TechNation Magazine May 2020 by MD Publishing

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Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

MERGERS

MAY 2020

AND

ACQUISITIONS Proven Practices for CE Departments page 48

Article Title of the Month 14 Professional ##

Topic Recksiek Travis

Article Title Cutting 28 Ribbon ##

Topic Biomedical Support Systems

Article Title Review 71 ## Roman

Topic Hemingway Effect

## Article Title

Topic TO AAMI PAGE 80 GUIDE

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CONTENTS

FEATURED MERGERS AND

ACQUISITIONS

HE ROUNDTABLE: T REPLACEMENT TUBES AND BULBS More and more healthcare technology management (HTM) professionals are entering the imaging service arena. TechNation quizzed some experienced professionals about replacement tubes and bulbs to provide valuable information to readers. Next month’s Roundtable article: Training/Education

ERGERS AND ACQUISITIONS: M PROVEN PRACTICES FOR CE DEPARTMENTS When companies determine that there is an economic benefit to merge, it can be challenging for employees. In health care, many of these changes impact the HTM department. A merger can shift the corporate culture, create changes to procedures and impact vendor relationships. Next month’s Feature article: Which Certification is Right for YOU?

TechNation (Vol. 11, Issue #5) May 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

MAY 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 BSW-McKinney Healthcare Technology Management Department p.14 Professional of the Month: Travis Recksiek p.18 Association of the Month: The Central Florida Biomedical Instrumentation Society (CFBIS) P.21 p.21 p.28 p.30 p.32

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

P.35 p.35 p.36 p.39 p.40

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

P.54 EXPERT ADVICE p.54 Career Center p.56 20/20 Imaging Insights, sponsored by Innovatus Imaging p.59 Cybersecurity p.60 The Growing Problem of a Shrinking HTM Workforce, sponsored by TKA p.62 The Future p.64 Be Prepared When Calling for Help, sponsored by Avante Health Solutions p.66 View on Value p.68 The Other Side p.71 Roman Review P.72 BREAKROOM p.72 Did You Know? p.74 The Vault p.76 MedWrench Bulletin Board p.79 Clean Up Contest p.80 Guide to AAMI p.85 HTM Week Contest p.90 Flashback p.86 Service Index p.89 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

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SPOTLIGHT

DEPARTMENT OF THE MONTH The BSW-McKinney Healthcare Technology Management Department BY K. RICHARD DOUGLAS

hirty-two miles north of Dallas is the city of McKinney, Texas. The city is just one of many that surround the Dallas-Fort Worth “metroplex.” The city sports a historic district, a performing arts center, farmers market, breweries, parks and trails.

McKinney also has the Baylor Scott & White Medical Center-McKinney; a campus of Baylor Scott & White (BSW) Health. It is just one of 46 hospitals that make up the large Texas health system. The healthcare technology management (HTM) team at McKinney includes Director Carol Wyatt, Manager James Swandol, Senior Tech Scott Gillett, BMET II Alan Nicewarner and BMET I Charlotte Threlkeld. The team of biomeds have caught the attention of leadership at McKinney. “The HTM team at BSW McKinney is known around campus as highly competent and reliable. Not only are they quick to respond and identify solutions; they do it with excellent customer service,” says Kimberly Bones, MBA, vice president of finance at McKinney. “The team has developed strong relationships across the hospital and continues to identify opportunities to provide helpful education to departments that not only results in better care of our equipment, but cost avoidance for unnecessary repairs,” Bones says. “BSW McKinney is extremely fortunate to have this team supporting our campus. They truly exemplify our organization’s core values of serving faithfully, acting honestly, never settling and being in it together. Each team

member is greatly valued and appreciated,” she adds. The team supports three facilities including the McKinney hospital – currently 143 beds and in the process of expending to 191 – and two specialty heart hospitals located in McKinney and Denton. On-call, they support eight hospitals and one remote emergency department. Swandol says that the team of biomeds is like family. “We work hard together and play hard together. Every day we eat lunch together and talk about things besides work. From Christmas parties to going out shooting clays at the range, we make sure we have fun together. We huddle three times a week with our other campus to go over PM updates and repairs,” he says. He says that they share in PMs – even if they are assigned to another tech. “We will also go to another campus if they require assistance or share test equipment. We pride ourselves on our teamwork and do not let each other fall behind. We each work to our strengths so that we can work on our weaknesses.

This allows us to improve as techs every day,” Swandol says. In order to collect data, the department has recently transitioned to a new database system. “HEMS/EQ2 is our new database for equipment maintenance. Over the past year, we have been adjusting EQ2 to meet our growing needs as well as expanding the everyday capabilities such as regular PM scheduling,” says Brian Lauer, MBA, MS, HEM, director of operations/ECEM for Carrollton, McKinney, McKinney Heart, Plano Heart and Plano Regional, Baylor Scott & White Health. “We also intergraded our PO (purchase order) system into EQ2/HEMS. Now when we need parts or service for a unit, we can open a PO from the work order instead of having to go through our purchasing site. This has helped us track costs since the PO is tied to the work order. We have added inventory so that every tech can keep up with their on-hand parts. With the PO integration, parts can be consumed accurately thus providing a more complete cost of service,” Lauer says.

Members of the BSW-McKinney HTM Department are seen at a team building event.

TECHNATION

MAY 2020

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The BSW-McKinney healthcare technology management team, clockwise from top, Manager James Swandol, BMET II Alan Nicewarner, BMET I Charlotte Threlkeld and Senior Tech Scott Gillett.

The team’s approach to service contacts begins with gathering data for the facility first. “We then reach out to other hospitals in our system to verify a system need. Once we have identified a system need, we escalate all the data from the facilities to HTM leadership,” Lauer says. BIG PROJECTS AND PROBLEM SOLVING In addition to its regular duties, the team has participated in some large-scale projects. “Our largest project to date has been the opening of our Baylor Scott & White – The Heart Hospital McKinney. Before we broke ground, we were involved in planning, budgeting and evaluating all equipment for the heart hospital. We started by having a new IR room built on the McKinney side. Once completed, they moved on to the building of the heart hospital. After the outside walls were up,

SPOTLIGHT

we began coordinating vendors for the installing of new equipment like telemetry and nurse call. We played equipment shuffle with the three cath labs during this time as well since they also upgraded each cath lab one at a time while Heart was being built,” Lauer says. He says that when it was closer to the opening date, the team changed asset tags on equipment that moved from McKinney to Heart and repurposed beds and stretchers from other facilities that no longer needed them. “We tagged, inspected and input the remaining new equipment in our database system. We trained the staff on new equipment like our temperature monitoring system,” Lauer says. Another project involved planning to open a new floor. “McKinney is expanding by an extra 48 beds by opening the fourth floor, which is now just a shell space, to expand

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Ortho, ACU and dialysis capabilities. Biomed will assist in the equipment needed and location of equipment for the project,” Lauer says. The team has had to put their collective thinking caps on and problem solve. “A common problem many departments have experienced is missing or damaged patient cables. EKG, SpO2 and NiBP cables, for example, are constantly being lost, damaged or ‘borrowed’ from other departments. Our biomed department was asked to secure these cables to each patient monitor so that no more cables could inconveniently disappear,” Lauer says. He says that their first solution was using braided, manually crimped cables. But, he says, these proved ineffective because they are difficult to replace and possible to be cut with trauma shears. It was also time consuming. “Recently a more effective method has been found, using Voytek Cable Locks,” Lauer says. He says that these cable locks have a tougher, thicker braided cable that will make cutting much more difficult. “They feature a molded block that splits in half for easy cable securing or replacement, and it is secured shut using a security star wrench. The cost at first may seem steep starting at $75 each for the most basic three-hole model and going up to $135 each for the longer five-hole model each. But, when a single patient cable can cost $100+, a Voytek Cable Lock can pay for itself after saving one cable,” Lauer adds. Lauer says that the HTM team is one of the highest performing teams at BSWH-McKinney. “Not only are they highly competent in their field, but their reliability and personability takes them to the next level. This team truly embodies Baylor Scott & White Health’s core values: we serve faithfully, we act honestly, we never settle and we are in it together. Regardless of the situation or the time of day that you call on one of these team members, you can always count of them to answer the call and greet you with a smile,” he says. What more can you ask for from an HTM department?

MAY 2020

TECHNATION

SPOTLIGHT

PROFESSIONAL OF THE MONTH Travis Recksiek: One Person; Many Talents BY K. RICHARD DOUGLAS

hen the Corsicana Daily Sun, in Corsicana, Texas, recognized a local biomed in a feature story in February, the spotlight was on his one-man shop, a local biomed training program and the challenges generated by a retiring baby-boom generation of biomeds.

Travis Recksiek is responsible for medical equipment assets at Navarro Regional Hospital and four clinics in the city. Navarro Regional is a 162-bed acute care hospital with a cath lab, ER, outpatient surgery center and 51 physicians. In total, Recksiek is responsible for maintaining about 1,500 pieces of medical equipment. Recksiek was introduced to the field by his stepmom. “I was going through my senior year of high school and trying to decide what I wanted to be when I grew up. I knew I didn’t want to sit behind a desk crunching numbers all day and I wanted to do something that helped people,” he says. His stepmother’s occupation was the connection that led him to the biomed field. “My stepmom worked at a local hospital and told me about the biomed that worked there and what he did. It sounded interesting, so I found a local trade school that offered a biomed associates degree near me and decided

TECHNATION

MAY 2020

to go for it,” Recksiek says. The degree program that Recksiek chose was a little more than an hour away from his home in Waxahachie, Texas. “I graduated from Texas State Technical College (TSTC) in Waco with an associate degree in biomedical equipment technology in 2010,” he says. Recksiek’s supervisor at Navarro Regional, Chad Sanders, is also a graduate of the program. After graduating from the program, Recksiek gained hands-on experience before landing his position at Navarro Regional. “I’ve worked for three different hospital systems as a biomed technician with various numbers behind the title. Today my title is simply a biomed technician and my roll involves running a one-man shop for a small rural hospital,” he says. Recksiek describes himself as a “general biomed,” which is probably a good thing in a one-person department. Knowing how to work on most types of equipment is necessary when you are the only technician. BETTER BUSY THAN BORED Some of that “hands-on” experience included assisting with a major move. A task that can be a challenge for a biomed of any experience level. “The most exciting project I’ve worked on was a hospital move to a

new 800-plus bed hospital from the existing facility over the course of three days. I was primarily over the equipment move for the labor and delivery department,” Recksiek says. He says that he had to coordinate with the moving company, as well as members of his team and the clinical team, to balance the equipment needs for both the in-progress labors at the original facility as well as the patients being admitted to the new facility. “It was long days leading up to and during the move, but it’s a time I look back on as a major highlight of my career,” Recksiek says. He says that in his current role, the biggest challenge comes from being the only biomed on staff. “Whether it’s nursing staff, administration, corporate HQ or even Joint Commission asking the questions, I am ‘the guy’ that has to answer for all things medical equipment-related,” he says. Recksiek says that when he is not on site, he is on call. He takes a philosophical perspective on that challenge. He also finds time to assist with biomeds in training. “I’m the guy sitting in equipment planning meetings as well as the guy doing PMs on infusion pumps. It can be tough to manage it all at times, but it keeps me busy and engaged. I’d rather be busy than bored any day of the week. I’ve also been fortunate to maintain a

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SPOTLIGHT Travis Recksiek, right, and his supervisor, Chad Sanders, both graduated from Texas State Technical College.

