TechNation Magazine - March 2020 by MD Publishing

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Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

MARCH 2020

DISASTER

PREPAREDNESS Lessons Learned and How to Prepare page 50

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34 ECRI Update

The Rapid Adoption of Point-of-Care Ultrasound

20 Biomed Adventures

Restoration Guru

69 Roman Review

Customer Relationships

74 Scrapbook

CMIA

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CONTENTS

FEATURED

DISASTER

PREPAREDNESS Lessons Learned and How to Prepare

HE ROUNDTABLE: T ULTRASOUND For this roundtable article onultrasound, TechNation reached out tosome industry leaders for their input and insights regarding what to look forwhen purchasing an ultrasound system, the latest advancements in the modality,cybersecurity concerns and more.

DISASTER PREPAREDNESS: LESSONS LEARNED AND HOW TO PREPARE Disaster preparedness is important. Yet, sometimes we don’t understand how important it is until we have lived through an emergency situation. TechNation interviewed healthcare technology management professionals who have experienced natural disasters and man-made emergencies. Here they share advice and tips on how to best prepare. Next month’s Feature article: Future of HTM

Next month’s Roundtable article: Endoscopes

TechNation (Vol. 11, Issue #3) March 2020 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2020

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

MARCH 2020

TECHNATION

CONTENTS

INSIDE

Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley Karlee Gower Amanda Purser EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Jennifer Godwin

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Manny Roman, CRES, Business Operations Manager, Association of Medical Service Providers Jim Fedele, CBET, Senior Director of Clinical Engineering, UPMC Carol Davis-Smith, CCE, FACCE, AAMIF, Owner/ President of Carol Davis-Smith & Associates, LLC David Francoeur, CBET, CHTM, Senior Vice President Marketing and Sales, Tech Know Associates - TKA Jennifer DeFrancesco, DHA, MS, CHTM, System Director, Clinical Engineering, Crothall Healthcare Rob Bundick, Director HTM & Biomedical Engineering, ProHealth Care

P.12 SPOTLIGHT p.12 Professional of the Month: Matt Oetker p.14 Company Showcase: Summit Imaging p.18 Department of the Month: Ralph H. Johnson VAMC HTM Department p.20 Biomed Adventures: Restoration Guru P.23 p.23 p.30 p.32 p.34

INDUSTRY UPDATES News and Notes: Updates from the HTM Industry Ribbon Cutting: Chronos Imaging AAMI Update ECRI Institute Update

P.36 p.36 p.38 p.40 p.42

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

P.56 EXPERT ADVICE p.56 Career Center p.58 20/20 Imaging Insights p.60 Cybersecurity p.63 The Future p.64 View on Value p.66 The Other Side p.69 Roman Review P.70 BREAKROOM p.70 Did You Know? p.72 The Vault p.74 Scrapbook: CMIA p.76 MedWrench Bulletin Board p.86 Flashback p.79 Service Index p.83 Alphabetical Index Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag

MD Publishing / TechNation Magazine 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290 800.906.3373 â&#x20AC;¢ Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

TECHNATION

MARCH 2020

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Matt Oetker, CHTM, CBET: Well Rounded Biomed BY K. RICHARD DOUGLAS

ometimes our first career choice is not the one we settle on. Another occupation can come out of left field and captivate our interest and determine our future.

That was the case for Matt Oetker, CHTM, CBET, a technician III with HSS assigned to Montrose Memorial Hospital in Montrose, Colorado. Oetker is a one-man biomed department at his facility. “While I was still in high school, I was working with an Air Force recruiter to enlist during my junior year. Because they would not let me pick my career before enlisting, I chose not to sign the contract. As a result, I began speaking with a National Guard recruiter that had been at my school. He showed me a list of critical need Military Occupational Specialties (MOS) for the state of Iowa,” Oetker says. “There were a few that caught my eye, mostly dealing with being a chaplain’s assistant or some form of administrative MOS. I had originally planned to go to college to become a history teacher, so I was trying to pick a MOS that would translate somehow to that,” Oetker remembers. It turned out that a career field that Oetker did not even consider would catch his attention. “But then I saw ‘35G Biomedical Equipment Repair.’ I asked the recruiter what that was all about. He told me he wasn’t entirely sure but he thought it had to do with taking broken equipment

TECHNATION

MARCH 2020

Matt Oetker is among the CABMET officers and board members who attended the 2015 AAMI conference. apart, fixing it and then putting it back together. I had always tinkered with transistor radios and such as a kid so I thought that sounded kind of fun. I just had a gut feeling that I should choose that MOS over anything else. It also came with a student loan repayment plan and an enlistment bonus, so that helped a little too,” Oetker says. Oetker’s decision would send him to the military’s biomed school. “I graduated from the United States Army Medical Equipment and Optical School (USAMEOS) in December 1994. It was an intense program that had 12 modules with varying fields of study. I thought it was an excellent course. We had the opportunity to not only learn

electronic theory, but we also were able to learn about, and physically troubleshoot on, equipment that was currently active and being used in medical facilities. Not every biomedical training course can offer that, let alone the amount of equipment we were taught,” Oetker says. After training, Oetker’s career progressed from military to civilian, with a lot of on-the-job training and experience along the way. “I started in the field obviously as a biomed for the Iowa National Guard. In my civilian career, I started as a field technician on audiometry equipment and dental equipment. Later, I started an in-house position where I was trained on sterile processing equipment and OR tables, lights and equipment carriers. During this time, I also learned general biomed and covered a pediatric ER and PACU in addition to all of the sterile processing equipment,” Oetker says. From there, he became a field technician focusing on sterile processing equipment and lab sterilizers. “It was during this position I became a supervisor. After a few years as a supervisor, I made a decision to step down to spend more time with my family and am currently in a one-tech shop. Each position I have held has helped me further my career and every specialty I’ve worked on has helped me understand how to support a facility as the lone biomed. I do have co-workers in the area, at other facilities that help me on occasion, but for the most part I take care of my facility,” Oetker says.

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SPOTLIGHT

ABOVE: Matt Oetker is seen with his wife, three daughters, son, daughter-in-law and three granddaughters. RIGHT: Matt Oetker is seen at Fitzsimmons Army Medical Center after his 1994 graduation from the medical equipment repairer school.

FAVORITE BOOKS

“27” by Wiliam Diehl and “The Eagle Has Landed” by Jack Higgins

FAVORITE MOVIES

“The Shawshank Redemption,” “Raiders of the Lost Ark,” “Caddyshack”

FAVORITE FOOD

Pizza or Mexican

HIDDEN TALENT

For some reason, I retain a tremendous amount of useless music trivia. I also like to sing karaoke.

FAVORITE PART OF BEING A BIOMED

I get to interact with different people and equipment every day. I get a level of satisfaction when I can take something that isn’t working, figure out why and fix it.

WHAT’S ON MY BENCH?

• Ice Breakers spearmint mints • Speakers because I have music playing at my desk at all times throughout the day • SnapOn ratcheting screwdriver • Insulated stainless mug for hydration • A CABMET mug I use to hold Sharpies and pens

OLD PICK-UPS AND GRATITUDE While not facing any major challenges, one that Oetker remembers occurred during his time as a supervisor. “The most difficult challenge I’ve encountered is as a supervisor, finding a tech to work on sterile processing equipment. For some reason, a large percentage of biomeds seem to shy away from working on this modality. It is sometimes extremely difficult to find someone that not only wants to work on sterilizers, but also demonstrates the capacity to learn and become proficient at maintaining and repairing them,” he says. When not holding down the fort as a single-tech shop, Oetker enjoys his leisure time indoors and out. “As a kid of the 1980s, I still play video games from time to time. I also have taken up hunting in the last few years. I’ve really enjoyed learning how to hunt and continuing to improve on what the Army taught me with regards to handling and firing rifles. Also, growing up [I did not] learn how to work on vehicles. I purchased a 1972 Ford F100 a few years ago to learn on which I then traded for a 1979 Ford Bronco. Other than that, my spare time is spent shuttling my daughters to their various activities and attending high school sporting events,” he says. On the home front, he and his wife,

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Stephanie, will celebrate 19 years of marriage in September. Oetker’s family also includes a son and three daughters. He says that he is grateful for the opportunity he’s had to work in the HTM field. “I’ve worked with several individuals that took the time to teach me how to do the job. I make every effort to return those favors and pass on knowledge I’ve gained to new techs. I encourage every biomed to mentor someone. You’ll either learn something new while teaching someone or remember a detail you forgot,” Oetker says. “I also encourage biomeds to be involved in their local biomed association. The associations are a great way to network and ask questions of other techs in your region to get a different prospective on how the job is done. I have been a member of CABMET since 2010 and have served as vice president twice,” he adds. All of the training and experience, sterile processing and everything else, has made Oetker a well-rounded HTM professional.

MARCH 2020

TECHNATION

SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE SUMMIT IMAGING

ummit Imaging® is a technology-enabled ultrasound and mammography imaging equipment service business. We provide our customers with the highest quality repair services and replacement parts so they can remain focused on their primary job of delivering excellent patient care. Since 2006, Summit has leveraged a unique combination of sophisticated component-level repair capabilities, software development skills and an exceptionally customer-focused team to meet the needs of our customers and their patients. Our products and services help Healthcare Technology Managers (HTMs) increase equipment uptime at their facilities at a significant savings compared to other options. Summit truly values collaborating with health care facilities that seek to enhance access to quality medical services at a competitive cost. Customers consistently report that the more they work with us, the more savings they realize via cost reductions and improvement of key HTM operating metrics.

Summit Imaging provides product support and service for ultrasound equipment in the following areas: • Ultrasound transducer repairs and replacements • Ultrasound system replacement parts • Best in class diagnosis and installation technical support • Detailed hands-on service training for technical personnel In response to health care facilities requests, Summit has expanded the suite of solutions it offers into mammography

TECHNATION

MARCH 2020

Larry Nguyen Summit Imaging CEO and CTO

equipment. We now offer mammography equipment support in the following areas: • Mammography digital detector plate repair and replacement • A comprehensive inventory of mammography system replacement parts • A knowledgeable and responsive technical support team HOW DOES SUMMIT IMAGING FIT INTO THE HEALTHCARE TECHNOLOGY MANAGEMENT (HTM) INDUSTRY? Summit Imaging believes that our customers, sometimes with our help, have the ability to keep their imaging equipment running in tip-top shape. Our goal is to enable HTMs to service their medical devices much faster and at a lower cost than traditional, full service-oriented options. Our ability to help health care facilities optimize and improve their equipment management programs has become an extraordinarily attractive and lucrative alternative for

our customers. Often, in-house HTM and field service teams must focus on responding to a variety of failed medical device alerts with limited bandwidth to diagnose the faults. Summit Imaging’s technical support team assists HTMs with the technical knowledge and guidance needed to properly and quickly diagnose faults, remove faulty components and install high-quality, warranted replacement parts they can trust to quickly return their systems back to service scanning patients. And, at Summit Imaging, we continue to develop new technologies and methods to repair these complex systems in order to meet the needs of our customers which represent some of the largest health care networks in North America. SUMMIT IMAGING HAS A VERY UNIQUE OPERATING MODEL. WHAT INFLUENCED HOW SUMMIT IMAGING OPERATES? Summit Imaging’s humble roots began performing electronic component repairs on computer systems in medical devices. This was during a time when devices were transitioning away from analog and toward digital technologies. This experience helps us hone a unique skill set recognized by our earliest customers as an effective way to help them reduce their service and maintenance costs. This further led to opportunities to partner with well-known and highly respected health care organizations in tackling larger and more complex challenges. Summit Imaging came to understand that the needs of these organizations revolved around rapid access to high-quality replacement parts resulting in industry leading HTM performance benchmarks for time and cost savings.

WWW.1TECHNATION.COM

SPOTLIGHT

Summit Imaging worked closely with these customers to align our operations and business model with our customers’ needs. Looking back, we now understand that this was the beginning of an industry shift toward health care facilities developing internal HTM service departments. We are grateful to these early customers for leading us to operate in a manner that best served their needs, both then and now. This model of increasing reliance on in-house support services at medical facilities has now become the norm rather than the exception. Today, Summit Imaging continues to evolve in response to our customers’ quest for greater operational cost savings alongside improving patient care. WHAT ROLE DOES TECHNOLOGY SERVE TO SUMMIT IMAGING? Technology has fundamentally changed the HTM industry and leading-edge technology development is a philosophy deeply embedded in Summit’s culture. To us, it is one of the very best methods to reduce diagnosis and repair times as well as streamline installation time and complexity. Simply stated, our strategy is to resolve complicated problems and package solutions in simple-to-use form factors for health care facilities to deploy. These technologies do require significant development resources in order to deliver seamless, high-quality solutions. Some of our solutions have been transformative for healthcare facilities and how they operate their HTM programs. Some of the most promising outcomes include: higher yield on first service success, reduced HTM service time, lower total cost of fault diagnosis and repair, and increased patient care capacities. In the past, health care facilities’ repair options were limited to full-service solutions. Today, HTM groups can service their equipment with the support of an organization like Summit Imaging and realize savings ranging from 60% to 80% relative to traditional service options. Summit Imaging, alongside its health care facility customers, will continue

trailblazing more support options for ultrasound equipment, mammography equipment and other medical devices that contain complex electronics. Future growth in the HTM industry will require ongoing development of innovative solutions that drive increased productivity and efficiency. There is a generational shift underway in the HTM industry. As the experience level of engineers and technicians decreases and workloads increase, the need for powerful, technology-based solutions like ours becomes even more vital. HOW DO YOU PROVIDE YOUR TECHNOLOGY TO HTMS? Much of Summit Imaging’s technology is focused on repairing the sophisticated electronics of medical devices that are readily available when HTMs need it. Our core value proposition is delivering high-quality replacement parts that HTMs can install and, in the process, extend the mean time between failure, preventing additional unnecessary service calls. HTMs become very frustrated when they return to a recently repaired device only to find that the replacement part has failed again. It is abundantly clear to us based on our extensive experience with the healthcare technology management community, that the most precious resource for HTMs is time. We strive to help our customers fix things quickly, but most importantly to fix it right the first time. Summit Imaging has invested significant resources to ensure the products we sell and help our customers install last well into the future in order to prevent unnecessary service calls. In 2015, the company earned its initial ISO 13485:2016 certification for its Quality Management System (QMS) and has successfully passed annual certification audits every year since. Summit Imaging has deployed its QMS through integration with its cloud computing-based, Enterprise Resource Planning system to help us manage, streamline and enhance our operations. The impact to our organization has been dramatic and our

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

customers have really benefited. The application of 14 years of experience and advanced analytics tools has allowed Summit to collect and aggregate data, to utilize that information for better planning a customer engagement and to improve the quality of the products and technical support we provide our customers. Summit Imaging enjoys the industry’s best quality of product and best technical support metrics with a 93% accuracy rating for first time diagnosis amongst HTMs. We are proud of our performance and remain committed to continue to improve for the benefit of our customers and the patients they care for. WHAT DOES THE FUTURE HOLD FOR THE HTM INDUSTRY? Society needs healthcare technology management to continue advancing in order to deliver better patient care while simultaneously containing rising health care costs. One of the focus areas must be an emphasis on health care facilities delivering high-quality patient care at a sustainable cost. This is a direction we must pursue because without this HTM movement, we are exposed to the risk of ballooning costs, making quality health care out of reach to increasing segments of our population. One of the best strategies available for health care facilities seeking sustainable growth is to lower costs while concurrently maximizing their revenue generating opportunities. With health care facilities moving away from fully outsourced service models, it is clear they will increasingly need new solutions to expand their service capacity. Summit Imaging has always believed it is critically important to contribute to the welfare and evolution of the health care industry and we are excited to continue to evolve our current tools and develop new technological solutions to help health care facilities be in the best position to care for patients in need. FOR MORE INFORMATION, visit mysummitimaging.com

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SPOTLIGHT

DEPARTMENT OF THE MONTH The Ralph H. Johnson VAMC Healthcare Technology Management Department BY K. RICHARD DOUGLAS

hrimp and grits and she-crab soup are staples in Charleston, South Carolina. The seafood dishes are traits of the state’s oldest and largest city, which sits on the Atlantic coast.

The many veterans in the Charleston area are served by the Ralph H. Johnson VA Medical Center, a 152-bed, Level 1A complexity hospital. The medical center was named after Pfc. Ralph H. Johnson, USMC. During the Vietnam War, Pfc. Johnson shielded two of his fellow Marines from a grenade blast and saved their lives while losing his own. The medical center was renamed in Johnson’s honor in 1991 and is part of one of the largest health care systems in the world. The center’s HTM department is made up of dedicated professionals. The healthcare technology management (HTM) service at the Ralph H. Johnson VA Medical Center includes five sections and a total of 45 staff. The department is led by Chief Lucas Marsh and Assistant Chief Carl Cross, who oversee the administrative section which includes four biomedical engineers, an administrative officer and program specialist. He says that Britton McCaskill is the

TECHNATION

MARCH 2020

supervisory biomedical engineer. McCaskill manages a staff of 13, including Lead Biomed Technician Jim Scannell, 10 senior biomed technicians and two entry-level technicians. “Juan Valdez is the supervisory electronics technician. His section includes five electronics technicians and two telecommunication specialists,” Cross says. Cross says that Walter Morales is the supervisory computer engineer. The computer engineering section (CES) includes a staff of seven, including a

combination of computer engineers and coordinators for specialized systems like Vocera, E-Consults and electronic workflows. “Shalonda Oliver is the supervisor of clinical application coordinators (CACs), managing a staff of six CACs,” Cross adds. In addition to the hospital, the HTM staff also maintains equipment at six community-based outpatient clinics throughout the Lowcountry. “Last year, we broke ground on two new outpatient clinics. One in Myrtle ALL PHOTOS COURTESY OF RALPH H. JOHNSON VA MEDICAL CENTER

THIS PHOTO: Charity Blue replaces hardware in a server. ABOVE: Terry Benton works on an equipment repair for staff at the Ralph H. Johnson VAMC.

