TechNation Magazine July 2020

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ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

JULY 2020

Disposition K N O W Y O U R O P T I O N S

PG 54

33 MD Expo (Irvine)

Transitions to HTM Mixers

14 Company Showcase

ZRG Medical

51 Roundtable

Address Service Requested MD Publishing 1015 Tyrone Rd., Ste. 120 Tyrone, GA 30290

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Vol. 11

IV Pumps

63 The Future

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Always Keep Track of Your Medical Devices GET THE MOST FROM YOUR ASSETS Know exactly what devices are connecting to your network, when and where. Put this information to work for you to improve procurement, maximize deployment, and streamline management to extend the life and value of your assets.

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CONTENTS

FEATURED

51

HE ROUNDTABLE: T IV PUMPS It is time once gain for TechNation’s monthly roundtable feature article to focus on IV pumps. Experts share their thoughts regarding the knowledge HTM professionals need, share cost-savings tips and more in this look at IV pumps.

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EQUIPMENT DISPOSITION: KNOW YOUR OPTIONS Disposing of medical equipment can be costly. There are a number of considerations when disposing of used medical equipment and a number of choices as to how a particular piece of equipment is taken out of service and out of inventory.

Next month’s Feature article: Review HTM Standards

Next month’s Roundtable article: Asset Tracking (RTLS, RFID, etc.)

TechNation (Vol. 11, Issue #7) JULY 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

JULY 2020

TECHNATION

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INSIDE Departments

CONTENTS

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley

Karlee Gower

Amanda Purser EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Jennifer Godwin

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

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

P.12 SPOTLIGHT p.12 Department of the Month: Texas Health Central Region HTM Department p.14 Company Showcase: ZRG Medical p.18 Professional of the Month: Raymond Forsell, CCE: Answering the Call p.22 Association of the Month: The New England

Society of Clinical Engineering (NESCE) P.24 p.24

p.33 p.34 p.36 p.38 p.40

INDUSTRY UPDATES News and Notes: Updates from the HTM Industry HTM Mixers Announcement Ribbon Cutting: Althea AAMI Update ECRI Update Welcome to TechNation

P.42 p.42 p.44 p.47 p.48

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

P.58 EXPERT ADVICE p.58 Career Center p.60 Maintenance and Servicing: The Alaris 8100

Infusion Pump, sponsored by Avante Health

Solutions p.63 The Future p.64 View on Value p.66 20/20 Imaging Insights, sponsored by Innovatus Imaging p.69 Cybersecurity p.71 The Other Side p.72 Top 7 Reasons a Biomed Tech Is One of the

Best Jobs in Health Care, sponsored by TKA p.75 Roman Review P.76 BREAKROOM p.76 Did You Know? p.77 The Vault p.78 MedWrench Bulletin Board p.86 Flashback p.80 Service Index p.83 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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SPOTLIGHT

Texas Health Central Region HTM Department recently reopened an ICU floor.

DEPARTMENT OF THE MONTH Texas Health Central Region HTM Department

BY K. RICHARD DOUGLAS

W

hile HTM departments across the country had to help their clinical colleagues respond to the coronavirus pandemic, one team in Arlington, Texas showed the value of biomeds in a crisis by taking on an important project that helped prepare the hospital for an influx of COVID-19 patients.

The healthcare technology management (HTM) department at Texas Health Arlington Memorial Hospital were tasked with reopening an unused ICU floor.

The Arlington team of biomeds is part of the central region of Texas Health, which is made up of 16 members covering six hospitals and two surgical centers. HTM Operations Manager Douglas Redwine is joined by lead techs J.R. Martinez,

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Philip Gutierrez and Jaime Garcia.

The team also includes BMET IIs Thomas Helms, Matthew Mellor, Armando Gutierrez, Sheldon Svoboda and Adrian Rueda.

Other team members are techs with a BMET I title and include Jourdan Coleman, Lorenzo Roque, Cameron Curry, Kerry Snape, Armando Picazo and Stephen Parades.

The department also includes Biomed Coordinators Kiana Poole and Tatum Tietjen.

In addition to Arlington Memorial Hospital, which is a 369-bed acute care facility, the regional team also provides technology management at Texas Health Harris Methodist Hurst Euless Bedford, Texas Health Presbyterian Hospital Denton, Texas Health Harris Methodist Hospital Alliance and Texas Health Mans-

field; all acute care hospitals.

The group also provides service to the medical devices in a specialty cardiac hospital and two surgical hospitals.

How does the department deal with service contracts?

“Before an equipment manufacturer warranty expires, we analyze the service history and compare bringing service in-house (assess our techs training, cost for training, hiring, test equipment) versus the service options (OEM full-service contracts, T&M) to determine the most cost-effective and beneficial management plan. We manage the contracts and perform a yearly evaluation to determine the viability of the contract,” Redwine says.

He says that data collection is performed through its integrated CMMS.

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SPOTLIGHT

“ L ast month, with the impending threat of a pandemic surge, the HTM teams were called on to for their medical equipment expertise to support the front-line health care workers.”

“Clinical staff use a web portal to create service work orders using biomed numbers on the device and work orders are assigned to techs. PMs and safety alerts for the system are controlled and generated from our system’s corporate office.

Techs are responsible for inputting all the pertinent data on the work orders and uploading attachments of field service reports and invoices,” Redwine explains.

He says that all of the facilities have a high level of integration between biomed and IT. “Our ITS, MDI, risk analyst and HTM teams work together on various projects to ensure our systems are compatible or can be combined in the future as technology advances,” he says.

ADDRESSING A CRISIS Except for some extraordinary natural disasters like hurricanes, tornados or floods, there are few instances where biomeds nationwide are called upon to address the incalculable consequences of a worldwide pandemic. Hospitals nationwide were staring at predictions of a system overwhelmed with critically ill patients.

As the old saying goes; success is when preparation meets opportunity.

The opportunity in this case was to ramp up as many beds for very sick patients as possible and that is what the Arlington team accomplished.

“Last month, with the impending threat of a pandemic surge, the

HTM teams were called on to for their medical equipment expertise to support the front-line health care workers. The Healthcare Technology Management team for the Central Region at Texas Health Resources was ready for the task and honored to play an integral role in serving the patients and medical community during this serious state of affairs,” Redwine says.

He says that there were many unique requests as adjustments were made to prepare for a surge, but one of the sites in the Central Region was tasked with the responsibility of helping to reopen a defunct – for over two-years – ICU floor to provide care to COVID-19 patients.