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WHAT’S ON MY DESK?

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relationship with TSTC in Waco to take on an intern or two as needed to help me with some of the workload as well as pass on my knowledge to new techs entering the field,” Recksiek says. Away from work, Recksiek is kept busy with a growing family. “I have a wife, two daughters and a son on the way that will be born here at my hospital any day now,” Recksiek says. Some of Recksiek’s pastimes seem more like work while others are about relaxation. They all exhibit multiple talents. “I’m big into catering and competition barbecue, hunting, fishing and do a little welding on the side,” Recksiek adds. “I help admin a Facebook group called North Texas BBQ Addicts that currently has around 42,000 members. I do local meetups and BBQ competitions with them. I have also done work

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

catering events in the community. One of the more recent events was catering opening day of the local Miracle League. It is a baseball league for special-needs kids,” Recksiek says. He also helped start a mobile welding company with his father-in-law and brother-in-law. “We have a welding truck and do steel fence installs, farm/ranch repairs, BBQ smoker builds, etcetera. We work nights and weekends when we have downtime from our full-time jobs,” Recksiek adds. When asked what readers should know about him, Recksiek’s answer is somewhat tongue-in-cheek. “I’m more than just a pretty face and a mullet. I’m also a pretty darn good biomed technician,” he says. When it comes to holding down the fort as a one-person shop, this HTM professional proves he is “pretty darn good.”

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The May 2018 CFBIS Chapter meeting, sponsored by Agiliti Healthcare prior to public name change from Universal Hospital Services.

ASSOCIATION OF THE MONTH The Central Florida Biomedical Instrumentation Society (CFBIS) BY K. RICHARD DOUGLAS

lthough the state leads the country in thunderstorm activity, Florida is still known as the “Sunshine State” because of its 237 days a year of sunshine. Many travelers from the Midwest and Northeast make the trek to the state every winter to escape the snow and enjoy a warmer climate.

A peninsula surrounded by water, the state boasts beaches and waterside eateries all along its long coastline. The center of the state offers one of the nation’s most famous entertainment complexes. Because of Florida’s distance north to south, the statewide biomed association has many regional chapters that accommodate local biomeds and eliminate long trips for monthly or quarterly meetings. Serving healthcare technology management (HTM) professionals in the north-central portion of the state is the mission of the Central Florida Biomedical Instrumentation Society (CFBIS). The society is a nonprofit chapter of the Florida Biomedical Society (FBS). The current board includes President

TECHNATION

MAY 2020

The August 2018 CFBIS Chapter meeting, sponsored by Injector Service & Support prior to 626 Holdings Inc. merger. Vahid Majidi and Secretary/Treasurer Jennifer Vazquez. Edward Reyes serves as marketing director. The group has gone through a couple of iterations during its history with the focus always on providing a local society to benefit biomeds in central Florida. The group’s predecessor organization was established in the early 1980s by biomeds who wanted to make a difference in their community.

Reyes says that the group was once known as the Sun Coast Association of Medical Instrumentation. “For several successful years, it was headed up and run by Bill Hart out of Lakeland Regional Medical Center. The association saw tremendous growth in membership and vendor involvement,” Reyes says. He says that after the Sun Coast group was disbanded, and partly split

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SPOTLIGHT

into what is now the Bay Area Association of Medical Instrumentation (BAAMI), the Central Florida region sought a replacement for the lost source of biomed community and education. The group was active until the mid-1990s and then took a 15-year hiatus until 2010. Later, it disbanded once again. Reyes says that in 2017, FBS President-Elect Jim Bowles and the other members of the board thought it necessary to revitalize the community of HTM professionals in the Central Florida area. “Since Carlos Villafane had success as BAAMI president, they elected him to be CFBIS’s FBS Chapter Representative to get ‘the ball rolling,’ so to speak,” Reyes says. He says that the society saw a spike in growth and interest including those in search of education and free resources that could assist them at their local hospital organizations. Reyes says that more recently, it was a group effort to get the local biomed society re-established. “There wasn’t really an individual person that ‘started’ CFBIS. It was more of a joint effort to start up something that some of us thought was necessary to start up again,” Reyes says. He says that in 2017, he and Villafane, Luis Galarza, Alberto Feliciano and Jennifer Vazquez met at a Golden Corral and discussed the arrangements and what it would take to make the society come back to life. “I’m sure it was the push from the Florida Biomedical Society to head Carlos in the position of sparking up the conversation with individuals he deemed would be able to take the society to where it is now. If I could grant any one person or entity credit for the initial starting phases, it would be Carlos and the members of our FBS board,” Reyes says.

CFBIS members, from left, Carlos Villafane, Edward Reyes, Jennifer Vazquez and Luis Galarza are seen at the 2017 MD Expo in Orlando. GETTING EVERYONE INVOLVED While education is often the central focus for many biomed associations, the opportunity to learn about new products and services and rub elbows with local counterparts is also beneficial. “Often, we are asked to just provide a conduit where HTM professionals can be exposed to additional service resources available to them. During membership meetings, members have an opportunity to engage with sales teams, from their local backyard to across the state, to be pre-exposed to numerous service opportunities that might benefit their organization or their day to day. Sales teams take advantage of our ability to be flexible and provide societal socials that might help them engage with current and potential consumers of their products and services,” Reyes says. He says that in the future they are looking to engage in a new outreach effort and better community outreach to strengthen the bonds between people. “The more you know, the more people you have to network with, the stronger the ties and resources you bring to the table,” Reyes says. The group does not yet hold its own symposium, but there are plans to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

expand the scope of the society and get more involved with local hospitals and health care systems. “With our new president, Vahid Majidi, we are hoping to bring back the initial spark that started it all. Our current president has plans to push education, relationships and other resources that hopefully our current network of hospital organizations see as advantages,” Reyes says. “We plan to address local needs head-on by outreach to local directors and providing the means of support they need to better enforce their ‘boots on the ground.’ We see hospital organizations and their involvement as crucial when it comes to showcasing the benefits of being involved in something greater than themselves – to join as one under a common goal,” Reyes adds. He says that at the end of the day, patients are number one. “If we can aim to provide onsite professionals a means of doing their jobs better, safer and smarter then we have accomplished our goal,” he says. The re-emergence of this storied biomed society will benefit the HTM community in central Florida and cement the relationship between biomed departments in the region.

MAY 2020

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry

MD EXPO IRVINE MOVED TO JULY 27-29 MD Expo’s return to California now set for this summer. MD Expo Irvine, originally scheduled for April 20-22, is set for July 27-29, 2020 at Hotel Irvine. “Following the outbreak of coronavirus (COVID-19), there have been widespread travel restrictions and strict recommendations for gatherings. We believe it is in the best interest of all our exhibitors, attendees and colleagues to postpone the show,” MD Publishing President John Krieg said. “We have chosen the earliest and most convenient date that ensures Hotel Irvine can accommodate our guests in a manner that MD Expo patrons have come to expect.” Regarding conference details, aside from the new dates, nothing will change for MD Expo Irvine. “We will keep the same schedule, exhibit space, speakers, class times and social events,” he added. “Finally, we wish to thank those who participate and support MD Expo. We greatly appreciate your patience and understanding,” Krieg said. “We truly value your support

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and look forward to seeing you all this July in Irvine!” The 2020 MD Expo is approved for up to 10 CEUs by the AAMI Credentials Institute. The Biomed 101 Course 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! • FOR MORE INFORMATION, visit MDExpoShow.com.

MAY 2020

TECHNATION

INDUSTRY UPDATES

STATEMENT: THE JOINT COMMISSION SUSPENDS SURVEYS The Joint Commission released a statement on March 16 that is will not be conducting surveys. “In light of President Trump’s declaration of a national emergency regarding the COVID-19 virus and to assure we are not interfering with the work you are doing to prepare and care for your patients during this pandemic, The Joint Commission is suspending all regular surveying beginning Monday, March 16, 2020. In some cases, there may be a small number of surveys that will need to continue, such as high-risk situations. We will provide more details soon on what surveys are proceeding,” according to the statement signed by Mark Pelletier, RN, MS, Chief Operating Officer/ Chief Nursing Executive, Accreditation and Certification Operations, The Joint Commission. “At this time, we do not have an anticipated restart date. All postponed survey events will occur once we resume operations. If any organizations go past their accreditation due date, accreditation will be extended without disruption to their accreditation status. The Centers for Medicare and Medicaid Services has assured us that Medicare payment status also will not be affected,” the statement continues. “We know this is a very difficult time for all health care providers. We are here to provide expert advice and guidance. Please reach out to your account executive to assist. Thank you for the work you do every day to support safe and quality health care for all.” •

AZHTM HOLDS INAUGURAL MEETING AZHTM, the brand new Arizona healthcare technology management association, held its inaugural meeting on Wednesday, March 11 with 42 attendees. The AZHTM was created to provide the Arizona healthcare technology management community a place to network, receive ongoing education and have some fun along the way. The kick-off meeting was held at the Half Moon Windy City Sports Grill and was sponsored by Innovatus Imaging with a happy hour, food, beverages and education provided by the sponsor. Matt Tomory from Innovatus Imaging explained that AZHTM is picking up where AZMIA, founded in 2008, left off. AZHTM founding members include Tomory, Perry Kirwan and Josh Trueblood. Tomory, who also presented a class on ultrasound basics and theory, said “all the major health care providers from the valley and even some from outside the valley” were represented with over 45 attendees. • FOR MORE INFORMATION, and updates regarding upcoming events, visit AZHTM.org.

