TechNation Magazine - November 2019 by MD Publishing

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Vol. 10

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

A WORKABLE

NOVEMBER 2019

AEM

PROGRAM GETTING THE BASICS RIGHT PAGE 56

14 Company Showcase

Medzon

24 Company Showcase MedWrench

28 News and Notes

Industry Updates

50 Roundtable

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CONTENTS

FEATURED

HE ROUNDTABLE: T X-RAY TechNation reached out to healthcare technology management gurus and original equipment manufacturers to find out the latest regarding X-ray tips for maintaining these important devices. Next month’s Roundtable article: Test Equipment

A WORKABLE AEM PROGRAM: GETTING THE BASICS RIGHT Uncertainty is bad for the stock market and not something HTM professionals want either. When it comes to PM schedules, for instance, every HTM professional wants to know what the accepted standard is. If there is a standard approach, so be it, but if it is an approved alternative, then spell it out.

ext month’s Feature article: N 2020 Vision: 3 Conferences Every Biomed Should Plan to Attend

TechNation (Vol. 10, Issue #11) November 2019 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2019

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

NOVEMBER 2019

TECHNATION

CONTENTS

INSIDE

Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley Karlee Gower Amanda Purser EDITOR

John Wallace

EDITORIAL

Roger Bowles Jenifer Brown K. Richard Douglas Jim Fedele Joe Fishel Inhel Rekik Manny Roman Cindy Stephens Steven J. Yelton

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Manny Roman, Business Operation Manager, AMSP Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System Jim Fedele, Sr. Program Director, Clinical Engineering, BioTronics, UPMC Susquehanna Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Clinical Engineering Manager, Medstar Georgetown University Hospital

P.12 SPOTLIGHT p.12 Professional of the Month: Calvin Hoang p.14 Company Showcase: Medzon p.18 Department of the Month: The Carroll Hospital Clinical Engineering Department p.20 Association of the Month: The Kentucky Association of Medical Instrumentation p.24 Company Showcase: MedWrench P.28 p.28 p.34 p.36 p.38 p.40

INDUSTRY UPDATES News and Notes: Updates from the HTM Industry Ribbon Cutting: Medinas AAMI Update ECRI Institute Update Welcome to TechNation

P.42 p.42 p.44 p.47 p.49

THE BENCH Biomed 101 Webinar Wednesday Tools of the Trade Shop Talk

P.60 EXPERT ADVICE p.60 Career Center p.62 20/20 Imaging Insights p.65 Cybersecurity p.66 Equipment Purchasing Decisions Should Be Driven by Data Sponsored by Edge Biomedical p.69 The Future p.70 The Other Side p.73 Roman Review P.74 BREAKROOM p.74 Did You Know? p.75 The Vault p.76 MedWrench Bulletin Board p.82 Flashback p.78 Service Index p.81 Alphabetical Index

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SPOTLIGHT

PROFESSIONAL OF THE MONTH

Calvin Hoang: Taking Customer Service Seriously BY K. RICHARD DOUGLAS

verything is big in Texas. The state is twice the size of Germany. Besides being the U.S.’s second-biggest state in square miles, it is also the second most populous state and has the largest domed capital in square footage of any state.

In keeping with this theme, the account that our professional of the month is assigned to is one of the largest health care systems in Texas and the U.S. Calvin Hoang is a customer service representative with Modern Biomedical & Imaging Inc. The company is an independent service organization that provides HTM services to health providers; large and small. Their customer service position actually translates to biomed/ imaging tech. Hoang is assigned to a major health care provider in the Dallas-Fort Worth area. In his nomination, Hoang’s boss had high praise. “Calvin is your ideal biomed. He works on anything and everything you could think of in the biomedical field and then some,” says Travis Brown, CBET, Dallas-Fort Worth regional manager with Modern Biomedical & Imaging. Brown says that a typical day for Calvin may start with a sterilizer repair, then lead him to work on a contrast media injector, replace a high voltage cable on a C-arm after lunch and knock out some routine PMs on his way home. “Calvin has proven himself to be the go-to resource for our team of nine

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NOVEMBER 2019

biomeds and he fields calls from our technicians nationwide for phone support. Just the other day, he was able to walk one of our guys through the process of loading SW and basic calibrations on a 9800 Elite C-arm over the phone,” Brown says. Hoang came out of a different field when he became interested in biomed. “Prior to the biomed profession, I was experienced in the electronics field. I worked previously in optical assembly lines with telecommunication companies such as Fujitsu. I wanted to pursue my career in the electronics field that was more stable, so I chose the technical side of health care,” Hoang says. “I went to Texas State Technical College (TSTC) in Waco, Texas. The

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“Being employed to a third-party medical service provider gives me many circumstances to work on a diversity of equipment. I am eager to learn or to work on newer/unfamiliar equipment.”

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SPOTLIGHT

school provides a variety of hands-on experience to help assist you in the technical field. The instructors at TSTC were very knowledgeable when it comes to teaching their courses,” Hoang adds. Hoang says that he started as an intern with Modern Biomedical and became permanent after he finished college. “The job title is customer service representative, though we are considered a biomed/imaging tech. I also worked previously as an imaging service engineer for a couple of years, servicing Toshiba CT and MRI. I was also a medical imaging installation technician and installed mostly CT or PET/CT,” Hoang says. He says that he is OEM trained on the GE Healthcare Avance CS2 anesthesia machine. “I also specialize in portables, OEC C-arms, ultrasounds, contrast injectors, Steris sterilizers, washers and boilers. Working with Modern Biomedical gives me an opportunity to expand my skill sets in a broad range of equipment/modalities,” Hoang adds. Brown says, “with already having so many specialties, somehow, we were able to convince him to go to anesthesia training and now he has added anesthesia to his repertoire of skills.” GOING ABOVE AND BEYOND Hoang is a big advocate for his employer and is hands-on with everything from promotion to training. Supporting colleagues is also a priority for Hoang. “I’ve provided excellent service, gained customer’s trust and helped my company expand through word of mouth. Previous customers moved on to a newer facility and have requested my company for their service. I feel that it’s a great challenge to expand into new territories and to provide consistent service to new customers. By helping ‘start-ups’ to new customers, we aim to give a good impression,” he says. Hoang says that he typically trains the new hires on using the company’s software efficiently when it comes to performing

PMs, creating purchase orders, adding new equipment onto inventory and more. “I also provide feedback to our IT department on how to improve our software. I also typically train new hires on new biomedical equipment or imaging modalities to perform preventative maintenance/repairs that the new hires are not familiar with; such as contrast media injectors, ultrasounds, GE OEC C-arms, GE AMX portables, the list goes on. I also provide technical support for my company across the nation on the modalities that are listed previously,” Hoang says. The effort does not go unnoticed. His supervisor reflects on his level of customer service. “What impresses me the most about Calvin is how he is never too busy to help out the customer or fellow technician with something trivial,” Brown says. “Our customers love him because he takes the extra time to fully hear their concerns and address them to the fullest extent. A great example of this is how he went above and beyond to locate repair parts for a wheelchair we didn’t even cover. There are countless examples of this type of attitude, but what it equated to was a repaired wheelchair that the facility is able to continue using without any added headache or grief,” Brown adds. Hoang’s description of himself is simple. “I like to think of myself as ambitious, a team-player, goal-driven and, for the most part, humble,” he says. “Long story short, when Calvin sees an issue, he heads it off and addresses all concerns. He is extremely family-oriented and often goes out of his way to build fences, carports and various other projects for his friends and family. His family often gets together for giant crawdad cookouts where they purchase over 10 pounds of crawfish,” Brown says With praise like that, HTM is the perfect field to excel in. It’s all about helping others and Hoang has that down to a science.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

NOVEMBER 2019

TECHNATION

SPOTLIGHT

COMPANY SHOWCASE

edzon started with a vision to revolutionize health care by improving quality of service, advance technology and reduce significant cost. The result allows hospitals to be successful and profitable. TechNation recently interviewed Medzon CEO Dr. Abdul Alsaadi to find out more about the company and its vision.

Q: WHAT ARE SOME ADVANTAGES MEDZON HAS OVER THE COMPETITION? A: Medzon is considered a consultancy and a technology management solution company. When Medzon partnered with General Medical Equipment (GME), a full support service company

TECHNATION

NOVEMBER 2019

that encompasses all types of services to unlock the full potential of medical equipment, Medzon became the go-to company that can solve most issues in a hospital. Q: WHAT ARE SOME CHALLENGES THE COMPANY HAS FACED? A: One challenge the company has faced was getting the C-Suite to see the bigger picture and the advantages to using us. Now that we have succeeded at several sites, our reputation is all that is needed. Q: CAN YOU EXPLAIN MEDZON’S CORE COMPETENCIES AND UNIQUE SELLING POINTS?

A: Medzon’s leadership has a tremendous amount of hospital experience, our team incorporates their education at the doctorate-level from Harvard and MIT, and a robust background on how health care should operate. Medzon offers free evaluations to hospitals with a presentation on the potential outcome it can have after joining our program. Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW? A: Medzon consults and creates procedures to reduce operating cost for the hospital by up to 30% annually.

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SPOTLIGHT

feedback with management to present the best solution to offer to the hospital that we evaluated. Q: CAN YOU HIGHLIGHT ANY RECENT CHANGES TO YOUR COMPANY? A: Medzon now offers a membership program that a hospital can utilize for making better decisions for better efficiency.

Dr. Abdul Alsaadi CEO of Medzon Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? HOW WILL IT EVOLVE IN THE COMING YEARS? A: Eventually Medzon will be the backbone and a partner to the hospital rather than being a vendor that only bills for services rendered. Q: CAN YOU PLEASE SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS? A: Medzon was able to save a hospital from shutting down due to very poor previous management that was focused only on profit and not on the quality of care. A dedicated team from Medzon worked side by side with each hospital department from purchases, contracts, supply chain, EHR and more to save the hospital and help it become profitable. Q: CAN YOU DESCRIBE YOUR COMPANY’S FACILITY? A: Our facility consists of the following teams – Innovation, IT, Engineers, Population Officers, Supply chain, etc. The team works together and shares

Q: CAN YOU TELL ME ABOUT THE MEDZON EMPLOYEES? A: One of the employees that was part of making this a success is Janelle Elsisy. She was working with every individual in the company to make sure he/she understands the philosophy of Medzon/GME and the expectations of our customers. Q: WHAT IS YOUR COMPANY’S MISSION STATEMENT, OR IF YOU DON’T HAVE A SPECIFIC ONE, WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS? A: Our mission is: “Medzon will Revolutionize Healthcare by bringing back customer service and quality, while advancing hospitals in Technology.” The Medzon vision is to “Guarantee a hospital will be a spearhead in technology utilized by patients, with improved quality, reduced cost and revenue.” Q: IS THERE ANYTHING ELSE YOU WANT READERS TO KNOW ABOUT MEDZON? A: Yes, there are three areas that Medzon can add value: 1. Service Value • Medical Equipment Planning: Guarantee hospital procures the right equipment from the right Original Equipment Manufacturer (OEM). Taking into consideration

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

the cost, longevity, ease of use for technicians/doctors, parts and services readily available for engineers, overall value and quality of system throughout the house. • Consultancy: Medzon can take a failing hospital and change it to a profitable organization. Through review of current practices, we study each department and create an efficiency report. With implementation and training of new procedures, within a year you can see the transformation to SUCCESS! • Qualified Staffing: Onsite engineers providing service coverage 24×7, increasing uptime on equipment, preventing delays in patient care and treatments. • Management Involvement: Medzon is not a separate entity but a team player in the hospital as we join in committees, meetings, and future development ideas. Medzon is here to grow with the hospital and improve quality of care for its patients. 2. Technology Value Artificial Intelligence and machine learning are incorporated on medical equipment to help in predictive failures which allow Medzon to improve uptime on equipment. The Medzon Innovation Team is always searching for state-of-theart technology that can be implemented to make your site technologically advanced. 3. Client Benefits Medzon is committed to the partnership with your hospital to guarantee uptime commitment and ensure patient satisfaction. This illustrates Medzon’s dedication to ensuring your hospital is a leader in all aspects of patient care.

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Left to Right: Felix Tatienou, Dave Moore, Mike Grim and Drew Pastorek.

DEPARTMENT OF THE MONTH Carroll Hospital Clinical Engineering Department BY K. RICHARD DOUGLAS

arroll County, Maryland is west of Baltimore and borders Pennsylvania to the north. It is directly north of Washington, D.C.

Serving the health care needs of the people of Carroll County, and the greater Baltimore region, is Carroll Hospital, a LifeBridge Health Center. The hospital originally was Carroll County General Hospital and opened its doors on October 1, 1961. It is located in Westminster, Maryland. The hospital’s clinical engineering team consists of six members, including leaders John Knapp, corporate director for clinical engineering, and Wayne Jenkins, CBET, manager of clinical engineering. Other team members include Mike Grim, BMET III; David Moore, BMET III; Drew Pastorek, BMET II; and Felix Tatienou, CBET, BMET II. With 21 years at Carroll, Grim’s main area of focus is patient monitors, infant security systems, anesthesia/OR

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NOVEMBER 2019

Wayne Jenkins (left), clinical engineering manager, and John Knapp (right), corporate director for clinical engineering and fleet operations. and general biomed. Moore has 19 years at the hospital. He specializes in diagnostic imaging, PCA pumps and general biomed. With more than six years at Carroll, Pastorek’s main area of focus is respiratory, laboratory and general biomed. Tatienou has been at Carroll for six

years and specializes in the OR, TempGenius, patient monitoring, and general biomed. The team supports the 200-bed Carroll Hospital. The facility has a 12-bed CCU, 24-bed IMC, 24-bed step down unit, eight operating rooms, three cath labs, four X-ray rooms, two CT scanners, two nuclear medicine scanners, an echo lab, several portable C-arms and ultrasound units, a 20-bed birth unit and five couplet care rooms. Although each member of the team has an area of specialty, Jenkins says that any one of the techs is responsible to respond to a customer need. “We rotate staffing between repairs and PMs monthly to keep everyone current on the equipment inventory. We also provide A/V support for offsite educational and charity programs for the hospital and foundation,” he says. Jenkins says that service contracts are managed by the clinical manager via OEM contracts, an insurance program and some third-party assistance. He says that CE makes all the contact calls

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SPOTLIGHT Felix Tatienou, BMET II working on a slide printer in the lab.

with service vendors to coordinate repairs and PMs. “The department utilizes a CMMS (TMA) to track equipment records, work orders (PM and corrective), and the PM schedule. The technicians are responsible for inputting the information and tagging for each piece of new equipment prior to it being placed into service,” Jenkins says. “The PM schedule is generated by the system each month and the techs monitor what devices are due for PM. The techs are also responsible for the completion of corrective work orders, which are submitted online by the end-users via the computer system. All the information is stored electronically,” he adds. The CE department at Carroll handles equipment evaluations for other departments. It assists with equipment purchases, equipment installs and relocates equipment for renovation/ construction projects. “We are a one-stop-shop when it comes to equipment issues. The techs know they have the responsibility and authority to do what it takes to satisfy the customer. Current inventory is about 6,000 pieces of equipment,” Jenkins says. Jenkins says that the CE department works closely with IT on integrating patient care equipment to the network for EMR, PACS, etcetera. “We have all our patient monitors connected to the EMR and ADT systems. We have our digital X-ray equipment connected to the ADT and PACS systems. We have worked with the vendors and IT to connect our lab analyzers to the network for the ADT system and automatic reporting of results,” he says. SPECIAL PROJECTS Networking devices and developing monitoring capabilities have been special projects that the team has tackled. “The department participates in all

renovation, construction and I.S. integration projects that deal with equipment. This past year, we collaborated with IT to do the interface builds and testing of the associated equipment when they installed several new EMR software programs (Cerner, Fetallink, Vital link, Provation),” Jenkins says. “We work with IT on the equipment side when they changed out the wireless scheme for a number of pieces of equipment, i.e. portable X-ray, EKG machines, etcetera,” he adds. Jenkins says that the group is actively involved in the current renovation of the hospital birthing unit with regards to removing the monitoring equipment from the rooms and re-installing it once the room renovation is completed as well as other equipment-related aspects of renovations. “The department plays a key role in helping departments evaluate equipment prior to purchase and the installation of new equipment,” he says. Several years ago the department took on a project to purchase and oversee the installation of a hospitalwide temperature monitoring system so that departments can use computers to track temperatures and over-temp alerts for devices that are in their departments. This included alerts for items such as blanket warmers, dietary refrigerators/freezers, pharmacy med refrigerators/freezers and lab specimen/ reagent refrigerators/freezers. “The department is responsible for maintaining the temperature measuring hardware and network connections. IT worked with us to install the software on the desktop computers for the end-users,” Jenkins says. Outside of the workplace, team members remain active in the HTM

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

community. “We are members of the Baltimore Medical Engineering Society (BMETS), which Wayne helped start in 1983 and is currently serving as treasurer and has severed in all the offices — president, vice president, secretary, and treasurer — many times over the years. The group meets once per month except in the summer,” Jenkins says. He says that he and Tatienou are also AAMI members. In July, the Carroll CE team was recognized with the Heart of Carroll Award. “Cath Lab Associates recently selected the clinical engineering staff as the next Heart of Carroll award recipients for their outstanding performance,” Jenkins says. The nomination reads, “Their ability to resolve equipment issues for the cath lab quickly has helped the department continue to care for their patients at all times. According to a nominee, ‘Clinical Engineering has directly assisted us on probably a weekly basis for years, and we really appreciate their dependability and competence.’ Congratulations, Clinical Engineering.” “The Heart of Carroll award was created by the patient experience committee as a way for departments to recognize one another for their aboveand-beyond performance,” Jenkins says. The Carroll Hospital CE team has assisted in a positive patient experience and achieved much more for their clinical colleagues.