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SPOTLIGHT

Beach (75,000-square feet) and one in North Charleston (84,000-square feet). The new clinics will provide primary care, mental health, dental and select specialty services to the increasing population of veterans in these areas,” Cross says. The HTM team provides the medical center with several services. It is a comprehensive list. “Medical equipment management for all hospital-owned patient care equipment, including inpatient, operating rooms, imaging, sterile processing, ophthalmology and dental. Electronics technicians maintain non-patient care equipment such as nurse call, security systems, pneumatic tube system, patient TVs, guest Wi-Fi and much more. The computer engineers and clinical application coordinators provide a second tier of service for server-based systems and those that interface with the EHR,” Cross explains. The department is very involved in project management and capital acquisitions. It plays an important role in the equipment management life cycle. “We are usually facilitating at least 10 long-term projects that involve implementing or replacing technology systems in the hospital. We either initiate or get involved early upon a request from a clinical department, and assist in all phases of planning, market research, procurement and implementation,” Cross says. In their role as equipment experts, Cross says that an engineer meets with each department in the hospital every year, ahead of the fiscal planning period, to review their equipment needs. “We make suggestions for equipment that needs replaced, and listen to their requests for new equipment to support an expanded program they are pursuing. We compile and prioritize the requests from each department and present it to leadership for funding approval,” he says. When dealing with service contracts, the team approaches the matter by only using first-look contracts when technicians are not fully trained to maintain the equipment and when it is apparent that it contributes to savings in cost or turnaround time.

Ralph H. Johnson VA Medical Center Healthcare Technology Management Service.

“This includes the large imaging modalities, lab analyzers, sterilizers, lasers and others,” Cross says. “The facility is part of VISN 7 (VA Southeast Region) comprised of eight medical centers. Charleston manages the VISN 7 Biomed Risk Pool which allows the facilities to pool money together for maintenance of select medical equipment. This creates a cost savings where service contracts are not required or not as cost effective. The targeted medical equipment to include in the risk pool are those with a high potential for monetary return and low potential for failure,” Cross explains. Integration with IT has been simplified since the HTM team is already IT-savvy. “There is significant IT knowledge and skills within our HTM department. HTM takes the lead on interfacing devices with the EHR. This includes everything from running a new CAT6 cable in a patient’s room, to setting up HL7 links on the interface server and creating the consults or orders in our EHR that are mapped to a device,” Cross says. A MYSTERY SOLVED The Ralph H. Johnson VA HTM team have collectively taken the role of detectives and made a not-so-obvious

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

discovery that highlights the team’s abilities. It has saved radiology from some future grief. “One story of how our department has helped problem solve was the work we did to eliminate artifact issues seen on our 3T MRI on the second floor of the hospital. We worked with radiology staff to gather information on how often and when the artifacts were seen,” Cross says. He says that what they discovered was that there was a large construction vehicle on the ground floor outside the building below the MRI when the artifacts were observed. “Then, we did calculations and drawings to quantitatively confirm that the artifacts were most likely attributed to this vehicle. We gave this information to our engineering staff to take action on, and the area was blocked off so that no more vehicles could park there. In fact, that area went on to become a large open-air dining area, so we like to think that we had a hand in bringing that extra bonus to the employees and patients,” Cross adds. The brave soldier who is the namesake of the Ralph H. Johnson VA Medical Center would be proud of the facility’s HTM team who live up to a code of excellence that he personified.

MARCH 2020

TECHNATION

SPOTLIGHT

LEFT: This Triumph TR6 is one of many Triumph automobiles Cliff Hall has owned. RIGHT: The Mobil Pegasus adorns this gas pump jukebox.

BIOMED ADVENTURES Restoration Guru BY K. RICHARD DOUGLAS

ans of the original 1980s TV show “Magnum P.I.” know well the iconic red Ferrari that actor Tom Selleck drove around Oahu while investigating cases. Viewers knew that the car was actually owned by Robin Masters, but private eye Thomas Magnum seemed right at home behind the wheel.

Of all the models that Ferrari has produced, that vintage 308 GTS model became the most recognized for a generation of TV viewers. To own one would be a slice of nostalgia. If you possess the skill set and knowledge to work with tools and build and restore things that require craftsmanship and mechanical aptitude, then finding an old Ferrari 308 GTS might be the perfect project. For Cliff Hall, president of Signature Emergency Products (SEP) in Boothwyn, Pennsylvania, the challenge was worth it and he had the skills to make it happen. Hall isn’t only restoring an iconic car

TECHNATION

MARCH 2020

Cliff Hall bought a Ferrari 308 GTS off eBay with hopes of restoring it. like the one that Magnum fans remember. He has restored other cars as well as jukeboxes. It takes a special skill set to do both. Learning auto mechanics and the beginnings of Hall’s restoration skills go way back. “I was about 12-years old when my dad forced me to go to his shop and help him. I hated school and he found out I was hanging at the gas station around the corner of our house. Once at his shop, I got to learn how to work on cars with him and the mechanics that worked for him,” Hall says. “My first job was to do a clutch job on a Triumph Spitfire. It took me a long time, but it went well. I started to like doing

work on cars and found it rewarding – not money wise – that’s for sure; working alongside my dad was an experience I’ll never forget,” Hall says. Hall says that he has three different kinds of welders; MIG, stick (electric/arc) and gas welders and that he took an auto body shop course in school which was a big help in getting into the restoration of cars. “I have replaced more rocker panels than I can or want to remember which isn’t an easy task on a convertible because if it’s not correct you won’t be able to shut the doors and things will never line up the way it was before you started. I have mostly all the tools and supplies I need at a glance – which is great because I live in

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SPOTLIGHT

the country and the closet auto parts store is about eight miles away. I have to have things on hand or I would be running around for hours before getting anything done,” Hall says. With tools and knowledge, what led to restoring a classic Ferrari like the Magnum car? “The Ferrari was on eBay for sale. One day, I wasn’t even looking for the car, the page just opened up to it. That was weird, I thought. So, I traveled up to a little town in New York – I forget the name of it. But it turns out it was an auto body shop and he was retiring, so everything had to go. It has taken me a long time to gather the parts for the car because he lost a lot of them and some are just not available anymore. It’s been like trying to find hen’s teeth,” Hall says. In addition to exotic Italian cars, Hall has experience restoring British classics. He is currently restoring two Triumph TR6s. “The first Triumph TR6 (of the two owned right now), I had purchased from a friend that is still in the British car business. Funny enough, his place is called ‘British Racing Green’ in Newark, Delaware. He used to have cars piled up on his property. But as all things go, they are slim pickings now. When I think back on how many cars I have purchased, it boggles my mind,” Hall says. Hall says that he purchased nine Triumph Spitfires at once and his wife went into panic mode. She asked him “Where are you going to put all these cars?” “Well, I sold off most of them very quickly, so panic over. So, back to my friend; he had a TR6 in a storage container and one day I stopped in to see him and I asked what have you got for sale? Well once I saw it, I said, ‘I’ll take it.’ Well, a few months later, a friend of his called me and said he had a TR6 that he was restoring, but needs the room, so he trailered it to my house and, well, I bought the car and the trailer! Wow, that was unexpected. The wife thinks he is

This jukebox makeover included a corvette logo. coming back for the trailer. Ha, ha, I finally told her the truth,” Hall jokes. JUKEBOX HERO While restoring jukeboxes may seem to have nothing to do with Hall’s passion for classic cars, the two actually have several parallels. “After I got out of the automotive business, I got into the arcade business, which is a long while ago now. I had bars, campgrounds, barber shops and a few other places that customers had to hang around. I liked that business and it was a good earner for many years, but after a while things slowed up. I remember lying in bed one-night thinking what the heck am I going to do with all the equipment,” Hall remembers. It dawned on him that he could combine his passions. A car show he had attended for years was coming up and would be the perfect venue to sell the jukeboxes. “How about making them look like cars, gas pumps; anything. As time goes on, people would suggest different themes to turn them into and the rest is history. I sold all I had and began purchasing jukeboxes from other vendors in the business who had the same problem I was having,” Hall says. He says that the digital jukebox you see hanging on the walls of bars or other places are all set up through the Internet.

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“Now, the vendors don’t have to change the CDs every few months; it’s all automated. But so is the money, no more cash, it’s all credit cards and the manufacturers send the owners of the machines the money it produces,” Hall says. “Kind of put a real damper on that part of the business, but a great opportunity for me to pick up the jukeboxes they had sitting around. I was flooded with guys calling me once the word got out [that] I was buying old jukes. So, that’s how it started. I had already learned how to repair them at the school of hard knocks,” Hall adds. Some of the jukeboxes take on a car theme and this is where Hall really brings his specialties together. “I had a few that I have put those wings from the rear of like a Porsche or any other sports car. I also did one for an older gentleman who had a couple of 1955-56 Chevys, so I would look around at the car shows for good looking used parts like the fins on the tail lights and I would put LED lights in them and they would blink to the music. That was very popular; I was putting blinking LED lights on anything I could think of,” Hall says. Hall’s jukeboxes have become a big attraction at car shows and have left attendees amazed and dancing. “I can honestly say it has been a fun trip and a great adventure seeing people’s faces light up when they purchased one of those creations. When I was at a show, and a customer would walk up to the booth, they would say to someone that was looking at a box that it was the best thing they had purchased next to the car they owned,” Hall says. From offering important medical supplies to practicing two creative and skilled hobbies, Cliff Hall has shown that you can balance work and pastimes and get a lot accomplished. Whether rocking around the clock or reproducing a vehicle like the one that was once tooling around Oahu, Hall’s efforts are restoring the best from the past.

MARCH 2020

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INDUSTRY UPDATES

Updates from the HTM Industry STAFF REPORTS

FAILURE TO TRACK DIAGNOSTIC RESULTS PUTS PATIENTS AT RISK ECRI Institute’s multi-stakeholder collaborative, the Partnership for Health IT Patient Safety, announces new research on reducing errors related to diagnostic testing and specialty referral tracking: • Implementing Closing the Loop Safe Practices for Diagnostic Results describes a focused project with ambulatory care facilities • Close the Loop in Your Organization: A Step by Step Guide includes practical guidance for health care facilities across all care settings The Partnership invited ambulatory care sites to follow one of its safe practice recommendations – implement IT solutions to track key areas – for the tracking of diagnostic test results and specialty referrals. The overarching goal was to improve results tracking using the technologies at hand and, ultimately, to improve the timeliness and accuracy of diagnoses. Three sites began the process; two followed the project to completion. “Reducing diagnostic errors requires more attention by leaders in all care settings—acute, long-term, and ambulatory,” says Marcus Schabacker, MD, Ph.D., president and CEO, ECRI Institute. “This research is important because it demonstrates how health IT processes can be implemented to reduce diagnostic errors.” In the pilot project, participants used strategies and tools, including the Agency for Healthcare Research and Quality’s

(AHRQ) Improving Your Office Testing Process, a toolkit that outlines steps for a testing process. Insights gleaned from the pilot project informed the Partnership’s development of a step-by-step guide. Close the Loop in Your Organization offers practical guidance on how to identify project resources, evaluate current processes, and implement change across various practice settings. “By working collaboratively across multiple health care sectors, the Partnership is demonstrating its ability to improve health IT safety for patients,” says Partnership program director Lorraine Possanza, DPM, JD, MBE, ECRI Institute. Each year, five percent of adults in the United States are subjected to a diagnostic error, and of the estimated 12 million diagnostic errors in the U.S., 20 to 30 percent are caused by breakdowns in the referral process, according to Hardeep Singh, MD, an expert advisory panel member of the Partnership for Health IT Patient Safety. The Partnership, sponsored in part through funding from the Gordon and Betty Moore Foundation, leverages the work of multiple Patient Safety Organizations (PSOs), along with providers, vendors, an expert advisory panel, and collaborating organizations to create a learning environment that mitigates risk and facilitates improvement. •

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MASIMO TO ACQUIRE CONNECTED CARE BUSINESS FROM NANTHEALTH Masimo and NantHealth Inc. have announced the signing of a definitive agreement under which Masimo will acquire the Connected Care assets from NantHealth Inc. for a $47.25 million upfront cash payment. NantHealth’s Connected Care solutions provide medical device interoperability to hospitals and health systems. The portfolio includes DCX device connectivity (formerly known as DeviceConX), VCX patient vitals software (formerly known as VitalsConX), HBox connectivity hub and Shuttle interface cable. The acquisition supports Masimo’s goal to help hospitals improve the continuum of great care through hospital automation, connectivity, and innovative noninvasive monitoring technologies. The Connected Care franchise is an established leader in providing connectivity solutions to hospitals, enabling streamlined collection and storage of medical device data through a vendor-agnostic platform into the EHR or other clinical information systems. “One of the strategic priorities for Masimo is, through our Hospital Automation solutions, to reduce clinician cognitive overload and reduce errors of omission. Through connectivity, predictive algorithms and decision support, we hope to improve the continuum of great care. The connectivity assets we are acquiring are completely in line with our mission as they will help accelerate our internal growth initiatives in this area,” said Joe Kiani, founder, chairman and CEO of Masimo. “Not only does Connected Care immediately increase our customer footprint but also provides us with products which complement our current portfolio. As a result, we are very excited to welcome the Connected Care’s talented team to Masimo and look forward to realizing our vision together.” The transaction is expected to close in the first quarter of 2020, subject to customary closing conditions. Masimo expects to fund the acquisition with existing cash on hand. •

MARCH 2020

TECHNATION

INDUSTRY UPDATES

CLOUDBREAK HEALTH LAUNCHES MARTTINEXT Cloudbreak Health LLC has officially launched its most advanced product offering to date, MarttiNext. The solution brings significant enhancement to the user experience with rock-solid network stability that enhances accessibility, scalability and reliability. “Hundreds of our large health system customers have made the transition to MarttiNext in 2019 and now it’s time to expand this breakthrough offering to all existing and future customers,” said Jamey Edwards, Cloudbreak Health CEO. “Cloudbreak Health has a tradition of being the first to market with innovations that significantly improve how care is delivered. MarttiNext will play a vital

role in addressing hospitals’ focus on decreasing health disparities. MarttiNext is the last mile solution that will allow doctors and caregivers the ability to truly communicate with patients and their caregivers regardless of language barriers.” MarttiNext is the latest generation of Cloudbreak’s signature anytime, anywhere, any device video medical interpretation software, providing access to certified medical interpreters in hundreds of languages at the push of a button. MarttiNext will now be available nationwide to Cloudbreak customers on iOS, Android, PC, Chrome Browser and Kindle Fire. •

CHRISTIANACARE NAMED A “MOST WIRED” HEALTH CARE TECHNOLOGY LEADER For the fourth consecutive year, ChristianaCare has earned the “Most Wired” designation from the College of Healthcare Information Management Executives (CHIME), which recognizes health care organizations that demonstrate the best practices through their adoption, implementation and use of information technology. ChristianaCare earned the award in Most Wired’s new ambulatory category – which recognizes outpatient practices that demonstrate excellence in health care IT – as well as its hospital category, for both Christiana Hospital and Wilmington Hospital. “We are leaning confidently and deliberately into a future where all care will be digital – except that which cannot be – and all care will be home-based – except that which cannot be,” said Randall Gaboriault, MS, chief digital and information officer at ChristianaCare. “That digital imperative is our organizational imperative, and it reinforces why we are relentlessly focused on leveraging technologies to forge deep connections with our neighbors to help them achieve their personal health goals.” ChristianaCare’s place on the forefront of IT trends is the product of a long-term investment in culture and a

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MARCH 2020

reimagining of IT processes, creating an environment in which good ideas can rapidly progress from concept to impact. ChristianaCare’s use of transformational technologies to improve patient care includes: • Video monitoring to help protect hospital patients from falls. • Telemedicine advancements, including video visits with clinicians. • Direct access by patients to the physician notes in their electronic health record, and the ability to contribute to their record through an online patient portal. • Online express check-in at ChristianaCare’s five urgent care centers. Exemplifying ChristianaCare’s effective use of technology to serve its neighbors is the organization’s electronic health record system, which enables providers to have access to all of a patient’s medical information, regardless of whether they show up at one of ChristianaCare’s primary care or specialty practices, hospitals, labs or emergency departments. It’s a concept that ChristianaCare’s IT team refers to as “one patient, one chart, one experience.” With leadership from Gaboriault and his team, ChristianaCare also has earned a “Best Places to Work in IT” from

IDG’s Computerworld. ChristianaCare’s Information Technology team also played an integral role in ChristianaCare receiving the Magnet Prize from the American Nurses Credentialing Center for positive distraction therapy through virtual reality. In addition to the Most Wired designation, Gaboriault and the IT team have been recognized with the IT industry’s highest awards, including being a four-time awardee of IDG’s CIO 100 award, a three-time awardee of Computerworld’s Laureate Award and multiple recognitions by InformationWeek, including “Most Innovative Organizations,” and “20 Innovative IT Ideas To Steal.” In 2019, Gaboriault was named to IDG’s CIO Magazine’s Hall of Fame. CHIME noted that health systems recognized as Most Wired have demonstrated an ability to use their newly developed resources to improve care in their communities in an ever-changing industry. Organizations were also evaluated for their performance in administrative and supply chain, analytics and data management, business and disaster recovery, clinical quality and safety, infrastructure, interoperability and population health, patient engagement and security. •

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INDUSTRY UPDATES

EQUIPS ADDS GENERAL MANAGER OF HEALTHCARE Equips has announced John Clark as general manager of healthcare. He will be responsible for leading the healthcare division of equipment management. “Clark joins the Equips team from Cookeville, Tennessee. He offers a unique combination of hands-on administration that maximizes organizational productivity, efficacious operations-oriented leadership and family-oriented mentorship which yields uncompromised results. Throughout his 25-year healthcare career he has succeeded in providing and maintaining financially successful programs for numerous health care organizations,” according to a press release. His career started in the U.S. Army working as a biomed engineer. After leaving the military he applied his

expertise to cost containment and became director of clinical engineering. He successfully moved up to the implementation and administration of equipment maintenance management programs increasing the book of business to over 50 facilities, plus saving those facilities over $19 million dollars in revenue. He holds an master’s in finance, a bachelor’s in organizational management, and is a certified clinical engineer. “I am excited to welcome John Clark to Equips. As we expand in the health care industry he brings great leadership, organization, and experience with equipment management.” Equips President Adam York said. •

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INDUSTRY UPDATES

CARESTREAM DIGITAL TOMOSYNTHESIS RECEIVES FDA CLEARANCE Carestream’s digital tomosynthesis (DT) functionality – a three-dimensional extension of general radiography – has received 510(k) clearance from the U.S. Food and Drug Administration. Simplifying workflow and reducing exam time, DT technology is an upgradable option on the Carestream DRX-Evolution Plus System, a versatile digital radiography system that can perform a wide range of general radiographic exams. Digital tomosynthesis uses a single sweep of X-ray exposures and streamlines operator workflow by separating the process of DT exposure acquisition from image volume formation. As a result, it can generate data from a series of low dose X-ray images of the same organ, taken at the same X-ray exposure, from different angles. “The images captured by digital tomosynthesis technology offer greater depth and enhanced visualization,” said Sarah Verna, worldwide marketing manager for global X-ray solutions at Carestream. “Doctors and radiologists will be able to perform scans quickly, improving the workflow in an X-ray room and providing valuable clinical information for further diagnosis.” Digital tomosynthesis, like a computed tomography (CT) scan, can produce cross-sectional images of an organ, allowing for increased visibility. This capability enhances the DRX-Evolution Plus in situations where physicians need quick answers.