2020 HTMA-SC ANNUAL MEETING SET FOR MAY The 2020 HTMA-SC Annual Meeting (originally scheduled to be held May 1) is now scheduled to be held in October. “Given current circumstances with COVID-19 we have postponed the 2020 HTMA-SC Symposium until October 9, 2020. The location of the event will remain the same. (William Yates Conference Center, Columbia, SC). We look forward to seeing everyone on October 9th. In the meantime, please stay healthy and safe,” the HTMA-SC website reports. “If you have any questions please reach out to HTMA-SC Vice President Dan Paladino (dpaladino1721@gmail.com)” “We’ve organized the classes to give you the best chance of getting to the classes you want to see. But if there is some overlap, bring a friend to take notes for you,” a previous email about the

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MAY 2020

conferences states. “Second, we are announcing that we have four $500 scholarships. These scholarships cover the costs of achieving your CBET certification. They are only available to those who attend the conference.” Breakfast and lunch will be provided free-of-charge at the annual meeting thanks to generous sponsors. “This will be the best opportunity for you to mingle with others in your profession this year. You may learn of great opportunities for parts and supplies. And you may even pick up the knowledge to save your hospital thousands of dollars in vendor PMs and CM parts,” the email states. FOR MORE INFORMATION, visit https://scba.wildapricot.org/ event-3779867.

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INDUSTRY UPDATES PARTSSOURCE APPOINTS JODY HATCHER TO BOARD OF DIRECTORS PartsSource has announced that supply chain industry veteran Jody Hatcher has joined the company’s board of directors. Hatcher’s more than 30 years of health care executive experience will support PartsSource’s engagement with progressive supply chain organizations across the U.S. Hatcher is the former president of supply chain services for Vizient, and the former president and CEO of Novation, which was merged in 2015 with VHA and UHC to form Vizient, the largest member-driven, health care performance improvement company in the country. Widely respected across the industry for his accomplishments, Hatcher served for 14 years as a board member of the Healthcare Industry Supply Chain Association, including four years as chairman. “Jody is a seasoned commercial leader who has committed his professional life to helping health care organizations transform their supply chains and has a strong understanding of the technologies, processes and trusted advisorship required to deliver reliable and reproducible outcomes,” said Philip Settimi, MSE, MD, president and CEO of PartsSource. “We’re delighted to have Jody join our board and support our effort to engage supply-chain thought leaders across the country.” Under Hatcher’s leadership, Novation achieved record-breaking member savings and consistently increased member participation in offerings. He oversaw growth in gross revenues of more than 47 percent, and spearheaded Novation’s investment to build worldclass data assets and analytics that are key foundational components of Vizient’s data and analytic solutions today. 1In addition, vc_TechNation_Clr Ad_7x4.5_20Mar25.pdf 3/19/20 he3:51 led a variety of key initiatives including Novation’s entry into the

global marketplace through its partnership with DHL in the United Kingdom. Since 2016, Hatcher has served as a board member of Provista, Vizient’s subsidiary serving non-acute members. Previously he served for six years as a member of the board of directors for the Global Healthcare Exchange LLC and its audit and compliance committee. He served as board member and chairman of the Healthcare Group Purchasing Industry Initiative, the health care industry’s initiative to promote best practices and ethics. He also served as a board member of the Irving Healthcare System Foundation. “During my 30 years at VHA, Novation and Vizient, I witnessed numerous approaches to drive supply chain standardization, productivity and cost reduction, and I came to understand the importance of bringing people, process and technology together to create lasting change in health care,” said Hatcher. “As I came to know PartsSource, I realized that their software platform and evidence-based approach to procurement, with significant outcomes at numerous Vizient clients, is the future of supply chain optimization for top-performing health care systems across the U.S.” Hatcher joins existing PartsSource board members Mark Taber, managing partner of Great Hill Partners; Rafael Cofiño, a partner at Great Hill Partners; James Weinstein, MD, emeritus chief executive officer and president of Dartmouth-Hitchcock and the Dartmouth-Hitchcock Health System; and Settimi. Hatcher earned a bachelor’s degree from the University of Texas at Arlington and a master’s degree in business administration from PM the University of Dallas. •

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HTM CONTEST ENCOURAGES CLEAN WORKSPACE A new contest for healthcare technology management professionals promotes an organized and clean workspace. In the spirit of previous contests like Trick Out Your Cart, iMed Biomedical ask biomeds to spruce up their space. The grand prize is a $300 gift card and a lunch for the HTM department. The runner-up and third-place winners will receive a $100 gift card each. To participate in the contest HTM professionals or departments should pick an area of their department, then get up and clean up. Submit a before and after photo of the workspace to be entered to win. Be sure to include yourself or members of the department in the photo. Submit photos to www.1technation.com/contest-workspace-win to enter. •

INTERPOWER AVOIDS COVID-19 DELAYS Interpower remains unaffected by global shipping delays as a result of coronavirus quarantines, according to the company. The company’s one-week lead-times on all USA-manufactured power cords and components – and same-day shipping on all in-stock products – remains on schedule. Far less than 1% of Interpower’s purchased components come from Chinese suppliers. “Interpower recognizes many are concerned about the impact of the coronavirus on production schedules,” said Amy DeBruin, executive vice president of Interpower. “We are committed to continuously assessing its impact and our ability to meet your product needs. We will take precautionary steps to proactively manage risks associated with the coronavirus.” • FOR MORE INFORMATION, visit interpower.com.

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MAY 2020

GE HEALTHCARE LAUNCHES NEW MEDICAL DEVICE CYBERSECURITY OFFERING GE Healthcare has introduced a new cybersecurity service offering that brings together medical device expertise, artificial intelligence and process management tools to help hospital groups in their fight against cybersecurity threats. The new solution, called Skeye, augments hospitals’ existing resources and capabilities by providing proactive monitoring through a remote security operations center (SOC) – helping them detect, analyze and respond to cybersecurity threats and events in real time. As more devices become connected, cybersecurity risk increases – and security incidents can profoundly impact an organization’s productivity, finances, quality of care and reputation. GE Healthcare’s Skeye aims to address those risks by providing customers with a complete medical device security assessment to help identify risks and vulnerabilities, recommended action plans, remediation advice and execution strategies – facilitating collaboration across customers’ clinical engineering, IT and security teams. Additionally, AI tools will automate connected device inventory and equipment risk profiling throughout a hospital to create a dynamic management system for device onboarding and decommissioning. “Our customers need visibility to what medical devices are connected to their networks and the right resources to mitigate potential threats. This new offering provides customers with 360-degree threat visibility and a resolution roadmap to help defend and protect against vulnerabilities,” said Matt Silva, chief information security officer, GE Healthcare. “Our security operations center can augment customers’ in-house security teams by addressing cybersecurity events, as well as providing the latest information on malware and other malicious threats.” GE Healthcare’s Skeye utilizes AI-enabled tools together with the security operations center to analyze, monitor and help manage cybersecurity vulnerabilities. As a vendor-agnostic solution, Skeye helps protect networked medical devices, regardless of age, OEM or operating system. Its 360-degree coverage starts with risk assessment and moves to real-time networked device discovery. A SOC team provides monitoring and threat detection and remediation for connected medical devices under a GE Healthcare service contract. “We strongly believe that security is a shared responsibility across various stakeholders, and with this new solution, hospitals will now have access to a range of proactive and reactive cybersecurity services to support their own security programs,” added Silva. Skeye is currently available to customers in the U.S. •

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PHILIPS GRANTED UNDERWRITERS LABORATORIES PRODUCT CYBERSECURITY TESTING FIRM REGISTRATION Royal Philips is the first medical device manufacturer to receive a new Underwriters Laboratories (UL) product cybersecurity testing certification. UL is an independent global safety certification and testing company with locations worldwide. The UL IEC 62304 certification was designed by Underwriters Laboratories to provide an overall framework to evaluate the robustness and maturity of a medical device manufacturer’s cybersecurity controls and capabilities for product development. In support of the successful Philips firm registration for the security option of IEC 62304, UL performed a comprehensive audit of the Philips Security Center of Excellence. The center was launched in 2015 to develop cyber-resilient products and services through security-by-design, risk assessment, vulnerability and penetration assessment, specialized trainings and incident response.

The audit reviewed and verified core Philips Security Center of Excellence product security processes, including security risk management and risk control measures, software security verification planning, change management and continuous improvement, and the center’s laboratory quality management system. The UL certification combines cybersecurity testing elements of the established UL 2900-2-1 standard for Software Cybersecurity for Network-Connectable Products, which focuses on the demanding requirements of health care and wellness systems, as well as security principles from international standards (ISO 13485 and ISO 14971). “For the Philips Security Center of Excellence to receive this certification from Underwriters Laboratories, a

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long-established global leader in standards creation and safety testing, is a strong validation of our program and an opportunity to advance healthcare and personal health product security even further,” said Michael McNeil, global product security and services officer, Philips. “We’ve spent years building and investing in a robust end-to-end Security by Design program, embedding security principles and best practices throughout a product’s life cycle,” McNeil added. “At Philips, we understand that our customers have high and growing expectations for the security of the solutions that they rely on. In addition, global regulatory authorities have also increased the scope and scale of product cybersecurity compliance requirements to help protect patients and consumers. We look forward to continuing to meet these critical commitments.” •

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VIZZIA TECHNOLOGIES DELIVERS CONTINUED GROWTH IN 2019 Vizzia Technologies, a leading provider of managed real-time location systems (RTLS) for health care organizations, announced strong growth of revenue and customers in 2019. Vizzia was recognized as one of America’s fastest-growing private companies on the Inc. 5000 list for the second year in a row. Only one in four companies have made the prestigious list two times.