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TECHNATION

SPOTLIGHT

ASSOCIATION OF THE MONTH The Kentucky Association of Medical Instrumentation BY K. RICHARD DOUGLAS

uilding something can be a challenge. When it is an organization that is the new project, it takes ascending the learning curve, the help of many contributors and plenty of goal-setting to see it grow.

That was the case with the Kentucky Association of Medical Instrumentation (KAMI). Creating a biomed association is one thing but organizing and launching its first symposium is another major step. The association was started in early 2010 when Patrick “Pat” Lynch started traveling to Kentucky and meeting with several HTM managers of local shops gauge interest in a biomed association. Lynch’s involvement also helped shorten the learning curve. From its beginnings more than nine years ago, the organization has found its footing and serves the state’s biomed community, as well as others. “KAMI has three pillars of concern which are education, networking and community outreach,” says Tom Bledsoe, KAMI president. “We are connected in a couple ways to our local community. First, we have a local non-profit called Supplies Over Seas (S.O.S.) that supplies slightly used equipment and other supplies to needy

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NOVEMBER 2019

countries throughout the world. There are volunteer opportunities twice a month for testing biomedical equipment for safety and function, sorting the medical supplies and packing the crates in preparation for shipping,” he says. Bledsoe says that KAMI is also associated with local colleges. The group hopes to build on these relationships to promote and grow the HTM career field. “The institutions are MedQuest College, University of Louisville through their BMES group of engineering students and Madisonville Community College. We have faculty and students that are active members of our association and on the board of directors as well,” Bledsoe says. He says that KAMI is also involved in starting and growing the Nicaragua Biomedical Association. In the recent past, the group has held quarterly meetings. One of the challenges of being a statewide organization has been where to hold meetings. “We try to move around the state of Kentucky and have interesting meeting content to help draw engineers to educational and networking opportunities. We are now switching to three quarterly meetings and this new annual HTM Symposium,” Bledsoe says.

“We have a technology and social media committee that is working on telecasting portions of our meetings. I think it’s more important to record and have the content available online for viewing at a later date or go back and view it several times if it’s a subject that has some interest to you,” he adds. The group’s meetings can be informative and educational. “Our last meeting included a roundtable discussion of ECRI’s top 10 safety hazards. It was a very engaging and lively discussion between the panel and general membership. Some of the panel members included nurses and managers of hospital departments as well as HTM engineers and managers,” Bledsoe says. Some biomed associations try to offer scholarships, while some have found other ways to help introduce students to the profession. “We do not currently have a scholarship program, but do plan on having a special meeting for students or members interesting in CBET, CRES or other certifications,” Bledsoe says. He says that KAMI will look into ways to financially assist those in need as the group grows. “This will be an important way to grow both our association and the HTM field in general,” Bledsoe says.

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SPOTLIGHT Physician’s Resource Network

“ KAMI has three pillars of concern which are education, networking and community outreach.” TOM BLEDSOE, KAMI PRESIDENT BRINGING TOGETHER A WORKING SYMPOSIUM The inaugural KAMI healthcare technology symposium kicks off November 9, 2019 at the historic Boone Tavern Inn in Berea, Kentucky. “This will be the first symposium or annual meeting in our history. It will be November 9 and 10, 2019. I am so proud of how hard the KAMI board is working to pull this together. Some of our board members are vendors that travel to other national shows and can use their experiences and contacts to improve our event,” Bledsoe says. He says they are using feedback from members of other local associations and attending their annual meetings to gain important contacts and other crucial information. “A side benefit is that it has been a real team building project. I feel it has united our board of directors. By the way, it also has been a lot of fun,” Bledsoe says. The Boone Tavern Inn is a special venue. “The hotel is on the national historic registry and we are so excited to present this conference to our members and host our special guests. We will have educational presentations, breakout sessions for HTM engineers as well as some sessions focused on management teams and other decision makers in our HTM family,” Bledsoe says. The symposium will kick off with a reverse expo on Friday afternoon and a vendor appreciation murder mystery dinner on Friday evening.

“Our main focus items are education, networking and of course; fun,” he adds. A challenge, and mandate, for all biomed associations is to find creative ways to help offset the large number of baby boomer generation HTM professionals who are retiring or who have already retired. “In a couple of ways, we are reaching out to the younger population for growth,” Bledsoe says. “First, as mentioned previously, our strong connection to local colleges who are active members. Keeping them involved in the board and planning committees, I feel keeps them engaged and networking with HTM professionals gives them insight on their career path,” he says. “Secondly, we are forming a committee to work with MedQuest College, that as a team will visit local middle and high schools for career days or special events to help promote HTM as a rewarding profession. We plan on giving a PowerPoint presentation and live demonstrations with medical equipment and some of the high-tech equipment that exists in hospital equipment in hospital environments today,” Bledsoe adds. The bluegrass state has a wellorganized statewide HTM organization and now that organization has accomplished a major milestone in launching its first symposium. It should provide even more incentive for a new generation of biomeds to join the group’s ranks.

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SPOTLIGHT

COMPANY SHOWCASE

edWrench (MedWrench.com) is a resource and sharing network for users of medical equipment. It is an online community where those who use, service, and maintain medical equipment can get answers, find information and read what others think about the equipment they use. It is free to join and easy to keep informed.

TechNation interviewed the experts at MedWrench to find out more about the company and the services it offers to those in the medical equipment industry.

MedWrench users can build their own digital workbench and add equipment, categories or manufacturers to their “My Bench” area and then they are given an intelligent feed of information from other professionals as they help each other troubleshoot and solve problems. The “My Bench” page can also help users: • Manage bookmarked equipment and adjust how they are notified about new information;

Q: CAN YOU TELL US A LITTLE BIT ABOUT THE COMPANY’S HISTORY? A: MedWrench was first launched in 2009 by MD Publishing and LabX as a product support network where technicians, purchasers, manufacturers, nurses, doctors and industry experts could connect and discuss equipment that they use or service every day. With an end goal in mind, the first year was dedicated to product research and data entry by a team of product specialists. They helped to bring a pool of

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• See what other professionals in their discipline are using; • Ask questions and get answers about equipment; • Talk to industry experts and manufacturers directly about issues; • Contribute to the community by providing accurate information about medical equipment; and • Connect with other medical equipment professionals and find out how they use their equipment effectively.

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SPOTLIGHT

Opposite Page: MedWrench homepage. Above: MedWrench was happy to give away several grand prizes at the 2019 AAMI Exchange in Cleveland, Ohio. information to each product page that included product descriptions, features, specifications, photos, manuals, articles and much more. In 2010, and with more than 2,000 members and 10,000 monthly visits, MedWrench was introduced as the industry resource at it’s first MD Expo in Napa, California. With hard work and dedication, MedWrench has grown to include more than 75,000 members, over 80,000 monthly visits and 10,000 product pages. Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION? A: We like to think that we do not have competitors. However, we can sometimes be confused with listing sites. The difference with MedWrench is that we feature products by providing product information. This not only gives our users a platform to easily discuss specific equipment, but it allows for us to provide a database of product knowledge without having to constantly “manage inventory.” Our main goal is to be the go-to resource. We want our users and visitors to go to MedWrench and be able to find all the information needed to perform a specific task or to make a purchasing decision, without having to go anywhere else on the web. Q: WHAT ARE THE COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS? A: We provide many resources to both visitors and members. One of MedWrench’s main, and most used, resources is our Q&A forums. Our forums provide a platform for members to discuss equipment that they are working on or have an interest in. It’s a great way to connect with others in the industry and solve tough medical equipment problems.

Another great feature of MedWrench is the ability to add categories, products and/or manufacturers to your My Bench. This allows for MedWrench members to build a digital bench of products that they have an interest in or are servicing. Adding products to your My Bench gives access to instant email notifications alerting you of discussions, new product resources, videos and much more. MedWrench also has a bulletin board, where visitors can read our weekly blog, find expo/event information, continuing education opportunities and a job board. And of course each product page provides an array of product information, articles, resources, videos and the option to request a quote. Q: WHAT PRODUCT OR SERVICE ARE YOU MOST EXCITED ABOUT RIGHT NOW? A: We launched a new ‘Ask the Expert’ resource about a year ago. These articles are designed to educate readers on a specific topic or piece of equipment from an industry expert. Topics range from PM tips/servicing to training to advice on implementing new programs. The best part about these articles is the ability to ask the expert directly by filling out the question form at the bottom of each article. Q: CAN YOU TELL US ABOUT A TIME THAT MEDWRENCH “SAVED THE DAY” FOR A CUSTOMER? A: One of our favorites is when a MedWrench member came up to me at a conference. He shared with me that

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

“MedWrench helps to save lives.” He told me about a time that he was working internationally with limited resources. He said that he turned to MedWrench for support and within minutes received an answer to his question and was able to solve his problem and help a hospital in need. Until then, we never actually thought about how we help to save lives. Hearing his story made me feel extremely happy to be part of a company that helps to bring industry professionals together, worldwide, and allows them to solve problems together and, ultimately, save a patient’s life. Medwrench is doing bigger things than we could ever imagine and it took his story to put it into perspective for us. Q: WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS? A: We find it most important to listen to our users’ needs. Without them, MedWrench would not be where it is today. We welcome suggestions from our users and have even developed and grown MedWrench based off of those suggestions. I find it important for our growth and future success. For additional information and to join the MedWrench community, visit www.medwrench.com.

MEET BEN CALIBRATING! Ben Calibrating, or Ben C. for short, is the face of MedWrench! While he may just be a small Lego figure, you can find him all over the world! At MedWrench, we have an ongoing competition to see where Ben C. is traveling! Follow us on social media to follow the adventures of #BenC and join in on the fun!” /MedWrench

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry STAFF REPORTS

NEW UNIMAX HOODS AVAILABLE The UniMax series of hoods has been expanded to include a wide selection of models that feature fire suppression systems to meet California requirements. Standard models range from 6 feet to 24 feet wide, 4 feet to 8 feet deep and 7 feet to 16 feet high. Tall apparatus/distillation processes, roll-in reactors, or long integrated instrumentation systems can be accommodated in these hoods. UniMax floor mount hood’s are constructed of chemical resistant, non-conductive modular panels featuring composite resin surface material. This modular design allows for onsite assembly and the ability to disassemble at a later date, move and reassemble. Custom sizes and designs can also be designed and built to exact specifications. For more information, visit UniMaxFumeHoods.com.

ECRI INSTITUTE ISSUES FIRST INTERNATIONAL MEDICAL DEVICE EVALUATIONS ECRI Institute has released its first international device evaluations just five months after opening its International Research Centre in Malaysia. ECRI established the international laboratory to evaluate medical devices used across all care settings in Europe and Asia. More than 55% of the world’s medical devices are manufactured and sold outside the United States. “By conducting rigorous, hands-on testing of devices, ECRI Institute is helping medical professionals worldwide make informed decisions that improve patient safety,” says Marcus Schabacker, MD, Ph.D., president and CEO, ECRI Institute. “Often, this work leads to product improvement.” Among ECRI’s just-released reports are evaluations of surgical lights made in Germany and Italy, and a large-volume infusion pump made in China. “We uncovered a serious design flaw with the infusion pump that put patients at risk,” says Eric Woo, regional director of ECRI Institute’s Asia-Pacific office. Testing revealed that the infusion mechanism could be loaded backwards, causing it to extract blood from the patient

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instead of delivering the infusion solution. This delay in treatment would cause severe harm for some patients. The next international devices to be evaluated include point-of-care blood gas analyzers, portable ultrasound machines and continuous positive airway pressure (CPAP) units. Evaluations outside the United States are conducted with the same independent protocols ECRI Institute has upheld for more than 50 years. “These international evaluations provide crucial support not only for foreign hospitals and ministries of health, but also for American health systems who are opening facilities in Europe and Asia,” adds Schabacker. Members of ECRI Institute’s Technology Decision Support services can access the Health Devices evaluations by logging into the membership website at www.ecri.org. Additional resources are available on ECRI Institute’s International Patient Safety Day Resource Center. • To learn more about ECRI Institute, contact the U.S. headquarters at clientservices@ecri.org, or 610-825-6000, or the Asia-Pacific regional office at asiapacific@ecri.org or +603-5613-2919.