“The project was most definitely a great collaborative effort between many different departments to quickly get the area up to speed, with HTM playing an integral role in successfully completing several urgent tasks in a timely manner to ensure success,” Redwine says.

Redwine says that the HTM team specifically performed an overall assessment to test and determine operational medical equipment for each room, repaired malfunctioning devices, determined needed inventory, cost to make operational and the turnaround time to get the area up and running.

“The team also performed the conversion of anesthesia units for use as ventilators to ensure there wouldn’t be a shortage of vents to care for our patients,” Redwine says.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

He says that in less than three weeks, the project was completed, and the hospital was able to successfully meet the demands of housing and serving patients during this critical time.

Beyond their work at the system’s hospitals, the team also represents the HTM field through participation in Healthcare Technology Management Association-North Texas (HTMA-NTX), AAMI and the MD Expo.

Although HTM professionals contribute to good outcomes for patients every day, the coronavirus pandemic and COVID-19 patients have tested the mettle of biomeds worldwide. At a time when hospitals saw an influx of very ill patients, the HTM profession showed its versatility and readiness.

The biomeds at Arlington Memorial Hospital, part of the Texas Health Central Region team, jumped into action and helped prepare for the very worst. Their efforts, along with those of other departments, put the necessary equipment and repaired equipment into place to be ready for the unknown.

If it were not for a dramatic change in human behavior, that headed off many statistical probabilities, the hospital would have been faced with a difficult emergency.

With the help of the biomeds, the situation became manageable.

If the fall brings a second wave, Arlington Memorial and the other hospitals in the region will be prepared.

JULY 2020

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE ZRG Medical

A

rmed with a passion for repurposing, recycling, donation, and respect for the medical industry professionals who provide life-changing care through technology, Mimi and Tony Lively started ZRG Medical in 2013. Today, ZRG provides tailored asset disposition services for hospitals and health care facilities that want their surplus equipment to have a second life. By reselling, renting, donating, and responsibly recycling medical equipment they can keep these lifesaving devices out of landfills and give them a new life where they are needed. ZRG Medical is also Certified Women Owned by the Women’s Business Enterprise National Council (WBENC).

SUSTAINABILITY DIVERSITY GIVING BACK ZRG Medical has become the leading medical asset disposition vendor in

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Southern California since its start in 2013 and is forecasting exponential growth in the coming years by expanding to service health care facilities on a national level. Their environmentally friendly and customer-centered approach is the future of health care asset disposition and is continuously evolving to benefit the global economy.

At ZRG, they realize that every health care facility does not have the same needs and priorities when it comes to removing their surplus assets. Because they specialize in both the reselling and recycling of medical equipment, they can create tailored solutions for managing all surplus assets within a hospital or health care facility that fits the needs of the customer.

ZRG Medical is licensed by the California State Board of Pharmacy to sell medical equipment and follows all state and federal regulations. Having

MIMI LIVELY CEO been an R2 and RIOS certified recycler for several years, ZRG follows strict recycling guidelines that ensure all assets removed are handled according to compliance standards, including

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

HIPAA. Each piece of equipment removed is documented in ZRG’s customer portal and all confidential data and hospital identifiers are wiped clean to remove any liabilities and keep patient information secure. Depending on the condition, need and value, the equipment is then refurbished, resold, rented, donated or broken down for parts and responsibly recycled.

Through their online customer portal, customers can view all equipment removed from their facility and access all documentation with clarity and ease. Inventory lists, releases of liability and certificates of recycling are at customers’ fingertips. Designed with convenience in mind, the portal can also be used to request new liquidation jobs and review past jobs ZRG has already completed.

ZRG Medical never charges a fee to remove medical equipment from health care facilities and will purchase the equipment depending on the value and condition of the medical devices.

ZRG’s goal is to ensure that every piece of medical equipment removed from health care facilities receives a second life for the benefit of earth and mankind alike –- their mission statement reflects just that. According to Mimi Lively, CEO and owner of ZRG Medical, “Our mission is to give economically disadvantaged people access to outstanding medical care, create new jobs in a working environment that celebrates equality and diversity, and eliminate needless waste in landfills through the reselling and donation of hospital medical equipment.”

Mimi and Tony are active in the biomedical community, supporting the education of both existing and upand-coming HTM professionals. Mimi spearheaded the Biomedical Technician course MiraCosta College now offers at its Technical Career Institute

location in California. Mimi is especially passionate about helping people throughout the world to get the medical care they deserve – she works closely with charitable organizations to provide them with medical equipment to complete their missions. Tony sits on the California Medical Instrumentation Association (CMIA) board of directors and is a valuable networking resource for biomeds and supply chain management throughout the nation. He also helped in organizing the relaunch of the Arizona Healthcare Technology Management Association (AZHTM), that held its first in-person meeting just this past March of 2020.

One new venture ZRG Medical is taking on is the expansion of its parts division. Because they have worked closely with clinical engineers for many years, they have seen up close the struggle HTM professionals have getting access to parts for end-of-life equipment. According to Tony Lively, “We saw a need in the health care community and are doing our best to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

fill it.” The parts division will focus on providing hard-to-find preowned parts so health care facilities worldwide can continue to service their older or end-of-life equipment until it can be replaced.

I’M SYDNEY HUMES, the new Director of Business Development and Strategic Sourcing at ZRG Medical as of March 2020. I have always been inspired by the works that Tony and Mimi do to support both the HTM community and world health. I can now say firsthand that company culture is extremely important at ZRG Medical. We work as a cohesive team and tackle issues head-on to maximize efficiency. Our company’s dedication to transparency incites honesty and accountability in our practices. The employees are the number one priority at ZRG Medical. Something Mimi told me when I was hired on at ZRG is, “We understand that without our team we’re not able to take care of our clients or follow through with our mission to benefit the environment and mankind.” By showing appreciation for the ZRG Medical team members, allowing for a healthy work-life balance, and approaching all situations with empathy, our team is able to pass that culture on to our clients, creating strong and trusting long term relationships.

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EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2020

TECHNATION

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Raymond Forsell, CCE: Answering the Call

BY K. RICHARD DOUGLAS

A

n old English proverb, in an attempt to describe typical weather patterns during the month, states that March comes in like a lion and goes out like a lamb.

For the United States, March of 2020 would require reversing the order and applying the phrase to daily life and not weather. That is how the month will be remembered in the history books.

