TechNation Magazine June 2020 by MD Publishing

1technation.com

Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

JUNE 2020

14 Company Showcase

Elite Biomedical Solutions

20 Department of the Month

The Primary Childrenâ&#x20AC;&#x2122;s Hospital Clinical Engineering Department

52 Roundtable

Education & Certification

77 Roman Review

On Self-Quarantine

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CONTENTS

FEATURED

HE ROUNDTABLE: T EDUCATION & CERTIFICATION TechNation recently contacted HTM experts to find out more about education and certification opportunities. We quizzed the panel about education opportunities and asked them to share their thoughts on certification.

WHICH CERTIFICATION IS RIGHT FOR YOU? TAKING YOUR GAME UP A NOTCH The list of certifications for those in the HTM profession has grown over the past four decades. The list has expanded in recent years as connectivity and information storing have increased. Is certification necessary? Is it a job prerequisite? Is it a career accelerator? TechNation explores these questions inside. Next month’s Feature article: Equipment Disposition

Next month’s Roundtable article: IV Pumps

TechNation (Vol. 11, Issue #6) June 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

JUNE 2020

TECHNATION

CONTENTS

INSIDE Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley Karlee Gower Amanda Purser EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Jennifer Godwin

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

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

P.12 SPOTLIGHT p.12 Professional of the Month: Kenneth Shearer, CBET, CET: Supporting a Good Cause p.14 Company Showcase: Elite Biomedical Solutions p.18 GEMS Helps Fight Battle Against COVID-19 p.20 Department of the Month: The Primary Children’s Hospital Clinical Engineering Department p.24 Biomed Adventures: Changing Lives in Guatemala P.29 p.29 p.36 p.38 p.40

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

P.45 p.45 p.46 p.48 p.50

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

P.62 EXPERT ADVICE p.62 Career Center p.64 20/20 Imaging Insights, sponsored by Innovatus Imaging p.67 The Future p.68 View on Value p.72 Telehealth’s Perfect Storm, sponsored by Medigate p.75 The Other Side p.77 Roman Review P.79 BREAKROOM p.79 Clean Up Contest p.81 Did You Know? p.83 The Vault p.84 MedWrench: Where In The World Is Ben C.? p.94 Flashback p.89 Service Index p.93 Alphabetical Index

MD Publishing / TechNation Magazine 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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JUNE 2020

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Kenneth Shearer, CBET, CET: Supporting a Good Cause BY K. RICHARD DOUGLAS

ew Jersey has been one of the hardest hit states in the COVID-19 pandemic. Many biomeds in the state saw their hospital’s resources tapped out. The proximity to New York City, and the impact on the entire East Coast, all contributed to the increased state of readiness required in hospitals throughout the state.

One of those hospitals is Deborah Heart and Lung Center in Browns Mills, New Jersey. The hospital began as a tuberculosis sanatorium and pulmonary center in 1922, so its experience with treating the lungs and the heart includes a long history. Today, the hospital offers “leading edge surgical techniques and non-surgical alternatives for diagnosing and treating all forms of cardiac, vascular and pulmonary diseases in adults, congenital and acquired heart defects in adults and children,” according to its website. It is the only cardiac and pulmonary specialty hospital in New Jersey. Kenneth Shearer, CBET, CET, a BMET 3 in the hospital’s biomedical engineering department experienced the additional urgency brought on by the pandemic. Shearer did not enter the HTM field directly, but spent time working on

TECHNATION

JUNE 2020

consumer electronics for several years as groundwork before entering the biomed profession. “I came into the biomedical instrumentation field through the ‘back door.’ I was trained and CET-certified in electronics through a home study course and worked in consumer electronics for 10 years fixing everything from stereos, televisions, VCRs and microwaves to refrigerators and air conditioning,” he says. Shearer says that he was fascinated with how electronics were applied to the health field. “I started in consumer electronics, which was amazing, but seeing it applied to the health field to help with treatment and diagnosis is really something special. I’m still amazed and learning something new every day,” he says. That consumer electronics experience was also what first got him into the door at a hospital. “I was first hired at a hospital to fix and maintain all the televisions, the television system, pillow speakers, and security cameras and whatever else I could get my hands into,” Shearer says. “My supervisor at the time offered a small clinical unit for me to take and I jumped at the opportunity. After a couple of years, I took on more respon-

sibility and soon became a full-time biomed. I studied and learned everything I could and became CBET certified in 2010. I let that expire and took and passed again in 2019. I had some awesome coworkers that mentored me and challenged me to become better,” Shearer adds. The many years in consumer electronics allowed Shearer to leapfrog into a BMET 2 position and then eventually become a BMET 3. He does not have a particular specialty, but describes himself as a “jack-of-alltrades.” HELPING KIDS SMILE There can be no better way to spend time away from work than volunteering your time and skills. This pursuit has taken Shearer from New Jersey to Central and South America. “I went on three Operation Smile missions. I went to Cali, Colombia; Manizales, Colombia; and Managua, Nicaragua. Each mission was 10 days in length. I was in charge of all the equipment that we brought. I had to unpack and check all the equipment, set up the OR rooms, manage the gases, and pack all the equipment back up when we were done. They were long days,” Shearer says. He helped out in all areas from

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SPOTLIGHT

BMET 3 Kenneth Shearer is seen with Mark Williams, Ana Diaz, Garry Chamberlain, Kamlesh Patel and Randy Cremer.

Kenneth Shearer is seen with his family.

transporting patients to running for supplies. “I helped out wherever I was needed. I even helped the local biomed of the host hospital fix their equipment. I remember in Cali that they had a new C-arm that they couldn’t get running, and I was able to get it running by the end of the week. It was really great to be a part of those missions and seeing all those children with their new smiles,” Shearer says. He says that he was also part of a neonate ECMO team. “We would build the circuit in a sterile field. Then we would saline prime and then blood prime the ECMO circuit. We were responsible for making sure the ABG stayed perfect until the surgeon was ready for the circuit,” he says. “We would move our cart into bedside position and then hand the lines to the surgeon for hookup. I was on call a lot and

Kenneth Shearer played a key role as part of a neonate ECMO team.

even missed my daughter’s birthday party one year as I was paged as we were leaving the house to go to it. The ECMO team was a great experience because we did more than the normal biomed work and duties,” Shearer adds. The great outdoors is Shearer’s favorite environment. That includes staying active. “I love being outdoors, whether I’m coaching my daughters’ softball team, fishing, hunting or training our dog,” he says. He says he has an awesome wife and two beautiful teenage girls and a dog; Hunter. Shearer is a good example of how a biomed’s skills can be applied to help people outside their immediate community. From working on VCRs to helping kids in another country find some happiness is a good example of heading in the right direction.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

FAVORITE BOOK:

“Life at Full Draw” by Chuck Adams

FAVORITE MOVIE:

“Step Brothers,” but really any comedy movie.

FAVORITE FOOD:

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FAVORITE PART OF BEING A BIOMED:

Always being challenged. Satisfaction that you helped somebody. Nothing better than being able to help the doctor or clinician so they don’t have to inconvenience somebody by canceling a case or procedure.

WHAT’S ON MY BENCH? • • • • •

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JUNE 2020

TECHNATION

SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE ELITE BIOMEDICAL SOLUTIONS THE SHIELD YOU KNOW. THE SHIELD YOU TRUST. It was a Monday morning. Rumors had been transpiring for weeks leading up. Experts had warned. Whispers raised questions, “What is going to happen?” “Is this true?” Just as the first morning coffee was poured, the executive team was called for a meeting. News of COVID-19 had infiltrated the U.S. health care industry. Hospitals buckled down and Elite customers called in. As the Elite executive team met, it was apparent what needed to be done. A CALL TO ACTION A plan centered around both the state of Ohio and the Centers for Disease

TECHNATION

JUNE 2020

Control and Prevention (CDC) guidelines in protecting and preventing the spread of COVID-19 was immediately developed and implemented. Increased sanitization, social distancing and internal restructure became our new normal. A CALL TO OHIO MANUFACTURERS Pursuant to the executive order as issued by the state of Ohio, Elite Biomedical Solutions LLC was deemed an “essential” company. As a health care device manufacturer, Elite answered Governor Mike DeWine’s urgent request in this battle against COVID-19. We provided letters to the suppliers we are partnered with, in order to justify their need to remain

open for business as a critical supplier to Elite. Our CEO spent time on conference calls with the Ohio Manufacturing Association listening to “key” speakers, such as Lt. Governor John Husted and other experts in the field. As a USA manufacturer, we were able to quickly respond to the call by a) developing a plan to manufacture six months of inventory in-house, b) contacting our customers to outline our game plan, and c) increasing hours of operation to ensure the continuation of medical supply delivery. THE GAME PLAN Symptoms and temperatures were monitored daily. Policies became

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

flexible in order to permit our employees to stay home while sick. All incoming shipments were quarantined for 24 hours. In addition to this, Elite employees were assessed, evaluated and placed into three different platoons. Both Platoon A and Platoon B were deemed “essential” workers needed in assembly, manufacturing, repair services, customer service and quality. We equally split these essential employees into two separate platoons, then into two separate rotations (3.5 days on and 3.5 days off) on different schedules. Platoon C was a combination of those employees who could work remotely as well as what was defined by CDC as “high risk.” The three-platoon system accomplished several objectives: a) protect our employees by thinning the teams out,

b) creating greater than 6-feet social distancing, and c) ensuring that if we had an employee get sick, Elite had two more platoons that could fill in the gap. WHAT KEPT US GOING Working diligently to support and provide for all our customers fighting on the frontlines, our employees took on the challenge. We knew of customers, family members, friends and neighbors risking their health for the sake of others. It was our honor to serve them. As a team we counted our blessings, pulled up our bootstraps and united to support these fearless individuals. The morale of the team was and always is crucial. With the extreme safety measures and new schedules much of the “ordinary” was gone. Positivity, proactive leaders and individual

accommodations helped. However, at the end of the day we had a job, we had a roof over our heads, we had our health and we had a purpose to serve others and that … that was enough. WHAT WE LEARNED As a collective, the nation’s health care industry was tested. Opening the gaps, pushed to capacities and placed in the limelight individuals, hospitals, communities and companies came together to fight. No amount of competition or difference stood a chance. Because where there is darkness, there is light. Where there is pressure, there is growth. And where there is tragedy, there is triumph. For more information visit elitebiomedicalsolutions.com

“ We knew of customers, family members, friends and neighbors risking their health for the sake of others. It was our honor to serve them.”

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JUNE 2020

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SPOTLIGHT

GEMS HELPS BATTLE COVID-19 PANDEMIC G

ilbert Exposition Management Services (GEMS), longtime trade show partner of MD Expo, has its own story to share during the global COVID-19 pandemic. In an effort to prevent the overflow of hospitals and health care facilities, GEMS helped construct off-site hospital locations for COVID-19 patients. The first project in Detroit, Michigan, resulted in the build of 1,000 patient rooms, and the second project in Novi, Michigan, requested another 1,100 rooms. As a part of these efforts, GEMS was deemed an essential business.

GEMS Managing Partner Chance Lutz provided TechNation an inside look into these projects and how GEMS is placing itself on the frontlines of battling COVID-19. Lutz explained their start-up process on the construction of off-site hospitals.

TECHNATION

JUNE 2020

“GEMS has an office as a decorator at the TFC Center, formally known as the COBO Hall, in Detroit, Michigan,” said Lutz. “We heard rumors on Friday that this was a possibility at the center, so we started the process of securing the equipment needed and the logistics for transporting the items from our locations in Detroit, Orlando, Dallas and Las Vegas.” Even though they had not yet been awarded the bid, Lutz and his colleagues knew they wanted to be a part of the meaningful project. “When the facility heard we had already started to make moves at our own cost, they allowed us the opportunity,” noted Lutz. On the next Tuesday, only a few days after the go-ahead, Lutz and the team began the build. Throughout these projects, GEMS experienced many achievements, as well as some challenges.

