ICE Magazine - December 2019

ADVANCING THE IMAGING PROFESSIONAL

DECEMBER 2019 VOL.3 NO.12 THEICECOMMUNITY.COM

YESTERDAY, TODAY & TOMORROW THE EVOLUTION OF DIAGNOSTIC IMAGING

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Insight

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IMAGING ENGINEERS At Tri-Imaging Solutions, we strive to live up to our name and be a Solution for our Customers and ultimately, helping to Empower the EngineerTM

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contents

ICE FEATURES

DECEMBER 2019

“I’ve had to evolve over the process of not knowing very much in the way of networking at all to ‘I’ve got to know this”

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rofessional P 26 Spotlight

Yesterday, Today & Tomorrow

The evolution of diagnostic imaging can be seen in the imaging

Peter Nerat is a talented

equipment, new processes, changes to reimbursements and the

diagnostic imaging engineer

tools used to maintain and repair these high-tech devices. We

specialist with HonorHealth.

check in with experts and share their insights regarding the past,

He is also a people person who

present and future of imaging in the health care setting.

turned a casual interaction at a MIlwaukee Brewers game into a wonderful career opportunity.

ISS / Injector Support & Service Injector Support and Service LLC (ISS) began operations in 2011. By teaming up with other third-party service providers and in-house biomed staff, many of which were already managing the injectors, ISS has been able to essentially create a virtual team of over 1,000 engineers and service technicians who support injectors across the nation.

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ADVANCING THE IMAGING PROFESSIONAL

contents

ICE DEPARTMENTS

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32

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DECEMBER 2019

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news

people

products

insight

9 ICE 2020

26 Professional Spotlight

44 Corporate Profile: Injector Support & Service

10 Company Showcase: Medzon

28 Department Spotlight

31 Contrast Injector Spotlight 32 Contrast Injector Gallery

13 Imaging News

36 Solutions Guide

22 People on the Move

39 Tools of the Trade

48 Career Center 51 Imaging Matters 52 Conflict Resolution 201 54 Index

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ICE2020 IMAGING CONFERENCE & EXPO

FEBRUARY 9-11, 2020

Scottsdale, AZ

COOL PRIZES AWAIT ICE ATTENDEES Staff report

T

he Imaging Conference and Expo (ICE) is excited to make its way to Scottsdale, Arizona in February 2020.

The beautiful Hilton Scottsdale Resort & Villas will be the hub for imaging professionals from across the country to gather for three days of networking, education and exhibit hall access. Get ready to soak up the sun with colleagues in Scottsdale, Arizona by registering today.

A current early bird promotion means three lucky attendees will win great prizes.

Everyone who registers before December 12th will be entered to win a pair of RayBan sunglasses (up to $100 value). Those who register before January 9, 2020 will be eligible to win Apple AirPods. The grand prize, for one lucky attendee who registers before January 30, 2020, is a three-night stay at the Hilton Scottsdale Resort & Villas during the conference.

Attendees also have the opportunity to win one of several prizes valued at more than $100 during the exhibit hall raffle.

This raffle is a great way for attendees to get to know more about many of the different companies exhibiting at the conference, make new contacts and take home a valuable prize.

Every attendee will be a winner with exceptional education, amazing networking opportunities, a fun atmosphere and an exhibit hall featuring the latest and greatest products and solutions for imaging professionals.

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Education ICE offers valuable continuing education certification from ASRT. Building on the success of previous conferences, ICE offers world-class presentations and instructors.

It offers complimentary admission for all hospital employees.

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

Fun The conference’s unique atmosphere and signature events provide ideal venues for fun while also boosting one’s education, adding industry-leading professionals to your list of contacts and creating lifelong friendships with colleagues throughout the nation.

Exhibit Hall Don’t miss the opportunity to interact with some of the industry’s leading companies all in one place. Representatives will be available at each booth to help you perform your roles and responsibilities even better when you return to work. ICE Register today at AttendICE.com/Register.

ICE2020 IMAGING CONFERENCE & EXPO

FEBRUARY 9-11, 2020

Scottsdale, AZ

Early Bi rd prizes REGISTER EARLY FOR MORE CHANCES TO WIN!

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COMPANY SHOWCASE

MEDZON M

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. ICE 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 that encompasses all types of services to unlock the full

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ICEMAGAZINE | DECEMBER 2019

potential of medical equipment, Medzon became the go-to company that can solve most issues in a hospital.

Dr. Abdul Alsaadi CEO of Medzon

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?

ADVANCING THE IMAGING PROFESSIONAL

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A: Medzon consults and creates procedures to reduce operating cost for the hospital by up to 30% annually.

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?

company showcase

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: 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.

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:

Q:

A: Our facility consists of the following teams – Innovation, IT, Engineers, Population Officers, Supply chain, etc. The team works together and shares feedback with management to present the best solution to offer to the hospital that we evaluated.

A: Yes, there are three areas that Medzon can add value: 1. Service Value • Medical Equipment Planning: Guarantee a hospital procures the right equipment from the right Original Equipment Manufacturer (OEM), taking into consideration 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

Can you describe your company’s facility?

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.

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

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-ofthe-art 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. ICE For more information, visit medzonhealth.com.

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Introducing A complete solution for CT and fluoroscopy dose optimization and compliance OPTIMIZE enhances your productivity by automating data collection and providing in-depth analysis so can you focus on patient care and throughput

Easy Setup LANDAUER prepares everything according to your specifications for automated protocol mapping

Robust Technology View your data—from all scanner types—through the power of artificial intelligence for continuous improvement

Professional Monitoring We analyze your data, review dose incidents and notify you if incidents are detected that require immediate attention. You have unlimited access to LANDAUER medical physicists

To learn more visit landauer.com/OPTIMIZE

news

IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

BWXT to Produce Medical Radioisotope Germanium-68 BWX Technologies Inc. (BWXT) plans to produce the medical radioisotope Germanium-68 (Ge-68) with a focus on addressing a growing global demand for the product.

BWXT’s isotope technologies group in Canada has developed proprietary manufacturing technology to produce high purity Ge68 and is in the process of scaling up its capacity to move into full production in 2020 to address growing global customer demands.

Ge-68 will be produced using cyclotrons at BWXT’s Vancouver facility located on the TRIUMF site. TRIUMF, which is Canada’s particle accelerator center, and BWXT’s medical isotopes group have been working together to support medical isotope production for over 40 years.

BWXT’s Ge-68 product will be used in Gallium-68 (Ga-68) generators, a source of the diagnostic radioisotope Ga-68. Using specific disease-targeting molecules, Ga-68 provides diagnoses and enables treatment planning using positron emission tomography (PET).

Diagnostic applications for Ga-68 include prostate cancer and neuroendocrine tumors. In addition, a number of other thera-

peutic and Ga-68 imaging agents are in various stages of development and clinical trials that are expected to result in a further increase in demand for Ga-68.

“BWXT is in an excellent position to be able to respond to the market’s growing demand for this critical radioisotope,” said Rex D. Geveden, BWXT’s president and chief executive officer. “We acquired the medical isotope business just over a year ago, and we are very pleased with this business and its growing portfolio of products.”

“BWXT’s isotope technologies group has had a very productive year and we are excited to announce the upcoming supply of Ge-68,” said Tom Burnett, BWXT ITG Canada Inc.’s vice president and general manager. “We will continue our strategy of advancing innovation and bringing new products to market to enable reliable supply.”

“TRIUMF and BWXT collaborate to enable the development and ongoing supply of crucial medical isotopes around the world,” said Kathryn Hayashi, CEO of TRIUMF Innovations, the commercialization arm for TRIUMF. “We look forward to supplying this critical isotope to a growing global market.” •

First U.S. Installation of Multix Impact Announced DHR Health in Edinburg, Texas, recently became the first health care facility in the United States to install the Multix Impact, an affordably priced, floor-mounted digital radiography (DR) system from Siemens Healthineers that expands access to high-quality imaging and enhances the patient experience.

The Multix Impact is distinguished in part by its intuitive operating system, versatile wireless detectors, and free-floating, flat tabletop, which enables easy patient access, according to a press release. The touch user interface on the system’s X-ray tube permits the technologist to remain by the patient’s side for longer periods of time. And when in the control room, the technologist can utilize the patient positioning camera to continuously monitor the patient, potentially reducing repeat imaging and avoiding excessive patient dose. The Multix Impact also has an intuitive

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user interface with graphical organ program selection as well as a patient positioning guide on the in-room touchscreen and control room workstation.

“We’re a growing health care system that’s focused sharply on quality care, innovation and patient comfort,” said Melissa Peña-Flores, vice president of imaging services at DHR Health.

“We needed an X-ray system that delivered the most advanced technology that our budget would allow. The Multix Impact is a perfect fit because it helps us deliver on our patient-first mission.”

“Siemens Healthineers is proud to provide DHR Health with the Multix Impact, a competitively priced, floor-mounted DR system that offers patients greater access to state-of-the-art imaging while making X-ray exams comfortable,” said Niral Patel, vice president of X-ray products at Siemens Healthineers North America. •

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news THE WORLD MOVES FAST. WE MOVE FASTER.™

626 Receives ISO 13485:2016 Certification

NYC Health + Hospitals Invests Millions to Upgrade Imaging Technology NYC Health + Hospitals announced that it is investing $224 million over 10 years to upgrade medical imaging technology system-wide. Across the NYC Health + Hospitals system, there are 470 imaging machines, and they are used to screen, diagnose and treat numerous disease states. Within the first four years, 230 medical imaging machines will be updated, including MRI, CT, nuclear cameras, X-ray machines, catheterization labs, PET/PETCT machines and fluoroscopy units. The new equipment, supplied under contract with GE Healthcare, will support the public health system’s goal of standardizing care and providing patients modernized, state-of-the-art technology that will produce faster and better image quality, and lead to quicker diagnoses and treatment for patients.

“At NYC Health + Hospitals, we are making investments that will improve patient experience and provide the highest quality of care, diagnosis and treatment for all New Yorkers,” said Mitchell Katz, MD, president and CEO of NYC Health + Hospitals. “We’re standardizing our technology to offer patients the same quality of care regardless of what facility they visit.”

“GE Healthcare is honored to work alongside NYC Health + Hospitals in its mission to improve patient care and clinical outcomes for the people of New York,” said Everett Cunningham, president and CEO of GE Healthcare, U.S. and Canada.

“Providing premium care to a growing patient population continues to be challenging in today’s health care environment.

This relationship will provide both clinicians and patients access to the latest imaging technology while helping NYC Health + Hospitals meet its goals of reducing costs, increasing hospital efficiency, enhancing clinical quality and improving patient experience.”

The investment and partnership with GE Healthcare will standardize and modernize the imaging equipment for the city’s public health system. This partnership will also modernize and streamline the capital imaging equipment planning and replacement process.

Of the total investment, $20 million has already been allocated for NYC Health + Hospitals/Coney Island, which is undergoing renovations as part of its Hurricane Sandy recovery project. The hospital will receive 47 new imaging machines, including ultrasounds, MRI and a variety of X-ray units.