It was also a time when individuals with the fortitude to operate under crisis conditions were able to rise to the occasion and make a difference. It comes as no surprise that a resourceful HTM professional would step up to the plate and accept this responsibility.

Raymond Forsell, CCE, a clinical engineer with the University of Vermont Technical Services Partnership, provides consultation services to every New Hampshire and Vermont hospital except the University of Vermont Medical Center.

Forsell’s background as an EMS captain and Lieutenant Colonel in the Vermont State Guard help make him uniquely qualified in times of emergency.

The coronavirus pandemic and the resulting numbers of COVID-19 patients that have required emergent treatment have tested health care resources in every state.

The governor’s office in the state of Vermont had an urgent need to respond in the early days of the pandemic. Forsell and a colleague answered the call.

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“Throughout Ray’s career he has, with true dedication, thoughtfully and professionally applied his engineering and management skills to advance patient and staff safety for the clients the University of Vermont Technical Services Partnership serves. With the COVID-19 crisis, Ray jumped into action to help our clients in the region, and the state of Vermont, prepare,” says Michael Lane, MBA, CMQOE, CHTM, director, University of Vermont Instrumentation and Technical Services.

“His willingness to investigate and lead efforts on the vast array of problems presented by the crisis is a testament to Ray’s character and his emphasis on valuing the safety of others. The University of Vermont-TSP has an incredible team of HTM professionals, and we are continually thankful for Ray’s contributions to the team,” Lane says.

Forsell says that he detoured from his original educational pursuits and found medical device management the right fit.

“I was a mechanical engineering (ME) student, pursuing an ME degree that would have been in the manufacturing/ equipment disciplines. I had been involved with my local emergency medical services squad since high school and became aware of increasing technology use in medicine and it was intriguing,” he says.

“The University of Bridgeport had a bachelor’s degree in biomedical engineering, so I transferred to that school. The program included cooperative education in

local businesses, and I worked in both medical equipment manufacturing and the clinical engineering department at Norwalk Hospital. Working in hospitals with equipment and clinical delivery of care was rewarding and challenging,” Forsell says.

He says that he started out as a BMET II after college. He split his time between serving two hospitals in Vermont and one in upstate New York.

He was also working in the open-heart surgery group at the Medical Center Hospital of Vermont.

“My employer, through this and most of my whole career, has been the University of Vermont (UVM) Technical Services Partnership (TSP), an academic, non-profit shared service clinical engineering provider in New England,” Forsell says.

He says that at UVM, he became a clinical engineer and began providing engineering consultation services to 22 hospitals in Vermont and New York.

“I went to Connecticut and was the assistant director of biomedical engineering at Bridgeport Hospital in the early 1990s before returning to Vermont. Back in Vermont, we expanded the footprint and scope of CE services and now serve hospitals in Vermont, New Hampshire, New York and Maine.

I earned my professional engineering license in fire protection engineering, which has helped in areas of code and standards,” Forsell says.

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SPOTLIGHT

FAVORITE BOOK:

Bible; “Mover of Men and Mountains” (RG Letournneau); “Perfect Consulting”; “NFPA 101”

FAVORITE MOVIE:

“Hunt for Red October”; “Man in the Iron Mask”

FAVORITE FOOD: Maine seafood

HIDDEN TALENT: Pretty good shot

FAVORITE PART OF BEING A BIOMED:

Oddly enough showing our stuff to surveyors during TJC, DNV, CMS visits.

WHAT’S ON MY BENCH?

Ray Forsell and his daughter, Becca, help work a vehicle extrication call as members of the South Burlington, Vermont Fire Department. Ray Forsell retired as a captain and safety officer after 27 years of service.

HTM – STEPPING UP Forsell and his colleagues have proven instrumental in addressing many of the challenges the coronavirus pandemic has brought to his state.

“The COVID emergency has been a wild ride. Prior to the declaration of an emergency in Vermont on March 13, I had kept marginally involved with the Vermont Health Care Emergency Preparedness Coalition, a group of all the hospitals and the state emergency preparedness team. I always offered that if there were any emergencies that required medical equipment involvement, call us since we took care of most of the equipment in the state,” Forsell says.

He says that he got a call from the Emergency Operations Center after Gov. Phil Scott declared an emergency. Forsell explains that they wanted to buy ventilators and wanted makes, models and vendors in an hour.

“I engaged the other skilled clinical engineers at TSP and within the time allotted we had the information to the EOC. We aligned ourselves to be the receiver for 400+ ventilators purchased, so

we could get them inventoried, tested and ready for deployment statewide. Our office location is strategic with access to the largest hospital, interstate and helispot.

Data from our HEMS CMMS has been critical to providing inventory information to the state EOC on numerous occasions,” Forsell says.

“We have also been very involved in evaluation and promotion of innovative ways to disinfect N95 respirators. Where does CE end? I do not know. We happened to have the technical abilities to evaluate current technologies such as UV-C, hydrogen peroxide and other technologies to mitigate the shortage of N95 respirators.

In our state, Steris and Sterrad H2O2 sterilization was the best answer, and testing was done to evaluate filtration effectiveness to 20 cycles for some respirators,” Forsell adds.

“We also modified the application of an existing particle counter to help us evaluate materials for alternate surgical mask and isolation gown usage,” he says.

Forsell says that Vermonters are nothing if not innovative and giving.

“Teams of locals were ready and

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

• Notepad, I take lots of written notes or I forget everything.

• Pencils- I love pencils. You can leave them in a drawer for decades and they still work.

• Cell phone – things are happening so fast I need to be accessible.

• Picture of the wife.

• Leatherman – when they let me fix stuff, you can do a lot with that tool.

willing to sew masks. Guidance from UVM and UVMMC helped them to choose materials which were safe and effective,” he adds.

Forsell explains that in his department, there are research engineers and clinical engineers working to develop low-cost ventilators under the FDA Emergency Use Authorization.

“While the emergency may have peaked for now, these innovations will not be lost for future use or in off ‘grid’ locations near and far,” he says.

Forsell says that most of what he has been doing is putting different people together with ideas and resources.

“During late March, TSP began to run a weekly web meeting that has been open to Vermont Healthcare Engineering Society members as well as our client hospitals in Vermont, New Hampshire, New York and Maine. This has been a forum to share best practice in terms of technical challenges to COVID-19 preparation. This has included ventilators, monitors, medical equipment procurement, CMS waivers, negative pressure rooms, PPE, oxygen connectors and supply, and

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SPOTLIGHT

Ray Forsell and his wife, Suzanne, are seen relaxing at Schoodic Point, Maine. It is one of their favorite spots.

now recovery to normal,” he says.