“Our team’s focus in helping healthcare systems to be more efficient, improve patient care and reduce expenses by leveraging our real-time actionable data has provided us with a platform for continued growth,” said Andrew L. Halasz, founder and CEO of Vizzia Technologies. “We are proud to serve top healthcare providers and collaborate with innovative partners as we build on this momentum throughout 2020.” •

DIAGNOSTIC ERRORS TOP ECRI’S 2020 PATIENT SAFETY CONCERNS ECRI, an independent nonprofit organization improving the safety, quality, and cost-effectiveness of care across all health care settings worldwide, today released its Top 10 Patient Safety Concerns 2020, naming diagnostic errors and maternal health in the top two spots. The annual report helps organizations identify looming patient safety challenges across the continuum of care, and includes suggestions and resources for addressing them. The launch was in conjunction with Patient Safety Awareness Week, March 8-14. “Unsafe health care delivery harms millions of patients,” said Marcus Schabacker, MD, PhD, president and CEO, ECRI. “Our annual patient safety report provides a roadmap to help health care leaders know what goes wrong and how to prevent harm.” ECRI’s Top 10 Patient Safety Concerns relies on the analysis of more than 3.2 million patient safety events in its Patient Safety Organization reporting program, as well as the judgment and experience of its interdisciplinary patient safety and medication safety experts. This list identifies areas that are high priorities for a variety of reasons, such as new risks, existing concerns that are changing because of new technology or care delivery models, and persistent issues that need focused attention or pose new opportunities for intervention.

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ECRI’s list of patient safety concerns for 2020: 1. Missed and Delayed Diagnoses – Diagnostic errors are very common. Missed and delayed diagnoses can result in patient suffering, adverse outcomes, and death. 2. Maternal Health across the Continuum – Approximately 700 women die from childbirth-related complications each year in the U.S. More than half of these deaths are preventable. 3. Early Recognition of Behavioral Health Needs – Stigmatization, fear, and inadequate resources can lead to negative outcomes when working with behavioral health patients. 4. Responding to and Learning from Device Problems – Incidents involving medical devices or equipment can occur in any setting where they might be found, including aging services, physician and dental practices, and ambulatory surgery. 5. Device Cleaning, Disinfection, and Sterilization – Sterile processing failures can lead to surgical site infections, which have a 3% mortality rate and an associated annual cost of $3.3 billion. 6. Standardizing Safety across the System – Policies and education must align across care settings to ensure patient safety.

7. Patient Matching in the HER – Organizations should consistently use standard patient identifier conventions, attributes, and formats in all patient encounters. 8. Antimicrobial Stewardship – Overprescribing of antibiotics throughout all care settings contributes to antimicrobial resistance. 9. Overrides of Automated Dispensing Cabinets (ADC) – Overrides to remove medications before pharmacist review and approval lead to dangerous and deadly consequences for patients. 10. Fragmentation across Care Settings - Communication breakdowns result in readmissions, missed diagnoses, medication errors, delayed treatment, duplicative testing and procedures, and dissatisfaction. The full Top 10 Patient Safety Concerns report provides detailed steps that organizations can take proactively to prevent adverse incidents. The executive brief version is available for public download at www.ecri. org/2020patientsafetytop10. In keeping with its mission of effective, evidence-based health care globally, ECRI launched a publicly available COVID-19 (coronavirus) Outbreak Preparedness Center to help hospitals protect health care workers and patients as the threat of coronavirus rapidly spreads across the globe. •

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INDUSTRY UPDATES

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TECHNATION ANNOUNCES HTM WEEK PHOTO CONTEST 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. •

eMAINT AMONG GARTNER PEER INSIGHTS CUSTOMERS’ CHOICE HONOREES Fluke Reliability shared that eMaint, part of the Fluke Reliability family of maintenance and reliability tools, software and services, has been named a 2020 Gartner Peer Insights Customers’ Choice for Enterprise Asset Management (EAM) Software. “We are honored to be recognized as a Gartner Peer Insights Customers’ Choice solution,” said Ankush Malhotra, vice president and general manager of Fluke Reliability. “Great customer relationships are paramount to us, so to be recognized utilizing peer reviews speaks volumes to us about how we are achieving excellence by delivering a quality product and ensuring customer success.” eMaint was also recognized as a Visionary in the 2019 Gartner Magic Quadrant for Enterprise Asset Management software.

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RIBBON CUTTING Biomedical Support Systems BY ERIN REGISTER

lmost 10 years ago, Hawa Zamani started in the medical equipment and service industry as a sales rep. Today, she is CEO of Biomedical Support Systems.

“A passion for what I was doing grew within me, and I knew I was going to pursue this industry,” Hawa stated. “I knew that it would be a part of me for many years to come. Six years ago, my mother and I made a decision to start our own company and create a more personal touch in the medical equipment sales and service industry. There are many female sales reps in this industry. However, the service side is a predominantly male industry, and I wanted to be part of it.” TechNation learned more about Biomedical Support Systems in a question-and-answer session. Q: WHAT IS THE MAIN FOCUS OF BIOMEDICAL SUPPORT SYSTEMS? A: Our goal is to provide excellent service at a fair and cost-effective price. We are offering our services with a more enhanced and personal touch and really like to cater to the needs of our customers, creating a one-stop biomed shop. We provide our customers with the most up-to-date technical advice that’s available in today’s market with the latest and most advanced equipment available to provide quality repairs.

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Q: WHAT SERVICES DOES BIOMEDICAL SUPPORT SYSTEMS OFFER? A: We offer service, repair and sales of medical equipment for hospitals, clinics and doctors’ offices. Our repair services specialize in, but are not limited to, patient monitoring, respiratory equipment, surgical equipment, defibrillators, ESUs, infusion pumps, fetal cable repair and more. In addition, we sell parts, accessories (such as ECG and SPO2), new fetal probes and refurbished equipment. Q: HOW DOES BIOMEDICAL SUPPORT SYSTEMS STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: I truly love working in this field because of the enormous responsibility of being able to provide support for hospitals, doctors and biomeds. They depend on equipment for the care of their patients. We are committed to staying up-to-date on the latest advances in the industry and to provide technicians with the support they need. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT BIOMEDICAL SUPPORT SYSTEMS TO ACHIEVE IN THE NEAR FUTURE? A: There are not very many female-owned businesses in this industry. We would like to create a personal touch. Our main focus is to stand out from the crowd by offering not only a personal touch but the highest level of service. In fact, we demand that.

Hawa Zamani CEO, Biomedical Support Systems

Within our website, we wish to create the most up-to-date information that is needed to serve our clients. We also wish to create an online portal for technical information needed from our technicians. As the CEO, my personal goal is to expand nationally and create jobs, continuing to grow and be innovative enough to create the most up-to-date information at the touch of your fingers. I want to expand and share our knowledge and experiences through an interactive website. Therefore, our clients can add personal experiences that would add knowledge and benefits for the patients that use the equipment needed for their care. Being able to provide jobs and helping others through my company is our ultimate goal. FOR MORE INFORMATION, visit www.biomedicalsupportsystems.com.

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AAMI UPDATE BY AAMI

AAMI UPDATE ON CORONAVIRUS The health and safety of our global community is our highest priority. As the situation involving the coronavirus (COVID-19) outbreak continues to evolve, AAMI is working to ensure a seamless experience for our members and customers. No matter the circumstances, we remain committed to supporting you in carrying out our shared mission of advancing patient safety. FOR THE LATEST UPDATES, including rescheduled or reconfigured events, visit www.aami.org/coronavirus.

AAMI NAMES 2020 AWARD AND SCHOLARSHIP WINNERS Several members of the health technology community will receive an AAMI award or scholarship and be recognized during the AAMI Exchange, June 12–15 in New Orleans, LA. Each year, AAMI and the AAMI Foundation recognize health technology’s best and brightest for their leadership, dedication, and contributions to AAMI and their fields. “Together, these clinicians, healthcare technicians, engineers, standards volunteers, young professionals, and students are advancing the field of healthcare technology and improving patient outcomes,” said AAMI President and CEO Rob Jensen. “It’s the honor of AAMI and the AAMI Foundation to celebrate these individuals for their achievements and to thank them for inspiring us all to push harder for safe and effective health technology.” This year’s winners are: • The AAMI Foundation’s Laufman-Greatbatch Award: Michael Scholla, DuPont Medical Packaging • The AAMI Foundation & ACCE’s Robert L. Morris Humanitarian

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•

Award: Frank Painter, University of Connecticut The AAMI Foundation & Institute for Technology in Health Care Clinical Solution Award: Samuel Gurmu, University of Maryland Medical Center The AAMI Foundation & TRIMEDX John D. Hughes Iconoclast Award: George Mills, Jones Lang & LaSalle AAMI & Becton Dickinson’s Patient Safety Award: Michelle Jump, MedSec AAMI’s HTM Leadership Award: Kurt Finke, U.S. Department of Veterans Affairs AAMI & GE Healthcare’s BMET of the Year Award: Nicholas Grecco, Baycare Health, Morton Plant North Bay Hospital AAMI’s Young Professional Award: Angela Bennett, TRIMEDX/ Ascension Borgess Health The Spirit of AAMI Award: Steven Baker, Oregon Health and Science University AAMI’s HTM Association of the Year Award: New England Society of Clinical Engineering Standards Developer Award: Daniel J. Cooke, Boston Scientific; Theodore Heise, MED Institute, and Dennis Jenke, Triad Solutions; and Changfu Wu, Food and Drug Administration The AAMI-HSEA Health Systems Engineering Scholarship: Rima Viradia, Bayside Medical Center, University of Connecticut AAMI Foundation Michael J. Miller Scholarship: Isha Arora, Cornell University; Mutegki Baguma, South Hills High School; Jacqueline Bertan, University of Connecticut; Taylor Dade, Columbia University; Shelby Johns, University of Connecticut; Jonathan Low, St. Petersburg

College; Darian Napolean, Harvard University; Joseph Rowan, Texas State Technical College; Emily Sizemore, University of Connecticut; and Rudolph Wagner, Texas State Technical College FOR MORE INFORMATION about the AAMI Awards Program, visit www.aami.org/awards. For scholarship information, visit www.aami.org/scholarships.