Carestream customers will now have the option to purchase the DT software for their DRX-Evolution Plus systems. Coupled with the company’s new ImageView Software that is powered by the Eclipse image processing engine, the DRX-Evolution Plus with Digital Tomosynthesis transforms into a powerful digital imaging tool for hospital systems. •

EPIPHANY HEALTHCARE IS ISO 27001 CERTIFIED Epiphany Healthcare announces that it has become the only vendor in the niche market of ECG management software with a cybersecurity certification. Epiphany is officially ISO 27001 certified for all of its products and locations. To be ISO 27001 compliant means Epiphany meets the security standards from the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC). The goal of being ISO 27001 compliant is for companies to provide IT security management standards that ensure the protection of data. Risk management is a key component of ISO 27001, which holds companies accountable for their strengths and weaknesses. Considering risk assessment and treatment options, Epiphany chose to establish a low-risk tolerance, which was the most demanding standard. Epiphany implemented all recommended controls in ISO 27001, including those for Epiphany Cloud Services, creating a total of more than 121 controls. Epiphany then applied these controls to all aspects

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MARCH 2020

of its business and products. “This certification reinforces our commitment to protect our customers’ vital information and data,” says Epiphany Healthcare’s product manager of new ventures, Eddie Hernandez. Becoming ISO 27001 certified brings information security under management control with clear guidelines being met. Some of the guidelines established to increase IT security are for responding to security events, employee onboarding/off boarding, mobile device management, office security, secure software development, ransomware and malware strategies, and more. Epiphany Healthcare has focused on becoming ISO 27001 compliant to reduce the risks associated with increasing security threats. By applying standards and best practices of information security, Epiphany has strengthened its processes to enable better safeguards. Being ISO 27001 compliant enables Epiphany Healthcare to be better prepared in preventing any potential security incidents. •

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INDUSTRY UPDATES

STRYKER LAUNCHES FIELD ACTION FOR LIFEPAK 15 Stryker is launching a voluntary field action on specific units of the LIFEPAK 15 monitor/defibrillators. The company is notifying a population of LIFEPAK 15 customers of an issue that may cause their devices to fail to deliver a defibrillation shock after the “Shock” button on the keypad is pressed. This is a result of oxidation that may have formed over time within the “Shock” button. The company is contacting customers with impacted devices to schedule the correction of their device(s), which will include replacement of the affected keypad. Stryker anticipates that all devices subject to this field action will be serviced by June 2021. Most complaints associated with this issue were detected prior to patient use. Routine testing of the device can detect this fault condition. If a customer experiences this issue, they should contact Stryker as soon as possible at 1-800-787-9537 and select option 2. The company is instructing customers to continue to use their LIFEPAK 15 monitor/defibrillator according to the Operating Instructions until the correction can be completed. Customers should continue to perform the daily check as described in the Operator’s Checklist, specifically, the QUIK- COMBO therapy cable check as described in the General Maintenance and Testing Section (pages 10-4 and the LIFEPAK 15 monitor/defibrillator Operator’s Checklist, number 7). •

MEDSPHERE TO GROW INTEROPERABLE HEALTHCARE IT PLATFORM Medsphere Systems Corporation has announced new $40 million funding to support organic growth and pursue opportunistic strategic acquisitions through a preferred equity investment by TPG Sixth Street Partners. “We are pleased to add a new partner to our software solutions-driven campaign for quality, affordable health care,” said Medsphere President and CEO Irv Lichtenwald. “Our technology and business model allow all providers to address core needs and we are energized by the support of institutions like TPG Sixth Street Partners.” “Medsphere represents a compelling opportunity to support a differentiated health care technology platform,” said Michael McGinn, partner and co-head of TPG Sixth Street Partners’ Capital Solutions business. “Medsphere’s portfolio of highly regarded, complementary products allow it to reach a wide range of inpatient and ambulatory providers, and we are excited to partner with them as they enter their next phase of growth.” Lee Mooney, principal at TPG Sixth Street Partners will join Medsphere’s Board of Directors as part of the capital raise. With this investment, TPG Sixth Street Partners joins Morgan Stanley Investment Capital, Azure Capital, EPIC Ventures and NextEquity investing in support of Medsphere’s vision and continued growth. •

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TECHNATION

INDUSTRY UPDATES

INPIXON EXTENDS PATENT PROTECTION INTO CANADA Inpixon has announced that the Canadian Patent Office has granted it Patent number 2,835,210, titled, “Managing Network Interaction for Devices.” This patent serves to extend protection of embodiments within Inpixon’s U.S. Patent 9,742,773 previously issued by the U.S. Patent and Trademark Office. “While mobile phones, IoT devices and BYOD policies can be a big productivity booster, organizations need to mitigate risks,” noted Adam Benson, CTO of Inpixon. “Whether used as part of a mobile device management (MDM) system or standalone, Inpixon’s patented technologies can help identify rogue devices, enable geofence alerts, disable phones in no-phone zones and provide overall situational awareness for effective physical

cybersecurity.” The patent covers techniques to locate, track and manage wireless devices. Signals from an unidentified device at a location related to a communications network are correlated with identification patterns of managed devices to identify whether or not the unidentified device corresponds to a managed or unmanaged device in the communications network. Both managed and unmanaged devices can be tracked, and network interaction can be managed for devices that are identified as managed devices. •

MEDCRYPT CSO TO SPEAK AT 2020 HIMSS CONFERENCE MedCrypt Inc. Chief Security Officer Axel Wirth will present three sessions at the 2020 HIMSS Global Health Conference & Exhibition in Orlando, Florida. Session details are as follows: • “Balancing costs for resource-intensive remediation” will take place from 2:30 to 3:30 p.m. on Wednesday, March 11. Wirth will present alongside Priyanka Upendra, quality and compliance program director at Banner Health. Attendees will learn how to assess security vulnerabilities using quantitative methods, estimate costs of labor for remediation and make risk-based mitigation decisions. • “Cybersecurity: to be proactive or reactive” will take place from 1:15 to

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MARCH 2020

2 p.m. on Thursday, March 12 in the Cybersecurity Command Center. Wirth will discuss the current approach to securing medical devices, identify strengths and weaknesses of the current industry strategy and outline necessary changes required to move the industry forward. • “Surviving 2020 while planning for 2025” will take place from 4 to 4:30 p.m. on Thursday, March 12. Wirth will discuss the impact of the Food and Drug Administration’s (FDA) cybersecurity guidance on Healthcare Delivery Organizations (HDO) as it pertains to device security, identify potential challenges HDOs may face and create awareness for the strategies HDOs have been

advocating for. “A single health care organization may include thousands, if not tens of thousands, of medical devices from hundreds, if not thousands, of medical device manufacturers,” said Wirth. “As we enter a new decade, these numbers will continue to grow, and more of these devices will be networked and integrated with clinical workflows, indicating a critical need for proactive cybersecurity measures to be taken and deployed across the industry. HIMSS provides a platform for key industry players to discuss what’s important and educate on the state and future of healthcare technology.”

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RIBBON CUTTING Chronos Imaging

Q: HOW DOES CHRONOS IMAGING STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: DUNLEE helped create the third-party CT service market with 100% form-fit-function replacement tubes that meet or exceed all OEM specifications. Chronos Imaging continues this tradition today. Our quality is legendary with each tube we manufacture going through final testing and calibration on an OEM CT scanner to all but eliminate DOA failures.

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hronos Imaging was formed in February of 2018 to acquire the former DUNLEE factory in Aurora, Illinois, with a contract to continue manufacturing DUNLEE-branded replacement CT tubes.

Rob Piconi, executive chairman, led the group to form Chronos Imaging. Rob is the former president and CEO of ReMedPar. He was also the founder of Mesa, known today as Althea, the largest multi-vendor service group in Europe. Chronos Imaging President Pat Fitzgerald was the president and general manager of DUNLEE for 15 years. Immediately prior to joining the team at Chronos Imaging, Fitzgerald was the executive vice president and general manager of the Richardson Healthcare business, where he helped establish CT tube development and manufacturing as a Greenfield activity. TechNation learned more about

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MARCH 2020

Pat Fitzgerald President, Chronos Imaging

Chronos Imaging in a question-and-answer session. Q: WHAT IS THE MAIN FOCUS OF CHRONOS IMAGING? A: We develop and manufacture CT replacement tubes that make it economically feasible for third parties to service OEM CT scanners. Without an alternative tube, this would not be practical. Most of our business today is manufacturing DUNLEE-branded replacement tubes for GE CT scanners sold via the DUNLEE channel. We also own and manufacture a line of CT replacement tubes that we market under our own Chronos brand.

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT CHRONOS IMAGING TO ACHIEVE IN THE NEAR FUTURE? A: Chronos Imaging will continue to work closely with the DUNLEE team, including developing new products like a replacement for the GE Performix 40 Plus CT tube that is expected to be released later in 2020. At the same time, we intend to continue to enhance our contract manufacturing and developing new product capabilities, which may include an introduction of additional Chronos-branded products in the coming years. FOR MORE INFORMATION, visit www.chronosimaging.com

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MARCH 2020

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INDUSTRY UPDATES

AAMI UPDATE BY AAMI

ASK THE JOINT COMMISSION Do you have a burning question about a Joint Commission regulation, standard or practice? Here’s your chance to ask all your questions and have them answered by The Joint Commission (TJC) team. Just submit your question and name at www. aami.org/AskTJC, and be on the lookout for the answer to your question in AAMI’s weekly Ask the Joint Commission post in AAMI Connect (http:// connect.aami.org) and in AAMI’s journal, BI&T (www.aami.org/BIT). HEALTH TECHNOLOGY ALLIANCE: NEW ENERGY, NEW ACTIVITIES The Health Technology Alliance (HTA), a joint collaboration between AAMI, the American College of Clinical Engineering (ACCE) and the Health Information Management Systems Society (HIMSS), is bringing new energy and plans for 2020. “The past year was spent redefining the alliance’s mission, polishing its strategic plan and building a strong bond among our three organizations,” said Danielle McGeary, AAMI’s vice president of HTM and member of the HTA committee. “ACCE, AAMI and HIMSS members have immense expertise; bringing these associations together to achieve a common goal creates a powerful solution.” The precursor to the HTA began in 2008 as the CE-IT Collaborative Community. Recently, the alliance consolidated AAMI’s former Wireless Strategy Task Force (WSTF), a group of experts working to clarify the roles and responsibilities of wireless technology management and often guidance to the health technology field. HTA’s newly integrated WSTF is preparing to publish a set of wireless

TECHNATION

MARCH 2020

community frequently asked questions (FAQs) to tackle many of the most pressing wireless issues seen in the health care environment. It includes updated answers to long-standing issues, expanded sections on security, Bluetooth technology, risk mitigation and troubleshooting IEEE 802.11 connectivity issues. The alliance currently is developing a toolkit for HTM-IT professionals, intended to include basic guidelines for establishing a more effective HTM program as well as practical examples of how organizations of different scales can implement these guidelines – from 100-bed hospitals to 2,000-bed academic medical centers. The HTA has hosted several free webinars, currently available for download. These include an update on medical device cybersecurity resources and practices, using the new version of MDS2, and building cybersecurity into the medical device life cycle. The HTA is seeking volunteers to share their ideas, expertise and time. Membership is open to anyone who has an interest in healthcare technology. FOR MORE INFORMATION about membership and the alliance’s activities and to download resources, go to www.healthtechnologyalliance.org

AAMI PUBLISHES FIRST CONSENSUS REPORT AAMI has published its first consensus report, a new kind of document developed to provide concise, prompt and practical guidance on narrowly focused topics of high importance to the health technology community. “The pace at which technology is evolving makes it difficult for traditional standards and technical information

reports to keep up. AAMI members have voiced the need to have quicker guidance on issues where limited data exist, where there is variation in practice, or where there is confusion among stakeholders,” said Jen Padberg, AAMI senior vice president of standards program and policy. “To that end, the AAMI staff have, with consultation from members, developed a process by which much more rapid guidance can be provided in a new deliverable – an AAMI consensus report on emerging issues, or consensus report.” AAMI CR500:2019: Basic Introduction to the IEC 60601 Series, is intended to clarify and to point out the importance of the IEC 60601 series of standards as well as to provide guidance to understanding and to implementing the series. It is available in the AAMI Store at www.aami.org/store. 2020 INTERNATIONAL STANDARDS CONFERENCE TO FOCUS ON HEALTH TECHNOLOGY LIFECYCLE Registration is now open for the April 2020 International Conference on Medical Device Standards and Regulations (ISC 2020). This year, meeting topics will focus on the health technology life cycle and delivering better patient outcomes. ISC 2020 is hosted by AAMI, the Food and Drug Administration (FDA) and the British Standards Institution. The conference’s keynote speakers will be Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, and Graeme Tunbridge, director of devices at Medicines and Healthcare products Regulatory Agency in London, UK. Other ISC 2020 schedule highlights include a deep dive into the European Union’s impending implementation of the Medical Device Regulation and a workshop on compliance with the

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AAMI RISK MANAGEMENT STANDARD, TIR RECOGNIZED BY FDA The FDA has designated two AAMI risk management resources as recognized consensus standards: ANSI/AAMI/ISO 14971:2019, Medical devices – Application of risk management to medical devices and AAMI TIR97, Principles for medical device security – Postmarket risk management for device manufacturers. By attaining FDA recognition, voluntary consensus standards can be used in premarket submissions to demonstrate conformity with relevant FDA regulations and requirements. A fundamental risk management standard, the newly updated ANSI/ AAMI/ISO 14971:2019 establishes a

process for medical device manufacturers to identify, evaluate and mitigate risk. The 2019 update aligns the standard with international medical device regulatory changes and clarifies technical requirements. An accompanying draft technical report, AAMI/ISO DTIR24971:2020, Medical devices— Guidance on the application of ISO 14971, is currently available for preorder. TIR97 is a new AAMI resource that provides detailed guidance for addressing the unique challenges of maintaining the security of a medical device during its entire life cycle. Designed to be used in conjunction with TIR57:2016, Principles for medical device security – Risk management, TIR97 provides guidance on performing postmarket security risk management for medical devices in the context of the safety risk management process required by ANSI/AAMI/ISO 14971. AAMI standards are available for purchase in the AAMI Store at www. aami.org/store.

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MARCH 2020

TECHNATION

INDUSTRY UPDATES

ECRI UPDATE

The Rapid Adoption of Pointof-Care Ultrasound and the Potential for Patient Harm

an a medical technology be too easy to use? It’s hard to imagine how that could be a problem – but it’s not too far from the truth when it comes to Hazard No. 2 in the 2020 edition of ECRI Institute’s Top 10 Health Technology Hazards. This new addition to the annual list highlights safety concerns associated with the rapid adoption of point-of-care ultrasound (POCUS) technology.

POCUS scanners are highly portable, comparatively inexpensive and easy to use – or seemingly so. These characteristics have fueled the technology’s rapid growth, to the point that POCUS scanners are changing the practice of health care in many specialties. But the change is happening so quickly that safety policies and practices have struggled to keep up. And that’s where the problems creep in. ULTRASOUND AT THE BEDSIDE POCUS imaging refers to the use of medical ultrasound by the treating clinician at the bedside, as opposed to referring the patient to an imaging specialist when an ultrasound exam is indicated. The main benefit of POCUS is that it allows clinicians to quickly determine whether an abnormality is present so they can immediately make patient management decisions. Because

TECHNATION

MARCH 2020

patients don’t need to be referred to imaging specialists, they don’t need to make an additional appointment for the imaging exam, and they don’t need to wait for the diagnosis to be provided to their treating physician. The result is more time-efficient and effective patient care. POCUS scanners come in a variety of formats – including handheld, tablet and laptop models – all of which are highly portable and battery operated. These devices are generally inexpensive and simple to operate, which has led to their rapid adoption. In fact, “many clinicians are choosing to use POCUS scanners independently from the institution,” notes Daniel A. Merton, BS, RDMS, FAIUM, FSDMS, a principal project officer and the diagnostic ultrasound specialist in ECRI Institute’s Health Devices Group. “Physicians are buying their own devices and using them as they see necessary to enhance patient care.” THE POTENTIAL FOR HARM POCUS is a powerful tool for diagnoses and for guiding interventional procedures in many clinical environments. At many health care facilities, however, the safeguards needed to ensure that all POCUS users have the requisite training, experience and skill to use the technology appropriately and effectively – as well as to correctly interpret the findings – have not kept pace with the speed of adoption.

