TechNation Magazine - April 2020 by MD Publishing

1technation.com

Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

APRIL 2020

VIEWPOINTS from

LEADERSHIP page 60

18 Professional of the Month

Bob Meninno

38 Ribbon Cutting

Medigate

46 Biomed 101

Certifying to ISO 9001:2015

74 The Future

Rudolph Wagner

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CONTENTS

FEATURED VIEWPOINTS from

LEADERSHIP

HE ROUNDTABLE: T ENDOSCOPY Representatives from third-party service organizations and original equipment manufacturers share knowledge and insights regarding endoscopes. Next month’s Roundtable article: Tubes/Bulbs

HE FUTURE OF HTM: T VIEWPOINTS FROM LEADERSHIP What will the future of the HTM profession look like? Will national standards be adopted? Will the efforts to generate interest in the field among high school and college students succeed? Will continuous advances in medical technology change the nature of the job? These are some of the questions the HTM field faces. Next month’s Feature article: Mergers & Acquisitions: Proven practices for HTM departments

TechNation (Vol. 11, Issue #4) April 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

APRIL 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 Department of the Month: The Summa Health Healthcare Technology Management Department p.14 Company Showcase: Riken Keiki and A.M. Bickford p.18 Professional of the Month: Bob Meninno p.20 Company Showcase: Interpower Corporation p.24 Association of the Month: The Colorado Association of Biomedical Equipment Technicians p.26 Company Showcase: Retrieve Medical Equipment P.31 p.31 p.38 p.40 p.42

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

P.46 p.46 p.48 p.51 p.52

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

P.66 EXPERT ADVICE p.66 Career Center p.68 Avante Health Solutions p.71 Cybersecurity p.72 MME Utilization sponsored by Agiliti p.74 The Future p.76 20/20 Imaging Insights sponsored by Innovatus Imaging p.78 View on Value p.80 AEM Schedules sponsored by Nuvolo p.83 The Other Side p.85 Roman Review P.88 BREAKROOM p.88 Did You Know? p.90 The Vault p.94 MedWrench Where In the World is Ben C.? p.102 Flashback p.97 Service Index p.101 Alphabetical Index

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

APRIL 2020

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SPOTLIGHT

The Summa Health Healthcare Technology Management Department maintains a wide array of medical equipment at four hospitals and other medical facilities.

DEPARTMENT OF THE MONTH The Summa Health Healthcare Technology Management Department BY K. RICHARD DOUGLAS

“P

opulation health” is a principle that focuses on keeping people healthy through healthy lifestyle guidance. This includes a proactive approach to contact members of the local community and provide them with information to help keep them healthy. This approach reduces the cost of health care.

Summa Health, in Akron, Ohio, employs this model to manage health care for the local population and help prevent illness instead of just dealing with the consequences of illness once it is discovered. The Summa Health system was formed in 1989 and consists today of the Akron, Barberton and St. Thomas campuses and Summa Rehab Hospital.

TECHNATION

APRIL 2020

The system provides care to one million individuals across five northeast Ohio counties. Managing the medical equipment at the four hospitals, as well as 12 outpatient medical centers, two urgent care facilities, two free-standing emergency departments and 141 medical group offices is the system’s healthcare technology management (HTM) department. The department includes System Director Ken Mylar, MBA, CHTM, CBET and Manager Ken Hart, BBA, CBET. Team members include Biomedical Technician III Wayne Unger, Biomedical Equipment Technician III Dwight Epling and Biomedical Equipment Technician III Sandra Munsey, CBET. The team also includes Biomedical

Technician II Anson Sheck, Biomedical Equipment Technician II Antoinette Hale, Biomedical Equipment Technician II Chris Merkle, Biomedical Equipment Technician II Daniil Mamedov and Biomedical Equipment Technician II Roger Hale. Baridor Badom is a biomedical equipment technician I. The imaging team includes Scott Hendershot, biomedical equipment technician III/imaging; Charles Tyree, biomedical equipment technician III/ imaging; Dan Bevin, biomedical equipment technician III/imaging; and Richard Bodjanac, biomedical equipment technician III/imaging. The team has a good synergy with their counterparts in IT. “We have a great working relationship with IT as we pretty much need to in today’s world. All of our imaging and

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SPOTLIGHT

“ We have a great working relationship with IT as we pretty much need to in today’s world. All of our imaging and monitoring equipment is integrated into EPIC and our PACS system, so working with their integration team in crucial.” – KEN MYLAR, SYSTEM DIRECTOR monitoring equipment is integrated into EPIC and our PACS system, so working with their integration team in crucial,” Mylar says. “In the last couple years, we have been working close with the network security team on the cybersecurity issues and were involved in the trial and selection of a network scanning device used to identify equipment on the network and the associated risks with those devices,” he adds. BIG PROJECTS Mylar says the department always seems to be involved in a dozen-plus projects of various sizes. “We have been expanding and remodeling a lot of our offsite medical group offices. We make sure everything needed is standardized with our Summa standard devices. Then, when they arrive, we tag and inspect the devices,” he says. One of the team’s bigger projects over the last couple of years was replacing its entire monitoring fleet, systemwide, with a new Philips platform which is run through a virtual server. “The project, done over a couple years, strengthened — or maybe tested — our relationship with IT networking/ server teams due to the infrastructure required and the crossover needed between our two departments. Integration with EPIC was another area that created a crossover of departments with the IT Integration team,” Mylar says. They also had a new construction project, the West Tower project, which is a new six-floor patient tower at the Akron City Hospital campus that took two years to build. “Over that two years, my staff and I

spent countless hours determining equipment needs. The staff knew they needed monitors, but we had to assist with the planning that they aren’t aware of, like integrating with EPIC or our Vocera system for alarms. Do they want remote monitors? If so, do they want to just see the display or do they want it to be functional? Do they want alarms to go to an overhead marquee? There are multiple central stations; which patients do you want to see on which central?” Mylar asks, reflecting the considerations of the project. He says that there were many issues and questions that happen behind the scenes. He got his staff involved to help ask the right questions and get the vendors onsite to meet with HTM and nursing to make sure they got it right. “For the most part, we went live in June without any issues on the medical equipment side,” he says. “Over the last few years, we’ve replaced a lot of our X-ray with new digital units and added digital retro-fit systems to the ones that were not replaced at a lot of our off-site locations. We have standardized with AGFA rooms, so we negotiated up front for service training so we can cover all of the units in-house post warranty,” Mylar says. “Since we are growing as a system, and not individual locations, we have spent some time standardizing protocols on our stress system, ultrasound equipment, etcetera, so everything is the same at all locations,” he adds. He says that the team was also involved in the build of a hybrid OR, which was completed from scratch in nine months and included seven miles of cabling.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

“Our design ideas for redundant video systems is not being used in other hospitals/designs,” Mylar says. “The key to being involved with all of the projects above, even if they don’t involve a lot of medical equipment, is to be there to ask the right questions,” he says. Mylar says that they had a CT renovation/replacement project that moved a few CT scanners to a newly built area in one of the hospitals. The construction team worked with radiology on the project and left HTM out of the loop. “When the department opened, they realized they didn’t have the ability to monitor patients wirelessly from the ED like they used to in the old location. Having us in the project meeting could’ve planned for that in advance instead of delaying the go live or creating the need for emergency purchase orders,” Mylar says. The team stays busy with HTM outside of work hours as well. “Of the 15 current employees, we have two CBETs and one CBET/ CHTM. We have a local biomed association, HTMA-OH that we have several employees attend the meetings and the annual conference. I was also just recently named to the board of directors of HTMA-OH,” Mylar says. “We are also members of AAMI with myself and the department manager attending those conferences as well. We also try to attend one of the two annual MD Expos,” Mylar adds. While population health helps keep the people in the Akron area healthy, this top-notch HTM team treats the medical device population the same way.

APRIL 2020

TECHNATION

SPOTLIGHT

SPONSORED CONTENT

COMPANY SHOWCASE Riken Keiki and A.M. Bickford

imply known as the “RIKEN,” Riken Gas Indicators have been the trusted tool of choice for clinical engineers. They have been described by our customers as “weekend warriors,” “a work horse” and the “foundation of my business.” Manufactured by the Riken Keiki Co. Ltd., the world leader in gas detection and sensor technology, the product line helps to insure safety by preventing industrial disasters.

The Riken Keiki Co. Ltd. headquarters is in Tokyo, Japan. They provide a network of support with three manufacturing factories, 28 maintenance facilities and offices in more than 60 countries. They are ISO 9001 certified for quality and an ISO 14001 certified environmental protection corporation. Riken Keiki Co. Ltd. and A.M. Bickford have been partnered over 40 years to distribute, sell and service the Riken Gas Indicator for testing anesthetic vaporizer concentration output. Yasunari Nagashima from Riken Keiki and Tim Keohane from A.M. Bickford recently shared more information about Riken’s past, present and future. Q: WHY DID YOU FEEL IT IS IMPORTANT TO WRITE A COMPANY PROFILE ABOUT THE RIKEN KEIKI CO. LTD.? KEOHANE: Riken is an iconic brand name and piece of equipment! Clinical engineers know the Riken brand and the majority have had experience using one. However, I strongly believe it is important to know about the corporation that is manufacturing test equipment. It is part of the

TECHNATION

APRIL 2020

purchasing process to evaluate manufacturers. There are many things to consider. For example: • Does the manufacturer have a great reputation? • Is the manufacturer proven, stable, reliable and established? • Do they provide support and training? • Do their products have a track record of reliability, durability and accuracy? For over 80 years the Riken Keiki Co. Ltd. has had a global reputation of providing lifesaving products in many different industries. They are committed to safety and manufacturing quality products. Q: CAN YOU SHARE ANY DETAILS ABOUT THE RIKEN KEIKI CO. HISTORY? NAGASHIMA: Established in 1939, the Riken Keiki Co. Ltd. is headquartered in Tokyo, Japan. Since our founding, we have specialized as a manufacturer of

gas detection and monitoring equipment. We currently offer almost 100 different products to help ensure safety by preventing industrial disasters such as explosions caused by combustible gases, and monitoring for toxic gas leakage in workplace environments. Our success has been achieved by investing in research and development, extensive product line, developing high-quality products and providing our customers with a network of support all around the world. Riken Keiki and its partners have sales and support offices in more than 60 countries, offering a global support and service network. The large scale of this operation ensures low cost, high-quality and good service for our customers. Q: WHAT DO YOU MEAN BY “HIGH-QUALITY” PRODUCTS? NAGASHIMA: High-quality products don’t

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SPOTLIGHT

SPONSORED CONTENT

just happen, they are designed that way from the start, then built to meet the design ideal. Our manufacturing system is ISO 9001 certified for quality and ISO 14001 certified for environmental protection, which means that our manufacturing is good for our customers and good for the environment. We pledge to ensure the safety of the public in working environments. In light of this, we have zero tolerance for compromises in quality in any manufacturing process. It can be difficult and demanding to satisfy the basic conditions for precisely ensuring that a facility or system is completely free of gas leaks. Riken Keiki is able to produce high-quality goods through its R&D department, the production technologies of its manufacturing sites, its services to provide accurate information to all customers and its no-compromise attitude. Q: WHAT IS THE RIKEN KEIKI CO. LTD. MISSION STATEMENT? NAGASHIMA: Riken Keiki’s mission statement or “eternal theme” is the following: To create safe working environments

for people. Now and into the future. Our policy is to react quickly to design and provide products needed to prevent industrial disasters. Our goal is to use our expertise and years of experience to protect precious lives and valuable assets. We feel our eternal theme is identical to the roles and responsibilities that clinical engineers perform every day, keeping people safe from harm. Q: CAN YOU SHARE A SUCCESS STORY? KEOHANE: Our success story starts by partnering with TechNation magazine and MD Expo. Working with the staff, especially Jayme McKelvey, Lisa Lisle and John Wallace, has been an amazing experience. They are always willing to help, always available and they make my job easier. I consider the staff trusted advisors. The MD Expo conferences have provided A.M Bickford Inc. a tremendous amount of value and has given us

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

the opportunity to connect with new and old customers. We are a small family company and we monitor our ROI very carefully, especially trade shows. We receive a great amount of value at each show. MD Expo Seattle did not start out great for me. I lost two credit cards in one day. Let’s just say my wife was not thrilled. Things turned around when during the trade show I met Patrick Treffery, Division Director of Catholic Health Initiatives and his team. Catholic Health Initiatives is the third-largest nonprofit health system in the nation. Our conversation started when his team noticed an old Model 18 Riken in my booth. They shared a “back in the day” story about the old Riken. That conversation led to the new FI-8000P Riken. By the end of the trade show we had the framework to replace Catholic Health’s entire Riken inventory. It was a win/win for both companies. This deal would not have happened if Riken was not a strong brand with a great reputation and great products. It also would not have happened if we didn’t exhibit at MD Expo. Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? NAGASHIMA AND KEOHANE: The Riken Keiki Co. Ltd. products are known worldwide for their long life cycles. For example, the FI-21 Riken Gas Indicator was extremely popular and successful. Its life cycle was well over a decade long. Our focus now is on the FI-8000P Riken Gas Indicator. We are excited to announce a firmware update for the FI-8000P RIKEN Gas Indicator. The update improves the user’s experience, eliminates key strokes and saves time. The update was a collaborative effort between our customers, the Riken Keiki Co. Ltd. and A.M. Bickford Inc. FOR MORE INFORMATION, visit https://am bickford.com/riken/fi-8000p-firmware-update/.

APRIL 2020

TECHNATION

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SPONSORED CONTENT

COMPANY SHOWCASE Interpower Corporation

n the Interpower Corporation website, company president Robert D. Wersen says he has witnessed lots of change since starting the company in 1975 including the rapidly rising expectations that customers have regarding quality of products and services.

“We choose at Interpower to treat changes as opportunities, not as threats and we can do that because we have a culture that prizes teamwork above everything else. We focus on not just satisfying the customer, but really delighting them with outstanding quality and outstanding service,” Wersen states on the website. TechNation quizzed Interpower Corporation Vice President of Marketing Ralph Bright to find out more about the company. Q: CAN YOU SHARE A LITTLE BIT ABOUT YOUR COMPANY’S HISTORY AND HOW YOU ACHIEVED SUCCESS? BRIGHT: Robert Wersen started the company in California in 1975. In 1993,

TECHNATION

APRIL 2020

he moved the company to Iowa in order to start manufacturing more of what we sold. At that time in 1993, we manufactured about 15% of what we sold and now we are at 75%. We realized we had a niché and our quality products and service that delights. Being fast is what differentiates us from the competition. Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION? BRIGHT: The major competitive advantage for Interpower is our lead times and quick service. We manufacture in Iowa and have a one-week cycle time. We can have any quantity of product to a customer in a week. Our competition cannot compete with that. Interpower also has just over 4 million parts in stock and most items can ship the same day we receive the order. A lot of customers use us as an extension of their warehouse. Q: WHAT ARE SOME CHALLENGES THAT YOUR COMPANY FACED LAST YEAR? HOW WERE YOU ABLE TO OVERCOME THEM? BRIGHT: Interpower’s main customer base is made up of companies that export products around the globe. This

has presented Interpower and our customers with challenges. Some recent challenges include the political climate and tariffs with China and other countries. We are able to overcome these by giving our customers a one-week United States manufacturing lead time and by keeping 4 million parts in stock for same day shipments. Q: CAN YOU EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS? BRIGHT: Interpower’s core competencies and unique selling points are our ability to supply power system components to our customers … FAST! Our strength is our people and their ability to delight with same-day shipments, no minimum order quantities and our one-week United States manufacturing lead time. We manufacture power cords used around the globe for AC power. All of our cords are 100% tested. EVERY cord is tested for continuity and to make sure it is a QUALITY cord when our customer receives it. All of the cords around the world carry all the necessary approvals as well.

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SPOTLIGHT

SPONSORED CONTENT

Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW? BRIGHT: The two products we are excited about right now are: 1. Tool Free Connector Lock: A tool free way to lock in your IEC 60320 connector. These connector locks can retain Interpower’s IEC 60320 C13/C14 and Sheet E/Sheet F combinations, along with C15/C16, and C17/C18 combinations. While built specifically for Interpower connectors, including angled models, the Interpower connector lock also secures a variety of other brands. They will transmit any pull force to the cabinet, eliminating any stress on the electrical components. 2. Interpower Inlets and Outlets: Interpower manufactures IEC 60320 C14, C16, C18, C20, C24 inlets and Sheet F outlets. Snap-in and screwmount options are available in a variety of panel thicknesses. Solder tab and quick disconnect options are also available. With our one-week United States manufacturing lead time and no minimum order quantity, if we don’t have them in stock we can ship them to a customer in one week. Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? HOW WILL IT EVOLVE IN THE COMING YEARS? BRIGHT: We are vertically integrating nonstop. Since our move to Iowa in 1993, we have been manufacturing more and more of what we sell. We are currently working on several new products for the all markets we serve,

including the medical market. One product evolving right now is our cable. Interpower now extrudes all of its power cables for both international and North America. This means we can not only have fast turnaround for power cords, but also bulk cable with custom colors and packaging. Q: CAN YOU SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS? BRIGHT: Honestly we have these on a weekly basis. The scenario is usually that a customer has a line down, the manufacturer overseas has dropped the ball and they need X amount of cords immediately. Interpower bends over backwards on a consistent basis to make sure our customers are delighted. Q: CAN YOU DESCRIBE THE INTERPOWER FACILITY? BRIGHT: Our headquarters are in Oskaloosa, Iowa and is home to our manufacturing, customer service, purchasing, accounting, shipping and quality departments. Most power cords and made-to-order products come out of our headquarters. Ames, Iowa is home to our product development department, marketing department and our test lab where we conduct a variety of tests including withdrawal force, pull test, flex test, torque twist test, crimp cross section test, temperature rise test, flame test and tumble barrel testing chamber. Lamoni, Iowa is home to our extrusion line for North American and international cable along with cable testing and molding of power cords including hospital-grade cords for our

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

North America customers. Q: CAN YOU SHARE ANY RECENT CHANGES TO INTERPOWER? BRIGHT: Interpower has ramped up inventory over the last several years and now has over 4 million parts in stock. This was a decision by company management to ensure our same-day shipments and, hopefully, to delight each and every customer. Q: CAN YOU TELL US ABOUT THE INTERPOWER EMPLOYEES? BRIGHT: The key to Interpower’s success is definitely our people. The individuals who work for Interpower realize the responsibility they have when making cords, especially for the medical market. We are not just manufacturing power cords, we are helping to save lives. Ensuring that the cord is 100% tested and will not fail in the field is vital. Q: WHAT IS YOUR COMPANY’S MISSION STATEMENT, OR IF YOU DON’T HAVE A SPECIFIC ONE, WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS? BRIGHT: Our vision is to be the premier supplier of power system components for worldwide markets. Our mission is to make it easy for customers to design, build and maintain products for worldwide markets. To use teamwork that provides our customers quality products and services that delight – fast. To earn sufficient profit that sustains normal growth and reasonable return to the shareholders. FOR MORE INFORMATION, visit www.interpower.com.

APRIL 2020

TECHNATION

Test. Calibrate. Validate. Riken

Riken FI-8000P Portable Gas Indicator

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CABMET is involved in the community. Here officers donate money to Project C.U.R.E.

ASSOCIATION OF THE MONTH The Colorado Association of Biomedical Equipment Technicians (CABMET) BY K. RICHARD DOUGLAS

any biomed associations are known by HTM professionals in other states, but few are known by biomeds nationwide. One of the more widely known associations is the Colorado Association of Biomedical Equipment Technicians (CABMET). Besides being one of the nation’s first biomed associations, the group became well known for its CBET preparation course.