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INDUSTRY UPDATES GBIS SHARES SCHOLARSHIP NEWS Bhumika Patel recently became the first GBIS ACI Scholarship candidate to receive a reimbursement check for completing the CBET certification test. GBIS offers the award to qualified applicants to encourage individuals to become certified and to help reduce their cost. Patel earned her diploma in biomedical engineering from Government Polytechnic in Gandhinagar, India in 2010. She continued her education and earned a bachelor’s degree in biomedical engineering from L.D. College of Engineering in Ahmedabad, India. She has received several honors and attended various activities involving biomedical engineering. She presently works for GE Healthcare in Atlanta, GA. Her job duties include service excellence, equipment evaluation, repairs, calibrations, preventative maintenance, environmental inspections andvarious other responsibilities. Patel spoke at the 2019 GBIS Technical Conference after Horace Hunter, executive director, and Mike O’Rear, board of trustee member, presented her the award and reimbursement check. AAMI’s Martin J. McLaughlin presented her with an AAMI pin. “I am extremely honored to be receiving this GBIS ACI Certification award. I am very grateful for the recognition

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

that I have received for my achievement,” Patel said. “I have faced several challenges on my way here, but would like to thank almighty for giving me strength to achieve this. Moreover I would like to thank my better half, my husband, for encouraging me. My parents, my in-laws, family and friends for their tremendous support. Winning this award would not have been possible without the inspiration.” “The toughest battles are the ones fought against nature’s will. When ‘un-explainable phenomena’ cripples one’s body, one tends to ask ‘Why me?’ And there are too many people in the world fighting this battle,” Patel added. “This gives my life purpose and inclines me to be involved in health care. Mary Schmidt once wrote, ‘Our body is the most important instrument we’ll ever possess’ and through biomedical engineering, I hope to keep this instrument ‘sharp-sounding’ when the music fades away. This will be my gift to the world.” “I also promise to only get better at my work. Thank you all. Thank you GBIS for believing in me. I encourage you all to be certified. It’s better for us, for our society and for the health care industry,” Patel said. MediMizer Inc. was the sponsor for this year’s award. •

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TECHNATION

INDUSTRY UPDATES

SIEMENS HEALTHINEERS, EQUIPX ANNOUNCE COLLABORATION EquipX, a health care software company, has announced a collaboration agreement with Siemens Healthineers to better manage clinical equipment portfolios by understanding real operating costs, utilization and business profitability on all levels, at all times. “Siemens Healthineers is very excited to work with EquipX in helping our mutual customers be more successful and make truly informed decisions regarding their capital equipment purchases,” said Dave Edwards, Siemens senior vice president and general manager. “This is more than just a business relationship. This is a true collaboration of like-minded organizations working to bring our customers complete transparency into their capital equipment performance, and enabling their ability to receive the highest return from their investment. The EquipX solution offers the opportunity to unlock hidden capital and allow reallocation of funds to address their most pressing needs.” The EquipX platform delivers comprehensive financial and performance analysis of equipment portfolios. It identifies underutilized assets, driving redeployment and

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optimization. It also forecasts the full P&L of existing and future equipment portfolios as well as determines true market value of equipment, an industry first. The platform also provides insight into the optimal point in time to sell clinical equipment “EquipX specializes in maximizing the financial return on investment of capital equipment, a critical and timely solution to curb one of the largest expenses for hospitals and health systems today,” EquipX Founder and President Jeff Aronson said. “We are thrilled to announce this partnership, and we look forward to putting critical information at Siemens Healthineers clients’ fingertips to help with capital planning, lifecycle management and service contracts,” EquipX Founder and CEO Ilan Mintz added. “EquipX allows us to gain never-before-seen insight into our capital equipment portfolio, yielding significant opportunities to generate untapped funds to invest in our health system’s most critical priorities,” Memorial Health System Executive Vice President and Chief Administrative Officer Matthew Muhart said. •

TJC APPOINTS NEW DIRECTOR, ENGINEERING, TO STANDARDS INTERPRETATION GROUP The Joint Commission announces the appointment of Herman McKenzie, MBA, CHSP, to director of the Department of Engineering, Standards Interpretation Group. McKenzie reports to Executive Vice President and Chief Medical Officer Ana Pujols McKee, MD. “I am really excited about Herman’s new position. He will be a great leader for his team and for The Joint Commission,” McKee said. In his new role, McKenzie will lead standards interpretation and customer support activities relative to the life safety and environment of care standards. His previous roles at The Joint Commission prepared him for his new responsibilities. McKenzie joined The Joint Commission in 2017 as a staff engineer, and in January 2019, he was promoted to senior engineer. McKenzie rose to acting director of the department of engineering in February. McKenzie previously served 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, having held managerial and directorial roles in clinical engineering, plant operations and facilities services during his career. McKenzie earned his Master of Business Administration from Governors State University, University Park, Illinois, and his bachelor’s degree from Southern Illinois University, Carbondale, Illinois. He is also a Certified Healthcare Safety Professional (CHSP). McKenzie is past president of the Healthcare Engineers Society of Northern Illinois and is a member of the American Society for Healthcare Engineering. • For more information about The Joint Commission, visit www. jointcommission.org.

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INDUSTRY UPDATES

CONNEXIENT, INTELLIGENT LOCATIONS INK PARTNERSHIP Connexient has announced a strategic partnership with Intelligent Locations to deliver enterprise-class digital wayfinding and real-time location system (RTLS) services to health care customers. By joining forces, Connexient and Intelligent Locations will leverage a common Bluetooth Low Energy (BLE) Beacon infrastructure, providing customers with a greater economy of scale for their combined deliverables. Connexient and Intelligent Locations will deploy the Unified Location

Architecture at all four hospitals in the Cone Health System in North Carolina. “We’re excited to announce a strategic partnership with Intelligent Locations,” said Connexient CEO and co-founder Mark Green. “The combination of Connexient’s market-leading MediNav digital wayfinding solution with Intelligent Location’s innovative BLE-based RTLS platform provides health systems with a unified approach to handling all their locationbased Use Cases.” •

ASPEN LASER OFFERS 5-YEAR WARRANTY Aspen Laser has announced its new 5-year warranty coverage program for all new product purchases. The company developed the program to reinforce its commitment to excellence in product design and customer service. Buyers can expect the following coverage with their 5-year warranty: free from defect in workmanship and materials for the period of five years from the date of shipment and under normal use and service. During this warranty, a customer can be ensured that all costs to the laser device – including parts, labor and shipping – will be covered by Aspen Laser. Additionally, in the event that a customer’s laser needs to be repaired, Aspen Laser will provide a loaner laser via next-day delivery, thereby keeping the practice operating as normal and no patients will be turned away for treatment. This warranty is made available on all new product purchases from the company’s Summit, Pinnacle and Pinnacle Pro Series. “Our goal was to develop a warranty that would protect our buyers and cover our products for the lifetime of a lease, which is most commonly five years,” said Justin Vorwaller, chief operating officer at Aspen Laser. “This new warranty program provides customers with peace of mind, by ensuring that they will not be responsible for additional financial commitments, should they require maintenance.” • For more information, visit www.aspenlaser.com.

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TECHNATION

INDUSTRY UPDATES

CLEARWATER PARTNERS WITH NSA CENTERS OF ACADEMIC EXCELLENCE Clearwater, a provider of cyber risk management and HIPAA compliance solutions, is addressing the nation’s widening cybersecurity talent gap head on, partnering with three of the nation’s leading information security and intelligence programs to help train the next generation of cybersecurity professionals. Health care is a target for cyber attacks, yet a big challenge is sourcing the talent to fight the onslaught. With more than 300,000 unfilled cybersecurity jobs – a number expected to rise to 1.8 million by 2022 – Clearwater is collaborating with Kennesaw State University, Ferris State University and, most recently, the University of Texas at Austin to design and deliver programs that provide students with the knowledge and skills they need to protect information infrastructure. The National Security Agency (NSA) and the Department of Homeland Security have designated Kennesaw State and Ferris State as National Centers of Academic Excellence in Cyber Defense Education. Both universities include Clearwater’s IRM|Pro Enterprise Cyber Risk Management Software (ECRMS) in their curricula and offer postgraduate and bachelor’s degrees as well as certificates within their cyber programs. “For a degree that prepares students to protect the most critical assets in an organization, it is important that we arm them with critical thinking and problem-solving skills,” said Mike Whitman, executive director, institute for cybersecurity workforce development at Kennesaw State. “Extensive instruction coupled with the tools provided by Clearwater are preparing the next generation of the cyber workforce.” Clearwater’s IRM|Pro software enables faculty to expose students to enterprise-class, industry relevant risk analysis scenarios and drive home learning objectives in an experiential way. The software helps students apply proven NIST-based risk management methodologies to assessing risks associated with their assigned case study, and it serves as their guidepost throughout the semester

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with course deliverables aligned to the software’s workflow. “We include Clearwater’s IRM|Pro cyber risk management software in our curriculum because it is imperative that we are training our students to understand and implement a high-quality cyber risk management program,” said Jim Furstenberg, assistant professor of information security and intelligence at Ferris State. “Clearwater saw an industry that wasn’t adopting the necessary practices and behaviors and created a software platform to help health care providers take a more advanced approach to cyber risk management. The ability to use the software to drive home lessons is priceless.” In addition to Clearwater’s support of the Kennesaw State and Ferris State programs, company founder and Executive Chairman Bob Chaput and Chief Risk Officer Jon Moore have recently joined the faculty for the professional certificate program, Leadership in Healthcare Privacy and Security Risk Management, being offered by the University of Texas’ (UT) McCombs School of Business. “While there’s a massive shortage of cybersecurity talent across all sectors, health care has been specifically challenged as one of our nation’s last industries to undergo significant digital transformation,” Chaput said. “The UT curriculum is focused on risk-based cybersecurity strategy development and offers a significant opportunity to train individuals for many critical, non-technical cyber risk management roles needed in health care. “The health care industry is facing a crisis,” Chaput said. “Ransomware and data breaches are hitting record levels this year without the talent to combat them. Clearwater is proud to help these institutions address industry demands, provide guidance and supplement classroom instruction with valuable experience using its software.” •

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INDUSTRY UPDATES

FBS OFFERS CBET EXAM The Florida Biomedical Society has once again partnered with AAMI/ACI to offer the CBET exam at this year’s FBS Symposium (December 5-8 at Disney’s Coronado Springs Resort). The exam will be administered by ACI on Sunday, December 8 beginning at 8 a.m. In addition, FBS will show support for HTM professionals participating in the exam. FBS will reimburse $100 of the exam fee for the first 10 applicants whose applications are approved by ACI when they take the CBET exam at the 2019 FBS Symposium. Applicants must submit their application to ACI by November 21 and

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

be scheduled for the exam on December 8, 2019. FBS will also reimburse $100 to those who pass the test taken at the 2019 FBS Symposium for up to 15 new CBETs. Proof of passing the test will be required to receive $100. FBS is offering a CBET Review class at the symposium to help brush up on skills prior to the exam. Class space is limited. There is no charge for 2019 symposium educational sessions for FBS members and HTM professionals. • For more information, visit www.fbsonline.net.

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TECHNATION

INDUSTRY UPDATES

RIBBON CUTTING Medinas BY ERIN REGISTER

n 2015, Chloe Alpert’s grandmother was diagnosed with terminal brain cancer and she spent four months in and out of hospitals. While there, she started to see the challenges hospitals faced with supply chain and excess equipment, and a year later, she met someone who had started a nonprofit that took in donated excess supplies from hospitals.

“It was so inspiring that I started looking into the medical equipment market myself,” said Alpert. “I ended up falling down a rabbit hole and spent an entire year researching the secondary market. I realized the way we buy and sell medical equipment really has not changed in nearly 30 years. There have been some minor concept changes, but it is largely brokers, auctions and listings.” Alpert then realized hospitals need a total digital asset management solution, and that is what she set out to build with the co-founders of Medinas. Since starting Medinas, Alpert and company have won the $500K Forbes Under 30 Global Change the World Competition and the $1M Global Wework Creator Awards, and helped hospitals save over $30 million in sales equivalency in their first year of operating. Q: WHAT IS THE MAIN FOCUS OF MEDINAS? A: Medinas is a total asset management solution for hospitals and health care facilities. We help them easily manage all

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of their assets while they’re in service and then find the optimal buyer for those assets when it’s time to upgrade or replace them. And we do mean all of a facility’s assets. We do not just come in and “cherry pick” their best equipment or drive off into the night with a truck full of equipment and send them a check after the fact. We come in early in the process, so we can help simplify and solve asset management, redeployment and remarketing with one-click data-driven solutions. Q: WHAT ARE SOME OF THE SERVICES MEDINAS OFFERS? A: Medinas’ five main product features include a pre-owned medical equipment marketplace that includes digital offer management, an online bluebook for real-time and forecasted capital equipment pricing data, asset management, asset redeployment and maintenance management. Q: HOW DOES MEDINAS STAND OUT IN THE MEDICAL EQUIPMENT FIELD?

Chloe Alpert CEO and Co-founder of Medinas A: Each hospital is assigned its own dedicated account managers, who are located onsite and help hospital personnel with the tedious and time-consuming actions involved in the management and sale of assets. The platform only offers assets for sale from hospitals. Brokers, dealers or individuals are allowed to purchase from the platform but cannot sell, giving buyers the security of knowing that every asset listed exists, is high quality “as-is” and “where-is” equipment, and has been serviced and maintained to Joint Commission standards. We also have a smarter way of selling equipment than through auction, which is the status quo. We’ve analyzed over 10 years of data and discovered the auction model fails to produce the best prices for used medical equipment. That’s because

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INDUSTRY UPDATES auctions end at a pre-set time, rather than when the ideal buyer is found. That means sellers lose money and equipment doesn’t end up where it is needed most. By using an offer-based model with equipment listings that don’t have an artificial end-date, Medinas ensures that the right buyer is matched to each piece of equipment we sell. We further ensure that equipment sells for the right sale price by providing suggested equipment values based on real market data. Lastly, we value our buyers just as much as our sellers. Medinas treats and deals with our buyers as partners, not just as a way to sell equipment, and we work to help bring our buyers’ valuable services to the hospitals that we are partnering with.

WE BUY AND SELL PRE-OWNED MEDICAL IMAGING EQUIPMENT. TOSHIBA • GE • PHILIPS • SIEMENS AND MORE!

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU

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CUSTOMERS FIRST SINCE 1987 Silicon Valley with the best minds in health Website: carePLEASE to create a true digital assetTHAT management CONFIRM THE FOLLOWINGwww.InternationalXrayBrokers.com ARE CORRECT solution that hospitals need and deserve. Right Email: admin@intxray.com LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING now, we are focused on partnering with more Call: 508.730.9544 or 508.559.9441 hospitals since the success of our pilots has been overwhelming.

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NOVEMBER 2019

TECHNATION

INDUSTRY UPDATES

AAMI UPDATE BY AAMI

AAMI TO OFFER CBET REVIEW COURSE For the first time, AAMI is offering a review course to help biomedical equipment technicians (BMETs) prepare for the CBET certification exam. The four-week online CBET Study Course covers all six areas of the CBET exam, providing participants with a world-class instructor. “The feedback we’ve received is that a common obstacle for those considering certification has been a lack of preparation materials for the certification exam,” said MJ McLaughlin, program manager for certification at AAMI. “We heard you. With this course, AAMI intends to offer the best resources in the country to help prepare eligible candidates for the CBET exam.” The online course meets twice each week in the evenings, but all sessions are recorded. For more information and to register, visit www.aami.org/ACI.

AAMI STANDARD IS A FRESH START FOR MEDICAL DEVICE INTEROPERABILITY AAMI has published a new standard, AAMI CDV 27001:2019, that marks the start of a grander vision for the field of medical device interoperability – an interoperable clinical environment (ICE). The idea behind the standard is to encourage the design of “plug-and-play” ICE platforms that work seamlessly once they’re connected. This plug-and-play capability would allow clinicians to combine data from different medical devices made by different manufacturers to yield new patient information in ways that are not possible with stand-alone medical devices and equipment. “When you plug in your monitor, mouse or a USB port into your computer, you don’t have to do all kinds of stuff to get them to work. The computer recognizes these devices and automatically integrates them into the functionality of the system,” said Sandy Weininger, co-chair for the AAMI Medical Device Interoperability Working Group. “The AAMI Medical Device Interoperability Working Group is looking five to 10 years down the road, and we welcome input from a

TECHNATION

NOVEMBER 2019

broad diversity of stakeholders to make the standards as robust as possible.” AAMI REVITALIZES MENTORSHIP PROGRAM After a nearly two-year hiatus, AAMI has revived its mentorship program, which pairs AAMI members who are early-career and seasoned healthcare technology management (HTM) professionals for a year-long mentoring relationship. AAMI started the program in 2015 as a resource and networking opportunity for members, especially those early on in their career. The goals of the program are to: • Help protégés develop the skills and knowledge necessary to succeed and grow in the healthcare technology field. • Provide a venue for them to discuss issues or concerns that are unique to healthcare technology professionals. • Encourage long-term career planning. The AAMI mentor/protégé relationship is a year-long agreement with a commitment to meet at least once per month via email, phone, video chats or in person. AAMI provides monthly prompts to help guide discussions in the mentorship meetings, checks in after each meeting for feedback on progress being made toward goals, and conducts semi-annual surveys on the success of the program and any additional resources could provide. For more information about AAMI’s Mentorship Program and access mentor or protégé applications, visit www.aami.org/Mentorship.