“With a project like this, something that has not been done before, you face a lot of unknown obstacles,” said Lutz. “Timelines, safety, types of materials used, labor willing to do the job, what company can or is able to do what part of the build and trying to find materials during this economic shutdown were all challenges we faced. GEMS was able to meet the timeline set for us to have the rooms completed by and also assist with numerous additions before the deadline.” When asked if there were any concerns about any risk involved during the construction process, Lutz answered, “There was always a concern in the back of everyone’s mind as we were fighting an invisible enemy that nobody really had answers for. We all took the necessary precautions provided by FEMA and wore all the PPE equipment we could find. When there was a

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SPOTLIGHT

shortage of facemasks, the community came together and made some for the workers. It was truly amazing to see how many people wanted to help in any way they could.” GEMS built 1,000 rooms at the TCF Center and 250 rooms in Novi, Michigan. “The second build in Novi was stopped at 250 rooms, as it was only 40 miles from Detroit, and the rooms there were far from being filled,” stated Lutz. “We took this as a good sign, perhaps that social distancing is working and we are winning this battle. Although nobody can predict the future, and nothing is guaranteed, we were on the front lines and have heard the rumblings that the worst is over.” Lutz noted that while they did not personally meet any biomeds during their portion of the build, there were many qualified Army Corps of Engineers who planned in advance and during these builds. “Really this was a team effort, not only from GEMS but from carpenters, plumbers, electricians, Army Corps of Engineers, FEMA, the TFC facility staff and all of the doctors and nurses,” Lutz concluded. “The assistance and support of the local community was beyond amazing.” TechNation is proud to highlight GEMS as part of the essential businesses in the United States that are doing their part to combat this global pandemic. For more news updates on COVID-19, visit 1technation.com.

GEMS helped construct hundreds of hospital rooms like the one seen above.

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TECHNATION

SPOTLIGHT

The Primary Children’s Hospital Clinical Engineering Department contributes to the healing of pediatric patients.

DEPARTMENT OF THE MONTH

The Primary Children’s Hospital Clinical Engineering Department BY K. RICHARD DOUGLAS

or more than 95 years, Primary Children’s Hospital (PCH) in Salt Lake City, Utah has operated by a simple philosophy; “The Child First and Always.”

PCH is one of 24 hospitals within the Intermountain Healthcare system. The 289-bed facility is a Level I pediatric trauma center and a part of Intermountain Healthcare that “cares for children with complex illness and injury, including organ transplants and complex birth defects,” according to its website. In addition to the main hospital, there is also the Wasatch Canton Pediatric Behavioral Health campus, which has 23 inpatient rooms and serves about 40 patients at a time through its day treatment program, as well as two offsite rehab clinics. One department within PCH that is contributing to the healing of the hospital’s pediatric patients is the in-house clinical engineering department. The motto; “The Child First and

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JUNE 2020

Always” has not been lost on the CE department. “The CE team is fully engaged with this philosophy and it drives the quality of our work. Some of the team members have had their own children cared for here and have an emotional attachment to the hospital. When we return serviced equipment for use, we do so as if it would be used on our own children,” says Brian Bowles, supervisor of clinical engineering. The department supports more than 11,000 medical devices including 27 anesthesia machines, 14 sterilizers, 209 ventilators, including 19 unique models, nurse-call, overhead paging and Life Flight neonatal and infant transport. There are 10 technicians in the department, including Bowles. He reports to Scott James at a regional level and Mike Busdicker at a system level. Scott James is the clinical engineering director, north, and oversees hospitals in northern Utah with an office at McKay-Dee Hospital in Ogden, Utah. Mike Busdicker is the clinical engineering system director.

Other team members include Clinical Engineer IIIs Bob Coombs, Marty Davis, Bill Engar, Michael Levesque, Donn Rogers, David Snieder, Mark Toronto and Ramsey Worman along with Clinical Engineer I Jordan Gale. The team not only is aware of the status of the equipment in their immediate inventory, but also across the entire system. “Our CMMS program encompasses every Intermountain Healthcare clinical engineering department. We can view work orders and equipment across the system. This becomes particularly useful when devices move between facilities,” Bowles says. He says an example of common devices that move between facilities are infusion pumps. “Inventory is moved based on need. Once a device is moved, its bar code is scanned to update the location of the device. If the device in question moves during the PM cycle, we are able to view that in the CMMS and reassign the open PM work order to the technician in the

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SPOTLIGHT respective CE department of the facility who is assigned infusion pumps,” Bowles says. “Our team members are self-starters, who enjoy a great deal of autonomy. Each member manages his own workload, including balancing schedules across the calendar and updating asset properties in the CMMS,” Bowles adds. The team believes in adding value to the hospital that they serve. They do this by remaining customer-focused, staying organized and efficient, making certain they are being cost effective and always working to keep updated through consistent training, he explained. One result of this philosophy is the team’s PM completion rate, which is over 98 percent. “I attribute our high PM completion success rate to: workload balancing, organizing like devices into single PM cycles, meticulous updating of device locations with equipment bar-code scanning, careful note taking, updated in the database, using available networking tools, such as the EMR (electronic medical record), bedside monitor network scans and the infusion pump wireless network combined with the EMR and preparation – ordering scheduled replacement parts, PM kits and batteries in advance of upcoming PM cycles,” Bowles says. RENUMBERING AND ALIGNMENT One recent project that the crew helped with was to update the room numbers in the facility to be more intuitive, along with updating the associated equipment and systems for each room. “The team is currently engaged in a hospital room re-numbering project. Over the years, the facility has undergone many changes through construction and department reconfigurations. The result is a room numbering system that has become less way-finding friendly for the patients and visitors we serve. Hospital leadership has decided to address the concern, so it is more intuitive,” Bowles says. He says that from a CE perspective, this project entails a great deal of preparation and well-planned execution, as the go-live dates for each phase must align with signage and work being done by the hospital’s IT team. CE’s areas of

responsibility in the project include reconfiguring each bedside monitor and shuffling central monitors and network switches to align with the new department configurations. They are also working with the EMR team to ensure that bedside monitors are configured to reflect the new room numbering system. Bowles says that they are reprogramming the nurse-call system to align with the new room numbering system and reprogramming the automated overhead paging system to reflect the new room numbering system. “PCH has an automated overhead paging system that uses programmed WAVE files to annunciate events such as Code Red and Code Blue. For example, when a code-blue button is pushed in a patient room, the automated system announces the Code Blue and the location of the event,” Bowles says. “Our team is also involved in ongoing construction projects, including the demolition phases – removing medical devices and system hardware from areas under construction – and the finishing phases (replacing medical devices and system hardware such as nurse call),” Bowles adds. In addition to the renumbering project, the team has helped problem solve, with team members contributing to help the hospital and clinicians. “One problem-solving story that stands out to me is related to the Life Flight transport department. The department uses an oxygen-air proportioner (blender) on their transport incubators to deliver medical gases to their patients in transport. They had a need to view gas-source

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

pressures displayed on the front of the incubator,” Bowles recounts. He says that, as might be imagined, it is imperative to ensure blended medical gas concentrations are accurate, particularly in neonatal patients. “If the air source is not supplying gas, the patient will receive 100 percent O2, which can cause permanent eye damage in neonates. They approached Ramsey Worman to provide a solution. Ramsey developed two digital gauges, which he integrated into the front panel of the incubator that monitored medical gas supply pressures at the input of the blender,” Bowles says. He says that the team has also been involved in educating frontline patient care providers. “For example, Donn Rogers has provided formal documented training to our surgical services staff on device checks and user-level troubleshooting techniques for anesthesia machines,” Bowles says. “We have developed a user accessible web page that offers ‘quick tips’ for commonly encountered device troubleshooting on devices such as thermometers and how to activate bedside monitor functions. The format is PowerPoint slides with pictures and concise instructions. The web page born out of some of the often-repeated work orders we were seeing with a goal of empowering caregivers, reducing labor demands on our department and minimizing downtime of devices,” Bowles adds. This special biomed department is helping to bolster the good outcomes for pediatric patients in Salt Lake City and beyond.

Ramsey Worman works on a Life Flight incubator.

JUNE 2020

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JUNE 2020

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SPOTLIGHT

Melissa Wilke was part of a team that delivered care to Guatemala.

BIOMED ADVENTURES

Changing Lives in Guatemala BY K. RICHARD DOUGLAS

or many people in the developing world, the need for medical intervention might go unanswered if not for the donation of time and medical equipment by big-hearted clinicians and support personnel. Many of those volunteers come from the United States.

One recent example was a team of 14 who traveled to Jalpatagua, Guatemala in February to perform 76 surgeries over the course of five days. Among the volunteers was a surgeon, residents and other core members, but the 2020 trip was the first one to include a biomed. Melissa Wilke, CBET, a clinical engineering specialist at Gundersen Health Systems in La Crosse, Wisconsin, was the first HTM professional to join the group on one of its trips to Guatemala. “I was chosen to come on this trip by surgeon, Dr. Dave Rowekamp, who started this annual trip 11 years ago. Dr. Rowekamp is a retired surgeon from

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JUNE 2020

Winona Health. He would often stop in throughout the year to pick up donations for the mission trip. I was working as a biomed at Winona Health. My primary responsibility at Winona Health was supporting the OR. It was through the need of equipment evaluation and repair that Dr. Rowekamp’s path crossed into mine,” Wilke remembers. She says that over the years, she would help repair and acquire equipment for Rowekamp to bring to Guatemala. “At one point he told me, ‘When your kids get a little older, we could really use your help in Guatemala.’ He was patient while my expertise and kids continued to grow. Then, it came to be my time to join the team. It was with much excitement and comfort of knowing others that have gone before me that made my decision to go a little easier,” Wilke says. Wilke says that there is another surgeon on the team who has been going on the trip for the last nine years. “His name is Dr. Micahel Sarr from Mayo Rochester and he is extraordinary.

Melissa Wilke holding a tray that Willie Hahn and she modified so that multiple peel packs can be processed at one time. Dr. Sarr and I only knew each other through email, text and phone calls before the trip. So, it wasn’t until we were in Guatemala that I could see how great he truly was. He and Dr. Rowekamp are both genuinely concerned for others and always put everyone else’s needs first. Unfortunately for this trip, Dr. Rowekamp had a family emergency and was unable to come,” Wilke says. She says that Sarr and his wife had every detail of the trip planned out. OVERCOMING A FEW CHALLENGES The team flew into Guatemala City, a more populace urban area and spent the night before heading out the next day to San Juan Bautista Regional Hospital in Jalpatagua.

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SPOTLIGHT “Once we left Guatemala City, road maintenance and rules of the road seemed to be non-existent. The drive from Guatemala City to Jalaptagua went from a massive city, with hotels and big box stores, to small, poor villages with houses that looked like they could crumble under a strong wind,” Wilke says. She says that fruit stands were dotted alongside the road. “Sometimes, there would be fried chicken being sold as well. The drive was also very scenic. Beautiful rolling green hillsides, coconut and avocado trees, sugar cane fields, it was magnificent. Again, I had the feeling of a child. I didn’t know where we were going, how long it would take to get there or what it would be like when we did arrive,” Wilke says. She says that the hospital is one of four buildings laid out in a square with a beautiful, inviting courtyard in the center. “On one side of the hospital is a women’s recovery ward and the other side is the men’s recovery ward. Directly across from the hospital and between the two wards, is a tranquil and serene little chapel and the dorm,” Wilke says. As the first biomed to make the trip, Wilke had to pre-plan based on the information she was given about what to expect. “I had to bring everything I thought I would need to repair and test equipment. Bringing tools was no problem. It was the test equipment that was going to be the obstacle. Test equipment is expensive. Typically, most hospitals don’t have an extra ESU or flow analyzer laying around. Even if our hospital did, the equipment is too bulky to bring along. We each already had two extra suitcases full of surgical supplies. Which begs the question, how do you troubleshoot issues with question-

able ESU output or anesthesia machine flow issues? Well, you do what you can with the experience and knowledge you have. Sometimes it’s enough and other times it’s not. And that’s just the way it is,” Wilke says. She says that everyone on the team was already in the mindset; how can we get by to make this work with the little that we have? “It is not the same level of expectation that it is back home in our ORs. Everyone knows we are working with equipment that may or may not be fully functional, but we still have to find a way to meet in the middle. Patient safety is consistently at the forefront of everyone’s concern and is never compromised. Still it is a situation that leaves you feeling helpless. To make me feel better, I started an inventory and noted what needed to be repaired or replaced. This gave me peace of mind to communicate back to the team to plan for next year’s trip,” Wilke says. Beyond the challenge of questionable equipment, there were some other issues the team encountered. “A challenge that we face in the OR is unstable power. There is a retired engineer that has also been going on this trip for the past decade, Willie Hahn. With his brilliance he started bringing voltage stabilizers to plug the ESUs in to. The ESUs are sensitive and would experience line fluctuations. This would cause the ESUs to fail and they would frequently replace them. Now that they had the stabilizers, the ESUs were going to be fine, or so we thought. The voltage stabilizer had 220 and 110 outlets on it and one of the nurses inadvertently plugged the ESU into the 220. The ESU started smoking,” Wilke says.