The lack of sufficient oversight, policies and procedures increases the potential that patients will be adversely affected by problems associated with use, or lack of use, of the technology. Patient safety concerns include: • Misdiagnoses – For example, a user who is not sufficiently skilled at interpreting ultrasound images could confuse air-filled bowel for a gallstone. • Inappropriate use of the modality – That is, using POCUS for a clinical application for which ultrasound is not indicated, or for an entity that could be better assessed using other imaging modalities. • Overreliance on POCUS when a more comprehensive exam by an imaging specialist is indicated. • POCUS not being used when warranted – In addition to potential clinical consequences, several published reports describe litigation and legal awards from the misuse of POCUS, including the failure to perform a POCUS exam when one was clinically indicated and available. Legal cases have the potential to affect a facility’s finances and reputation. “Clinicians just want to do the best they can for the patient in front of them, and they’ll use whatever tool they have at their disposal to do that job,” explains Merton. “Particularly in acute settings

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Daniel A. Merton testing a point-of-care ultrasound (POCUS) scanner in ECRI Institute’s laboratory. such as an emergency department, care providers may be less concerned with policies, procedures and other aspects of proper use, such as properly documenting exams, communicating results in a timely manner, etc.” Health care institutions, on the other hand, must have plans in place for dealing with all of these considerations to meet the standards of care and to avoid potential litigation. ECRI INSTITUTE RECOMMENDATIONS Despite POCUS being the fastest-growing segment of the diagnostic ultrasound market, there are no universal guidelines or recommendations regarding POCUS use, training, licensure/credentialing or competency testing. The only existing guidelines are those that have been developed for specific clinical applications. Some health care systems have created relevant policies and procedures, but those may not be consistent between users, departments or individual facilities. Similarly, POCUS training is inconsistent, with some users having

greater exposure to the technology than others. To rectify this situation, ECRI Institute recommends that health care facilities consider instituting a multidisciplinary POCUS committee tasked to provide oversight, with the goal of standardizing the use of the technology throughout the facility or health care system. The committee should include relevant stakeholders to establish policies and procedures that address, for example: • Training, including ultrasound physics and instrumentation, specialty-specific clinical utilization, scanning techniques and exam interpretation • Competency, as demonstrated using formal testing instruments and/or demonstration of scanning skills • Credentialing, including initial credentialing requirements and ongoing maintenance of the clinician’s credentials • Interpretation competency, defining the qualifications required for staff to

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interpret POCUS data and provide formal reports • Communicating/documenting POCUS results, including: who is responsible for communicating the results and how the results are to be communicated; when and how results are to be incorporated into the electronic health record (EHR); and what methods should be used for archiving images, preliminary findings and final reports so they are available for review, as needed. • Continuing medical education specific for POCUS • Device processing, specifying cleaning and disinfection procedures for scanners, probes and accessories • Technology management, including device tracking within a facility, routine maintenance and required service • Technology acquisition • Billing and reimbursement For ECRI Institute’s complete recommendations, including department-level responsibilities, refer to the report cited below. This article is adapted from ECRI Institute’s “Top 10 Health Technology Hazards for 2020” (Health Devices 2019 Sep 26). The nonprofit research organization produces its list each year to raise awareness about critical hazards associated with medical devices and systems and to promote solutions that can help prevent patient harm. An Executive Brief version of that report is available for complimentary download at www.ecri.org/2020hazards. The full report, accessible to ECRI Institute members, provides detailed steps that organizations can take to prevent adverse incidents. To learn more about membership, visit www.ecri.org/solutions/ evaluation-and-comparison, or contact ECRI Institute by telephone at (610) 825-6000, ext. 5891, or by email at clientservices@ecri.org.

MARCH 2020

TECHNATION

THE BENCH

BIOMED 101

Clinical Safety Begins with Equipment Cleanliness, Maintenance Program BY DAVE FRANCOEUR

here is it? Is it being used? Is it broken? Is it clean?

Every day, hospital clinical staff waste valuable time asking these questions about portable clinical devices – questions an established clinical equipment maintenance program would render moot, because staff would have what they need when they need it. Without a clinical equipment cleanliness and maintenance program in place that improves access to hygienic, operable portable clinical devices, staff can spend up to 15 minutes per device searching for missing equipment, room by room, floor by floor. Once they find what they’re looking for, staff then have to determine whether the device is working and whether it’s clean. If it’s not working, or if it’s not clean, staff either have to search for another device, or take the time to properly prepare the one they found for patient use. All the while, the patient is waiting. The result? Inefficient processes. Dissatisfied patients. And frustrated staff. Obviously clean equipment is essential to infection prevention in the medical

TECHNATION

MARCH 2020

environment as well. From wheelchairs and stretchers to infusion pumps and pulse oximeters, cleanliness is the number one priority. Clean equipment is a critical component of preventing healthcare-associated infections (HAIs), which are a significant risk to patient health and safety. HAIs, many of which are preventable, are responsible for tens of thousands of deaths and billions of dollars of medical expenses every year. In fact, the Centers for Disease Control and Prevention (CDC) estimates 1 in 31 patients daily in the U.S. has at least one HAI. THE BASICS: CLINICAL EQUIPMENT MAINTENANCE PROGRAMS Clinical equipment maintenance programs ensure at-the-ready access to clean, operable portable clinical devices using one of three methodologies: 1. Forward stocking: Staff access devices in a self-serve setup, based on established PAR levels; 2. Central stocking: Staff request delivery of devices from a central location, from which devices are dispatched as needed; 3. Hybrid stocking: Staff have self-serve access as well as the availability of a central location from which devices are dispatched.

Dave Francoeur Tech Knowledge Associates

Clinical equipment maintenance programs feature a dedicated equipment maintenance team whose time and resources are exclusively focused on ensuring equipment function and availability, including inventory and storage as well as cleaning and repair. Additionally, all team members are highly trained on established protocols regarding the appropriate cleaning and handling of portable clinical equipment. Often, device repair can be addressed more quickly simply due to the fact that the devices are handled more frequently and by individuals trained to fix them. More touches and more training means more opportunities to find minor problems that can be corrected before they turn into major ones. Clinical equipment maintenance programs typically replace similar functions through environmental services or central sterile supply. Programs can be scaled to meet the needs of any hospital, based on the size of the facility, the size of the staff, patient volume, the equipment needed and each hospital’s own set of issues to solve – because every hospital has its own unique challenges and opportunities when it comes to device availability and maintenance.

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THE BENCH THE BENEFITS: CLINICAL EQUIPMENT MAINTENANCE PROGRAMS Clinical equipment maintenance programs can improve the efficiency and effectiveness of managing portable clinical devices. They’re better for patients, better for staff and they’re better for hospitals’ bottom lines. Benefits of a clinical equipment maintenance program include: Safety • Reduces the risk of cross contamination • Reduces the risk of HAIs • Includes dedicated staff trained in established protocols for cleaning and handling devices Efficiency • Improves the availability of clean, operable portable equipment • Reduces the occurrence of lost and missing equipment • Reduces staff time spent searching for equipment Utilization • Improves equipment utilization • Increases device uptime

• Savings • Increases device lifetime • Decreases equipment rental and purchase expense • Improves inventory management and control Compliance • Drives consistent required compliance • Improves program reliability and consistency Satisfaction • Improves patient satisfaction • Improves staff satisfaction, which increases productivity and retention If you want to improve patient care, boost efficiencies, impact the satisfaction of both patients and your medical staff, and drive savings in bottom-line equipment-related costs, a clinical equipment maintenance program might be just what you’re looking for. DAVID FRANCOEUR is the senior vice president of marketing and sales at Tech Knowledge Associates.

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Professional OF THE Month SPOTLIGHT FAVORITE BOOK “The Romance of Photogen and Nycteris” by George MacDonald FAVORITE MOVIE “Blazing Saddles” FAVORITE FOOD My wife’s Mulligatawny soup and pecan pie HIDDEN TALENT Problem solving/troubleshooting ability Favorite part of being a biomed “The satisfaction of completing a repair and knowing that a patient will receive the care they need. I also like working with our interns to make sure they begin their careers off right.”

SPOT

WHAT’S ON MY BENCH? Coffee, my favorite soldering iron, a book of 19th and 20th Century paintings from the Art Institute of

LIGHT

NAL ESSIO PROFHE MONTH OF T rtoglio ic Rock

Chicago, flash drives with equipment documentation and notes, my Day-

Timer to keep track of activities for documentation purposes

Nathan Burks enjoys being outdoors. When not working on medical equipment, Gravel Grinder. seen participating in the Lowell 50

Above he is

not you to places you would otherwise had nearly every day. I hit a plateau and there are fewer cars to deal visit and the G ISSUES job to change my eating habits to lose in several races and IMAGIN I’ve ridden the with. with TY AND next 75 pounds. My weight still k Iceman Cometh, come including SECURIbut ges challenges, pounds, 10 RK networ fluctuates plus or minus d onBottoms Gravel Grinder, NETWO and challen Funk seven worke s for about weight off g issues. of I’ve kept the g to Project Mayhem, Lowell glio has imagin Michigan Mountain care and to a meetin s and now by staying active taking Grinder, and Marto are Little Miami Dirty wentyears . I was 50 Gravelthere I eat.” security projectchallenging I), and nt seemed what d that Dozen, and be as itwatching lly whenPittsburgh Dozen, at differe Dirty t I receive tion (BAAM as good suppor “It canover the has had many hobbies especia Burks time D DOUGL t Burks says. it was by the many others,” le sites, the same playing t see if RICHAR or medat er at included years, which have multip that doesn’a suppor elmed BY K. few guys like to create issues on cars a few lio says. r, a manag ately, “Me and overwh with computers, only guitar, tinkering get good or ourselves whenever we critical Martog Booke you work there are g ns. Fortun routes and I and abuse als. Notand hether night,” knowin ent, David locatio very often service staff We completed a 213 photography hospit ns, heothers. stics, “I met BayCare I is cycling and have time free. questio ical equipm– diagno as tanding hobby current happen other field says. “My it out. the nts ging of my adventure this past road he the out mile-in-a-day check fit in r all and undersThe goal consta one of I started I general.from site,” can be challen many self-supported tryingtoto stay answe shop s on as with toolsnents work. summer, as well of people le causes did he me to the the short als work make and commuting biomed cyclinghospit or roads near road M issues are multip on caliber to hilly how to t compo both; to cturer gravel grinders invited “DICO up a e there d. Thedistance of the access work. I picked with I have ul Itomade have areas how differen nshipshe adds. Ohio,” becaus Loudonville, the same as the manufa was hooke in all and thankf winter the always in relatio tions, well bike to commute fat me with Burks spends time good homefront, is always e work do not make work bike trails that I as of. HavingOn thel applicabeen key mountain ian ues to started adds. riding that machin l and gets out in nature. his family technic contin withclinica ,” he d it to. rs has king, contro auto been he says. some well,” 18 intende membe I have been networ wife and I’ve y married the changefrom the “My ne who with on y team I started cycling past year, “Thismeant he adds.“ someo g. Marto son. Going into HTM seven-year-old a securit have k that d and wenetwor yearsg,” trainin receive Gravel and securitshootin (gravel sion gravel roads ized and grinding). e then, automobilesion r of y assiste profes trouble My wife is a runner surpris on numbe recentl and recently time. they cantotake to school nal specialgoare because transit great same d in a projects. I ns It’s no to to work set to additio ableroads sion. at the d involve ring ion r locatio profes the skill is trained glio involve glio was experience nics enginee have the HTM and migrat and vasculak. This Marto unity on tions, would to heart Chuck Comm handshe networ l applica special the electro skills three PROFESSIONAL roughTHE BIOMEDICAL/HTM to ensure erthose exactly whatfield service “I took EMPOWERING e to our clinica an A.S.,” Hillsbo a is migrat with our l engine y teams secured m at ted with g That glio is the clinica re progra and gradua and securitred and workin a chance healthking, at BayCa of did. Marto und, in , I got eer. I College configu in out ges of ment networ in school a volunt ing was 1802_TNMag.indd 15 ist, ultraso s depart challen very active is based says. as I was isor at everyth With the been , which I ing service ly. “While Dave’s shop superv have ent. My out ian for System . proper in y, we biomed at a BAAM technic Florida Health al, securit medical equipmd locking tech to work Bill Hart, ater, repair a career care include and al Hospit me PM g our Clearw of an auto I also met Region were s have patching, securin a part-ti nd “I was was in need of what sibilitie Cry y team,” I of mine Lakela and landed opportunities I idea respon no Wanna securit years. g, while friend ned had a 23 nce ports, meetin there. These for our day, , but fter mentio USB n le experie says.“A change to do. One therapist ing data ues. positio at good gather ely valuabMartoglio biomed be a wanted respiratory glio contin II ,” extrem as a Marto is a bers. school t I would hired to a biomed who ion, I was was in M ted he though glio remem profess tion, n, field TION.CO that the hed it, gradua I was promo t positio d,” Martoheard of TECHNA I researc what re. biome WWW.1 more never BayCa to my currenhe says. “I had into it. The was exactly the and thenultrasound,” that it , and joined Bay but lookedI realized service the found for. I group, the more entaking looking l Instrum networ I was Medica biomed tion of local Associa Area

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My completed her first half marathon. son loves to play Minecraft and harass are our cats. The Toledo Metroparks of awesome, so you will find us at one says. them at least once a week,” Burks the For his efforts on the job, he won Shining Star, an award given to outstanding UTMC employees. There’s little doubt why Burks was nominated for the award and to be that featured in TechNation; he proves when you set your sights on something, you can achieve it.

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MARCH 2020

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THE BENCH

WEBINAR WEDNESDAY

2020 Webinars Start Strong BY JOHN WALLACE

he successful and informative Webinar Wednesday series is back for its sixth season in 2020. The series saw growth throughout 2019 and continues to be a valuable resource for healthcare technology management professionals in the new decade.

DEVICE SECURITY ADDRESSED Webinar Wednesday continues to assist HTM professionals with continuing education goals in 2020. The recent webinar “Steps to Build an Effective Medical Device Cybersecurity Program” provided information and attendees were eligible to receive 1 credit from the ACI. The session was sponsored by Asimily. The webinar featured Asimily CEO Shankar Somasundaram. He discussed the key elements needed to build an effective medical device cybersecurity program. His talk provided valuable information, both for organizations who are starting on the topic of medical device security as well as for organizations who are already deep into this topic. The webinar attracted 160 attendees for the live presentation. A recording of the webinar is also available for on-demand viewing. Attendees gave the session high marks in a post-webinar survey and

TECHNATION

MARCH 2020

“ Speaker was passionate and kept my interest during the description of each of the steps.” C. RAMOS, BESS

answered the question “What did you like most about today’s webinar?” “I like learning about cybersecurity since I have limited experience with it,” said S. Sirois, BMET III. “Good points on security. I still need to work more with IT to establish what is acceptable without compromising security and still be able to take advantage of using advances in technology,” shared L. Munoz, BMET III. “A good broad-based overview on creating a cybersecurity plan for medical equipment management,” said C. Rodriguez, MSET II. “Easy-to-read slides with pertinent information, and the speaker was very knowledgeable on this topic,” said R. Sable, product manager. “The webinar presentation provided insight into what data is needed and how to gather that data to help reduce cyber risks,” Biomedical Systems

Analyst L. Riley said. “It gave me more insight on the importance of cybersecurity and the need to have HTM get more involved,” said H. Hunter, owner. “Speaker was passionate and kept my interest during the description of each of the steps,” said C. Ramos, BESS. “Loved the nuts and bolts approach,” said R. Womack, CBET. VENDOR CONTRACTS AND TRANSITIONS The first session of 2020 was sponsored by Nuvolo and attendees were eligible to receive 1 CE credit from ACI. “Evaluating Contract Transitions and Project ROI with a Focus on Data Governance” was presented by Dustin Smith, director of central support, clinical engineering at Intermountain Healthcare, and Kyle Holetz, senior solution consultant at Nuvolo. They discussed what is needed to evaluate the effectiveness of vendor contracts and transition plans with a focus on data governance. This included the setup of business processes and workflows in and out of the CMMS to capture the data elements needed to properly measure contract effectiveness and a department’s success. The webinar was popular with 153 attendees for the live presentation and more have viewed a recording of the

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Advancing the Biomedical/HTM Professional

“ I try to never miss a webinar if I’m not doing something else over my lunch hour. It was worth seeing how other biomedical groups handle their data, and what steps would be if we were to go to a better system.” O. STEPHEN, BIOMEDICAL TECHNOLOGIST

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ing contracts, so it was worth my time,” said E. Bican, lead technician clinical engineering. “We are always balancing contracts with in-house service and are always transitioning between the two with all our medical equipment constantly being moved around the U.S. This webinar helped tie some of these details together,” Field Service Engineer K. Saager said. “My boss invited me to this webinar and I accepted. I thought it was well worth my time. I got to see the other side of business applications from the business perspective rather than the technician side only,” Clinical Engineer G. Huber said.

g hin Bend 30269 Publis k y, GA MD stbroo e Cit ed 18 Ea tre est Peach Requ vice ss Ser dre Ad

webinar online. Attendees gave positive reviews in a post-webinar survey and answered the question “Why did you attend today’s webinar? And, was it worth your time?” “I wanted to hear their approach for contract decisions and how they arrive at that point. Definitely worth the time, reinforced the need for good data,” said Biomed V. Schill-Mason. “VA is transitioning to Nuvolo, so I was interested in hearing how data could be used,” Clinical Engineer C. Mahoney said. “To keep current with trends in the industry and maintain certification CEUs,” said P. Graham, manager, IT clinical engineering. “It provides additional learning. Yes, since attending webinars will keep you updated with the latest trend of technology and also acquiring the continuous professional development,” Biomedical Engineer E. Gonzales said. “Hunger for new information. And yes it is always worth attending,” shared R. Mesropyan, CBET. “I try to never miss a webinar if I’m not doing something else over my lunch hour. It was worth seeing how other biomedical groups handle their data, and what steps would be if we were to go to a better system,” said Biomedical Technologist O. Stephen. “I am now involved with maintain-

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MARCH 2020

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TOOLS OF THE TRADE Netech

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TECHNATION

MARCH 2020

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SHOP TALK POWERED BY

PHILIPS DIGITRAK XT HOLTER RECORDER

How do I clear the 602 Error code on my DigiTrak XT holter monitors? Every single one of them is showing 602 error code.

A: A:

GE HEALTHCARE OPTIMA XR220AMX I did a short video on how to repair this problem. You can go to YouTube and type “Error 602 repair.”

This is a new problem affecting all 860322 Holters, per Philips directly. Please contact them at 800-7229377 and create a Case ID against your serial number(s). Further information is expected, but at this time the holters cannot be used whatsoever. It appears to be a 2020 date rollover issue that corrupted the firmware.

Recorders cannot be restarted. Philips sincerely apologizes for the inconvenience this situation has caused. If you have any questions regarding this incident, please contact the Customer Care Solution Center at (888) 744-5477.

Subject: 860322 Philips DigiTrak XT Holter Recorder – Reported Error

Dear Valued Customer: We want to bring to your attention an issue with the Philips DigiTrak XT Holter Recorder (Model 860322). Philips has confirmed that – beginning on January 1, 2020 – if a battery is inserted in the recorder and a user attempts to start it, or if the recorder is inserted in the docking station, the recorder will display “Error: 602” and fail to function further. At this time, there is no action that the user or Philips Service can take to clear this error. Philips has determined that an issue with the firmware results in an abnormal device behavior associated with the recorder’s internal real-time clock. This manifests itself when the year rolls over from 2019 to 2020. It affects all DigiTrak XT Holter Recorders, but no other Philips system or device. Immediately upon learning of this issue at the beginning of January, Philips began to work on a solution, dedicating both internal Philips and external resources. That high priority effort continues. We will communicate with you as soon as a solution has been confirmed. By no later than Friday, January 10, Philips will provide an update and guidance. Regrettably, until then, your DigiTrak XT Holter

I need some troubleshooting help. I have an Optima 220 that won’t start. When you press the power button it starts for 2 or 5 or 10 seconds and then shuts down. Parts replaced: main power supply, LVLE power supply and still the same problem. I appreciate any help.