In 1974, instructors at the old Army/ Navy Biomed School at the Army base, formerly called Fitzsimons Army Medical Center, started CABMET. Some of the founding members were Jim O’Brien, Jon Fink, Archie Hopkins, Gene Bacon, George Luttkus and K.C. Rock. CABMET was one of the first

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nonprofit, statewide biomedical associations in the country. The group’s current officers include President Leticia Reynolds, Vice President Nathan Bell, Secretary John Jetchick and Treasurer Jonathan Howell. Like many biomed associations, education and training have always been a central focus for CABMET. The group took it up a notch with its popular CBET study group. “Up until just recently, we ran the CBET/CRES/CHTM study groups. We recently sold these to AAMI. It is still many of our members that help present the material just under the AAMI umbrella now. We also try to send one of our members every year to the AAMI conference,” Reynold says. The CABMET CBET Study Group

was started in 2004 by then CABMET President Dave Scott and several other CABMET members. “It ran for 15 years as part of CABMET. CABMET member instructors include Brian Wilson, Bruce Schaff, Charlie Garascia, Matt Baretich, Cindy Lusietto, Ken Humphrey, Tom Dinkleman, Dave Smith and Dave Scott. Each contributed in areas they work or are considered subject matter experts,” Scott says. He says that other professionals outside of CABMET helped with the Study Group and include Gary Troutman; Brian Schuster; Julianne Kohler, RN; Maggie Cavanaugh, RN; and Rita Cassatori, RN. “The group was sold to AAMI in August 2019. Over the 15 years it ran as part of CABMET, over 2,000 techs

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SPOTLIGHT obtained their certification as part of the group. Many of the certified techs in Colorado were student members of the group. The CABMET Study Group offered review courses for CBET, CRES, CLES and CHTM over the years. CABMET also presented the CBET Review at the MD Expo for five years before the sale,” Scott says. It’s no wonder that CABMET is a recognized acronym in the biomed world. Scott says that in 2019, CABMET was awarded the AAMI Biomed Association of the Year. “This award was based on work CABMET has done in the biomed community and beyond. Every year, CABMET has a volunteer day at Denver area-based Project C.U.R.E. All of the $1,500 prize money CABMET was awarded for Association of the Year was donated to Project C.U.R.E.,” Scott says. The group gives members a chance to rub elbows and gain more knowledge through regular meetings. “We hold quarterly meetings (January, March, May, October and December). While our December meeting isn’t actually an educational meeting, we do volunteer work with Project C.U.R.E. We have, when vendors allow, tried to do Facebook Live. This is still a work in progress that we hope to continue,” Reynolds says.

venues to a larger facility to be able to host more members and vendors in 2019. “Our biggest highlight last year was just the opportunity to move to a new, bigger location. This allowed us to bring in more vendors as well as have more class options for attendees. Last year, we had presentations by David Francoeur, Carol Davis-Smith, Al Gresch and Matt Baretich. This year we are looking at having someone from ECRI come present,” Reynolds says. CABMET also holds a contest that allows one lucky person to get all the benefits from the annual AAMI Exchange. “We have two ways to potentially win the trip to AAMI (we cover registration, flight and hotel). The first way is to attend all the meetings between now and May; three meetings. We understand that some people live on the western slope, so the second way is to write an essay on why you should go and what you plan to do with the knowledge you gain,” Reynolds says. She says that they thought the meeting attendance requirement would help encourage members to come to the quarterly meetings, but they also wanted to give the opportunity to people who can’t come due to location or work schedule. One important role that state associations can fill is to help replenish

the HTM field through local activities, events and job postings. “We do have a spot where companies can post their open jobs to help, but I think the biggest thing we do is just promoting our field to the people still in school. HTM is a position that not everyone knows exists. I know personally if I hadn’t known someone that just entered this job in the Army Reserves, I would have done something different in the reserves. I think we also try to partner with the military, as a lot of us are prior military, to promote the networking to get them into some of the local open positions we have,” Reynolds says. Also, CABMET member Rob Sanchez has worked with Career Days events throughout Colorado to promote HTM to students at area schools. “We do try to attend a variety of different job fairs at either colleges or high schools around the area and this is something we try to do on a regular basis. We have a variety of pieces of older equipment that attendees can see how they work or even try it out (patient monitor, ESU, pulse ox device). The handout helps spark the interest,” Reynolds says. From furthering biomed careers to volunteering and recruitment, CABMET is advancing the HTM profession in creative ways.

The CABMET meetings and symposium always draw a crowd.

POPULAR SYMPOSIUM The CABMET symposium provides attendees with many benefits, including educational classes, interaction with vendors and networking opportunities. “Our symposium is a three-day symposium in August. The first two days are when we do the educational classes as well as the vendor expos. Last year, we had almost 40 vendors and close to 24 different classes. We not only have local members and/or vendors teach, but we also brought in SMEs from across the field to present on many important topics or issues. This year, we are potentially looking at holding the CBET test during our symposium as well,” Reynolds says. The CABMET symposium changed

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TECHNATION

SPOTLIGHT

SPONSORED CONTENT

COMPANY SHOWCASE Retrieve Medical Equipment

etrieve Medical Equipment began as a company that does exactly what its name says – retrieve medical equipment. Since their first days in business, they have helped hundreds of hospitals, imaging centers and other medical facilities turn their out-of-service imaging and biomedical equipment into a revenue source. Six years later, the company has experienced 300% growth since it first began.

The company has also expanded its offering to continue to help the clinical engineers, imaging directors and the HTM community it serves. They now provide refurbished equipment solutions, deinstallations, service, and financing options, in addition to retrieving out-of-service equipment, to more than 850 clients across the United States. TechNation magazine recently found out more about the company during a question-and-answer session with Retrieve Medical Equipment Owner Randall Brunswick. Q: CAN YOU SHARE A LITTLE ABOUT RETRIEVE MEDICAL EQUIPMENT’S HISTORY AND HOW THE COMPANY HAS ACHIEVED SUCCESS? BRUNSWICK: As an account manager working for other companies, I felt most fulfilled when I could really provide value to the clients I worked with and develop longstanding relationships. So we have built our company around the customer experience and making our customers’ lives easier. Here’s one example: When purchasing out-of-service equipment, we pay

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APRIL 2020

before we pick it up. We want our clients to feel 100% confident that they’ve chosen the right company to work with; therefore, we make that commitment. We understand the revenue earned from the sale is ultimately going to improve patient care. A department is going to use the funds to purchase next generation equipment, service or make other improvements. We respect their mission to take care of the people in their community – the mothers, fathers, teachers, leaders and children that live there. Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION? BRUNSWICK: One of our main advantages is that we have designed our service to be easy for you. When purchasing equipment, we return offers quickly. We always work around your schedule for deinstallations and pickups. We also have reps across the country that we can send in – at no charge to you – if you have lots of items and not enough time to inventory them. Q: CAN YOU EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS? BRUNSWICK: In our core business of purchasing equipment from hospitals, we have several unique selling points. • Upfront offers and funding. You’ll receive an offer from us in advance of pick up, which you then decide to accept or decline. Our payment to you will arrive before the equipment is picked up. • No premiums or service fees. You receive full value of the offers you

accept from Retrieve Medical Equipment. There are no hidden premiums or service fees to cut into the full value of the offers. • No equipment minimums. We will work with you on the equipment you have available – no matter the quantity or dollar value. We can help with one EKG machine or treadmill to a MRI needing to be deinstalled or a lot of equipment that you need to clear from a storeroom. Q: WHAT ARE SOME CHALLENGES THAT YOUR COMPANY FACED LAST YEAR? HOW WERE YOU ABLE TO OVERCOME THEM? BRUNSWICK: Retrieve Medical Equipment has experienced steady growth yearover-year. In 2019, we needed to change the way we run our business in order to continue to manage our expected growth. We needed additional team members, space for a larger headquarters, and new internal processes to bring it all together. Good communication, great project management skills, diligence, and always staying focused on our customers have been the center of our success, now and in the future. Q: CAN YOU SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS — ONE TIME THAT YOU “SAVED THE DAY” FOR A CUSTOMER? BRUNSWICK: This year, we deinstalled eight operating rooms for a hospital in the southeast – everything from the surgical lights, video monitors, tables, and warming cabinets to a uroskop. We purchased the equipment from the rooms, which made the entire project cash flow

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SPOTLIGHT

SPONSORED CONTENT

Key staff at Retrieve Medical Equipment with Randall Brunswick, owner, far right.

positive for them. They received funding from us for that equipment – and the deinstallation was done at no charge to them. This solved both their need for deinstallation and to remove their equipment. They were very happy. Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW? BRUNSWICK: We have been able to provide great value to our customers with our deinstallation service – in some cases gaining up to 30-40% savings for them. Our technical teams are also top notch – so our customers have really appreciated the quality of service plus the value. Oftentimes, we can even provide free phone-based technical service to clients, and we encourage

them to reach out to us for this service. Q: CAN YOU HIGHLIGHT ANY RECENT CHANGES TO YOUR COMPANY, INVENTORY, SERVICES, ETC.? BRUNSWICK: Our most recent addition to our offerings are our financing options. For customers looking to lease equipment, we offer a better option than many OEMs or banks will provide. First, we will finance not only the equipment, but include labor, shipping, software, full-service warranties and maintenance agreements to complete the solution for you. Second, the residual is fixed and fully disclosed, which allows you to build equity quickly. If you need to upgrade the equipment in a few years’ time, you would receive the profitable difference between

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the residual and the equipment sale – which is a big benefit. We also offer no prepayment penalties and the ability to extend the term, should it be needed. Q: HOW DOES YOUR BRANDING TIE INTO THE MISSION OF YOUR COMPANY? BRUNSWICK: People often recognize us as the company with the dog in our logo. He stands not only for what we do – retrieving, as he jumps for the ball – but who we are and how we do it. We are your loyal friend, happily jumping higher, running faster and working harder for you. FOR MORE INFORMATION, call 330-963-0277, email info@retrievemedicalequipment.com or visit www.retrievemedicalequipment.com.

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CYNERIO INTRODUCES VIRTUAL SEGMENTATION TO HEALTH CARE IOT CYBERSECURITY

TECHNATION ANNOUNCES HTM WEEK PHOTO CONTEST

Cynerio has added virtual segmentation capability to its platform. Safe and effective health care IoT security projects can take over a year to execute due to a lack of visibility into network topology and sensitive device operations. Building effective cybersecurity policy requires thorough analysis and the ability to contextualize and prioritize devices according to impact. The Cynerio platform’s new virtual segmentation capability automatically delivers safe and effective policies in a matter of weeks by customizing segmentation policy for every device type, limiting the attack surface and ensuring clinical services remain intact. The virtual segmentation capability profiles device communications and generates east-west and north-south segmentation policies, allowing IT security teams to test the policies and monitor for violations before pushing it to live clinical network environments. The AI-based technology groups devices and segments them according to network behavior while risk is prioritized based on device criticality and medical impact. The platform then monitors the network to ensure all traffic is compliant with policy, and provides tools to refine it, sending automatic updates when policy is safe to push to firewall and NAC. “The challenge of achieving safe and effective segmentation is what inspired us to develop the virtual segmentation capability for our customers,” states Leon Lerman, CEO and co-founder of Cynerio. “Our top priority is making health care IoT security projects as easy and painless as possible by helping hospitals safely navigate the risks of immediately enforcing segmentation policies in clinical environments. Cynerio already offers seamless integration with top-tier cybersecurity tools like Cisco, Check Point, Forescout, Palo Alto and more. Adding virtual segmentation to our platform saves hospitals years of time and resources spent on IoT security projects and provides policies that can be easily enforced with confidence.” •

TechNation will once again celebrate HTM Week (May 17-23) with a contest. HTM professionals are invited to participate in the “selfie” contest by submitting a photo of yourself or your department reading TechNation magazine or performing an HTM task. Photos may be shared online at https://1technation.com/htm-week-contest/. One lucky winner will be selected at random on Friday, May 22 and announced via social media. The winner and his/her department will win a pizza party and HTM T-shirts. •

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

HTMA-SC ANNOUNCES ANNUAL MEETING Exhibitor Registration is now open for the 2020 HTMA-SC one-day conference in Columbia, South Carolina. The conference will be held on May 1. “We will offer educational classes for technicians and managers, keynote presentation and ample opportunity to socialize with other biomeds from South Carolina and beyond. An exhibit hall will feature our corporate sponsors and exhibitors,” according to an email sent to prospective exhibitors. “We expect over 90 attendees and 30 exhibitors. Registration includes breakfast, lunch and snacks. The cost for attendees will be free, due to your generous and continued support.” •

APRIL 2020

TECHNATION

INDUSTRY UPDATES

AGILITI ACQUIRES MOBILE INSTRUMENT SERVICE & REPAIR INC. Agiliti Inc. has acquired Mobile Instrument Service & Repair Inc., the third largest provider, by revenue, of surgical equipment repair services to the U.S. health care industry. The transaction was priced at 11-times the company’s 2019 Adjusted EBITDA. “Mobile Instrument is an exciting new addition to our leading medical device service platform,” said Tom Leonard, CEO of Agiliti. “This acquisition builds on our proven, customer-centric model for outsourced clinical engineering services.” Like Agiliti, Mobile Instrument operates at scale, serving customers nationwide. “Our teams share a common approach based on localized, responsive service, expertly trained technicians and certification to the quality gold-standard of ISO 13485:2016,” added Leonard. “I look forward to the value we will bring to our customers as a combined company.” Mobile Instrument specializes in servicing flexible and rigid endoscopes, powered surgical equipment, general and laparoscopic handheld instruments, video cameras and processing systems, case carts and rolling stock sterilizers. Headquartered in Ohio, the business operates through a

network of more than 200 mobile repair labs along with satellite repair facilities in Tennessee, Missouri, Kansas and Southern California. “Our founders helped pioneer the delivery of onsite clinical equipment repair more than 40 years ago,” said David Anbari, CEO of Mobile Instrument. “Since then, we’ve maintained a strong reputation as a highly skilled and reliable partner to our health care customers. Agiliti provides a platform that will enable us to grow within a broader, value-based solution portfolio. I see tremendous potential for us and for our customers as we combine our offerings.” “Our Equipment Value Management solution provides a flexible roadmap to lower the cost and complexity of acquiring, owning and managing medical equipment. Within that framework, we help health care providers address the critical need to efficiently manage and maintain a growing and ever more complex range of equipment and technology across the spectrum of care,” Leonard added. “Our services help optimize the clinical, financial and operational health of our customers, and we remain committed to building and investing in capabilities that further expand and strengthen our unique role in health care.” •

MEDIGATE AGAIN NAMED TO CONSTELLATION SHORTLIST Medigate was named to the Constellation ShortList for Medical Device Security in Q1 2020. Medigate’s platform enables accurate and comprehensive device discovery of connected medical and IoT devices, contextual and behavioral anomaly detection, as well as clinical policy creation for enforcement across clinical networks. “As we enter 2020, health care delivery organizations are more connected than ever. Unfortunately, these devices typically have little to no security built into them. As a result, they become a backdoor for attackers and, once in, they can manipulate the device, spread ransomware and steal the black market’s

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APRIL 2020

most valuable target – patient records,” said Jonathan Langer, co-founder and CEO of Medigate. “Medigate is helping health care organizations around the world safeguard against these types of attacks. Being named to the first Constellation ShortList of the year, after consistent inclusion in 2019, reinforces the value that Medigate is bringing to the industry as we aim to stay ahead of an ever-increasing number of security threats.” “With cyberattacks on connected devices only increasing, organizations implementing generic IoT solutions to secure their medical devices are unknowingly leaving themselves open to risk since

medical device protection is a unique problem that requires clinical context for success,” according to a press release. “Medigate is the only platform using deep packet inspection on proprietary protocols, which provides the clinical context needed for building automated, rulebased, clinically contextual security policies. As health systems look to secure all the devices on their networks, large health care systems to smaller hospitals are coming to Medigate for its legacy medical device security and visibility as well as their IoT devices.” • FOR MORE INFORMATION, visit: https://www. medigate.io/.

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INDUSTRY UPDATES

PROBO MEDICAL ANNOUNCES ‘SIGNIFICANT ACQUISITIONS’ Probo Medical has announced the acquisitions of Elite Medical Technologies LLC and Future Medical Equipment Ltd. The terms of the transactions were not disclosed. “Probo is tremendously excited to announce these significant acquisitions,” said Michael Asmer, CEO of Probo Medical. “Over the past five years, Probo Medical has become a leader in the global ultrasound market. As we look forward, our strategic plan involves expansion into adjacent imaging modalities where we can leverage our supply chain and sales channels. In terms of strategic fit, Elite Medical and Future Medical represent ideal partners, and, as equally important, we share a cultural philosophy that places customers, suppliers and employees at the center. We are pleased to welcome the Elite Medical and Future Medical teams to our family and are excited to accelerate down this growth path as a combined organization.” Elite Medical is a U.S.-based wholesale reseller of preowned digital medical imaging equipment, including CT, MRI and PET/CT across all major OEM manufacturers. Future Medical, based in Bristol, UK, specializes in the de-installation, purchasing and sales of pre-owned medical equipment across a wide array of imaging modalities and equipment types. Both the Elite Medical and Future Medical management teams will remain in place leading their respective organizations. “We have known and respected the Probo team for many years,” said Frank Lewis, managing director of Elite Medical. “As we have grown, we have realized the complementary nature of our businesses, and we believe our partnership with Probo will only provide a wider and deeper solution set for our customers.” Future Medical Managing Director Richard Hart added, “By aligning with Probo, we are able to further enhance the value we provide to our customers and other constituents in the medical imaging space. The wealth of experience in the Probo group will help in maximizing the value we can deliver.” Probo Medical is backed by Varsity Healthcare Partners, a lower middle-market private equity investment firm focused on partnering with founders, entrepreneurs and management teams to build leading health care services companies. •

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APRIL 2020

TECHNATION

INDUSTRY UPDATES

2020 A Wisconsin Biomedical Association (WBA) Event

ONESOURCE ANNOUNCES NEW FACILITIES MAINTENANCE DATABASE

WBA, TECHNATION ANNOUNCE HTM MIXER Save the date for the 2020 HTM Mixer, a Wisconsin Biomedical Association (WBA) event powered by TechNation! The Wisconsin Biomedical Association (WBA), formerly Biomedical Associations of Wisconsin (BAW), is re-launching as the association for HTM professionals for the state of Wisconsin. WBA is joining forces with TechNation to host the 2020 HTM Mixer in place of the annual meeting BAW held in previous years. Melissa Wilke, CBET, is a WBA board member and treasurer. Wilke, a clinical engineering specialist at Gundersen Health Systems, said there is a lot of excitement about the relaunch of the organization and the mixer. “For the mixer, we are looking to celebrate our roots because we have quite a bit of history as BAW, but we also want to take the opportunity to announce our new name,” Wilke said. “And, its an opportunity to redefine ourselves. There have been a lot of advancements through the years. We have a lot of technicians coming into the field and this is an opportunity for everyone to feel included in defining what the goals are for our group and make it something that everyone can benefit from.” “One common theme I always seem to encounter is truly our commitment to support and grow the biomed field through networking and education,” she added. “We all have a lot we want to learn and we can all learn a lot from each other.” As a developing organization, WBA has sought the assistance of TechNation to coordinate this year’s event to best serve its members and corporate sponsors. TechNation has success in this arena having organized

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APRIL 2020

the 2017 Northwest Mixer supported by the Washington State Biomedical Association and the Oregon Biomedical Association. “TechNation is honored to assist with the re-branding of the WBA. The Biomed Association of Wisconsin has a phenomenal history and we are excited to lend our resources to re-launch as the WBA,” MD Publishing President and TechNation Publisher John Krieg said. “We will use every sales, marketing and event team tool we have to help bring the necessary exposure and visibility to the WBA. Their current board is dedicated to this new association and TechNation is proud to support this great state and bring WBA back to it’s rightful place.” The 2020 HTM Mixer will be held October 1-2 at the beautiful Potawatomi Hotel & Casino in downtown Milwaukee, Wisconsin. Following a WBA members meeting, attendees and exhibitors are invited to attend a welcome reception featuring hors d’oeuvres and adult beverages in an intimate setting ideal for networking. The second day of the mixer features continuing education sessions, an exhibit hall and a special happy hour event. Wilke expressed gratitude to TechNation for supporting WBA and helping with the upcoming mixer. “This is exciting that we have this opportunity with TechNation to help rebrand ourselves,” she said. Registration is free for all hospital employees, active military members and students. Exhibitors are encouraged to reserve a booth early as space is limited. • FOR MORE INFORMATION and to register for the mixer, visit HTMMixer.com.