NYC Health + Hospitals has 89,000 pieces of medical equipment, ranging from low-complexity equipment to sophisticated imaging and operating room equipment. NYC Health + Hospitals performs 1.5 million imaging procedures each year. •

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626 has received ISO 13485:2016 certification from SAI Global, which is backed by Exemplar Global. The HTM company began the certification process in November of 2018 and completed it in September of this year.

The International Organization for Standardization (ISO) is the world’s largest developer and publisher of international standards for the implementations of QMSs and various other technical and operation standards.

626 Director of Quality Lyndsey Natterer noted that one of the reasons 626 decided to achieve this certification was due to the company’s passion for continuous improvement and quality.

“Becoming ISO certified was the best way to demonstrate our commitment to the gold standard of our industry,” Natterer said.

For Natterer and the rest of 626, this new certification has significant benefits for the company and customers. This new certification as well as 626’s overall company wide commitment are geared toward patient safety and quality.

“The professional in me appreciates the metrics and stringency of the standard, while the patient in me appreciates the focus on patient safety and customer satisfaction,” Natterer stated. “I am very proud to work for a company who is so like-minded and takes every aspect seriously.”

Natterer emphasized how customer satisfaction equals patient safety. Some safety measures are written within the ISO standard, such as making sure the dose meters for the X-rays are calibrated and writing down the serial numbers of any device used in field service reports.

“Certain customers expect some sort of quality program as a minimum requirement for their servicing companies,” added Natterer. “While we have always been a quality-driven company, our customers can sleep better at night knowing that we run our service business to this gold standard.”

626’s new achievement is opening a lot of doors for the company.

“Our processes have become more robust and will continue to be scrutinized and re-visited to ensure the utmost efficiency and while maintaining the utmost quality,” said Natterer. “It has kind of geared everyone’s thinking to remember that we are all here for a patient. Some of us might not even encounter or talk to a patient, but we can all affect patient safety. We can make an impact from an entry-level employee all the way up to the CEO.” 626 CEO Philip Revien had positive words to say about the ISO 13485:2016 certification.

“We achieved ISO together,” Revien said. “It not only made us better, but it also brought us together. It was awesome to be a part of this process and to witness the successful conclusion. I am beyond proud of my team.” •

ADVANCING THE IMAGING PROFESSIONAL

news

Hyperfine, Yale School of Medicine Collaborate on Portable MRI Technology Hyperfine Research Inc. has announced its collaboration with the Yale School of Medicine to pioneer the use of the world’s first portable, low-cost magnetic resonance imaging (MRI) system at the bedside of patients in the neuro intensive care unit of Yale New Haven Hospital. Hyperfine’s system can move directly to the bedside, plug into a wall outlet and operate in any health care setting. In inventing Point-of-Care (POC) MRI, Hyperfine aims to make MRI accessible and available anywhere, anytime, to any patient who needs it.

Yale New Haven Hospital (YNHH) is the first hospital to use the Hyperfine POC MRI system on patients, as part of a twoyear study in conjunction with the American Heart Association. This study aims to overcome barriers that have prevented the routine use of MRI on unstable neurology intensive care unit patients who cannot be transported.

“The MRI systems we currently use around the world require a strict, limited access environment due to their highfield magnet design,” said Kevin N. Sheth, M.D., professor of neurology and neurosurgery. “The result is that we’ve taken a very safe technology and made it very difficult for patients and clinicians to access it. I’m excited to be part of a project that is finding a way to bring MRI to patients in a feasible, safe and efficient way. The availability and accessibility of a portable MRI scanner has allowed us to test some patients with multiple MRI exams over a time span of hours to days.

This could open up a new level of access to the rich data MRI brings, and that could have a significant impact on how we care for patients.”

Hyperfine Portable POC MRI Device is currently 510(k)-pending and not available for sale in the U.S. •

IS HIRING! Multiple locations and positions Growth opportunities Competitive salary FUN culture and more!

Visit WeAre626.com/Careers WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

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news ICH Software to be Integrated on Philips CT Systems

Company Launches Second-Generation Ultra Portable Wireless Scanners Clarius Mobile Health has launched its second-generation series of wireless ultrasound scanners, putting the power and image quality of larger, more expensive systems in an affordable device that fits in a pocket.

“Handheld ultrasound is revolutionizing the delivery of patient care,” said Clarius CEO Laurent Pelissier, whose company pioneered handheld ultrasound devices with its first release in 2016. Pelissier said there are 25 million medical professionals globally who don’t have access to medical imaging.

“They are trying to guess what’s happening inside the patient – such as during labor and delivery in underserved communities, or knowing where to inject pain management medication, or for paramedics being able to determine internal bleeding at the accident site,” he said. “We are taking the high performance only found in expensive, high-end machines and making it available to the mainstream medical community to use anytime, anywhere.”

Until now, shrinking the size and price of portable ultrasounds has meant compromising performance and image quality. Clarius’s second-generation devices, almost half the size of the original devices, have eight times the processing power of most handheld scanners, resulting in faster imaging with higher resolution and more detail.

“Doctors are making health care decisions for their patients,” said Pelissier. “They need an image they can trust.”

The new line up, which includes two multi-purpose scanners and four scanners dedicated to specialities such as sports medicine and anesthesia, delivers the performance of a $25,000 scanner at a lower price. •

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MaxQ AI announced that the company’s Accipio intracranial hemorrhage (ICH) and stroke software will be integrated on Philips’ computed tomography (CT) systems. The integration of Accipio’s AI-powered solutions into Philips CT systems will support the detection of ICH to augment caregivers in identifying and prioritizing patients suffering from stroke, traumatic brain injury, head trauma and other life-threatening conditions.

MaxQ AI’s ACCIPIO ICH and Stroke Platform utilizes deep learning technologies to analyze medical imaging data such as non-contrast head CT images. The results provide deep clinical insight and actionable data in minutes that will enable physicians across the world to make faster assessments in any location, at any time. Accipio Ix enables automatic identification and prioritization of non-contrast head CT images with suspected ICH. Accipio Ax provides automatic slice-level annotation of suspected ICH. Both Accipio Ix and Ax are FDA cleared and CE approved.

The Accipio platform will be available with new Philips CT systems and as an upgrade to previously installed Philips CT systems throughout U.S. and E.U. markets. The first deployments are expected to take place in 2020. •

Sectra Highlights Amplified Radiology Efficiency at RSNA 2019 In booth #6113 at the 2019 Radiological Society of North America (RSNA) annual meeting, the international medical imaging IT and cybersecurity company Sectra will showcase its complete enterprise imaging offering – including the latest advancements within AI and workflow orchestration – that empowers radiologists to accomplish more in less time.

“New technology and ways of thinking are reshaping the imaging landscape, enabling health care providers equipped with the right technology and skills to compete not only on price, but on the value and level of service they provide,” says Fredrik Gustavsson, Sectra chief technology officer.

In early October, Sectra published “The radiologist’s handbook for future excellence 2020: Four technologies to amplify success,” providing guidance on key technologies within four areas that will enhance radiologists’ skills, scope and ability to cope with future demands and to spend their time more wisely. These technology areas – workflow orchestration, artificial intelligence (AI), multiparametric MRI (mpMRI) and cross-discipline collaboration with pathology – are in the spotlight at Sectra’s booth at RSNA 2019. •

ADVANCING THE IMAGING PROFESSIONAL

news

Change Healthcare Brings AI to CareSelect Imaging Change Healthcare has announced that its artificial intelligence (AI) technology has been added to the CareSelect Imaging decision support solution. The new AI capabilities will help health care providers using leading electronic health record (EHR) systems enhance workflow efficiency, improve patient safety, provide higher-value care, and meet pending regulatory requirements.

CareSelect Imaging now uses Change Healthcare AI in EHR workflow to help physicians streamline imaging orders. In addition, it helps providers comply with new Protecting Access to Medicare Act (PAMA) requirements governing advanced imaging ordered under Medicare Part B. “Bringing Change Healthcare AI to CareSelect Imaging helps providers ensure they’re delivering the highest quality, most appropriate care, while reducing their administrative and regulatory burdens through advanced automation,” said Michael Mardini, CEO of National Decision Support Company, a Change Healthcare

Company. “This is a perfect example of how strategic applications of AI will continue to improve healthcare processes and benefit all stakeholders.”

Beginning Jan. 1, 2020, The Centers for Medicare & Medicaid Services (CMS) PAMA regulation requires physicians ordering advanced imaging exams for Medicare patients to consult Appropriate Use Criteria (AUC) through a qualified electronic clinical decision support tool. CareSelect Imaging is fully qualified by CMS to meet this requirement.

“We’re committed to optimizing clinical, administrative and regulatory processes by infusing Change Healthcare AI into existing workflows across our large installed base of payers and providers,” said Nick Giannasi, Ph.D., executive vice president and chief AI officer for Change Healthcare. “This is the latest example of our commitment, which, in the end, helps improve care quality, ensure regulatory compliance and free providers to spend more time with patients and less with paperwork.” •

DO IT RIGHT, DO IT TIMELY. WE ARE CONTRAST INJECTOR & MEDICAL EQUIPMENT REPAIR SPECIALIST

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news

Dicom Systems Strengthens Enterprise Imaging U.S. Patents Dicom Systems announced that the United States Patent and Trademark Office (USPTO) has issued U.S. Patent 10,437,877 B2 to support the company’s position as a health care and medical imaging software developer of solutions designed with interoperability and user-configuration at the forefront.

The newly granted patent is an expansion of Dicom Systems’ 2016 US patent 9,390,153 entitled “User-configurable Radiological Data Transformation and Archiving.”

“Since our founding, Dicom Systems has been committed to building dynamic solutions and tools for health care IT. As our customers’ ever-changing IT environment has evolved, so has the Unifier platform which ensures providers can securely share, move, transform and normalize health care data,” said Dmitriy Tochilnik, president and CTO of Dicom Systems and principal author of the patent. “This is a major milestone for Dicom Systems

to be issued a patent recognizing our contribution to Enterprise Imaging.”

The patent covers proprietary technology in the Dicom Systems Unifier, its signature Enterprise Imaging platform, for integrating radiological data (patient studies, orders and reports) across disparate radiology systems (e.g., RIS, HIS, EMR and/or other radiological systems) to provide a universal worklist and/or standardized data.

“This new patent reaffirms Dicom Systems’ position as a market leader in Enterprise Imaging and highlights our professional competence on behalf of our customers. We believe in supplying providers with the knowledge and tools they need to succeed, and this technology further demonstrates the power of interoperability and vendor neutrality,” said Florent Saint-Clair, Executive Vice President of Dicom Systems. •

FDA Clears XACT Robotic System for Percutaneous Interventional Procedures XACT Robotics Ltd. announced that its first robotic system was cleared to market in the U.S. for use during computed tomography (CT) guided percutaneous interventional procedures. XACT’s technology is the first hands-free robotic system combining image-based planning and navigation with insertion and steering of various instruments to a desired target across an array of clinical applications and indications, according to a press release.

“We are committed to redefining the way the entire medical community utilizes robotics, beginning with interventional radiologists,” said Harel Gadot, founder, executive chairman and president, XACT Robotics. “Being the first to introduce a handsfree robotic system, we have the potential to provide significant clinical, technical and economic value while democratizing interventional procedures. Our system’s small footprint and high

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ICEMAGAZINE | DECEMBER 2019

mobility design will enable care providers to treat a broad range of patient care needs in various clinical sites of service.”