Forsell says that the whole team at UVM Technical Services Partnership has been unbelievably creative and supportive of him, each other, client hospitals, the states they serve in and all patients.

“With little or no notice, our whole leadership and team changed staffing focus while at the same time supporting regular care and service and daunting requests by the hospitals and state governments. Monitoring systems were moved into makeshift negative pressure wings, testing locations supported with equipment, surge hospitals supported with monitors and equipment. It has been clinical engineering/biomedical engineering/healthcare technology management’s gallant hours,” Forsell says.

HTM ADVOCATE Forsell has had varied experiences leading up to his current role; all of which have been beneficial in expanding his HTM and consultation duties in recent months.

“Having left EMS in Connecticut, I joined one of the busiest fire departments in Vermont and served 27 years before retiring as captain and safety officer. In the early 2000s, I joined the Vermont State Guard and have worked my way up to lieutenant colonel and presently serve as the G-3, director of training and operations for the state,” he says.

When away from work, his attention turns to family.

“I love to camp with my family in Maine and doing family things with my

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four kids, wife, and grandchildren,” Forsell says.

“I have been married to Suzanne since 1986 and have four children. Three girls and one boy. Most are in health care or public safety with one a very creative artist. Two boy grandchildren so far will carry on the family name into the future,” Forsell adds.

The efforts during this crisis have been noticed by leadership.

“Ray has always shown rapid action and expert decision making when an emergent situation arises. His work related to the COVID-19 pandemic clearly brought out these traits, and he has been immensely valuable to Vermont and our regional health care institutions,” says Tobey Clark, MSEE, CCE, CHTM, FACCE, engineering supervisor and co-director, WHO Collaborating Center for HTM, University of Vermont Instrumentation and Technical Services.

Forsell says that one of the biggest career challenges is to remain relevant to his clients; the facilities that are members of the UVM-TSP family.

“The primary outcomes to our clients of clinical engineering/biomedical engineering/healthcare technology management have not really changed in my 35 years: Improve the quality of patient care; reduce risk; and contain the cost of health care,” Forsell says.

He says that the technologies have changed; the people have changed; the organizations have changed.

“Because of the changes, we have to

always be recreating ourselves and looking for the needs to fill,” Forsell says.

“As a profession, CE/BE/HTM is unique in health care. I am so proud of the technicians, engineers, managers and support staff that make up our and other departments. They interpret technology to the non-technical.

Systems that are mission and life critical are prioritized and supported like little SWAT teams. The workshops may look like a bomb went off in them, however, the thousands of devices that the average HTM member manages is mind boggling. Most are T-shaped people. Broad competence with many manufacturers and types of devices, but with some deep specialty. If you subtract the equipment that HTM professionals support, medicine is basically a loincloth and a machete,” Forsell says.

Forsell proffers some advice.

“So much has changed in 35 years in HTM. So much is the same. Stick to the basics. Listen to your client. Seek to effect the outcomes your client thinks are important: patient care; risk reduction; cost containment; innovate whenever possible,” he says.

Have there been awards worth mentioning? Forsell says that the opportunity to serve in many roles has been reward enough.

He adds; “One of the best awards I get is to be asked: ‘Are you (Ellen, Becca, Chris, Jenny)’s dad?’ Yes, yes, I am.”

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SPOTLIGHT

NESCE is a professional alliance of members who support medical technology in health care organizations across New England.

ASSOCIATION OF THE MONTH The New England Society of Clinical Engineering (NESCE)

BY K. RICHARD DOUGLAS

T

he northeast U.S. has been one of the hardest hit areas during the coronavirus pandemic with New York, New Jersey and Massachusetts in the top spots as of early May. Connecticut is in the top 10. Healthcare technology management professionals in the region have been challenged during this difficult time.

The New England region is served by a biomed association with a long history.

For 45 years, the New England Society of Clinical Engineering (NESCE) has provided its members with education, training, networking opportunities and information from manufacturers. The society was started by a small group of like-minded medical technology supporters and founded on December 10, 1975.

“Erin Gignon and Mark English and others started in Connecticut [and] started a local clinical engineering professional society. At the same time, other local clinical engineering professional societies were started in Albany, New York; Boston, Massachusetts; Maine, Vermont; and New Hampshire,” says current NESCE President Vinnie

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DeFrancesco.

“Erin Gignon was the director of clinical engineering for UConn Health Center in Farmington, Connecticut and Mark English was director of clinical engineering at Hartford Hospital,” DeFrancesco says.

He says that the group started locally in Connecticut as the New England Society of Clinical Engineering (NESCE) and partnered with the other existing biomed groups across the region.

Four of the societies rotated hosting an annual symposium. When the other societies disbanded, they joined NESCE and it became a regional society.

Other officers in the group’s current roster include Vice President Ashley O’Mara, Secretary Samantha Herold and Treasurer Frank Painter.

DeFrancesco says that membership meetings are held at least quarterly throughout the year and the group rotates the venue throughout the New England region.

Like many of NESCE’s counterparts, the group brings a strong training and education focus to the region’s biomeds.

“We do subsidize education programs, training – PM class, networking

class – reimbursement for CBET certifications and give out scholarships for BMET student graduates,” DeFrancesco says.

He says that throughout the year, the society hosts at least two technical or professional training courses and offers them to members at a reduced rate.

“We arranged for a project management trainer to provide a one-week course on-site (in the past it has been in a local hospital’s conference room). We have also set up networking or computer classes at a training facility that provides many networking classes at a reduced rate to our members,” DeFrancesco says.

The group holds one to two major educational events a year for professional development of the membership, along with networking classes, project management classes and cybersecurity classes at a highly discounted rate. They offer quarterly networking dinners DeFrancesco says that they have a partnership with UConn and other local universities to assist with succession planning for the HTM field.

With the exodus of many baby-boom generation HTM professionals in recent years, there is always a need to replace

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SPOTLIGHT

those members with new members. In addition to efforts to fill those seats, many biomed associations make an effort to help bring new colleagues to the field and fill existing positions.

NESCE is no exception. “[The] symposium offered the job board and networking room for interviews, positing ads on the NESCE site, great collaboration on the UConn Clinical Engineering Internship Program and partnering with local universities. We do advertise job openings at our meetings,” DeFrancesco says.