In February, oneSOURCE launched its highly anticipated Facilities Maintenance database for use in health care facilities across the country. This premium non-medical system maintenance and care solution is added to the company’s offerings in the tissues/ implants, biomedical, dental and surgical and equipment sectors. “In the last year, The Joint Commission has reinforced and emphasized their structured guidelines and regulations for a hospital’s health care facility management department and we are confident that our new, comprehensive database will allow those professionals to get their job done easily and effectively,” said Jack Speer, co-founder and president of oneSOURCE. “It’s more important than ever that team members have immediate access to large volumes of manufacturer manuals and guidance documents in order to demonstrate systemic competence.” The Facilities Maintenance database includes all non-medical grade equipment utilized in a hospital or a large facility. Manuals and parts list are a primary focus in the database in addition to fire protection equipment, emergency lighting systems, various alarms, elevators and more. In addition to having thousands of preventative maintenance service manuals available, customers will benefit from having access to an experienced oneSOURCE point person to help organize and customize the database to meet the The Joint Commission’s active list requirements as well as handle specific document requests directly from the manufacturer. oneSOURCE is also equipped to load and house any proprietary documents and integrates with all the CMMS software companies providing one location for retrieval of information and seamless integration. •

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INDUSTRY UPDATES

M&A DEALS TOTAL $2.7 BILLION IN DECEMBER INVESTOR GROUP ACQUIRES TENACORE An investor group led by The Courtney Group Inc. has acquired the medical device repair and service business of Tenacore Holdings Inc. based in Santa Ana, California. Tenacore repairs and services medical devices and sells new and used medical equipment, including patient monitors, infusion pumps, portable ventilators and telemetry transmitters. Investors in the transaction include The Courtney Group, Centerfield Capital Partners and Jim Willett, a seasoned health care executive whom The Courtney Group recruited to join Tenacore as CEO. Willett brings relevant experience in the manufacture and design of medical devices as well as the outsourced management of hospital equipment. Peter Bonin and Brand Caso, who founded Tenacore in 2000, will continue to retain significant ownership in the company. “Tenacore has established a reputation for excellent work and fast turnaround times,” said Willett. “Our plan will be to maintain that commitment to quality and service as we seek to grow our business geographically.” Partners Tom Courtney, Ed McKenna and Alan Macksey of The Courtney Group led the transaction and will serve on the board of Tenacore. Terms of the transaction were not disclosed. •

Total medical devices industry merger and acquisition (M&A) deals in December 2019 worth $2.7 billion were announced globally, according to GlobalData’s deals database. The value marked a decrease of 54.7% over the previous month and a drop of 15.3% when compared with the last 12-month average, which stood at $3.19 billion. Comparing deals value in different regions of the globe, Asia-Pacific held the top position, with total announced deals in the period worth $1.62 billion. At the country level, Japan topped the list in terms of deal value at $1.55 billion. In terms of volumes, North America emerged as the top region for medical devices industry M&A deals globally, followed by Europe and then Asia-Pacific. The top country in terms of M&A deals activity in December 2019 was the U.S. with 15 deals, followed by Australia with two and France with two. In 2019, as of the end of December 2019, medical devices M&A deals worth $40.4 billion were announced globally, marking an increase of 9.8% year on year. •

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Irvine, CA • July 27-29, 2020

MD EXPO EDUCATION APPROVED FOR UP TO 10 CEUS The 2020 MD Expo, being held April 20-22 in Irvine, California, has been approved for up to 10 CEUs by the AAMI Credentials Institute. The Networking Basics Course offered at the 2020 MD Expo, held April 20-22, has been approved for up to 8 CEUs by the AAMI Credentials Institute. The Biomed 101 Course offered at the

2020 MD Expo, held April 20-22, has been approved for up to 7 CEUs by the AAMI Credentials Institute. MD Expo strives to provide healthcare technology management (HTM) professionals with a unique, intimate and rewarding conference second to none. For three eventful days, clinical engineers, biomedical technicians, directors and

managers, procurement/asset managers and others responsible for medical technology will gather in a one-of-a-kind warm and welcoming environment to network with peers, learn the latest technologies and advances in HTM. Find out what everyone has been talking about; this is one event you can’t afford to miss! •

HEALTH TECHNOLOGY ALLIANCE LAUNCHES NEW ACTIVITIES, ENERGY As health technology becomes increasingly connected, coordination between the fields of health care technology management, clinical engineering and IT is more important than ever. That’s why AAMI is joining forces with two other organizations to bring more information technology (IT)-related resources to the healthcare technology management (HTM) and IT communities. 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), has already lined up several projects for 2020. “The past year was spent redefining the alliance’s mission and building a strong bond among our three organizations,” said Danielle McGeary, AAMI’s vice president of HTM. “ACCE, AAMI and HIMSS members have immense expertise; bringing these associations together to achieve a common goal creates a powerful solution.” The HTA is working to do a better job of collaborating with its representative fields of HTM and IT, added Stephen L. Grimes, principal consultant at Strategic Healthcare Technology Associates and member of the HTA Steering Committee. “Our aim is to provide guidance and assistance to these professionals as they

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work to support the constantly evolving and converging information and medical technologies,” he said. The precursor to the HTA was started by AAMI, ACCE and HIMSS in 2008 as the CE-IT Community, which evolved into the HTA in 2017. 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 offer guidance to the health technology field. “The Internet of Things has come to health care … all of the devices that have been ‘dumb’ are becoming ‘smart’ and connected,” added Michael Marchant, director of health information exchange and system integration at UC Davis Health and member of the HTA committee. “This interoperability brings a whole host of new challenges for health care institutions’ HTM/CE and IT departments. HTA will hopefully help these three groups work better together in this new Internet of Healthcare Things.” HTA’s newly integrated WSTF is preparing to publish a set of frequently asked questions (FAQs) to tackle many of the most pressing IT-issues seen in the health care environment. This document updates the group’s 2014 wireless FAQ document to better reflect the current state of the industry with connected

technologies. It includes updated answers to long-standing issues, with expanded sections on security, Bluetooth technology, risk mitigation and troubleshooting IEEE 802.11 connectivity issues. In addition, the HTA has hosted several free webinars, currently available for download on the resources page of the alliance’s website. These include an update on medical device cybersecurity resources and practices and using the new version of MDS2. The alliance is also 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. Finally, the HTA has launched an online discussion group through AAMI Connect, additional webinars, and sessions and symposia to be presented at association meetings. The HTA committee is seeking volunteers to share their ideas, expertise and time. HTA membership is open to anyone who has an interest in healthcare technology. FOR MORE INFORMATION about membership and the alliance’s activities and resources, go to www.healthtechnologyalliance.org.

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RIBBON CUTTING Medigate BY ERIN REGISTER

oughly 500 cybersecurity companies, comprising 5% of the current global cybersecurity solutions market, were founded in Israel. The Israeli Defense Force (IDF) knows how to identify and develop cybersecurity talent. Therefore, the venture capital firms have created an assembly line to facilitate cyber-entrepreneurs. Medigate is a beneficiary of this system.

“After nearly two decades of leading a team of technical analysts focused on the research of cyber-related domains in the IDF, I was eager to apply my cybersecurity expertise to something in the private sector,” Medigate CEO and Co-founder Jonathan Langer said. “I wanted to start a company that would solve a challenging problem for society. That’s when WannaCry hit. After seeing it shut down the operations of many hospitals around the world, I knew that this was a problem that my colleagues and I could solve. So we forged a partnership with a major Israeli health system to figure out what happened and how to prevent it from happening again in the future. In short, we incubated inside that health system, developed some valuable knowledge, successfully raised our seed capital and set our sights on selling our solution in the U.S. market. We were fortunate to have been able to partner with several healthcare systems early on, which validated our solution and problem-solving approach.” Q: WHAT IS THE MAIN FOCUS OF MEDIGATE? A: We are a healthcare-dedicated IoT cybersecurity and biomedical analytics company. Rather than developing products aimed at cross-industry audiences and wrestling with the tradeoffs, Medigate’s position has always been about going deep into healthcare. While our beliefs were

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clearly shaped by the early stage challenges that we faced, our experience has always indicated that a healthcare focus is necessary. Analysts say that nearly 40% of all new IoT devices over the next five years will be healthcare related, so we’re not short on action. While we may not grow as large as our cross-industry competitors, we believe that we can dominate in healthcare and couldn’t imagine it any other way. Q: WHAT ARE SOME SERVICES MEDIGATE OFFERS? A: Healthcare cybersecurity is a team sport, and health systems tend to have short benches. Not only are hospitals constrained from an HR perspective, but their environments tend to be highly nuanced, making talent recruitment a special challenge. As Medigate knows healthcare, it integrates and orchestrates data in clinically relevant ways that leverage existing systems spanning IT security, information services, biomed, clinical engineering and even supply chain, procurement and finance. We do not introduce new workflows; we enhance existing ones, integrating long missing data that benefit operations and security practice. It works because we provide a common data foundation. The data not only stimulates non-traditional collaborations, but also stimulates where gaps are identified. It enables a managed service approach to be seamlessly added/ integrated. While “tech-enabled” service models are generally hard to support across industry, I think our singular focus is what allows it to work well for us and our clients. Q: HOW DOES MEDIGATE STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: We are distinguished by our data quality and meaningful integrations. I could stop there, but I want to touch on the significance of Medigate’s engineering-heavy company profile and the value of our client partnerships. The healthcare-dedicated skill sets we continue to develop and employ have allowed us to be ultra-responsive to our clients. In terms of

Jonathan Langer CEO & Co-founder, Medigate

product development, those collaborations are shaping our solution in ways that are changing everyone’s view of what’s possible. Based on the quality of endpoint visibility that we provide and the resulting operational improvements that we’re enabling, we’re already viewed as strengthening the ROI mission of the healthcare professionals with whom we work. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT MEDIGATE TO ACHIEVE IN THE NEAR FUTURE? A: Ultimately, I would like to see Medigate recognized for having elevated IT cybersecurity practice and helped its leadership achieve more strategic organizational influence. As I mentioned, I know that risk reduction can be monetized, so I know that IT security leadership has an opportunity here. If digital transformation is all about eliminating silos and connecting front, middle and back offices in more powerful, transparent ways, then IT security leadership has the opportunity to repurpose “security data” and orchestrate them to imbue more powerful, cross-functional workflows. If we’re recognized for facilitating that trend, that would make me happy. FOR MORE INFORMATION, visit www.medigate.io.

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AAMI UPDATE BY AAMI

ARE YOU READY FOR HEALTHCARE TECHNOLOGY MANAGEMENT WEEK? This year’s Healthcare Technology Management (HTM) Week celebration will take place May 17-23. HTM Week is an opportunity to promote awareness of – and appreciation for – the critical work of biomedical equipment technicians, clinical engineers and other members of the HTM field. The events for HTM Week 2020 were planned by members of AAMI’s Technology Management Council to support professional development and promote this vital career to a new generation of HTM professionals. The TMC has developed several resources and tools to help you get your celebration underway (available online at www.IamHTM.org) that include a news release template, ideas for showing support of HTM Week on social media, and the 2020 HTM Week poster that can be printed and displayed at work. In addition, HTM Week will feature several fun contests. Contact dmcgeary@aami.org for more information and to enter: • High School Essay contest. We have contacted high school guidance counselors and science teachers around the country to encourage their students to participate and to learn more about the field. • Funniest HTM Story Contest. Either in writing or in a selfie-style video, tell us your most hilarious HTM work story! We will be sharing all your stories throughout HTM week. Three winners will be selected and will win up to $300 dollars in prizes. • Creative Photo Contest. Send us creative photos to showcase the important work of your HTM department, and we’ll feature them throughout the HTM Week on social media! AAMI will buy lunch for the department with the best photo.

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AAMI SELECTED TO HOST 4TH ICEHTMC The Clinical Engineering Division of the International Federation of Medical and Biological Engineering (IFMBE/ CED) selected AAMI to host the 4th International Clinical Engineering and Health Technology Management Congress (ICEHTMC). In partnership with CED, ICEHTMC 2021 will be a global event focused on international knowledge sharing, global networking and increasing the visibility of the clinical engineering and healthcare technology management fields. The Congress will take place Sept. 28-29, 2021, at Disney’s Coronado Springs Resort in Lake Buena Vista, Florida, with a call for abstracts expected in the summer of 2020. The 2019 Congress in Rome, Italy involved more than 1,000 CE and HTM leaders representing 70 different countries. “Our mission at AAMI is to advance the safety and effectiveness of medical devices all over the world,” said Brad Schoener, vice president of innovation at AAMI. “We’re proud to be selected by and collaborate with IFMBE/CED to host this event and bring the global health technology community together.”

host AAMI’s standards meetings, industry training sessions and events. A complete redesign of the AAMI website is also underway for deployment in the first half of 2020. The modernized website will make it easier for members to find the content they want and will offer a more customized experience depending on their interests. Behind the scenes, the IT department is also planning to launch a new association management system (AMS) and a new e-commerce solution. The AMS will help AAMI staff to more effectively provide members with the services they want, while the new online store will present a more customer-friendly shopping experience. Finally, the AAMI IT department is also working on a new standards delivery platform that will replace the Higher Logic Workspaces software currently in use. The platform will incorporate features and functionality needed by committee members and AAMI staff to streamline meeting planning and document sharing. ALG labs are ISO/IEC 17025:2017 certified and follow applicable guidelines from the FDA and industry groups for all validation testing.

FOR MORE INFORMATION about the event, visit www.ICEHTMC2021.com.

VOLUNTEERS NEEDED TO JOIN HTM GROUPS Here’s your opportunity to give back to the HTM community! AAMI is seeking applications for membership on the Technology Management Council (TMC) and the Healthcare Technology Leadership Committee (HTLC). TMC and HTLC members hold three-year terms during which time they must participate in quarterly calls, join an AAMI subcommittee, give a yearly presentation promoting careers in healthcare technology management (HTM) and contribute to an AAMI publication. The TMC provides networking

IT UPGRADES AT AAMI IMPROVE MEMBER EXPERIENCE AAMI’s IT staff have already completed several major upgrades last year, with many more on the horizon for 2020. One of the most visually striking technological upgrades was the AAMI Center for Excellence (ACE). The ACE, located at AAMI’s headquarters in Arlington, Virginia, is now equipped with state-of-the-art audio, visual and teleconferencing technologies. The conference room space was designed to

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opportunities for its members; advances and promotes the HTM profession to others in health care and to the public at large; and develops career and technical resources for local HTM associations, health care facilities, manufacturers and other professionals. To apply for TMC membership, visit bit.ly/2SHS4Gr. The HTCL nurtures leadership skills among HTM professionals and aims to advance the professional interests of HTM managers and up-and-coming HTM leaders. The HTLC has developed several books and other resources and other committee projects include developing standardized job descriptions for the HTM field and uniform terms and definitions related to adverse events. To apply for HTLC membership, visit bit.ly/2SGdVh7.

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AAMI EXCHANGE IOTXPERIENCE DEMONSTRATES THE FUTURE OF THE INTERNET OF THINGS The 2020 AAMI Exchange, June 12-15 in New Orleans, Louisiana, will feature an Internet of Things (IoT) forum to provide healthcare technology management (HTM) professionals with exciting informational sessions and demonstrations from experts who are defining the future of IoT – the IOTXperience. “Last year’s IoTXperience wowed attendees with interactive sessions that explored the risks and opportunities in a future of connected medical devices,” said Sherrie Schulte, AAMI’s vice president of education. “For the 2020 AAMI Exchange, we’re excited to assemble another high-tech IoTXperience that will provide AAMI members with an informative and entertaining Exchange experience.” FOR MORE INFORMATION about the IOTXperience and register for the AAMI Exchange at www.AAMIExchange.org.

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ECRI UPDATE

Coronavirus Outbreak Preparedness – The Equipment Maintenance Perspective

or long-time health technology management professionals, the COVID-19 outbreak – first detected in late 2019 – likely stirs memories of the SARS outbreak from 2003. Similar to COVID-19, severe acute respiratory syndrome, or SARS, is caused by a coronavirus (CoV) that first infected humans in China. During the 2003 outbreak, SARS affected more than 8,000 people worldwide, contributing to more than 700 deaths. In less than two months, the impact of COVID-19 has far surpassed those totals.

Considerable attention has been given to the risks faced by health care workers treating patients who may have been exposed to the novel coronavirus (2019-nCoV) that causes COVID-19. However, a risk of exposure may also exist for clinical engineering, respiratory therapy and other personnel involved in maintaining equipment that potentially has been exposed to such pathogens. PROTECTING STAFF DURING EQUIPMENT MAINTENANCE The following list of protective measures, which ECRI developed in response to the SARS outbreak, should be implemented to protect personnel while they are maintaining and repairing equipment that has been used on

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– or that has been in the same room as – patients who have been, or may have been, exposed to the coronaviruses causing COVID-19 or SARS or to similar pathogens. For the most part, these measures represent good infection prevention practices that should be followed when servicing any device, independent of concerns associated with the current epidemic. Furthermore, recognize that “drilling and simulation in situ can be extremely valuable for this type of work,” adds Jim Davis, a senior infection prevention and patient safety analyst at ECRI. “Training and simulation saves lives.” 1. Adhere to isolation precautions. Patients who have confirmed disease or patients of interest will be under isolation precautions – practices designed to minimize disease transmission. Access to such rooms should be restricted to trained personnel to ensure the safety of staff, other patients and visitors. If you are authorized to enter the room, follow all hospital policies and procedures to minimize the exposure risks. 2. Minimize exposure of medical equipment to infected patients. Remove any unessential equipment before the patient is brought into the room, Use breathing-circuit filters to protect exhalation valves and other ventilation components

from contamination. Use disposable devices or accessories for these patients whenever possible. 3. Observe proper hand hygiene. Frequent and thorough handwashing with soap and water is essential. Alcohol-based handrubs can be used when hands are not visibly soiled and handwashing facilities are not immediately available. Personnel should not rub their eyes or touch their mouth, nose or other mucous membranes while working on exposed equipment. While wearing gloves, personnel should also avoid touching other surfaces in the room that are not involved in the equipment repair (e.g., doorknobs, phones, test equipment, computer terminals, keyboards, manuals). In addition, personnel should not eat, drink, chew gum, smoke or apply cosmetics until they have removed all protective wear and washed their hands. 4. Use proper decontamination and transport procedures. Equipment should not be transported from the care area until it has been cleaned and disinfected following current guidelines and until disposables have been removed by housekeeping, central processing or other appropriately trained personnel. If equipment must be removed from the room before the exterior can be

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cleaned and disinfected, follow any hospital policies on transporting contaminated devices. 5. Choose an appropriate work area. Equipment that poses particular infection concerns should be worked on in designated, appropriately equipped areas where servicing can be performed without the risk of infecting patients or other employees. Such areas should have appropriate environmental controls (e.g., negative-pressure processing areas) and signage; and they should not be near any patient care areas, food preparation or storage areas, medication areas or other clean areas. 6. Wear personal protective equipment (PPE). ECRI recommends using the PPE listed below for personnel working on low-risk surfaces, such as the interior of a device that may have been exposed to the CoV from room air drawn into the device by a cooling fan. (The warm air that generally circulates inside a device with a cooling fan promotes drying and dilution of contaminants, which may reduce the viability of some viruses.) Note that compliance with federal and international guidelines with respect to PPE should take precedence, when applicable. • Gloves • Clean, nonsterile gown or disposable coveralls

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• Eye protection (e.g., goggles, face mask) • Respiratory protection (e.g., an N95 respirator) • Hair covers worn only in the decontamination area • Designated shoes or shoe covers worn only in the decontamination area Before starting work … If there is any question about whether the exterior surfaces of the equipment were adequately disinfected, including the bottom, back and casters (if applicable), disinfect those surfaces immediately. Also, if disposable components have not already been discarded, do that right away as well. If the interior of the equipment is dusty … Use a vacuum cleaner with a HEPA filter to remove dust as soon as adequate access is gained during disassembly and before working on the interior. Never blow on the equipment or use compressed air to remove dust or other particulates. Clean up when done. Clean and disinfect the work area after servicing is complete. If an exposure occurs … If you believe you have been exposed to a pathogen while unprotected, consult with the hospital’s infection control practitioner, epidemiologist or employee health staff for the procedures to follow.