AAMI FOUNDATION AWARDS MARY K. LOGAN RESEARCH GRANT TO CINCINNATI HOSPITAL The AAMI Foundation Board has awarded the $40,000 Mark K. Logan Research Grant to the Cincinnati Children’s Hospital Medical Center in Ohio to fund a project entitled “Dissemination of the Best Evidence for Effective Pediatric Monitoring Study Results.” The goal of the study is to disseminate and distribute recently developed indications for continuous pediatric monitoring to ensure the appropriate monitoring of patients.

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The team, under the leadership of Amanda Schondelmeyer, division of hospital medicine, established cardiac-respiratory monitoring protocols for patients through testing private adoption within Cincinnati Children’s sites, qualitative and survey methods used to understand barriers, and test usability of guidelines to validate acceptability of providers to use guidelines. The project will create a toolkit as a result of the stakeholder experience and expand to other Children’s Hospitals.

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Medical Device Accident Investigation: 4 Tips for HTMs

espite the extraordinary efforts of legislators, grassroots organizations, and individual healthcare organizations nationwide to prevent accidents related to medical devices, procedures, and processes, serious and fatal events continue to occur.

A recent survey undertaken by ECRI Institute revealed that 75% of approximately 450 respondents do not involve third-party investigation assistance, even in the most complex and confounding events. In those cases, incident investigation was carried out by hospital personnel, and in some cases, by personnel actually involved in the incident. Hospitals should ensure that an internal accident investigation be performed and have a mandate to do so; however, there are some circumstances in which it may be unwise to rely solely on an internal investigation. In most cases, more than one of these circumstances may be involved. Events involving serious injury or death are likely to result in legal claims by the injured party or the estate of the deceased. The defense of such claims involves investigation and potentially court testimony that must ultimately withstand the courtâ&#x20AC;&#x2122;s requirements. In addition to education and training, the professional needs expertise in the matter at hand and must be capable of applying that expertise, scientifically, to the issues in the case. TIP 1: ELIMINATE INVESTIGATION BIAS The qualifications of the health technology management (HTM) or facilities investigative staff persons to provide expert opinion and testimony is likely to be problematic. Foremost, the investigation is always vulnerable to the suggestion of bias, if not actual bias. The claimant will argue that the same person using the same test methods with the same test equipment can repeatedly miss a problem. Using internal staff to perform incident investigation exposes them to subpoena, deposition, and trial that in most cases is not part of their job description, experience, or expertise. TIP 2: SEEK IMPARTIAL, SPECIALIZED ENGINEERING EXPERTISE Healthcare-related incidents frequently involve technology, such as a medical device, procedure, or process that includes

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NOVEMBER 2019

equipment of some type. For this reason, an essential component of the investigation is to have engineering expertise brought to bear. Medical devices and instrumentation typically involve biomedical/clinical engineering personnel, whereas process equipment, such as that used in central sterile processing, involves facilities engineering personnel. In either instance, with internal investigations, the same persons responsible for the maintenance of the devices or equipment can become tasked with testing the incident devices or equipment as part of the investigation. In a very real sense, they are investigating themselves. In general, facilities, HTM, biomedical engineers, and associated technicians are not experienced, trained investigators. Their main responsibility is to maintain devices and equipment so that they continue to work properly, meet the manufacturerâ&#x20AC;&#x2122;s performance specification, and are safe. Incident reconstruction, devising simulations, or developing test methodologies to scientifically explore possible mechanisms of injury is neither in their wheelhouse nor comfort zone. Therefore, their focus can become testing, rather than investigating. The testing usually involves the same persons, methods, and test equipment that is used for the periodic inspection and maintenance tests. TIP 3: REMOVE THE DRAIN ON INTERNAL RESOURCES Internal investigations can consume significant staff time and resources, which can potentially affect work flow and ability to complete routine tasks needed to maintain patient safety. The time needed to perform investigation testing always exceeds that needed for routine maintenance testing in that investigation testing requires test protocol development and is more documentation intensive. Frequently, proper investigation requires equipment that is not available in the hospital. Incidents involving mechanically

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broken devices, such as catheters and guidewires, require, at minimum, the use of a visual light stereo microscope with photographic capability. Hospitals generally do not have these microscopes. Occasionally, scanning electron microscopy is needed to perform a defensible failure analysis. TIP 4: BENEFIT FROM INDEPENDENT EXPERTISE Internal investigations can often benefit from outside perspectives, such as when a cluster of incidents involve a particular device or process. Oftentimes, the healthcare facility has to change to a different manufacturerâ&#x20AC;&#x2122;s product line entirely in order to maintain services and prevent clinical migration. However, rather than going to such an extreme, retraining may be a better and less expensive solution. An outside perspective can often calm the situation and avert the crisis. The complexity of advanced medical care is daunting. We often find that internal investigations target the wrong device and/or reach the wrong conclusion regarding the cause of the injury. For example, intraoperative skin injuries are often charted in the patientsâ&#x20AC;&#x2122; records as a â&#x20AC;&#x153;Bovie burnsâ&#x20AC;? from an electrosurgical injury. However, in many cases, the skin injury was actually due to pressure, contact with a hot object, or chemical irritation. An experienced, knowledgeable investigator knows the various mechanisms of iatrogenic skin injury and how those injuries present and progress. When a patient has been injured or died from their injury while under a healthcare systemâ&#x20AC;&#x2122;s care, the institution needs to have the unvarnished truth upon which to base decisions related to patient safety, device/equipment decisions, staff credentialing and training, negotiations with the patient/family, while maintaining the integrity of the institution. Assistance from an independent investigator is well worth the cost because it helps to: â&#x20AC;˘ Infuse your investigation with the cumulative investigative knowledge and experience of a professionally trained medical incident investigator â&#x20AC;˘ Increase the likelihood of rapid, impartial, and accurate conclusions and actions â&#x20AC;˘ Remove any potential bias associated with self-investigation â&#x20AC;˘ Relieve facility staff pressure and stress resulting from being assigned â&#x20AC;&#x153;expertâ&#x20AC;? responsibilities in the event of a claim â&#x20AC;˘ Resolve potential internal disputes â&#x20AC;˘ Reduce the potential for spoliation of evidence For nearly 50 years, ECRI Instituteâ&#x20AC;&#x2122;s Accident and Forensic Investigation team has been conducting independent accident investigations in healthcare settings. In fact, our team of PhD-level biomedical engineers has conducted thousands of independent investigations primarily on behalf of healthcare organizations, but also for general counsel offices, insurance providers, and defense attorneys. For more information about ECRI Instituteâ&#x20AC;&#x2122;s capabilities or you are seeking assistance with an incident, please contact us at accidents@ecri.org or visit https://www.ecri.org/solutions/accident-forensic-investigation-services/

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Four Reasons Inventory Management is Mission-Critical BY GUS GUEVARA, CHTM

ver my career spanning more than three decades in healthcare technology management, I’ve learned a thing or two. One thing I’ve learned is that proper management of your inventory of medical devices and equipment will help you improve patient care, strengthen patient safety, reduce risk, and save time and money.

Is your clinical equipment inventory management system performing at its highest level? To find out, you need to dig deeper than the typical inventory data sets such as manufacturer, model and serial number. Read my list of the four reasons why accurate clinical equipment inventory management is mission-critical for your hospital or health care system. For each, I’ve also included three non-traditional items to consider when assessing your own clinical equipment inventory. FOUR REASONS WHY ACCURATE CLINICAL EQUIPMENT INVENTORY MANAGEMENT IS MISSION-CRITICAL 1. Compliance Mission-Critical Benefits: Patient Safety, Patient Care, Costs Regulatory compliance mandates from various agencies – including the FDA and TJC – outline strict requirements to not only have a detailed inventory of all medical devices and equipment, but also to ensure your meticulous inventory is at-the-ready. To meet compliance regulations, it’s critical that your hospital or health care system

TECHNATION

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has a comprehensive, accurate clinical equipment inventory management system in place that’s easily maintained, updated and accessed. If not, you risk compliance violations, which can be costly to your bottom line as well as your reputation. The ultimate goal of regulatory compliance is to ensure patient safety and the standard of patient care – both of which are the number one priority for every hospital and health system. Does Your Inventory Have: • An inventory of all medical equipment, regardless of ownership • Preventive maintenance documentation, including vendorsupported items • Data analysis looking for trends in equipment failures and subsequent follow-up actions 2. Strategic Capital Equipment Planning Mission-Critical Benefits: Time, Costs, Patient Care Efficient, effective strategic planning relies on accurate data. A thorough clinical equipment inventory will provide you with the data you need to understand, plan for, and project future healthcare technology investments. What are your historical maintenance costs? What is the maintenance schedule for your medical devices and equipment? When will devices and equipment need to be replaced, based on their age and use? An accurate inventory management system will help you substantiate and support informed decision making and budgeting during

Gus Guevara Tech Knowledge Associates the strategic capital equipment planning process. Proactive planning for both major and minor costs will save you both time and money in the long run, as well as position your hospital or health system to make investments that will reduce equipment downtime – ultimately impacting your ability to provide the level of patient care your patients expect and deserve. Does Your Inventory Have: • Installation dates and useful life information • Service costs to determine whether to fix or replace • End of service/life dates of all equipment 3. Recall Management Mission-Critical Benefits: Patient Safety, Risk Management Urgent response to recalls of medical devices and equipment is crucial for every hospital and health system. An accurate, comprehensive clinical equipment inventory – down to the

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THE BENCH serial number level – empowers your team to immediately identify impacted items and address a recall, which often requires pulling items from service. Swift and thorough recall management is obviously a vital part of maintaining your commitment to patient safety, as well as being a fundamental element of your risk management protocols. Does Your Inventory Have: • Serial numbers of subcomponents, such as X-ray tables • Location of devices for quick retrieval if necessary • Inventory of patient monitoring multi-parameter modules 4. Cybersecurity Mission-Critical Benefits: Patient Safety, Risk Management, Costs Yes, medical devices and equipment can be hacked! Specializing in Philips, Picker/Marconi, Specializing in Siemens, Philips, Picker/Marconi, MRI & CT Systems Siemens, MRI & CT Systems An accurate clinical equipment inventory will help you strengthen your cybersecurity to thwart health 512.477.1500 512.477.1500 care hackers and protect sensitive patient data – such info@keimedparts.com info@keimedparts.com as names, addresses and social security numbers. Tracking software versions as part of your clinical www.keimedparts.com www.keimedparts.com equipment inventory ensures your team can maintain the highest level of security by installing updates and KEI MEDPARTS KEI MEDPARTS revisions when they become available, at the machine MRI & CT Equipment MRI & CT Equipment and network levels, to prevent data breaches as well as Knowledge, Experience, Knowledge, IntegrityExperience, Integrity nefarious cyber attacks. Hacked data can be sold, or hackers can hold your organization hostage with the demand for ransom payment. Responding to cybersecurity breaches can be costly beyond ransom payments. Legal and other costs have bottom-line consequences. Reputational risk response can also generate a significant price tag, and news of a breach can cause patients to take their business elsewhere. Privacy and data security is a hot-button issue today that hospitals and health systems, especially, need to address. It’s another issue impacting risk management as well as your overall commitment to patient safety. Does Your Inventory Have: • Current version of software • Inventory of networked devices • Whether the device stores, displays or transmits electronic personal health information If you don’t think your clinical equipment inventory management system is performing at its highest level, I am happy to share more about how best to maintain and improve patient care, strengthen patient safety, reduce risk and save time and money. Riken FI-8000P Portable Gas Indicator Send your questions to gus.guevara@ii-techknow.com.

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‘Fascinating’ Webinar Delivers ‘Great Information’ BY JOHN WALLACE

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 well did the content that was delivered match what you were promised when you registered?” “The webinar was great. I am trying

TECHNATION

NOVEMBER 2019

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

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. 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”

“ This was a very good webinar for people in our business that would like to understand the workings of CT. I enjoyed it very much.” G. HUANGS, SENIOR BMET 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.

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

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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.

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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 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,”

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STERIS - AMSCO 3080 RL I received a call to the OR and the staff reported the table had a burning smell coming from it. I verified the smell and also found that the pump continues to run as soon as you plug it into AC. I removed the hand controller and still the pump runs. I checked override switches and foot lock switch under AC receptacle. I am looking for suggestions.

Check the actuation solenoid on the control panel. If it was fused shut, it will run continuously. It is soldered on the board, but you can replace or swap the whole board.

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So you could have a short in the wire going from the motor to the control board and that is keeping the motor running all the time. Just a thought.

the flat cable that connects the ECG connector to the electronic board without any result. It always appears ECG lead off. Can someone help me?

Most likely it is the power control board mounted on the inside cover of the power supply assembly. Disconnect P1 & P3 from the table control board (box on column with cover) this eliminates the control board. Disconnect P7 from the overide board (top of column without cover) this eliminates the overide board. If the pump is still running, replace the power control board or the complete power supply assembly.

ZOLL - E SERIES I have a Zoll E series monitor that does not recognize the ECG cable. I tried the same cable on another device and it works. The cable is new. I tried to replace the connector and also

Sounds like itâ&#x20AC;&#x2122;s your main system PCB and or possibly the system interconnect PCB.

Since you have switched out the ECG connector and the ECG cable and no results, the only component left is the system board. It may have blown fuses or something. You may want to switch out with a good system board to confirm it.

Possibly unplug your analyzer, it may have interference. Check to see if the is frequency set to 60HZ? Also check to see if you have a damaged ECG connector.

SHOP TALK

is compiled from MedWrench.com. Go to MedWrench.com community threads to find out how you can join and be part of the discussion.

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NOVEMBER 2019

TECHNATION

ROUNDTABLE

ROUNDTABLE X-ray

echNation reached out to healthcare technology management gurus and original equipment manufacturers to find out the latest regarding X-ray and tips for maintaining these important devices.

Participating in this Roundtable on X-ray are RSTI Training CEO Todd Boyland, Siemens Healthineers Vice President of Service Business Management Matthew McCallum, Konica Minolta Healthcare Americas Inc. Director of Marketing, Digital Radiography Guillermo Sander, Biomed Security DBA/ProHealth Careâ&#x20AC;&#x2122;s David Yaeger. Q: WHAT ARE SOME OF THE NEWEST FEATURES IN X-RAY THAT FACILITIES SHOULD CONSIDER WHEN BUYING NEW? BOYLAND: Some of the newest features in X-ray that facilities are considering

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NOVEMBER 2019

when purchasing equipment revolve around patient dose reduction and technically advanced features that aid in diagnosis speed and accuracy. Some examples of technically advanced features include tomosynthesis, 3D reconstruction, workflow automation and Computer Aided Detection (CAD) integration. When people consider CAD, digital mammography comes to mind, but other modalities (digital radiography chest X-Rays) in addition to digital mammography are seeing the benefits of CAD. Data metrics is likely to be an important consideration soon as Artificial Intelligence (AI) implementation continues to expand. MCCALLUM: When purchasing X-ray systems, facilities should consider features that ensure a foolproof system. The system design should allow future innovations and options to be added easily. Also, consider any features or algorithms that assist with reducing

patient dose while maximizing image impression. Finally, consider artificial intelligence (AI), which can be utilized not just for clinical diagnosis but also to improve automated workflow and perform system self-diagnosis. SANDER: At Konica Minolta Healthcare, our newest innovation in X-ray is Dynamic Digital Radiography (DDR), an enhanced X-ray technology that enables clinicians to analyze and quantify the dynamic interaction of anatomical structures with physiological changes over time to enhance diagnostic capability and efficacy. Clinical studies have shown that DDR may be a clinically relevant option to assess COPD and allow for earlier discovery and a better understanding of dyspnea. Future studies will examine the use of DDR for assessing joints and joint movement. AeroRemote Insights is a system monitoring service that providers and

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ROUNDTABLE

organizations can utilize to manage their X-ray assets and help improve department productivity. Buyers should also consider the total cost of ownership, including what is covered in maintenance/service contracts, how a manufacturer addresses software obsolescence (since many systems can have a 15-20 lifespan) and if there is an upgrade path for new technology (e.g., new detector technology). YAEGER: Radiology departments continue to evaluate systems for image quality with reduced dose. Adding remote monitoring availability of systems to help troubleshoot system failures can be a valuable tool for biomed technicians. Predicting failures is a future possibility with remote monitoring of systems.