“The XACT Robotic System provides a unique platform to the interventional radiology community which can help improve the delivery and quality of care for the patients we serve,” said Professor Nahum S. Goldberg, M.D., who is the principal investigator in a multi-site study using the system, which is still an investigational device in Israel. Goldberg is the head of interventional oncology unit and director of the applied radiology research lab at Hadassah Hebrew University Medical Center. “Based on our experience with this unique robotic technology, we can reach very small targets with unprecedented accuracy. Furthermore, this system holds much promise for enabling more efficient use of time and hospital resources.”

The XACT Robotic System is based on research originally conducted at the Technion–Israel Institute of Technology, by Professor Moshe Shoham, founder of Mazor Robotics (acquired by Medtronic in 2018). The company plans to launch the system to select U.S. radiology Centers of Excellence partners. • For more information, visit xactrobotics.com.

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• Lead Lined Cabinets • Radiation Barriers • Modular Booths/Walls • Lead Curtains • Lead Bricks • Sheet Lead • Borated Polyethylene • Leaded Glass & Acrylic • Lead Lined Storage Containers • X-Ray Rooms Design & Construction • In-House Design Assist Team

Canon Medical’s Ultra-High Resolution CT Receives FDA Clearance Canon Medical Systems USA Inc. has received 510(k) clearance on its Advanced Intelligent Clear-IQ Engine (AiCE) for the Aquilion Precision further expanding access to its new deep convolutional neural network (DCNN) image reconstruction technology. This technology, now available on both the Aquilion Precision and Aquilion ONE/GENESIS Edition premium CT systems, uses a deep learning algorithm to differentiate signal from noise so that it can suppress noise while enhancing signal, forging a new frontier for CT image reconstruction.

Aquilion Precision is an Ultra-High Resolution CT that provides two times the resolution of conventional CT, revealing detail that is typically only seen in cath labs, according ot a press release. With AiCE, the system now enables clinicians to perform super-high resolution studies at doses equivalent to standard resolution CT (with traditional hybrid iterative reconstruction techniques). AiCE learns from the high image quality of Model Based Iterative Reconstruction (MBIR) to reconstruct CT images with improved high contrast spatial resolution.

“As we strive for precision medicine, we realize the importance of starting with the foundation of a precise diagnosis. Canon Medical is committed to developing intelligent solutions that help providers generate clearer, more holistic images to help achieve better outcomes, without increasing dose,” said Tim Nicholson, acting managing director, CT Business Unit, Canon Medical Systems USA. “This technology represents a new era in image reconstruction, which may help provide more possibilities in improving patient care than ever before.” •

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Accumen Acquires 3DR Laboratories Accumen Inc. has acquired 3DR Laboratories, a 3D medical post-processing laboratory in the United States.

Accumen’s team members work side-by-side with hospital, health system, commercial laboratory, payer and pharmacy clients to provide strategic solutions, services and technology that deliver sustainable performance improvements in operations, clinical services and data management. These offerings include lab and imaging transformation, consulting, supply chain optimization, lab outreach, patient blood utilization, test utilization, anemia management and clinical data exchange. Accumen’s offerings enable its clients to achieve and exceed their cost, quality and service targets, as well as deliver excellent patient care through evidence-based data and clinical decision support capabilities.

The addition of 3DR Laboratories to the Accumen portfolio of companies brings expansion to Accumen’s clinical offerings, as well as depth to its imaging transformation offering, which is focused on operational performance in imaging departments and centers across the country bringing meaningful savings, operational efficiencies and improved patient care.

“We are delighted that 3DR Laboratories is joining our clinical performance business unit and further strengthening our imaging transformation service line. We are very impressed with the high quality and consistency of 3DR’s computed tomography (CT) and magnetic resonance imaging (MRI) post-processing work, as well as its strong service-centric reputation which is enabling radiolo-

gists to meet even the most urgent patient needs,” said Accumen President and CEO Jeff Osborne.

Since it was founded in 2005, 3DR Laboratories has provided post-processing services to hundreds of hospital radiology departments, stand-alone imaging centers and radiology practices, enabling them to obtain expert processing of their medical imaging cases within hours or even minutes for emergencies.

3DR Laboratories has processed more than 400,000 cases and has more than 450 active clients nationally.

“At Accumen, we are steadily expanding our portfolio so that we can help our clients to optimize their performance; whether it be operational, clinical or data-focused. We want to assist all health care clients in resolving inefficiencies so they can meet their patient experience goals, while also preparing for continued reimbursement reductions. Our clients can then reinvest the time and cost savings achieved through our partnerships into patient care, so everyone benefits,” Osborne said.

“Accumen is continuing to aggressively invest into its already strong imaging transformation offering and we are excited to have become a key part of their team. This is a great strategic fit because our companies share a similar vision with complementary cultures and values. Furthermore, we will now be able to significantly expand the range of services that we can offer to our clients,” 3DR CEO and Chairman of the Board David E. Ferguson said. •

Detection Technology Awarded ISO 13485:2016 Certification Detection Technology, a leader in X-ray detector solutions, has been awarded the ISO 13485:2016 certificate from the TÜV SÜD Product Service GmbH certification body. The certification covers the development, production and distribution of X-ray flat panel detectors.

“We are proud to have a certified Medical Device Quality Management System (MDQMS) that will support us to ensure the quality of our newly launched X-Panel product family. The implementation of ISO 13485:2016 is internationally one of the most valued models for demonstrating compliance with the customer and the applicable regulatory requirements of the medical industry,” says Kai Utela, vice president operations at Detection Technology.

“The certification represents an important milestone for

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ICEMAGAZINE | DECEMBER 2019

our company and our commitment to deliver solutions for stringent applications with a quality-first attitude. With the certified MDQMS, our customers can be confident that our CMOS X-ray flat panel detector solutions will enhance safety and the patient experience, and that we are meeting their efficiency and responsiveness expectations. Furthermore, we can easily widen the scope of the certification to also cover our other existing and future medical product portfolios, if it is seen to benefit both our customers and our business,” he adds.

The company’s MDQMS was audited in September, and the ISO 13485:2016 certification was granted to its Beijing manufacturing site in October. The new certification complements the company’s existing ISO 9001:2015 and ISO 14001:2015 certifications. •

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Study Seeks Effective Method to Identify People at Risk for Heart Disease Researchers from the Intermountain Healthcare Heart Institute are launching one of the largest and most ambitious research initiatives ever undertaken in the state of Utah to test a new standard of care to better identify and treat people at risk of having a heart attack – and to potentially stop it before they ever have one.

Findings from the first-of-its-kind study, which will involve more than 90,000 people in Utah, could possibly change the way cardiovascular-related diseases are diagnosed in the future – and potentially save thousands of lives due to more accurate screening and better diagnosis.

The Intermountain Coronary Calcium study, or CorCal study for short, is seeking to determine the best way to proactively identify patients who may be at high risk for coronary heart disease to prevent a future heart event and is unique as participants will register online.

For the study, researchers will test the effectiveness of presently existing standard heart prevention guidelines (centered around cholesterol testing) compared to a novel strategy that includes performing a low-dose CT scan of the heart to screen for the build-up of calcium in the arteries.

The presence of coronary calcium indicates a build-up of atherosclerotic plaque in the arteries to the heart and brain and is associated with an increased risk of a future heart attack or stroke. Some patients enrolled in the study will undergo a CT heart scan, while others will not.

“The CorCal study will determine if adding a CT scan to the tests we already do will help to more accurately identify people that are at risk of a heart attack or stroke,” said J. Brent Muhlestein, principal investigator of the study and co-director of cardiovascular research at the Intermountain Healthcare Heart Institute.

Currently, the American Heart Association standard is to test a person’s choles-

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terol levels through a blood test called a “lipid panel.” Cholesterol levels are then used with other information to determine a person’s atherosclerotic cardiovascular disease risk score that is used to predict their risk of developing heart disease in the next 10 years and can guide health care providers in determining appropriate prevention treatments.

“Doing a CT scan will create a coronary artery calcium score. Looking at both scores together may identify people with coronary heart disease better than just using one score,” Muhlestein added. “It’s also possible that doing another test and looking at another score will not make any difference. Our goal is to find the test or group of tests that are the best at finding people with a risk of having a heart attack or stroke, so they can be prevented.”

Based on a person’s results, their primary care physicians may be notified if those people should start taking statins and/or aspirin to prevent potential future heart events.

Researchers will use Intermountain Healthcare’s electronic medical records system to identify patients who meet the study criteria, which includes being between 50 and 85 years old, not being on statins at the time of the study and having no known history of diabetes or vascular disease of the heart.

Researchers will be reaching out to 90,000 potential enrollees by mail and email and hope to enroll at least 9,000 into the randomized trial. The CorCal study is scheduled to run until March 2023.

This potentially groundbreaking research initiative is made possible by a major donation and funding to the Intermountain Foundation from Utah businessman, community benefactor and professional sports owner Dell Loy Hansen. ICE For more information, visit www.corcalstudy.com

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PEOPLE ON THE MOVE

By Matt Skoufalos

1

BD will see CEO Vincent A. Forlenza retire January 28, 2020. Forlenza will continue to chair the BD board of directors. President and COO Thomas E. Polen will become CEO and president. Forlenza has been BD CEO since October 2011 and chairman of the board since July 2012. He has also been chairman of the Advanced Medical Technology Association (AdvaMed) Board of Directors from 2015 to 2017 and chairs its legal committee. He also serves on the Moody’s Corporation board of directors and chairs the Valley Health Systems board of trustees.

2

Proton Therapy Partners named Neil Jesuele, Bruce Lawrence and Michael G. Rock to its board of directors.

Jesuele has spent more than 35 years in senior positions with Johnson & Johnson and the American Hospital Association (AHA); he most recently was the AHA executive vice president of leadership and business development and president of its for-profit subsidiaries, Health Forum and AHA Services Inc. Lawrence is president-CEO of Lawrence Strategic Solutions, and had been president and CEO of INTEGRIS Health. Rock is a surgeon and educator who spent a long tenure with Mayo Clinic Hospitals/Mayo Foundation, most recently as its chief medical officer.

3

Washington-based Allen Institute debuted its 2019 Next Generation Leaders, a group of six early-career neuroscientists who will form an advisory council for its Allen Institute for Brain Science. They include Aparna Bhaduri, Ph.D., postdoctoral scholar at the University of California, San Francisco; Christina Kim, Ph.D., postdoctoral research fellow at Stanford University; Scott Linderman, Ph.D., assistant professor at Stanford University; Michael Lodato, Ph.D., assistant professor at the University of Massachusetts Medical School; Nick Steinmetz, Ph.D., assistant professor at the University of Washington; and Eric Yttri, Ph.D., assistant professor at Carnegie Mellon University.

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01

04

05

07

4

Joshua Milner has been named division chief of pediatric allergy, immunology and rheumatology at Columbia University Vagelos College of Physicians and Surgeons and professor of pediatrics in the Institute for Genomic Medicine at Columbia University Irving Medical Center, both of New York, New York. Milner will also serve as chief of the allergy, immunology and rheumatology services at New York-Presbyterian Morgan Stanley Children’s Hospital. Milner previously was a National Institutes of Health (NIH) physician-scientist at the National Institute of Allergy and Infectious Disease (NIAID). Milner is board-certified in allergy and immunology, has been elected to the American Society for Clinical Investigation, the Association of American Physicians and the Henry Kunkel Society.