ECRI RESOURCE CENTER In keeping with its mission of effective, evidence-based health care globally, ECRI has developed a free public resource – the COVID-19 (Coronavirus) Outbreak Preparedness Center – to help hospitals protect health care workers as well as patients. Available at www.ecri. org/coronavirus-covid-19-outbreak-preparedness-center, the site includes: • Preparation and patient handling checklists • Equipment and alternative supplier lists • Patient care equipment evaluations, including ratings of portable/transport ventilators • Recommendations for infection control • Links to useful resources from organizations like the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). This article is adapted from content that is now freely accessible through the ECRI web page Outbreak Preparedness and Response: The Essentials. The page includes checklists, equipment recommendations, alternate suppliers, and infection control guidelines to help biomedical and clinical engineers, supply chain professionals, and clinicians prepare for contagious outbreaks. To learn more about membership in ECRI programs, visit www.ecri. org/device-evaluations, or contact ECRI by telephone at (610) 825-6000, ext. 5891, or by email at clientservices@ecri.org.

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hristianaCare’s Clinical Engineering Department is certified and registered as ISO 9001:2015. The journey we took to achieve this was unique, and the experience helped us to understand the benefits of each quality management system (QMS) – and which would support our commitment to excellence. Through courageous self-evaluation and empathy, we became aware of our strengths and weaknesses and the need for a more formal QMS.

As a clinical engineering department, our responsibility is to always provide proper working equipment so that our employees, whom we refer to as caregivers, can leverage that equipment to treat or diagnose our patients. This responsibility is underscored by our organization’s core value to be exceptional today and even better tomorrow. We decided to embark on this journey in 2016, after attending a Food & Drug Administration (FDA) workshop titled, “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices.” At the time, the industry was seemingly moving toward a formal QMS as a best practice. Since then, ChristianaCare has helped participate or drive several projects, including the 2018 FDA workshop “Medical Device Servicing and Remanufacturing Activities” and the development of

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Medical Imaging & Technology Alliance’s QMS standard for imaging devices. Our budget for 2019 was approved with a line item for ISO certification. Calendar 2018 ended, and we made 2019 goals, one of which was to complete our certification process. I attended an American Society for Quality (ASQ) class on biomedical auditing, attempted to write our quality manual and generally found the whole endeavor daunting. It was hard to know where to begin, what to measure and how to convert our concepts into actionable items. In the end, we hired a facilitator who helped guide us through the implementation of and certification to ISO 9001:2015. Our decision to go with ISO 9001:2015 may be surprising, given the penchant in the industry for the ISO 13485:2016 Medical Devices Standard. However, when mapping the requirements for our compliance with the laws and regulations of federal, regional and state authorities – as well as our environment of care tasks from our Joint Commission accreditation – we discovered a few things that shaped our goal to be the adoption of ISO 9001:2015. Being an accredited Healthcare Delivery Organization (HDO) meant that we had 90% of the requirements for a formal ISO 9001 QMS already established and in place as processes and habits. For that reason, we would be able to use our resources wisely and effectively for certification of

Mike Powers, MBA, CHTM, CDP, CBA ChristianaCare

our well-run in-house program. The first thing we found was that The Joint Commission requirement for continuous improvement aligned more elegantly with the ISO 9001:2015 framework around continuous improvement of customer service. This was due to several reasons, such as The Joint Commissions’ polling mechanisms, solicitation of feedback, and corrective and preventative actions (CAPA) language. As we worked through the process of certification, we discovered other variables by having to define our core processes, instead of a focus on core products and reproducibility of each product. Based on our understanding, ISO 13485:2016 is more concentrated on reproducibility and regulatory compliance around post-market surveillance instead of the formalization of growing benefits to patient care. In our journey to certification, we stopped and formalized our management processes, which had been in place but less rigorous in implementation. Our key processes were identified to be in four areas: • Parts acquisition • Project management

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• Preventative and planned maintenance • Corrective maintenance For those processes, we established metrics for “what excellence looks like” and implemented key performance indicators (KPIs). Furthermore, we found that our great ideas needed a home. We took the initiative to vet proposals and establish a cost/benefit analysis and a reporting feedback loop. In our management reporting weekly meetings, we document ideas, task a colleague with the research and, if appropriate, the item’s implementation. We establish a timeline for completion and follow up to make sure the project is completed. We analyze

whether the expected benefits matched the actual results. The process of documentation to maintain compliance with our QMS has been a blessing that has allowed and provided a framework for advances such as: • Digital project management in lieu of paper copies that get damaged and misplaced. • Changing the wording of some of our work order close codes, to facilitate what is occurring and improve accuracy in reporting. • Re-evaluation of our approved vendor list and establishing requirements for how vendors are added and managed as well as periodical re-evaluation to ensure that our clinical engineers are providing the

materials and services expected while minimizing risks. • Reports delivered to internal stakeholders that document the value of our cost center, and our timely delivery on quality and safety metrics that enable caregivers to deliver world-class care. Having completed our certification journey, and now progressing through the regular day-to-day work of performing tasks in compliance with our QMS, we highly recommend the implementation of a formal QMS for any organization that strives for excellence. MIKE POWERS, MBA, CHTM, CDP, CBA, is the Clinical Engineering Quality Manager at ChristianaCare.

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WEBINAR WEDNESDAY

Experts Share Knowledge, Tips STAFF REPORT

he 2020 Webinar Wednesday series continues to wow attendees with insightful education and tips for healthcare technology management (HTM) professionals. Three webinars spread out over January and February drew a crowd and positive feedback.

DUO SHARES TIPS FOR HTM PROS The February 19 webinar “Challenges and Opportunities for HTM Professionals” was eligible for 1 credit from the ACI. The presentation was sponsored by CyberMDX. The webinar featured Ido Geffen, vice president product management at CyberMDX, and Derek Board, security analyst at CommonSpirit Health. Geffen and Board conducted an interactive session where they discussed the top challenges and opportunities facing HTM professionals today. They shared insights on how to deliver 360-degree visibility, protection and optimization for all connected devices. Attendees heard about tips and tricks from the field, as well as lessons learned from Board, as he described how his organization approaches device security. About 200 people attended the live presentation. Attendees shared positive feedback in a post-webinar survey and answered the question, “What information did you learn during today’s

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webinar that you can apply to your role?” “All great info to bring to a fundamental biomed program,” Biomed M. Jackson said. “That I need to take the interconnectivity of our medical equipment and security more seriously,” is what A. Dicks, Biomed III, said he learned. “All the different modalities that can be networked and issues that may occur,” R. Naranjo, Lead BSS, shared. “Points where I must be careful when implementing an AI project, the importance of the work team and the functions of each of them,” student B. Hernandez said. “Reaching one plus teaching one, makes IT and HTM do better for the patient,” said H. Hunter, executive director. “To become more aware and involved in cybersecurity,” Lead Tech E. Bican said. “Great information for cybersecurity, which is becoming a forefront of HTM management for device risk,” HTM Director K. Forsythe said. “Multiple different medical device security issues to remain aware of and the importance of developing a good relationship between Biomed and IT,” said R. Toeller, BMET IV. “An ongoing collaborative effort is required between IT and clinical

Great information for cybersecurity, which is becoming a forefront of HTM management for device risk.” – K. FORSYTHE, HTM DIRECTOR engineering to mitigate cybersecurity threats to medical devices, leveraging strengths from each team to maintain a safe environment for our patients,” said C. Virzi, Regulatory Compliance Specialist Clinical Engineering. “I can share the information about improving security to staff during presentations and demos,” said J. Eden, clinical design and implementation specialist. AAMI SHARES HTM IN A BOX Danielle McGreary, CHTM, PMP, vice president of healthcare technology management at AAMI presented a Webinar Wednesday session in February. McGreary’s work experience includes district manager at Aramark, healthcare technology director of clinical engineering at VA Boston Healthcare System and clinical engineer and project manager at Hartford Hospital. In the webinar McGeary “unpacked” AAMI’s new “HTM in a Box” tool and illustrated how HTM professionals can use it to promote the field to all different age levels. With fewer qualified candi-

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I think the presentation is a good tool to use to promote the HTM field and hopefully get more high school students and other qualified people interested in our field. I’ve been in it for 40 years and the field has grown so much.” – W. HALLMAN, SENIOR BIOMEDICAL TECHNICIAN dates in the hiring pool and an aging workforce, recruiting new HTM professionals is more important than ever. With “HTM in a Box,” AAMI has helped make promoting HTM easy! Webinar Wednesday would like to thank AAMI for sponsoring the webinar. The Association for the Advancement of Medical Instrumentation (AAMI) is a nonprofit organization founded in 1967. It is a diverse community of approximately 7,000 professionals united by one important mission — the development, management, and use of safe and effective health technology. Attendees provided feedback via a post-webinar survey and answered the question “How did today’s webinar meet your expectations?” “Good information to use in promoting clinical engineering,” said M. LaPlante, biomedical supervisor. “Gives us a good tool to use to attract more people to our profession,” shared M. Scheppegrell, senior biomedical technician. “I am glad I logged on. I have been wondering how to go about promoting biomed in the community,” said M. Manzo, biomedical engineering technologist. “Love the tool to help our industry draw in talent,” said J. Ruiz, site manager. “I think the presentation is a good tool to use to promote the HTM field and hopefully get more high school students and other qualified people interested in our field. I’ve been in it for 40 years and the field has grown so much,” said W. Hallman, senior biomedical technician. “It really hit the point and seemed to

be enlightening about the need for new techs in the biomed field,” said R. Akins, biomedical manager. “It is good to know there is a plan to keep this career alive and kickin’,” Biomed D. Tomczak said. “Informed me that there are tools out there to help with recruiting so I don’t have to reinvent the wheel,” Biomed C. Joerger said. RTLS PRESENTATION PROVIDES INSIGHTS Midmark RTLS sponsored the Webinar Wednesday presentation “Mixing it Up: Combining Accurate and Zonal Location for Campus-Wide RTLS” on January 29. The presentation by Timothy Killmer, information systems analyst at Billings Clinic in Montana, was approved for 1 credit from the ACI. The webinar discussed how real-time locating systems (RTLS) have become more prevalent in health care. Killmer spoke about how biomedical and clinical engineering teams are at the forefront of selecting the right RTLS technology for their hospitals. Yet, there are differing technologies used for RTLS, and their capabilities vary. Killmer shared how the Billings Clinic applied two different RTLS technologies to solve its asset challenges. He explored the pros and cons of different technologies and what can be achieved with each. Almost 200 people joined the live presentation and a recording of the webinar is available online where additional HTM professionals can watch the insightful seminar. Attendees provided positive feedback in a post-webinar survey in which they were also asked to describe the webinar in three words.

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“Informative, interesting, positive,” C. Ramos, BESS, said about the webinar. “Important for biomeds,” Biomed T. Wade shared. Some attendees needed more than three words to express their thoughts. “It is a time-saver for technicians,” Clinical Engineering Supervisor P. Thibodeaux said. “Nice to hear the customer experience and several good reasons to implement this technology,” said System Director M. Philpott. “Very informative and gave me views/ideas I had not considered,” Chief BMET P. Leon-Guerrero wrote. “Informative, well organized, detailed illustrations,” Director P. Sloane said. “Very informative and well worth the time to understand how the solution fits into their workflow and addressed their needs,” said S. Dodge, clinical design and implementation. THE WEBINAR WEDNESDAY SERIES continues throughout 2020. Additional information, including a calendar of upcoming presentations and an archive of on-demand webinars, is available at WebinarWednesday.Live.

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SHOP TALK POWERED BY MAQUET POWER LED 500/500

We have a satellite boom arm that continues to move slightly when it is put into required working position. How is this corrected?

More than likely a friction brake needs tightening or replacing. Check the horizontal arm for a flat head where the spring arm meets it, or perhaps a #4 mm Alan.

Is there a “release” button on the handle for when you position the boom? If so, it probably has pneumatic brake bladders that are not working for some reason. Could be low supply pressure, a kinked line or ruptured bladder. If the mount is not level or strong enough to remain rigid when articulated, equipment booms can drift regardless of what style brakes they have – friction or pneumatic. Friction brakes frequently wear out prematurely due to them being over tightened to compensate for poor celling mounts.

If it only moves slightly, I’d say friction. If it was air related or electric, those two are typically go or no-go.

In this picture [online] (tinyurl. com/tvbx9hd), the lower six dots you can see on the hubs of the four suspension arms are the brake adjust-

ment screws, there are two for each rotation point on each arm. Some will be behind plastic covers, such as lighthead and yolk. These brakes are for rotation points, elevation drift has to be addressed by adjusting spring tension in the spring arm. You should remove the brake screws and inspect the pad. Just like auto brakes, once the wear portion is gone, replace the brake. HILL-ROM TOTALCARE P1900

I have Hill-Rom Totalcare and am moving. How can I disassemble the bed from the frame to be able to get it through a door and down some stairs?

I believe we’ve been through this recently. It depends on how skilled you are. Medical devices, including hospital beds, are not designed nor built to be easily disassembled and reassembled. The first question would be: Are you sure the floor in the room where you wish to use this device can support the bed? It weighs a lot more than a normal bed. The second question is; Do you own the bed or is it a rental? You’re going to need a few people to haul this bed through the doorway and up to the room you want it in. I can’t give you exact instructions on how to do this, just general and am in no way accepting any liability for what you do. Raise the bed to max height to get access and maximum visibility, unplug from

wall. Removed base covers and disconnect batteries if it has any. Engage each function to help drain any power form caps and such. Label each cable and it’s connection before disconnecting. Disconnect any cable connecting the top half to the bottom half. Find a way to support the top half, then disconnect any hardware joining the two halves. Now you can separate the two halves. This should be enough to get the unit through the doorways.

This bed has hydraulics for all of the mechanisms, so if you are not familiar with hydraulic systems I would advise against taking it apart. PHILIPS RESPIRONICS V60

I have a V60 ventilator that will not pass test 5 air flow and test 6 oxygen flow. Both are constantly >20 SLPM below passing specs.

Did you have the red flag in? Sometimes that flag is loose and you can bypass that by clamping off the exhaust tube with hemostats. If replacing the gas delivery system didn’t fix it, it seems like a leak in test equipment. Either that or the white clamps are loose that connect the GDS to the gas outlet.

Have you tried the flow sensor assembly?

SHOP TALK

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

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ROUNDTABLE

ROUNDTABLE Endoscopes

echNation contacted experts in the health care community seeking input regarding endoscopes for this roundtable article. Representatives from third-party service organizations and original equipment manufacturers replied with an interest to share knowledge and insights.

Those participating in the roundtable article are Olympus Corporation of the Americas Global Senior Manager of Infection Prevention Melinda Benedict, FUJIFILM Medical Systems USA Inc. General Manager-Endoscopy Taisuke Fujita, MultiMedical Systems (MMS) Director of Surgical Services and BioMedical Solutions Chyrill Sandrini and Biomedical Support Systems Owner/CEO Hawa Zamani. Q: WHAT ARE THE LATEST ADVANCES IN ENDOSCOPES IN THE PAST YEAR? BENEDICT: Olympus continuously makes advances in its endoscopy equipment.

Melinda Benedict Olympus Corporation of the Americas

The most recent advancement is the new TJF-Q190V duodenoscope, which received FDA 510(k) clearance on January 17, 2020. The advanced features of this duodenoscope include a sterile, disposable distal endcap designed for ease of reprocessing, as well as an expanded field of view and improved handling for improved clinical performance.

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FUJITA: 2019 was a big year for Fujifilm as the company advanced the market with the launch of eight new endoscopes, fulfilling a demand for new, high-quality, endoscopic imaging technology. This device is intended for the visualization of the duodenum and upper digestive tract, specifically for the observation, diagnosis and endoscopic treatment of the esophagus, stomach and duodenum. It features a removable, single-use distal end cap – a design that provides direct access to mechanically brush clean the elevator mechanism and surrounding recessed distal tip surfaces. Fujifilm’s suite of 700 Series endoscopes were designed for use with the ELUXEO video processor. Together, this technology duo combines unparalleled visualization capability with exceptional maneuverability and control to streamline access and enable optimal detection in both routine and complex procedures. ELUXEO’s 4-LED Multi-Light Technology creates Blue Light Imaging (BLI) and Linked Color

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Imaging (LCI) visualization modes which are designed to aid clinicians in the detection and their characterization analysis during exams. Additional interventional launches include the EI-580BT Short Double Balloon Endoscope, a new tool designed to facilitate access in altered anatomy, as well as the EG-580UT and EG580UR Endoscopic Ultrasonic Scopes equipped with a high resolution Super CCD image sensor which helps ensure sensitive and high quality images and are utilized in conjunction with the SU-1 Ultrasound Processor. SANDRINI: With Olympus owning over 70% of the market share and over $350 billion in revenue annually in the GI field I will answer to their advancements. I find it exciting after the introduction of therapeutic ultrasound scopes just two years ago how physicians are becoming more versed and skilled with higher success rates with these procedures. Also imaging across the GI platform continues to improve with 3D technology. The HD advancements are helping make early detection possible. Early detection, treatment and overall patient health is remarkable compared to just 10 years ago! ZAMANI: Olympus received FDA clearance for the removable Endocap on their duodenoscopes due to the reprocessing concerns. Their model 190 series are coming out with these disposables that help lower contamination risk. Traditional endoscopy systems utilize Xenon white light design. However, newer systems utilize smart technologies that generate sharper pictures and videos with high-definition imaging. Q: CAN YOU BRIEFLY DISCUSS ANY FDA UPDATES AND WHAT THEY MEAN FOR ENDOSCOPES? BENEDICT: The FDA issued a Safety Communication concerning duodenoscopes in August 2019. The agency recommended that duodenoscope manufacturers develop devices that

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include disposable components or that are fully disposable, and Olympus is continuing its work in furtherance of this recommendation. As duodenoscopes are used to access tortuous anatomy, their design is necessarily complex and design advancements need to be carefully tested to ensure the devices continue to meet vital clinical needs.