SYMPOSIUM The group’s most recent symposium was held last October at the Framingham Hotel and Conference Center in Framingham, Massachusetts. Attendees included biomedical equipment technicians, clinical engineers, hospital directors, technology managers, administrators and other health care professionals from across the region.

“I do not have the exact count of the attendance, but it is was about 200-225.

This was about what we expected, which did cover our expenses. The attendance was very high in the cybersecurity track as well as the

executive leaders (C-Suite) and physician hot topics, which was new this time,” DeFrancesco says.

He says that the majority of instructors at the symposium were from the New England area, although this is not always the case.

The group had a raffle in conjunction with the closing of the exhibit hall.

The symposium is held every other year at locations throughout New England.

DeFrancesco says that the 2019 event included two outstanding keynotes by Jeff Cooper and Carol Davis-Smith.

Cooper’s keynote presentation was titled “How Clinical Engineers affect Patient Safety.” Davis-Smith presented “Planning the Hospital of the Future.”

“We have seven educational tracks: under clinical engineering – CE/IT, HTM program management/risk management and compliance and executive leaders (C-suite) and physician hot topics,” DeFrancesco says.

He says that they also had a BMET group of tracks that included an all-day imaging workshop, specialty (ultrasound or anesthesia) and general biomed all-day patient monitoring.

“On the second day, the all-day training classes changed to lasers and

portable RO systems, and defibrillators.

The last track for the entire symposium was CBET review,” DeFrancesco adds.

He said that over the entire two-day event, it included two keynotes, an expo with 50 vendors, and a networking dinner along with a wine and cheese event.

DeFrancesco says that the symposium had a great networking social event the night of the first day. That evening, there was a comedian for entertainment and the show provided a “great relaxing atmosphere and networking in a casual fun event.”

In addition to the many workshops and sessions, vendors provided one- and two-day technical hands-on classes.

The society’s next symposium is scheduled for the fall of 2021.

The group continues to help further the HTM profession in the New England region and offers opportunities for career growth, networking, education and enjoyable interactions with colleagues from across several states.

For more information, visit nesce.org.

NESCE’s mission is to provide educational and networking resources to its members while increasing awareness for the safe and beneficial use of medical instrumentation.

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry ADVAMED, MITA EXIT COLLABORATIVE COMMUNITY Manufacturer trade groups AdvaMed and MITA sent emails a week apart informing members of the FDA-recommended Medical Device Servicing Collaborative Community (MDSCC) that they will no longer participate. Remaining members David Francoeur, senior vice president of marketing and sales for TKA, and IAMERS President Diana Upton each expressed disappointment in the decision.

The creation of the MDSCC was prompted by a 2018 FDA report. The report was issued after a probe found that there was not enough evidence to warrant increased regulation of third-party, or non-original equipment manufacturer (OEM), for maintaining and providing service of medical equipment.

The MDSCC was intended to bring all entities representing the industry together to discuss issues in an effort to find

opportunities/solutions related to establishing a baseline, verify tools/key performance indicators (KPIs) that demonstrate, and where possible raise the level of quality, safe maintenance of medical equipment. As of today, the MDSCC has not made the progress they hoped/envisioned, however, progress has been made, and the membership is encouraged and engaged, Francoeur explained.

“While it is always helpful to have all stakeholders participate and in particular the manufacturers’ trade associations, they departed MDSCC before substantive work in the work groups on Training, QMS, Data/Benchmarking and Education could complete their work,” Upton wrote in an email to TechNation. •

PHOENIX DATA SYSTEMS INC., ASIMILY SOLIDIFY PARTNERSHIP Phoenix Data Systems Inc. recently announced a mutual partnership with ASIMILY, a health care sector-leading comprehensive connected and medical device asset, cybersecurity and lifecycle management platform. Together the firms provide clients with a complete, end-to-end lifecycle, cybersecurity, asset and risk management solution for health care delivery organizations.

“Blending the most complete feature-function health care CMMS available with a comprehensive connected asset inventory, cyber-risk threat prioritization, intelligence and lifecycle data processing platform; the two industry partners enhance and deliver a world-class medical device cybersecurity risk mitigation platform to support the HTM departments, as well as the broad ecosystem of stakeholders across today’s always connected health care organization,” according to a press release.

The integrated solutions deliver auto-discovery capabilities that automate the challenging process of creating and maintaining a single, trusted medical device inventory with the critical data elements required in the connected health care environment. As the BlueKeep vulnerability exposed earlier this year, the need to quickly identify, locate and track

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connected devices is critical to maintain patient safety and hospital operations; as well as securing private data and health care networks.

With the two platforms integrated, clients are able to meld connected device profiles on the network for identification and classification along with new, modern capabilities to prioritize at-risk devices and the most critical vulnerabilities to provide device and vulnerability specific remediations, and create a seamless resource allocation and ticket management workflows and provide end-to-end risk- and life-cycle management for critical, connected medical device and Internet of Things (IoT) assets.

Phoenix Data Systems’ AIMS and ASIMILY’s INSIGHT platforms support non-invasive monitoring for real-time threat detection and a system of action for HTM and security operations teams to work together for rapid remediation of known vulnerabilities and threats. With the bi-directional integration AIMS benefits from real-time security incident information to drive the cybersecurity remediation workflows and enriches ASIMILY’s machine learning and AI capabilities using rich contextual medical device data. •

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INDUSTRY UPDATES

ADVAMED ANNOUNCES VENTCONNECT ONLINE PLATFORM As part of the medical technology industry’s multi-front battle to combat the coronavirus (COVID-19) pandemic, the Advanced Medical Technology Association (AdvaMed) announced the launch of a new platform (www.

VentConnect.org) to connect ventilator companies with component suppliers to help quickly scale production and distribution of these devices.

The new platform was developed pro bono with the Aerospace Industries Association (AIA), Google and other industry alliances and partners. AIA represents more than 300 high-tech manufacturers and suppliers of all sizes across a range of sectors. AdvaMed is the world’s largest medical technology association, representing more than 400 companies, including ventilator manufacturers. In addition to AIA members, more than 50 companies – such as Stanley Black & Decker, and Arrow Electronics – from a range of industries are contributing as suppliers to VentConnect.