UPDATED RESOURCE ANSWERS WIRELESS TECHNOLOGY’S FREQUENTLY ASKED QUESTIONS With more and more medical devices going wireless, there are bound to be questions – from what to look for in a wireless medical device to the importance of wireless bandwidth. That’s why AAMI has released The Medical Connectivity FAQs, a free resource developed to help healthcare technology management (HTM), IT, and facilities management professionals understand the state of wireless tools and technologies, their use in healthcare, and how they can best be managed based on each profession’s responsibilities. “We hope that this document serves as a medium for HTM professionals to increase their understanding of wireless topics, enabling them to participate more fully in conversations about hospital network decisions that have a clinical impact, leading to increased communication and cooperation, and ultimately, improved patient outcomes,” said Steve Baker, PhD, clinical assistant professor at Oregon Health and Science University in Portland, OR, and editor of the FAQs. To that end, the FAQs provide answers and actionable tips from the WSTF to 81 questions submitted by subject matter experts, including security and network architects, HTM professionals, software and device

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manufacturers, and healthcare providers. The FAQs were developed by AAMI’s Wireless Strategy Task Force, which was recently integrated into the Health Technology Alliance, a partnership consisting of AAMI, the American College of Clinical Engineering, and the Healthcare information and Management Systems Society. The first edition was published in 2014. The Wireless FAQs are available for free download in the AAMI Store. AAMI MOURNS THE PASSING OF CESAR CACERES, FATHER OF CLINICAL ENGINEERING Cesar Caceres, cardiologist and former AAMI Board of Directors chair and president, passed away on February 9, 2020. Caceres was known as the “father of clinical engineering” for his early work combining computers with healthcare. His contributions to healthcare technology greatly improved patient care. “Cesar was an AAMI founder and certainly helped the association find its way,” said Michael J. Miller, former AAMI president and CEO. “His work extended to all facets of AAMI, including the journal (BI&T), education programs, standards, and acting as a liaison with other professional organizations. He was instrumental in developing our clinical engineering certification program as well as defining the concept of clinical engineering.” Caceres was one of AAMI’s first members. He joined the association while employed at the Public Health Service (PHS) Medical Systems Development Laboratory. There, he and his colleagues developed the first functional computer electrocardiographic interpretive system in the U.S. During an interview about his work at PHS, Caceres used the term “clinical engineering” to describe the combination of computers and healthcare. In 1983, Caceres founded and served as the executive director of the Institute for Technology in Health Care (ITHC). The nonprofit group encourages the use of technology to benefit health or the delivery of health-related services. In collaboration with the AAMI Foundation, ITHC offers an annual Clinical Solution Award to a healthcare technology professional or group that has applied innovative clinical engineering practices or principles to solve patient care problems. “On behalf of all of us at AAMI, we send our sincere condolences. Our heart goes out to his friends and family. Dr. Caceres’ legacy will live on with the annual AAMI Foundation and ITHC award,” said Steve Campbell, AAMI chief operating officer and executive director of the AAMI Foundation.

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ECRI UPDATE

When it Comes to Medical Device Software, Think Before You Patch

pplying software patches to address security vulnerabilities within a device or system is considered a fundamental cybersecurity practice. For most types of equipment, the appropriateness of applying a patch is noncontroversial. For medical devices and systems, however, the guidance is not so clear-cut. In fact, ECRI advises against patching medical devices without specific guidance from the medical device manufacturer to do so.

“Patching is key, but the process must be driven by sound policy and conducted in coordination with the medical device manufacturer,” notes Chad Waters, senior cybersecurity engineer in ECRI’s Health Devices Group. For medical devices – including equipment like radiology viewing consoles, laptops used with USB-connected ultrasound probes, and other control workstations – an unvalidated patch could do more harm than good. 3 REASONS TO WAIT Reason 1: Medical devices are different. Medical devices differ from many consumer devices and other types of equipment in that a malfunction of the device could lead to patient harm. Thus, any modification to the device – including a software patch – must be validated by the manufacturer to ensure that the intended use is not affected. Unvalidated patches can make medical devices faulty or inoperative. Additionally, potential effects on device interoperability must be considered. Many medical devices are connected to, and exchange information with, other devices and systems. Thus, the possibility exists that a patch could affect the way connected devices and

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MAY 2020

systems interact with each other. Reason 2: The manufacturer knows the device better than you do. The manufacturer is in a better position than the hospital to assess the implications of a security patch, and is required to do so. In its fact sheet The FDA’s Role in Medical Device Cybersecurity, FDA specifies: “The medical device manufacturer is responsible for the validation of all software design changes, including computer software changes to address cybersecurity vulnerabilities.” Medical device regulations require that modifications to a device not affect the device’s safety or effectiveness; thus, manufacturers must verify that their devices will function properly after the patch has been applied. Reason 3: Applying an unvalidated patch can increase your liability. A hospital that applies an unvalidated software patch risks shifting liability for problems that occur with the device from the manufacturer to the hospital. In its white paper Medical Device Software Patching, Integrating the Healthcare Enterprise (IHE) notes that directives not to “install any software or components on the medical device that have not been validated and approved by the manufacturer ... may be further enforced through contracts and warranty conditions,” adding that, “as a result, any change to the device without manufacturer approval can create substantial liability for the [health delivery organization].” 4 STEPS TO TAKE RIGHT NOW ECRI recommends the following steps to improve your preparedness for, and management of, security updates and patches for medical devices and systems: Step 1. Institute a policy that details when and how medical device patches

will be applied, and which staff will need to be informed about and involved in the process. The policy should specify that medical device security updates or patches must first be validated by the medical device manufacturer before being installed. Step 2. Establish processes and assign responsibilities for learning about and disseminating cybersecurity information, including information about software patches. During the WannaCry cybersecurity attack in 2017, one of the issues that emerged was the difficulty healthcare organizations had obtaining timely information from medical device manufacturers and government agencies. There remains no single channel through which manufacturers disseminate information for easy access by healthcare organizations. (To help address this issue, ECRI now disseminates cybersecurity notices to hospitals via its Health Devices Alerts service.) Sources of information about device patches include: • The medical device manufacturer. Most major manufacturers will post advisories on their website or customer portal, or send notifications by email or postal mail. • U.S. government agencies and groups, such as FDA and the Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) • Independent patient safety organizations, such as ECRI (through Health Devices Alerts) • H-ISAC (the Health Information Sharing and Analysis Center), ISAOs (information sharing and analysis organizations), and other health IT organizations Step 3. Follow the device manufacturer’s instructions, if supplied, about

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how to proceed until a validated patch becomes available. Often, device manufacturers will issue an advisory with interim guidance when a security risk has been identified. The manufacturer may recommend mitigations. For example, if the vulnerability is network based, compensating controls may include network segmentation. Step 4. Update your device procurement practices to include obtaining information about a device manufacturer’s patching policies and how the manufacturer distributes software updates. It will be important for healthcare providers to know – before purchase – how often a manufacturer intends to patch and update a device. The updates may need to be applied by the manufacturer, either remotely or on-site by a field technician. The 2019 revision of the MDS2 form includes a section that specifically addresses patches and other cybersecurity product upgrades. (Device manufacturers use the MDS2 form – the Manufacturer Disclosure Statement for Medical Device Security – to communicate information about a product’s security capabilities to their customers.)

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WHEN IT’S TIME TO ACT Once a patch for a medical device or system has been made available and validated, you’ll need to (1) coordinate next steps with device stakeholders and clinical staff and (2) apply the patch according to your patch management policies. According to ECRI’s Waters, these policies should provide guidance for activities such as prioritizing devices to be patched, managing devices that need to be removed from service to apply a patch, and responding if it becomes necessary to roll back the patch. LOOKING FORWARD Difficulties in medical device patching should lessen over time as suppliers include support for security patching in their new device design requirements. FDA is working on ways to clarify and improve the regulatory requirements for the design of new medical devices so that future devices will be better suited to being updated as new cybersecurity risks become known. For medical devices currently marketed and in use, however, healthcare facilities will need to rely on manufacturer communications and internal policies and mitigation strategies to identify the need for, and to implement, medical device software patches. This article is adapted from ECRI’s Guidance Article “Software Patches for Medical Devices: Vendor Validation Is Essential” (Health Devices 2020 Jan 22). The complete article is available to members of ECRI’s membership programs. To learn more about membership, visit www.ecri.org/solutions/device-evaluations, or contact ECRI by telephone at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

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HIDDEN TALENT Problem solving/troubleshooting ability Favorite part of being a biomed “The satisfaction of completing a repair and knowing that a patient will receive the care they need. I also like working with our interns to make sure they

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

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

ssic Marto Chuck ound to Cla Ultras

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Assessing Your Cyber Risk Impact: Intent vs. Opportunity BY JOSHUA MABERRY

ybersecurity is no longer just a concern for large corporations and government entities. One of the largest attack surfaces today is health care where facilities rely on ease of access and fast sharing of data to facilitate immediate and effective care.

Breaches in health care are occurring more frequently than ever before. According to HIPAA Journal, an estimated 494 data breaches of more than 500 records were reported to the HHS’ Office for Civil Rights in 2019. Additionally, more than 41 million records were stolen, and/or disclosed without permission last year. As of November 2019, the health care industry accounted for four out of five data breaches, with predictions that 2020 could be a record-breaking year. The financial impact also hurts the health care industry, with costs from those breaches estimated to reach approximately $4 billion in 2020. Given these escalating stats, there is no such thing as out of bounds businesses in the cyber threat world. The only real question is whether your organization is a target of opportunity or intent. A target of intent is one that an attacker is seeking to cause notable impact, while a target of opportunity is one that an attacker is simply exploiting in order to get to their real target. Attackers, especially those driven by geopolitical motives, are looking for disruptive impact and notoriety. While health care is an obvious target of intent for attackers looking to cause tangible impact, they typically will not attack these entities directly due to higher risk

of detection. This is where the targets of opportunity come into play. An attacker looks for existing trusted connections with their end targets. For example, an experienced thief may not attempt to rob a bank directly through the front doors, but rather looks to see if there is a way in through a trusted connection such as a connected building that shares a ceiling or some other form of less visible entry. In the digital world this means observing who their end targets are connected to and how those connections are implemented, monitored and leveraged. Companies rely heavily on digital connections with their vendors, partners, service providers and customers. These connections present potential risk on all sides. A supplier who has a connection to a medical facility for billing may serve as an optimal target of opportunity for an attacker to gain access to the facility’s patient information, details of upcoming procedures and scheduling, supply orders and even physical power and/or HVAC capabilities. Small to medium-sized businesses are frequently targeted by phishing attacks. The attacker’s intent is to set up a presence on their network to gain access to larger businesses with whom they may have connections. Alternatively, larger entities need to assess not only how they connect with these other businesses but also how their network is designed to prevent these attacks from moving forward should a partner connection be compromised. This means taking a holistic approach to reviewing their network visibility, how it’s constructed, segmented and used.