Day 1: OR Setup/ Testing/Fixing

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She says that, unfortunately, she wasn’t able to repair it because it melted several components. “The team didn’t realize that the ESU was plugged in to a 220 outlet. So, when they got a replacement ESU, they plugged it into the same outlet. This time when they turned it on it just blew the fuses. We were able to go to a hardware store in Jutiapa – a town an hour away – to get replacement fuses. With the 220 outlets taped off and new fuses in the ESU, things were back on track,” Wilke says. She says that a safety analyzer would have been useful on the trip. “I did bring a multimeter and was able to check the ground on electrical cords. In turn, I replaced almost every cord I tested because they well exceeded 0.5 ohms. Another challenge was sometimes a fly would find its way into the OR. There were ants, flies and other tiny bugs in the ‘lounge’ as well. They all come in freely because there are gaps around windows. Also, the doors to the hospital are propped open letting in a wonderful breeze. And yes, even a bird or maybe a chicken finds its way in. It’s kind of a beautiful thing in a non-regulatory/ compliant way,” Wilke adds. THE NEED FOR BIOMEDS Wilke says she is confident that a biomed will be a regular member of future trips. “The benefits were evident every day. As biomeds, we are providing technical knowledge and sharing our expertise in our field. You are put in situations with a great deal of limitations that you have to think outside the box to resolve. Plus, being designated to tend to the equipment allows other team members to focus on their jobs and fulfill their expectations. Having a biomed on any mission trip is invaluable,” she says. What are her thoughts on HTM professionals committing to this kind of experience? “I would encourage anyone to be a part of a mission trip. It is an experience that will change you for the better. It’s like any new experience, there has to be a first one sometime so you might as well go for it. There are people and mission teams all over the world waiting for someone like you to help them,” Wilke says.

JUNE 2020

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry ASHE ANNOUNCES NEW EXECUTIVE DIRECTOR The American Society for Health Care Engineering (ASHE) of the American Hospital Association (AHA) has announced Deanna Martin, MS, CAE, as its new executive director. Martin, who has worked with ASHE for nine years, was most recently as ASHE’s deputy executive director for operations. “Deanna is a respected leader within ASHE who will work tirelessly to build a better future for ASHE members and their organizations,” says Dale Woodin, CHFM, FASHE, AHA Vice President for Professional Membership Groups. “Her rapid rise within the organization over the past decade demonstrates the dedication, creativity and focus that

ASHE deserves and requires.” In her previous role, Martin managed ASHE’s day-to-day operations. She served on ASHE’s executive management team and worked closely with the ASHE Board, committees and team. “I am honored to lead ASHE as we continue working to optimize the health care physical environment,” said Martin, who is a Certified Association Executive. “I look forward to continue working with ASHE’s Board, our team and our dedicated members. We will remain focused on supporting our members with the information and resources they need to overcome the challenges we face today and in the future.” •

CYBERPOWER EXPANDS MEDICAL-GRADE POWER PROTECTION LINE CyberPower Systems Inc. has launched two new medical-grade products, expanding its product line for the health care industry. Both the CyberPower MPV615P Power Strip and the MPV615S Surge Protector are certified to UL 2930, the standard for surge protectors and power strips, which complies with the UL-defined standard for Patient Care Vicinity (UL 60601-1). The UL certification standards mean both types of the CyberPower Medical-Grade outlet assemblies are compliant for use in hospitals, clinics, group practices, private practices, laboratory or other medical facilities, and allowed for use within six feet of a patient for non-critical care applications. The new products add to the CyberPower Medical-Grade UPS (uninterruptible power supply) product line which includes three UPS models. “Following our successful launch of our Medical-Grade UPS systems, it’s a natural progression to add medical-grade surge and power strips,” said Mike Dresen, senior product manager at CyberPower. “We have included a number of features to

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ensure the durability and safety that we’re known for in power protection. We gave special attention to ensure reliability for medical and patient environments, making the CyberPower Medical-Grade Power Strips and Surge Protectors a standardized, safe choice.” Both the CyberPower MPV615P Power Strip and the MPV615S Surge Protector feature six hospital-grade NEMA 5-15R receptacles with locking outlet covers. The receptacles allow for greater performance than ordinary outlet assemblies, including grounding reliability, assembly integrity, strength and durability. Additional features of the CyberPower Medical-Grade Power Strip and CyberPower Medical-Grade Surge Protector include LED status indicators, UL 2930-compliant grounding lugs, 15-foot 12AWG heavy-duty power cords and keyhole mounting slots for flexible mounting and placement. The CyberPower MPV615S Surge Protector features 1560 Joules of surge protection, and fireproof MOV technology providing industry-leading protection and peace of mind. •

JUNE 2020

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FIVE STATE TREASURERS CALL ON MANUFACTURES TO RELEASE VENTILATOR REPAIR MANUALS Advancing the Biomedical/HTM Professional

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Pennsylvania Treasurer Joe Torsella recently joined with Delaware Treasurer Colleen Davis, Illinois Treasurer Michael Frerichs, Rhode Island Treasurer General Seth Magaziner and Colorado Treasurer Dave Young to call on manufacturers of ventilators to release service manuals to repair ventilators, for the duration of the coronavirus pandemic. Without this critically important information, hospitals are unable to make repairs to ventilators, rendering them unusable during a time of dire need. “In a public health crisis, every second counts. There shouldn’t be a single ventilator sitting in a closet because a hospital, already under extreme pressure, isn’t able to make necessary repairs to it. I call on manufacturers of this lifesaving equipment to release this information and remove this barrier that hospitals are facing,” said Pennsylvania State Treasurer Joe Torsella. In a letter, the treasurers expressed their concern for hospitals that have ventilators in stock but are unable to use them due to repairs that are needed. It is of particular concern that rural or needy hospitals that may use secondhand equipment without a service contract are unable to make their own repairs without the proper manuals from the manufacturers. “Having enough ventilators to care for critically ill patients is vital. If the ventilators malfunction and operators don’t have manuals on how to make repairs, the results could be tragic,” said Delaware State Treasurer Colleen Davis. The American Hospital Association has estimated that 960,000 Americans with COVID-19 will require treatment using a ventilator, while there are only 170,000 ventilators in the United States. “These ventilators are a matter of life or death for people fighting COVID-19. With a national shortage of ventilators, it is incomprehensible that these life-saving devices are sitting in hospitals across the country waiting to be fixed. Today, I call on ventilator manufacturers to step up and help hospitals address these desperately needed ventilator repairs,” said Illinois State Treasurer Michael Frerichs. The U.S. Public Interest Research Group recently delivered a petition with 43,000 signatures to 25 ventilator manufacturers, asking them to release service manuals, service keys, and schematics, as part of its ongoing Right to Repair campaign. While some manufacturers have taken meaningful steps, state treasurers are asking all ventilator manufacturers to release all necessary information to repair ventilators, immediately. Repair information is not made readily available by manufacturers, limiting who can fix the equipment when it malfunctions. Releasing these manuals during this crisis would empower hospitals to take matters into their own hands, treat more patients in critical condition, and protect third-party repair companies from unnecessary exposure to COVID-19 when making repairs. •

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2020 AAMI FELLOWS HONORED FOR ACHIEVEMENTS, COMMITMENT TO AAMI MISSION Fourteen AAMI members who have provided substantial service and contributions to the health technology field and to AAMI have been selected as the 2020 class of AAMI Fellows. AAMI Fellows are health technology leaders who are recognized for extraordinary achievement in their careers. “Our second class of AAMI Fellows come from a variety of fields. However, they all share a commitment to AAMI’s mission: The development, management, and use of safe and effective health technology,” said Sabrina Reilly, vice president of membership at AAMI. “We congratulate our Fellows for their numerous accomplishments, as well as their drive continue to grow, to achieve, and to improve the world around them.”

AAMI recognizes Fellows for the depth and breadth of their accomplishments in seven core areas: professional experience, education, technical contributions, presentations and publications, professional participation, certification, and awards and honors. The 2020 Class of AAMI Fellows are Steven Baker, Damien Berg, James Caporali, Mary Ann Drosnock, Larry Fennigkoh, Greg Gdowski, Larry Hertzler , Clark Houghtling, Jim Keller, James Linton, Alan Lipschultz, David Osborn, Arif Subhan and Priyanka Upendra. • For more information about the 2020 class of AAMI Fellows, visit https://tinyurl.com/AAMI-Fellows2020.

ACCRUENT LAUNCHES FREE VENTILATOR PREDICTIVE MAINTENANCE DATA Software provider Accruent is offering newly developed resources to hospitals and medical facilities to assist the health care industry in combatting the COVID-19 pandemic. These new resources include: • A free app to assist in prediction of parts required to keep ventilators operational • Reporting packages available at no cost to its CMMS users to assist in workload optimization and maintenance planning • Free access to coding strategies for tracking and auditing of COVID-19 activities As health care organizations experience hourly increases in ventilator demand, the performance and uptime of ventilators is among their most important considerations. Healthcare technology management (HTM) departments at hospitals are charged with deploying and maintaining these devices, ensuring that proactive and scheduled maintenance is completed, that replacement parts that may be needed are stocked and maximizing the number of ventilators that are available for patient care. To complicate matters, hospitals will need to track all COVID-19 related activities in order to qualify for future government reimbursements. The resources Accruent is making available will

help hospitals manage ventilator maintenance and parts inventories and track parts and labor associated with COVID-19 to justify reimbursements. Because it provides health care asset management software to more than 55% of U.S. hospitals, Accruent possesses a high volume of HTM data and healthcare facilities management (HFM) data. The new resources being offered leverage data from the documented experience of these facilities to assist hospitals in preparing to deliver care to large numbers of patients and to help them manage the financial impact of the coronavirus outbreak. Each of these resources is available free of charge to all hospitals and health care facilities: PART PREDICTOR FOR VENTILATORS APP To provide the most accurate information on predictive maintenance for ventilators, Accruent is providing predictive maintenance and part data at no cost through a free online app. This allows HTM teams to determine what replacement parts they should have on-hand to maximize uptime of their ventilator inventory. REPORTING PACKAGES Reporting packages for Accruent’s TMS, Connectiv and Asset Enterprise CMMS

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software solutions to assist in optimization of HTM workload, equipment and maintenance planning are also being offered. Utilization of these comprehensive, standardized reports can help hospitals forecast resource needs, mitigate potential equipment failures and reduce bottlenecks to minimize delays in equipment availability. Improvements in proactive maintenance can maximize the impact of available biomedical equipment. BEST PRACTICES FOR CODING WORK ORDERS Based on their critical role in delivering medical care during the coronavirus pandemic, it is expected that the federal government will authorize economic aid to hospitals and health care providers. Properly coding maintenance activities related to COVID-19 will help providers apply for aid and make justification of reimbursement much easier. Accruent will continue to seek ways to leverage its experience working with health care facilities to aid these organizations during the COVID-19 outbreak. As additional resources are developed, they will be posted on the Accruent’s COVID-19 resource web page. •