Todd Boyland RSTI

Q: HOW CAN FACILITIES OVERCOME BUDGET CONSTRAINTS WHEN IT COMES TO ACQUIRING X-RAY DEVICES? BOYLAND: Many facilities are working to stretch the lifecycle of imaging equipment to help reduce costs. Ensuring parts availability and support for legacy devices needs to be weighed against the cost of replacement or

upgrade. There are many providers that will sell and install DR FPD upgrades onto systems that weren’t originally designed to accept newer FPDs. This can be a cost-savings that allows health care providers to keep up with technological demands. While DR FPD upgrades can be a major improvement over current technology, facilities need to be aware of who is responsible for various components related to the upgrade. For example, if an OEM or service provider is responsible for servicing a radiography system, who is responsible when there is a failure and determining if that failure is a result of an FPD upgrade provided by another vendor. MCCALLUM: To optimize system maintenance, facilities with experienced in-house biomed departments can reduce service costs by looking for OEMs with shared service contract options that include tech support, access to system maintenance, and troubleshooting information, as well as software diagnostic license keys and discounts or price caps on certified spare parts. Another cost-saving measure: detector pooling and deductibles, which can provide greater budget flexibility over the system’s life. Providers with limited or nonexistent medical imaging biomed capabilities should holistically examine their entire X-ray fleet to determine cost-saving opportunities where there is redundancy or with respect to systems with lower productivity requirements. With this approach, you can prioritize higher coverage levels on your more critical equipment to protect patient exam volumes. SANDER: Seeking the lowest price is usually not the best long-term option after considering the time and cost for maintenance and repairs. Leasing or pay-per-use capital agreements can help

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

facilities invest in new technology without a large outlay of funds upfront. Both approaches can also change the investment from a capital to an operating expense, which can help alleviate purchasing constraints. YAEGER: Create a plan that identifies the potential life of this equipment. Determine, or develop, an organizational life cycle management program that identifies the expected length of time each piece of equipment should be replaced. Also take into consideration the utilization of your equipment. As an example, if you have determined that the lifecycle is 8 years and your utilization is at 40%, consider extending the lifecycle past the 8 years. If your utilization is at 90% consider replacing that unit earlier than the 8 years. Understand that replacing all units in one year may not be fiscally possible for your organization and involve the provider with this plan. Q: WHAT SHOULD ONE LOOK FOR IN AN X-RAY/RADIOLOGY SERVICE PROVIDER? BOYLAND: Engineer certification is a hot-topic item for most health care providers today. Facilities want to be assured that the engineers who are servicing their equipment are doing so in a safe, cost-effective manner that helps to minimize equipment downtime and maximize patient throughput. Flexibility is another key attribute when considering imaging service providers. Service providers today need to have the technical capabilities and required tools to work on a large array of systems from many OEMs. MCCALLUM: For a true provider/vendor partnership, look for a vendor that offers comprehensive, personalized service offerings that align with your department’s critical patient care objectives – for example, providers with

NOVEMBER 2019

TECHNATION

ROUNDTABLE

24/7 or extended care access command service coverage outside the typical 8 a.m. to 5 p.m., Monday to Friday workdays. Find a service partner that performs routine maintenance or non-urgent service on days and times that don’t compromise critical patient care. When you can determine when your service provider has access to the system, you operate at maximum productivity, accommodate higher patient volumes and ultimately achieve higher revenue. Additionally, providers should look for robust training solutions that enable and empower clinical staff to provide a higher level of patient care and prevent employee burnout. Solutions like on-demand applications support, ongoing clinical education and soft skill development training ensure that technologists, staff and managers receive up-to-date support when, where and how they need it. SANDER: Look beyond the acquisition price and consider the cost and coverage of the service agreements. If the supplier does not offer solutions to help manage your systems, such as dashboards that capture utilization, exam volume, image reject reasons, exposure levels for exams and critical events such as dropped panels, you will have to invest additional resources over the life of the system. Also, find out what type of upgrade path is available for a system and whether new technologies or features can be added over time. Again, consider that a typical X-ray system can last up to two decades, so it is important to acquire a solution that allows your organization to change and adapt to advancements in technology – both hardware and software. YAEGER: There should be a strong local service team willing to partner with the in-house team. The provider should be well established in the industry, responsive to the needs of your

TECHNATION

NOVEMBER 2019

organization, whether you have an in-house biomed department, thirdparty repairs or you contract with the manufacturer themselves. They should provide a clear escalation process for unresolved service events. Knowledge from the provider that they understand security needs of your organization and are willing to keep their equipment up to par with OS and application versions and security patches. Q: WHAT STEPS CAN BE TAKEN TO FACILITATE FUTURE UPGRADES? BOYLAND: Ensuring compatibility with the current/desired facility workflow is something that needs to be considered for future upgrades. This can ensure future upgrades integrate seamlessly with the goals of the department. Having IT and PACS involvement is important to ensure systems comply with their expectations regarding security and interoperability.

systems are typically available 3 to 10 years after purchase, while minor software updates may be available for the system’s entire life. Budget at least one upgrade into the total cost of ownership calculation. By planning for this at the point of sale, you’ll obtain access to new features down the line and potentially extend the system’s useful life by several years. SANDER: Don’t just look at what you are doing now, but rather what role radiology or X-ray will play in your practice or hospital department in the future. Hospitals are becoming more networked and interconnected, so pay particular attention to this. Also, look for systems and platforms that are designed to grow and evolve with your practice. YAEGER: When purchasing equipment, identify in the SOW or SLA the upgrade timetable established by the provider and any associated costs. Negotiate the costs into the purchase price as to eliminate costly upgrades throughout the lifecycle of the equipment. Q: WHAT ADVICE WOULD YOU GIVE A BIOMED INVOLVED IN THE PURCHASING OF A FACILITY’S X-RAY DEVICES?

Matthew McCallum Siemens Healthineers

MCCALLUM: Software upgrades drive advancements in today’s imaging equipment, sustaining the life of an X-ray system and avoiding more frequent and costly full-system upgrades. Factory upgrades for X-ray

BOYLAND: Develop an understanding of biomed and in-house engineer access to servicing newly installed systems. OEMs work hard to create a sense that they are the only one who can service their imaging equipment. The reality is that OEMs have a responsibility to provide access and documentation necessary for the in-house engineers (and third-party engineers) to ensure safe compliance following in-house service of imaging systems. The in-house and third-party engineers also have a responsibility that the imaging system performs to OEM criteria following service by the in-house or third-party engineer.

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ROUNDTABLE

MCCALLUM: Understand what you need from the OEM to service and maintain new equipment. Will you only require an on-demand level of support for your entire department – or will you need technical training to deliver a higher level of expertise? Or will you need something in between? Do you have preventative maintenance and a parts strategy in place to maintain compliance? Do you understand all the risks of opting for time and materials?

criteria following service by the in-house or third-party engineer. MCCALLUM: At the point of sale, an OEM may offer a haggle-free, best-offer service contract that simplifies and expedites deliverables required by most customers – including basic tube, battery and detector coverage – and protects parts that will most likely fail in the early years of ownership. Lock in prices early to avoid increases.

David Yaeger Biomed Security DBA/ProHealth Care

Guillermo Sander Konica Minolta Healthcare Americas Inc. SANDER: Really pay attention to maintenance costs. Consider the tools provided to manage the equipment as well as the type and quality of service solutions the vendor provides to monitor and manage your systems; for example, the ability to gather reject and usage data for all systems in the network without having someone manually download the data. Talk to your supplier to find out how they can help you plan for the future to help you do more. YAEGER: Prior to purchase, request a listing of any special tools and test equipment (including service software)

with part numbers and pricing. Request training costs with any required prerequisite classes. Purchasing – have detailed discussion with your provider surrounding the security capabilities of their equipment. Obtain a Manufacturer Disclosure Statement for Medical Device Security (MDS2) form from them that shows their capabilities to secure their product. Collaborate with your security team in reviewing the document for strengths and weaknesses. Does it support the latest networking capabilities? Can you change admin passwords from their defaults? Can you install antivirus protection software, etc.? Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING X-RAY EQUIPMENT? BOYLAND: That OEMs have a responsibility to provide access and documentation necessary for the in-house engineers (and third-party engineers) to ensure safe compliance following in-house service of imaging systems. The in-house and third-party engineers also have a responsibility that the imaging system performs to OEM

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SANDER: X-ray is no longer just about the image capture, you also need to consider the image processing. Think of a camera for photography: would you want to buy an old digital camera that has lower resolution compared to today’s digital camera? Think about digital radiography in the same way: 10 years ago DR technology was expensive, but today the price has gone down, the quality has greatly improved and there are advancements in image processing that you’ll likely want to utilize either today or in the near future. Also, consider the ability of the manufacturer to service and help you manage the asset. With film X-ray, many sites had two systems in case something went down or broke. This may not be the case with DR, so inquire how your vendor can provide not just preventative maintenance, but prescriptive maintenance and help self-predict when maintenance is needed. YAEGER: Ensure you have received all documentation for service and support of your equipment and accessories prior to acceptance. Have a clear communication path for service and support requests from your vendor. Review the service history with department staff and leadership prior to the end of warranty. Follow up with the vendor to resolve any outstanding warranty services issues.

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TECHNATION

Accidents Happen. You Need Answers. When a medical device-related incident occurs in your hospital, get answers from a source you can trust. ECRI Instituteâ&#x20AC;&#x2122;s experienced team will respond immediately with a systematic, unbiased approach to accident investigation. Get the answers your leadership demands, and your patients deserve.

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www.ecri.org

A WORKABLE

AEM

PROGRAM GETTING THE BASICS RIGHT BY K. RICHARD DOUGLAS

ncertainty is bad for the stock market and not something HTM professionals want either. When it comes to PM

schedules, for instance, every HTM professional wants to know what the accepted standard is. If there is a standardized approach, so be it, but if it is an approved alternative, then spell it out.

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NOVEMBER 2019

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In 2013, with the release of a memo by the Centers for Medicare and Medicaid Services (CMS), Survey & Certification (S&C) Letter S&C:14-07-Hospital (Hospital Equipment Maintenance Requirements), the idea that AEM programs could be an alternative to manufacturer’s recommended maintenance schedules was born. But the discussion goes back to 2010 when The Joint Commission (TJC) and CMS met. CMS asked that TJC surveyors scrutinize the effectiveness of maintenance strategies more closely. Former TJC Director of Engineering George Mills laid out the case for developing a “defensible AEM program.” The premise was that upon scrutiny, the program, its procedures, and documentation, could be carefully outlined and defended as well thought out, comprehensive and evidence-based. In short, if a surveyor was the prosecuting attorney and the judge, the defense would mount a case that the judge would agree with. A more recent AAMI article stated that a recurring theme from The Joint Commission was “the importance of healthcare technology management (HTM) departments having documented, defensible evidence supporting their equipment management strategies.” “Implementing a well-designed AEM program can reduce PM time while maintaining equipment safety and regulatory compliance. Perhaps more importantly, adopting sound AEM principles can help HTM programs be more proactive in identifying equipment-related problems,” says Matt Baretich, PE, Ph.D., founder of Baretich Engineering Inc. in Fort Collins, Colorado. Baretich is the author of AAMI’s “AEM Program Guide: Alternative PM for Patient Safety.” BUILDING BLOCKS FOR A SUCCESSFUL PROGRAM To begin a new AEM program, or review the components of an existing program, it is necessary to include several elements for success. There are also practices to avoid. D. Courtney Nanney, BSBME, CCE, CLSGB, national quality manager, clinical engineering/physical asset services for Catholic Health Initiatives (CHI), says that there are several important considerations. “(You) need enough device history. We (CHI) defined that as 50 device-years of history (i.e. 25 devices x two years, 10 devices x five years, etcetera),” Nanney says. Nanney emphasizes that you “do not include imaging, laser or other specifically regulated devices.” “Review Mean-Time-Between-Failure (MTBF) to determine PM frequency and a review of patient incidents work orders,” as well as a “review [of] work orders flagged PM Preventable,” he says. Nanney also asks; Do you have backup equipment? Do you have AEM Committee Review PM recommendations? Do you have Environment of Care (EOS) approval? Nanney says that if an HTM department does not have an existing AEM program in place, the starting

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

point should be, “after completing a batch of PMs, ask the technicians what they found that was PM preventable and what was useless or redundant,” he says. He says to analyze work orders to see if they support the technician’s findings. Use that data to adjust PMs. While Nanney cites some of the desirable best practices to follow in establishing an AEM program, Baretich describes those practices that should be avoided. “Instead of best practices, here are three ‘worst practices’ I’ve seen quite often,” Baretich says. Not including all aspects of PM. “PM (planned maintenance) includes activities to reduce the likelihood of failure, such as replacing batteries before they fail. But PM also includes inspection activities to discover latent failures the user may be unaware of, like defibrillator output testing,” Baretich says. Not measuring PM program performance. “We don’t want our AEM program to reduce equipment safety, so how do we know? There’s a growing consensus that we should be proactively measuring and monitoring PM-related failures (including latent failures) that could be averted by better PM,” Baretich adds. Not establishing and sustaining CMMS data integrity. Baretich also points out that those who establish an AEM program are “going to be making critical data-driven decisions, so we need good data. We need to clean up existing data, adopt good data hygiene to keep it clean and do regular data auditing to check for deterioration.” There is also the perspective of the vendor that produces CMMS software, with an eye on compliance. What is their take on establishing an AEM program? “First, HTM leaders should attend seminars to ensure they completely understand AEM. Also, AAMI sells an AEM guide that provides detailed information on the AEM implementation process. Being educated on the subject by doing these kinds of things will make you more confident in your decisions,” says Rich Sable, CBET, product manager at EQ2 LLC. “Second, HTM leaders should create the policy and procedures for the organization’s AEM program, and make sure that their CMMS can retrieve the metrics outlined in the policy easily, especially if HTM leaders need to present them to a regulator during an inspection. For instance, EQ2’s AEM dashboard is continuously checking live data for updates to metrics in the database that would be part of the AEM policy, like equipment history, failure rates, device years, etcetera,” Sable adds. He says that finally, you should identify all the “taboo” devices that should not be placed into an AEM program such as medical lasers, radiologic and imaging equipment, and high-risk devices. “Once those items are identified, you can move on to the other inventory items for evaluation for AEM eligibility based on the metrics outlined in your organization’s AEM policy. It is important to remember that you must not reduce the safety or reliability of any medical device placed into an AEM program,” Sable says.