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Joshua Maberry Critical Start

Simply purchasing a new security tool will not improve your security risk posture if you have abundant faults in your IT implementation and utilization. To assess your risk and impact, here are some questions your organization should consider: • Is your network segmented properly? • Do you have the right controls in place to limit permissions? • Are you able to detect and respond to attacks? • Can you enforce the policies you have written and do those policies make sense? • Have you built the right security culture within your company to prevent the exploitation of your people? • What do you have that would be of value to an attacker? • Do you know what activity is normal for your network? These are just some of the questions that must be asked when assessing your risk and impact. If you are not pursuing answers to these questions, then you are exposing your business and those you do business with to unnecessary risk. To mitigate risk, every organization should be breaking down silos and self-centric thinking and considering the world outside your business to determine what impact we have on each other. JOSHUA MABERRY is the director of customer success at Critical Start.

MAY 2020

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WEBINAR WEDNESDAY Series Delivers Virtual Educational Sessions STAFF REPORT

ebinar Wednesday continues to deliver valuable content to the healthcare technology management (HTM) community. Recent presentations have received positive reviews along with valuable information.

WEBINAR ADDRESSES MEDICAL DEVICE SECURITY LIFECYCLE MANAGEMENT The recent Cynerio-sponsored session “Medical Device Security Lifecycle Management” was presented by Daniel Brodie and eligible for 1 credit from the ACI. This 60-minute webinar featured Brodie, co-founder and CTO of Cynerio Inc., as he examined the three stages of medical device security lifecycles. He focused on best practices and key milestones for effectively managing device lifecycles from an IT security perspective. He also discussed the importance of aligning the clinical engineering and IT departments. The webinar, which drew almost 200 attendees for the live presentation, received positive reviews in a post-webinar survey. “Encompassing illustration of life of medical devices with IT elements,” A. Warren, QA manager, said about Brodie’s presentation. “Good information for our program and applicable for our use,” HTM Director K. Forsythe said. “Interesting information toward a change in the future of how to develop

TECHNATION

MAY 2020

“ [Webinar Wednesday is] a great resource for learning about the trending topics in healthcare technology management.” – A. BARTH, BIOMEDICAL ENGINEER IoMT into hospitals,” shared J. Tamaiz, general manager. “Seemed very helpful to organizations starting to travel down the security road,” said M. Slater, supervisor, biomedical electronics. “A good overview of medical device security lifecycle management, including risks and usage,” said M. Katz, associate. “Cybersecurity is a growing concern at healthcare delivery organization. HTM must know how to countermeasure cyber threatens for connected devices. This webinar provided us with a big scope in this area from the beginning to the end,” said T. Koh, MET. Attendees were also asked, “How would you describe Webinar Wednesday to your colleagues?” “Worth the time, very informative,” said R. Cremer, director. “Great source of information you wouldn’t normally be exposed to,” said J. Pleiman, senior biomedical electronics technician. “A great resource for learning about the trending topics in healthcare technology management,” Biomedical Engineer A. Barth said. “Easy to join meetings and moderation is excellent,” Equipment Support

Technician J. Banuelos said. “Informative on the day’s subject/ topic. Presenters possess a very good working knowledge of their subject matter,” said Design QA Staff Engineer S. Trainor. “Gives you the ability to maintain your CBET as well as learn new skills or learn of new products,” said J. Carter, BMET. RADIATION SAFETY WEBINAR DELIVERS SOUND ADVICE The Webinar Wednesday presentation “Radiation Safety and Protection in Fluoroscopy – Utilizing RTI’s Piranha and Ocean Software QA Tool Measurements” was eligible for 1 credit from the ACI. The 60-minute webinar featured Christiane Burton, Ph.D., diagnostic medical physics resident at Boston Children’s Hospital and Harvard Medical School. She focused on radiation safety and how she utilizes RTI’s Piranha and Ocean Software QA Tool Measurement tools to increase efficiencies in the X-ray room. She also discussed how to obtain the necessary measurements and walk out with automated reports so she can focus on other tasks. The webinar was sponsored by RTI Group.

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“ As a radiology support engineer, this webinar broadened my knowledge base for radiation safety.”– R. HARBICK, BMET III The webinar was popular among healthcare technology management professionals with almost 200 individuals attending the live presentation. The webinar is available online where even more people are increasing their radiation safety and protection knowledge. A post-webinar survey resulted in positive feedback and answers to the question “How will today’s webinar help you improve in your role?” “[It] gave me a better understanding of the types and use of different X-ray machines,” shared L. Barton, biomedical equipment service specialist. “This would be good for users or people new to the X-ray field. I have been doing this for 20 years, so this was more of a review than anything new,” explained J. Monnig, biomedical equipment service specialist. “Enables me to understand the radiology role in regarding patient safety as well as the employee,” Biomed D. Tomczak said. “Radiation safety is without a doubt one of the most serious concerns that all staff members in health care should be aware of. This is because being invisible with no immediate signs, whether accumulative or a possible overexposure, can pose serious health risks. We must educate ourselves how to limit exposure to patients as well as all staff members. Radiation safety is on the top of my list along with infection prevention,” said B. Hayes, CBET III. “Reviewing dose and exposure concepts always helps, especially listening to a physicist give me a great point of reference for the testing’s perception,” Technical Support Engineer M. Galeano said. “As a radiology support engineer, this webinar broadened my knowledge base for radiation safety,” shared R. Harbick, BMET III. FOR MORE INFORMATION about Webinar Wednesday, including recordings of previous presentations and a calendar of upcoming webinars, visit WebinarWednesday.Live.

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SHOP TALK POWERED BY GE HEALTHCARE VOLUSON S-SERIES

I recently encountered a problem with a Voluson S6. The first probe port cannot detect the probe, but when I transfer it to the next probe port it’s detected. I also noticed that the mechanical behavior of the copper pins in the said probe port is not the same as to the other two working probe ports. Can this be fixed manually by bending or improvising a fix or will it need an assembly replacement?

the diagnostic may be more complicated if the fuses are good.

It is very clear that the TRIAC board (near LV unit small board) is faulty. Replace it and your problem will be solved.

Check the video graphics board secondary output with another monitor to find out which component is faulty – the graphics board or the monitor. MIDMARK RITTER M11

The issue is with the port itself. This is not a field repairable part. You will want to replace the entire Probe Interface Board (Part # 5366065-3).

The first port is for “parking” a probe. There are only three active connectors on the Probe Interface Board of a Voluson S6. GE HEALTHCARE LOGIQ 400

When I power on the machine, only the keyboard backlight is on for 1 second and then there is no response from the machine. The same thing will happen when I power off the equipment. Can you help?

Have you controlled the fuses? If the fuses aren’t burned, it probably is the power transformer, but

I have a Midmark M11 autoclave. It just started blowing fuses yesterday. I have replaced the fuses and watch when it trips. I close the door and initiate a cycle, but as soon as it says it starts heating it blows the fuse. Any thoughts on which component is faulty?

I would check any voltage regulators around the heating controls.

A: A:

Heater shorted, or shorted to ground, possibly.

A number of known issues: fuse holder on the PCB; burned traces on the PCB near the fuse holder or heat relay. Visually check for damaged connections and/or melted wiring beneath the chamber at the heater and the overtemp thermostats and visually

inspect the heater inside the chamber for cracks, breaches or gross deformities. This assumes you have already checked for shorts with a meter. SIEMENS ACUSON X150

I am getting a self diagnostics check signal cable no signal error on a Siemens Acuson X150. I have checked the cables to the unit. The only one disconnected is the staff report that I am not using and plugging it in does not clear the error. I have rebooted the unit and still have the same error. Siemens is not providing tech support on this unit. Is there a service manual available? Does anyone know how to clear this error?

The issue you are having is with the BE board and RM board. These boards are the main computer of the system and are failing to start. You will want to replace both parts. For serial # less then 307998 use parts 10131804 and 10349420. For serial # greater then 307999 use parts 10349464 and 10349439.

It could be a power supply issue. Verify AC/DC power supply LEDs located on the back of the system. If DCDC power supply is bad then DC LEDs are solid amber (yellow orange) the system might have over current or over voltage or over temp. Same for the AC LEDs.

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ROUNDTABLE

Replacement Tubes and Bulbs

ore and more healthcare technology management (HTM) professionals are entering the imaging service arena. TechNation, always looking to provide valuable information to readers, quizzed some experienced professionals about replacement tubes and bulbs.

and are backed by a warranty. It also means there is continuous improvement in the manufacturing process.