“The medical technology industry is stepping up to meet the unprecedented demand from hospitals and patients across the country for ventilators,” Scott Whitaker, AdvaMed president and CEO, said. “Our companies have added shifts, started new production lines and hired new workers so that soon our capacity will be tenfold what it was before the pandemic. But to keep producing these life-saving devices, our member companies need a steady stream of key components from beyond the normal supply chain, and that’s where this new online platform developed with the AIA and Google will be of tremendous value. We thank the Aerospace Industries Association for their creativity in striking up this collaboration – and we thank Google for so generously offering to build this valuable, powerful resource pro bono.”

Ventilator manufacturers can sign up on the VentConnect site and create secure spreadsheets identifying parts and components that are in short supply. Suppliers wishing to help complete a brief application on their company’s capacity and materials. Manufacturers can review supplier applications and decide whether to share their supply list needs. The manufacturer and supplier can then separately choose whether to enter an agreement to provide the needed materials.

While the immediate objective of the new platform is to support the production of ventilators and vent-critical devices that may have parts and materials constraints, the platform – VentConnect.org – may serve to address additional challenges that may arise related to ventilator logistics, distribution or other operational needs. •

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INDUSTRY UPDATES

INNOVATUS IMAGING EXPANDS RAPIDREPAIR PROGRAM Innovatus Imaging has announced the expansion of its RapidRepair program which began April 2019 and provided five-day worst-case repair times for the Philips X7 and X8-2t TEE probes. “We’ve invested millions in improving infrastructure and staff, accelerating our training programs, increasing efficiencies and developing additional proprietary processes,” said Matt Tomory. “Our RapidRepair processes enable devices to be evaluated, repaired, tested and returned in the most efficient manners possible and are key to our customers maintaining workflow, high-quality patient care and the financial bottom line.”

RapidRepair for MRI coils will be executed at Innovatus Imaging’s MRI Center of Excellence in Pittsburgh and ultrasound probes at the company’s Ultrasound Center of Excellence in Tulsa, Oklahoma.

“RapidRepair allows us to get the most popular makes and models of ultrasound probes and MRI coils back to technologists faster than ever before, while remaining consistent with OEM design,” Tomory added. •

TECHNATION LAUNCHES HTMJOBS.COM TechNation is excited to announce the launch of a new career networking site. The site, HTMJobs. com, is a one-stop resource for biomedical equipment technicians seeking employment and career advancement opportunities.

The website is designed to connect its secure talent network with employers and hiring managers from leading health care systems and companies throughout the United States. There is no cost to join HTMJobs.com where profiles are protected and private.

“We are proud to offer the resources of the TechNation community to connect potential employees with the best employers in the industry,” TechNation Publisher John Krieg said. • For more information, or to join, visit HTMJobs.com.

For more information, visit www.innovatusimaging.com.

FIME 2020 POSTPONED FIME Marketing Manager Christina Sanchez sent an email informing interested parties that FIME 2020 is postponed.

“Over the past few months, we have continued to monitor the impact of COVID-19 on our ability to stage a successful FIME on August 25-27, 2020. We know that our visitors and exhibitors need to start planning now for logistics related to an August show, and given that each country, state and city is implementing a different, phased reopening plan, we have made the decision to postpone

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FIME to a later date,” the email reads.

“We have spoken to many of our valued clients and partners about this decision, and based on those conversations we are working on scenarios for the last quarter of this year,” it continues. “Our promise to you is that we will continue to track this situation and follow all guidance from local and global health authorities, and we will provide regular and timely updates as we look to make an informed decision on whether staging FIME this year is achievable.” •

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INDUSTRY UPDATES

CYNERIO WINS SILVER STEVIE AWARD Cynerio, a provider of Internet of Medical Things (IoMT) security solutions, recently announced that the company won the Silver Stevie Award in the Healthcare Technology Solution category in the 18th Annual American Business Awards. The awards will be virtually presented to winners on August 5.

Cynerio enables health care organizations to meet the unique security challenges of securing medical and IoT devices. Cynerio provides full visibility into connected devices, including location and profiling, as well as ongoing health care-specific risk analysis and accurate anomaly detection to prevent clinical service disruption, data theft and compliance violations.

“We are proud to be recognized for our medical-first

solution that is pioneering IoMT security,” said Leon Lerman, CEO and co-founder of Cynerio. “During the pandemic, health care organizations have been under tremendous pressure adding dozens or even hundreds of connected devices to their networks to help service the influx of new patients. Our security solution enables organizations to meet highly dynamic health care requirements while keeping patients safe and their data secure.”

More than 230 professionals worldwide participated in the judging process to select this year’s Stevie Award winners. • For more information, visit www.StevieAwards.com/ABA.

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INDUSTRY UPDATES

GROUPS ISSUE ‘RE-ENTRY GUIDANCE’ FOR MEDICAL DEVICE REPS

FLUKE ADAPTS TO ASSIST AMID COVID-19 PANDEMIC As companies around the world experience shortages of protective gear due to COVID-19, they shift to homemade supplies or use supplies multiple times to make up for the lack of resources.

“Engineering safe test tools has always been at the forefront for Fluke, and while we don’t have a stockpile of PPE, we do have tools,” a press release states.

The Fluke Plastics team in Everett, Washington developed a prototype for much-needed industrial face shields.

The Fluke Plastics team worked with users on the design, which is intended for non-medical use.

These industrial face shields will be used by non-medical staff at the hospital and surrounding facilities.

“It’s nice to see that we are really driving toward improving and helping out the communities in which we live in a really big way,” Product Manager Michael Seaholm said. “There are really significant gaps in what hospitals have versus what they need, and any way we can help support that is just awesome.”

The team began with a daily production goal of 1,000 shields and, eventually with practice, ramping up to 10,000 per week. This is on top of the team’s regular daily work. •

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The Association of periOperative Registered Nurses (AORN), the American Hospital Association (AHA) and AdvaMed have released “Re-entry Guidance for Health Care Facilities and Medical Device Representatives.” As health care professionals and organizations consider when and how to safely resume elective surgeries paused during the COVID-19 pandemic, this guidance adds principles and considerations to support the vital collaboration between health care personnel and medical device representatives.

The guidance for re-entry builds on the April 17 joint statement by AHA, AORN, the American College of Surgeons and the American Society of Anesthesiologists – entitled “Roadmap for Resuming Elective Surgery” – with expanded, clinically based recommendations supporting the safe return of medical device representatives into health care facilities, consistent with the AdvaMed Code of Ethics.

The guidance seeks to align access standards and processes across health care facilities, with principles and considerations rooted in health authority guidance, including from the CDC, FDA, and state and local authorities.