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TECHNATION

As Nanney also suggested, Sable says that as a final best practice, the HTM leaders can involve the EOC committee in approving and understanding the reasons that the organization is adopting these alternative strategies. This also serves to add organizational acceptance of the program which may prove to be beneficial during a regulatory inspection. What has EQ2 learned while developing software/ dashboard for this kind of program? “Like many HTM standards, the rules are continuously evolving, and it requires effort on the software vendor to be in close contact with their customers and to attend AEM seminars and conference sessions provided by both AAMI and MD Expo,” Sable says. “Also, as new metrics are revealed the software dashboard must be updated to reflect those new metrics used in applying an AEM program: for example, adding corrective maintenance history and device years to the interface. Consequently, we have learned that you cannot stand still and must continuously respond to changes to the program and requirements,” Sable says. ONE DEPARTMENT’S EXPERIENCE One example of the experience of starting an AEM program comes from Seth Blanchard, biomedical site coordinator, clinical engineering at WakeMed Health & Hospitals in Raleigh, North Carolina. Blanchard and his department’s experience is instructional. “When we first entered into the AEM program, we knew that several steps needed to take place first. First, we needed to right-size our 20,000-device inventory. It is difficult to understand what devices you want to add to the AEM process if you don’t have a good grasp of what’s in your inventory,” he says. Blanchard says that this process included correcting and standardizing model records. “For example; a printer with a model number ‘PRN

ARTICLE

CONTRIBUTORS Rich Sable,

CBET, Product Manager, EQ2 LLC

TECHNATION

NOVEMBER 2019

50’ needs to align perfectly with what the manufacturer has named it. It cannot be ‘PRN-50’ or ‘PRN50.’ Otherwise, we would have had multiple model records for the same model. This is a giant step and one that took time. Once we had a good clean inventory, we took the next step and listed devices that have a factory recommended or required PM against those that do not,” Blanchard says. He says that once complete, they then developed a flow chart to help decide what devices they could include in the AEM program. “We realized that the WakeMed clinical engineering technicians were the best suited to help us decide what devices should and could be included in the program. The technicians were to modify the maintenance procedures and create standard checklists that were included in the model record for each device in our CMMS. These checklists cannot be modified at the technician level and have fields that need to be completed in order to close the PM work order. This helps keep the modified PM standard across the board for all techs,” Blanchard says. He says that at this point, they felt they had established a strong AEM program at WakeMed. “However, we quickly realized that we needed to track not only device repairs for trending issues but, patient risk and impact. We developed a three-question survey that is mandatory to fill out as the CMMS will block the tech from closing out the work order if they do not enter the answers, and is part of every work order generated (scheduled and non-scheduled). The answers are only ‘yes’ or ‘no,’” Blanchard says. He says that each question, in a normal circumstance, will receive a “no” answer. “However, if someone were to answer ‘yes’ to any of the questions, it will flag the work order and we will then have a chance to look into the issue right away. So, instead of lagging metrics and looking at data that happened in the past we have developed leading metrics and can find

Matt Baretich,

D. Courtney Nanney,

Seth Blanchard,

Thomas Todro,

PE, Ph.D., Founder, Baretich Engineering Inc.

Biomedical Site Coordinator, WakeMed Health & Hospitals

BSBME, CCE, CLSGB, National Quality Manager,Catholic Health Initiatives

Engineer, The Joint Commission

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issues in real-time to help prevent duplicate incidents,” Blanchard adds. He says that similar to the three AEM questions, they also make it mandatory to fill in a field regarding patient impact. The five choices to the “Patient Impact Level” question are: 1) No Impact to Patient, 2) Delayed/Rescheduled (regarding a patient’s case/ procedure), 3) Patient In the Room (we believe this is a patient satisfier issue. No patient or family member wants to know that a device we hook them up to might not be working properly and was that issue caused by AEM), 4) Patient on the Table (Device failed during an invasive procedure) and 5) Patient Injury or Death.

strategy implemented. “The hospital is expected to adhere strictly to the AEM activities or strategies it has developed. ‘Strict adherence’ is generally interpreted by CMS to mean completing 100 percent of the activities in a frequency identified by the organization,” Todro says. Todro says that TJC considers a well-developed AEM strategy as a way of achieving “zero harm to patients and high reliability,” as well as a tool that clinical technology management departments can use to demonstrate their quality maintenance management system. “There are several organizations that have implemented effective AEM strategies and key to their success was analysis of data, well-written implementation plan and periodic monitoring of the failures for the devices under the AEM,” Todro adds.

THE ACCREDITOR’S SUGGESTIONS HOW DO YOU MAKE A PROGRAM DEFENSIBLE? Baretich says that a year ago if a Joint Commission Make certain to have an annual review and adjustments surveyor asked if you have an AEM program, many to the AEM program, according to Nanney. He also HTM professionals thought the safe answer was “no, we suggests weekly monitoring of patient incident work follow OEM recommendations.” orders and weekly monitoring of “Now, if that’s the answer you work orders flagged PM preventable, give, the surveyor is likely to say as well as an annual review by the ‘Why not? An AEM program is best EOC. practice,’” he says. Blanchard says that WakeMed “The Joint Commission’s has been on the AEM journey since position on AEM focuses on the 2014. ability of a health care organization “During this time, we have not (HCO) to use the tools of an AEM seen an uptick in medical equipmentprogram to work smarter, reduce related patient or staff injury. Patient harm, increase reliability and and staff safety is our number one maintain safe operation of medical goal, as it is for everyone who works devices,” says Thomas Todro, at WakeMed or in any health care engineer, standards interpretation system. So, I can end on that note,” group, engineering at The Joint he says. Commission. “However, fiscal responsibility is “There has been very little change MATT BARETICH also a big goal for any health care regarding our position in the last two system in this day and age. AEM has years. The Joint Commission, when surveying an HCO’s not only helped reduce patient and staff injury but has AEM strategy, is looking for documented, defensible also saved us a huge amount of money by allowing us to evidence that supports the alternative equipment decide what safe maintenance looks like on our devices. management strategies being used,” Todro says. We can use third-party vendors and ISOs for parts and He says that for organizations looking to implement service. We don’t need to utilize much overtime to get the an AEM program, we recommend first starting with last-minute devices completed before the end of the month EC.02.04.01 EP 6, which addresses how the medical deadline,” Blanchard adds. equipment is used, including the consequences of He says that tracking the fiscal impact is one metric he equipment failure or malfunction, including seriousness would urge anyone on the AEM journey to track. and prevalence of harm to the patient or the operator. “We, unfortunately, did not start tracking this until Todro says that there are several key considerations much later into the program. We have also freed up labor when devising an AEM program. Among them is: hours for our staff to work on improvement projects • Availability of backup equipment/alternative throughout the shop and hospital. Are we Maytag Men equipment. napping and twiddling our thumbs? No, not yet. There is • Incident history of identical or similar equipment. always more than enough work to do. However, AEM • Consideration of other maintenance requirements definitely helps to feel less constrained and managing your of the equipment not identified by the OEM and work seems just a bit easier,” Blanchard adds. • Ongoing review of the effectiveness of the AEM

“Implementing a well-designed AEM program can reduce PM time while maintaining equipment safety and regulatory compliance.”

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NOVEMBER 2019

TECHNATION

EXPERT ADVICE

CAREER CENTER

Can You Hold Off on Accepting Job Offer? BY KATHLEEN FURORE

ou or someone you know likely has been in this situation at one time or another during a job search: You get a job offer almost immediately after an interview, but have interviews lined up with other companies. How long can you wait before giving an answer? And should you mention you’re also interviewing for other positions?

That depends on how interested you are in the offer on the table, career experts say. “First and foremost, weigh the value and importance of the offer,” advises Adrienne Tom, an executive resume writer and interview coach with Career Impressions. “If the offer is for a role you really want and it seems like a good fit, with appropriate compensation, then you may not need to attend additional interviews.” That doesn’t mean accepting the offer right away, even if it’s your top choice, according to Keirsten Greggs, the founder of TRAP Recruiter, LLC, who recommends job seekers take the following steps: • Express your excitement and desire to make an informed decision but don’t accept on the spot. • Ask for the offer in writing. • Review the offer thoroughly, taking into account not just the salary but total compensation including benefits and perks, location and growth potential. As for those other interviews you’ve

TECHNATION

NOVEMBER 2019

scheduled, consider how appealing they are. “If you don’t have a strong interest in the roles for which you’ve yet to interview, cancel them,” Greggs says. Tom concurs. “Reach out to companies you are scheduled to meet with to express appreciation for the opportunity, letting them know you’ve accepted a position and need to cancel any upcoming interviews,” she says. “Be gracious and courteous in all communications, as you never know if you will find yourself applying to these organizations again in the future.” However, if you’re interested in learning more about those other opportunities, there are acceptable ways to buy some time. “Ask the offering company for time; yes, simply ask,” says Tom. “There is no need to mention your other interviews. Keep the conversation focused on the company/ role at hand, expressing interest and enthusiasm for the role while making a polite request for additional time to carefully consider the offer. “Requesting up to an additional week to review is usually within reason, but be prepared that the company may not accommodate,” she says. “If the company returns with a firm deadline, you will need to respect their requirements and make a decision.” And should you let those companies know you’re entertaining another offer? “When it comes to the upcoming interviews that are real contenders,

Kathleen Furore

you should absolutely mention that you’re interviewing/have interviewed for other positions and that you’ve received a verbal offer and/or are waiting for an offer in writing,” Greggs says. “Many recruiters will inquire outright during the preinterview phase of the recruiting process about which stage you’re in of your job search. Providing them and/ or the interviewer with the information that you’re fully engaged, interviewing and/or entertaining offers can motivate them not to drag their feet on making a hiring decision if you’re their top choice.” KATHLEEN FURORE is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

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EXPERT ADVICE

20/20 IMAGING INSIGHTS The Secret to Extending Coil Longevity is Often Still Just Down the Hall BY TED LUCIDI

ast month’s article focused on strategies that HTM professionals could use to extend the lifecycle of their MRI coils. This month, the focus is on end-user contributions that can affect uptime. As an imaging service engineer for 20 years, I’ve learned that clinicians, technologists and other staff play a critical role minimizing service costs and maintaining uptime.

I was amazed that three different imaging departments/facilities, having very similar equipment, could experience such very different points of failures. One department experienced almost zero failures in a six-month time period, while the second had multiple devices with accelerated wear and the third having an unusual number of devices with physical damage. I worked with department/ practice managers and reviewed the types of failures. Together we presented findings in informal staff meetings, discussed how they could be minimized and developed strong working relationships to affect uptime and longevity. Following are some best practices to help your end-users lower repair frequency and increase uptime for MRI coils: VISUAL INSPECTIONS Most OEMs recommend that technologists inspect EACH coil before EACH use. The entire and all housing(s) and accessories should be assessed for cracks, fractures and impact marks. Cables and strain reliefs should be examined for cuts, major abrasions, roll-over damage, evidence of pulls and exposed wires. The

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NOVEMBER 2019

connector(s) should be inspected for cracks, missing pieces and bent and/or missing pins. Any concerns should result in removing the coil from service. TRANSPORTATION PRACTICES It should never be assumed that MRI coils, especially multi-piece, have been stored properly by the prior user. It’s a best practice to transport (any distance) by firmly gripping the coil and supporting it from the sides/bottom. Coils should never be picked up from a single section. When transporting coils between rooms, the use of a cart is highly recommended. Flex coils should always be cradled from the bottom, gripped at the center housing or carried by the designated handle. Flex coils should NEVER be carried by the flexible portion, as there are sensitive components contained within that can be damaged by doing so. No medical device, including MRI coils should be carried or moved by the cable, as strain relief, cable sheathing, wiring harness and component damage could occur. PATIENT PLACEMENT PRACTICES When attempting to scan with a flex coil, NEVER attempt to adjust the position of the patient by using the coil as it may cause both physical and internal electromechanical damage. For multi-piece coils, such as a head coil, the anterior portion should always be removed by pulling STRAIGHT-UP. If the anterior is removed at an angle, the fragile connections between the various sections could easily become damaged or undergo premature wear.

Ted Lucidi Innovatus Imaging CABLE ROUTING PRACTICES Based upon the design of the specific coil, it is possible to induce image artifacts based upon cable placement. It’s a best practice to NOT loop or cross the cable when in use. Looped cables may cause RF coupling issues and may degrade image quality. Some of the individual wires with the cable sheathing are actually very fine. It’s important to NOT permit the cable to be bent at extreme angles. Route the cable using soft angles as to not damage the internal wiring. Another best practice is to be sure that the coil is unplugged prior to lowering the table. Failing to do so may damage the coil, cable or connector and would typically NOT be covered under the OEM warranty or service contract. CLEANING PRACTICES OEM’s spend considerable time developing lists of approved cleaning agents. ONLY follow OEM guidelines and ONLY use OEM-approved cleaners and disinfectants.

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EXPERT ADVICE Using an unapproved cleaning agent or using an OEM-approved cleaning agent improperly can void the warranty as well as disqualify coverage under a service contract. It’s a best practice to detach the coil from the scanner before attempting to clean it and it’s also important to NOT submerge, pour or spray a cleaning agent directly on to the coil as internal circuitry could be damaged.

e n i v Ir S A V E

STORAGE PRACTICES OEMs provide recommendations for coil storage in their user and/or installation manuals. It’s a best practice to ensure that all the various housings/accessories are fully and firmly attached to one another, that all latches are firmly secured and that good cable management practices are employed. From employing good cable management A C practices to using the correct cleaning product/practices and reinforcing CHANGES best PROOF APPROVED NEEDED practices for care and handling, the secret to extending MRI coil longevity is just down the CLIENT SIGN–OFF: I R hall.

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CYBERSECURITY Mitigating Controls BY JOSEPH E. FISHEL, CBET, MBA

ometimes you can’t use the normal set up and have to be creative to continue to keep medical equipment working/communicating and still protect it from vulnerabilities. Medical equipment lags the IS/IT industry by a minimum of three years. Mitigating controls are a type of control we can use when normal controls are unable to correct or prevent a problem. Recently we had BlueKeep with its Remote Desktop Protocol (RDP) issues appear. Some of the manufacturers wouldn’t support the Microsoft Patch nor would they provide one of their own. In addition VXWorks an embedded system has announced that they have some vulnerabilities. So, what can we do?

There are short-term solutions and long-term solutions. All of them come down to time and money. Which way you go is your institution’s decision. You can go in-house or hire a thirdparty organization such as GE Healthcare for its cyber solution. The other option is to create a program yourself. I previously discussed some options. I am going to try to put them all here in more detail. A patch is a short-term solution. A vulnerability comes out and if the device is patchable you patch it. When the next vulnerability comes out you patch again and the cycle continues until the OS becomes obsolete and there are no more patches to be had. When this happens, a patchable device moves to mitigating controls solutions. Long-term solutions are solutions that when put in place require minimal maintenance and provide ongoing protection.

DESIGNATED VLANS A VLAN, or virtual area network, is a subnetwork that groups together a collection of devices from different physical LANs. We talked about putting medical devices on designated VLANS and assigning an ACL Access Control List to limit what talks to the device and what the device talks to. You can even limit how the access takes place. This protection is very labor intensive as settings have to be done manually and must be continuously maintained and monitored. An update of security protocols on the switch can possibly disable the VLAN for a while until corrected. Devices on a VLAN are also able to be scanned by vulnerability products as well as system scanning tools. These can often knock systems of the network. FIREWALLS AND FIREWALLING DEVICES Firewalls are another form of protection. These have advanced from a simple device such as a Silex bridge to advanced systems where a small box is installed between the device and the network. This isolates the device from the network. These can be programed remotely to perform similar functions as the VLAN and ACL either singularly or in mass should the need arise. This requires a lot of upfront cost for the firewall boxes. It also requires work to install the devices which will require the creation of IPs and host names for each device. Once set up, it will allow remote access so that any changes needed due to vulnerabilities are done on the box eliminating anything being done on the device preventing the manufacturer’s OS and applications from being

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Joseph E. Fishel, CBET, MBA HTM Manager for Sutter Health eQuip Services touched. This also firewalls devices so they can’t be seen on the network as only the box can be seen. It also isolates the device from scans. SYSTEMS CONTROL ENGINES These are relatively new to the cyber scene. System Control Engines use machine learning to completely and continuously inspect and baseline the behavior of every device. It is able to provide security, ongoing management and optimization of all assets. It integrates with existing frameworks such as CMMS, ITSM, SIEM, NAC and firewalls. It eliminates the need to administer multiple, disparate systems. This includes identifying when new devices are put on the network and using artificial intelligence as well as what the devices could possibly be. The list of companies’ that provide this type of a system are growing. Some of the early developers for this technology are ORDR and Zingbox. Through the use of this technology you can gain remote isolation of the devices yet your devices can be seen on the network by your vulnerability scanning tool. Using any three of the above will give you mitigating controls to protect devices on the network.

NOVEMBER 2019

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EQUIPMENT PURCHASING DECISIONS SHOULD BE DRIVEN BY DATA BY MATT SPENCER

he improvement over time in medical technology, diagnostic, and therapeutic devices has been nothing short of amazing. Our country’s medical industry is the envy of the world, and for good reason. Medical device manufacturers invest tremendous resources to develop the latest machines to diagnose and treat patients. Of course, the latest and greatest technology comes with a hefty price tag.