You should try reseating the cable between the PC and the Spyder. When it is starting, do you get the GE icon on the bezel to light up? Does the battery bar light up? On the PC, are you getting any of the three green LEDs?

Check each battery pack voltage on start up. One is probably dropping out. Will prevent start up even if plugged in. Had it happen to me once.

A: A:

Check the cricket battery board for any signs on a burnt component.

Did you properly charge the batteries? Also, you may have faulty battery(ies). I had a faulty battery shipped to me once. It would be odd that your problem started when you replaced the batteries unless it existed prior

A: A:

Has GE performed the battery charge firmware update on this system?

It should be FMI 10910. There should be stickers near the cord reel. One of them should have that FMI on it. Though I have seen FEs not install the sticker so you may call GE if you don’t see the sticker. They should be able to look it up.

SHOP TALK

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

TECHNATION

MARCH 2020

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RepairMed is the industry BEST one-stop component-level repair depot whose services include the most comprehensive and cost effective flat rate repair pricing!

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• Provides Consistent Reliable Credible Depot Repairs RepairMed repairs all models of these devices to component level: • All Models of Infusion Pumps Including Baxter Sigma Spectrum , Medfusion, Medley, and Plum Series, including Plum 360’s.

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EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

MARCH 2020

TECHNATION

ROUNDTABLE

ROUNDTABLE Ultrasound

or this roundtable article on ultrasound, TechNation reached out to industry leaders for input and insights regarding what to look for when purchasing an ultrasound system, the latest advancements in the modality, cybersecurity concerns and more.

Participating in the roundtable are The Intermed Group Imaging Service Engineer-Ultrasound Jacqueline Browning, MW Imaging Senior Field Engineer Tom Hanak, Summit Imaging CEO Lawrence Nguyen, Ampronix Director of Business Development and Marketing Michael Thomas and Innovatus Imaging Vice President of Ultrasound Center of Excellence Matt Tomory. Q: WHAT SHOULD HEALTH CARE FACILITIES LOOK FOR WHEN PURCHASING AN ULTRASOUND SYSTEM? BROWNING: Health care facilities should look for a system that fits their specific needs. Whether that need is identifying

TECHNATION

MARCH 2020

vascular. Each OEM specializes in different applications, though some have closed the gap between the other OEMs. The second should be the availability of parts and probes in the third-party market. You want to make sure youâ&#x20AC;&#x2122;re not tied down to just going direct to the OEM for a part or a probe outside the standard warranty they are providing to you when you buy the system.

Jacqueline Browning The Intermed Group

what system is compatible with a workflow the customer is implementing or a budget constraint. Having a variety of vendors to choose from is a plus. HANAK: When searching for an ultrasound system the facility should first look at what type of application they will be using the system for. The most typical applications include OB, cardiac and

NGUYEN: Healthcare technology managers are actively looking for ways to reduce the total cost of ownership of ultrasound systems while providing quality patient care. A popular strategy is to assess the ability to bring the service in-house once the warranty expires on the systems. It is critical to assess the support available from OEMs and independent service providers to enable HTMs to support the systems that can significantly reduce costs and maintain quality. THOMAS: First and foremost, they need to determine if a console or portable version would best suit their requirements. Next, start researching options such as 3D/4D

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ROUNDTABLE

probes and software that would be the optimal choice within their budget. Due to ease of use and cost savings, we are starting to see an increased shift toward the use of portable ultrasounds. TOMORY: Just because a facility is loyal to or heavy with one OEM, it’s not the reason to purchase from that OEM. Facilities, more importantly individual departments, need to be sure that the OEM and the system model meets the specific needs of the imaging specialty. OEMs do typically lean to one or more specialties. Also, research post-purchase support options. Ensure that the OEM will guarantee that the system is at the current software and hardware level when it rolls off of warranty or contract. Q: WHAT ARE SOME OF THE LATEST ADVANCEMENTS IN ULTRASOUND TECHNOLOGY? BROWNING: One of the exciting latest technologies emerging are chip-based transducers. Chip-based transducers use silicon chips to convert voltage to resonance. It’s still in its infancy stage and produces lower image quality. The lower quality images would be most viable in point of care, health clinics and physicians’ offices. A feature that is very promising is that it is an early-stage technology to combat chronic illness by using sound waves to destroy diseased tissue. HANAK: The industry is starting to see everything go toward a more wireless approach. Whether it’s the systems or probes, it’s becoming the standard now. After completing the exam the sonographer has the ability to speed up the diagnosis for the patient. Ultrasound systems are also becoming smaller and ergonomically designed to increase the workflow without compromising image quality. Advancements in software also continue to include higher levels of AI that can speed up the time that it takes to complete a study and reproduce consistent image quality with even the

newest sonographer. NGUYEN: One of the latest advancements in ultrasound technology is the ability of new ultrasound transducers to capture higher resolution images, enabling technicians to perform a wider variety of studies. This is great for the health care system and patients as ultrasound studies are non-invasive, relatively quick and a lower cost than other imaging modalities. THOMAS: We are noticing the release of wireless Wi-Fi ultrasound probes. This is an incredible advancement as there are no actual wires being connected to the probes or tablets, which can be very helpful depending on your area of focus, such as veterinary clinics. Also, 4D ultrasound scans still seem to be an industry leader, especially for Millennials, as they want to utilize the latest technology. TOMORY: Single-crystal technology, CMUT technology and wireless-probe technology have been emerging lately, but none seem to be growing at the pace of 3D volumetric imaging. Although 3D Matrix array probes have been available for about 10 years, the technology is maturing and gaining a larger install base. Probe designs, which traditionally contained less than 100 acoustic elements, now contain thousands. We can expect a greater number of probe models and systems from a greater number of OEMs supporting this complex imaging modality. Q: HOW DO YOU THINK THESE ADVANCEMENTS WILL AFFECT TROUBLESHOOTING AND SERVICEABILITY? BROWNING: Chip-based transducers would make serviceability more cost effective. There is no risk of accidental damage to the array. The current FDA guidelines for transducer repair facilities is driving up repair prices due to the added time needed in testing and validating a transducer. HANAK: Servicing the newest ultrasound systems can be costly but not compared to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Tom Hanak MW Imaging

the cost with the OEM. The availability of parts may be limited to third-party suppliers. Also, having well-trained and qualified engineers who know the newest platforms and the system architecture is essential when troubleshooting. NGUYEN: These advancements will likely not impact troubleshooting or serviceability as the same principles of testing image quality and failure modes are largely unchanged. THOMAS: Some ultrasound manufacturers are now creating apps that can be downloaded on any handheld device, which would then become the software for the ultrasound system. This would reduce the need for units being serviced utilizing the app interface as manufacturers can send an update to the device to address common issues. Before this, most units would need to be sent into a service center for further diagnosis. TOMORY: One of the biggest challenges with supporting diagnostic ultrasound these days is related to software. The hardware itself is fairly stable. Being able to distinguish between a hardware failure, probe failure and/or software (or even a user-related) issue can be challenging. It’s important to have a strong foundation with ultrasound technology and a robust support network. It’s also recommended

MARCH 2020

TECHNATION

ROUNDTABLE

to image the hard drive on all critical systems and create frequent backups anytime a change is made to the configuration. Be ready for a failure and minimize opportunities for software corruption using all available technologies. Q: WITH AI BECOMING A POPULAR TOPIC IN MEDICAL IMAGING, HOW DOES THIS AFFECT TROUBLESHOOTING AND SERVICEABILITY OF ULTRASOUND SYSTEMS? BROWNING: AI focuses on working with and amplifying end user knowledge. An effect on serviceability and troubleshooting will be continuing to keep a spotlight on optimal system performance keeping a high focus on image optimization. Image quality checks is a key part of scheduled maintenance. This is important due to the diverse pool of end users relying on reproducible imaging in AI. HANAK: Troubleshooting can be somewhat challenging if you are not sure how the AI software works with the system. You would need a trained engineer who understand the terminology and can accurately identify the specific problem.

derived from AI will occur when cloud platforms become more sophisticated and integrated into workflows of HTMs. THOMAS: Since this is a newer technology, biomeds and service centers will need to work closely with manufacturers to diagnose possible new issues that might arise. The best way we have found is by being in direct communication with our customers at least weekly. This allows us to see how each system is being implemented within their facility and receive valuable feedback when an issue does arise so we can further troubleshoot. TOMORY: Simply put, AI is just complex software. Like all computers and software, garbage in-garbage out. Service engineers need to have good, solid troubleshooting skills and insure optimal image quality prior to addressing any complaints or trouble calls related to AI. In ultrasound, it all starts with a healthy probe, performing as expected. There is going to be increased need to ensure the use of a repair provider that can demonstrate that probes perform as the OEM intended. Q: WITH TECHNOLOGY ADVANCING SO QUICKLY, DO YOU THINK THAT ITâ&#x20AC;&#x2122;S POSSIBLE FOR A SINGLE SERVICE PROVIDER TO ADDRESS SYSTEMS AND PROBES? BROWNING: At Intermed, we make it a priority to partner with our customer in identifying system and probe issues. Technology is advancing quickly, and the needs of the customer are changing dynamically. Listening to the customer and regularly scheduled maintenance makes this possible.

Lawrence Nguyen Summit Imaging

NGUYEN: AI is a popular topic in medical imaging, however, it has yet to gain traction in service of ultrasound systems rolling into 2020. The shift in workflow

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MARCH 2020

HANAK: Yes, it is possible. Keeping up with the latest technology and advances is challenging but we take pride in our continuing education process here at MW Imaging. NGUYEN: Absolutely. It is key for HTMs to identify organizations to partner with that have the ability to support systems and

Michael Thomas Ampronix

probes. This ensures HTMs are receiving the best quality of support possible when troubleshooting problems that could arise from either the system or the probe. THOMAS: There are many variables to consider when servicing and repairing ultrasound machines. One is the availability of parts as some manufacturers limit the number of service centers they will sell parts to. Another variable would be downtime. Some facilities are not able to have any downtime and would require a loaner to be sent to them prior to sending in their unit for evaluation. TOMORY: Itâ&#x20AC;&#x2122;s my belief that systems and probes are best supported individually. Probes are a field of study within themselves. Although some do, there are only a few OEMs that actually manufacture their own probes. Typically, they are outsourced to specialized companies, one being Innovatus Imaging that operates an FDA-registered probe manufacturing facility. Systems are also their own specialty. Combining the number of potential hardware and software configurations available on a single platform, the number is staggering. Although a one-stop shop sounds convenient, the best results may be obtained by using providers who specialize in one or the other.

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ROUNDTABLE

Q: WHAT ARE IMPORTANT THINGS TO CONSIDER REGARDING CYBERSECURITY WHEN IT COMES TO ULTRASOUND SYSTEMS? BROWNING: Health care organizations need to develop and maintain a strong security culture with ongoing cybersecurity training and innovation. They need to seek ways to stay ahead of a possible cyber attack. It’s important to assist our customer in identifying any upgrades or patches for their systems that are available through the system’s ultrasound manufacturer. The InterMed Group has cyber specialized teams who perform medical device profiling (MDP) for cybersecurity. HANAK: Making sure your ultrasound system software is up to date is always crucial with regard to cybersecurity. OEMs will always release a newer version of software that includes patches to fix the bugs or any other issues related to the software. Does your facility have an old or outdated system that the OEM no longer supports? If so, we recommend updating the system to ensure the safety of data on your system. The OEMs have taken steps to ensure that their current line of ultrasound systems tackle cybersecurity issues by adding features such as whitelisting to their software, and encrypting the patient information on the hard drive. NGUYEN: The same basic principles of security apply to ultrasound systems as any other connected device in a health care facility. Strong network security will help reduce risks of attacks. THOMAS: Having your system up to date is vital in extending the life of your unit. Manufactures at times will release patches to address bugs within the software, and having your unit updated will prevent unforeseen errors. Additionally, having a network firewall is another layer of protection if the ultrasound is going to be connected to a network. TOMORY: Be prepared. Be sure that, while systems are under warranty or OEM-con-

tract, that the OEM is performing regular software updates. Post-warranty/contract insist on the same level of service. While software upgrades come with a cost, software updates are typically free. Create an image of the hard drive and perform a backup anytime the software is updated, upgraded or user-configurations are modified. It’s also critical that the original software not be modified in any way (virus protection, widgets, etc.). Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING AN ULTRASOUND SYSTEM? BROWNING: When it comes to communicating with a service provider or vendor about purchasing and servicing an ultrasound system, make sure they are listening until you feel understood. Every customer has a unique situation and it’s not one size fits all. HANAK: When purchasing a new ultrasound system for your facility we recommend getting the CES/HTM and IT departments involved in the decision as well. Try and work into the purchase agreement some type of training so that the specified department(s) can perform preventative maintenance and assist when the system goes down. We also always recommend negotiating a copy of software with the system. Improper shutdowns can and will corrupt the software or can cause damage to the system hard drives. NGUYEN: There is a major shift underway of taking ultrasound equipment service in-house. It is a proven strategy to reduce service costs, increase scanning efficiency and enable health care facilities to meet tight budgets. Identifying organizations that can support them at the time of purchasing a system allows optionality for HTMs to decide which service option is best at any given point in time. All HTMs have plans and timelines and we all know things don’t always go as planned. Maintaining optionality allows HTMs to modify how they operate at their

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

discretion to best serve their patients. THOMAS: I would encourage the readers to do their due diligence on what options they want in an ultrasound system. Most facilities use the same ultrasound systems for five-plus years, so it is essential to try and purchase a system with all of the features dependent on what the facility can afford. If they are not able to buy a new system, consider purchasing a refurbished system which, in most cases, still will come with a comparable warranty as a new system would. In regards to choosing a service provider, make sure to ask if the provider has serviced or repaired your specific ultrasound/probe before as this will help reduce future complications that might arise.

Matt Tomory Innovatus Imaging

TOMORY: Insert clinical engineering into the purchasing process for any capital equipment purchase. Do your homework ahead of time and learn what support options are available post-warranty and insure that the OEM provides the necessary tools to support the system post-warranty (service manuals, service training, access codes, software updates, etc.). Everything is negotiable up-front. Be sure to research non-OEM support options and choose one with an ISO 13485:2016 certified quality management system.

MARCH 2020

TECHNATION

IT ALL STARTS ONLINE WEBINARWEDNESDAY.LIVE

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SPECIAL REPORT

Top 10 Health Technology Hazards for 2020

Expert Insights from Health Devices Unexpected health technology hazards can blindside hospitals and harm patients. Our top 10 hazards report can help you prioritize efforts and reduce risks to patients.

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Download the Free Executive Brief www.ecri.org/2020hazards

DISASTER PREPAREDNESS Lessons Learned and How to Prepare

By K. Richard Douglas

n November 2018, the deadliest fire in California history ignited. For more than two weeks, it would cause catastrophic damage to the town of Paradise. The Camp Fire resulted in 85 people losing their lives, more than 153,000 acres were burned and 14,000 homes were lost.

When the fire was approaching Adventist Health Feather River Hospital in Paradise, the staff realized that they would have to quickly evacuate 67 patients. Clinical and support staff all went into action including the hospital’s four-man biomed department. The biomeds found as many wheelchairs as they could and staged them in front of every patient room in the med and cardiac/neuro units. They pushed patients

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in their beds to the ambulance bay for evacuation. Patients also had to be quickly loaded into ambulances and personal vehicles for evacuation. One of the hospital’s biomeds at the time of the fire was Marc Silver, BMET III. “Pay attention to, and know what to do, in a disaster. Be prepared and be ready. Know your role and learn the job of others as well so you can assist. Know where things are stored or how to properly mark a room cleared in a fire/drill,” Silver says. “Keep a calm head, and be flexible. Adapt and overcome,” he adds. While most hospitals are more likely to experience a number of other emergencies before the risk of a wildfire, the experience of the biomeds at Feather River is instructive; an emergency could arrive at

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the doorstep and biomeds have to be prepared. Biomeds may have to take on a role that goes beyond medical equipment. “In hindsight, the only thing I can think of is biomed departments should have a clear plan for evacuation. There were only a few minutes for any discussion. We evacuated 10 years prior, having a whole day to do it. We were able to check all equipment leaving with patients and where they were going. This one was all about escaping with our lives,” says Rob Harry, the biomedical engineering site director at Feather River at the time of the fire. In 2016, CMS published the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule. Health care providers were expected to have the rule implemented by November 15, 2017. The purpose of the regulation was to “establish national emergency preparedness requirements to ensure adequate planning for both natural and manmade disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems,” according the CMS’s website. The agency further stated that compliance with the regulations was necessary for participation in the Medicare or Medicaid programs. It was also a requirement that each provider and supplier have their own set of emergency preparedness regulations. The need for these established procedures has become evident for the many health care facilities that have experienced natural and man-made disasters such as hurricanes, tornados, flooding, wild fires, the treatment of victims of mass shootings and earthquakes.

Having an emergency plan provides a framework for emergency preparedness. These rules are in place to deal with homeland security, power outages and disease outbreaks as well. The rules protect patients, clients, residents and participants during disasters or emergency situations. According to the 2019 revised rule, “The requirements are focused on three key essentials necessary for maintaining access to health care during disasters or emergencies: safeguarding human resources, maintaining business continuity and protecting physical resources.”

Biomedical engineers are used to working under pressure to begin with, since power is not reliable,” says Enrique Vazquez, field sales service liaison with Avante Health Solutions.

““ After the hurricane passed, it was total chaos for everyone that worked in a biomedical service roll. They were the front line to evaluate all of the damage, even the big iron like MRI.”” - Vazquez

HTM PROFESSIONALS PROVIDE SPECIAL SKILL SET Biomeds have learned from experience that emergency situations have called upon both their skill sets to prepare and protect medical devices, and often to assist facilities in helping to evacuate or move patients. Those HTM professionals who have been on duty during an emergency have learned that it is often an “all hands on deck” situation and clear thinking and situational awareness are crucial. In the case of the Camp Fire, biomeds sprang into action to help evacuate patients. In the case of Hurricane Maria, which hit Puerto Rico in 2017, the devastation was so vast that many hospitals were caught unprepared and half of the back-up generators failed. “Hurricane Maria was not the only hurricane to hit Puerto Rico that year; Irma had some impact as well. The island infrastructure is old, so power becomes one of the biggest issues.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Vazquez visited the island to repair equipment after the hurricane. “While Hurricane Maria was close to the island, the biomedical teams were making sure that all the battery-operated equipment was working in good condition because of the category of this hurricane. The people knew this was going to have a big impact on the power grid and utilities,” he says. Vazquez says that the surgical rooms needed to be preserved because even with power generators, power would need to be steady and maintained. The parts of the hospital that didn’t need power were turned off to minimize the load on the generators. “Biomedical engineers, that had the task to work during the hurricane and after, [were] under great stress not knowing how their family were, among other worries. After the hurricane passed, it was total chaos for everyone that worked in a biomedical service roll. They were the front line to evaluate all of the damage, even the big iron like MRI,” Vazquez says.