5

Integrity Locums of Denver, Colorado promoted Executive Vice President Jeff Files to president of the company. In his 15-year career, Files has been a territory consultant and executive vice president at Martin, Fletcher and vice president at Fastaff Travel Nursing.

6

The Inova Schar Cancer Institute of Falls Church, Virginia named Jennifer Bires executive director of its life with cancer and patient experience programs. Bires joins Inova Schar from the Washington, DC-based Smith Center for Healing and the Arts, where she was executive director. She holds an MSW from Washington University in St. Louis.

7

Dorin Comaniciu, senior vice president of AI and Digital Innovation at Siemens Healthineers of Malvern, Pennsylvania, has been elected to the National Academy of Medicine (NAM). Comaniciu is a Fellow of the Institute of Electrical and Electronic Engineers (IEEE), the Association for Computing Machinery (ACM), the Medical Image Computing and Computer Assisted Intervention (MICCAI) Society, and the American Institute for Medical and Biological Engineering (AIMBE).

ADVANCING THE IMAGING PROFESSIONAL

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8

The Washington, D.C.-based Unity Health Care named Jessica Henderson Boyd its new chief medical officer (CMO), effective November 18, 2019. Boyd was a consultant at McKinsey & Co. and a medical strategist at the Cystic Fibrosis Foundation, and previously was CMO at Baltimore Medical Systems.

9

Accuray of Sunnyvale, California added Suzanne Winter as senior vice president chief commercial officer. Winter has more than 25 years of medical technology experience in senior executive roles, most recently as group vice president of the Americas region at Medtronic Diabetes; previously, she was general manager of GE Healthcare’s Detection and Guidance Solutions operations. ICE

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WEBINAR WEDNESDAY Webinars Deliver Knowledge, CE Credits Staff report

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he Webinar Wednesday series continues to provide knowledge and CE credits to imaging service professionals around the world.

The live and recorded sessions are a popular way to gain additional insights that empower these professionals to perform their many tasks better.

“ I attended today for continuing education. Thank you very much for providing these webinars.”

– T. Heininge, Biomedical Technician said M. Reynoso, imaging specialist I.

X-Ray QA The Webinar Wednesday presentation “Ocean Software – X-Ray QA Simplified” delivered great insights about a helpful tool for imaging service engineers. Attendees were eligible to earn 1 credit from the ACI. Presented by RTI Group AB Global Manager Distributor and Partner Sales Lee Evans, and sponsored by RTI, the 60-minute webinar explained the path from regulatory testing requirements to the generation of a suitable report. Along the way, examples of different levels of automation were visited. Attendees also gained an insight into the efficient use of s/w tools in the field of X-ray QA. The webinar was attended by 135 individuals and more have watched a recording of the webinar online. Attendees were asked ‘What did you like most about today’s webinar?” in a post-webinar survey.

“Good information. Interesting to see the software to perform this,” said M. Hoffman, CBET. “The information presented was concise and understandable,” said W. Polcin, lead biomedical technician II. “It seemed like a very versatile tool allowing you to test and store readings from multiple systems with ease,” shared F. McVean, business process manager.

“The presenter drawing the line between what needs to be done and why, and what regulations requires us to do so,” 24

ICEMAGAZINE | DECEMBER 2019

Automating Medical Device Management Medigate Director of Sales Engineering Salil Panicker presented “Automating Medical Device Management” as part of the Webinar Wedensday series of free educational sessions. Participation in the Medigate-sponsored presentation was eligible for 1 CE credit from the ACI. Panicker discussed key differences and use cases for device inventory and management tools. He also explained the importance of clinical context when inventorying medical devices and unleashing the power of one’s NAC. The webinar drew 178 attendees for the live presentation with more HTM professionals watching a recording of the webinar online.

Attendees were asked “Why did you attend today’s webinar? And, was it worth your time?” The responses centered on gaining more information and education.

“To learn something. It was worth it, the seminar was informative,” said G. Koch, BMET III. “Learn more about the CVA tools and solutions that are out there,” explained J. Ruiz, technology manager.

“I attended today for continuing education. Thank you very much for providing these webinars,” Biomedical Technician T. Heininge said.

“It was definitely worth my time to join, but the material was pretty detailed. I’m not sure how many people were able to follow what he was saying. It was obvious the presenter was an expert in his field,” Biomedical Coordinator S. Roberts said.

“Interested in learning more about the platform and approach” Operations Manager L. Zipkis said.

“Cybersecurity is a hot item in our field and being able to automate some of that process would be more efficient approach to it,” said K. Mylar, system director healthcare technology.

“I am working toward biomed management. Working on education that will help me grow. Also gathering this information to be able to talk with management on new products and services that are available to our industry,” Biomedical Technician G. Seastrand said.

AEM Program Implementation The Webinar Wednesday session, sponsored by Nuvolo, featured Senior Solution Consultant Kyle Holetz. Attendees were able to earn 1 CE credit from the ACI for this 60-minute session entitled “Clinical Asset Management: AEM Scheduling and Device Risk Scoring Solution.”

Holetz discussed how implementing an Alternative Equipment Maintenance (AEM) program can improve the effectiveness of a clinical engineering team, but doing so can consume more resources than it ADVANCING THE IMAGING PROFESSIONAL

news “ This webinar was very informative. We are currently moving to AEM based PM scheduling and the presentation gave some valuable insight.”

– E. Bican, Lead Technician of Clinical Engineering saves with legacy CMMS technology. He then demonstrated modern HTM software technology that includes built-in AEM automation functionality that delivers the data-driven AEM program for teams to leverage, saving time and effort.

The webinar had 246 attendees for the live presentation, and the session received an attendee rating of 3.7 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 much new information did you receive from today’s webinar?”

“I enjoyed seeing Nuvolo’s solution to AEM and learned more about the product,” Clinical Engineer C. Mahoney said.

“It was great to see the CMMS take a lot of the work out of determining the

effectiveness of an AEM program” said S. Keeny, biomedical supervisor.

“Refreshed some older understanding and introduced some newish concepts.

Looking forward to more scoop on that CMS/Service study on effectiveness of AEM in the clinical arena. We used some elements of this concept as far back as the early 90s when I was a hospital biomed.

Effort to increase utilization was very high back then. Looks like strides have been made,” Principal FSE H. Tucker said.

“It was very informative concerning the AEM programs being implemented and how the schedule change is being justified,” said J. Vogel, biomedical technician III. “This webinar was very informative.

We are currently moving to AEM based PM scheduling and the presentation gave

some valuable insight,” Lead Technician of Clinical Engineering E. Bican stated.

“As we already have an AEM, this information identified new gaps in our process and gave us insight into some opportunities moving forward,” said J. Newell, interim director of clinical engineering. ICE For more information about the Webinar Wednesday series, including a calendar of upcoming presentations and recordings of previous webinars, visit WebinarWednesday.Live.

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

STA

Ice editorial board

INTRODUCING

RT I

NEXT MONT H!

NG

Mario Pistilli

Meet our first featured member of the ICE Editorial Board: Mario Pistilli.

Mario is the Administrative Director of Imaging and Imaging Research at Children’s Hospital Los Angeles. He is certified as a CRA, CHFP, FACHE, FAHRA and CNMT. Mario has a bachelor’s degree in Nuclear Medicine and Chemistry, a master’s degree in Healthcare Administration and Business Analytics. He was an Executive Leadership Fellow at the University of Southern California Keck School of Medicine. Mario grew up and worked in the Chicago area but currently resides in Southern California. He’s been married to his wife, Suzanne, for 27 years. They enjoy the outdoors in Southern California by hiking, biking, sailing or simply hitting the beach to relax. Mario’s son, T.J., is a senior at Northern Illinois University, where he is studying business management, entrepreneurship and marketing. His family also loves sports of any kind, especially football. They can often be found at local sporting events. When asked about any hobbies or hidden talents, Mario answered, “I secretly unwind by playing video games (still!) and have never outgrown it.”

NEW YEAR

NEW MAGAZINE

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For more information, go theicecommunity.com to view some of Mario’s columns.

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Peter Nerat: Take Me Out to the Ballgame

N

icknamed, “The West’s Most Western Town,” Scottsdale, Arizona bears homage to that nickname with its Arabian stallion horse ranches, some desert areas to its east, an annual Parada del Sol Parade with horses and cowboys and a few reminders in its “Old Town” area. Other than that, it is more like a ritzy, modern-day chic refuge with resorts for tourists, high-end neighborhoods and luxury brand car dealers. It is one of the East Valley communities in the Valley of the Sun. HonorHealth operates many health care facilities, including three hospitals in Scottsdale: HonorHealth Scottsdale Osborn Medical Center, HonorHealth Scottsdale Shea Medical Center and HonorHealth Scottsdale Thompson Peak Medical Center. The Osborn and Shea locations have been health care fixtures in Scottsdale for many years.

Servicing imaging equipment in all three locations is Peter Nerat, a diagnostic imaging engineer specialist with HonorHealth.

Nerat first became interested in the field while serving in the U.S. Air Force.

“My formal introduction to this career began through military training in the Air Force where I was assigned to NORAD computer maintenance,” Nerat says. “After the Air Force, I received my training ‘on the job’ at GE Medical Systems along with

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Peter Nerat enjoys being outdoors. a great deal of self-study. I had a push to learn as much as I could from senior staff. I started out in the staging bays and worked the graveyard shift; as that is where I could learn the most and get assigned jobs that would normally go to more senior people.

This helped to further my understanding of the systems. I guess sleep at the time was not a priority.”

The song “Take Me Out to the Ballgame” should be at the top of Nerat’s favorite song list. It was a trip to the ballpark that changed his life in a way that seems more than coincidence.

“When I first got out of the Air Force, I did a six-month contract job for a small engineering company in Milwaukee, Wisconsin. I was hired to help design a digital flow meter,” Nerat says.

He says that the company let him go after he completed the design.

Favorite part of being an imaging professional?

“I love learning and this field is nothing but a constant classroom in every aspect.”

“Feeling upset about not having a job, I called my Grandpa for advice and he told me to go to a Milwaukee Brewers game and to not worry; according to my Grandpa, life has a way of working out. I sat in the cheap seats, and when I went to get a beer, I asked the folks behind me if they would like one also,” Nerat remembers.

He says that when he returned, they asked what he did for a living and were incredulous after learning that he had been just laid off, but had still offered to buy them a beer.

“As a happy coincidence, the people

ADVANCING THE IMAGING PROFESSIONAL

people

GET TO KNOW THE PRO Favorite book: “1776” by David McCollough Favorite movie: “Adams Rib” Favorite food: Fresh caught trout in a frying pan over a campfire.

Hidden talent: I can spin my wedding ring on a desk top for long periods of time What’s on my bench?

Ice cold water, a Bluetooth speaker for my jams, a great set of tools, my grandson’s toy dinosaur and a picture of my family.

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Peter Nerat enjoys spending time with his family.