JUNE 2020

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INDUSTRY UPDATES

TKA ANNOUNCES NEW DIRECTOR OF QUALITY TKA recently welcomed its newest team member in Director of Quality Raymond Reid. “I was hired to assist TKA with acquiring ISO 9001 certification,” Reid said. “My primary role right now is learning about how TKA functions, understanding how people do their jobs, and how those activities already align with the standard, then documenting the processes and procedures so they can be replicated, and updating and fine-tuning existing documentation. Admittedly, it’s challenging right now because of COVID-19 and not being able to travel to be onsite with the TKA team in different parts of the country.” “I also have ownership of a third-party quality management system called ZenQMS. I’ll be managing that system to create, implement, and maintain it in coordination with everyone at TKA. The system will allow us to build a repository for procedures, records inventory, track improvement activities, track training, keep records of corrective action processes, and conduct audits,” he added. Reid joined TKA on March 2, 2020. He has 35 years of experience in both aerospace and medical. “I started out in aerospace as a line inspector at Northrop Grumman. There I discovered I had a knack for inspection and processes, so I moved into a quality engineering role, and kept increasing my overall knowledge of quality systems and activities,” he said. “I later moved to Boeing, where my team was in charge of the quality of the C-17 final assembly. At Boeing I also worked with the Space Shuttle, the International Space Station, and Delta rockets. After Boeing I went to Honeywell, where I was a supplier process improvement manager and helped suppliers improve how they built parts for Honeywell – how to build them faster and better.” “When I made the switch from aerospace to medical devices, I started working for Baxter, where I was the quality manager for production operations including microbiology, supplier quality, receiving, in-process and final inspection departments. I then went to LivaNova, where we were building tube and filter sets used for heart-lung bypass machines. My last stop before TKA was with Nuvectra, which made an implantable pulse generator, where I returned to doing supplier management overseeing the contract manufacturers of components,” Reid added. •

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AMA, AHA RESPOND TO RISE IN CYBER THREATS EXPLOITING THE COVID-19 PANDEMIC Responding to a spike in cyber threats that exploit telework technologies during the COVID-19 pandemic, the American Medical Association (AMA) and the American Hospital Association (AHA) have teamed to provide physicians and hospitals with guidance on protecting a remote work environment from cyber criminals. The two leading associations have created a joint cybersecurity resource offering actions to strengthen home or hospital-based computers, networks, and medical devices from the rise in COVID-19-themed security threats and attacks. The resource includes checklists, sources, tips and advice on strengthening protections to keep pace with deceptive cyberattacks that could disrupt patient care or threaten medical records and other data. “Amid increased reports of malicious cyber activity, some physicians and care teams are working from their homes and relying on technologies to support physical distancing measures while ensuring availability of care to those who need it,” said AMA President Patrice A. Harris, M.D., M.A. “For physicians helping patients from their homes and using personal computers and mobile devices, the AMA and AHA have moved quickly to provide a resource with important steps to help keep a home office as resilient to viruses, malware and hackers as a medical practice or hospital.” On April 1, the Federal Bureau of Investigations (FBI) released a public advisory noting that more than 1,200 complaints related to COVID-19 scams were received at its Internet Crime Complaint Center. According to the FBI, “in recent weeks, cyber actors have engaged in phishing campaigns against first responders, … deployed ransomware at medical facilities, and created fake COVID-19 websites that quietly download malware to victim devices. Based on recent trends, the FBI assesses these same groups will target businesses and individuals working from home via telework software vulnerabilities, education technology platforms, and new Business Email Compromise schemes.” •

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INDUSTRY UPDATES

PHILIPS TO INCREASE HOSPITAL VENTILATOR PRODUCTION Royal Philips recently provided an update on its plans to double the production of its hospital ventilators by May 2020 and achieve a four-fold increase by the third quarter of 2020. This plan builds on Philips’ initial production increase in the first three months of the year, which already enabled the supply of additional ventilators – that are critical for the treatment of COVID-19 patients – to hospitals in the most affected regions in China, southern Europe and the U.S. To further address the huge global demand, Philips introduced its new Philips Respironics E30 ventilator, a versatile and easy-to-use non-invasive and invasive ventilator, which has been designed for large scale production. “In line with Philips’ mission, we are fully committed to helping as many health care providers as possible diagnose, treat and monitor the growing numbers of COVID-19 patients,” said Frans van Houten, CEO of Royal Philips. “We have been mobilizing as a company to do so since January. The collaboration with our trusted partners Flex and Jabil will rapidly expand our hospital ventilator production capacity and reinforce the supply chain to enable the ramp up to a production of 4,000 hospital ventilators per week by the third quarter. To complement this, our team has developed the new Philips Respironics E30 ventilator, which can be safely used when there is limited access to a fully featured critical care ventilator. The Philips Respironics E30 ventilator can deliver a range of treatment options, and we will quickly scale its production to 15,000 units per week in April.” •

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JUNE 2020

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ECRI LAUNCHES NEW BRAND IDENTITY For more than 50 years, ECRI has advanced the science of patient safety and healthcare effectiveness through an unbiased evidence-based approach. Now, the nonprofit organization introduces a new brand identity – ECRI (pronounced ék-ree) – that builds on the best of its past, articulates its values, and positions itself to lead through a new decade in healthcare. ECRI’s new tagline is “The most trusted voice in healthcare.” Its new brand mark represents the layers of integrity, rigor, and independence--guiding principles that fuel the organization’s ability to empower healthcare professionals to save lives and provide the highest level of care. ECRI provides assurance to make healthcare safe in three main areas: • Patient Safety. As one of the largest Patient Safety Organizations in the U.S., ECRI has studied millions of adverse events and near misses from more than 1,800 healthcare facilities across acute care, ambulatory surgery, aging services, and physician offices. Armed with this data, the ECRI patient safety team studies the causes of serious

patient safety incidents, researches best practices, and disseminates guidance, benchmarking, and recommendations. • Evidence-based Medicine. ECRI, a federally designated Evidence-based Practice Center, is recognized as a trusted source of guidance and consulting on new and emerging medical technologies, procedures, genetic tests, and clinical practice guidelines. ECRI monitors developing technologies to provide insight into the forces that shape the healthcare of tomorrow using all the available evidence from around the world. • Technology Decision Support. The nation’s only independent medical device evaluation organization, ECRI continuously issues safety and performance ratings and guidance reports from testing and evaluating thousands of devices. Real-time pricing databases enable members to compare products and benchmark pricing on nearly two million supplies and more than 100,000 capital equipment items. • For more information, visit www.ecri.org.

AGILITI SUPPORTS FRONT LINE RESPONSE TO COVID-19 Agiliti Inc. is partnering with U.S. hospitals and federal and state agencies on the front lines of the COVID-19 pandemic to deliver critical services where they’re needed. Since January, Agiliti, which provides medical device leasing, maintenance and logistics programs, has focused on helping to ensure health care providers are prepared to meet the medical equipment challenges posed by the COVID-19 pandemic. To date, the company has: • Fully deployed its fleet of more than 250,000 medical devices and related accessories across the U.S. health care system and partnered with medical device brokers and manufacturers to deliver additional equipment where it’s needed. • Assigned its team of biomedical repair technicians to hospitals across the country to ensure provider-owned equipment is safely and rapidly tested, repaired and made ready for patient use. • Redeployed equipment service technicians from its 92 local service centers to support the stand up of surge medical capacity in parks, gymnasiums and hotel rooms across the country. • Engaged and empowered its more than 1,300 teammates who everyday work side-by-side with clinicians via the

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JUNE 2020

company’s hospital-based programs to manage intrafacility and system-wide transport, delivery, reprocessing, repair and maintenance of medical devices. “Agiliti is in the business of ensuring health care providers have the medical equipment they need, where and when it’s needed – but during a crisis like this, the services we provide play an even more vital role,” said Tom Leonard, CEO of Agiliti. “We have put forth the full weight of our resources – our unmatched fleet of medical devices, our nationwide logistics infrastructure to mobilize medical equipment, and our team of more than 3,800 medical equipment professionals – to accelerate the availability of patient-ready devices for caregivers and their patients.” On January 24, 2020, the company was awarded a contract by the Division of Strategic National Stockpile (DSNS) to provide maintenance services for the national stockpile of LTV Series ventilators. On April 1, the DSNS issued an extension of that contract allowing Agiliti to accelerate the preventive maintenance work on the first tranche of ventilators rotated out of the stockpile for maintenance. The contract also engages Agiliti’s nationwide team of field service technicians to maintain and repair ventilators once they are deployed by the DSNS in response to the rapid spread of COVID-19. •

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FORD EXPANDS MEDICAL EQUIPMENT PRODUCTION EFFORTS Ford is expanding its efforts to design and produce urgently needed medical equipment and supplies for health care workers, first responders and patients fighting coronavirus. In addition to the current production of more than 3 million face shields in Plymouth, Mich., Ford-designed powered air-purifying respirator production began Tuesday, April 14. Ford also is now producing face masks and leading an effort to scale production of reusable gowns for health care workers. Lastly, Ford started providing manufacturing expertise to help scientific instrument provider Thermo Fisher Scientific quickly expand production of

COVID-19 collection kits to test for the virus. “We knew that to play our part helping combat coronavirus, we had to go like hell and join forces with experts like 3M to expand production of urgently needed medical equipment and supplies,” said Jim Baumbick, vice president, Ford Enterprise Product Line Management. “In just three weeks under Project Apollo, we’ve unleashed our world-class manufacturing, purchasing and design talent to get scrappy and start making personal protection equipment and help increase the availability and production of ventilators.”

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RIBBON CUTTING Twilight Medical BY ERIN REGISTER

ravis Turner, founder, CEO and president of Twilight Medical, brings over 20 years of field service experience and knowledge to fit the unique needs of hospitals and clinics. Turner and his team created Twilight Medical as a flexible alternative to the normal daytime preventative maintenance (PM) in order to work around patient scanning hours with no impact on workflow.

Turner spent 17 years of his career in the health care field as an OEM-trained CT/PET, MRI and ultrasound field engineer. Late in his career, he advanced to become a manager and led a multi-modality team. “I’ve always had a love for starting a business; the issue was ‘what’ business,” Turner stated. “I loved fixing medical equipment and working with people. Early in my career, I thought it would be amazing to own a CT service business, but it seemed impossible. I decided to dig in and learn everything I could. I realized your blessings are always on the other side of tough moments. One night at dinner with my wife, I reflected and determined that life was short and that I was going to start that business. Two weeks later, I was listening to a program on entrepreneurs and leadership, and one of the speakers mentioned that it’s a mistake opening a business in an area with no expertise or love. Do what you love!” Turner decided imaging service was the business for him. After one and a half years of research, planning, hard

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JUNE 2020

work and grit, Twilight Medical Inc. was born. “The idea of Twilight Medical developed from years of observing, listening and understanding the needs of hospital organizations,” Turner stated. “I talked to leadership and technologists to understand their challenges and how maintenance and service impacts their business when a system is out of service. Listen fiercely, passionately execute, be flexible and help customers succeed. The conception of Twilight Medical Inc. was based upon these principle cornerstones.” TechNation learned more about Twilight Medical in a question-and-answer interview. Q: WHAT IS THE MAIN FOCUS OF TWILIGHT MEDICAL? A: We provide extended imaging service after 5 p.m. and on weekends, so there is no equipment downtime during patient hours. Q: WHAT SERVICES DOES TWILIGHT MEDICAL OFFER? A: Twilight Medical provides after-hours preventative maintenance (PM) on imaging equipment. We partner with hospitals, OEMs and third parties to offer extended coverage for night and weekends. Located in Sacramento, California, we service the entire country and have actively working contracts from the East Coast to the West Coast. In addition to our normal equipment service model, we offer “stop-gap” services to help support customers’ equipment needs after the loss of a highly skilled imaging engineer. This

Travis Turner Founder/CEO, Twilight Medical

includes any coverage issues they may encounter. Q: HOW DOES TWILIGHT MEDICAL STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Twilight Medical provides extended service and support for medical equipment 24/7. Our customers are not restricted. We believe service should be based around our customers’ needs and when they want it, and that is seven days a week. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT YOUR COMPANY TO ACHIEVE IN THE NEAR FUTURE? A: We want to help our customers achieve the highest levels of equipment performance and service. We are dedicated to putting all of our resources into this goal. We will acquire highly skilled engineers to provide support to our customers, so our customers will enjoy the highest level of quality, maintenance and service. FOR MORE INFORMATION about Twilight Medical, visit www.twilightmed.com.