MARCH 2020

TECHNATION

DISASTER PREPAREDN DISASTER PREPAREDNESS

He says that because of the hurricane, the cooling and the air conditioning failed for the MRI. “Power surges, due to generators failing, caused other equipment like CT scanners to fail,” Vazquez says. He says that despite the mass destruction, there was one hospital available that was built to survive off the grid; built in between a mountainous area off of a small highway in the west coast of Puerto Rico. “This hospital never closed its doors, it didn’t sustain any power damage, had minor structural building damage but never closed; it worked off its own power generators battery backup, water tanks that had unlimited supply because they tapped in to a well. It was a well-oiled machine,” Vazquez says. Vazquez says other hospitals had to close because the damage was high, especially with power and utilities, oxygen was low and they could not generate it. He says to prepare for a major disaster like Hurricane Maria, it is imperative that biomeds maintain critical medical equipment, find ways to work the hospital infrastructure off the grid, have a reliable safety plan with backup plans. Vazquez also suggests that biomeds and other hospital staff run practice scenarios. “How can we ensure that the hospitals have enough support staff. Biomedical engineers are working with so many pieces of equipment and short staffed until the hospital has a major event. Keep the communication lines open from phones and cell service. Radio emergency communication is very important. I understand that biomedical departments have emergency plans, but are they really involved in the plan-

TECHNATION

MARCH 2020

““ HTM professionals have critical thinking capabilities that are essential when dealing with disasters and quite often we have a very good understanding of how the organization is laid out and how different departments operate.”” - Piepenbring ning?” he asks. Vazquez went to the island right after Hurricane Maria and has been there several times since to help repair equipment. “Even today some of the equipment is down due to the extent of damages,” Vazquez says. The list of natural and man-made emergencies that have impacted hospitals during the past decade is extensive.

HOSPITALS CHALLENGED BY TERRORISM The year 2013 was a year that tested biomeds and other hospital staff at Boston Medical Center, when a terrorist attack during the running of the Boston Marathon took a devastating toll on spectators and racers. Terrorists had detonated two homemade pressure cooker bombs near the finish line. More than 260 people were injured in the bombing, 16 lost limbs and three died. The worst injuries were traumatic amputations. Victims were taken to 10 different

hospitals in the Boston area. Twenty-three of the victims were transported to the Boston Medical Center, which is a level I trauma center and the city’s busiest. In TechNation’s January 2015 cover story about disaster preparation, we quoted Jim Piepenbrink, who was the director of clinical engineering at the Boston Medical Center at the time of the bombings. Piepenbrink said that he strongly encouraged others to take part in their organization’s emergency preparedness team. “HTM professionals have critical thinking capabilities that are essential when dealing with disasters and quite often we have a very good understanding of how the organization is laid out and how different departments operate,” he said. “We have a renewed focus on increasing the number of people who will participate in disaster management, especially at the command team level,” Piepenbrink said. “Disasters can last for days and we have worked at ensuring that we have a better bullpen of people we can draw from to ensure that people limit their shift so that they are making effective decisions and not getting burned out.” “Additionally, we have beefed up our software solution to better capture necessary information so that we have a single lens into the activities during a disaster instead of manual and electronic monitoring of the situation,” he added. Sonoma County, California was hit by wildfires in 2017. Jorge Contreras, CBET, TechNation’s professional of the month for May of 2018, experienced first-hand the requirements of dealing with an emergency. Contreras worked

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NESS for enBio Corp and was assigned to Sonoma West Medical Center 2017. He is currently the director of procurement at Sonoma Specialty Hospital in Sebastopol and oversees the biomedical engineering program there. In his 2018 profile, Contreras recounted: “The fires started hours before the sun came up. By the time I woke up, we were in full-on disaster mode. I made it as early as I could and there were many unexpected challenges. Two of the other hospitals had closed and the hospital I support, Sonoma West Medical Center, was the only hospital open in the western part of the county,” he said. “We received a large number of patients and suddenly there wasn’t enough staff because many had to escape the fires themselves with their families. I helped other departments whenever I could. I picked up empty food trays, helped environmental services out, whatever was needed – it was all hands on deck,” Contreras said. “A strong challenge that came during the fires was the short supply of biomedical equipment at the hospital. It’s a 37-bed facility, but suddenly, we had patients out in the hallways and we needed equipment direly. Other hospitals in the area helped us out by loaning us their equipment and as the sole biomed, I was responsible for testing each device before placing it in service,” Contreras remembered. “Other challenges were a lack of patient beds. I sought out vendors who could rent us the equipment but because of the fires there weren’t many responses. But; we pulled through, and the county, the staff and the residents of the town all became closer because of these events,” Contreras added. Looking back with some more time

to reflect on that experience, Contreras has some advice for other HTM professionals. “First, one needs to be available to help. It begins with the willingness to put one’s self aside and make the patients the priority. I remember not eating at all during the first fire because I was needed on-site,” he says. “Another thing, track all equipment that comes in. With the incoming patients we needed extra equipment and keeping track was vital. It’s easy to mix up your equipment with loaners so it’s important not to lose track of what comes in,” Contreras suggests. He says that rental companies are necessary. During the floods last year, he says they struggled with finding spare equipment. The company he used quickly ran out and it’s necessary to have backups to your backups. “Work with engineering. Know what challenges they face. If the facility starts running low on oxygen, then us biomeds need to find alternatives such as oxygen concentrators or compressors for ventilators,” Contreras says. “Always keep an emergency supply of batteries. Telemetry, SPO2, etcetera, require batteries and during an emergency, deliveries will be slow to arrive. Remember, there’s your standard supply and then there’s the emergency supplies. These are two different things and one should never take from the emergency bin without replenishing,” he adds. Contreras says that during any

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

disaster it is all hands on deck. Come to work and be prepared to offer help in any way possible. Help with distributing supplies to the nurses. “Environmental services crew may not be able to come to work and you may be needed to help clean up a room. The staff won’t have time to take a break and I remember the DON was making ham and cheese sandwiches for everyone. This is our duty during a disaster. We aren’t biomeds. We are members of the community and we’re called upon to help our neighbors,” he says. Contreras says that a last thought on the topic is that you will be needed on-site. It’s our responsibility to be there and help sustain the hospital. “You may feel the need to flee but you’ll be safe at your facility. There’s generators, food and safety in numbers. Bring your family if you have to. However, you will be needed to serve the hospital during an event. If not us, then who?” he asks.

““ First, one needs to be available to help. It begins with the willingness to put one’s self aside and make the patients the priority. I remember not eating at all during the FIrst fire because I was needed on-site.”” - Contreras Preparation is key in any disaster or emergency and knowing the experience of other HTM professionals can provide some useful guidance to know what planning is needed before or after the event. Knowing ahead of time can make life much easier and prevent further tragedy.

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CAREER CENTER 2020 Career Resolutions BY TIM HOPKINS

t’s that time of year again! I’m talking about when people start to break New Year’s resolutions. Some of the most common resolutions are exercising more, losing weight, stop smoking and advancing in your career. All these are great ways to improve your quality of life, so why is it so difficult to achieve them? Forbes magazine states that only 8% of people will meet their New Year’s Resolution. So, let’s be honest, it’s easy to slip early on.

If your goal is to advance your career, my hope is this article will help you along the way. While there may not be a magic formula that works for everyone, here are 11 things I encourage you to do when planning to advance your career. 1. Set the End Goal. With any goal-setting objective, the best way to get started is to simply write down what you are trying to achieve. Determine what your end goal is and write it down! 2. Research & Evaluate. Don’t just say, “I want to be a manager” and expect it to happen overnight. There are steps you need to take to be qualified for management. So, what are those steps? Do you need to continue your education or achieve additional certifications? This evaluation process is probably the most important piece to making it happen. Take the time to research and build a path. 3. Measurable Path. It is important to have attainable and measurable objectives along your path. Ideally,

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MARCH 2020

this is so you are building up experiences and the credentials you need along the way, but doing this also allows you to have victories along the way to your end goal. For example, it would be challenging for most of us to wake up one day and simply complete an MBA. Take the smaller but equally important steps first. For instance, look at attaining your CBET or HTM certification. Make them measurable and manageable pieces. Nothing can derail us faster than feeling defeated, so create a path that allows you to see progress and celebrate along the way. 4. What’s the Plan? Develop a plan to reach each of your measured objectives that includes a timeline. For example: Set a schedule of studying every Tuesday and Saturday for two hours to attain a certification on a specific date. 5. Add Benchmarks. Provide benchmarks to your plan to check-in with yourself and make sure you are achieving your objectives. Read your goals on a monthly basis to see where you are. At each of these benchmark periods, evaluate honestly how things are going and if adjustments need to be made. Remember this is your plan and it needs to fit with your life. 6. Remind Yourself of the Goal. Keep a copy of your goal in your wallet/ purse or on the refrigerator as a reminder. Visualize yourself achieving your goals. Much like writing your goals down, visualization is a great way to “see” your goal. It helps

Tim Hopkins Stephens International Recruiting, Inc. promote positive thinking and will help you stay on track and hit your benchmarks. Professional athletes such as Tiger Woods, Micheal Phelps, Larry Bird and Michael Jordan have utilized visualization as one of their many training tools. 7. Engage Professional Support. Communicate your long-term goals to your manager. You might be surprised by their willingness to help. Obviously, the way you convey your desire to achieve more needs to be tempered. The HTM profession is getting older and looking at a wave of retirements in the near future. Many organizations are developing exit strategies for leadership who are approaching retirement. Utilize performance appraisals as a benchmark and a way to improve your performance at work. 8. Professional Network. In any profession, it is always great to

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network with professionals within the industry. The sharing of ideas and information is vital for the growth of the industry, but even more importantly – for you. Updating your LinkedIn profile and taking time to connect with others takes a few minutes, and should be incorporated into your plan. Networking will build on existing relationships and often open doors to new ones that may be beneficial in the future. Attending local biomed meetings is a great way to get in front of contemporaries in the community. Who knows where the conversation might go! This is also an opportune time to let people know you are continuing, or have completed, your educational goals. If you have the resources, try attending AMMI and MD Expo conferences. Take these opportunities to learn more about the industry and leverage the connections in a way that will help you reach your goal. Give a presentation or sit in on a panel where you can share your knowledge. You will gain new insights, add more connections to your network and build your industry profile. 9. Share Accountability. Discuss your goals with family and friends. You will not only get the moral support needed, but you may inspire them as well. Individual goals do not need to be the same to help support each other and hold each other accountable. Someone in your circle may want to lose weight. Help them develop their plan with similar steps. Set up a weekly call to keep each other accountable, share your victories as well as struggles. 10. Learn from the Bumps in the Road. It can be challenging. Focus on the success of each step along the way, not the failures. One of my favorite quotes: Failures are part of life. If you don’t fail, you don’t learn. If you don’t learn you’ll never change. 11. Celebrate! Give yourself a reward for completing each objective. It does not have to be anything elaborate; something as simple as a walk in the park is great. Just mark the occasion and keep pushing forward. Most things in life do not come easy, including reaching career goals. Working hard for something makes the reward that much sweeter. Just starting your journey can get the wheels in motion to becoming a better person, employee and spouse. You can do it!

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Philips X5-1 Got You Down: Part III BY TED LUCIDI, CBET

ur last two columns have provided some technical information on the differences between traditional ultrasound probes and newer live-3D volumetric probes, specifically cardiac probes such as the Philips S5-1 and X5-1.

We highlighted that, over time, cardiac probes begin to exhibit intermittent performance issues due to a breakdown of one or more wires in the wiring harness and that they intermittently present as static in CW Doppler mode, flashes of color in color Doppler mode and dropout in B-mode. We also discussed that if a poor, intermittent, compromised or questionable connection results on one or more of the 12 control lines within the X5-1, then constant static in CW Doppler mode may be experienced. Let’s begin troubleshooting by potentially eliminating or identifying if the root cause is cable related. 1. Firmly connect the X5-1 to the scanner and initialize using the Adult Echo preset. Be sure that all water or gel has been removed from the lens of the probe. 2. Enter CW Doppler mode and move the sample volume cursor slightly left or right of center. (Avoid a straight vertical/centered line.) 3. Adjust the Doppler gain so there is very minimal or no background

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MARCH 2020

noise in the spectral area. 4. Flex each strain relief and the length of the cable while observing the scrolling spectral Doppler area and listening to the Doppler output. 5. Move the sample volume cursor to multiple locations within the image and retest. When testing factory new and slightly used probes, results will present audibly as, what sounds like, slight rubbing and visually as minor gray spikes, peaks and valleys in the spectral area. If the wires are beginning to fail (or have failed) hard/heavy static will be heard, and very pronounced white spikes will be visualized. The amount of acceptable static is highly subjective and can be interpreted differently by different people. Typically, more than one wire breaks down at a time and failures will be identified at multiple locations throughout the image. If constant static is encountered at some point, the point of failure may not be cable related. Remember from last month, anything that compromises the quality of

Ted Lucidi, CBET Innovatus Imaging

the connection or conductivity of one or more of the 12 control lines leading to the ASIC may result in constant static. Begin troubleshooting by thoroughly inspecting the pin bank on the reported probe and all ports on all scanners on which the probe may be used. Under magnification, inspect each pin. Look for deformations, compressed areas, oxidation and corrosion. The Compact Extreme (CX/Epiq) style connectors can be challenging to fully visualize, so use items such as headset magnifiers and dental mirrors to assist. Defects can be easily missed. It’s also possible that a single bent pin on a single probe has compromised the connectors across multiple ports on multiple scanners. The damage to one port, then affects the next probe connected. So on and so forth. Consider that the spring tension of the pins on either the single X5-1 or the scanner(s) has weakened or deteriorated to a point where it affects the X5-1. Don’t assume that because other probe models don’t experience this scenario that the problem is not scanner related.

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SUBMIT YOUR NOMINATIONS FOR So far, we’ve identified that this failure is isolated to the X5-1 only. Also, don’t assume that replacing the probe will solve the issue. It may, but may only for the short-term. The spring tension of the pins on new probes may be better than on used/older probes but using a new probe on a scanner that has worn/ compromised connectors can result in the same problem arising later. When complaints of constant static arise, actively work with your sonographers. When the issue is encountered, or when troubleshooting, work together. Have the sonographer disconnect and reconnect the probe. This may solve a temporary seating/connectivity issue. If the problem persists, disconnect the probe and reconnect it to a different port. Spring tension can wear, and oxidation can build up on probes/ scanner ports over time, even if the probe is never disconnected. Finally, test

the affected probe on another scanner. As with most performance testing within ultrasound, consistency is key. Test the probe using the identical settings with the Doppler sample volume in the identical location. To help, capture photos of the scanner settings and sample volume locations using a mobile device. On the surface, replacing a probe may seem like the easiest and most efficient method to troubleshoot or solve this particular failure. With today’s more advanced probe designs, you may just need better tools in your toolbox. Make sure to partner with a provider that has advanced as much as the products they support.

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The David Grant Medical Center Medical Equipment Repair Center

BY K. RICHARD DOUGLAS

ifty miles northeast of San Francisco, and seven miles east of Fairfield, in northern California, sits Travis Air Force Base. It leads the country in the amount of passenger and cargo traffic compared with any other military air terminal. It is home to several units in addition to the 60th Air Mobility Wing. It is also home to the David Grant USAF Medical Center. The facility, operated by the 60th Medical Group, sees 400,000 patients annually.