Taisuke Fujita FUJIFILM Medical Systems USA Inc.

FUJITA: In August, 2019, the U.S. FDA issued a Safety Communication recommending health care organizations transition to duodenoscopes with disposable parts and innovative designs to aid in the reprocessing process. Consistent with the FDA’s recommendation, Fujifilm has developed, and has already begun transitioning health care facilities to the ED-580XT duodenoscope that features a removable, single-use distal end cap – a design that provides direct access to mechanically brush clean the elevator mechanism and surrounding recessed distal tip surfaces. With the distal cap detached, the scope tip surfaces are more readily exposed and can be more easily reached and cleaned by brush compared to the fixed-end cap designs. SANDRINI: The examination of the bile duct or pancreas is a procedure called an ERCP and a duodenoscope is used.

This is the “superbug” scope that Olympus answered a lawsuit with a recall after several deaths occurred. The FDA is now suggesting disposable caps to help reduce possible errors in the HLD reprocessing procedures around the elevator channel. These caps are trying to eliminate the chance of human error and increase patient safety. If implemented, all ERCP manufacturers would have to comply. It will take time to study the between patient contamination to see if the caps are effective. I would like to challenge every facility across the U.S. to examine their patient scheduling practice and allow more than sufficient time for proper bedside cleaning and ample time for detailed HLD reprocessing times. I have seen a lot of issues with lack of sufficient ERCP scope inventory and back-to-back patient scheduling. Training, training and regular update trainings to all handling or cleaning these scopes will help reduce the margin of error. Follow the IFUs – have them posted, and available for all employees to reference. Bottom line – do you have enough ERCP scopes for the cases being scheduled? And is your facility allowing the staff enough time to correctly disinfect? These two points will increase patient safety – with or without disposable caps! ZAMANI: There were many infection transmissions occurring from the moving parts of duodenoscopes. They were difficult to disinfect as a result of the moving parts. So, the FDA recommends for end users to transition from fixed end caps to disposable or removable end caps. The FDA understands this will take time for everybody to transition. This new recommendation minimizes the risk of infection, but it still does not guarantee it. Q: WHAT STEPS SHOULD BE TAKEN PRIOR TO REPAIR/SERVICE OF AN ENDOSCOPE? BENEDICT: Users should contact their endoscope manufacturer and/or repair company when damage has been found

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on an endoscope. The manufacturer should be able to provide directions on how to reprocess a damaged endoscope prior to sending the endoscope in for service and/or repair. For example, it may sometimes be necessary to manually disinfect the endoscope prior to service. Although the majority of endoscopy clinics use automated endoscope reprocessors, technicians should be trained on manual disinfection and the supplies required to perform this task should be stocked should the need arise. FUJITA: As routine service and occasional repairs are to be expected in medical devices, Fujifilm recommends health care enterprises partner with a vendor that both provides a service package suitable for their needs, as well as resources to prolong the life of the technology. In the last year Fujifilm has made efforts to ensure adequate resources for reprocessing professionals. To prolong the life of and preserve the cleanliness of equipment, Fujifilm encourages health care institutions to only use cleaning brushes validated by the manufacturer, and if using Automated Endoscope Reprocessors (AERs), they should only use validated re-processors with the appropriate connectors. In addition, health care organizations should allow reprocessing professionals to dedicate adequate time and resources to reprocessing per the manufacturer’s instructions for use. If a health care organization needs to return an instrument for service, Fujifilm recommends the following steps: • Before returning any instrument for service, all devices should be reprocessed consistent with manufacturers’ validated instructions. • If a scope has a leak before being returned, special handling/reprocessing recommendations should be followed. This information is typically made available by scope OEMs separate from the standard instruction manual.

Chyrill Sandrini MultiMedical Systems

SANDRINI: First suggestion – glove up! All endoscopes whether rigid, semi-rigid or flexible are dirty until proven differently! Communication with your SPD/CS, urology, RT and HLD staff is imperative! Know the history. Ask – Was this endoscopy sterilized or was it disinfected? If not, make sure it comes to you in a red bag. In my experience the biomed staff isn’t directly involved with hands-on reprocessing, but handle the scopes when sending out for repair. Your repair company will be very thankful for your detective work and passing along your discovery! ZAMANI: I tell my clients to make sure the scopes I pick up are safely stored in a case. That keeps them safe upon return and it assures safety and care for the equipment all around. Clinical engineers can begin validation processes as per FDA and OEM recommendations. The two methods utilized are by ATP swab sampling or colormetric protein swab sampling. These two methods are recommended by both state and federal and are located on their respective websites. Q: HOW CAN BIOMEDS HELP LOWER THE RISK OF PATIENT INFECTION WHEN IT COMES TO ENDOSCOPES? BENEDICT: Biomeds need to ensure

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endoscopes and related equipment and accessories (reprocessors, leak testers, flushing pumps, etc.) are maintained per the original manufacturer’s recommendations. Sending endoscopes to the manufacturer for repairs whenever any abnormalities or damages are observed is important. Although it may not be recommended by endoscope manufacturers, if biomeds choose to use a third-party repair center for endoscopes or choose to perform repairs themselves, they need to ensure they are aware of related issues and risks that may be associated with this practice. FUJITA: The U.S. FDA has been diligently working with industry to address and prevent potential infection issues. Fujifilm urges health care facilities to follow the recommendations stated in FDA safety communications to lower risk of patient infection in medical procedures. A few tips for biomeds are as follows: • Ensure that manufacturer’s device specific instructions are readily available to staff for all endoscopes and related validated reprocessing equipment (AERs, channel flushing aids, etc.). • Provide proper training for reprocessing personnel utilizing but not limited to manufacturer provided training materials. • Ensure only manufacturer validated brushes and AERs are utilized in the reprocessing process. • Ensure single-use, disposable components are in fact disposed of, and are not reused. • Confirm endoscopes are properly maintained and function as intended. • Ensure that institutional policies and procedures have been established for equipment maintenance including periodic maintenance as recommended by each scope manufacturer. • Work closely with staff to ensure applicable personnel routinely inspect endoscopes for damages including missing/chipped adhesives, broken/cracked lenses/distal tips as well as any signs or evidence of

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residual foreign matter on scope surfaces. If any damage or residues are observed, scopes should be returned for evaluation/service. • Educate reprocessing personnel that irregularities (ex. resistance) detected during channel cleaning by brush can be indicative of kinked/damaged channels which may interfere with ability for channels to be adequately cleaned. • Develop procedures for periodic evaluation of already reprocessed scopes in storage cabinets. Any observed traces of fluid/droplets beneath scope hanging in cabinet or signs of stains/residues on distal scope tip may be indicative of inadequately dried scopes. SANDRINI: Respond quickly to any requests for help from your SPD or HLD departments. Follow the OEM guidelines on PMs and test cycles of your reprocessing devices. Prepare yourself with troubleshooting information from the OEM manuals and suggest to those departments, or if you are responsible for managing the endoscope fleet, set up a preventative maintenance inspection to occur every six months. Suggest regular in-service training to occur every six months for your biomed team and those departments involved in the care, handling and reprocessing.

Hawa Zamani Biomedical Support Systems

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ZAMANI: Biomeds can help develop performance improvement programs for endoscopy scope and systems that can provide monitoring and surveillance. They can help lower risks by reporting noncompliant measurements. The safety committees at these facilities or the environment of care can take these hazards and figure out the resolutions for each hazard to seek closure. Proper documentation is the key that will make a successful program. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING ENDOSCOPES? BENEDICT: Endoscopes play an important role in the detection, prevention and treatment of many types of cancers and other conditions throughout the body. They are intricately designed and engineered devices with hundreds of unique parts working in tandem to provide clinicians with the access and image quality required to see and treat irregularities. As such, it is vitally important that customers treat the after-sale service decision with just as much care and deliberation as the decision to make the actual purchase. To ensure endoscopes are functioning as they were designed, the OEM should be used for service and repair needs. This is important to ensure: that the parts used to repair the endoscope are never compromised, that the repair process is done according to current OEM protocol, and that the technicians performing the repair are OEM trained. OEMs are uniquely qualified to perform the service and repair of the endoscopes they manufacture due to the rigor and quality standards they must adhere to as FDA regulated entities. Third-party repair organizations may provide more economical servicing options due to use of non-OEM parts, a repair process that is not OEM certified and technicians who have not been trained by the OEM, but it is important to note that these organizations are neither FDA regulated nor FDA registered.

FUJITA: While state of the art technology and clinical utilization of endoscopes are crucial factors for physicians, other purchasing considerations should include after sales support, comprehensive product in-services, training aids and educational materials such as informative quick reference guides which describe manufacturer’s reprocessing recommendations in a simpler format (to be used in conjunction with the standard operation manuals). Fujifilm wants to drive home the message that appropriate endoscope care can benefit patients and hospitals. Patients can face a reduced risk of cross-contamination, and hospitals can face less scope downtime, less administrative work when scopes are properly cared for. All of these factors contribute to ensuring health care organizations are selecting the right vendor for their technology needs. SANDRINI: Certified preowned with warranty can save your facilities thousands of dollars. Always buy from a reputable re-seller such as MMS. Your vendor should be able to provide installation and training. Ask for final inspection reports so you have record of what repairs occurred to add to your CMMS. This will help you to be ready for any questions from surveyors. Remember “working good enough” on your flexible endoscopes isn’t OK! Every device should be working to OEM specifications! When it isn’t, send it out for the quick minor repair or it is in danger of becoming a major repair or a patient fail during procedure. These minor repairs are quick and are minimal in cost. This will help your facility increase uptimes and decrease major repair costs! ZAMANI: My clients utilize my services because I go out of my way to help build long-lasting relationships and we provide excellent customer service and support. I really like to go above and beyond for our clientele.

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LEADERSHIP By K. Richard Douglas

“ HTM must be positioned to evolve into the future by addressing past, current and future changes facing the entire health care industry. This means we need to be more than an equipment fix-it shop.” – Mike Busdicker

eorge Orwell died in 1959 at age 46, but his final novel “1984,” which was finished in 1949, would prove profound in many ways. Many elements of the book look very familiar in 2020. Orwell’s ability to look into the future with such accuracy is unnerving. While the British novelist let his imagination create fiction that provided glimpses of the technology familiar today, the ability of most people to get the future right comes out of educated guesses and the observation of trends. Looking into the future, with the help of several members of healthcare technology management (HTM) leadership, allows for some speculation along with accurate predictions based on current knowledge. What will the future of the HTM profession look like? Technology will continue to advance and the skill set of the average biomed will need to continue to adapt. There will continue to be more cross-over with IT – networking skills and cybersecurity knowledge will be important. Will HTM own 100 percent of the product life cycle in every facility? Will any final rules from the FDA change the direction of HTM? Will national standards be adopted? Will the efforts to generate interest in the field among high school and college students succeed? Will continuous advances in medical technology change the nature of the job? These are some of the questions the HTM field faces. Human resources will continue to be a challenge and future FDA rules could change procedures. “I believe we will be moving past

alternative maintenance practices and progressing to more maintenance practices based on specific clinical operational needs of an organization as well as infection prevention-focused activities of the equipment. I also see IT skills being more of a mandatory skill set and the compensation practices moving out of the shadows of the IT industry,” says Matt Royal, MS, CTM, CHSP, CHFSP, CHEP, CHTM, CLSO-M, CHC, CHFM, CBET, director of biomedical engineering at Eskenazi Health in Indianapolis, Indiana. “HTM will also need to evolve into more clinical education activities; there is a need for HTM professionals to assist clinical staff with application support on a regular basis. The importance of HTM is going to be a larger investment by an organization and those larger organizations with more resources will look to move away from third-party service companies to in-house programs with more flexibility for customization of services,” Royal says. Mike Busdicker, system director of clinical engineering at Intermountain Healthcare in Salt Lake City, Utah says that over the past 20 years, the level of change in HTM has been accelerated by health care reform and the advancement of technology. “HTM must be positioned to evolve into the future by addressing past, current and future changes facing the entire health care industry. This means we need to be more than an equipment fix-it shop located in the basement and will require involvement of personnel across all levels. Also, HTM staff will need to stay on top of technology

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advancements and continue to grow personally and professionally,” Busdicker says. Gregory Herr, BSEE, MBA, CCE, CHTM, Director of Healthcare Technology Management with The Christ Hospital Health Network in Cincinnati, Ohio, says that he has been in the field since the mid-1970s and has watched HTM evolve from an electronics (some mechanical) support to today’s multi-specialty programs. He says the evolution has resulted from the needs and requirements of the provider and requests of clinical users. Through training and supporting systems, he says that HTM has been able to offer these services in a cost-effective manner with reduced or no service agreements.

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“HTM needs to become the ‘technical owner’ of a health care’s medical systems, providing the long-term planning for capital budgets, expense budgets, recall/alerts, incidents, recommending if more or less systems are needed, and closely partnering with the clinical service or business owners. We must be in sync. Then, add IT and facilities overlap, HTM needs to be elastic with the ability to adapt to change, and not be left behind. Change is inevitable and HTM needs to keep preparing for it,” Herr adds. Will there be a fusion of HTM and IT that coalesces the departments together? It is possible according to Matthew Kenney, CHTM, director of HTM/ biomed at Aiken Regional Medical Centers in Aiken, South Carolina. “Every year, it seems we get further and further into the IT world. I think, in the future, HTM will be even more intertwined with IT to the point that a basic requirement will be to have networking experience,” Kenney says. “It is possible to see HTM and IT become one and share one office space and work even closer; side by side. With just about all new equipment going into EMRs in this day and age, I see a lot more service calls for equipment not communicating. With IT by your side, the troubleshooting would be more flawless which would help in keeping the equipment online and allow nursing to focus more on patient care,” Kenney adds. Part of the evolution of HTM may be closer collaboration with clinicians. “I feel that in order for HTM to continue our contribution in patient care, we need to be on the front lines with the clinicians. Transitioning from a break/fix support model to a real-time collaboration model at the bedside. I am sure everyone in the profession has repaired their fair share of ‘broken’ equipment, we need to fix the ‘broken,’” says Neil Feldmeier, MBA, CHTM, director of biomedical engineering for Norton Healthcare in Louisville, Kentucky.

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“ Every year, it seems we get further and further into the IT world. I think, in the future, HTM will be even more intertwined with IT to the point that a basic requirement will be to have networking experience.” – Matthew Kenney MAINTAINING AN ADEQUATE WORKFORCE One of the biggest concerns in HTM is the question of adequate staffing. A generation of biomed professionals have retired in recent years and training new biomeds to replace them presents a challenge. With fewer training programs nationwide, and the obscure nature of the profession, the number of trained applicants to replenish a departing and knowledgeable workforce is difficult at best. According to AAMI, 60 percent of those in HTM are over age 52. This portends a mass exodus from the field in the next decade. With only 400 new candidates graduating from HTM training programs nationwide each year, the effort to replenish retiring biomeds will be challenging. One answer to the shrinking HTM pool of candidates is AAMI’s “HTM in a Box,” which is an initiative to bring the career field to those in middle school, high school or college and adults. The online resource brings the profession of HTM to an audience of likely candidates. The online resource can be used when presenting to any of these groups and provides an oversight of the profession. The adult presentation can be tailored to the group that is the audience for the presentation. The AAMI “HTM in a Box” presentation slide deck can be found at: https://www.aami.org/htminabox. The AAMI effort is one reason Matt Baretich, PE Ph.D., president of Baretich Engineering Inc. in Fort Collins, Colorado, is optimistic. “I’m a baby boomer myself and, although I’m not planning to retire any time soon, there is a genuine need to

bring more professionals into the HTM profession. But there are hopeful signs. AAMI is doing great work with its #IamHTM and “HTM in a Box” initiatives. It’s no longer remarkable to see women at every level in HTM. Creative alternatives to traditional education are getting off the ground,” Baretich says. Even before the departure of many of the senior technicians and managers, there exists tighter resources as departments try to make due with constrained budgets. Busdicker suggests that concerns about a thin candidate pool might be replaced with a focus on tweaking available resources. “The first thing a department needs to do is work smarter and not harder,” Busdicker says. “We need to think outside the box and look at the overall operation of the department. Ask questions like: Are we doing things we shouldn’t be doing? Can we eliminate waste or inefficiencies that will allow staff more productive time?” “Sometimes we go straight to the need for more staff when the issue could be resolved through creative thinking or refining work flows and processes,” he says. He also suggests being proactive and not reactive when staffing a department. “Understand your staff and talk with them about the future of the department and the organization. Every HTM leader should have a succession plan for their department(s) along with understanding the future of the HTM industry. Success planning can fill the voids created by staff moving on to other opportunities or retiring after a successful HTM career,” Busdicker adds.

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Feldmeier says that his department has established connections with local colleges to provide shadowing and co-op opportunities. “This is building serious excitement with the students that we have worked with so far. This should help increase word-of-mouth about the profession,” he says. Royal says that with the exception of two in his department, most of the baby boomers have retired. “When a retirement was expected, we removed routine work for those employees such as PMs and some repairs and had them focus on knowledge transfer and training a back-up or replacement,” he says. “Management has also advocated for a robust training budget, not only to close the skills gap, but to help with employee satisfaction and retention. The team has also had formal IT training classes presented on-site to promote IT certification. Job descriptions were also added to allow for an IT designation which the HR department allowed for an increase in pay as incentive. We also have created positions that are meant for succession planning such as a biomedical/imaging hybrid to back fill vacant radiology repair technician roles,” Royal adds. Royal says that the HR department also has offered customer service classes that focus on difficult conversations and leadership classes that have developed leadership skills in higher level techs. “We have also utilized interns and volunteers. We have agreements with a local university, high school and a program through the hospital foundation. Our goals with interns and volunteers is to have them job ready at the end of their program as they would be a potential hire for open positions,” he says. REGULATORY CHANGES Many changes throughout culture come from government. New regulations and rules are passed into law to enforce safety standards or standardize procedures.

“The techniques we have developed for AEM programs will become standard practice for all planned maintenance (PM). We can save time and improve equipment safety while staying in compliance with regulatory and accreditation requirements,” Baretich says. “Following the 2012 edition of NFPA 99 Healthcare Facilities Code, adopted by CMS and accrediting organizations like The Joint Commission, we’re finally starting to see the end of routine electrical safety testing,” Baretich adds. ADDRESSING THE THREAT Cybersecurity was once the province of specialized departments in the Pentagon, major intelligence organizations and home and business anti-malware software. As criminals have become more sophisticated, health care organizations have become a more frequent target. This has required the involvement of HTM with the growing number of connected devices and those storing patient information. This reality has positioned HTM, alongside IT, in the trenches to secure their facilities.

continued education and ongoing monitoring of medical equipment cybersecurity for all caregivers in the health care facility. “Also, the department will need to ensure all data and information related to medical equipment cybersecurity is up to date in the asset record and be able to quickly identify devices when threats are published,” Busdicker adds. The future of HTM and its cybersecurity focus can include a vigilant approach along with more hybrid specialists. “I think HTM is another advocate for the information security officer and program. HTM frontline staff might spot a vulnerability or poor security practice. HTM can also offer mitigation solutions such as encrypted USBs or outdated operating system. Some devices may need to be removed from the network or disabled such as USB ports or network ports,” Royal says. Herr says that cybersecurity is still an evolving area and his department has developed a specialist to work alongside their IT counterparts. “Our department has been able to develop an HTM cybersecurity specialist to work with IT’s cybersecurity

“ I feel that in order for HTM to continue our contribution in patient care, we need to be on the front lines with the clinicians. Transitioning from a break/fix support model to a real-time collaboration model at the bedside. – Neil Feldmeier “In order to reduce the cybersecurity risk and threat to health care organizations and patients, the HTM department must be involved at all levels. This will require an understanding of existing vulnerabilities, implementation of security controls, ongoing monitoring of risk, and knowledge of threats by all staff,” Busdicker says. He says that the HTM department will need to be involved with the

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team. This position helps keep HTM aligned and knowledgeable about what the enterprise cybersecurity effort is planning/implementing. Several of us, including the HTM specialist, sit on various committees run by Compliance and IT Security to address the medical systems,” Herr says. Herr says that HTM’s role is also to educate those who may not be familiar with current medical device security

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limitations (e.g. patching, virus protection, etc.) and help them understand what can and cannot be done using their tools. “Also, we work with the vendors/ OEMs to make our requirements known as new systems are purchased. Everyone in HTM will need to become better educated in the cybersecurity and IT processes, IT will become the new electrical safety, and until OEMs have developed standardized processes for medical systems, then HTM needs be on the frontline to protect the patients/ customers,” he says. “HTM needs to ensure we have all of the operating systems, firmware, IP addresses and MAC address documented in their CMMS to be able to track where they may be vulnerable when alerted to a possible attack. This will lead to a quicker response and hopefully safeguard against any and all possible attacks,” says Kenney.