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AAMI UPDATE BY AAMI

THE LATEST CORONAVIRUS UPDATES FROM AAMI The health and safety of our global community is our highest priority. As the situation involving the COVID-19 coronavirus outbreak continues to evolve, AAMI is working to ensure a seamless experience for our members and customers. FOR THE LATEST UPDATES, including rescheduled or reconfigured events and special HTM Town Halls (live or recorded), visit www.aami. org/coronavirus.

ACI EXAM REGISTRATION AND TESTING WINDOWS EXTENDED Due to global closures of testing sites through June, the AAMI Credentials Institute has postponed its spring testing window to August 1-31, 2020. If closures remain on a global scale at that time, registrants may need to move to the November testing window. This decision will be made in June as the situation unfolds. ‘SAFE PASSAGE’ LETTER FOR HTM PROFESSIONALS HTM professionals are mission-critical to the fight against Coronavirus. If you need support establishing yourself as “essential personnel” in order to perform your duties, download this “safe passage” letter from AAMI and keep it with you. GET THE PDF at https://go.aws/2RyZ4Eo.

EMERGENCY COVID-19 GUIDANCE FOR VENTILATORS AND RESUSCITATORS AAMI has released emergency guidance documents to enable the rapid development of safe and effective emergency use ventilators and resuscitators, which are essential to treating patients with COVID-19 respiratory failure. Published as the first four AAMI Consensus Reports (CRs), this emergency guidance was developed by the AAMI COVID-19 Response Team, consisting of manufacturers, clinicians and Food and Drug Administration representatives. “These CRs are an especially valuable roadmap for companies new to the health technology space who are stepping up to build emergency-use ventilators and resuscitators. While they have talented engineers, many do not have the foundational knowledge in this area, particularly when it comes to

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JUNE 2020

patient safety,” said Julian M. Goldman, MD, co-chair of the AAMI COVID-19 Response Team, anesthesiologist and director of the Program on Medical Device Interoperability and Cybersecurity at Massachusetts General Hospital, and medical director of biomedical engineering for Partners HealthCare System. In addition to design and safety guidance, the CRs help manufacturers save valuable time by pointing them to the standards documents and clauses that are most relevant to them. AAMI CRs provide concise, prompt, and practical guidance to respond to an urgent/immediate need for the health technology community. The following documents are available for free download at www.aami.org/COVID_CR. As these documents will continue to evolve, check back frequently for the latest updates. • AAMI CR501:2020, Emergency Use Ventilator (EUV) Design Guidance • AAMI CR502:2020, End User Disclosures for Emergency Use Ventilators (EUVs) • AAMI CR503:2020, Emergency Use Resuscitator Systems Design Guidance • AAMI CR504:2020, End User Disclosures for Emergency Use Resuscitator Systems HEALTH TECHNOLOGY EXPERTS A ‘VITAL RESOURCE’ FOR CORONAVIRUS RESPONSE Health care organizations need to ensure that medical equipment is maintained by trained healthcare technology management (HTM) professionals, especially during this COVID-19 pandemic. That’s the guidance from AAMI in the wake of news reports that individuals who are not trained in healthcare technology are recommissioning, repairing or maintaining life-saving technologies like ventilators. “While AAMI is aware of well-intentioned work in response to the coronavirus pandemic, it is imperative that patients are not put at risk,” said Rob Jensen, AAMI’s president and chief executive officer. “AAMI strongly encourages those new to this arena to seek out health technology management experts at the earliest opportunity to maximize the benefit of your efforts.” Recent news has cited efforts that include designing new

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equipment, recommissioning old or out-of-service devices, refurbishing devices and adapting technologies to serve additional patients. Ensuring the use of proper testing procedures and test equipment to confirm that these medical devices are working properly represents a few examples of how health technology experts can assist. Additionally, HTM professionals are a critical knowledge base for equipment planning, purchase, installation, maintenance, troubleshooting and on-call technical support. FREE eLEARNING STUDY COURSE FOR DISPLACED STUDENTS AAMI is offering students enrolled in nonprofit biomedical equipment technician (BMET) programs who have been displaced by closures due to COVID-19 free access to its CBET eLearning Study Course. “We hope that this eLearning course will provide these students with a way to continue their BMET studies while classrooms are closed and to prepare for the Certified Biomedical Equipment Technician (CBET) exam, should they wish to take it when they are eligible,” said M.J. McLaughlin, director of education programming at AAMI. “The CBET eLearning Study Course is a powerful tool that allows learners to navigate the key content areas that successful BMETs should understand using an interactive, self-paced experience.” Users can master each of the six core topic areas with a combination of lessons and practice quizzes. While scrolling through the lessons, learners will be presented with several opportunities to “Check Your Understanding.” These pop-up features allow the learner to interact with the content by flipping flash cards, matching terms, answering multiple choice questions and exploring schematics/diagrams. The online study course will be made available to students through their training program’s faculty. AAMI will provide interested faculty members with unique access codes for their institutions. Please email Education@aami. org if you are a faculty member or student interested in this special offer. Each course module begins with a knowledge assessment of 10-15 questions and ends with a practice exam of 30 questions. This feature gives the learner an idea of how much time and effort they may need to allocate to each module.

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ECRI UPDATE

Considerations for the Safe and Effective Use of UV Disinfection

he COVID-19 pandemic has thrust many medical technologies into the spotlight. Ultraviolet (UV) disinfection systems – devices that use light from the UV spectrum to disinfect surfaces – are one of those technologies. “We’re getting questions every day about ways hospitals can use these systems to help stop the spread of the SARS-CoV-2 virus,” explains Mairead Smith, senior project engineer in ECRI’s device evaluation group.

ECRI’s evaluations of two different configurations – moveable towers used for room disinfection and countertop models designed to disinfect tablets, phones and other small devices – show that the technology can effectively reduce bioburden on surfaces. With respect to SARS-CoV-2 in particular, experts expect its response will be similar to other coronaviruses, like SARS-CoV-1 and MERS-CoV, which have been shown to be inactivated by UV light. “But,” Smith stresses, “proper use is key.” Note: This article was developed in early April 2020. With the rapid pace of change associated with the COVID-19 pandemic, the challenges facing hospitals and the evidence supporting various methods may evolve substantially by the time of publication. DISINFECTING WITH UV LIGHT At the right wavelengths and with an appropriate exposure time, UV energy can disrupt the DNA or RNA of microorganisms that are exposed to the

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light, preventing them from replicating. Studies indicate that sufficient exposure to UV light can inactivate a wide range of microbes, including methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile (C. diff). Most UV disinfection devices use UVC light – that is, light within the 200-280 nm range, although some systems use UVB or far-UV wavelengths. Within a health care facility, the technology may be applied in various ways: • Room disinfection devices typically consist of a movable tower that houses mercury or xenon lamps that emit UV light. The devices may be placed in patient rooms, procedure rooms or other locations following cleaning to help fight environmental contamination. Depending on the system, the tower (or towers) may remain in one location during the disinfection cycle, or the cycle may be paused, and the device repositioned midway through the treatment period. • Countertop models are smaller, enclosed devices that are typically used to disinfect mobile devices such as phones or tablets – items that may be susceptible to damage by chemical disinfection methods. Users first clean the surface of the item to remove debris; then they place it in the UV device and initiate the disinfection cycle. • Additional designs include wall- or ceiling-mounted systems, systems designed for use in air-handling units and other configurations.

When used properly and as a supplement to normal cleaning and disinfection processes, UV disinfection can be effective at reducing the environmental bioburden in a facility. However, UV disinfection technology may be less effective, or on occasion dangerous, if not used properly. During the COVID-19 pandemic, it has been suggested that UV disinfection units could be used to disinfect N95 respirators to help address personal protective equipment (PPE) shortages. At the time of this writing, ECRI considers that approach acceptable in limited reuse situations, but cautions that UV disinfection could (1) be ineffective at successfully deactivating pathogens located deep within the layers of filter material or (2) damage the respirator in a way that reduces its effectiveness, such as by degrading the elasticity of the strap that secures the mask to the wearer. Research in this area is evolving rapidly, however, and recommendations may change by the date of publication. 9 THINGS TO KNOW ABOUT UV DISINFECTION The safe and effective use of UV disinfection devices requires a clear understanding of what the technology can and can’t do. ECRI stresses the following points in its studies: 1. UV disinfection is a supplement; cleaning is still required. Solid particles and residues act to shield microbes from UV irradiation. Surfaces must be cleaned before UV disinfection is used. 2. UV does not offer sterilization. The dose provided is sufficient only for

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ECRI’s Mairead Smith and Dr. Andrew Furman discuss UV disinfection systems during a live-streamed ECRI lab webcast. The March 18 webcast was part of an ECRI series addressing technology challenges facing hospitals during the COVID-19 pandemic. disinfection of non-critical items, not sterilization. Countertop UV disinfecting devices, for example, cannot be used to sterilize materials such as surgical supplies or devices. 3. Line of sight is key. Surfaces that are not in a direct line of sight from the source may not be exposed to sufficient UV light and will not be reliably disinfected, unless steps are taken to increase exposure. Commonly shadowed surfaces include the undersides of tables, the backs of devices and door handles, and low areas such as under beds or chairs. 4. System settings and device positioning make a difference. The germicidal effectiveness of a system is related to the exposure of UV light incident on a surface. That depends on factors such as the output of the UV device, the distance from the light source, the wavelength emitted and the exposure time. 5. UV may not reliably disinfect fabrics, the inside of tubing or other materials. UV disinfection has not been proven to be effective on fabrics, like privacy curtains. Additionally, UV doesn’t penetrate through most materials, including clear or translucent plastics. Thus, the lumens of clear plastic tubing won’t receive an effective dose. The

same can be true of the nooks and crannies on devices. Just because a device or object has been exposed to UV, that doesn’t mean it’s been effectively disinfected. 6. UV light can harm patients and staff. Safety precautions are needed to limit human exposure to UV light, which can damage an individual’s eyes or skin. To reduce the risk, many UV room disinfection devices require the use of door or motion sensors that terminate the disinfection cycle if triggered, and manufacturers may recommend the use of signs outside the treatment room. 7. UV light can damage certain equipment. UV light breaks down certain materials over time. The degree of damage depends on the cumulative dose of UV and the type of material. Damage occurs more quickly for certain plastics and organic materials and if treatment cycles deliver higher UV doses or are performed more frequently. 8. UV disinfection systems are not regulated as medical devices. UV disinfection systems are not classified as medical devices and thus are not regulated by FDA. Further, there are no standardized test methods for comparing systems. Thus, facilities should regard manufacturer claims

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

with a healthy dose of skepticism; be sure to read the fine print and look for citations that provide study details. 9. Other practices should take precedence. UV disinfection is not a requirement – thus there’s no need to purchase a system if you don’t already have one – and it is not a standalone solution that can address your disinfection needs. Proper cleaning of surfaces and equipment is required regardless of whether or not UV is used; and proper hand hygiene and PPE use still must be observed. If UV technology is to be used, be sure to use it in accordance with manufacturer recommendations and best practices. This article is adapted from ECRI’s evaluations of UV room disinfection systems and countertop UV disinfection devices. Additional guidance is also available through ECRI’s COVID-19 Resource Center, a free public resource to help hospitals protect healthcare workers and patients during the COVID-19 pandemic. Access that site at www.ecri.org/coronavirus-covid-19outbreak-preparedness-center. To learn more about ECRI’s device evaluation program, visit https://www.ecri.org/solutions/ device-evaluations, or contact ECRI at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

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BIOMED 101 AAMI Shares ‘HTM in a Box’ BY DANIELLE MCGEARY

any healthcare technology management (HTM) departments are struggling to find the right people to fill their open positions and dealing with the frustration that comes with being short staffed. Do you wish you could do more to help solve this problem, but are short on time and don’t know where to start? We have all been there, and you certainly are not alone!