Military Treatment Facilities in eight states Active duty HTM professionals are trained in the Western Region of the United through the same school that many current States.” civilian biomeds graduated from. Haskin adds that each site is visited “Active duty technicians are trained annually for routine maintenance. through the DoD Biomedical Equipment “We also support the facilities with Maintenance program at the Medical technician support for installations of Education and Training Campus (METC) various equipment including PCRI on new at Fort Sam Houston, in San Antonio, radiology equipment before patient use. Texas,” says Haskin. Additionally, we work hand-in-hand with “Additionally, before deployment, physicists during initial inspections/ technicians attend DoD advanced courses acceptances of new radiology equipment,” including the Advanced Field Medical he says. “MERC technicians also provide Systems course, and a manufacturer CT “David Grant Medical Center (DGMC) quality control oversight for supported school to prepare them for down-range is the Air Force Medical Service’s bases during annual visits.” support of a field CT system with little to flagship medical treatment facility in the Both service contracts and database no outside support,” he adds. United States,” says U.S. Air Force management are handled by unique, Part of the reason the team is well Senior Master Sgt. Bruce Haskin, 60th dedicated entities that are a part of the trained is that METC training is so Medical Support Squadron section chief military biomed infrastructure. comprehensive. Haskin points out that of clinical engineering. “An in-house contract services team members may have also taken some The HTM professionals managing the department, a subsidiary of medical advanced courses through the DoD school. medical equipment at Travis are part of the logistics, oversees annual service contracts Medical Equipment Repair Center and manages one-time repairs and WIDE-RANGING UNIQUE CUSTOMERS (MERC). services,” Haskin says. The MERC team at Travis Air Force Base, Leadership in the MERC includes Paula “All equipment inspections, BY K. California, has a worldwide reach. They RICHA Binns, chief of clinical engineering; Kevin preventative maintenance, calibrations, RD DOUG have also loaned personnel to important Hoellein, CBET, chief of the Medical LAS other services, repairs, and modifications humanitarian missions. Equipment Repair Center; Master Sgt. are recorded into the Defense Medical he Sonor “This facility has a high operations an Deser Aubrey Durkin, NCO in charge, Medical Logistics Standard Support database countr tempo y unlike for tdeployments is a region throughout the Equipment Repair Center; and Haskin. passe world,” system,” Haskin adds. says Haskin. of “Our s southe any southe other. the technicians The MERC also includes 31 It encom astern have rn Haskin says this includes documenting in many Arizon countries in CBET Europe, The city Califor served a as well , manag technicians, who service an inventory of the amount of time the technician(s) niaand of TucsoAfrica andthe Middle desert spent er of asEast.” TMC. n, Arizon parts 10,187 pieces of equipment. clinica region on the equipment, and the specific services of Mexic “Twoamembers the DGMC team . l engine “TMC sits withinof o. The group has wide-ranging done to the equipment. The system ering also has were recently ‘deployed’ Antonio, this to Santhat at provid responsibility for multiple facilities. provides historical information, e prima a netwo cost of specia Texas, to support humanitarian medic The metro relief list-sys ine, intern ry care rk of 21 “At David Grant Medical Center, we services (including contractnearly -Tucso efforts after multiple hurricanes costs), Garcia numb tems; clinics struck n area er the al medic and family Guille , a service multiple clinics, and have a joint historical cost, life expectancy, specia BMET BMET II; engine of rmina the Univemillion people is popul ine United States and nearby countries,” says lty service as well Darell ering “Mina ated venture with the Veterans Administration rsity maintenance timelines and . The Lynn, III; Jaye Johnso Hendr as a well other pertinent Natio Haskin. ” s. as the supports city is with BMET nal Park. of Arizon ickson where we service equipment items to serve all of Clinical follow data to determine when the III; Jim TMC: U.S.equipment III; Scott n, BMET , Sgt.home and Sagua RyantoSchaffer andhospic Senior It is 60 a“Tech. borde ing faciliti these areas II; John VA patients,” says Haskin. “As a MERC, MacL r with miles Nathan Roone Pangrac, should be replaced. geriatr larges as es ande, ambu BMET achlan north ro Howard inspected MexicAirman t city y, ic psych latory affiliated we support 34 Department of Defense , BMET of themillion of service BMET I; in Arizon reconstituted gym,” III; o and Training is also uniqueHand to the military. service with equipment surger and Joe Smith Rebecca s is the $4 she a. ling y center and an imagin engineer second those Clinic says. , imagin , emplo people the medic g service I; and al engine al needs 14 Direct TECHNATION yee (TMC MARCH 2018 is the Brish s engine Mark Weltz, g WWW.1TECHNATION.COM ering or of ), Tucso of all er. centra says servic IT Infras report tions ty-bas which is senior n Susan s to TMS lly mana ed hospit a stand- Medical of e contra tructu each up of Sneda Cente ged al license alone, “Hosp cts depar 16 memb ker. The re and Opera r 1803_TNMag.indd 14 ital specia tment by clinica were not ble for pediat d at 600 communiCEAMteam The ers. 2/1/18 9:46 l engine mana ric beds. their the contra ger was includ team under is made orthop emergency lty areas ering; depar includ cts for es edics,” respon care, Cahill Ellis Brittin Brish’s direct equip cardio e: says In 2016, tment. si, ment imagin Karla , BMET logy leader equipm Calde that chang in and Brish, g service ship II; ron, MBA, BMET s lead; Walter ed assign ent service Tim 12 Cassel Rober ed I; agreem and all medic TECHN l, senior Dirk Call, depart to the clinica to engine ATION ents al ment er; Brian BMET imagin APRIL l engine were to be III; g service “This 2018 Darr, ering manag move biome s leader ed. dical s as many was well-r equipm time or expert of them eceived ent of a service did not by clinica ise to l have contra manage ct,” Brish the delive the rables says.

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The Tuc son Me dical Cen ter Clin ical Eng ineerin g Dep artme nt

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TED LUCIDI, CBET, Customer Experience and Clinical Insights, Centers of Excellence for Ultrasound and MRI Coil Repair, Radiography, Design and Manufacturing, Innovatus Imaging.

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CYBERSECURITY BY JOSEPH E. FISHEL, CBET, MBA

hich cyber standard is right for you? There are several standards or frameworks out there from various organizations. This isn’t an exact science and vulnerabilities are coming from many directions so there is no one cure for all. These frameworks are primarily recommendations built on best practices developed in the IT world. They have a generic quality that allows for customization. Because much of our medical equipment has an IT component, we need to look at how to create plans, policies and procedures to protect or recover from an attack. Winston Churchill is credited with saying “He who fails to plan is planning to fail.” This is true in the biomed world, that is why we do preventive maintenance, to prevent equipment from failing. A cyber plan needs to be looked at in the same way as a Medical Equipment Maintenance Plan (MEMP). This is what we do and how we do things to maintain our medical equipment for the network side of things. This plan needs to be reviewed and be a living and working document.

The standards that I am familiar with are CIS CSC 19, Cobit 5, ISA 62443-2-1:2009, ISO/IEC 27001:2013 and NIST SP 800-53. There could be more. The primary question that should be asked is “Does your institution currently have a cybersecurity standard or framework currently in use and if so what is it?” This can work to your advantage as you will just need to put your information into the plan. If you don’t have a plan, let’s look at some of your options. CIS CSC 19 CIS Center for Security Controls (CIS CSC) is an organization that has developed various options for organizations depending on their size and what they want. They have over 20 different products from developing standards to

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MARCH 2020

providing monitoring, as well as security controls and testing for potential vulnerabilities. In regards to organizational controls, they have standards or guidelines for best practices. COBIT 5 DSS03.04 COBIT is a framework created by ISACA for information technology (IT) management and governance. ISACA is an international professional association focused on information technology governance. They have developed a generic framework for the management of IT, with each process defined with process inputs and outputs, key process-activities, process objectives, performance measures and an elementary maturity model. ISA 62443-2-1:2009 4.3.4.5.2 ISA 62443-2-1:2009 4.3.4.5.2 security for industrial automation and control systems is a spinoff of ANSI standards. This standard describes the elements contained in a cybersecurity management system for use in the industrial automation and control systems environment. It provides guidance on how to meet the requirements described for each element. ISO/IEC 27001:2013 ISO/IEC 27001:2013 specifies the requirements for establishing, implementing, maintaining and continually improving an information security management system within the context of the organization. It also includes requirements for the assessment and treatment of information security risks tailored to the needs of the organization. NIST SP 800-53 REV. 4 This is put forth by the National Institute of Standards and Technology (NIST) and is a publication with a catalog of security and privacy controls for federal information systems and organizations. As this is a government framework, agencies such as the Food

Joseph E. Fishel, CBET, MBA HTM Manager for Sutter Health eQuip Services and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) fall under these guidelines for their applications and network communications. HOMEGROWN There is a final one and that is the homegrown program that can be developed when your group pulls the best from each of these different frameworks. Selecting the best, or the most applicable, for your institution’s current practices and creating one document creates a plan. Because there is no lawful standard, and all of these are basically recommended best practices at this time, this is acceptable until a law is passed or a certifying group such as Joint Commission or CMS sets framework requirement. When selecting a cyber framework, list out the different requirements of each and review them to see what is being recommended compared to what you already are doing and what aligns with your current programs. Once that is done, you can review the other frameworks and create a crosswalk matching up their standards to your program. This way, if you are using COMI and someone wants to see how compliant you are to NIST standards it is easy to see. JOSEPH E. FISHEL CBET, MBA, is the Healthcare Technology Systems Manager for Sutter Health eQuip Services.

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THE FUTURE

Why I Believe the Future is Bright BY JOIE N. MARHEFKA, PH.D.

am excited to be writing my first “The Future” column. I thought a good place to start would be by sharing my thoughts on why I think the future of healthcare technology management (HTM) is so bright. Before I get to that, I’d like to briefly introduce myself.

I am an assistant teaching professor and program coordinator for biomedical engineering technology (BET) at Penn State New Kensington (PSNK) – just outside of Pittsburgh, Pennsylvania and have been in this role for just over four years. I teach courses on medical equipment, electronics, networking and troubleshooting. Prior to starting at PSNK, I worked in research and development of medical devices and technologies while doing some part-time teaching. I am glad that I made the decision to become a full-time educator. I certainly enjoy working with and sharing my knowledge and experience with biomed students. I believe that education is one of the best ways to prepare for the future, and I’m glad to be a part of that in the HTM field. Over these past four years, a number of things that I have seen and experienced make me believe that the future of HTM is bright. The first is our students. In the short time that I have been teaching at PSNK, we have had many excellent students in the BET program. Many of our students do a great job with troubleshooting and problem-solving. In recent years, we’ve

had several students recognized for their academic excellence by winning national and local scholarships. The motivation of some of our students gives me hope for the future, too. We have students working on research projects, volunteering at local hospitals and presenting at conferences in addition to their class work. It has also been great to see the successes of our recent graduates – getting the jobs they want, advancing quickly in their careers, getting certified and presenting at national conferences. Many of these students – past and present – truly want to make a difference with their work and that gives me hope for the future. The second is the great people that I’ve had the opportunity to work with over the past four years. The local biomed community has been supportive of our students and program by providing internship opportunities for students, speaking to classes and serving on our industrial advisory committee. The commitment that HTM professionals have shown to fostering future biomeds has been amazing and that makes me confident that young biomeds in the future will have the mentoring that they need to flourish. The third reason that I see a bright future is the opportunities that HTM careers present, which I believe will continue to attract talented, creative and motivated people. HTM jobs offer interesting work, competitive salaries, plenty of opportunities for advancement and the chance to help people. All of

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Joie N. Marhefka, Ph.D. Penn State New Kensington these attributes are attractive to those entering the workforce as well as those looking for a career change. Therefore, I am confident that great people will continue to enter the HTM field in the future. The BET students that I’ve taught, the local biomed community that I work with and the opportunities that the HTM field presents make me confident that the future is bright. Sure, there are challenges that will need to be overcome, including how to fill the numerous vacancies – current and anticipated – created by the wave of retirements. However, the people that I have met and the opportunities that are available give me hope for the future and confidence that these challenges can be overcome. I am happy to have the chance, by teaching biomeds, to play a small role in shaping this future. I look forward to sharing my thoughts with you about “The Future” throughout the year! JOIE N. MARHEFKA, Ph.D., is the biomedical engineering technology program coordinator at Penn State New Kensington.

MARCH 2020

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VIEW ON VALUE

Protocolized Medicine – Goal or Ghost BY PATRICK FLAHERTY AND JOE HADUCH

ince W. Edwards Deming stunned the manufacturing world with his industrial engineering insights, global manufacturing has embraced the need for highly replicable work-processes as a precursor for a sustainable level of quality; where extreme quality and low deviation is required, successful businesses have elevated the management, measurement and implementation of highly defined work processes even further. Quality expectations for health care, in manufacturing and care delivery, far exceeds even the automotive and airline markets. The need for health care to incorporate progressive approaches to sustainable quality is self-evident.

Health care has accepted the concept of clinical standards and practices as tools to address practice variation, the presence of which directly correlates to increased costs and variable clinical quality. Clinical pathways (the sequencing of care based on a common diagnosis) and protocolized medicine (the highly defined use of tests and technology to assess a common diagnosis) are the primary vectors used to translate Deming’s ideas into direct care delivery but, for many, protocolized medicine is not perceived as a universal good. For the naysayer, protocolized medicine is a restrictive and obtrusive care delivery model that threatens personal care and is akin to assembly line medicine. For proponents, it is a standard delivery of care derived from terabytes of patient data that minimizes clinical errors and

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Matching equipment capabilities, both existing and future, to clinical outcomes at the modality level will be instrumental in protocolized care. precisely defines patient treatment without individual bias. The current cost pressures driving programmatic change in health care are highlighting this disparity in thought as protocolized medicine offers a structured means to define and control what are currently highly-variable internal costs at a time that value-based care demands cost-effective solutions across the entire health care continuum. While most of us know intuitively that standardizing our equipment fleet will directly lead to fewer clinical-user errors, lower service and application training costs, and materially lower capital and operational expenses, few of us are familiar with the importance of standardizing medical care and the effect it has on our organizations. Much like standardizing a fleet of equipment, standardizing care through protocolized medicine affords many of the same opportunities, lower clinical errors as a result of predefined standardization of care through the continuous analysis and consolidation of normalized patient

data. This needs to be done across a wide spectrum of like-cases that objectifies and integrates diagnosis and clinical decision support resulting in improved patient outcomes. While this may seem straightforward, it is anything but simple. Entire articles could be written about the challenges associated with normalizing patient populations and acquiring the standardized data required to effectively manage this activity. For this discussion, the focus is on clinical equipment and the role it plays in the success or failure of this critical quality improvement effort, as well as the essential role HTM professionals occupy in ensuring success in this initiative. What will be required of HTM in this type of delivery model and how can we better prepare our organizations to contribute to this environment? Some of you may recall from our previous column how we talked about the need for HTM departments to collaborate in “defining the clinical business language” and “assess value appropriately” using unbiased and objective data. Nowhere is that more important than in defining and supporting a dynamic protocolized medicine program. Matching equipment capabilities, both existing and future, to clinical outcomes at the modality level will be instrumental in protocolized care. Once again, our HTM departments will be called upon to help define the existing equipment’s use and capabilities, both hardware and software, at increasingly granular levels of diagnosis while developing a robust research and

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analytical capacity capable of organizing current market offerings and product capabilities against real-world clinical need. For example, while the integrated use and implementation of protocol management software for imaging will monitor, restore and normalize imaging protocols across your entire imaging fleet it still requires a commitment by the imaging physicians and clinicians to connect protocols consistently with common patient diagnoses. This connective effort further increases the burden both in data acquisition and in contracting for a definition of the variable aspects of the technology (slice count, primary resolution, software) specific to a measurable clinical outcome. HTM is essential in the collection of critical data elements which will form the basis of the first baseline assessment and connection of diagnostic equipment to variable outcome quality and expense. Cloud-based software applications, available to every facility within your organization, will offer the same clinical solutions to every patient whether at a small community hospital or a major academic medical center. These are just two examples of the role medical equipment will play in protocolized medicine and the important role HTM will have in supporting and identifying these types of solutions. Part of the HTM’s function in this process will be to influence and require manufacturers to design and engineer products that support a protocolized care model. Manufacturers need to adopt better value engineering practices that advance clinical efficacy and support new care practices within an economic model reflective of the financial reality of patients and providers. In addition, it is difficult to standardize care without a standardized fleet of equipment and associated diagnostic software. Protocolized care is one of the definitive operational outputs of implementing a standardized fleet strategy centered around total cost and value of ownership. While clinical teams will need to lead the conversion to protocolized medicine, HTM departments need to start positioning themselves as a capable support mechanism that can provide expertise for the evaluation and assessment of their medical equipment fleet as well as unbiased appraisers of new technology and equipment functions. Protocolized care will require HTM organizations to develop and deploy sophisticated data collection and analytic capabilities in order to catalyze and manage the supplier change needed to successfully move in this direction.

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PATRICK FLAHERTY is the vice president of operations for UPMC BioTronics. JOSEPH HADUCH, MBA, MS, is the senior director of clinical engineering for UPMC BioTronics.

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THE OTHER SIDE

You Don’t Know What You Don’t Know BY JIM FEDELE, CBET

n my opinion, asset management is the one of the most valuable activities we do. Guiding and recommending purchases for our customers is probably one of the most frequent requests I get. Our processes direct requestors of equipment to contact us to assist them with equipment selection. This ensures that we get equipment that we can service, that is our standard throughout the system, and it is from a partnering vendor. By being included in the process early, we can eliminate serviceability and installation surprises. However, for the purpose of this article, I would like to discuss the pro and cons of the standardization of equipment purchases from a specific vendor perspective.

I have and always will be a proponent of standardizing equipment purchases by vendor and model. Having the same patient monitors throughout a facility has many benefits; it eliminates the need for nurses to be trained on multiple devices, it allows for better pricing, and serviceability issues are easier to manage and solve. Today, nurses do not always work on the same unit. Nurses are often moved around where needed. When monitors are the same everywhere, a nurse can easily adapt and not have to worry about how

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to use the equipment. This reduces the potential for user errors and improves nursing satisfaction. From a pricing perspective, everyone knows the more volume you purchase the better the pricing. Vendors always sharpen their pencils when they know they will get all your business. Service issues are easier to manage too. From spare parts to training, having to only accommodate one type of monitor makes life simpler. As I think about some of the problems we have had lately, it would have been difficult to get the vendor to help us if they weren’t our partner for monitoring. The loyalty and cooperation that a vendor will provide when they know you have committed to only purchasing their equipment is many times better than those on which you only have a couple devices. Standardization makes sense and is the right thing to do, but there is a downside. The downside to standardization is “you do not know what you do not know.” What I mean is that when you lock into a certain vendor and model you may be missing out. Competition is the greatest asset we have in this country; everyone is always trying to improve their products to be able to dethrone the market leader. That means if a competitor has “built a better mouse trap,” you may not even be aware of it. If you are like me, when

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

a competing vendor wants to demo a new monitor that is not part of my standardization plan, I choose not to meet with or talk to them. Really, who has the time to listen to someone’s product pitch when you know you won’t be purchasing it? However, after some reflection on this, I may be missing out on some knowledge. I have seen the market leaders’ product development become stagnant, for whatever reason. Meanwhile, the competition is working hard to develop a product that mitigates the weakness of the leader. Vendors are very good at pointing out the other’s weaknesses,

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“ Nurses do not always work on the same unit. When monitors are the same everywhere, a nurse can easily adapt and not have to worry about how to use the equipment. This reduces the potential for user errors and improves nursing satisfaction.” sometimes it is minor and sometimes it is not. It may not be something I even thought of as a weakness. I am learning that there is value in at least hearing what other vendors have to offer. Today, we live in a world where advances in technology are coming at a feverish pace, this make the time right for a lot of big improvements in medical technology. Add in the necessity that equipment talk to the electronic medical record (EMR) and there are a lot of new developments. I experienced this firsthand when we trying to integrate our old monitoring standard to our EMR. Due to the age and lack of advancement from the vendor, it was going to be a very long and expensive process to get our monitors to talk to the system. This forced us to make a change to our “standard” company and our new vendor can seamlessly dump into the EMR. In our crazy world of multiple priorities and emergencies it is hard to find time to listen to a vendor that, in our minds, has no chance of selling a product to us. However, I think in the future that I will be making time so I can learn what is new and question our “standardized” vendor when I see an advancement they do not have. JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He magazines six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations. Send questions or comments to Editor@MDPublishing.com.

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ROMAN REVIEW My Mother’s House BY MANNY ROMAN, CRES

am writing this in early January as I recuperate from the New Year’s festivities. We had some dear friends visiting us and we wanted to take them somewhere that none of us had been. We chose a throwback supper club reminiscent of the old Las Vegas. My Mother’s House is a small Italian restaurant in a mostly residential area called Sun City, in the Summerlin suburb of Las Vegas.