The recommended framework calls for hospitals to be the primary provider of personal protective equipment (PPE) to control for potential contamination, so that PPE is prioritized to providers where it is most needed. The guidance accounts for crisis capacity situations by allowing for company reps to be the back-up providers of their own PPE for emergency procedures. The guidance also recommends against COVID-19 diagnostic testing of asymptomatic reps, so that diagnostic testing resources can be prioritized for patients, symptomatic health care workers, and those with known or suspected exposures, consistent with CDC and other clinical guidelines. •

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INDUSTRY UPDATES

U.S. PIRG CONTINUES RIGHT TO REPAIR CAMPAIGN U.S. PIRG delivered a letter to congressional lawmakers on May 18, signed by 326 hospital repair experts, calling for manufacturers to stop withholding what technicians need to fix medical equipment such as ventilators. It’s part of U.S. PIRG’s larger Right to Repair Campaign, which aims to remove unnecessary barriers to repair that drive up costs for product owners and increase electronic waste.

“Keeping equipment working under the stress of the COVID-19 pandemic is a matter of life and death,” said Campaign Director Nathan Proctor. “This is no time to squeeze hospitals into paying extra for proprietary repairs.”

“We believe that every organization that purchases medical equipment or

services them, should have the right to get trained and be able to procure parts to repair the equipment they own,” said Ilir Kullolli, president of the American College of Clinical Engineering. “This will make health care delivery better, faster and safer – especially during a pandemic or a national emergency!”

Echoing the technicians’ comments, a group of state treasurers sent a similar letter to manufacturers calling for them to “release all service manuals, service keys and schematics during this crisis,” for ventilators.

COVID-19 is putting incredible stress on our medical system, including the work of hospital biomeds. But in some cases, manufacturers restrict access to what

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Manufacturers claim that these restrictions are in place to ensure safety.

But in 2018, FDA found third-party repair carries no additional risk and that both they and manufacturers “provide high quality, safe and effective servicing of medical devices.” Instead of restricting third-party repair, the FDA says “the continued availability of third-party entities to service and repair medical devices is critical to the functioning of the U.S. health care system.”

“Restrictions on repair aren’t about safety, as the FDA report shows – everyone who is doing repairs is doing it carefully and safely. These restrictions are about control and about money,” said Proctor.

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INDUSTRY UPDATES

DUDE SOLUTIONS OFFERS BIOMED MODULE Dude Solutions, a software-as-a-service (SaaS) provider of operations management solutions, recently introduced BioMed to its award-winning computerized maintenance management system (CMMS) – TheWorxHub. This new BioMed module provides a cloud-based platform for connecting the people and systems around biomedical engineering to better allocate staff time, automate assignments, help engineers and technicians prioritize work and ensure optimized patient care.

With BioMed for TheWorxHub, clinical engineering teams can standardize intake information and apply set asset management processes with requirements and approval permissions for evaluating new equipment models. This new model evaluation process brings consistency across all biomedical equipment and ensures required inspections and preventive maintenance tasks are properly tracked. Additionally, accreditation standards, such as The Joint Commission, and information on medical equipment management plans are easily accessible from prebuilt reports highlighting standards as they apply to specific categories of equipment, work and battery management.

“Biomedical departments lead the way in bringing new technology, like advanced robotics into operating rooms, all while servicing critical, lifesaving equipment throughout the hospital daily. Multiple departments are needed to get this important work done, and hospitals face the challenge of keeping it all organized with proper documentation required for compliance,” said Josh Malbogat, director of healthcare at Dude Solutions. “We designed BioMed for TheWorxHub with efficiency in mind. Our cloud-

based software is accessible from a mobile device or desktop for clinical engineering teams to visualize their work across departments.”

Bringing departments together, TheWorxHub delivers a connected suite for biomed and facilities teams to collaborate and track information across multiple sites or locations. The analytics dashboard provides actionable insights ranging from operational efficiency and staff productivity to risk scoring and analysis on equipment data.

Key features of BioMed for TheWorxHub include: ·F ile management - one place to house and access all instruction manuals and attachment files from TheWorxHub, Microsoft OneDrive or Dropbox · Battery management - immediately recall battery details, such as chemistry, capacity and voltage, and easily coordinate regular preventive maintenance to better manage battery life and replacements · Round Robin Work Assignment Automation - channel work orders directly to a technician to increase patient safety and time to resolution · Scan existing barcodes - print or scan barcodes directly from TheWorxHub mobile app to streamline workflows and increase data accuracy ·N ew model evaluation - apply data requirements and approval rules for new equipment models to easily keep up with inspections and preventive maintenance •

FDA LIFTS INJUNCTION ON PHILIPS’ DEFIBRILLATORS Royal Philips has announced that its Emergency Care and Resuscitation (ECR) business is resuming manufacturing and shipping of external defibrillators for the U.S., following notification from the Food and Drug Administration (FDA) that the injunction prohibiting those activities has been lifted.

This business has been operating under a consent decree with the FDA since November 2017. Under the terms of the consent decree, Philips was required to suspend the manufacture and distribution of its defibrillators from specific Philips facilities in the U.S., pending FDA certification via inspection of the facilities’ compliance with Quality System Regulation. However, in order to ensure uninterrupted availability of these life-saving devices in the U.S., the consent decree included exemptions for specific Philips Automated External Defibrillator (AED) models to continue to be

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manufactured and shipped, in addition to providing necessary device servicing, accessories and consumables.

Philips continues to comply with the terms of the consent decree, which remains in effect, and includes ongoing regulatory compliance monitoring and facility inspections of the ECR business and of Philips’ other patient care businesses by the FDA. “The injunction lift is an important milestone for Philips, as we have enhanced the regulatory compliance processes in our ECR business and throughout the company,” said Frans van Houten, CEO of Royal Philips. “Providing our customers with safe and reliable products and solutions remains our highest priority, and I am proud that our AEDs save lives daily, with their very high reliability record.” •

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INDUSTRY UPDATES

MD EXPO (IRVINE) TRANSITIONS TO HTM MIXERS Regional Events Will Connect Hospitals, Vendors

BY JOHN WALLACE

A

mid the rapidly evolving COVID-19 pandemic and the unique challenges it continues to create, MD Publishing is committed to doing its part to reopen and help everyone get back to business.

The MD Expo (scheduled for April of this year) was re-scheduled to be held in Irvine, California on July 27-29. However, Hotel Irvine (the venue) recently announced that it will remain closed through July, and likely for the remainder of the year, as it plans a remodel for the property.