To help address this challenge, AAMI has created a series of canned presentations that anyone in the HTM field can use to plan a fun HTM career presentation for any age group. We call it: “HTM in a Box.” HTM in a Box doesn’t actually come in a box – it’s an online set of presentations developed by AAMI that contain a strong and consistent message about the HTM field. No matter what age audience you plan on presenting to, AAMI has you covered. Three presentations are included: • Elementary and middle schoolers • Junior high and high school • College-aged students and adults We’ve also created two HTM career brochures, one for younger children and the other for high school

ages and above. We will happily mail you copies – just email me at dmcgeary@aami.org to request your copies. AAMI also has a slew of other resources available to make your HTM outreach even easier, all available for free at www.aami.org/ HTMinaBox. You don’t need to be an AAMI member to use HTM in a Box or any accompanying resources. The website also contains talking points to help you better prepare for your presentation, a pre-written script to use when reaching out to organizations and schools via email/ phone to ask for presentation time, a video about the HTM field and a list of all current HTM specific academic programs by state. Now is a great time to show your HTM pride by telling others about this amazing career path. While we are all busy, it is important that we work together to help solve our workforce challenges – in particular, ensuring that a new generation will be ready to take up the mantle when many of the field’s most experienced HTM leaders and BMETs begin retiring. Promoting our field does not need to be a grand effort. It could mean setting up a table in your hospital’s

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Danielle McGeary AAMI

lobby during HTM Week to show off your department to hospital staff, volunteers, families and patients. This display can have a lasting impact, as many hospital staff members may not be aware of the important role of HTM in the hospital. When we take the time to explain and educate, people begin talking and the results can be huge. Other ideas include visiting local community colleges and universities to educate students about this field. That’s where the HTM in a Box tool comes in handy. I encourage you to focus on those general electronics, IT and biomedical engineering majors and to ensure they know that HTM is a rewarding and sustainable option for them. For instance, biomedical engineering majors need to know before graduation that they can be a clinical engineer working in a hospital instead of working in lab or in an industry R&D environment. DANIELLE MCGEARY is the Vice President, Healthcare Technology Management, AAMI.

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WEBINAR WEDNESDAY

Remote Learning Made Easy STAFF REPORT

he Webinar Wednesday series continues to deliver valuable knowledge and expert insights to healthcare technology management (HTM) professionals throughout the world in 2020. More than 3,000 registrations through April 15 illustrate the popularity of Webinar Wednesday.

“It was worth my time. I look forward to advancing in my career and it helped me understand my field a little bit more.” L. SANTOS, BMET III

‘VERY COOL’ CYBER SECURITY WEBINAR DELIVERS INSIGHTS The April 15 webinar “Is Your CMMS Cyber Security Ready?” from Webinar Wednesday was eligible for 1 credit from the ACI. More than 200 people attended the live presentation and even more have viewed a recording of the session. The 60-minute webinar, sponsored by Nuvolo, addressed how to protect and manage medical and IoT devices using an integrated solution with Ordr and Nuvolo. The webinar featured Ordr Vice President of Product Strategy Russell Rice as well as Nuvolo Senior Solution Consultants Kyle Holetz and Dustin Smith. The trio discussed and demonstrated how integrating Ordr’s IoT and medical device security platform and Nuvolo’s cybersecurity-enabled CMMS solution can help individuals discover, risk-assess and improve the security and utilization of critical health care devices. With attacks on health care practitioners increasing

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during the COVID-19 outbreak, organizations must accurately inventory their devices, understand their risks and protect themselves from attacks like WannaCry, Bluekeep and ransomware before they impact the business. The webinar also included a quick overview by Kaiser Permanente Ventures on why solving these problems are critical to health care organizations, and why they invested in both Nuvolo and Ordr. Attendees enjoyed the webinar and shared positive feedback via a post-webinar survey, including answers to the questions, “Why did you attend today’s webinar? And, was it worth your time?” “I am new to UPMC and wanted to learn more about any additional steps or precautions I need to be taking,” said K. Russo, radiology engineering specialist. “I wanted to see how a CMMS platform could help in keeping an eye on the medical devices on a hospital network.

Definitely worth my time,” Clinical Engineering Tech II M. Ramano said. “We are supposedly getting Nuvolo in our health system, so I thought I’d see a bit of what we were getting. It was well worth my time. I think it does a lot more than we will ever utilize, but it’s nice to know we have options. It was a very cool webinar for sure,” said D. Salyer, BMET III. “Need all the IT information/training possible,” Senior Biomed Electronics Specialist P. Lindquist said after watching the webinar. “Good information about CMMS programs and security,” Biomed S. Gillett said. “It was worth my time. I look forward to advancing in my career and it helped me understand my field a little bit more,” explained L. Santos, BMET III. “I wanted to see the demo of the Ordr software package. This was a great presentation by industry experts,” Field Services Engineer D. Banister said. “The threat of cyber-crime against medical facilities and equipment has become increasingly important. We need to know how to recognize and stop these threats,” said T. Stevenson, BMET II. ‘RIGHT TO REPAIR’ IS BIGGEST WEBINAR OF 2020 The April 8 webinar “Right to Repair” set new record highs for registrations and attendees for the 2020 Webinar Wednes-

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day series. The webinar saw 455 individuals register with 284 attendees for the live presentation. The session was eligible for 1 credit from the ACI. The webinar was presented by Bill Bassuk, CEO and president of the College of Biomedical Equipment Technology, and Larry Nguyen, CEO and CTO of Summit Imaging, and provided insights regarding a hot topic. It was sponsored by The College of Biomedical Equipment Technology. Bassuk and Nguyen said “Right to Repair” is among the most important challenges facing the industry. Repair monopolies, created by equipment manufacturers, are driving health care costs up and patient care down. The duo shared their thoughts and insights regarding the issues and challenges health care faces. In a post-webinar survey, attendees were asked “How much new information did you receive from today’s webinar?” “Great perspective considering the current health care climate,” shared P. Vestal, NCOIC, medical equipment repair center. “This is great news for us, that like to turn the screwdriver, apply logical thinking and use troubleshooting skills,” said J. Machicao, imaging service specialist. “I found the info on COVID-19 timely, and about the manufacturers trend to make their equipment proprietary so we have to have them come in and repair them,” said L. Barton, B.E.S.S. “Really enjoyed the personal insights both panelists provided,” said C. Nieland, manager. “Really informative. I was not aware of the push in our industry by the OEMs to remove third-party services. I utilize these services on a regular basis and without these services it will become harder to meet the needs of maintaining our devices within the budgets we are given,” Biomedical Engineering Manager J. Piercy said. “Lots of useful takeaways from the webinar with respect to helping our administration understand the importance of asking the right questions of the OEMs

before issuing a PO to ensure we can service the devices we buy with in-house resources after the warranty,” Director HTM/Biomed C. Hulet said. “Hot topic. Good to see this topic’s importance to us all in HTM,” said M. Kolb, supervisor. WEBINAR EXPLORES HOW TO RETRIEVE DIAGNOSTIC INFORMATION The Webinar Wednesday presentation “Retrieve Diagnostic Information of Devices by Slaving the Hard Disk” presented by Summit Imaging CEO and CTO Larry Nguyen was eligible for 1 credit from the ACI. Often HTMs are called to service a device following complaints from users of faults and codes. Commonly, HTMs are blind to fault data making troubleshooting and diagnostics of the failure extraordinarily difficult and time consuming. As the webinar workbook explained, “Summit is committed to empowering HTMs to service their own equipment to lower total cost of ownership and improve patient care. Join us for a webinar that educates HTMs to obtain critical fault information for immediate and accurate diagnostics to return the device back to service as quickly as possible by slaving a hard disk to view critical service data.” Attendees were able to learn how to: • Slave common hard drives to a PC or tablet. • Gather error logs and system build information. • Find system errors. The webinar was popular with 143 live attendees. A recording of the session is available online for even more HTM professionals to access the information. A post-webinar survey garnered feedback and posed the question, “How well did the content that was delivered match what you were promised when you registered?” “It matched what I expected very well. There were some things I already knew, having used one of the USB to HD adapters before, but I still learned a few

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more things as well,” Biomedical Technologist O. Stephen said. “Well done, I have this slave and use it often to transfer files from one unit to another. I feel dumb for having not used it for the purpose in this presentation. Well done and thanks,” shared Senior Instructor T. Bracewell. “Exceeded! The title of the webinar did not capture the extensive scope of the presentation,” Clinical Engineer Technician L. DaFoe said. “This was great content for the purpose. It would be a good addition to provide some resources to ghost a healthy hard drive in the future,” said D. Banister, field service engineer. “Was a very good look at how the drives store information and ways to retrieve it,” said K. Ferguson, clinical engineer. “The content was perfect. I have worked with Summit over the years and Larry did not disappoint,” Manager Biomedical Engineering C. Langmeyer said. FIND OUT ABOUT UPCOMING WEBINARS and register for one at WebinarWednesday.Live.

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GE HEALTHCARE DASH 5000

Q: A:

Has anyone had a Dash monitor turning on and off? If your monitor is running on V7.2, then that’s the problem. You will need to upgrade the software to

V7.3

A: A:

This happens sometimes if you replace the DAS module. Reloading the software will fix the issue.

The DAS module information is correct, but there is more to it. If the main board has V7.2 loaded on it, it will need to be upgraded to V7.3. Reloading V7.2 may not fix it or only fix it temporarily. GE came out with V7.3 to correct the rebooting issue. This rebooting happens at the GE logo when it is first turned on. Now, if the rebooting happens at the main monitoring screen, then the problem is the DAS Module, and that module will need to be replaced. PHILIPS IE33 ECHOCARDIOGRAPHY

I have an IE33 that with three different X7-2t TEEs the system will over temp within minutes intermittently over the past two weeks. Some days it’s fine and other days it displays the first message to adjust setting before it forces a cool down, and then sometimes it forces a cool down. They do not over temp on other systems. Has anyone had this type of issue on these before? I am planning on swapping out the NAIM since it does a lot of the temp/voltage monitoring. Any other suggestions would be appreciated.

I would encourage you to NOT invest time in replacing any parts in the scanner. Typically, this is an applications issue. The user is most likely NOT following the proper instructions in minimizing acoustic power, minimizing the

use of Color and 3D modes. There are instructions in bold print in most OEM user manuals that speak to this.

We have seen and had customers with that problem a fair amount of times and it is almost always caused by a NAIM board. As you know, the signals go through the Scanhead Select and I remember seeing that cause the same symptom once. PHILIPS IU22

Q: A: A:

What causes error code 201 on a Philips iU22? Replace the front-end controller.

The error code indicates the following: 201 FEC Failed With Error Code 1 The Front-End Controller has reported an error for which there is no recovery. Scanning has stopped. This indicates a software defect which probably resulted from a hardware error. Please run diagnostics on the FEC board and replace as needed. It is pretty likely that the FEC needs to be replaced. Since it does not seat into the AFP or the scan head select board, like the other front-end boards do, the best “re-seat” attempt you can do is to check the ribbon cable connections, just to have a look, but it is likely the FEC is shot.

It is worth checking the power connections to the acquisition front plane and the two ribbon cables at the rear of the FEC to make sure they are not loose, but a 201 almost always means a failed FEC. If you are not trained or experienced on accessing the front end using the “Beverly Crusher” bar and how to reseat the FEC cables, I suggest you seek help. The parts can be easily damaged.