The useful life of medical products varies greatly and depends on the environment and frequency of use. The severity of conditions will affect the longevity of equipment in any industry. A stretcher in a hospital may last longer than one on an ambulance. An AED on a fire engine may not last as long as one tucked safely in an office wall cabinet. Regardless, all devices should be inspected by a certified biomed at least annually. The results of these inspections should be diligently documented and organized in a way that is easily accessible by administrators. Each service event should be documented as well. Only cataloging equipment history can provide decision-makers a full picture of what has occurred to keep that device in working order, and the expense

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NOVEMBER 2019

incurred to maintain it. Much like the way your physician monitors your blood pressure and labs over the course of years to determine the best treatments, keeping an accurate log of a piece of equipment’s history is the only way to make an informed decision on when it is time to retire and replace a device. Nurses, doctors, EMTs and other medical professionals could use dozens of devices in the course of a day’s duties. In addition to caring for countless patients, how can these providers possibly be expected to remember what devices were serviced, and how frequently, over the previous 12 months? This is the responsibility of a robust asset management program and a competent, thorough biomedical service company. When it comes time to standardize your equipment, or simply evaluate ways to save money, a complete history on each device can allow you to make a quick and informed decision. A singular, downloadable report can serve as all the evidence needed to make the call to upgrade or replace a device. If the decision-maker can easily see the annual maintenance costs on a machine exceeded the cost of replacing it, the decision is simple. As groups expand and practices are acquired, the acquired offices typically come with equipment that may be

Matt Spencer President of Edge Biomedical

different than the mother ship normally purchases, and the past service could be inconsistent with the standards of the larger group. After a period of expansion, with several acquisitions, we have seen groups use data to determine the cost efficiency of standardization versus “run it until it quits.” No group or product is the same, but the one thing that never changes is the value of accurate, historical data to make the most cost-effective decision when it comes to your investment in the equipment you rely on to provide the best patient care. MATT SPENCER is the president of Edge Biomedical.

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THE FUTURE Fresh Blood

BY ROGER A. BOWLES, MS, EDD. CBET

ur last two fall semesters have been good as far as the number of incoming new students. This semester, fall 2019, the incoming group in our Biomedical Equipment Technology Program numbers is 54 students strong. This brings the total number of students in our program to about 150. We typically graduate about 40 to 50 entry-level BMETs a year. However, with the larger number of incoming students, the graduating groups should continue to grow.

With every Introduction class, I usually try to find out more about the students. For example, what led them to the career field, where they hope to work, etc. For such a large group, like we have this semester, it is a bit difficult. So, I thought I would administer a short, informal survey. The results are interesting on several fronts with the most interesting change being the average age of incoming students. Here is a quick rundown. Out of the 54 surveys administered, 47 were returned. Out of those 47 surveys, not every question was answered by every student. I’m sure they have their reasons. Of the 47 students submitting the survey, 38 of them are male, 6 are female, and 3 chose not to answer that question. Twenty-five of the students are between the ages of 18 and 20. Five are between the ages of 21 and 24. Five are between the ages of 25 and 29. And five are between the ages of 30 and 40. We have 3 students in this group between the ages of 40 and 50 and 1 student over the age of 60. Three students chose not to answer this question. This represents a bit of a trend shift from the past. Over the years, the

average age of our students has been between 28 and 30. We have never had this many in the 18 to 20 range. Before we enroll students in the program, we emphasize to each of them the need to be flexible about relocating as there are not many regular job openings in the Waco, Texas area. In the survey, I asked them about their willingness to relocate for a job. Thirty-four of the students indicated they are willing to relocate. Seven of the students said they would be willing to relocate for the right position and/or location. Six of the students said they are not willing to relocate. I plan on restating this requirement again in the class so there will be no misunderstandings. As for incoming education level, 33 of the students have a high school diploma. One student indicated “some college” before enrolling in our program. Nine students stated they already have an associate degree in a different career field. Two of the students have a bachelor’s degree. One student has a graduate level degree. One student did not answer. Three of the students indicated prior military service. Word of mouth in our career field must be pretty good … 25 out of the 47 students know someone who works as a BMET. Fifteen of them chose the field primarily based on recommendations of family or friends. Other popular reasons stated (and the number of students who stated it) for why they picked our line of work were, “because it’s hands on”(8), helping people (9), the job description itself and the environment (11), job security (3), good pay (3) and job stability (3). Most of these students are just now becoming familiar with the types of

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Roger A. Bowles

potential employers. In the introductory course, we explore in-house departments, independent service organizations (ISOs) and original equipment manufacturers (OEMs). Even though it is way too soon for them to make any decision about type of preferred employer, I threw it into the survey anyway. So far, 23 of the students indicated they would prefer to be in-house, 8 stated they were interested in working for an ISO and 6 preferred OEMs. Ten students left that question blank. I don’t blame them at this point. Another question on the survey asked them to state the number one thing they would be looking for in an employer. Here are some of the responses followed by the number of students who responded that way: good pay (12), job stability (9), potential for growth (9), good benefits (9), good work environment (4), respect (3), flexibility (3), happy co-workers (2) and professionalism (2). Some other answers included travel, job security, loyalty and training. Keep in mind that this survey was not scientific and the students are only in their second week of the program. I am curious to see how answers might change during their time in the program. That will probably be a future article!

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EXPERT ADVICE

THE OTHER SIDE A Lesson in Integration BY JIM FEDELE, CBET

t is amazing that in a relatively short time, we have become dependent on the connection of medical equipment to networks. I can easily remember a time that patient monitoring was either a stand-alone device or a simple system with a central station that combined a group of monitors together. Nurses printed reports and manually documented the vitals in the patient chart. Now equipment can be connected directly to the medical information system and be set up to automatically document in the record with just a click of the button. We recently transitioned to a new medical information system. In one very large project, we worked to connect as many devices as possible to the system. I would consider the energy and activity needed for preparation to be more involved than what we did for the Y2K transition. I learned a lot and think this is likely a scenario many other biomeds will be facing soon. So, I wanted to share a little of the experience.

The initial preparations for our project (to convert all six of our facilities) started over a year in advance. The IT team had a lot of work to do to identify and evaluate all our networks. They evaluated everything from the wireless infrastructure to the routers, switches and access points. For us, things did not get busy until we were about six weeks out. The integration team needed equipment inventories, to know which models we had and their age and condition. It was a mixed bag of equipment types and vintages over six facilities. However, the project team developed plans to replace and repurpose any equipment that couldn’t be connected to the new system. Three weeks before go live things became extremely busy. Our existing integrated monitoring systems needed a lot of work. Also, there was also not a good way to test the connection to the new

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NOVEMBER 2019

system. Since our monitoring systems were in use, we couldn’t just turn them off to make changes and see if it would work. This created quite the challenge for me and my team. We weren’t sure how the system was going to react when making changes. We also had to visit every piece of imaging equipment and change labels and settings on them, and then test. For imaging equipment, we were able to make changes to some equipment ahead of the go live day. I am glad we did because we found issues we had not thought about. Whenever I would try to help and make changes on equipment; it took hours to resolve as opposed to the minutes it should have taken. We had the full gamut of issues with our equipment from password access issues to equipment needing full operating system reloads after changes were made. When we got two weeks out, my team and I started meeting twice a week. We were brainstorming any issues that may not have been thought of or worked out. One big issue was how patient information was pulled into our monitoring system. We found that the monitor vendor and the new medical record team had not been working together to get that solved. From a task perspective, the problem is small and just needs some setting changes to point to the new system. I could not find the project manager that had this task on their list. After many emails, phone calls and pleas for attention, I finally got to the right person. They set it up 24 hours before the go live. As I am writing, we are now 48 hours past the go live and our systems are up and running. Issues have tapered off and there are just some minor problems that need attention. Here are a few things we did that I think were very helpful in preparation for our event. My team and I talked about this at every weekly staff meeting. I tried to over communicate it.

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

We listed all our equipment that was connected to the network and gathered as much network information as possible. We listed equipment and systems we knew were problematic and discussed them with the project managers. I met with nursing managers monthly and then weekly to walk through their work flow with equipment to identify any processes that would be affected by the change. We created a schedule to know what each tech was doing during go live and what time they would be doing it. We made changes ahead of go live on any system we could. We engaged our vendors at least two months before go live so they could schedule support. Some issues that were challenging specifically for me were getting purchase orders for vendor support and storing the large amounts of equipment that was needed to support the change. For instance, we received 20 pallets of EKG machines in one shipment that certainly would not fit in our shop. Currently, I feel confident stating this

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EXPERT ADVICE

was a successful project. My team was awesome. They worked hard supporting everyone with a smile on their face and a helpful attitude. They all rose to the occasion and in my mind made it look easy. Our vendors were also very helpful and did everything we asked and more. I feel that it is worth stating that for me this was an incredibly stressful project. In my mind, I had visions of the entire monitoring system not working, X-ray equipment crashing and computers needing to be replaced. I mention this to just say that our minds always make things worse than they are and don’t account for the teamwork and support that occurs during projects like this. I hope this is helpful and please feel free to contact me if you have questions. JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He magazines six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations. Send questions or comments to Editor@MDPublishing.com.

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ROMAN REVIEW Charisma BY MANNY ROMAN, CRES

on’t you just hate that guy who seems to be blessed with a magnetism that attracts everyone around him? When he walks in, he immediately becomes the focus of attention. He tends to dominate the conversation and no one seems to mind. He makes us want to be with him. He just has what is often referred to as charm or charisma.

Right now, name someone whom you feel is charismatic. Now tell yourself why you think so. What are the characteristics the person possesses that you consider him or her charming or charismatic. Hard to pin these down, right? We just know that we are drawn to them and we have difficulty describing why. By the way, the person does not have to be a good-guy to be charismatic, charismatic villains do exist. It is commonly thought that charisma is divinely awarded at birth, and it may be for some. Ancient Greeks described charisma as a gift of grace. Others have to work at it. Actually, charisma is a skill and like all behavior it can be learned. According to Olivia Fox Cabane in “The Charisma Myth” there are three pillars of charisma – Presence, Power and Warmth. These are three behaviors that will aid you in your charisma quest. Presence relates to being in the moment. Stay focused on what is transpiring right now in you interactions. Re-engage if you start to wander off. A great way to stay focused is to ask relevant clarification questions. Power relates to the removal of your fear that you are not worthy of the power and status that you have achieved. This apprehension has been called the “Impostor Syndrome” and is the thief of confidence. Warmth relates to a genuine

demonstration of kindness and acceptance of the other individual. To do this, even if you have just met, think about your own feelings of affection. This can change your body chemistry which will then radiate warmth. As in all interactions, communication is key. The skillful use of verbal and nonverbal skills is a major component of charisma. Another critical component of charisma is solid self-confidence. A critical element of self-confidence is a clear sense of purpose and motion in the right direction. A clear sense of purpose is based on personal satisfaction in what we do and why we do it. Since people are naturally attracted to confidence, to increase your charisma, increase your confidence. Ask charismatic people what makes them so and they will confidently deny that they are. Nothing projects charisma like confidence. Look closely at that guy and you will see an aura of confidence as he does what he is doing at that time. Charismatic leaders radiate confidence even during challenging times. Watch world leaders as they walk and talk and the common thread is confidence. Even when faced with adversity, they do not waver. This is how they project leadership charisma. So find a way to increase your self-confidence. Ask yourself what you can change to increase your sense of purpose and personal satisfaction. Decide to become more knowledgeable in your profession. Become more active in the industry. Enhance your social interactions. These items will increase your skills and sense of purpose, and your confidence. Purposely step outside your comfort zone. Use visualization and your mind. To the brain, there is little difference between real and imagined events and the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager

subconscious is always on autopilot in whatever search mode you program. This is why great athletes visualize every move necessary to win even before the event begins. This is why a speaker goes into the room before the audience to visualize himself giving a great speech. This is why businessmen plan. Napoleon Hill said, “Any ideas, plan, or purpose may be placed in the mind through repetition of thought.” Earl Nightingale said, “You become what you think about.” So start in you mind. Think about what will make you more charismatic and you will become more charismatic. Now the bad news: Although it is key, confidence alone is not enough. Ask the impressed group why a person is charismatic and they will tell you that they feel or fare better after interacting with “that guy”. That guy just acts like he is supposed to be doing what he is doing, and we receive something, even if intangible, from his presence. So charisma is obviously whatever others observe it to be. We need the presence of others to be charismatic. Charisma is a group of observable actions. Charisma, like leadership, is in the “eye of the beholder” and tends to be situational. “That guy” may actually look like a fool to some and, in the wrong situation, to most. Even I am not charismatic to everyone all the time. It’s a shame that those two people miss out.

NOVEMBER 2019

TECHNATION

BREAKROOM

DID YOU KNOW? Science Matters

Endoscope

Ultrasound and light see inside brain Researchers have found a way to use ultrasound to direct light through tissues to obtain images of the brain and other deep organs without breaking the skin.

Current, invasive endoscopy

uses a fiber-optical camera (endoscope) inserted through an incision (or down a channel such as the gut) to see area of interest

Surface endoscopy patch

Ultrasound-assisted optical imaging Works because laser light of correct wavelength can penetrate tissue

1 Patch transmits Light beam Ultrasound waves

very high-frequency sound waves (ultrasound) through skin and skull, into brain tissue

2 Patch receives

AREA OF INTEREST

echoes back from brain and is positioned over area of interest

3 Ultrasound creates lens

of tissue, more transparent to light than usual, that can focus light on area of interest

4 Light penetrates Source: Maysam Chamanzar of Carnegie Mellon University College of Engineering; Light: Science and Applications journal Graphic: Helen Lee McComas, Tribune News Service

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NOVEMBER 2019

several centimeters of skull and brain tissue without causing injury

Reflected light is captured, creating image of area inside brain

WWW.1TECHNATION.COM

BREAKROOM

THE VAULT

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/ vault-november-2019. Good luck!

SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing.com and you could win a $25 Amazon gift card courtesy of TechNation!

CONGRATULATIONS! JEFF BECK, BIOMEDICAL EQUIPMENT SUPERVISOR OF SUBURBAN HOSPITAL, IS SEPTEMBER’S WINNER!

OCTOBER PHOTO

SEPTEMBER WINNER

Sterilizer

Jeff Beck, Biomedical Equipment Supervisor, Suburban Hospital

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

NOVEMBER 2019

TECHNATION

BREAKROOM

BULLETIN BOARD

n online resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.

Career Opportunities CONTINUING EDUCA TION

Visit www.MedWrench.c om/BulletinBoard for m ore details and to register for these upcoming classes .

Decembe r 9, 2019 - Tri BMET to Im Imaging Solutions: aging 2

Reference the career section: https://www.medwrench.com/bulletin-board/careers

Company: Exclusive Medical Solutions Position Title: Field Service Engineer Description: Exclusive Medical Solutions was created by a group of experienced Field Service Engineers. Ask how you can be part of the team! More info on how to apply here:Â http://bit.ly/EMSFieldServiceEngineer

December 9-13, 2019 RSTI: Basics of Networking for Service En gineers

TECHNATION

023, 202 February quipment 3 1 ry Janua dical E al iomedic of Biome College AAS Degree - B gy: ician Technolo uipment Techn Eq

NOVEMBER 2019

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BREAKROOM

Follow Ben Calibrating!