I had treated to a beer worked in human resources at GE Medical Systems. They felt that my training would make a perfect fit for the staging bays for the new 9800 CT they were putting out. The rest, as they say, is history,” Nerat says.

Nerat has remained an imaging engineer throughout most of his career as a CT, MRI or cath lab specialist.

A Filter is not a Filter When happy customers are your primary goal, achieving that goal can be fraught with challenges.

“My biggest challenge is the ongoing push for customer satisfaction. Nothing gives me more job satisfaction than shifting a dissatisfied customer to a satisfied customer that trusts us to take care of all of their needs. This I find most times is more challenging than a hard technical problem,” Nerat says.

Customer satisfaction is where the game is won.

There is always the occasional detective work that is required of any engineer when attempting to diagnose a problem.

Nerat is no stranger to this aspect of the field.

“We had a CT issue that was ongoing for a group of mobile CT units our team was responsible for. We were getting a faint ring artifact on the head studies. We had tried, as a team, all sorts of fix actions;

Das boards, tube alignments, tubes, recon units, high voltage systems, to no avail.

Different techniques caused the problem to go away for a while, but we still had issues,” Nerat says.

He tried replacing the collimator and that did not help.

“I took a suspect collimator apart so we could see if there were any visible issues with the collimator unit. I used a C-arm to X-ray the collimator for problems and was able to see micro fractures in the Mylar filter. To determine if the systems in the field had any issues, we used a Sharpie pen on the filter and you would be able to see the ink build up on the micro fractures on the face of the filter,” he says.

Nerat says that the fix action was to go back to using a replacement filter that was more expensive, but better made.

Away from work, Nerat enjoys scuba diving, travel, photography and reading.

Family includes his wife, Laurie, two stepdaughters and “a perfect grandson.”

What would Nerat want you to know about him?

“I take pride in making sure my customers are as happy as possible whether that is external or internal customers. I like to leave everything that I engage in life to be a little bit better when I am done,” he says.

With a philosophy like that, you can’t go wrong. ICE

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By K. Richard Douglas

DEPARTMENT SPOTLIGHT Pardee Hospital Imaging Service Team

T

wenty-two miles south of Asheville, North Carolina and nestled in the western North Carolina mountains, is the city of Hendersonville. The city is in Henderson County and sits just 15 miles north of the state’s border with South Carolina. The city was officially recognized as the county seat in January of 1847 and today includes many historic buildings, situated in seven historic districts.

In one of those districts, known as the Hyman Heights/Mount Royal Historic District, the city’s first hospital was built. Patton Memorial Hospital had 13 rooms, including one for surgery, and a staff of four physicians.

Many of those physicians settled in the same area. The hospital opened its doors in 1913 and 40 years later, patients were moved to the city’s new hospital; Margaret R. Pardee Memorial Hospital.

Among the workers who call this beautiful location home, are the team of imaging service professionals within the biomedical engineering services department at Pardee

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Hospital. The department’s biomed and imaging services are provided through a third-party service provider; The Intermed Group.

The portion of the biomed department that makes up the imaging team at Pardee includes Director Matt Yates, CBET; Brian Russell, CRES; and Russell Hemingway.

Yates has 32 years of experience in biomed and imaging. Russell has 25 years of experience. Hemmingway has served in the HTM and imaging field for a decade.

Hemingway specializes in CT, MRI and ultrasound. Russell specializes in rad, R&F, ultrasound and mammography. Yates also specializes in rad, R&F, ultrasound and mammography.

The imaging service specialists are so integrated into the hospital, and so well-regarded by clinical staff, that the source of their paychecks is never considered.

“The hospital, however, doesn’t view us as a vendor. We are treated by everyone from administration, nursing, imaging techs, to the shipping and receiving department as a valued

“[We are] currently working with IT and radiology evaluating status of equipment vulnerability and security of Windows OS and determining product life cycles.

This has become a very important security measure in determining what equipment needs to be replaced. member of the health care provider team and a trusted advisor,” Yates says.

“Managed by UNC Health Care, Pardee Hospital is a not-for-profit community hospital founded in 1953.

It is the first and only hospital in North

ADVANCING THE IMAGING PROFESSIONAL

people

ABOVE:The members of the Pardee Hospital Imaging Service Team are (from left) Brian Russell, Matt Yates, and Russell Hemingway.

RIGHT: Russel Hemingway works on a CT.

Carolina to be accredited with the International Organization for Standardization (ISO 9001:2008) for quality health care standards,” Yates says.

The hospital is licensed for 222 acute care beds and is the second largest employer in Henderson County. The hospital has several locations separate from the main campus, including a comprehensive physician practice network, five orthopaedic clinics and three urgent care locations. The health system’s Cancer Center provides a state-of-theart healing environment for cancer patients along with an optimal work environment for health care professionals.

The team tries to cover as much of the imaging equipment as possible, but some service contracts are still used.

“The equipment we don’t cover is under a service agreement with the manufacturer and I monitor those contracts. We do have some shared service agreements on a few of the

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systems. We do ‘first call’ on most of the systems,” Yates says.

In addition to management duties, Yates is involved with the selection of equipment and is on the capital budget committee and capital projects committee along with assisting in preparation of equipment installation.

Russell and Yates are also involved with working with IT projects concerning the radiology equipment.

“Our company requires annual training to stay current with ISO standards. We normally use third-party and manufacturer when available. Training is considered part of the expectation of the hospital to stay up to date on the equipment we service,” Yates says.

Keeping an Eye on Software The small imaging team has addressed other concerns beyond the routine calibrations, repairs and maintenance. “[We are] currently working with IT and radiology evaluating status of

equipment vulnerability and security of Windows OS and determining product life cycles. This has become a very important security measure in determining what equipment needs to be replaced. This is an ongoing project. What I am realizing is that it is sad that equipment that is only a few years old has to be replaced due to incapability of operating software to meet security standards,” Yates says.

He says that they also had an issue with the lock assembly consistently being damaged on a rad table that is out of support for parts.

“We had a part manufactured that was beyond manufacturer specs and the problem has gone away,” Yates says.

Despite these challenges, the team continues to keep the hospital’s imaging equipment operational and maintained.

Health care is better in Henderson, North Carolina, thanks to these three dedicated imaging service professionals. ICE

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PRODUCT SPOTLIGHT Contrast Injector Market Growth Expected Staff report

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ontrast media injectors are devices employed for injecting contrast media into the body to improve the visibility of tissues for medical imaging procedures. Currently, market players are engaged in developing contrast injectors with enhanced capabilities, such as improved patient safety, patient imaging data integration and higher specificity.

The contrast media injectors market is projected to reach $2.4 billion by 2024, according to a MarketsandMarkets report.

“The major factors driving the growth of the contrast media injectors industry include a large number of approvals for contrast agents, increasing investments, funds, and grants by government organizations, and rising demand for early diagnosis and widening the scope of clinical applications. However, the reluctance to adopt new technologies, and a shortage of trained professionals, will challenge market growth,” according to MarketsandMarkets.

The contrast media injectors market studied is anticipated to grow with a CAGR of 5.5%, during the forecast period (2019-2024), according to a Mordor Intelligence report.

The major factors attributing to the growth of the contrast media injectors market are increasing demand for minimally invasive surgeries. Even the technological advancements are helping the market grow, along with the increasing number of regulatory approvals, according to Mordor Intelliegence.

“For instance, there have been several advancements in contrast media injector technology to reduce contrast media waste

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and to automate data collection regarding the dose a patient receives. Such as the automated injector systems precisely collects the amount of contrast media used, and vendors have started offering personalized doses for the patients using the information pulled from EMR or PACS,” according to the report. “One such advancement in reducing contrast media waste is syringeless injectors. According to a study published online in, the Journal of Medical Devices: Evidence and Research in November 2013, syringeless injectors provide cost savings of about $8 per patient. Most of the companies are developing innovative products to reduce contrast media waste and gain a competitive advantage.”

“Bracco has developed smart syringeless injectors, which are able to use every drop of contrast loaded into the system for maximum economy,” the report adds. “The smart injectors record the amount injected and imaging protocol used and send the information to the PACS. These constant technological advancements in the contrast media injector technology are expected to boost the contrast media injector market during the forecast period.”

The CT injector systems segment of the market is expected to grow.

“CT injectors are expected to grow positively as the usage of the CT systems has been increasing from the past few years, and these CT systems use a dual-head injector, with two syringes for initial and follow-up contrast doses, during imaging,” according to the report. “There has been constant R&D activity by major academic centers and phar-

maceutical companies to develop protocols, which helps CT users with the advanced capabilities of newer imaging systems. And the injectors such as Covidien’s Optivantage dual-head contrast injector for CT, launched in 2012, use a radio-frequency identification (RFID)-enabled system. The integration of IT and contrast media dose management are prospective growth factors for the forecast period.”

Manufacturers of CT and automated contrast injectors are partnering to better integrate their systems.

“This includes contrast dose tracking.

Mallinckrodt has launched an OptiSync data management system, which is designed to collect and analyze radiology data when a patient undergoes a contrast-media-enhanced CT imaging procedure. All these factors are expected to help the market to grow positively over the forecast period,” Mordor Intelligence reports.

North America is expected to dominate the overall market.

“This is due to factors such as increasing preference for minimally invasive procedures and increasing prevalence of chronic diseases owing to changing lifestyles. Furthermore, technological advancements in contrast media injectors devices and increasing expenditure by key players, along with rising regulatory approvals, are also boosting the growth of the contrast media injectors market in North America. In North America region, the United States holds the largest market share,” the report states. ICE

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GE Healthcare SenoBright HD Performed as a follow-up to inconclusive mammography and ultrasound, SenoBright HD Contrast Enhanced Spectral Mammography (CESM) from GE Healthcare highlights areas of unusual blood flow patterns – all in a simple and quick procedure. CESM offers a high level of confidence for clinicians and patients, as it delivers clear image quality. The high specificity of SenoBright HD can help reduce the number of unnecessary biopsies and surgeries.1 The exam can be performed in less than seven minutes2 – using the same mammography equipment, in the same room, with the same staff. The next generation of SenoBright HD CESM is now available with Senographe Pristina, GE Healthcare’s latest mammography system.

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ADVANCING THE IMAGING PROFESSIONAL

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Guerbet Contrast Delivery Systems Guerbet’s wide range of contrast delivery systems enables health care professionals to work efficiently, in any application. Each delivery system is built for optimal flexibility, efficiency and safety, ensuring that medical staff and equipment work together to provide excellent patient care.

Guerbet offers a full line of injectors, prefilled syringes, consumables, digital solutions and service.

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MEDRAD Stellant FLEX CT Injection System The new MEDRAD Stellant FLEX CT Injection System addresses clinical and financial challenges of today’s evolving health care environment, including reduced operational budgets for hospitals which are creating the need for institutions to work more efficiently and economically, while maintaining quality patient care.

Clinically, the key features of the new Stellant FLEX were designed to drive workflow efficiencies, including: • Automated capture of contrast and injection parameters; reducing the number of manual tasks and potential errors • 150 mL and 200 mL syringe sizes with new beacon technology for easy visualization of fluids • Barcode identification, lot and expiry date information for increased accuracy and automation of documentation via a contrast barcode reader • Streamlined training program Financially, the TechCARE program allows radiology suites to maximize their CT equipment investment with flexible options for capital equipment purchasing.