SHOP TALK

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

TECHNATION

JUNE 2020

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TECHNATION

ROUNDTABLE

ROUNDTABLE Education & Certification

echNation recently contacted a variety of healthcare technology management (HTM) professionals and educators to find out more about education and certification opportunities. HTM departments continue to seek quality applicants as more and more experienced biomeds retire. We quizzed the panel about education opportunities and asked them to share their thoughts on the different certifications.

The following roundtable discussion includes insights from College of Biomedical Equipment Technology’s Bill Bassuk, Vice President of MD Publishing Kristin Leavoy, Penn State New Kensington Assistant Teaching Professor and Biomedical Engineering Technology Program Coordinator Joie Marhefka, AAMI Director of Education Martin J. McLaughlin and Cincinnati State Technical and Community College Professor Emeritus Steven J. Yelton, P.E.

TECHNATION

JUNE 2020

accredited institutions, including military training, technical schools and colleges. To transition from technician to manager or director, HTM professionals should consider pursuing a Bachelor of Science in a related field. Senior leaders in the industry should consider obtaining a Master of Business Administration. Education, matched with an array of diverse technical and business experiences in HTM, are critical to career success. Bill Bassuk College of Biomedical Equipment Technology Q: WHAT LEVEL OR TYPE OF EDUCATION DO YOU RECOMMEND FOR AN INDIVIDUAL INTERESTED IN PURSUING A CAREER IN HEALTHCARE TECHNOLOGY MANAGEMENT (HTM)? BASSUK: As an HTM professional and educator, I recommend formal education directly related to our field from

LEAVOY: An HTM career can begin with a two-year or four-year degree as well as with military training. Some individuals enter the professional ranks after an apprenticeship. The most important aspect of the education is that it be quality education with hands-on training whenever possible. MARHEFKA: I think it depends on the career path that you are looking to pursue. If you are interested in a career as a biomed – maintaining, trouble-

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ROUNDTABLE

shooting and repairing medical equipment – an associate degree will give you the education and skills necessary to be successful. This, of course, is the path I am most familiar with as I teach in an associate degree program. I know that the military training also is an excellent preparation for a career as a biomed. If you are interested in doing more project management in clinical engineering or in supervising biomeds, then a bachelor’s (and possibly an advanced degree) would be helpful. MCLAUGHLIN: While there are many different pathways into the HTM field to start, the recommended amount of education for an entry-level BMET would be a two-year degree and clinical engineers should have a four-year engineering degree. To move up within a health care system, however, HTM professionals should obtain higher levels of education beyond a four-year bachelor’s. Hospital executives often hold multiple graduate degrees and in order for HTM professionals to move into those types of positions, their education levels must match that of their peers. YELTON: I feel that it is possible to enter the HTM career field with an internship or military training. I would strongly suggest that the individual continue their education with a minimum of an associate degree. From there, depending on the individual’s career goals, I would recommend continuing their education with a bachelor’s degree and a certification. Q: WHICH CERTIFICATION(S) DO YOU ENCOURAGE HTM PROFESSIONALS TO OBTAIN AND WHY? BASSUK: The industry is rapidly evolving toward a highly technical, networked, Internet of Things (IoT) field. Traditional education opportuni-

willing to continue learning through continuing education. I also recommend networking certifications as so much of today’s medical equipment is connected to the hospital’s network.

KristinLeavoy MD Publishing

ties are fundamental, including certificate and degree paths. Similarly, obtaining professional certifications such as CBET and CHTM remain important features of a successful career path. However, we believe the trend toward networked devices and systems is driving change and are encouraging our students to seek advanced networking and IT certifications to enhance their professional skills and knowledge as we move into the health care environment of the future. LEAVOY: Certifications, while not necessary, add value to an HTM professional’s ability to market themselves. An HTM professional with a certification does not necessarily have more experience than someone without a certification, but a certification is something that can be listed on a resume for instant credibility and to set a candidate apart from others being considered for the same job opening. MARHEFKA: I encourage HTM professionals to pursue CBET certification, as it demonstrates commitment to your career, shows that you have met certain standards and shows that you are

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

MCLAUGHLIN: Certifications within the HTM field are great ways for professionals to stand out among their peers. ACI’s CBET, CRES and CHTM credentials show devotion to the field, dedication to professional development and a level of knowledge that meets the minimum competency to perform the job that the designation is aligned with. Outside of ACI certifications, project management and IT related programs will make any professional better at their job and should be strongly encouraged in the HTM field. YELTON: The certification that the HTM professional should pursue in my opinion would depend on their job. If they are a technician, I would recommend the CBET or CRES. If the individual is currently in a management position, I would recommend the CHTM certification. Many of our students pursue A+ or networking certifications to complement their education. Q: WHAT ARE SOME WAYS HTM PROFESSIONALS CAN CONTINUE THEIR EDUCATION? BASSUK: One of the best sources of continuing education is the nationwide network of professional associations and mentor groups available to HTM professionals. As the director of the college, I have the privilege of working with many of them, including organizations like the Kentucky Association of Medical Instrumentation (KAMI) and leaders like Tom Bledsoe who are passionate about guiding and mentoring the next generation of HTM professionals.

JUNE 2020

TECHNATION

ROUNDTABLE

LEAVOY: Our industry is quite fortunate to have not just one, but three annual conferences offered to a national audience on a yearly basis. The bi-annual MD Expo and the annual AAMI Exchange are great resources for HTM professionals. The education offered at these events is unparalleled. In turn, the free webinars offered by the Webinar Wednesday series are an amazing tool for professionals to stay abreast of the latest trends and best practices when the opportunity isn’t afforded to attend a national conference. MARHEFKA: There are a number of ways HTM professionals can continue their educations. Advanced degrees – in HTM, IT, engineering, business or other fields – and certification are two that we’ve already discussed. Manufacturer’s service schools are great to further technical skills. Attending conferences, participating in webinars and reading technical publications are good ways to keep up with the latest trends and developments in the industry. I also believe that teaching is the best way to learn – so if you are able to teach a course at a local school, give guest lectures to students or share your knowledge with colleagues, that is also an excellent way to continue learning. MCLAUGHLIN: As a representative for ACI, I encourage our certified individuals to reach out to their local or state HTM society for upcoming meetings, conferences or other education opportunities. For in-person education opportunities, the AAMI Exchange and MD Expo are events that all HTM professionals should attend to ensure they are receiving the most trusted and timely education the industry has to offer. For those who don’t have the time or funds to travel for an in-person event, we recommend the live and recorded webinars from both AAMI and TechNation. The webinars are great ways for professionals to stay on top of their education for free, while juggling their own busy schedules.

TECHNATION

JUNE 2020

certain knowledge and skills and that you are active in continuing education. Other pros of certification are that, in many cases, employers will pay more if you are certified, and having certifications on your resume can help you to stand out. I don’t see many cons, outside of the cost and time commitment.

Joie Marhefka Penn State New Kensington, Biomedical Engineering Technology YELTON: I would recommend an AAMI membership where they can take advantage of online and in-person continuing education opportunities. I would also recommend participation in a local HTM association where there are meetings with speakers, etc. An obvious choice would be course work at a local college and manufacturer’s training classes. Q: WHAT ARE THE PROS AND CONS OF CERTIFICATION? BASSUK: There are not many cons associated with continuing education and professional development. At the College of Biomedical Equipment Technology, we encourage our students to consider seeking specialized training and certification. The professionalization of our industry demands healthcare technology managers and technicians with both experience and education – including formal education and advanced and specialty certifications.

MCLAUGHLIN: Within the HTM field, certification is not a universally mandated requirement for technicians. Some hospitals and organizations don’t promote it, making it seem unnecessary for those HTM employees. What this does is place the initial onus on the individual to earn a certification that will spotlight their value to their employer and potential employers. Many hospitals and ISOs have stepped up to make ACI certification an internal requirement for employment after seeing the direct impact it has on lowering costs, improving recruitment and maintaining a strong HTM team. In the end, certification is about the individual who earns it and should be something that an HTM professional does to showcase their skills and grow as a professional. YELTON: There are many pros of certification. Certification not only shows a level of expertise in your field, it also shows that you have the initiative to advance yourself professionally. I have found that even if an individual decides

LEAVOY: No professional certification is easy to attain, but that accomplishment shows the dedication one has to their field. Without a doubt, the time and effort committed to earning a certification is a worthy endeavor. MARHEFKA: I recommend certification because it demonstrates a commitment to your work. It shows that you have

Martin J. McLaughlin AAMI

WWW.1TECHNATION.COM

ROUNDTABLE to switch fields, the fact that they possess a certification shows that they have the drive to advance themselves professionally. I honestly do not see any cons to certification.

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LEAVOY: All HTM professionals are invited to start a FREE subscription to TechNation at 1TechNation.com so that you can stay informed about your industry and peers. I also highly encourage readers to visit WebinarWednesday.Live to explore the library of hundreds of past webinars as well as a calendar of upcoming presentations. We welcome the opportunity to meet our readers in person at the MD Expo held twice-a-year. The next MD Expo is scheduled to be held in Irvine, California this July. The fall conference will be held this November in Tampa, Florida. For more information about this free conference for hospital employees, students and members of the military, visit MDExpoShow.com.

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YELTON: I think TechNation readers should investigate non-traditional HTM education. There are more online opportunities and remote learning opportunities available. I feel that they should become active in professional societies such as AAMI, ASHE, HIMMS, etc. depending on their job. These organizations are working hard to provide educational opportunities for members. As far as certifications, I feel that readers should pursue certifications. It not only helps you stay current in your field, but it will provide you with a credential that will set you apart from the person who chooses not to become certified.

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BASSUK: We are fortunate to work in an industry so heavily invested in education and professional development. A formal education is the bedrock of a strong and successful career. Certifications and specialty training augment formal education and experience and open doors to HTM professionals that might otherwise remain closed. For BMET and HTM professionals developing their career paths, we encourage them to seek all three â&#x20AC;&#x201C; formal education, certifications and a wide array of experiences.

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Steven J. Yelton Cincinnati State Technical and Community College

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT HTM EDUCATION AND CERTIFICATIONS?

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here is a general belief among human resources (HR) professionals and hiring managers that the more value an employee brings to the job, the more knowledge they have and the more that they can be utilized by the employer, the more opportunity they might have for advancement and job security. Certainly, there is no argument that self-development, continuous learning and an expanding skill set are all desirable qualities and traits in an employee, which makes that person more prized by leadership. Many occupations allow a certification as the sole means of entry into that career. These certifications, which are awarded by professional organizations or other nongovernmental bodies, demonstrate competency to do the job

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and often require a qualifying exam. Those who hold certifications, but not a professional license, can have varying levels of education from no high school diploma to advanced degrees. The list of certifications for those in the HTM profession has grown over the past four decades and has expanded in recent years as connectivity and information storing have increased. Consider that there was a time, not that long ago, when a biomed did not

even consider a degree in network security. In more recent years, it provides a very useful skill set for a changing workplace. Not all biomed jobs require a particular certification, but in an evolving landscape, the newer specialty degrees and certifications can prove valuable. Is certification necessary? Is it a job prerequisite? Is it a career accelerator? These are fair questions.