HTM should not be afraid to take on systems that are both clinical and medical devices, or those that are essential to the medical device’s capabilities,” Herr says. He says that each HTM department works in a unique environment, and the opportunities vary. “Chose those opportunities that HTM can provide clear benefits. For example, support is a challenge for IT to deliver on medical systems because IT may try to fit medical device support in the same bucket as its EMR. Medical devices often require onsite support at the bedside, operating room or other patient care delivery area. IT support models are geared for enterprise support, not necessarily an individual user standing at the bedside performing a procedure,” Herr adds. Busdicker says that, in his opinion, the advancement of technology will continue to move at a rapid pace and will require more involvement from HTM. “This will include the use of medical equipment in the home, wearable devices and more outpatient treatment settings. This equipment will require HTM to become more mobile – Neil Feldmeier and adapt to work outside of the acute care setting,” he says. TAKING ON MORE RESPONSIBILITY “Over the years, I have seen things Biomeds already serve a purpose in like nurse call systems move from sole health care that is critical and is directly responsibility of plant engineering to a instrumental in patient health and combined effort of information systems, well-being. But, in the future, the role of HTM and plant engineering. Each the biomed will expand, in part, department plays a role in the service because of technology, security and and maintenance of the system. This resources. trend will continue and involve even “HTM must continue its transition more departments like pharmacy, from stand-alone medical systems to laboratory, materials management, networked systems. Many of these telemedicine and home health,” systems are in a grey area. Are they Busdicker adds. under IT, HTM or even Facilities? Biomeds will continue to have an

“HTM needs to be involved more and more with the equipment life cycle process. This includes having access to capital funds to efficiently apply medical equipment technology.

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increasing role in every consideration throughout the device life cycle. “HTM needs to be involved more and more with the equipment life cycle process. This includes having access to capital funds to efficiently apply medical equipment technology. Cybersecurity assessment will also increase. We need to ensure that proper software patching is applied and equipment that is selected for use in the facility has been vetted for potential risks,” Feldmeier says. “We are also trying to find new ways to provide HTM services. We have a very repetitive profession, every year we have to climb the same mountain. How can we add a few more destinations in our yearly journey that actually re-energizes the team? The utilization of a solid AEM program should provide some breathing room and introduce some changes that allow for a change of scenery,” Feldmeier says. In what areas might HTM work more closely with other departments? “One of the major areas of collaboration is design and construction. HTM needs to ensure that utility specifications on replacement equipment and renovations meet higher standards for power quality and water quality if applicable,” Royal says. “Another area that HTM can work closely with is the infection prevention and environmental services team (EVS). EVS often covers more ground than the HTM department and help with locating or reporting equipment issues such as bed cables or damaged devices. Offering education from HTM to EVS is also impactful for infection control to ensure equipment is cleaned appropriately,” Royal adds. Orwell may have predicted “big brother” in his fictional tale, but he may not have foreseen the complexity of medicine, medical devices and the health care environment in the future. That is left to HTM leadership, who must look at trends and educated guesses to ensure the role of the HTM professional is fully utilized.

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Prompt Communication and Accessibility is Key BY JENIFER BROWN

find myself compelled to write about prompt communication because I am amazed that with today’s technology that this is even an issue. In my experience I have had difficulty connecting with, on average, one out of every five candidates. I am referring to candidates whom have responded to a job posting or sent me their resume. Oftentimes it is difficult to reach candidates because their voicemail box is full or has not been set up. This makes it impossible to leave a message. Then, there are the ones who take a week or longer to respond after someone leaves several voicemail messages. However, the worst-case scenario is when the cellphone number listed on the resume is no longer working.

So, I have to ask myself: Why do these candidates even respond to the career opportunity in the first place? If a talent acquisition/recruitment professional gets frustrated with this then you can only imagine what a potential employer may think or feel. In most cases, we will move on to the next candidate. So, those guilty of the above lose out on being considered for an opportunity altogether! In closing, please make sure that you

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have the current and correct phone number listed on your resume. Second, make sure your voicemail is set up – preferably with your name and a greeting. Third, if your voicemail box tends to fill up quickly or frequently (I can’t be the only one pointing this out) then you need to check and empty it on a regular basis. Another means of communication is email. Some potential employers like to engage with candidates first via email to schedule a phone or in-person interview. Candidates need to ensure that the email address listed on their resume is correct and the one they use the most. This should be the email address that is synced to your smartphone so that it is viewed on a regular basis. Finally, candidates need to be certain that their work experience and place of employment is always updated with current and correct information. Your resume and social media profiles, such as LinkedIn, are continually being reviewed by recruiters and employers. If not updated and/or correct, a candidate may be passed over because potential employers think a candidate does not have enough experience or the right skill set. Also, wherever a resume is posted it should reflect the same information posted on social media accounts

Jenifer Brown Health Tech Talent Management LLC because both are viewed for accuracy. Even if a candidate is not out currently seeking new opportunities, the information should still be current for networking purposes or for a potential internal promotion. Though all of these points may seem too simple or logical, they can be detrimental in one having or not having the career options that they were open to. JENIFER BROWN is president/owner at Health Tech Talent Management LLC. She has 20 years of experience in the healthcare technology management field.

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MAINTENANCE AND SERVICING: THE GE DASH MONITOR SERIES BY MAI SUMLUT AND MELISSA TAYLOR

WHAT MAKES THE GE DASH SERIES MONITORS STAND OUT? The GE Dash series of monitors are lightweight, ergonomic, and durable, and can be used wherever a reliable patient monitor is needed. The Dash seriesâ&#x20AC;&#x2122; smart battery management system incorporates up to two batteries per unit, each with a run time of 4-5 hours, and have a recharge time of 2-4 hours either internally or on a charger. The batteries can be changed one at a time without loss of function, which helps the operator maintain monitoring continuity. Network options for the Dash series include wireless and wired connectivity up to 7 waveforms and up to 4 invasive pressures, and are designed for integration into commonly utilized existing wireless networks, helping you leverage your investment in your current IT infrastructure. WHAT TYPES OF PARAMETERS DOES THE DASH SERIES MONITOR OBSERVE? Leading the industry in rejecting artifact from pacemakers, the GE Dash series has the best selection of algorithms to reduce false arrhythmia alarms. GE Healthcareâ&#x20AC;&#x2122;s exclusive blood pressure algorithms (DINAMAP classic and SuperSTAT) improve speed, comfort and artifact rejection while retaining superior accuracy. The SuperSTAT algorithm, available with the Masimo SpO2 option, assesses motion artifact to effectively distinguish signal noise. The option for IBP is also available for every Dash monitor, as well as a paper recorder and a handle with built in alarm light. WHAT ARE THE MOST COMMON ISSUES THESE UNITS EXPERIENCE, AND HOW CAN THESE ISSUES BE RESOLVED? From what we have observed so far,

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Mai Sumlut Technician Supervisor, Avante Health Solutions

Melissa Taylor Technical Scribe, Avante Health Solutions

mismatching software tends to be what causes the most issues with the GE Dash series. To be more specific, the software issues we see with these monitors involve either the device constantly rebooting, or the sound on the machine not working properly. Both of these issues are caused by the device not being up to date on the latest software. By updating the software on the monitor to the latest version, the issues with rebooting and/or sound will be resolved. The software must be only one digit different from the most current software version, otherwise the monitor will not work properly.

the physical device, and is not found on the software.

WHEN RECEIVING THESE UNITS IN FOR SERVICE, WHAT ARE THE FIRST STEPS YOU TAKE TO EVALUATE THE UNITS? First the technician must check the serial number and model number of the device. Each GE device has a unique serial number for identification, and each part of that serial number helps the technician identify exactly what type of device they are looking at and what characteristics that particular device has. The serial number is only found on

From the serial number, we are able to determine how the device will be serviced, based on the characteristics that the monitor has. For the most part, the components on the different models are the same. The only real physical differences of the devices are size, front bezel, and rear case.

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Next, we determine the options available on that particular device. For example, the devices have three separate SPO2 options they can be equipped with: Nellcor Oximax, Masimo SET motion tolerant, and Ohmeda Trusignal. Once the technician identifies what kind of SPO2 the monitor has installed they are able to evaluate and service the SPO2 option accordingly. The technician is also able to disable or enable other options for the device while the device is in service mode. In order to unlock all options for monitors, the technician can call GE and give them the serial number and MAC address of the device, and they will give you a code to unlock more options. To put the unit in service mode, select the service mode option on the main menu of the unit. Then input the passcode, which is simply the current day and month. GE excels at making their devices user friendly for technicians, and we have fun working on these devices! TO ENSURE THESE UNITS ARE WORKING THEIR BEST FOR A LONG TIME, WHAT DEVICE MAINTENANCE DO YOU SUGGEST TO THE BIOMED? Regular preventative maintenance, at least annually, is essential to ensure that the device is functional when it is required. Always check the software, and make sure to recalibrate the NIBP. MAI SUMLUT is a technician supervisor for Avante Health Solutions. MELISSA TAYLOR is a technical scribe for Avante Health Solutions.

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CYBERSECURITY Disaster Recovery BY JOSEPH E. FISHEL, CBET, MBA

t seems that the biomed field has been hit with more disasters in the past 10 years than in the previous 30 years. Many of these have been natural disasters such a hurricanes, tornadoes, snowmageddons, flooding, landslides, tsunamis, earthquakes and wildfires. Each is easily capable of taking out utilities and entire hospitals. Then, there are the manmade disasters.

Many of these disasters can impact your cyber network. Are you ready should your facility be hit with one? A master disaster recovery plan is actually a whole lot of individual plans that together create a comprehensive playbook. These individual plans can be in various areas, including servers, wired networks, wireless networks, applications and equipment. What should be included in a disaster recovery plan? Contact your IS/ IT departments to see what format they are using. You may want to integrate into their plan. An Internet search provides many different formats, but the content of the plan should include the following: • Application/device including manufacturer, function, description of what the application does and tier level • Last drill date/next drill date • Minimum return to operations hours • Minimum hours recovery point objective hours • Accountable manager(s) and contact information • Responsible manager(s) and contact information

• Subject matter experts and contact information • Individual and department business stakeholder(s) • Does this support acute care? • Is PHI transmitted? These are just the headings for the disaster plan. The service (disaster) recovery plan should describe who does what and what is done to put the device, app or service back into operation. This can be broken up into different sections. The service description describes what it is and its function. Included in this are notes regarding communications and updates to who and by whom. This should include IS/IT, clinical customers and clinical engineering/ biomed. Routing and support is broken up into the various groups that may support the recovery process. These can include service desk escalation, vendor support and biomed support. Which servers are part of the support? DNS, DHCP, network servers and application servers are just a few. What upstream or downstream dependencies can affect the service? Recovery design diagrams can be helpful to map out and provide a visual of the entire system – both upstream and downstream and it’s interconnected abilities. Finally, what are the procedure steps for recovery using backup? What are the options? Defining this up front can prevent a disaster from becoming a catastrophe. This gives the opportunity to pass down to others what was done before when this sort of thing happened and how you were able to work around it. This is extremely important when

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Joseph E. Fishel, CBET, MBA Healthcare Technology Systems Manager for Sutter Health eQuip Services running a 24/7 operation. In some cases, the recovery may require a rebuild or reloading of software. Identify where that software or a backup hard drive can be found. Also, if you can, identify where the latest version can be found. Finally, what is your testing protocol to identify that everything is back up and working? List this out in detail. You aren’t always going to be the one doing this. It might be someone else and what is normal for you may not be common knowledge to someone else. Plans should be reviewed on an annual basis. This can be done on a routine basis. Review a few plans every month. One of the best ways is in conjunction with a disaster drill. It can be as simple as a water pipe breaking at a server center and flooding the area. How would the device ready for review be affected and if affected how does your plan cover the recovery? If it doesn’t, then the plan needs to be expanded. These are just some of the topics to include in a recovery plans. As every institution is different, every plan will be different. JOSEPH E. FISHEL CBET, MBA is the Healthcare Technology Systems Manager for Sutter Health eQuip Services.

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WANT TO EASE THE BURDEN ON BIOMED TECHS? START BY EXAMINING YOUR MME UTILIZATION BY TIM MOSS

iomed engineers are caught in the middle of two interesting and accelerating trends in the U.S. health care market.

On one hand, emerging technologies like bioprinting, artificial intelligence, machine learning and wearables are creating new challenges for biomed teams. Clinical engineering departments are being pulled into strategic planning discussions about which technologies to acquire – and when and how to deploy them. Whether or not they’re included in strategic decision-making, biomed teams must handle the challenges and considerations of those new technologies – ranging from Internet of Things (IoT) connectivity and network security to basic service and support strategies for entirely new classes of hardware and software. At the same time, biomed teams face greater demand than ever to provide service and support for more traditional (but no less critical) medical equipment – including devices used for respiratory and infusion therapy, patient monitoring, maternal and infant care, safe patient handling and patient mobility. Hospitals need to evolve and take full advantage of new technologies, but they also need to provide patient care right now – and biomed teams are pulled between these two demands. The urgency of caring for patients in the hospital right this minute often prevents biomed teams and individual engineers from having sufficient time to understand and evaluate emerging technologies. One hidden metric is making this time crunch far worse than it needs to be: medical equipment utilization. Multiple studies show that utilization rates for ventilators, infusion pumps,

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APRIL 2020

specialty beds and other traditional equipment is less than 40%. The result? On the front end, hospitals are overspending on equipment rentals or purchases. On the back end, biomed teams are spending time maintaining and repairing more equipment than is needed – or they’re being stressed by service backlogs. Hospitals are beginning to explore new ways of solving this equipment utilization dilemma. But before we explore those new approaches, let’s examine what’s contributing to this troubling underutilization issue: • Equipment lost within the facility: The typical hospital has a surprisingly large amount of medical equipment hiding in closets or corners where it was mistakenly left. Sometimes equipment even walks out the front door with a patient. • Backlogs in clinical engineering: CE teams are managing a growing volume of increasingly sophisticated medical equipment – a 62% increase in devices per bed over the past 20 years – that have more stringent compliance requirements. Yet, there hasn’t been a parallel rise in headcount for in-house teams. • Equipment not patient-ready: Often, idle equipment isn’t broken, it’s just not being properly cleaned, serviced or managed in between patients. In fact, almost half of moveable medical equipment (MME) that is flagged as non-functional is due to user error. • Lack of centralized process: Equipment management spans multiple departments. The lack of a centralized process ensuring clean, patient-ready equipment is accessible leads to a cycle of waste that drives perceived shortages and unnecessary requests for more rental equipment. Biomed teams are preparing for unprecedented waves of new technology, while they’re still awash in service requests for highly underutilized equip-

Tim Moss Agiliti

ment fleets. Adding to the stress is an increasing scarcity of qualified workers. A growing number of U.S. hospitals are turning toward on-demand clinical engineering services to work through backlogs and handle the more mundane tasks of maintaining and servicing MME. Finding a regional clinical engineering service provider who can respond same-day to manage those tasks frees biomed teams to focus on more strategic work – like the evaluation, deployment and support of emerging technologies. This mix of onsite MME management and highly flexible clinical engineering resources gives biomed departments and supply chain teams the insights — and the breathing room — they need to fully understand the realities of MME utilization. Once a hospital has a strong grasp of utilization and equipment management workflows, better strategic decisions can be made upstream, which leads to significant cost savings, reduced MME repair backlogs and, perhaps most important, more manageable workloads for in-house biomed teams. TIM MOSS is the director of resident based programs for Agiliti.

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THE FUTURE An Up-and-Coming Star BY ROGER A. BOWLES, MS, EDD, CBET

ne of the biggest benefits to writing this column is the opportunity to award a $500 scholarship to one of our students each year. Selecting the winner of the scholarship is usually a hard job because we have many deserving students and selecting only one always proves to be a challenge. But this year, it was easy. Sometimes someone is just such a standout that he or she leaves a lasting impression on everyone. The second benefit of writing this column is getting a chance to write about this person and hopefully impress the readers of these articles and future employers.

Let me be the first to introduce Mr. Rudolph “Rudy” Wagner, a third semester biomedical equipment technology and medical imaging systems student at Texas State Technical College Waco. I’ve had Rudy in two classes so

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far and his demeanor and people skills immediately impressed me. He stood out in an already talented field. Wagner is one of those people who always has a smile on his face and has something nice to say. He always asks about the person he is talking to and truly listens to their response. No, he is not an “Eddie Haskell.” For you younger readers, this might give you something to Google. Wagner is the real deal. A little background on Wagner. He is no stranger to working in the medical field. In fact, he spent 19 years as a medical billing and coding specialist and four years traveling as a medical missionary with his family. In the mission field, Wagner also served as a lifestyle counselor in Los Angeles. He has also served as a volunteer for Pathways to Health, a nonprofit organization that offers free health clinics, triage, surgical procedures and many other free services in large urban

Roger A. Bowles MS, EdD, CBET areas. His travels have taken him to the island of Rota of the Mariana Islands and many, many states. He has been married for 17 years and has three children. A large part of Wagner’s life has been about service. Upon returning to the United States after his last mission, he heard about the biomedical equipment technology field and came down to Texas State Technical College to do a tour. Excited about what he saw and heard; he knew immediately this was a chance to continue to serve others in the medical field. I asked Wagner why he thought he

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would be a good fit in our field. He says that because he has spent many years in other aspects of health care, this has given him a greater understanding of how to give the best customer service to those who need it. Indeed, one of the first things I noticed about Wagner were his people skills. He credits his politeness and people skills to his upbringing, his belief in Christ and his genuine love for people. His plans for the future? He hopes to find an employer who trusts employees to get the job done well and efficiently and one that takes good care of employees while they take care of customers. He hopes to become the best technician possible, becoming certified and rising up the ranks, perhaps to even a management position in the future. He also hopes to serve on medical mission trips in a biomedical technician capacity. I have no doubt that he will succeed in whatever capacity he serves. Wagner hopes to complete the biomedical equipment technology program and earn an associate of applied science degree in medical imaging systems. He should be completing his studies in December 2020. I would encourage future employers to keep an eye out for him (he is on LinkedIn). He is a rockstar in the making.

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3 Strategies for Addressing MRI Failures

Ted Lucidi, CBET Innovatus Imaging

BY TED LUCIDI, CBET

o you know what’s NOT covered under warranty and contract on your MRI? More importantly, do you know how you’ll address it?