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ICEMAGAZINE | DECEMBER 2019

ADVANCING THE IMAGING PROFESSIONAL

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Siemens Healthineers SOMATOM go. CT platform The SOMATOM go. CT platform – consisting of the SOMATOM go.Now, SOMATOM go.Up, SOMATOM go.All, and SOMATOM go.Top systems – was designed by Siemens Healthineers with feedback from over 500 medical professionals globally, who identified key characteristics of an ideal CT scanner. That feedback led to the development of not only key features such as the platform’s mobile, tablet-based workflow, including automated inline reconstructions, but also the gantry-mounted contrast injector arm – an alternative that addresses the cost and complexities of traditional pedestal- and ceiling-mounted injector solutions. Additionally, the SOMATOM go. CT platform’s FAST ROI (Region of Interest) feature automates detection of the aorta to help the technologist identify the optimal moment to begin contrast administration.

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ADVANCING THE IMAGING PROFESSIONAL

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YESTERDAY, TODAY & TOMORROW THE EVOLUTION OF DIAGNOSTIC IMAGING

BY MATT SKOUFALOS

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ICEMAGAZINE | DECEMBER 2019

ADVANCING THE IMAGING PROFESSIONAL

A

s Imaging Support Specialist Chris Bryant was cleaning up some inventory in the biomed shop at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, something gave him pause. It was a Keithley survey meter, one of a number of old pieces of testing gear used in the calibration and maintenance of imaging equipment. It occurred to Bryant that not only had that device seen its day, but that none of his peers even knew what it was or what it had been used for.

“This was stuff I trained on,” Bryant said. “It’s fun to look back and lug around the old tools, but today, there’s a better piece out there that’s a heck of a lot smaller and a lot easier to use.”

For the past seven years, Bryant has focused his career on imaging technology; in the decade prior to that, he was a general biomedical technician.

At the outset, Bryant was a general electronics technician. The skills needed for that job were as much mathematical as they were mechanical, which hasn’t changed; what is different now is the degree of efficiency with which many of the formerly complicated procedures have been machine-automated.

“Mechanical knowledge is never going to go away,” Bryant said. “We always have to clean the brakes for the rails, grease the candles for the high-voltage connections; the room does the things it always did. But it’s now a lot more efficient.”

Like his shop, the business of medical imaging has evolved from much more analog processes to automated, computation-driven ones. If Bryant and his team are tasked with micro-level troubleshooting, the solution has become to just replace an entire component instead of wrenching or soldering malfunctioning elements. Similarly, the imaging equipment business as a whole has gone

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from evaluating the life spans of individual devices to advanced metrics like return on investment (ROI) and total cost of ownership (TCO). At the same time, consolidation in the service provision and replacement parts markets have integrated lines of business that once operated independently, while the devices themselves have grown more complex and reliant on software to expand, automate and unlock the fullness of their potential.

These changes obviate the need for technicians to possess the same degree of mechanical knowhow that Bryant did in his earlier years; ditto the level of computational ability that once was required of people doing the job.

“You used to have to be able to do the formulas to quantify [the repairs],” he said. Now much of that mathematical labor is given over to software, making things easier on repair specialists in some respects while opening up other knowledge gaps that have made it more difficult.

“If you don’t have network training to be able to diagnose where the actual network issue is, you’re so far behind the curve,” Bryant said.

“You’re at the mercy of the IT department, or the user. If you can’t definitively communicate to the PACS administrators on their level … if you can’t quantify the issue and say, ‘I checked this and the ball’s in your court,’ then you’re at their mercy.”

“I’ve had to evolve over the process of not knowing very much in the way of networking at all to ‘I’ve got to know this,’ ” he said. “I even picked up a LEED Six Sigma Yellow Belt. It wasn’t required, but to be able to interact with project managers and speak their languages, it was important, for implementation, planning and upgrades.”

Bryant has maintained a thirst for expanding his skill set throughout his career; as they were offered to him, he took on the responsibilities of maintaining laboratory, surgical and pulmonary

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devices, and when a spot opened up for someone to take on the care of medical imaging equipment, he grew into that as well.

Along the way, the environment at his workplace transitioned as well, merging in 2010 with the U.S. Navy to become a federal health care center, “and things have become a little crazy ever since,” Bryant said. The shift in focus at the facility has increased the amount of patients seen there by a factor of three, and uptime requirements along with them.

That extra workload has intensified the pace of the job, but another thing that’s changed is Bryant’s team. Today, it’s staffed by Navy-trained biomeds, renowned for their level of expertise, reliable work ethic and collaborative spirit. They’ve had two years of 10-hour days in which to hone their skills on a vast array of medical equipment, and their training has taught them to be self-sufficient in the workplace.

“Every single hire in the last five years is a prior service Navy active-duty member,” Bryant said. “One week they’re wearing a uniform, the next they’re in civilian clothes doing the same job. I don’t have to hold their hand when I have a work order.”

In addition to culture change at the tech bench, some of the biggest and most necessary evolutions in medical imaging are being driven in the realm of patient experience. Eric LoMonaco, director of diagnostic and interventional radiology at the Community Hospital of the Monterey Peninsula (CHOMP) at Monterey, California believes that “health care providers have to raise the bar” for patient access and convenience, not only for improved throughput, but also for improved revenues.

“All of us get pressured to improve our patient satisfaction scores, but we had no way of rectifying the situation that’s meaningful in a timely manner,” LoMonaco said.

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“ I’ve had to evolve over the process of not knowing very much in the way of networking at all to ‘I’ve got to know this.’ ” Chris Bryant, Imaging Support Specialist

With Medicare reimbursements tied to the patient satisfaction scores of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, health care facilities need to connect more easily and closely with the people they serve. Typically, they’ve faltered in doing so, in many circumstances owing to the way the institutions ask questions and gather responses. Distributing traditional mailers at CHOMP to patients after they’d seen yielded responses from less than a quarter of patients, mostly because of the process involved.

“Most hospitals use a survey tool post-experience,” LoMonaco said.

“Historically, it only used to be snailmailed, so the response rate used to be really poor. The patient would come in for an MRI, come home, they’d get a survey in the mail, it would get sent to the [data collection] company, and we’d get the report.”

“I was really handcuffed by the fact that when I got the data, the patient had left the building, and most patients were mad that it had taken me six weeks to call them,” he said. Additionally, “the time lapse was so long I could not have a discussion with a staff member [about any issues] with a serious face.”

“We’re still trying to resolve the problem from six weeks ago,” LoMonaco said. “Our patients are communicating at lightning-fast speed. Why aren’t we?”

Instead, CHOMP has had incredible success driving onsite feedback nearly in real-time via a digital survey tool

developed specifically for imaging patients. Upon registration, every patient is hand-delivered a VIP card signed by the hospital CEO. The card includes a QR code and a phone number for patients to use to identify any issues. Putting that “skin in the game” led to “almost overnight success,” LoMonaco said.

“We were at a net promoter score of -33 before we started,” he said. “One week after go-live, we hit 100. The second week, 100. The Ritz-Carlton uses this system. Their score is 75. In radiology, we went from the 30th percentile to the 90th and the 100th, and we’ve sustained that level for two years.”

The comment system made it easier for patients to submit feedback on their experiences while in the hospital, instead of after discharge; importantly, it also enabled CHOMP to do something about their complaints. In addition to resolving patient issues, the new system engendered a stronger sense of confidence among leadership that they could guide staff to meaningful improvements based on real issues.

“I don’t have this sense of hopelessness with the staff because the patients are telling us exactly where to spend our time and energy,” LoMonaco said.

“Now when I get 99-percent positive feedback every day, in huddle we can pull out the phone and say, ‘The person said you did this or that and it helped so much.’ It’s become this really positive environment.”

“Even when something goes wrong, people own it,” he said. “Maybe tomorADVANCING THE IMAGING PROFESSIONAL

row we do better. Maybe you can reach out for help, let’s put that on the board as something to work toward. It almost gives me purpose to be in the department.”

Expanding the program has also enabled CHOMP to intercept other patient issues before they even arrive at the facility. Once an appointment is booked, patients receive thank-you emails with directions to the location where they’re scheduled, video overviews of the procedures and a phone number to ask any outstanding questions.

Those phone calls are sent to the patient access desk as voice files, allowing staffers to call them back within minutes. Each link in the message is trackable, enabling staff to monitor how many patients are seeking information, and what kind they need – rescheduling or cancelling an appointment, finding out whether they’ve got insurance authorization for a procedure – and offering an opportunity to close that communication gap between patients and the health system.

“I can’t tell you how many patients showed up at the wrong location for a CT or MRI,” LoMonaco said. “It’s really frustrating or disappointing when someone shows up at your desk and is told, ‘I can’t see you today, you’re at the wrong location.’”

“If I get one cancelled CT rescheduled [in advance], that pays for [the cost of the system] in a heartbeat,” he said. “By sending the videos, more patients are less anxious and more prepared. Our noshow rate is at 0.01 percent; nationwide, it’s 5 percent.”

The program has also built fidelity with physicians, LoMonaco said; one radiologist asked to be put on the distribution list so that he could help respond to patient issues over the weekend. He plans to expand the program to help physicians provide feedback about their concerns with the WWW.THEICECOMMUNITY.COM

hospital environment as well, because “they’re our customers, too.”

“Hospitals have millions of dollars on the line [in HCAHPS scores] but they say we can’t afford this [type of system],” LoMonaco said. “You’re going to take that loss one way or the other.”

Samir Batra, founder and CEO at the Campbell, California-based BAHA Enterprises believes patient engagement and empowerment are only going to become more critical to the future of imaging, both in terms of how much operational efficiency they engender and the capacity for growth in those lines of business.

“It’s not rocket science to understand

into algorithms, the more quickly and broadly the knowledge gleaned from their pattern recognition can influence treatment decisions.

“I think the future is going to be more software driven, more machine-learning driven, more data driven,” he said. “Imaging devices are such large, really expensive solutions; the barrier to entry is very large. There’s tons of companies that hit the ground and said, ‘We need to do this,’ but I think their future is still coming.”

Instead, Batra foresees practitioners applying advanced software solutions to more broadly available personalized

“I think the future is going to be more software driven, more machine learning driven, more data driven.”

Samir Batra, founder and CEO at BAHA Enterprises what’s happening in health care from a consumer perspective,” Batra said. “If I want to go and spend $5,000, $10,000, I’m going to shop around. I think that experience becomes really, really critical.”

“You already know you’re going to undergo a clinical procedure, but the environment is going to help you have a good experience,” he said. “The better equipped your patient is to understand what’s happening, and the better you’re communicating the value of the information is not only valuable for the imaging department, but the entire ecosystem you belong to.”

Batra believes a handful of factors will continue to influence the expansion of that value proposition, some of them operational and some of them technological. The promise of artificial intelligence and machine learning as applied to imaging studies and personalized medicine has yet to be fully realized; however, the more data sets are fed

devices. He believes this same approach also will help manufacturers in the repackaging of their old technologies.