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Within the HTM profession, both for biomeds and managers, there are certifications that acknowledge a certain attained level of knowledge. As with all knowledge, there is an opportunity for the application of that information that bestows some additional value on the possessor of the certification. In a profession that requires computer, electrical and mechanical knowledge, the universe of information is vast. There are several certifications that can attest to competency in those areas. There are certifications that are right for both biomeds and managers. They can include CHTM, CBET, CRES or CCE. In the connected environment that health care facilities operate in, there are also certifications that represent a level of competence in network security. These can include CompTIA certification in Sec+, A+, Net+ and Cybersecurity+. “Since certifications aren’t necessarily required for our industry, I’ve always used it as a way to distinguish one technician from another. I looked to get the CBET back when I was a tech as a way to distinguish myself from others with my same experience and also a personal goal. When the CHTM became a new certification, I looked to achieve this for the same reasons,” says Ken Mylar, MBA, CHTM, CBET, system director of Healthcare Technology Management (HTM) at Summa Health in Akron, Ohio. As hiring managers forward their requirements to HR managers, and both review a pile of resumes, the candidate with the certification may stand out. “I believe it is a matter of where one wants to go with their career. If you are a biomed and want to excel, the CBET is a great option; if you aspire to be in management, you should be preparing for the CHTM, etcetera,” says John Noblitt, M.A. Ed, CBET, BMET program director at Caldwell Community College in Hudson, North Carolina. “All of the A+, Net+ certifications will be valuable as we continue to implement smart technologies and AI,” Noblitt says. The employer’s wish-list is also front

of mind for Bill Bassuk, president of the College of Biomedical Equipment Technology in San Antonio, Texas. “As far as what certifications are right for you depends on the hiring institutions. Some institutions will only hire a biomed if they have their CBET. The same applies for the manager or director role in which case they will need their CHTM. In most cases, experiences are looked at more closely than the certifications. In some cases, institutions will hire the qualified biomedical professional and or manager contingent on passing their exam within the following year,” Bassuk says. Bassuk also says that having A+ and networking certifications, such as cybersecurity, is a big plus because of the increasing need to be aware of the potential cyber threats to hospitals. “As far as positions in management are concerned, most organizations prefer their candidates to have a formal four-year degree in business or similar with biomedical experience as well,” he adds. Biomed students at Texas State Technical College hear about the benefits of certification also. “We encourage our students to work toward the CBET and/or CRES, realizing that it isn’t an entry-level

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

certification, but they can take the test after graduation. I recommend they wait about six months to a year after graduation to take the test, studying the whole time,” says Roger A. Bowles, MS, EdD, CBET, instructor of biomedical equipment technology at Texas State Technical College in Waco, Texas. Bowles says that they also encourage students to get the A+ and Network+ certifications. “They can get those while they are still students. If they achieve those before graduating, they will definitely have an advantage in their job search,” he adds. Salim Kai, senior director of information services/biomedical engineering at Children’s Hospital of Philadelphia says that technicians working in the HTM field should, at minimum, aim to get the CBET. “For managers that are managing the day-to-day operation, and staff, annual budget, they should aim for the CHTM,” Kai says. Kai breaks out some of the skill sets that are valuable for HTM professionals. “Cybersecurity knowhow; how to patch devices and servers, how to secure medical devices, physical inventory for connectable devices, cyber risk assess-

JUNE 2020

TECHNATION

ment, investigating events related to cyber threats,” he says. Kai also says that project management knowhow is a valuable skill. Know the anatomy of a health care project, how to track it, how to negotiate with vendors and contractors. One should also know how to create a project charter and budget and how to manage a project and stay on schedule. “Continuous process improvement and Lean Six Sigma; being able to identify value drivers for the HTM department and show value to the hospital leadership,” Kai continues. He says that data analytics is important to know. [To be] able to use data to show cost savings as in financial stewardship, improved customer satisfaction, and improved safety and quality. Kai also suggests HTM professionals acquire: • IT knowhow • The ability to understand how devices are connected and communicate on the hospital network, both wired and wireless. • Ability to understand how data travels and is archived. • General knowledge of medical apps. Many of these skills can be enhanced through a certification program. The CompTIA Project+ certification teaches essential project management concepts that go beyond one framework or methodology. To take the exam, the candidate should have one year of knowledge of project life cycle, communication skills, project documentation and the ability to manage resources and stakeholders. CREDENTIALS FOR HTM PROFESSIONALS Several certification exams can be taken through AAMI’s Credentials Institute (ACI). The granddaddy of the biomed certifications is the CBET, with the first exam administered in 1972. As of December 31, 2018, there were 4,099 holders of the CBET

TECHNATION

JUNE 2020

certification, including those who are retired and emeritus. “The CBET and CRES certification programs have been developed and revised by HTM professionals with the goal of testing the minimum competencies for an HTM with at least four years of experience in the field,” says M.J. McLaughlin, AAMI’s director of education programming. McLaughlin says that earning these certifications from ACI demonstrates a strong understanding of the core facets of the job, including anatomy and physiology; public safety in the health care facility; fundamentals of electricity and electronics; healthcare technology and function; healthcare technology problem-solving; and healthcare information technology. “For new hires who don’t yet meet the eligibility requirements of the CBET or CRES, ACI will soon be launching their Certified Associate in Biomedical Technology (CABT) certification, which is geared towards individuals just entering the field with no prior education or experience. AAMI’s BMET101 training will launch at the same time, acting as a key preparation course for those seeking to earn the CABT designation,” McLaughlin says. He says that on the other end of the career ladder is the Certified Healthcare Technology Manager (CHTM) designation. “This management level certification is for HTMs who have had at least three years of experience in a supervisor or managerial role. A candidate for this designation would be someone who is responsible for planning and directing activities of other HTM professionals, monitoring their work and taking corrective actions when necessary. The CHTM exam covers two major areas in HTM: management of health technology operations and management of personnel,” McLaughlin adds. AAMI also offers the Certified Industrial Sterilization Specialist certification, for those who understand the principles of sterilization process development, validation, control and

management as part of the manufacturing of health care products, according to the organization’s website. NETWORK AND COMPUTER FOCUS A complete understanding of how computers function is the first step in obtaining one or more of the specialized certifications in computers and network security. These certifications and degrees can launch a career in cybersecurity or enhance a biomed’s knowledge to be used on the job in a hybrid role or as a subject-matter expert in a biomed department. Knowing Linux and Unix, in addition to Windows, can help round out an HTM professional’s knowledge. Learning a programming language is also helpful. “We are definitely in the digital age in today’s world. Cybersecurity should be at the top of everyone’s list. We need to all be aware of any equipment that is connected to a network or Bluetooth and understand the significance of keeping that data secure,” says Matthew Kenney, CHTM, director of HTM/biomed at Aiken Regional Medical Centers in Aiken, South Carolina. Kenney says that in today’s world, everything is connecting to the electronic medical record (EMR). Understanding that more in-depth is very important with maintaining medical equipment. One provider of both training and certification is the Computing Technology Industry Association (CompTIA). According to the association’s website, they have awarded more than 2.7 million certifications in areas such as cybersecurity, networking, cloud computing and technical support. There are several certifications that are considered “core” that include IT Fundamentals (ITF+), A+, Network+ and Security+. IT Fundamentals allows professionals to determine if an IT career is right for them. It provides a broad understanding of IT. It establishes an IT education framework for students as

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well. The exam focuses on essential IT skills and knowledge, according to CompTIA. It is a good basis for those who are considering pursuing a professional level certification such as A+. The A+ requires the candidate to pass two exams and is a credential that establishes that the holder is someone who can think on their feet when performing critical IT tasks. The core certifications prepare the professional for the next level of certifications. Some of those more advanced certifications include CompTIA Security+, Cybersecurity Analyst certification, CompTIA Advanced Security Practitioner (CASP+) certification. The PenTest+ is a newer certification, which became available in 2018 and is for cybersecurity professionals who are tasked with penetration testing and vulnerability management. How resilient is the network to attack? An HTM professional may want to begin with some of the core offerings. A+ and Net+ are good building blocks for this purpose. Another certificate program, started less than a year ago, is the Leadership in Health Care Privacy and Security Risk Management program, an eight-week course offered by the McCombs School of Business at The University of Texas at

Austin. The program says its purpose “is to develop leaders who can manage risk in American health care systems, protecting them from fast-evolving cybersecurity threats.” “The role of HTM professionals has indeed expanded, and we’re struggling to keep pace. There are no signs of slowing down, so we might as well embrace and accept these changes. One area in particular that we are behind is in cybersecurity. It is imperative that our current and future HTMs get familiar and proficient in keeping our health care infrastructure healthy and protected from cyber-threats,” says Jojo Gonzales, BSHA, CBET, CHTM, A+, Net+, Sec+, Healthcare IT Certified, Lead BMET in the clinical technology department at Kaiser Permanente San Diego Medical Center. “I’ve been asked many times recently of my recommendations, and I’ve offered the same which is to get educated in cybersecurity either through formalized college-level education, specialized training or get certified. Here are a few certifications that are worth pursuing: CompTIA Security+, CPHIMS/CAHIMS, CISSP and CISM,” Gonzales says. It seems counterintuitive to learn about how to be a hacker when you are attempting to help an employer

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

strengthen a network against cyber threats, but thinking like the hacker offers insights. “A basic military tactic discussed by Sun Tzu in ‘The Art of War’ is that we should ‘know thy enemy.’ So, when I was first learning about cybersecurity, I picked up a few books on hacking which gave me some insight to the methods and techniques the bad actors were using. This knowledge helped me understand the how, what and why of the various cybersecurity countermeasures,” Gonzales says. Gonzales says that his recommendation is for BMETs to take the initiative to learn more about cybersecurity. “There are countless resources available online either self-paced or formalized training. Community colleges offer basic computer, networking, and security classes; others even have certification preparatory courses for A+, Network+, Security+, Cisco, etcetera,” he says. “Some local HTM associations offer them too. Attend as many webinars, symposiums and conferences as possible where they have plenty of educational sessions. And, if available, request these types of training from the employers. It’s a skill set that would not only benefit the employees but the organization overall,” Gonzales adds. Some conferences HTM professionals should consider attending is the AAMI Exchange and the MD Expo. MD Expo is free for hospital employees, students and members of the military. MD Expo strives to provide healthcare technology management professionals with a unique, intimate and rewarding conference second to none. For more information, visit MDExpoShow.com. It’s all a value proposition. How valuable does a biomed make him or herself to the team and their employer? Is learning a lifelong pursuit? There are many ways to look at earning certifications and there are no downsides. It should be approached as a challenge and a goal that has the potential to enhance your career.

JUNE 2020

TECHNATION

EXPERT ADVICE

CAREER CENTER

Handling Stress and Job Burnout in the Workplace BY JENIFER BROWN

ur industry is directly involved in the COVID-19 health care crisis on a daily basis. It is vital that we take care of ourselves physically by wearing protective gear and following federal and state regulatory guidelines. It is also important to take care of our mental and emotional health.

In today’s workplace environment, especially in light of the virus, achieving a work-life balance seems out of reach. Being stressed, tired and overextended has become a normal part of our industry’s professional life. Many psychologists and even the Centers for Disease Control and Prevention (CDC), “highlight long-term and unresolvable burnout as not a symptom but rather a major health concern.” Biologically we are not meant to be in that high-stress mode all the time. Oftentimes, we think that the only way to be productive is to be constantly on the go. Plus, job burnout may be hard to identify or accept due to feeling it is some sort of failure on our part. Common symptoms can be loss of

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appetite and passion for things you love or being unable to find motivation for things that you were able to accomplish easily before. It could also be more irritability or even anger toward co-workers or loved ones. These symptoms can lead to absenteeism, turnover and errors due to not being as careful on the job as normal. Here are some ways to avoid being overstressed or burned out on the job: • A trusted peer/mentor at work with whom you can discuss and strategize other ways to deal with work-related issues. That makes you feel that each of you have each other’s back and that you are there for each other so that you are not alone in this time of stress. • Try focused breathing at work to help you reduce or manage stress. This is due to tapping into your parasympathetic nervous system. • If possible take frequent breaks at work, preferably five-minute breaks for every 30 minutes spent on a single task. • Find or start a hobby where you can decompress, de-stress and totally

Jenifer Brown Health Tech Talent Management LLC dissociate from work. • Do regular exercise or fitness activity which has both stress relief and physical benefits. For example: Yoga is a great exercise venue which combines focused breathing, mental meditation and physical activity. • Aside from good diet, exercise and sleep, there’s one surefire way to combat stress, low job morale and burnout; “Laughter,” CDC Team Leader of Workplace Health Programs Jason Lang said. “Find some humor in daily life.”

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