STRESS MANAGEMENT FOR HTMs

BMETs are like everyone else. We are not immune to stress. I say this as I am in one of the highest stressed times of the year at my position and I have not been following my own advice for mana ging stress. Sometimes I must remind myself to manage my own physical and mental health. With “do more with less” becoming more common, it is especially important to take care of yourself. You can never eliminate your job stress, but you can manage it so that it doesn’t negatively impact your job performan ce, health, or personal relationships. Someone once told me, “The hospital was here before you got here and it will be here after you leave. Don’t put it all on your shoulders.”

ow Want to kn C. is? n where Be on Follow us Facebook nch and @MedWre ge! like our pa

Read more here: http://bit.ly/MWBlogStressMan agement

9 1 0 2 R E B M E N OV 1

Independence Day

Daylight Saving Time ends

Veteran’s Day

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Thanksgiving Day

NOVEMBER 2019

TECHNATION

SERVICE INDEX TRAINING

www.ambickford.com • 800-795-3062

RepairMED www.repairmed.net • 855-813-8100

SPBS, Inc www.spbs.com/ • (800) 713-2396

USOC Bio-Medical Services www.usocmedical.com • 855-888-8762

67 39 7

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Asset Management EQ2 www.eq2llc.com • 888-312-4367

Injector Support and Service

www.injectorsupport.com • 888-667-1062

International X-Ray Brokers

KEI Med Parts www.keimedparts.com • 512-477-1500

RSTI www.rsti-training.com • 800-229-7784

acelamedical.com • 770.371.8661

ALCO Sales & Service Co. www.alcosales.com • 800-323-4282

BC Group International, Inc www.BCGroupStore.com • 314-638-3800

Biomedical Repair & Consulting Services, Inc. www.brcsrepair.com • 844-656-9418

Crothall Healthcare Technology Solutions www.crothall.com • (800) 447-4476

InterMed Group www.intermed1.com • 386-462-5220

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

PRN/ Physician’s Resource Network www.prnwebsite.com • 508-679-6185

ReNew Biomedical www.ReNewBiomedical.com • 844-425-0987

RepairMED www.repairmed.net • 855-813-8100

SPBS, Inc www.spbs.com/ • (800) 713-2396

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37 BC 46

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64 71

P P P

61 21

P P

46 67

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Cardiac Monitoring Cardiotronix CARDIOTRONIXHEALTH.COM • (855)-4DEFIBS

Coro Medical www.coromed.us • 800-695-1209

sebiomedical.com/ • 828-396-6010

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

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Tri-Imaging Solutions

Medzon medzonhealth.com • 949-393-0330

NOVEMBER 2019

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14-15

Contrast Media Injectors Injector Support and Service www.injectorsupport.com • 888-667-1062

IntraServ Biomedical LLC www.intraservbiomedical.com • 980-269-5787

Maull Biomedical Training www.maullbiomedicaltraining.com • 440-724-7511

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P P P

Defibrillator Cardiotronix CARDIOTRONIXHEALTH.COM • (855)-4DEFIBS

Coro Medical www.coromed.us • 800-695-1209

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Diagnostic Imaging Avante Health Solutions avantehs.com •

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

International X-Ray Brokers internationalxraybrokers.com/ •

Cadmet www.cadmet.com • 800-543-7282

Healthmark Industries HMARK.COM • 800-521-6224

Multimedical Systems

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www.multimedicalsystems.com • 888-532-8056

P P

www.prnwebsite.com • 508-679-6185

PRN/ Physician’s Resource Network

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17 61 21

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Fetal Monitoring Multimedical Systems

www.eq2llc.com • 888-312-4367

Consultancy

CMMS EQ2

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Endoscopy 71

Cardiology Southeastern Biomedical, Inc

www.rtigroup.com • 800-222-7537 www.triimaging.com • 855-401-4888

Acela Medical

internationalxraybrokers.com/ •

RTI Electronics

Biomedical

TECHNATION

SERVICE

Computed Tomography

A.M. Bickford

PARTS

Anesthesia

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

www.multimedicalsystems.com • 888-532-8056

WWW.1TECHNATION.COM

SERVICE INDEX CONT. Monitors/CRTs 46

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Ampronix, Inc. BMES

ALCO Sales & Service Co.

www.bmesco.com • 888-828-2637

www.inrayparts.com • 417-597-4702

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Healthmark Industries HMARK.COM • 800-521-6224

Infusion Pumps AIV aiv-inc.com • 888-656-0755

Coro Medical www.coromed.us • 800-695-1209

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

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33 61

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aiv-inc.com • 888-656-0755

RepairMED www.repairmed.net • 855-813-8100

Select BioMedical www.selectpos.com • 866-559-3500

USOC Bio-Medical Services www.usocmedical.com • 855-888-8762

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67 22 7

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IV Pumps SPBS, Inc www.spbs.com/ • (800) 713-2396

Innovatus Imaging KEI Med Parts www.keimedparts.com • 512-477-1500

InterMed Group www.intermed1.com • 386-462-5220

Adel Lawrence Associates www.adel-lawrence.com • 866-252-5621

MedWrench Webinar Wednesday www.1technation.com/webinars • 800-906-3373

RSTI www.rsti-training.com • 800-229-7784

AIV aiv-inc.com • 888-656-0755 www.ampronix.com • 800-400-7972

Avante Health Solutions

Ozark Biomedical SPBS, Inc www.spbs.com/ • (800) 713-2396

Mammography Ampronix, Inc. www.ampronix.com • 800-400-7972

International X-Ray Brokers internationalxraybrokers.com/ •

RSTI www.rsti-training.com • 800-229-7784

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35 23

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Monitors Select BioMedical www.selectpos.com • 866-559-3500

www.brcsrepair.com • 844-656-9418

BMES www.bmesco.com • 888-828-2637

Coro Medical PRN/ Physician’s Resource Network www.prnwebsite.com • 508-679-6185

ReNew Biomedical www.ReNewBiomedical.com • 844-425-0987

RepairMED www.repairmed.net • 855-813-8100

Southeastern Biomedical, Inc 22

sebiomedical.com/ • 828-396-6010

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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64 24-25, 48

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www.coromed.us • 800-695-1209

P P

Patient Monitoring

Biomedical Repair & Consulting Services, Inc.

P P

PACS

avantehs.com •

Online Resource

Labratory www.ozarkbiomedical.com • 800-457-7576

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Nuclear Medicine

Ampronix, Inc. 39

MRI

www.MedWrench.com • 866-989-7057

Infusion Therapy AIV

USOC Bio-Medical Services

www.innovatusimaging.com • 844-687-5100

Infection Control

P P

www.usocmedical.com • 855-888-8762

Hand Switches inRayParts.com

www.ampronix.com • 800-400-7972

General www.alcosales.com • 800-323-4282

TRAINING

www.brcsrepair.com • 844-656-9418

SERVICE

Biomedical Repair & Consulting Services, Inc.

PARTS

Gas Monitors

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

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NOVEMBER 2019

TECHNATION

SERVICE INDEX CONT. acelamedical.com • 770.371.8661

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

P P

Acela Medical acelamedical.com • 770.371.8661

SPBS, Inc www.spbs.com/ • (800) 713-2396

P P

Surgical

inRayParts.com www.inrayparts.com • 417-597-4702

P P

Power System Components Interpower www.interpower.com • 800-662-2290

Healthmark Industries HMARK.COM • 800-521-6224

Tables IBC

Radiology

Acela Medical acelamedical.com • 770.371.8661

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Telemetry

Ampronix, Inc. www.ampronix.com • 800-400-7972

RSTI www.rsti-training.com • 800-229-7784

4 23

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Recruiting

AIV aiv-inc.com • 888-656-0755

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

Biomedical Repair & Consulting Services, Inc.

Adel Lawrence Associates www.adel-lawrence.com • 866-252-5621

Stephens International Recruiting Inc. www.bmets-usa.com/ • 870-431-5485

64 72

www.brcsrepair.com • 844-656-9418

BMES www.bmesco.com • 888-828-2637

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

Refurbish

ReNew Biomedical

AIV aiv-inc.com • 888-656-0755

www.ReNewBiomedical.com • 844-425-0987

RepairMED

Rental/Leasing Avante Health Solutions avantehs.com •

www.repairmed.net • 855-813-8100

Repair

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

USOC Bio-Medical Services

Acela Medical acelamedical.com • 770.371.8661

ALCO Sales & Service Co. www.alcosales.com • 800-323-4282

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

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Engineering Services, KCS Inc www.eng-services.com • 888-364-7782x11

www.usocmedical.com • 855-888-8762

A.M. Bickford www.ambickford.com • 800-795-3062

P P

BC Group International, Inc

P P

PRN/ Physician’s Resource Network

www.BCGroupStore.com • 314-638-3800 www.prnwebsite.com • 508-679-6185

Pronk Technologies, Inc. 6

Respiratory

www.pronktech.com • 800-609-9802

Radcal Corporation www.radcal.com • 800-423-7169

A.M. Bickford www.ambickford.com • 800-795-3062

Software

RTI Electronics www.rtigroup.com • 800-222-7537

Southeastern Biomedical, Inc

EQ2 www.eq2llc.com • 888-312-4367

NOVEMBER 2019

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Test Equipment

Replacement Parts

TECHNATION

Sterilizers

Portable X-ray

TRAINING

Acela Medical

www.goaims.com • 800-541-2467

SERVICE

Patient Monitors

Phoenix Data Systems

PARTS

P P

Company Info

AD PAGE

TRAINING

SERVICE

www.usocmedical.com • 855-888-8762

PARTS

USOC Bio-Medical Services

AD PAGE

Company Info

sebiomedical.com/ • 828-396-6010

43 BC

P P

5 72 67 68

P P

WWW.1TECHNATION.COM

SERVICE INDEX CONT. TRAINING

SERVICE

PARTS

AD PAGE

Company Info

ALPHABETICAL INDEX

Training Adel Lawrence Associates www.adel-lawrence.com • 866-252-5621

College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027

ECRI Institute www.ecri.org • 1-610-825-6000.

IntraServ Biomedical LLC www.intraservbiomedical.com • 980-269-5787

RSTI www.rsti-training.com • 800-229-7784

Tri-Imaging Solutions www.triimaging.com • 855-401-4888

64 11

Tubes/Bulbs Cadmet www.cadmet.com • 800-543-7282

Tri-Imaging Solutions www.triimaging.com • 855-401-4888

P P

Ultrasound Ampronix, Inc. www.ampronix.com • 800-400-7972

Avante Health Solutions avantehs.com •

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

Innovatus Imaging www.innovatusimaging.com • 844-687-5100

Ventilators Cardiotronix CARDIOTRONIXHEALTH.COM • (855)-4DEFIBS

SPBS, Inc www.spbs.com/ • (800) 713-2396

P P

X-Ray Engineering Services, KCS Inc www.eng-services.com • 888-364-7782x11

Innovatus Imaging www.innovatusimaging.com • 844-687-5100

InterMed Group www.intermed1.com • 386-462-5220

International X-Ray Brokers internationalxraybrokers.com/ •

RSTI www.rsti-training.com • 800-229-7784

RTI Electronics www.rtigroup.com • 800-222-7537

Tri-Imaging Solutions www.triimaging.com • 855-401-4888

8 71

P P P

35 23

P P P

67 26

P P P

A.M. Bickford………………………… 43 Acela Medical………………………… 29 Adel Lawrence Associates…………… 64 AIV…………………………………… 31 ALCO Sales & Service Co…………… 37 Ampronix, Inc.…………………………… 4 Avante Health Solutions………………… 2 Avante Patient Monitoring…………… 27 Avante Ultrasound…………………… 55 BC Group International, Inc………… BC Biomedical Repair & Consulting Services, Inc.………………………… 46 BMES………………………………… 16 Cadmet……………………………… 16 Cardiotronix………………………… 71 College of Biomedical Equipment Technology…………………………… 11 Coro Medical………………………… 33 Crothall Healthcare Technology Solutions…64 ECRI Institute………………………… 54 Engineering Services, KCS Inc………… 6 EQ2…………………………………… 22 Healthmark Industries……………… 17 Injector Support and Service………… 63 Innovatus Imaging……………………… 8 inRayParts.com……………………… 39 InterMed Group……………………… 71 International X-Ray Brokers………… 35 Interpower…………………………… IBC IntraServ Biomedical LLC…………… 37 KEI Med Parts………………………… 43 Maull Biomedical Training…………… 35 MedWrench………………… 24-25, 48 Medzon…………………………… 14-15 Multimedical Systems……………… 61 Ozark Biomedical…………………… 68 Phoenix Data Systems……………… 61 PRN/ Physician’s Resource Network… 21 Pronk Technologies, Inc. ……………… 5 Radcal Corporation…………………… 72 ReNew Biomedical…………………… 46 RepairMED…………………………… 67 RSTI…………………………………… 23 RTI Electronics……………………… 67 Select BioMedical…………………… 22 Southeastern Biomedical, Inc……… 68 Southwestern Biomedical Electronics, Inc.… 3 SPBS, Inc…………………………… 39 Stephens International Recruiting Inc.… 72 Tri-Imaging Solutions………………… 26 USOC Bio-Medical Services…………… 7 Webinar Wednesday………………… 41

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

NOVEMBER 2019

TECHNATION

BREAKROOM

FLASHBACK MD Expo April 2009

2009 marked the first year MD Expo held dual shows in the same year when MD Expo Spring was launched in beautiful Scottsdale, Arizona.

d the spon sore Im aging st Fiest a . e r u u q o n Co e Fin al F th t, n e ev m arquis

t he r prese n ares to p e alue” r V p g r por tin aninge e W R n d e n r ga Ka ea surin o n “M session

The exhibit hall was fille d w ith incred ve ndors who ible still suppor t M D E xpo to this day! uis event , Conquest Imaging spon sored the marq -Shot Pop-A the Final Four Fiest a complete with dees. atten for challenges

TECHNATION

NOVEMBER 2019

T he e xhibit w ith in hall w credib a s fille le ve n d s u p po d o rs w rt M D ho stil E x po l to this d a y!

, Dave Lamoureux Chris Con e of Echose rve ore of Sonora of GM I and G. Wayne Mo festivities. the yed enjo Medic al System s

WWW.1TECHNATION.COM

Made Your Way and Made in the U.S.A. Advocate, support, and empower good health. Interpower® can make hospital-grade cords to your specifications. Made in the U.S.A., value-added options are available, such as specialized labeling. It is important to know some countries have medical requirements, while others have recommendations. In addition, some select hospitals have requirements that they choose to follow specific to their facility. Special consideration is needed for products to be used in Australia, Canada, Denmark, Japan, and the United States.

Contact Customer Service for More Information • Made in U.S.A. • 1-week U.S. manufacturing lead-time on non-stock Interpower products • Same day shipping on in-stock products • Blanket or scheduled orders available • No minimum order or dollar requirements • Value-added options

Order Online! www.interpower.com

Business Hours: 7 a.m.–6 p.m. Central Time

NEW AA-8100 Anesthetic A g e n t A n a ly z e r

A Standalone Unit with Bluetooth Compatibility - Control Directly From Your Smartphone! Upgrade your Anesthetic Agent Testing with the NEW AA-8100! The AA-8100 adds Auto Agent ID, Bluetooth, iOS and Android Apps, CO2 Gas Analysis and 100 DUT Tags - downloadable from a PC, tablet or smartphone. It was designed to meet the demand for a more advanced, small, easy to use unit with high reliability and accuracy. Utilizing proprietary state-of-the-art digital NDIR (Non-Dispersive Infrared) Technology it provides a cost effective, high function, microprocessor-based analyzer that is simple to operate while maintaining high performance and accuracy.

AA-8100

AA-8100 Features: • Auto Agent ID • Bluetooth • iOS and Android Apps myBC_Mobile • 100 Downloadable DUT Tag Fields • State-of-the-art NDIR (Non-Dispersive Infrared) Technology • Measures 4 Anesthetic Agent Gases: • Sevoflurane, Isoflurane, Desflurane, Halothane • Measures CO2 • Small, Portable unit with adjustable Handle/Stand • Large Graphical Display with Backlight • User Friendly Interface: • One Button or Auto Agent Select • One Button Sample (Pump) Control

SCREEN VIEWS

Manual Data Reading of Isoflurane

Automatic Agent Selection: Sevoflurane

Download myBC_Mobile for your iOS or Android Device

Automatic Data Logging of Halothane Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited