ense He in cine and the of Def of and sciences.

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A/V sup d in abo d pretty a gre IMAGIN uding and help ember guys had THE me rke l, incl ING d floors y,” he rem to bio career.

ANC up. Wo hospita biome ed in the Favorite book ADV a rary dut out, the opened ent in the rest t I get Anything by Terry Pratchett “Turns me inte ended tha s more departm it got mm d job job and ervisor reco for biome Favorite move e The sup to compet “Circle of Iron” , degree Favorite food ER 2018 EMB It’s such a | NOV Chocolate covered candied ginger.

AZINE treat since it’s so hard to find.

ICEMAG practice. It’s not just one or the othbest to got 26 I that things “One of the proudest say. We make it Hidden talent actually er side of the house, per be a part of – firstly being able to we’re dedicated to taking because work, Certified Fiber Optic Cable Splicer guys old let don’t they get my hands dirty – says. care of our military family,” Bryant What’s on my bench? like me do that too much,” Bryant jokes. have any hobbies?

Bryant Does things camakes It optic stamp. fiber of name • My rubber “We pulled 10,000 feet little “Do kids count as a hobby? The to comofficial and efficient! Plus my handwriting ble and 3,000 feet of copper cable time, but I do care. guys take up most of the free is pretty unintelligible. pletely rewire the spaces for patient requires from like to run (although the military my Secondly, there was a tangible result • A small Lionel train keychain from familie’ it),” he says it our efforts. The members and their grandfather. He was a big railfan, and “I suppose table top miniature painting by our here quality of life was positively affected reminds me to treat all the old folks – my oldest son is into tabletop warcounts who direct actions,” he adds. togethat the facility like my grandfather ( gaming and we spend quality time Korea Bryant says one of his biggest ongoing Bryant says. was a patient here and a WWII and and the er painting up his army,” challenges is the merging of the VA of veteran.)

Also, away from work, he is a member Navy at the FHCC. and the confercommittee month education the the for list PM gov• The “It’s a challenge when two huge ence committee for the Clinical Engineerernment entities have to work together • The Coast Guard Advancement study and the Chapter Illinois of Association ing departguide – the test is coming up in a couple for a unified outcome when both DeMoDad for the Lakes Chapter of Illinois months. ments have different SOP’s and methods care of lay. of doing business. We are taking spe• Huge stack of business cards Imaging service has a dedicated patients in the entire military spectrum; A. Lovell Fedde- cialist at the Captain James from boot camp recruits to military in Bryant. And, the a very eral Health Care Center pendents, to the veterans. It’s military continues to have an experienced unique situation and we are constantly the Command Senior Chief. ICE learning from it and having to find

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