Along the way, Batra believes that the future of medical imaging also will emerge along a collaborative perspective. The most successful institutions realize that staying siloed, however comfortably, means they’ll simply fall behind. It can take them years to catch up. Alternatively, start-ups that have viable products often “need to get bought” to achieve the scale required for market viability, Batra said.

“You’ve got problems of bureaucracy in bigger organizations when small guys can raise a few million dollars and challenge a market,” he said. “Innovation outstrips you now. We’re seeing entrepreneurs from everywhere, and software levels the entire playing field. That’s why the future is going to be in the software side.” ICE

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profile

SPECIAL ADVERTISING SECTION

CORPORATE PROFILE

INJECTOR SUPPORT & SERVICE T

he health care industry is continuing to demand ways to lower expenses and minimize overhead while maintaining a high level of patient care. Over the last several years, health care facilities and hospitals have searched for service solutions beyond the OEM. As a result, many biomed departments are bringing maintenance of their equipment in-house. With this increase in self-service maintenance, there is a necessity for quality, low-cost support alternatives.

In 2011, Ryan Clarke incorporated Injector Support and Service LLC (ISS) to fill this void. Clarke has performed countless PMs and calibration verifications as well as service responses. He has taught first-response training courses, performed operational in-services, assisted countless biomeds via phone technical support and assisted in the creation of training manuals.

“Our mission is to provide our customers with professional, timely and superior support and service for their contrast injectors. To accomplish this, we offer telephone technical support, parts identification and sales, depot service, loaner injectors and on-site service response – we seek to become your preferred and only source for your contrast injector support and service,” Clarke said.

ICE magazine discovered more about ISS with via a Q&A session with Clarke.

Q:

Can you share a little bit about ISS’s history and how it achieves success?

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ICEMAGAZINE | DECEMBER 2019

An ISS service engineer conducting a depot repair on a contrast injector.

A: I started ISS in 2011 as I saw a void in the injector market. There were a few small injector ISOs in the business, but none of them were capable of providing a cost-effective national support solution By teaming up with other third-party service providers and in-house biomed staff, many of which were already managing the injectors, we have been able to essentially create a virtual team of over 1,000 engineers and service technicians.

From our office in Winter Garden Florida, we support injectors across the United States and internationally to Guam, South and Central America, Caribbean Islands,

Bermuda, England, Greece and more. Our goal is to provide quick, cost-effective repair solutions. To that end, we first look to provide telephone technical support to on-site engineers and service technicians.

Our phone support staff can oftentimes identify a suspect failure with nothing more than a telephone call and recommend parts to order should it be needed, even going so far as to put together a symptom specific “hero kit.” When the repair is too extensive to be completed successfully in the field, our loaner and depot service is key in providing a quick and cost-effective resolution to the failure.

ADVANCING THE IMAGING PROFESSIONAL

profile ISS’ new training facility - offering level-II training on contrast injectors.

Q:

Q:

A: Our staff of 9 service technicians, combined, holds more than 50 years of injector specific service knowledge. ISS offers loaner injector systems for use during the depot repair of a failed injector. We carry over 50 loaners in our inventory, 35 of which are the widely utilized CT Stellant injectors. This rather large inventory allows our team to readily supply a loaner injector for most every make, model and modality.

A: My team specializes in the repair and maintenance of contrast injectors solely.

Many other service providers, across the industry, offer services on a variety of modalities. By focusing on our niche, we are able to provide focused service, allowing us to be the best at one thing. It’s in our name, it’s what we do.

What are some advantages ISS has over the competition?

Q:

What are some challenges the company faced last year?

A: Hiring and growth. Thanks to the quality efforts and hard work of our team, we have had continued growth by 20 to 30% year over year. Keeping up with the continued demands has resulted in endless rounds of new hires over the years, but nothing quite like the growth we have witnessed in the past 12 months. We have hired four new service technicians and are on the verge of hiring two more office support staff and at least one more technician within the next three months. The growth and struggles that come with new hires, from training to company culture changes, have been quite an interesting challenge.

And, watching our small company grow from 1 person to 3 and then to 14 and beyond has been quite exhilarating.

WWW.THEICECOMMUNITY.COM

Can you explain ISS’s core competencies?

Q:

What product or service that your company offers are you most excited about right now?

A: We just launched a brand new service training course. Our new course will take service technicians and engineers already familiar with the PM process and perform a deep dive on injector repairs. This Level II course is a direct replica of the course we run our own service techs through. We will run the students through various error messages, troubleshooting, high failure items, parts replacement and in depth tear down to frame repairs. The goal of our course will be to make students subject matter experts for their region/company.

Q:

What is on the horizon for your company?

A: A vast majority of our customers have always been time and material based clients, rather than carrying full service

contracts. In the past 24 months, we have witnessed a strong uptick in contract clients, signaling a turn in the market. Not only are we writing contracts direct to facilities, but are working hard with our ISO partners across the industry so they may utilize our team to provide their customers a complete coverage solution for an entire room or facility. Through these relationships we have created a multitude of contract solutions, from full coverage through ISS to shared risk contracts. Our goal here is to give our customers and ISO partners the tools to limit risk exposure to themselves and their clients while providing a cost-effective coverage solution.

Q:

Can you share some company success stories with our readers – a time that you “saved the day” for a customer?

A: I can honestly say that our team has “saved the day” with our customers on a daily basis on a variety of levels.

Our telephone support technicians house a vast array of troubleshooting knowledge garnered from their years of field experience. They are regularly walking on-site service reps through troubleshooting/repair steps; something as simple as the cleaning of a dirty sensor can save thousands in parts cost and eliminate downtime waiting for parts to arrive.

We have had several instances where the OEM will refuse to complete a repair, citing the failure as unrepairable and a

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profile In their 3,000 sq ft renovation, ISS has added several new depot service work stations. replacement system must be purchased – oftentimes requiring an additional $10,000 to $14,000. Our depot repair service with loaner, on the other hand, can regularly save customers 50 to 75% of that bill as we are able to effect these repairs with usually only a few thousand dollars in parts cost.

We carry parts for sub-assemblies which the OEMs necessarily don’t. This allows on-site engineers/service technicians to complete a basic parts replacement in the field, rather than the costly replacement of an entire sub-assembly, usually again at a savings of 50 to 75%.

Our field service schedule is such that we always have at least one service engineer ready to respond to a service call on the same or next day – guaranteed. As such, we are prepared to fly across the country on a moment’s notice, typically with a quicker response time and at a lower cost than the OEM. Our “saving the day” for our customers isn’t a one-off instance, but rather an every day scenario. They occur at the user level, the facility’s monetary level and, ultimately, at the patient level by minimizing equipment down time.

Q:

Can you please describe your company’s facility?

A: We built and moved into our new Winter Garden, Florida facility in November of 2017. In 10,000 square feet, we house our depot repair center, admin, loaner injector storage and parts warehouse. And, in just two short years, we have expanded from a feeling of, “we will never use all this space” to the recent completion of a build-out for classroom space for training, We have also expanded our depot tech center. As we look to further expansion, we have the capacity to add-on an additional 10,000 square feet to our existing footprint for more field and depot techs as well as expanded inventory.

Q:

Can you highlight any recent changes to your company?

A: Growth. Growth has been and continues

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to be the constant with regard to change in our company. The word is spreading about our reputation as the premier third-party vendor in the injector arena. As I mentioned earlier, ISS started off in 2011 with myself and one part-time employee.

Here it is eight years later and Injector Support and Service employs 14 dedicated full-time professionals. We grew from an idea, housed in the second bedroom of my apartment, to a multi-million dollar company whose goal is to keep the customer’s injectors operational and, as a byproduct, save patients’ lives. Sure, we have a new facility, we offer more loaner injectors now than ever before and we are offering Level II maintenance training, but all of that is directly tied into our mission of supporting our customers in a timely, cost-efficient manner. In the end, if it is done correctly, you end up with a company that grows and that growth is the change.

Q:

Can you tell me about your employees?

A: Our employees are a unique group of professionals with varying levels of education, experience and expertise. All of our personnel are great at what they do, with a majority of them cross trained in other job functions within ISS. For instance, Stephanie heads up our clerical staff and is responsible for receiving purchase orders, issuing RMAs and responding to requests for part numbers, pricing and availability. If the need arises, she can pull parts for shipping.

Then there are Jonathan and Ethan, our two in-house, shake and bake, “we got an answer for that” technical support guys. These two not only provide our customers with technical support over the phone, but by email as well. They also serve as the backbone for our field

support technicians. It doesn’t matter if they are traveling to a site for a repair or working on a customer’s in-house depot repair, these are the guys our customers ask for when it comes to injector repairs and technical expertise.

Another one of ISS’s truly outstanding professionals is Blaine, our in-house depot level repair technician. He’s not much for small talk, but he sure knows his way around injectors.

Q:

What is your company’s mission statement?

A: Injector Support and Service serves its’ customers by providing professional, timely and superior support for medical contrast Injectors.

In that, we understand that limiting lab downtime is paramount. And doing so in the most cost-efficient manner is nearly as important. Our telephone technical support and, when needed, our loaner injectors bridge the gap between efficiency in timing and efficiency in dollars.

Q:

Is there anything else you want ICE readers to know about ISS?

A: I think the biggest takeaway your readers should know about Injector Support and Service is that if they aren’t using our services: our free technical support; our low-cost parts that come with a 90-day warranty; our loaner services; our next flight out option when ordering parts; our depot repair; our 90-day warranty on repairs, our full-service contracts; or our Level II maintenance training course, than they have not experienced true customer-centric injector support and service. ICE For more information, visit injectorsupport.com.

ADVANCING THE IMAGING PROFESSIONAL

INJECTOR SUPPORT & SERVICE • Loaner injectors • Depot service • P arts identification and sales • P reventative maintenance tools • On-site service • Injector sales

To learn more visit www.injectorsupport.com or call 888.667.1062

insight

CAREER CENTER Don’t Be Sabotaged by Social Media

M

ost of our decisions in life are made in an instant, and many big ones are based on first impressions until we dig deeper. In the recruiting industry, I have seen first-hand just how much first impressions count when it comes to securing a new job.

When our son was born, we knew we needed to find a good environment for our baby. My wife and I began our search for a day care provider by looking at centers that were close to home and we made personal visits. Maybe it was our newness as parents, but we struggled to find a satisfactory environment for our precious little guy. In many instances, our decision was made within the first few minutes.

Sometimes we instantly ruled out a center due to the lack of care of the building, or the cleanliness of the facility. Quite a few times we walked away because of the impression the staff left on us. So, why would employers base their decision any differently?

I have always looked at the job search process as a series of first impressions; your resume, telephone interview and face-to-face interview. Today employers are looking at another level of first impression – your social media profile.

We connect faster socially and professionally than ever before. There are 2.41 million active users monthly on Facebook.

As for LinkedIn, there are 645 million users worldwide, with 146 million of those users in the United States. The U.S. Chamber of Commerce Foundation estimates employ-

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ees spend a minimum of an hour on social media daily.

So, make social media work for you.