Joe Grace GE Healthcare

KRAMER: You need to have a level of comfort with your supplier, that X-ray tubes is a regular part of their business and they have the capability of supporting you if something goes wrong. When buying preowned tubes, ask for clarity about the history, manufacture date and usage. Make sure youâ&#x20AC;&#x2122;re comfortable with their answers to such questions and donâ&#x20AC;&#x2122;t appear dodgy. Viable suppliers should always offer a reasonable warranty.

often a key priority for customers. This includes quality of the supplier and their reputation, and quality of the X-ray tube. Having higher quality X-ray tubes will help mitigate unexpected downtime; higher quality X-ray tubes are designed and manufactured to provide maximum performance, image quality

NOWAK: The most important thing is to select a reputable business partner to purchase the glassware from for your needs. You need a vendor that will stand behind the products that they sell. From time-to-time, issues happen with products that fail prematurely, how your business partner responds means the difference for how you, your

Participants in the roundtable discussion are GE Healthcare Global Product Manager, Tubes & Service Offerings, Joe Grace; W7 Global LLC. President Wayne Kramer; and Universal Health Services Inc. Healthcare Technology Management Senior Director Christopher Nowak, CBET, CHP, CSCS. Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN PURCHASING REPLACEMENT TUBES AND BULBS? GRACE: Customers may value different things when it comes to purchasing replacement X-ray tubes, but quality is

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MAY 2020

TECHNATION

ROUNDTABLE

clinicians and the patients that are served. The reputation of the business and the sales and service people they employ is an earned characteristic that provides a consumer with a certain degree of confidence that there will not be disappointment when “things” go sideways with the parts or service purchased. Q: WHAT ARE SOME OPTIONS CUSTOMERS SHOULD INQUIRE ABOUT? GRACE: Customers should ask about tube options such as new, used or available low-cost brands. Customers should inquire about the options that surround the tube: Does your supplier have X-ray tube coverages that might save you cost? Does your supplier have predictive/ proactive capabilities you might benefit from? An X-ray tube is a critical item in the imaging chain and customers should be aware of additional benefits [options] that could improve their cost position and system performance. KRAMER: It makes sense to consider brand-new OEM versus brand-new aftermarket versus preowned options. The best deals often do not come directly from the OEM. Search the market and check for available options from aftermarket suppliers and dealers like W7 Global. At W7 Global, we now offer an extended warranty option for brand-new tubes under our TubeAssurance program. NOWAK: Consumers should look at all options available when purchasing from a reputable vendor, i.e. new, pre-owned or an alternative. An example of such options could be batteries used in our medical devices. You could purchase new batteries from the medical device OEM, who do not manufacture the batteries, or you could investigate alternatives. When looking at alternatives, you must use due diligence to investigate the vendor and the vendor’s

TECHNATION

MAY 2020

reputation, the chemistry of the alternative non-OEM battery and the specifications of the non-OEM battery. It is incumbent upon the HTM technical team to ensure compatibility and quality of any alternative or options available for your medical devices. Q: CAN YOU DISCUSS THE PROS AND CONS OF PURCHASING A NEW PRODUCT VERSUS A REFURBISHED PRODUCT? GRACE: A new tube has never been used and some customers prefer this fact. Refurbished tubes are another viable solution. Refurbished is not the same as “used.” Refurbished may be less expensive than new. When purchasing a refurbished tube, the customer should take the time to understand how the supplier defines refurbished and if there are any differences in the warranty between refurbished and new.

some dishonest people out there trying to peddle tubes as new that aren’t, so be careful. If an offer seems too good to be true, most of the time it is. You should be able to vet the supplier through industry references and websites. NOWAK: Obviously, a new product from the OEM should assure the appropriate fitment with the device model and version, at least that would be the expectation. A refurbished product, from a third-party, offers several opportunities for the consumer, such as lower cost, similar quality, and typically a selling vendor who is invested in your success for properly servicing the medical device. Of course, many of the OEM parts these days are refurbished parts, not new parts. Unfortunately, the majority of the OEMs look at your business as transactional business. Some of these OEMs are not invested in your success, they are invested in their own success and maintaining margins rather than maintaining a long-term client. It is not always a win-win relationship with transactional business. Q: WHAT TYPES OF WARRANTY AND PRODUCT SUPPORT SHOULD CUSTOMERS BE AWARE OF WHEN PURCHASING TUBES AND BULBS?

Wayne Kramer W7 Global LLC

KRAMER: New tubes tend to be associated with lower risk and higher cost. There can be many options for obtaining brand-new tubes, sometimes at very different prices. If you’re spending the money for a new tube, make sure you’re getting an OEM-level warranty, or at least a warranty that suits the price being offered. There are, unfortunately,

GRACE: A customer should know the warranty that is being provided and have it in writing. X-ray tubes can be very expensive, so knowing what warranty coverage is provided with an X-ray tube is imperative. The customer should be comfortable with the warranty terms and who is providing these terms. In addition, product support goes beyond the tube; customers should know the level of technical knowledge and support available from the supplier as it relates to the entire system. KRAMER: Any quality X-ray tube should be supported by a competitive warranty – always. Beware of sellers looking for a

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ROUNDTABLE

Advancing the Biomedical/HTM Professional

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NOWAK: TechNation readers should always understand that it is their responsibility, regardless of where you are buying products and services, for the quality and reliability of the products and services. Price is only one aspect of the relationship with your provider. Never make purchasing decisions based solely on price. The TechNation reader/ consumer should look at all the aspects involved in a purchasing decision and should always protect the brand of your employer. A poor purchasing decision, based only on cost, could place the name of your employer on the front page of a newspaper and in a court of law with significant consequences for all involved including, and most importantly, the patient.

g ishin 9 MD Publbrook Bend GA 3026 18 East e City, htre Peac

GRACE: Customers should consider the long-term when it comes to purchasing a tube. A less-expensive solution today could add up over time, by way of unexpected downtime due to shorter tube life. Customers should consider how a supplier could meet their needs beyond the tube. For example, does the

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Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING TUBES AND BULBS?

KRAMER: One of the most important things to remember is that, whether purchasing new or preowned, you have options. Don’t assume that you have to go to the OEM and pay their asking price, even if you want to buy brand new. Check around with companies in the industry to find the most cost-effective, reliable solution that fits your specific needs and budget.

D T ST PRSR stage . Po U.S PAID hing Publis MD

NOWAK: Consumers should expect the business partner from where you are buying parts and services to “stand behind” their products and services. Warranties should be similar, although a quality third-party provider typically has a better warranty than the OEM. It is that “investment” into your success that drives the third-party to offer a more robust product and service.

supplier have offerings that help them with their goals?

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quick, cheap sale and not offering a warranty. Even if you’re offered a warranty, it means nothing if the company doesn’t support it. I’ve personally experienced being offered a fantastic warranty for a used tube, only to find the supplier completely unresponsive when a claim was made. Always use a reputable company with a solid track record when buying an X-ray tube. Generally speaking, quality used and refurbished tubes will have warranties of at least 90 days on a prorated basis. New tubes typically come with 12 months and might vary between full replacement and prorated. Some also come with usage limits, such as 100,000 scan seconds for CT. All of this is standard in the industry. Don’t assume that buying a brandnew tube automatically means you’re avoiding the risk of warranty failure. We see plenty of warranty cases reported from tubes that came direct from the OEM.

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MAY 2020

TECHNATION

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TECHNATION

MERGERS AND

ACQUISITIONS

Proven Practices for CE Departments

TECHNATION

MAY 2020

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BY K. RICHARD DOUGLAS

very business in the U.S. has its own corporate culture and business model. Like people; no two are exactly the same. When companies determine that there is an economic benefit to merge, the cultures need to come together in a synergy, which can be challenging.

In health care, the need to form alliances and merge existing systems and hospitals has been borne out of economic necessity. It is sometimes necessary to “scale up.” Supply chain costs are second only to labor, accounting for 90 percent of a hospital’s expenses. “The total number of health care mergers and acquisitions hit a record high in 2018,” according to Becker’s Hospital Review. The trend remained strong in 2019 with a substantial number of agreements realized. According to a Price Waterhouse Coopers Health Research Institute report, there were 1,221 deals announced in 2019, which represented a slight decrease from 1,239 deals in 2018. The total value of the deals completed in 2019 was $91.2 billion. Deals among physician medical groups were down substantially during the same period. One mega-deal in 2018 in this sector caused the decline in the subsequent period. Even 2017 saw some major mergers announced. In December of that year,

Advocate Health Care and Aurora Health Care announced a merger that would result in a $10.7 billion system spanning several states. The merger did not involve any market “overlap,” which eased concerns of regulators. The combination of the two health systems created the country’s 10th-largest not-for-profit hospital network. The newly combined 28-hospital not-forprofit integrated health system is now called AdvocateAuroraHealth. Just after this deal was announced, another mega-merger was revealed; the merger of Catholic Health Initiatives (CHI) and Dignity Health. Again, this merger did not involve any overlap, so it was more palatable to regulators. The merger also embraced the co-CEO model. In early 2019, the newly aligned organization became CommonSpirit Health. The new health system spans 21 states with more than 700 care centers and 142 hospitals. The facilities reach from Washington State along the west coast down to Texas. They include states throughout the Midwest and as far south as Georgia. The merger created the largest not-for-profit health system by revenue in the country. The $29 billion mega-system focuses on solving national health challenges, according to one of its CEOs. There have also been deals that haven’t been consummated. Not every merger that is discussed or negotiated

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ends up as a done deal. It should be remembered that hospitals and health care systems are a business. Whether they are for-profit or not-for-profit, they have obligations to shareholders, the local community, the state, employees and patients. That last group is always the priority focus, but the rationale behind a merger or acquisition is also targeted at improving business metrics, offering more services and strengthening balance sheets. Smaller hospitals and systems are merging with larger hospitals to ease financial and regulatory pressures. Some also do so to increase credit ratings. Mergers allow health care providers to “scale up” in an effort to cover staff shortages. Some of the largest mergers of 2019 did not involve hospitals, but included the merger between CVS and Aetna and Total Health Care and Priority Health. A positive business climate during 2018 and 2019 provided the right environment for many health care businesses to pull the trigger and make what is often a risky, but calculated, business decision. This year was thought to maintain the same pace, but a strategic focus may replace financial incentives. In Louisiana, there is an anticipated merger between Lafayette General Health and Jennings American Legion Hospital. Lafayette also anticipates finalizing a merger deal with Ochsner Health System.