Warranties and service contracts provide us with a sense of security that sometimes can be misleading. It’s easy to think that because we have a warranty or contract in place, our MRIs are covered no matter what happens, and we’ll be back up and running in short order. However, what many of us might not know is that warranties and contracts are very different from insurance. You’re only protected under certain circumstances and you’re not covered under others. Like with your car, warranties cover manufacturing defects or failures, not user error or slip ups. Scenarios involving user error or human slip ups occur every day in health care facilities. For instance, while prepping for an MRI, a technologist drops a large body coil. While performing a scan, the patient loses bladder control. The magnet is quenched

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APRIL 2020

because a ferrous object is pulled into the field. While lowering the patient table, an MRI coil’s cable becomes trapped and is partially severed. Whether a new MRI, covered under warranty, or an older model, covered under OEM contract, addressing the failures described above are, most times, the responsibility of the facility. It’s not new. Failures considered preventable, avoidable or attributed to trauma and/or mis-use are often not covered by an OEM service contract. In the chance that a single, preventable, event IS covered, it most likely won’t be a second time. Understanding how and why out-of-pocket expenses occur and developing contingency plans for when preventable failures occur can have a huge impact on service budgets. For example, MRI coils. With a core team that once manufactured MRI coils, and a major repair provider for all makes and models for more than 25 years, Innovatus Imaging has amassed a large amount of failure analysis data. Data shows that most MRI coil failures are a direct result of

or related to mechanical damage or trauma. Over 35% of all coils present with mechanical damage due to trauma and an additional 18% are RELATED to trauma and/or improper use. Typically, when a coil fails, the OEM sends a replacement next day. It may take days or weeks before an invoice is received highlighting preventable damage and the out-of-pocket expense. You may be surprised to learn that some OEMs install shock sensors within their coils to determine if the coil has been dropped or exposed to an unusual amount of force. So, even though there are no outward signs or trauma or mechanical damage, coverage may be denied. The tough reality we have to face with most contracts we buy is that 50% of your coil failures may not be covered. Having to absorb an out-of-pocket expense of $35,000 to $100,000+ for a single coil failure can ruin any budget. At one point or another, we’ve all been asked, “Did you read the fine print?” Analyze your options when considering a service contract on your MRI.

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EXPERT ADVICE

COME GROW WITH US 1. Insure that, if you have a service contract, that ANY and ALL failures are covered in the final cost. Costs will be high, but this option can ensure maximum uptime and continued workflow while eliminating out-of-pocket expenses. 2. If a standard OEM service contract is in place, use an ISO 13485:2016 certified repair provider, such as Innovatus Imaging, to address any coil that shows evidence of preventable or avoidable damage. And, if there is ANY mechanical damage, do not assume that a replacement coil, through the OEM, will be covered. Address the failure via repair or non-OEM replacement using a qualified provider. 3. If magnets are not supported in-house, service contracts are a must to insure uptime and continued workflow. Knowing that over 50% of coil failures may not be covered provides some powerful information. Consider removing MRI coils from the service contract altogether. It is possible and there is a huge cost savings to be realized. Coil repairs start as low as $500 and some repair providers offer loaners and/or expedited repairs. The bottom line for any facility, large or small, is simple: When selecting a repair provider, be sure that repairs are performed with longevity in mind. Ask about their length of time in the industry and quantity of repairs performed. Both matter. For example, the team at Innovatus Imaging is applying experience from over 25 years and 30,000 plus repairs to define best-in-class coil repair processes and even help predict potential future failures. Ultimately, providers should demonstrate a dedication to quality by having ISO 13485:2016 certifications specific to the medical device(s) they support. FOR MORE INFORMATION on how Innovatus Imaging can help to reduce your service budget with quality, sustainable repairs for MRI coils and US probes, please contact TedL@innovatusimaging.com.

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APRIL 2020

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EXPERT ADVICE

VIEW ON VALUE

Partnership. Big P or Little p? Size Does Matter. BY PATRICK FLAHERTY AND JOE HADUCH

t’s as overused as any word in health care. It’s become so overused that those who strive to achieve and define it, primarily suppliers, often preface the use of it by saying something along the lines of “I know it’s cliché but I really think our company would be the perfect partner for your organization.” Those of us involved in the purchase or evaluation of medical equipment have all heard it. It’s not the word itself that has become trite or “cliché,” but rather the lopsided meaning of the word. A partnership evokes the very best of relationships, much like the Beatles or Simon & Garfunkel during the mid-sixties, not the ugly break-ups and accusations of inequality or disproportionate contribution which quickly followed.

Simon & Garfunkel are a good example for us to use as a segue into our health care problem with the concept of partnership. Very few people would find anything negative to say about the quality of the music produced by Simon & Garfunkel in their prime … inventive melodies and rhythms, poetic lyrics, and finely wrought harmonies with Mr. Garfunkel’s high range prominently on display; problem is Mr. Garfunkel wrote nothing and primarily executed the vision of another while being paid like a partner. When Mr. Simon balked at this and strove for a more proportional representation of contribution, the “partnership” crumbled. The problem was the division of benefits was not perceived to be correctly divided amongst the parties and certainly not connected to the variable contributions of the parties. Health care is in this situation … manufacturers perceive the partnership to be like Simon & Garfunkel post the release of “Bridge over Troubled Water.”

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APRIL 2020

Where is your supplier on the pyramid? Where should they be? The manufacturers are Paul Simon in this scenario, taking the vast majority of the financial rewards, and providers are Art Garfunkel, possessors of a killer falsetto and a diminished bank account. In health care, the definition of a “partner” has various meanings to various people. To some it’s as simple as “you give me money, I give you product hence, we are partners.” To others, it’s a supposed strategic relationship defined by volumes of contracts and a myriad of addendums, but nothing relative to better outcomes, more efficient workflows or improved financial impact. However a true partnership, not unlike a successful marriage or long-term friendship, is based on equality, reciprocal support and, most importantly, a willingness to subrogate one’s needs when the other’s requirements are more critical. Is this the type of “partnership” your organization has with any of your suppliers or does it more closely resemble the two former examples? Suppliers have continuously promoted partnerships that do not come close to

what most of us expect or would define as a true partnership. It is easier to objectively evaluate the presence or absence of partnerships as health care converts to a profit-and-loss business by examining the sustainable operating margins of the involved parties; while there is clearly a compelling inequivalence between providers and their suppliers in this dimension, it does not prevent suppliers from using the “p” word with alarming frequency. To be clear, providers who have paid 100% of the expanded access and risk of the ACA, who have seen billions of their revenue placed at risk related to quality, and who increasingly subsidize the costs of care for those who cannot pay for it, balk at the cavalier and twisted way in which suppliers, who have done nothing to cover ACA and who continue to blithely operate without transparency or warranty, use the term “partner.” Examples of this perverted interpretation of partner are found in “volume discounts” or “discounted upgrades.” A partnership, in its truest sense, isn’t

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PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT LOGO PHONE NUMBER WEBSITE ADDRESS

SPELLING

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EXPERT ADVICE TRIM 3.25”

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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based on the degree of profit for one entity but rather the ability of the other entity to reasonably meet its primary business goals in a sustainable manner. It is symbiotic, it is collaborative, it is equal in its opportunity for success and for failure. It is not one organization reducing its profit from 45% to 40% while my “partner” struggles to squeeze out a profit above two percent. So, what role does HTM play in re-aligning the partner paradigm? You may feel that your supply chain group or purchasing team owns the supplier relationship. In most instances this is true, however, progressive HTM departments can help define a true partnership by identifying opportunities of shared benefit. Parts pricing based on the OEM production cost of the part, not an arbitrary list price, dictated by suppliers is a good place to start. Defined margins instead of defined discounts will prove a supplier’s true commitment to partnership. Their ability to drive a reasonable and consistent margin while enhancing their customers’ bottom line is in the long-term interest of everyone. In addition, HTM teams will need to work with clinicians to identify opportunities for value based on OEM equipment functional claims. We can no longer survive in a business model where manufacturers of clinical medical equipment and devices, most if not all of which have yet to complete their first double blind trial to establish objective benefits, drive exponentially more operating margin than providers. Suppliers need to share in the benefit when their products drive efficiency, increase margins and improve outcomes. Conversely, they need to share the pain when these products fail to deliver as promised. This is not the model we currently have. This is not a partnership. Products need to become long-term annuities for suppliers, not a single transactional profit. Suppliers can no longer just drop off a product on your loading dock, and walk away without any interest in product use, implementation, security, value or PUBLICATION outcome. Sustainable profit needs to be derived over the life of the MEDICAL DEALER product as it delivers increased value and higher quality. A “system upgrade” now goes from being an expense to a revenue generator BUYERS GUIDE based on an increase in product value. Now suppliers and MONTH providers both benefit from this enhancement over the life of the equipment opposed to a supplier collecting a one-time profit without any interest in the derived outcome. J F M A M Though some of you may believe the possibility of creating a JL a true partnership with your primary suppliers isDESIGNER: akin to finding leprechaun galloping on a unicorn, the ability of health care to continue to support the current model of capital acquisition is equally laughable. Suppliers and providers need to develop true partnership opportunities based on delivered value not utopian ideals. HTM will need to be at the table helping to identify those opportunities, develop performance-based service models and bring the true definition of Partner, with a capital “P,” back to health care.

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EXPERT ADVICE

SPONSORED CONTENT

AEM SCHEDULES CAN REDUCE MAINTENANCE COSTS I f you could reduce the number of maintenance checks and assessments required for your clinical devices then you would obviously save time, effort and the associated technician labor. Alternative Equipment Maintenance (AEM) schedules can make this possible and can drive considerable cost savings for Healthcare Technology Management (HTM) teams. But how do you make AEM scheduling a reality and get your modified maintenance schedules approved by The Joint Commission? Therein lies the rub. You need a smart, modernized CMMS solution to help you validate and manage the entire process, and to pass a TJC audit.

Following is an overview of the January 2020 medical equipment-related Joint Commission Elements of Performance (EP) and what your CMMS must be able to document and report in order to be compliant for your AEM schedules. It is also important that your policies and procedures are well documented and aligned. #1 - EC.02.04.01 EP 4 – The hospital identifies the activities and associated frequencies, in writing, for maintaining, inspecting and testing all medical equipment in the inventory. These activities and associated frequencies are in accordance with manufacturers’ recommendations or with strategies of an alternative equipment maintenance program. On the surface it might sound simple enough, however, when you dig into the details it requires a lot from your CMMS to document compliance and validate the AEM eligibility of specific clinical assets. The most basic requirement is that your CMMS must have a way to identify every device that is on an AEM schedule and

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APRIL 2020

run an AEM inventory report if requested by The Joint Commission. A modernized CMMS should also manage the following: • Identify if the device type or model has been approved to be on an AEM. • Assign the appropriate PM frequency and activities to the asset. • Differentiate those devices that have their AEM eligibility set at the device-type level from those that are set at the model level and, as required in Per EC.02.04.01 EP 5, you need your CMMS to ensure the following types of equipment are not put on an AEM: lasers, imaging and radiologic devices and new equipment with insufficient maintenance history to support the use of an AEM. While it is not completely spelled out, this first EP also requires that the strategies of an AEM program must not reduce the safety of equipment and must be based on accepted standards of practice. The implication here is that you need a baseline of the equipment’s safety performance before you put it on an AEM and then the ability to measure changes in the equipment’s performance (KPI metrics) after it’s on an AEM. Finally, EP 4 also dictates that all medical equipment must have 100% completion rate of the maintenance activities and frequencies of the written AEM schedules. Your CMMS should have the ability to

generate different PM work orders, as well as track compliance, in order to validate their AEM authorization. When this EP was first introduced, there was a huge outcry from the HTM community, because it is nearly impossible to have 100% PM completion due to devices that aren’t available for their PM. So the Joint Commission has allowed PM Grace Periods and two other exceptions to this rule: if the device cannot be located or is in use for its scheduled PM, and reasonable attempts have been made to find or gain access to the device, it will not count against the hospital. These exceptions introduce the concept of PM Compliance (not to be confused with PM Completion). Whereas your PM Completion % is the percent of PMs that actually were completed compared to the number of PMs that were due, PM Compliance removes the devices that could not be found or were in use from the denominator, so that they don’t count against your compliance rate and 100% compliance is achievable. There are many more Joint Commission elements of performance that apply to medical equipment. The more your CMMS can simplify the data entry process for your technicians, and even automate it, the more accurate your data will be. As reported by one of our customers, Blake Collins (Clinical Engineering Director, Christiana Care, BioMed Engineering Management), “Nuvolo helps us successfully analyze and manage our AEM scheduling for clinical devices. Their solution enabled our planned ‘Digital Transformation’…” FOR MORE INFORMATION about the AEM management capabilities in Nuvolo, please reference our web page for clinical asset management: https://www.nuvolo.com/solutions/clinical.

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EXPERT ADVICE

THE OTHER SIDE Biomed to the Rescue BY JIM FEDELE, CBET

ecently, we experienced a software problem with a rather minor but important device. The software error takes the unit completely out of service. We have many of these devices and every one of them encountered the problem. Once the company figured out how to solve the problem, they needed the local biomed team to step in and do the work. My issue with this situation is this company has not been a biomed friendly company and has often locked us out of equipment to ensure we call them. Then they request a purchase order to move forward with the repair. I wondered if others had issue with this situation and the way it was resolved.

Our problem started on January 1 of this year, all our Holter recording devices were displaying an error 602 code (you can search ECRI’s alert database for details) which rendered them unusable. Nothing we tried would reset the code. All 30 of our units had the error and could not be used. The users and my team called the company for a solution and the company admitted that there was a fault with the device because of the year change and they were working on a solution. Our only mitigation was to cancel all the patients scheduled to receive a recorder until we had a solution. As luck would have it my 91-year-old father-in-law was one of those patients. He had a bunch of questions for me. The company promised us they would have a solution in a week, we held tight and waited. Before the week time frame ended, they said they were

still working on the solution and it would be another five days. At this point, we had patients who were anxiously waiting for their studies to be done so their treatment could be started. My father-in-law was one of them. His family doctor thought he might have A-fib and they wanted to do a study on him to verify it. I experienced firsthand the anxiousness of our patients waiting to use the units. It always reminds me that what we do is important and at the end of all we do, the health of someone’s mom, dad, brother or sister is at stake. We finally received a statement from the company on how to fix the units. The company said the challenge would be getting to the thousands of units in a timely manner. Then, they stated that they recommended having the biomed department handle the repair. They continued that the repair shouldn’t take more than 10 minutes per device. In my mind, I always knew the local biomed team was going to have to do something to help the company solve this problem. However, part of me didn’t want to help this company. This company has charged us for simple phone support, they came in and did an update on our ultrasound machines that then locked us out of them. In general, this company has not been very cooperative without a purchase order. I quickly remembered my father-in-law and the other patients waiting to have a study done. We quickly sprung into action and repaired all our units in a few hours. Reflecting on this situation, it does make me feel sad that the relationship between the local biomed team and

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

some OEMs isn’t better. I understand that service and service contracts are a revenue stream for the manufacturer. However, when equipment doesn’t work the on-site biomed team is here and ready to minimize patient impact. When I first started in this industry the collaboration between the OEMs and local shops was a lot better than it is today. Now, almost every request for tech support, documentation or even a parts contract is met with much resistance. At the end of the day, I know my team always works for the patient. We try to minimize the impact of downtime and maybe someday the OEM will realize it. 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.

APRIL 2020

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EXPERT ADVICE

ROMAN REVIEW Gambling vs. Calculated Risk BY MANNY ROMAN, CRES

was having a few cold ones and good conversation with some of my neighbors one beautiful Vegas night. We do this often and since we are all older, we can repeat the conversations and we think they are new. We never run out of repeated subjects.

On this particular night, a neighbor asked how I was doing with my poker playing. I again provided my standard answer that I am approaching my goal of becoming a mediocre poker player. This always garners a few chuckles and a toast. Then, the conversation took a different path from the normal. Or maybe I don’t remember having this discussion before. And they didn’t either. One of the retired fighter pilots asked me why I would gamble with my hard earned money in this way. I have an answer for that also: it is not gambling if your decisions matter. Gambling is putting money in a slot machine and hoping for the best. In poker, you make many decisions based on your knowledge, expertise, opponents’ actions, their body language, betting patters, blah, blah, blah. The point is that poker contains a great deal of skill at the highest levels and a medium amount at the mediocrity level. My retired dragster neighbor still had doubts even with my eloquent explanation of evaluating equity and risk during a poker hand. Then, it occurred to me that their chosen professions were overflowing with risk. A fighter pilot and a dragster questioning my risking $5 to buy into a poker

game seemed illogical to me. I threw this discussion in their direction and listened carefully as they defended risking their lives while I risked $5. It seems that their risks were calculated risks. They knew the capabilities of their machines. They had extensive training and experience. They had the best possible safety equipment and a highly competent support crew. They calculated that their chances of survival were excellent. They were willing to take the calculated risk. We laughed and retold old stories of old times, drank more cold ones and drifted off into the oblivion of memories and old glories. It was a wonderful time that none of us will remember and I look forward to repeating the conversations in the future. Why am I boring you with this? The next day, I had one moment of near clarity through the morning fog. Life is rife with risk. Most of the risk is unavoidable. You must get into your car and risk the drive to work. You must have that conversation with your boss or your team members. You must remember your anniversary. We take calculated and uncalculated risks all the time. It is those situations where we don’t calculate the risk that will likely get us into trouble. When we do not take the time to evaluate options and the risk vs. reward of each choice, that is gambling. Gambling is plowing ahead without thought of consequences. Gambling is avoiding the work required to explore ways to improve the chances of success while minimizing the risk of failure. Gambling is also when the requisite

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager

knowledge for success is ignored. Gambling is not surrounding yourself with the people and other physical and emotional items that will reduce your risk of failure. Gambling is not seeking advice from those who can help you. Gambling is having fear of failure with its accompanying freezing effects. Gambling is being too proud or fearful to admit that assistance is needed. Gambling is not accepting responsibility and accountability for actions. Gambling is refusal to learn from mistakes, both your own and those of others. My neighbors had incredible knowledge, experience and support systems in place. What they did for a living was definitely not gambling. Think about what you do for a living and life. Be sure that you are taking calculated risks and are not gambling. Each month, I take a calculated risk that what I write is of interest to a few of you. I carefully evaluate what I say and how I present it. I have proofreaders ensure that sense is made and interest is piqued. Well, not really. I gamble that my long-winded and winding prose reaches the very busy editor of this publication and he gives it marginal evaluation prior to forwarding for printing. Mediocrity in poker is not my only aspiration as evidenced by my writing.

APRIL 2020

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BREAKROOM

DID YOU KNOW? Fin

Science Matters

Genome of a sea monster Researchers have decoded the complete DNA sequence of the giant squid, a seldom observed 10-armed invertebrate that likely grows up to 43 ft. (13 m) and weighs over 1,800 lb. (900 kg). Lifespan About 5 years; reproduce once Diet Mostly deep water fishes and other squids

Human diver

Mouth and beak

Eight feeding arms

Long feeding tentacles seize prey

Soft mantle Giant squid Architeuthis dux Lives in deep ocean worldwide except in tropics, the high Arctic and Antarctic waters

Most often observed and caught in the deep waters around New Zealand

Wanted: A good DNA sample All known giant squid specimens had been held in formaldehyde solution or ethanol A “deep” analysis of a creature’s DNA – its genome – requires intact DNA that has not been modified by chemicals like these preservatives Finally, a fishing vessel came up with a sample of fresh giant squid tissue from the waters near New Zealand Source: Rute R. da Fonseca of University of Copenhagen, M. Thomas P. Gilbert of Harvard Medical School and others; Giga Science journal; Natural History Museum, London Graphic: Helen Lee McComas, Tribune News Service

TECHNATION

APRIL 2020

Preserved specimen at the Natural History Museum, London

What its genome may reveal Earlier studies of its mitochondrial DNA (lies outside the cell nucleus) confirmed that all giant squids are a single species The new DNA map will show its relationship to other squids, cuttlefish and octopus species – the cephaolpods – which evolved about 500 million years ago It may also provide clues to how some animals grow to be giants Toothed suckers on its long feeding tentacles

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MARCH PHOTO Portable Bovie Electro-Surgical Unit manufactured by the Liebel-Flarsheim Co.