Chef Mike and Chef Laura own and operate the restaurant and treat everyone as if they have been friends for years. We were greeted with hugs and hospitality unavailable anywhere we have been in Las Vegas. At My Mother’s House you are family. Before I get to the real reason for this writing, let me tell you about the evening. Chef Mike’s band played Rat Pack type music and Buddy Rich drums. (You young folks think Frank Sinatra and old style jazz.) There was a twist and jitterbug dance contest. The meandering violin and accordion players provided entertainment as well. None of this stuff is available anywhere else, especially the hospitality. The food was outstanding, especially considering that it had to be prepared for about 90 people. Uncle Sal, our server was attentive and especially accommodating, as is the entire staff. The atmosphere was one of joy, celebration and family. Oh yeah, they don’t turn over the tables. Your table is your table for the night whenever you visit. No “hurry up, eat and get out so we can make more money.” There was one regret that I had. After over indulging in the wine, as is

my custom, I severely under-tipped Uncle Sal. He never said anything and I did not notice until I reviewed the tab the next day. Immediately I was reminded of a “Sopranos” TV episode where the waiter was way under-tipped. He followed the characters out to the parking lot and after some discussion, the bad guy shot the waiter. I saw this in reverse order of course. The news would say that a waiter shot a customer for not tipping appropriately. I corrected my tipping error on a subsequent visit. We brought some neighbors on this next visit. Without the New Year’s Eve commotion it was even more welcoming. We were once again greeted with hugs and friendship. Chef Mike is a real old-time Vegas character. He had a hit record in the ’70s. He was cooking spaghetti sauce in his dressing room one day. Frank Sinatra was walking by and was attracted by the aroma. Mike invited him to eat. Sinatra called Dean Martin, told him to come over and said that this kid cooks like in my mother’s house. That is where the name came from. Mike’s animated and distinctive description of the day’s offerings is entertaining. “The shrimp are so big I had to ride them in on a saddle.” So, why am I telling you all this? At My Mother’s House they demonstrate that business can be conducted with personal attention and respect and that customer relationships are important. Not customer service, as most call it, but relationships building, which implies that the customer is also involved in the relationship. The entire staff shares that attitude and it is incredibly refreshing. No forged elegance, here everything is genuine. I know that most of you are thinking

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Manny Roman, CRES AMSP Business Operation Manager

that this kind of stuff will not work in our industry and that your customers would think this is all silliness. I’m not saying hug your customers every time you see them. I am saying, as I have always proposed, that the building of relationships is essential in any business. This begins with a genuine desire to provide value and a commitment to treating others as they wish to be treated. Trust is very important and what better way to establish trust than to be genuine and caring in you interactions with your customers. Following up with customers even if nothing is actually required is also important. Mike and Laura visited the table often just to let us know that they were available for us. For those of you who perform equipment service, do you want to be seen only when there is a problem? Be seen when all is well also. One of my customers once heard a nurse say, “Why is he here? Is there something wrong?” The bottom line is that “People like to do business with people they like to do business with.” Be that people. If you ever get to Vegas, get a reservation at My Mother’s House prior to arrival. Be prepared for the look when you tell your rideshare that you wish to be taken to My Mother’s House. They are mostly booked up, and now you know why: Customer relationships applied here.

MARCH 2020

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DID YOU KNOW? Science Matters

Send in the drone swarm A squad of tiny new drones can explore unknown places completely by themselves – a significant step forward in “swarm robotics.”

In 6 minutes, six drones searched 80% of an office for bodies; if any drone became disabled, the others carried on The 33-gram (1.2 oz.) CrazyFlie drone with motors, processor and camera

Fire ant swarm

The swarming drones are released in an area,

autonomously search it, take pictures and return to the release point, bringing back their images In a test, they searched offices for two dummies representing victims in a disaster

The Kilobot, an experimental 1,000-robot swarm Michael Rubenstein, Harvard University

Inspired by insects Insect swarms led roboticists to think that a team of small, cheap, smart robots could overcome a single robot’s limitations – and do things impossible for it Social Insects instinctively swarm to search for food, attack intruders and protect their colony’s reproductive queen

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THE VAULT

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-march-2020. Good luck!

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

FEBRUARY PHOTO Bantam Bovie Electrosurgical Unit, Model: B-2

JANUARY WINNER Dennis Austin, Biomed Tech, Marshfield Clinic Health System

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SCRAPBOOK CMIA

he 2020 California Medical Instrumentation Association (CMIA) Conference was held January 24-26 in San Diego, California. The educational conference and exhibitor fair featured a combination of 340 attendees and vendors with 60 vendor booths. The three-day event included a golf tournament, networking events, three keynote speakers, educational sessions and an outreach event to introduce high school students to the biomed field. 1.

The TechNation and MedWrench teams promoted the upcoming MD Expo in Irvine, California in April.

CMIA members were able to pick up CMIA logoed items to help promote their membership.

Jenn Nichols, CMIA chairman, and Karie Heiselt, officer at large, were on hand to greet attendees at check in.

Matt Tomory of Innovatus Imaging presented “Ultrasound Application Essentials & Image Artifacts” on Friday.

Herman A. McKenzie, acting director in the department of engineering at The Joint Commission, was one of three keynote speakers.

Local high school students attended a special outreach session to learn the importance of the HTM field. The students also enjoyed meeting vendors in the exhibit hall.

With over 60 vendor booths, this year’s exhibit hall provided an opportunity to network face-to-face with leading medical device companies.

The 2019 Professional of the Year Award was presented to Jose Zambrano of Kaiser Permanente.

The TechNation and MedWrench teams co-hosted a happy hour on Thursday night to kick off the annual CMIA Conference. This was also the first TechNation Tour Stop for 2020.

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BREAKROOM 10. Attendees were treated to an all-star line up of education, including classes taught by Banner Health’s Perry Kirwan(center) and Priyanka Upendra(left).

12. Kristin Leavoy and Megan Cabot were happy to greet attendees and share details about the upcoming MD Expo Irvine scheduled for April 20-22.

11. Local Californian companies, like Global Med Cables from San Bernardino, were able to share their products and services with the CMIA attendees.

13. Tony Lively(left), CMIA treasurer, was on hand throughout the conference and is pictured with attendees during Saturday’s networking breakfast.

14. Cadmet President James “Jim” Cadmus shared information with attendees. 15. Janet Mauck, biomedical specialist III at YUMA Regional Medical Center, was the MedWrench raffle winner.

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BULLETIN BOARD

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

Career Opportunities CONTINUING EDUCA TION

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

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April 1-3 TriImagin g: Introdu ction to CT

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

Company: Technical Prospects Position Title: Field Service Engineer Description: Technical Prospects is looking for motivated, creative, solutions-based Field Service Engineers, specialized in RAD, R/F, and Vascular! More info on how to apply here:Â http://bit.ly/TPFieldServiceEngineer

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OVERCOMING BIAS IN THE HTM WORKPLACE

MedWrench Guru, Tony Cody, Technology Mana gement Director at Banner Health, shares his wisdom on mitigating prejudices in the workplace.

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

Unconscious bias in professional environments is a significant issue and the HTM career field is not an exception. Our preju dices are ingrained in us by every experience of our life. It may manifest internally in the HTM department or it may even be demonstrated by the customers we serve. Whether prejudice is ageism, sexism, racism, or some other bias, it is important to overcome bias and preconceptions in today’s diverse and inclusive environment.

Read more here: http://bit.ly/BiasHTMBlog

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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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Tri-Imaging’s goal is to carry the replacement parts inventory critical to supporting the imaging service engineer. We appreciate your business and support during this exciting time of strategic investment and growth.

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P P

www.flukebiomedical.com • 800-850-4608

aiv-inc.com • 888-656-0755

P P

www.gehealthcare.com • 800-558-2040

Infusion Therapy AIV

MRI 41

Infusion Pumps AIV

multidiagnostic.com • 800-400-4549

Infection Control Healthmark Industries

multidiagnostic.com • 800-400-4549

Hand Switches

TECHNATION

SERVICE

Monitors

ALCO Sales & Service Co.

PARTS

General

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

P P

Multi Diagnostic Imaging

RepairMED

multidiagnostic.com • 800-400-4549 www.repairmed.net • 855-813-8100

P P

62 43

P P

WWW.1TECHNATION.COM

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

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

P P

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

www.ampronix.com • 800-400-7972

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

Soma Technology, Inc www.somatechnology.com • 1-800-438-7662

Medigate

Surgical Healthmark Industries

HMARK.COM • 800-521-6224

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

Radiology Ampronix, Inc.

www.cybermdx.com • www.medigate.io •

P P

62 25

Multi Diagnostic Imaging

Telemetry AIV aiv-inc.com • 888-656-0755

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

Elite Biomedical Solutions

Recruiting

elitebiomedicalsolutions.com • 855-291-6701

Stephens International Recruiting Inc.

Multimedical Systems

www.bmets-usa.com/ • 870-431-5485

AIV aiv-inc.com • 888-656-0755

www.repairmed.net • 855-813-8100

Rental/Leasing Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703

www.alcosales.com • 800-323-4282

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701

elitebiomedicalsolutions.com • 855-291-6701

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

GE Healthcare www.gehealthcare.com • 800-558-2040

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

33 59

P P

www.ambickford.com • 800-795-3062

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

www.usocmedical.com • 855-888-8762

BC Group International, Inc Clinical Dynamics Corp. Fluke Biomedical

Pronk Technologies, Inc.

P P

www.flukebiomedical.com • 800-850-4608

www.pronktech.com • 800-609-9802

Radcal Corporation

www.radcal.com • 800-423-7169

Training Althea https://www.althea-group.com/ • 888-652-5974

College of Biomedical Equipment Technology

ECRI Institute

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

www.BCGroupStore.com • 314-638-3800

P P

www.ambickford.com • 800-795-3062

Test Equipment

clinicaldynamics.com • 203-269-0090

Respiratory A.M. Bickford

www.swbiomed.com/ • 800-880-7231

A.M. Bickford

Replacement Parts Elite Biomedical Solutions

Southwestern Biomedical Electronics, Inc. USOC Bio-Medical Services

Repair ALCO Sales & Service Co.

www.multimedicalsystems.com • 888-532-8056

RepairMED

Refurbish

Tables multidiagnostic.com • 800-400-4549

TRAINING

Portable X-ray

CyberMDX

SERVICE

P P

Software

PARTS

P P

Company Info

AD PAGE

www.usocmedical.com • 855-888-8762

TRAINING

USOC Bio-Medical Services

SERVICE

www.swbiomed.com/ • 800-880-7231

PARTS

Southwestern Biomedical Electronics, Inc.

AD PAGE

Company Info

www.cbet.edu • 866-866-9027 www.ecri.org • 1-610-825-6000.

MARCH 2020

TECHNATION

SERVICE INDEX P

multidiagnostic.com • 800-400-4549

MW Imaging www.mwimaging.com • 877-889-8223

Tubes/Bulbs

Summit Imaging

Cadmet

www.mysummitimaging.com • 866-586-3744

www.cadmet.com • 800-543-7282

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

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

www.eng-services.com • 888-364-7782x11

Innovatus Imaging

P P

www.innovatusimaging.com • 844-687-5100

Ultrasound

InterMed Group

Ampronix, Inc.

www.intermed1.com • 386-462-5220

www.ampronix.com • 800-400-7972

P P

Multi Diagnostic Imaging multidiagnostic.com • 800-400-4549

ATS Laboratories www.atslaboratories-phantoms.com/ • atslaboratories@yahoo-com

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

P P

P P P

X-Ray Engineering Services, KCS Inc

TRAINING

Multi Diagnostic Imaging

SERVICE

PARTS

Company Info

AD PAGE

www.triimaging.com • 855-401-4888

TRAINING

Tri-Imaging Solutions

SERVICE

www.flukebiomedical.com • 800-850-4608

PARTS

Fluke Biomedical

AD PAGE

Company Info

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

8 68

P P P

Extend the Life of Your Ambulatory Infusion Pumps New AIV Manufactured Replacement Parts for Curlin 4000 & 6000

Attending MD Expo in Irvine? Visit AIV in Booth 119

Recertified Parts for Curlin 4000

Same Day Shipping for In-Stock Parts 120 Day Warranty on AIV Manufactured Parts 60 Day Warranty on Recertified Parts

New AIV Manufactured Replacement Parts for CADD Legacy & CME BodyGuard Pumps

888.656.0755 • aivsales@aiv-inc.com • www.aiv-inc.com The manufacturers listed are the holders of their respective names and/or trademarks, and are not to be taken as an endorsement or affiliation with AIV, Inc. 702A 82

TECHNATION

MARCH 2020

WWW.1TECHNATION.COM

ALPHABETICAL INDEX A.M. Bickford…………………………

Elite Biomedical Solutions……………

Multimedical Systems………………

AIV……………………………………

Engineering Services, KCS Inc………

MW Imaging…………………………

ALCO Sales & Service Co.……………

Entech…………………………………

Ozark Biomedical……………………

Althea…………………………………

Fluke Biomedical……………………… 3

Pronk Technologies, Inc. ……………… 5

Ampronix, Inc.…………………………… 4

GE Healthcare…………………………… 2

Radcal Corporation……………………

ATS Laboratories………………………

Healthmark Industries………………

RepairMED……………………………

BC Group International, Inc…………

HTM Education………………………

Select BioMedical……………………

Biomedical Repair & Consulting Services, Inc.……………

Injector Support and Service…………

Cadmet………………………………

Clinical Dynamics Corp.………………

College of Biomedical Equipment Technology……………

Coro Medical…………………………

Crothall Healthcare Technology Solutions………………

Medigate………………………………… 6

CyberMDX……………………………

MedWrench…………………………

ECRI Institute…………………………

Multi Diagnostic Imaging……………

Soma Technology, Inc………………

Innovatus Imaging……………………… 8

Southeastern Biomedical, Inc………

inRayParts.com………………………

InterMed Group………………………

Southwestern Biomedical Electronics, Inc.……………………

Interpower……………………………

Master Medical Equipment…………

Maull Biomedical Training……………

Stephens International Recruiting Inc.… 67 Summit Imaging………………………

SVI International, Inc.…………………

Tri-Imaging Solutions…………………

USOC Bio-Medical Services…………… 7 Webinar Wednesday…………………

EXPANSIVE SERVICE. ENTECH has been servicing major medical centers and hospitals, surgery centers and freestanding clinics throughout the Southwest for over 37 years. We service and maintain a wide scope of clinical equipment, including general biomedical, respiratory, anesthesia and medical imaging equipment. Our experienced technicians are based throughout the region so we can respond to your needs quickly and ensure your facility is running at peak performance with minimal interruptions.

EXPERTISE. ENTECH continuously monitors clinical equipment trends, licensing and accreditation agencies and service line procedures to support our customers with the most efficient, inclusive equipment services possible. Our proven technology management systems provide compliant clinical equipment service programs that free our clients to focus on their primary mission: patient care.

DELIVERING EXCEPTIONAL CLINICAL EQUIPMENT SERVICES F O R OV E R 37 Y E A R S Take advantage of our commitment to expanding our clinical equipment services by contracting with ENTECH today! Call us at 602-747-9081 to learn more.

VALUE. ENTECH is vested in solidifying partnerships with key healthcare vendors, expanding its operation and is committed to investing in financial and human resources in order to sustain and grow our clinical equipment services in this region and nationwide. ENTECH is able to deliver a complete suite of services both economically and efficiently that other companies can’t offer.

EntechBiomedical.com | Info@EntechBiomedical.com

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

MARCH 2020

TECHNATION

R E G I S T E R

N O W

e n i v r I A

APRIL 20 -2 2 , 20 20 HOTEL I

M D E X P O S H O W.C O M

MONTH WARRANTY ON

98% OF PROBE

REPAIRS Phone: 877.889.8223

Corporate Office

Email: info@mwimaging.com

920 Hemsath Road Suit 102 St. Charles, MO 63303

Website: mwimaging.com

brand and website development by:

// www.ipsocreative.com

TIRED OF DOWNTIME & REPAIRS? We understand the frustration when your ultrasound equipment fails in the middle of scan. When it does happen, we will be there for you and your customer every step of the way. Patient safety has been our top priority for over 25 years. We take pride in our work and ensure that every part and probe is repaired down to the component level and properly tested before shipping. We are here to help you eliminate downtime and inconvenient repair needs with reliable parts, probes, and probe repair provided by us. Save time and money and always be up and running.

Free Loaner Probes During Repairs Free Evaluations Free 24x7 Tech Support Industry-leading Warranties Probe Repair Programs Nationwide Service

BREAKROOM

FLASHBACK MD Expo 2010

Flashback to the fall of 2010 where MD Expo visited Austin, Texas. As it continues to do today, MD Expo had an incredible line-up of top-notch speakers!

il s” os/ E m a ve M e m n a ge r a “Effec ti M t r, Distric e k o C M ary e rplan for M a st

“2010 Joint Commission Upd ate” George Mills, Senior Enginee r, The Joint Commission

“Bridging th e C E /I T Gap Derek Brost ” , C hief Secu rity Offi ce r, eProtex

TECHNATION

MARCH 2020

E xam” T IA A+ e C omp th r fo re Pre pa struc tor, “How to S eele y, In ollege Garrett ic n h al C tate Tec S s a x e T

WWW.1TECHNATION.COM

If You Need Just One, Order Just One The Interpower® solution for hospital-grade replacement cords: if you need just one, order just one.

Made to order to your specifications, we offer replacement cords and special orders. With no minimum order or dollar requirements, this empowers you to order what you need—whether it’s 1, 5, or more. We provide value-added options, such as special labeling. Mark your cords with labels that contain identifying information (e.g. Operating Room 1). If you need to replace one, you only have to order one. Contact Customer Service for More Information •

Made in U.S.A.

•

No minimum order or dollar requirements

•

1-week U.S. manufacturing lead-time on non-stock Interpower products

•

Same day shipments on in-stock products

•

Blanket or scheduled orders available

Secure Connections Are Essential To help prevent accidental power interruptions, secure your cord set with the new Interpower Connector Lock. Before selecting your connector components, consult the appropriate medical equipment standards for connection security requirements.

Order Online! www.interpower.com

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

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

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

AA-8100

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

SCREEN VIEWS

Manual Data Reading of Isoflurane

Automatic Agent Selection: Sevoflurane

Download myBC_Mobile for your iOS or Android Device

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