MAY 2020

TECHNATION

MERGERS & ACQUISITIONS All departments in a health system have to prepare for, and adopt to, the changes that are part and parcel of a merger. There may be an existing culture, among both entities, which is similar, such as the CHI and Dignity Health merger, or one contingent of employees will have to adopt the other entity’s culture. Relations with vendors often change as well. It may be that preferred vendors change completely and the purchasing process may change as well. The brands that have been a mainstay for a health system may change as a result of an acquisition. Many of these changes impact the HTM department, both the corporate culture changes and the changes to procedures or in vendor relationships. The familiar salespeople may go away. INSIGHTS INTO PREPARATION As an HTM department, or staff member of an HTM department, there is no reason to confront an impending merger or acquisition uninformed. Because of the number of past mergers, several members of HTM leadership have garnered experience and insights that can be beneficial. Here are a few examples. When knowledge of an impending merger becomes known, how does an HTM department prepare?

“ When we merged, we reviewed each facility’s CMMS and decided collectively which one we would use and then simply imported the data from the other’s CMMS.” – JIM FEDELE

TECHNATION

MAY 2020

“The heads of each HTM department met well in advance of the merger to discuss the blending of two large and successful departments. On the support side, we prepared for what we would need to do to accommodate an influx of new technicians – training, CMMS usage, and supporting from another state, among other things,” says Greg Czajka, CBET, supervisor, healthcare technology management at Advocate Good Samaritan Hospital, part of Advocate Aurora Health in Downers Grove, Illinois. Beyond training and information for new colleagues, there is also the need to speak the same language beyond the esoteric “biomed speak” that is understood. There is also the set of terms that may be peculiar to members of one employer and the procedures that are understood by one group that must be shared. “There was a big push for standardizing nomenclature, models, PM frequency, etcetera. Clean data with connectivity data — I.P., Subnet, AE title, OS version, etcetera — helps when changing CMMS. Basically, dot the I’s and cross the T’s so that your records can be transported to a new CMMS if needed. Be the consummate professional,” says Scott Ostrand, CBET, CHTM, manager of clinical engineering at CommonSpirit Health in Lincoln, Nebraska. There may also be a need to adopt a new career progression formula and salary schedule. “When we merged, we reviewed each facility’s CMMS and decided collectively which one we would use and then simply imported the data from the other’s CMMS. When we were acquired, our inventory and locations were all put into their system. We adopted all their job descriptions pay scales and technical ladder,” says Jim Fedele, CBET, senior program director of clinical engineering, BioTronics at UPMC in Williamsport, Pennsylvania.

POLICIES AND PROCEDURES Policies and procedures are time-tested and formulated, often over several years, through committees, technical writers and out of experience. They are most often specific to an organization although there can be some standardization as well. “I have been through both a merger and an acquisition, even though they are used together, they are very different,” Fedele says. “When we merged with the local hospital down the street, we reviewed policies and combined them where it made sense. Biomed policies, for the most part, are pretty standard so it isn’t like it is a major change. Also, when we merged, the hospital I worked at was a Service Master account, the other hospital was an in-house program. Executive leadership chose to merge the other hospital program with Service Master, so essentially all policies and procedures were adjusted to support the Service Master program,” Fedele adds. He says that when they were acquired, they adopted the purchasing entity’s policies with minor adjustments for the situation, layout and support system. “Cultures come from the top. It is important to be the change agent and buy in. If you truly do not support the new organization’s methodology, and forming culture, you must leave it. The policy manuals are reviewed by a committee and any changes or official adoption is at that level. Site specific HTM departments do not have policies, but can keep guidelines for general practices,” Ostrand says. COMBINING INVENTORIES AND PRACTICES What are some of the major considerations when an HTM department knows that a merger is imminent? Preparing for change and adopting the best mindset are key.

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Proven Practices for CE Departments “ It’s imperative to keep up employee morale. Managers need to lead and also root out negativity. Morale is contagious. Low morale is not good for retention and retention keeps your core technologies, crucial customer relations, proprietary knowledge and vendor/industry relations,” – SCOTT OSTRAND “It’s imperative to keep up employee morale. Managers need to lead and also root out negativity. You must be open with communications and interactions. Morale is contagious. Low morale is not good for retention and retention keeps your core technologies, crucial customer relations, proprietary knowledge and vendor/industry relations,” Ostrand says. He says to start by showing a dedication to the new organization. Talk about the “alliance,” not the merger. “Respect confidentiality when the two organizations are performing due diligence. In general; be positive,” he says. With the merging of different HTM cultures, a concerted effort to meld best practices can result in a stronger combined entity. “Each system HTM lead needs to evaluate their own processes and be ready to bring their successes to the table. Neither system is perfect and each side should know what best practices they have so that they can be shared and hopefully integrated into the final product,” Czajka says. He says that when Advocate and Aurora merged, he found that they took processes from both sides to make the new system successful. How do you join two asset inventories; or do you? What do you do with an expanding database? “Our circumstances were unique because one of the two systems were going to transition to an in-house program at the time of the merger, so

there was not much of a choice as to which CMMS would be used post-merger,” Czajka says. He says that they had to transition everyone onto the one that was used within Advocate since their program was established. “We worked with the CMMS vendor to determine how to import all of the new inventory into it. A great deal of work had to be done because of differences in equipment coding between the two systems, but it was ultimately a successful implementation,” Czajka adds. Regarding the conversion of inventories, Ostrand says that much of the legwork was done ahead of time. “In our case, we had our IT work with their teams to convert their inventory to our CMMS prior to the official go-live date. During the official go-live, a team of our managers and administrative staff went to the new locations for a two-week stay and acted as a liaison to the managers. Most HTM departments are very similar in behavior. We are there to guide new staff and to help them adapt to the new ways,” he says. THE WHOLE IS THE SUM OF ITS PARTS With any merger that brings together separate and distinct biomed departments, there are considerations that include CMMS, personnel, assignments and leadership. Preparations have to be started as soon as possible and groups of technicians have to be merged.

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How do you merge two HTM departments into one? “The toughest challenge we had was integrating 90 technicians into a new CMMS while still supporting day-today activities,” Czajka recalls. “We had to plan training sessions and provide ongoing support to a widespread group of individuals. We also had to quickly acclimate them to a new equipment service call process,” he adds. Czajka says that there are a lot of routine activities that we take for granted, which can be a tall hurdle to overcome when changes are made to them on a large scale. The process does not occur overnight and often it is accomplished in stages. “We really have not merged fully. The overall framework is in place and we continue to roll out our ‘product,’ but new sites continue to on-board. Overall, we respect the existing managers and their teams. Each geographical market has an operations director that oversees the territory. We generally have not changed the existing personnel and assignments,” Ostrand says. HTM leadership has to consider every facet of the new organization and prepare. “Every time I have gone through this, I start preparing inventories for export. I get my employees to update their resumes so they can show off their skills. I gather all the information about our program that I can from policies to contracts so that information is ready for those who will be working with us to integrate to the new system,” Fedele says. He says that most importantly, he sets his mind to accept the change and does what he can to make the transition easy for his staff and tries to not be a barrier to the process. “The sooner you realize the change is going to happen, with or without you, the better you will be,” he says.

MAY 2020

TECHNATION

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CAREER CENTER

Remain Focused and Motivated to be Successful BY CINDY STEPHENS

t is so easy to lose focus and motivation, especially when there are so many demands placed on healthcare technology management (HTM) professionals today. It is especially hard to stay motivated when the day is filled up quickly with more distractions than just completing the normal day-to-day requirements of the job.

Productivity expectations are very high, and often the workload increases due to staffing shortages which quickly disrupts the planned objectives you started with that day. As you struggle to keep up with the myriad of daily tasks and challenges, it can drain your energy and you may begin to feel overwhelmed. Soon the best intentions you had at the beginning of the day or week are completely derailed. Feeling discouraged and frustrated often leads to procrastination and it is natural to lose focus and motivation. Most of us begin each year with clear goals and the steps needed to accomplish them. It is a great strategy to review these goals throughout the year to ensure you have a clear plan – updating the goals and steps as the year progresses. However, even the best laid plans and great intentions quickly get sidetracked by disruptions. Rather than becoming frustrated or discouraged, it is important to remain positive and motivated to work through the challenges. Sometimes that means taking a break to get a grip on reality and what is going on around you. Step back and remain flexible. Adjust your plan and stay focused on what is important. Realign your plan for the day and take control of your daily routines and responsibilities. It is also important to maintain daily “to-do” lists and schedules that are realistic and achievable in the time frame

TECHNATION

MAY 2020

allotted for each task. Revise it to meet the specific demands and requirements for that day or week. Priorities change and you should allow time at the end of the day to plan and prioritize your schedule and to-do list for the next day and week, allowing for revisions as needed. One way to remain motivated and focused is to clear away the clutter. Clutter and disorganization create stress in our lives, and sometimes we spend too much time looking for important information. Distractions are normal for everyone. While you cannot remove all distractions, you can eliminate those pointless disruptions that are interfering with your productivity. Do not waste time at work on non-productive activities. Make a list of those people and interruptions that drain your energy and time – and do something about it. Re-organize tasks that are necessary but not important, or set time aside after work hours to handle anything not work related. Personal interruptions can drain your time, focus and energy during your day if you allow it. If you find yourself receiving personal calls and texts from family and friends during the workday, make an effort to ignore them until you have a break or after work hours. Don’t allow unnecessary interruptions that will distract you from the critical tasks that you must achieve during your day. These interruptions can impede success to your overall goals and your career if it continues to impact your job performance. Co-workers can interrupt your focus as well, conversing about their personal issues or complaining about irrelevant issues that decreases productivity. Although management should take care of repeated time-wasters, it is important that you ignore them and continue to

Cindy Stephens Stephens International Recruiting Inc. work diligently on the important tasks at hand. It may not be easy, but avoid involvement in these types of distractions. Today’s technology allows non-work-related distractions for many employees who use work hours for personal online shopping, games, social media, etc. Do not fall into this trap and avoid it at all costs. Using work time and resources to access the Internet for personal purposes interferes with the overall productivity and effectiveness of employees and many people have been fired over it. It is important to balance your personal life and work. Taking time for family, friends and outside interests helps us to maintain our sanity via a well-balanced lifestyle. However, a healthy life includes some down time. That includes turning off your phone and electronics to ensure you are totally relaxing, not allowing electronic interruption of your personal time off. Although it is important to have set goals and steps to achieve them, flexibility is critical in remaining focused. Do not let obstacles throw you completely off course. Stay committed, focused and motivated to move forward to accomplish your goals for a successful career.

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