TECHNATION

APRIL 2020

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E C n r a E ! s t i d e Cr ed

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SERVICE INDEX Entech

www.entechbiomedical.com/ • 800-451-0591

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

RepairMED

www.repairmed.net • 855-813-8100

Soma Technology, Inc

www.somatechnology.com • 1-800-438-7662

USOC Bio-Medical Services

www.usocmedical.com • 855-888-8762

C-Arm

P 82 P 73 P

Retrieve Medical Equipment

Jet Medical Electronics Inc

Master Medical Equipment

Multi Diagnostic Imaging

14, 22

84 7

Asset Management Asset Services

www.assetservices.com • 913-383-2738

www.aami.org • 703-525-4890

www.retrievemedicalequipment.com/ • (330) 963-0277

Calibration Rigel Medical, Seaward Group

www.seaward-groupusa.com • 813-886-2775

Cardiac Monitoring www.jetmedical.com • 714-937-0809

P P P

MMEMed.com • 866-468-9558 multidiagnostic.com • 800-400-4549

Cardiology 91 92

Biomedical

Multi Diagnostic Imaging

Southeastern Biomedical, Inc

Southwestern Biomedical Electronics, Inc.

multidiagnostic.com • 800-400-4549

Association AAMI

sebiomedical.com/ • 828-396-6010 www.swbiomed.com/ • 800-880-7231

CMMS

P P P P P P P P P P

Agiliti

ALCO Sales & Service Co.

100

nuvolo.com • 844-468-8656

BC Group International, Inc

104

Injector Support and Service

International X-Ray Brokers

Multi Diagnostic Imaging

Retrieve Medical Equipment

Tri-Imaging Solutions

https://www.agilitihealth.com/ • 800-847-7368 www.alcosales.com • 800-323-4282 www.BCGroupStore.com • 314-638-3800

Biomedical Repair & Consulting Services, Inc. 70 www.brcsrepair.com • 844-656-9418

P P

Biomedical Support Systems

www.biomedicalsupportsystems.com 1-800-290-1345

Crothall Healthcare Technology Solutions

Entech

www.crothall.com • (800) 447-4476

www.entechbiomedical.com/ • 800-451-0591

P P P P

Health Tech Talent Management, Inc.

iMed Biomedical

www.HealthTechTM.com • 757-563-0448

www.imedbiomedical.com • 817-378-4613

InterMed Group

www.intermed1.com • 386-462-5220

Master Medical Equipment

MMEMed.com • 866-468-9558

Medical Equipment Doctor, INC.

www.medicalequipdoc.com • 800-285-9918

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

RepairMED

www.repairmed.net • 855-813-8100

P 75 P P P 84 P P 93 P P 73 P 87 P 91 P P

Nuvolo

www.injectorsupport.com • 888-667-1062 internationalxraybrokers.com/

multidiagnostic.com • 800-400-4549 www.retrievemedicalequipment.com/ • (330) 963-0277 www.triimaging.com • 855-401-4888

Contrast Media Injectors Althea

Master Medical Equipment

P P P

2, 68

P P

www.biomedicalsupportsystems.com • 1-800-290-1345 MMEMed.com • 866-468-9558

Diagnostic Imaging Avante Health Solutions avantehs.com

International X-Ray Brokers

Multi Diagnostic Imaging

Retrieve Medical Equipment

multidiagnostic.com • 800-400-4549

Total Scope, Inc

www.totalscopeinc.com/ • (800) 471-2255

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

P P

Biomedical Support Systems

33 101

P P P

Defibrillator

Sodexo CTM

www.sviinternational.com • 800-321-8173

Injector Support and Service

internationalxraybrokers.com/

SVI International, Inc.

P P P 81 P www.injectorsupport.com • 888-667-1062 P Maull Biomedical Training 67 www.maullbiomedicaltraining.com • 440-724-7511 P https://www.althea-group.com/ • 888-652-5974

www.sodexousa.com • 1-888-Sodexo7

44, 80

Computed Tomography

Retrieve Medical Equipment

www.retrievemedicalequipment.com/ • (330) 963-0277

TRAINING

www.ambickford.com • 800-795-3062

SERVICE

A.M. Bickford

PARTS

Anesthesia

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

www.retrievemedicalequipment.com/ • (330) 963-0277

Endoscopy Biomedical Support Systems

www.biomedicalsupportsystems.com • 1-800-290-1345

APRIL 2020

TECHNATION

SERVICE INDEX Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

Total Scope, Inc

www.totalscopeinc.com/ • (800) 471-2255

Equipment Management Agiliti

https://www.agilitihealth.com/ • 800-847-7368

P 87 P 89 P P 72

Fetal Monitoring Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

Gas Monitors

P 87 P

General ALCO Sales & Service Co.

www.alcosales.com • 800-323-4282

P P

100

Imaging Entech

Health Tech Talent Management, Inc.

Multi Diagnostic Imaging

www.entechbiomedical.com/ • 800-451-0591 www.HealthTechTM.com • 757-563-0448 multidiagnostic.com • 800-400-4549

Infection Control Healthmark Industries

HMARK.COM • 800-521-6224

Soma Technology, Inc

USOC Bio-Medical Services

P P P

P P

Ampronix, Inc.

P P

International X-Ray Brokers

Multi Diagnostic Imaging

www.somatechnology.com • 1-800-438-7662 www.usocmedical.com • 855-888-8762

Labratory Ozark Biomedical

www.ozarkbiomedical.com • 800-457-7576

Mammography www.ampronix.com • 800-400-7972 internationalxraybrokers.com/

Monitors

AIV

P P Biomedical Support Systems 82 www.biomedicalsupportsystems.com • 1-800-290-1345 P Elite Biomedical Solutions 30 P elitebiomedicalsolutions.com • 855-291-6701 P Master Medical Equipment 84 P MMEMed.com • 866-468-9558 P Multimedical Systems 87 www.multimedicalsystems.com • 888-532-8056 P aiv-inc.com • 888-656-0755

Infusion Therapy Agiliti

https://www.agilitihealth.com/ • 800-847-7368

AIV

Elite Biomedical Solutions

FOBI

aiv-inc.com • 888-656-0755 elitebiomedicalsolutions.com • 855-291-6702 www.FOBI.us • 888-231-3624

RepairMED

www.repairmed.net • 855-813-8100

APRIL 2020

P P P P P P P

Select BioMedical

Soma Technology, Inc

multidiagnostic.com • 800-400-4549

www.somatechnology.com • 1-800-438-7662

Monitors/CRTs Ampronix, Inc.

Multi Diagnostic Imaging

USOC Bio-Medical Services

www.ampronix.com • 800-400-7972 multidiagnostic.com • 800-400-4549 www.usocmedical.com • 855-888-8762

MRI Innovatus Imaging

www.innovatusimaging.com • 844-687-5100 multidiagnostic.com • 800-400-4549

P P P P

8, 76 73

Nuclear Medicine E.L. Parts

Multi Diagnostic Imaging

Infusion Pumps

TECHNATION

www.selectpos.com • 866-559-3500

Biomedical Repair & Consulting Services, Inc. 70 www.brcsrepair.com • 844-656-9418

Select BioMedical

multidiagnostic.com • 800-400-4549

TRAINING

HMARK.COM • 800-521-6224

SERVICE

Healthmark Industries

PARTS

P P

Company Info

AD PAGE

www.capitalmedicalresources.com • 614-657-7780

TRAINING

Capital Medical Resources

SERVICE

www.cadmet.com • 800-543-7282

PARTS

Cadmet

AD PAGE

Company Info

nuclearmedimaging.com • 847-421-1656

InterMed Group

www.intermed1.com • 386-462-5220

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

79 75

P P P P P

Online Resource MedWrench

Webinar Wednesday

www.MedWrench.com • 866-989-7057 www.1technation.com/webinars • 800-906-3373

Oxygen Blender FOBI

www.FOBI.us • 888-231-3624

PACS Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

P P

Patient Monitoring Agiliti

AIV

https://www.agilitihealth.com/ • 800-847-7368 aiv-inc.com • 888-656-0755

P P P

WWW.1TECHNATION.COM

SERVICE INDEX

RepairMED

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

Southeastern Biomedical, Inc

Southwestern Biomedical Electronics, Inc.

sebiomedical.com/ • 828-396-6010 www.swbiomed.com/ • 800-880-7231

USOC Bio-Medical Services

www.usocmedical.com • 855-888-8762

Portable X-ray Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

P P P P

Power System Components Interpower

www.interpower.com • 800-662-2290

Radiology Ampronix, Inc.

www.ampronix.com • 800-400-7972

P P P

Multi Diagnostic Imaging

Soma Technology, Inc

multidiagnostic.com • 800-400-4549 www.somatechnology.com • 1-800-438-7662

Recruiting

Sodexo CTM

Stephens International Recruiting Inc.

www.sodexousa.com • 1-888-Sodexo7 www.bmets-usa.com/ • 870-431-5485

aiv-inc.com • 888-656-0755

https://www.agilitihealth.com/ • 800-847-7368

Avante Health Solutions avantehs.com

Elite Biomedical Solutions

elitebiomedicalsolutions.com • 855-291-6703

2, 68 30

Elite Biomedical Solutions

www.jetmedical.com • 714-937-0809

Multi Diagnostic Imaging

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

P P P P

P P P

multidiagnostic.com • 800-400-4549

Respiratory A.M. Bickford

14, 22

FOBI

Multi Diagnostic Imaging

P P P

www.ambickford.com • 800-795-3062

Respiratory www.FOBI.us • 888-231-3624 multidiagnostic.com • 800-400-4549

Software CyberMDX

www.cybermdx.com

Medigate

38, 53

Nuvolo

44, 80

www.medigate.io nuvolo.com • 844-468-8656

Phoenix Data Systems

Surgical Agiliti

Capital Medical Resources

Healthmark Industries

Multi Diagnostic Imaging

Prescotts

https://www.agilitihealth.com/ • 800-847-7368 www.capitalmedicalresources.com • 614-657-7780 HMARK.COM • 800-521-6224 multidiagnostic.com • 800-400-4549

Tables

P P P P

multidiagnostic.com • 800-400-4549

Telemetry AIV

P P P P 30 P P 87 P 91 P P 29 P P 7 P P 37

Biomedical Repair & Consulting Services, Inc. 70 www.brcsrepair.com • 844-656-9418

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

RepairMED

www.repairmed.net • 855-813-8100

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

USOC Bio-Medical Services 100

Jet Medical Electronics Inc

Replacement Parts

elitebiomedicalsolutions.com • 855-291-6701

ALCO Sales & Service Co.

elitebiomedicalsolutions.com • 855-291-6701

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

Elite Biomedical Solutions

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

Engineering Services, KCS Inc

aiv-inc.com • 888-656-0755

Rental/Leasing Agiliti

elitebiomedicalsolutions.com • 855-291-6701

Multi Diagnostic Imaging

Refurbish AIV

Elite Biomedical Solutions

surgicalmicroscopes.com • 800-438-3937

Health Tech Talent Management, Inc. www.HealthTechTM.com • 757-563-0448

Replacement Parts

www.goaims.com • 800-541-2467

20,103

TRAINING

Multi Diagnostic Imaging

SERVICE

P P P P Biomedical Support Systems 82 www.biomedicalsupportsystems.com • 1-800-290-1345 P Jet Medical Electronics Inc 41 P www.jetmedical.com • 714-937-0809 P 4

PARTS

P Avante Health Solutions 2, 68 P avantehs.com BETA Biomed Services 39 P www.betabiomed.com/ • 800-315-7551 Biomedical Repair & Consulting Services, Inc. 70 www.brcsrepair.com • 844-656-9418 P www.ampronix.com • 800-400-7972

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

Ampronix, Inc.

AD PAGE

Company Info

www.usocmedical.com • 855-888-8762

Test Equipment A.M. Bickford

www.ambickford.com • 800-795-3062

BC Group International, Inc

www.BCGroupStore.com • 314-638-3800

14, 22 104 APRIL 2020

P P TECHNATION

SERVICE INDEX Clinical Dynamics Corp.

ATS Laboratories

Pronk Technologies, Inc.

Avante Health Solutions

Rigel Medical, Seaward Group

2, 68

Innovatus Imaging

Southeastern Biomedical, Inc

8, 76

clinicaldynamics.com • 203-269-0090 www.pronktech.com • 800-609-9802 www.seaward-groupusa.com • 813-886-2775 sebiomedical.com/ • 828-396-6010

Training

College of Biomedical Equipment Technology

www.cbet.edu • 866-866-9027

ECRI Institute

www.ecri.org • 1-610-825-6000.

Tri-Imaging Solutions

www.triimaging.com • 855-401-4888

86 17

Tubes/Bulbs Cadmet

www.cadmet.com • 800-543-7282

Tri-Imaging Solutions

www.triimaging.com • 855-401-4888

Ultrasound

www.innovatusimaging.com • 844-687-5100

P P P P

P P

www.ampronix.com • 800-400-7972

P P

Retrieve Medical Equipment

Summit Imaging

P P P

www.retrievemedicalequipment.com/ • (330) 963-0277 www.mysummitimaging.com • 866-586-3744

X-Ray Engineering Services, KCS Inc

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

Innovatus Imaging

www.innovatusimaging.com • 844-687-5100

8, 76

InterMed Group

International X-Ray Brokers

Multi Diagnostic Imaging

Retrieve Medical Equipment

Tri-Imaging Solutions

www.intermed1.com • 386-462-5220 internationalxraybrokers.com/

multidiagnostic.com • 800-400-4549 www.retrievemedicalequipment.com/ • (330) 963-0277

Ampronix, Inc.

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

Multi Diagnostic Imaging

multidiagnostic.com • 800-400-4549

avantehs.com

P P

Althea

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

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

TRAINING

SERVICE

PARTS

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

www.triimaging.com • 855-401-4888

800-323-4282

P P P P P P P

www.alcosales.com

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100

TECHNATION

APRIL 2020

Pen Stylus

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ALPHABETICAL INDEX A.M. Bickford……………………… 14, 22 AAMI………………………………… 92 Agiliti………………………………… 72 AIV…………………………………… 37 ALCO Sales & Service Co.…………… 100 Althea………………………………… 35 Ampronix, Inc.…………………………… 4 Asset Services………………………… 91 ATS Laboratories……………………… 75 Avante Health Solutions…………… 2, 68 BC Group International, Inc………… 104 BETA Biomed Services……………… 39 Biomedical Repair & Consulting Services, Inc.…………… 70 Biomedical Support Systems………… 82 Cadmet……………………………… 28 Capital Medical Resources…………… 50 Clinical Dynamics Corp.……………… 69 College of Biomedical Equipment Technology……………… 11 Crothall Healthcare Technology Solutions………………… 77 CyberMDX…………………………… 50

R E G I S T E R

E.L. Parts……………………………… 79 ECRI Institute………………………… 86 Elite Biomedical Solutions…………… 30 Engineering Services, KCS Inc………… 6 Entech………………………………… 82 FOBI………………………………… 28 Health Tech Talent Management, Inc.…………………… 69 Healthmark Industries……………… 54 iMed Biomedical……………………… 16 Injector Support and Service………… 81 Innovatus Imaging………………… 8, 76 InterMed Group……………………… 75 International X-Ray Brokers………… 41 Interpower……………………… 20, 103 Jet Medical Electronics Inc………… 41 Master Medical Equipment………… 84 Maull Biomedical Training…………… 67 Medical Equipment Doctor, INC.…… 93 Medigate…………………………… 38, 53 MedWrench………………………… 45 Multi Diagnostic Imaging…………… 73 Multimedical Systems……………… 87

N O W

Irvine A

Nuvolo……………………………… 44, 80 Ozark Biomedical…………………… 23 Phoenix Data Systems……………… 47 Prescotts……………………………… 87 Pronk Technologies, Inc. ……………… 5 RepairMED…………………………… 91 Retrieve Medical Equipment ………… 26 Rigel Medical, Seaward Group………… 3 Select BioMedical…………………… 23 Sodexo CTM………………………… 33 Soma Technology, Inc……………… 84 Southeastern Biomedical, Inc……… 65 Southwestern Biomedical Electronics, Inc.……………………… 29 Stephens International Recruiting Inc.………………………… 79 Summit Imaging……………………… 59 SVI International, Inc.………………… 101 Total Scope, Inc……………………… 89 Tri-Imaging Solutions………………… 17 USOC Bio-Medical Services…………… 7 Webinar Wednesday………………… 96

JULY 27-29, 2020 HOTEL I

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EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2020

TECHNATION

101

BREAKROOM

FLASHBACK MD Expo: April 2012

The 2012 spring MD Expo took exhibitors and attendees to the beautiful Harbor Beach Marriott Resort in Fort Lauderdale, Florida.

K are n

Wanin ge r p r e se nt s PA - P roac tiv on “ T he N e e M ain xt S hif te n an t in PM c e A ss essm e / nt s.”

hile mingle w mix an d s e g of e d in n tt e Att tiful se the beau . n o ti p e taking in o m e R ec the Welc

Bar y Feldman (lef t) and Bob Feldman (center) of Inte rnation al X-R ay Brokers enjoy the Welcom e Rec epti on.

M D E xpo 20 12 includ ed a powerhous at te nd ees in e lin e- up of cluding in du stry vete rans way, foun de M alcolm R id r of M aste rp ge lan (left) an TechNation d Jam es Fede contributor le , an d M D E xp o presente r (right).

102

TECHNATION

APRIL 2020

C linic al M ARK A R A f o sid e nt e y note plin , Pre nts the k es prese Bri an Po ic rv hip in e rs S e y d g e ve l L e a L Technolo t x e N e nt.” titled “ a n a ge m ad dress olog y M n h c e T are Healthc

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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 25. 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 just one, order just one! Contact Customer Service for More Information •

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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

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IPA-3400 Infusion Pump Analyzer

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The High Accuracy, Easy-to-Use System with Full Touch Screen Control of All Processes The IPA-3400 is the most compact, fully featured four channel analyzer on the market. The IPA-3400 has a Patented, dual syringe stepper motor driven system that offers continuous monitoring of the fluid flow, providing a more realistic flow path for the infusion device under test and more accurate readings. The independent stepper motor control of the custom designed, ceramic valving allows the system to run quietly and smoothly, with a bidirectional powered fluid flow for use in the built in cleaning cycle.

The Next Generation in Infusion Pump Analyzers is here!          

Large 7” Color Touch Screen 1,2,3 and 4 Channel Models available (Field Upgradeable) User Swappable, Fully Self Contained Flow Modules Calibration in Flow Modules No need to be down for calibration or service! Smooth Dual Syringe System Eliminates Drain Cycle Inconsistencies Whisper Quiet Operation Auto Start Built-in Auto Test Sequences Built-in Data Collection Built-in Reports

Screenshots from the IPA-3400

Easy access to modules for expansion and calibration. Each module is calibrated with up to four channels in each IPA-3400. Stagger the calibration time for modules to prevent downtime. Users can also run specific test routines specified by various manufacturers using built in autosequences. Advanced features in the autosequences even allows the inclusion of pictures to aid with the setup and configuration of each step. IPA-3400 with Swappable Modules

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