LinkedIn is a great way to network with peers in the industry. Professionals and companies use LinkedIn for various reasons, from exchanging knowledge and ideas to finding new talent. Most people start with LinkedIn by building their profile based on their resume and summarizing employment history, skills and professional accomplishments. Candidates are 36 times more likely to receive messages if they have a professional picture of themselves. Make sure your profile sends the right message with detailed, up-todate and accurate information. Employers often cross reference a LinkedIn profile with previous applications and resumes.

They are looking for career progression and any additional education, training or skills candidates may have picked up over time. On the flip side, they can also discover inconsistencies between the profile and a resume they have on file. These discrepancies could potentially damage your credibility. It is in your best interest to ensure your resume and LinkedIn profile convey the same message.

It’s no wonder employers turn to these resources to locate candidates and to find out more about potential talent. Criminal background checks, credit reports, Google searches and social media outlets (Facebook, LinkedIn, Instagram, Twitter, etc.) are all tools employers use to screen candidates. Think they don’t look at your

Written by Tim Hopkins Stephens International Recruiting Inc.

social media pages? Think again!

Connecting with family and friends on social media is a wonderful tool if used correctly and for the right purpose.

However, it can work against you in your professional career. Remember that once something is on the Internet, it is out there for a long time. Employers frequently utilize social media to find out more about a candidate’s character and ethical behavior. We have all done things in a social setting that would cause us embarrassment at one time or another. It is best to leave it in that place and time. Do not share it with the world to see, and certainly don’t leave a recorded timeline of your experiences.

1. Check Out Your Profiles! Go to each of your social media accounts and look at your profile. Ask yourself, “is this going to hurt me?” If you have to explain it, justify it or if you are embarrassed by it … the answer is yes. Remove it.

2. Privacy Please! While you are in each account, look at your privacy settings.

Are your settings open to the entire world to view? Don’t forget that on Facebook even if your page settings are set to private, your posts can still be global. Be informed about your settings in each type of account and spend time securing your accounts.

3. Keep it in Check! To keep yourself in check, consider friending your mom or better yet, keep your profile and posts set to private.

4. Google It! Have you ever wondered what the Internet might say about you?

ADVANCING THE IMAGING PROFESSIONAL

insight

S

I’m pretty sure you would be ruled out as the employee of the month.

Wondering who has the time to check on social media activity? Some organizations are utilizing companies that specialize in social media background checks. These organizations provide online research from social media sites, blog posts and other Internet sites looking for negative or illegal activity made by potential and current employees.

With technology evolving as fast as it is, who knows what is in store next. The good news is if you are educated and conscientious about how you conduct yourself with social media you have little to worry about. Remember, you cannot land a job in 10 seconds, but you can be ruled out in 5! So, keep all of your first impressions positive. ICE Tim Hopkins is an executive recruiter with Stephens International Recruiting Inc.

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Then Google your name and you might be shocked at what you find. Not only is it public information, but many local online newspapers also have entire sections dedicated to criminal activity ranging from assaults to drug possession. Chances are if you have been in trouble with the law, it will be public record. Be prepared to explain yourself if these things are in your past.

5. After You Are Hired. Your social media presence shouldn’t change too much after you get a job. Keep things private, don’t vent work frustrations, and never blast your boss or the company. It goes without saying that you should never use any social media while at work unless you are directly paid to do so. Most employers today monitor Internet usage. Imagine how your boss will react to finding out you posted on a social media site with time stamp at 9:30 a.m. when you should have been working.

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insight

IMAGING MATTERS How to be More Valuable

E

veryone is looking for the most value for every dollar spent. This is not unique to the imaging industry. As the world becomes more and more of a global economy, it will only become more prevalent. So, how do you make yourself more valuable?

How do you make every dollar spent on your pay and benefits become a better investment for your employer?

This is really about being relevant and making sure that your employer knows that you are relevant and a better dollar spent than any alternative. There are a number of the ideas that apply across industry and job description, and some specific to the Field Service Engineer (FSE).

First, get enough sleep. Being well rested will make you more able to think clearly and deal with whatever is thrown at you. Seems obvious when it is written down. However, a quick look at your favorite Internet search engine will show you that most people get only six to seven hours of sleep a night. Seven is typically the minimum recommendation. That also assumes you are getting restful sleep. That same search engine will also inform you that there are a number of health issues related to lack of sleep. A lack of sleep can lead to cognitive impairment. In layman’s terms, that is unclear or diminished thought.

WWW.THEICECOMMUNITY.COM

The inability to think clearly or at maximum capacity. Anyone that has changed a CT tube will tell you that it can be a physical job. But the troubleshooting that got you to the tube as the issue was driven by clear thought.

When you arrive at work, be ready to work. Sure it is nice to have a cup of coffee and chat with others in the shop or department, but when you go “on the clock” be ready to actually get some work done. Once again, it may seem obvious when it is written down. However, everyone has seen someone (or been that someone) who has gotten to work and had a call that they put off until they had a cup of coffee. You can drink your coffee before you get to work, have more after that first call. Be ready to walk in and work. If you can have that coffee before you get at it, look at it as a bonus.

Take care of your health. This connects with sleep, but it is a bit bigger.

Eat right, exercise, get check ups and keep stress manageable. This will lead to fewer sick days. It will also assist in allowing you to deal with the days that don’t allow you to get enough sleep or exercise. The day you troubleshoot most of the day, have to courier a part to the hospital, then install and calibrate it will be much easier to deal with. Your body and mind will have the reserves to deal

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

with the challenge. You don’t have to be an extreme athlete, just exercise and eat reasonably.

Read trade magazines and keep up.

Know what is available and what is coming. As technology changes more rapidly, this will be critical. A radiologist or hospital administrator needs to know that they can come to you to help them with understanding what is and isn’t important after a talk with a salesman. Do they really need the top of the line general radiation suite with all the options for orthopedics in a remote imaging center?

Finally, understand the national, regional and local goals. It is obvious that these may not all be the same goal set. Each may take a different priority.

Yet, being engaged and having a good grasp of the big picture will help you make the immediate decisions on parts, downtime and overall spending.

You will notice, none of this is technical. Because technology changes, what works today in troubleshooting and repair may not work tomorrow. The physical tools and practices may change as the government looks at changes to laws and policies. But making yourself valuable and being flexible and adaptable will bring you both financial success and personal satisfaction in a job well done. ICE

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insight

CONFLICT RESOLUTION 201: THE SKILL OF LISTENING n my last column, I wrote about the five universal fears and how they get in the way of conflict resolution. By way of review, they are fear of criticism, fear of failure, fear of rejection, fear of not getting what you want and fear of losing what you have. If we’re trying to resolve conflict, we need to minimize these fears, not only in ourselves, but also in those around us.

One way to minimize those fears and maximize our understanding of others is by practicing good listening skills, so that’s what we’ll cover this month.

Most communication classes focus on either speaking or writing – not many classes focus on listening. This is sad, because millions of dollars go down the drain each day because of poor listening The problem? Everyone wants to be heard first.

Think about it. If everyone is trying to be heard, then nobody is truly trying to understand. Then, when people don’t feel understood, they experience frustration, feelings of isolation, loss of team cohesion and lower levels of commitment. All these impact an organization’s bottom line, so it truly pays to learn how to listen.

• Listening: truly trying to understand what you hear Hearing happens passively. If our ears are functioning as designed, we can hear.

No thinking is required. Something happens that causes a noise, and if were close enough, we hear it.

Listening requires an active, conscious choice. To listen, you must have a purpose in your heart and apply mental effort.

Think of listening as a task to accomplish.

Other fears also get in the way of listening. If we truly strive to understand someone else’s point of view before stating our own, we may be afraid of several things.

• Our listening may be perceived as an agreement even if no agreement exists • We may learn something and realize our original perspective was incomplete (vulnerability) • We may fear that by listening first, we won’t be given opportunity to convey our perspective • All of the above I’m going to share two steps for effective listening, but before I do I first want to cover the seven deadly sins of not listening. Why? Although it’s important to know what to do, if you have listening sins that get in the way, good listening gets canceled out.

The Definition of Listening Let’s first clarify the difference between hearing and listening.

• Hearing: the act of perceiving a sound by ear

The Seven Deadly Sins of Not Listening 1. Filtering. This is when a person’s mind sifts through another person’s words looking for areas of agreement or dis-

Editor’s note: This is the second in a fourpart series on conflict resolution.

I

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Written by Daniel Bobinski Workplace Consultant

2.

3.

4.

5.

6.

7.

agreement. No effort is being made to truly understand the speaker.

Second-guessing. This is striving to assume – and judge – someone’s motives.

Discounting. This sin occurs when a listener lacks respect for a speaker.

Even if a speaker is 100% correct, a discounter dismisses what is being said.

This is sad, because discounters often miss genuine solutions to problems.

Relating. People who continually compare what’s being said to events from their own life are relating. You can usually identify this sin when you hear the phrase, “That reminds me of when I…” Rehearsing. This is mentally reviewing what you’re going to say while waiting for the speaker to finish. It’s hard to pay attention to a speaker when your mind is focused on how you’re going to state your next sentence.

Forecasting. This is letting your mind run too far ahead with an idea. There’s a fine line between knowing where the conversation is going and running too far ahead with it. If you forecast too far, a speaker will think you’re not listening, and this lowers trust.

Placating. Often committed by people pleasers, placating is when you say yes to everything for one of several reasons. A) You don’t want to take time or invest energy to listen, B) you don’t really care about what’s being said, or C) you’re just wanting to avoid conflict.

If conversations are smooth, the items

ADVANCING THE IMAGING PROFESSIONAL

insight

above aren’t necessarily sins. But in times of conflict or misunderstanding, the items listed above are behaviors to avoid.

Two Steps for Listening At its basic level, true listening is a twostep process.

Step 1: Focus on the other person.

Step 2: Seek confirmation of what you perceive.

To truly listen, you must first focus on the other person. What are they thinking?

What are they feeling?

Are they frustrated? Concerned?

Thrilled? Happy? Disappointed? Are they identifying a problem? Describing a solution to a problem? Expecting a particular action? Looking for help? Relaying information?

Don’t be limited by what you see here.

These are only examples. The idea is to look for the nuances of thoughts and feelings surrounding a person’s words.

Step two establishes a deeper connec-

tion with the speaker, and prevents you from acting on assumptions. The idea is to get verification that what you have perceived is correct. This can be done several ways.

• Ask questions. If I understand you correctly, you’re concerned about the deadline?

• Make statements, but with a voice tone that allows the other person to validate. You sound really concerned about the deadline.

By seeking confirmation, you’re allowing the other person to say, “Yes, that’s it,” or, “No, not quite.”

If the person says, “No, not quite,” ask the person to clarify what you didn’t understand.

The Danger of “I Understand” Two phrases to avoid are, “I understand,” and “I know how you feel.” First, there is no way for you to truly understand. People have deep feelings and experiences you

may know nothing about. Second, such phrases place the focus back on you, thus violating step number one. Third, the speaker can doubt you. Just saying the phrase, “I understand,” doesn’t mean it’s true.

Bottom line, so many of us are not taught to listen, and that makes it difficult to resolve conflict and misunderstandings. Listening is truly a skill that must be learned, and it is necessary if we are going to resolve disagreements.

In my next column, I’ll talk about how to maintain trust while getting to the root of a problem. ICE Daniel Bobinski, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him through his website, www.MyWorkplaceExcellence.com.

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