“This is a situation unlike any we’ve faced previously. We had an event planned, but no venue to hold it,” according to an email. “We are moving forward with our events in 2020 with a new, safer format that supports state HTM associations.”

The scheduled MD Expo Irvine has been replaced with three smaller, regional HTM Mixers in Colorado, Wisconsin and California. Also, four of the most popular MD Expo classes will now be available via Webinar Week beginning July 27.

“We understand that participants may be hesitant or unable to travel so by providing local, regional conferences, we will be able to provide the education and networking that they need,” the email adds. “If hospitals can’t come to us, we will go to them.”

WHAT ARE HTM MIXERS? Think of them as MD Expo 2.0 – a slightly

modified, smaller, shorter-duration, less-crowded and safer-environment event that still provides valuable continuing education, networking and vendor engagement opportunities.

“We took this opportunity to redesign how this program will look because MD Publishing wants to be a leader in restoring conferences to the HTM community,” MD Publishing President and Founder John Krieg said.

The first HTM Mixer is scheduled for Denver, Colorado on August 19 and 20. It is being held with the support of CABMET. “Cancelling our CABMET symposium was the hardest decision we have had to make as an organization,” CABMET’s Robert Smothers, CBET, said. “The timing was during the height of the pandemic, and the future was very uncertain. We decided, in an abundance of caution, to cancel it for this year. First time we have had to do that since the beginning of our annual symposium. Now, with the future a little clearer, we very much look forward to the opportunity you folks have provided us with the HTM mixer.”

CABMET President Leticia Reynolds said the HTM Mixer has the biomed community excited.

“I think the CABMET members will be excited to be part of the HTM Mixer. It will be a chance to relax and just see people again that maybe we haven’t had the opportunity to see in awhile,” she said.

The second HTM Mixer is set for

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

October 1 and 2 in Milwaukee, Wisconsin with support from the newly renamed Wisconsin Biomed Association.

WBA Board Member and Treasurer Melissa Wilke said the timing of the HTM Mixer is perfect.

“The HTM Mixer plays an integral part of building the foundation of our newly rebranded Wisconsin Biomedical Association. This event brings excitement with exposure to the latest medical equipment technology, the opportunity for education and to establish new relationships or catch up with old friends,” she explained. “We feel being a part of events such as this are essential in building and shaping ourselves personally and professionally. The WBA members feel very fortunate and indebted to TechNation for including our association in their efforts to promote the HTM field.

“The HTM Mixer will be an occasion that we are expecting to top any other WBA event we have had before. We are anticipating the turnout to be over 120 technicians and managers from all over the state of Wisconsin, Minnesota and Illinois,” Wilke added.

The third HTM Mixer, will mark a return to California. The event is set to be held December 9 and 10 in Costa Mesa, California and will be supported

by CMIA. FOR MORE INFORMATION, visit htmmixer.com or to register for Webinar Week visit webinarwednesday.live or see page 73.

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INDUSTRY UPDATES

RIBBON CUTTING Althea

BY ERIN REGISTER

D

an Siler, CEO of Althea, has been in the medical device industry for nearly 20 years. After graduating college, he started his career with GE Healthcare, where he serviced mammography, X-ray and CT systems. Siler then transitioned to a leading independent service organization (ISO) as an imaging service director.

“After supporting a startup division in Europe, I began to lead a parts refurbishment and replacement company that would later be acquired and moved to Charlotte, N.C.,” said Siler. “My team and I were able to successfully rebuild the organization from the facility to the team and processes. This experience really gave me a love for organization building and my passion for leadership. This is what excited me most when the opportunity arose to relocate back to Tennessee and grow Althea in the U.S. market.”

“Today, each modality leader has over 20 years in the HTM industry and a quality engineer that has spent his career building quality programs,” stated Siler.

“It is the quality culture that allows us to build programs with a continuous improvement mindset.”

Q: WHAT IS THE MAIN FOCUS OF ALTHEA? A: The business model of Althea is an outstanding combination of integrated solutions, OEM independence and deep knowledge of health care providers.

Specifically at Althea U.S., our main focus is two-fold: 1. Quality and 2. Our customers. As I always say, “Quality runs the show. If it doesn’t have quality, it isn’t 34

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worth doing.” Our customers are our livelihood. They truly are the reason why we are here, and they determine whether or not we are successful.

Althea focuses on delivering programs that improve customer outcomes. We do this by offering quality parts delivered on time, performing system sales and installs and educating our customers on how to operate and service equipment. All of this allows for customers to control cost and increase uptime.

Q: WHAT ARE SOME OF THE SERVICES ALTHEA OFFERS? A: An Althea program consists of replacement parts, customer education, system sales and maintenance, and depot repair (when applicable). We continue to focus on the core programs of CT, MRI and X-ray while bringing on new solution programs like contrast injectors, low-temp sterilization and our upcoming UVD robots.

Q: HOW DOES ALTHEA STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Althea brings an established global presence to the market space, managing more than 1.4 million medical devices in over 2,700 health care facilities across 17 countries. This presence enables us to maximize skill sets and supply chains from around the world to improve our customer outcomes. Our U.S. team, from the top down, knows what it means to be in the shoes of a field service technician.

This coupled with our competitive pricing will allow us to show customers

Dan Siler CEO, Althea

they have made the best choice for their HTM partner.

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT ALTHEA TO ACHIEVE IN THE NEAR FUTURE? A: I want us to be known as the industry’s full service solutions provider. In order to do that, we must maintain a good relationship with our customers and keep a pulse on their needs, as well as the industry’s needs. We are in the technology business, and technology is always changing, so we must do that too. We will continue to evolve and find efficiencies and solutions for our customers. Even the most recent pandemic has challenged us to think outside the box and look at other areas that our industry could benefit from as we prepare for the future. We are planning to build and expand multiple new programs every year that will include diagnostic imaging, biomedical, UVC disinfection and sterilization, each offering a full-service approach that includes parts, education, sales and maintenance and repair.

FOR MORE INFORMATION about Althea, visit www.althea-group.com.

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INDUSTRY UPDATES

AAMI UPDATE

BY AAMI

2020 AAMI FELLOWS HONORED FOR ACHIEVEMENTS, COMMITMENT TO AAMI MISSION Fifteen 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.

The 2020 Class of AAMI Fellows: • John E. Abele, cofounder of Boston Scientific, key founder of AAMI, and a member of the first AAMI Board of Directors.

• Steven Baker, PhD, principal consultant at Alpha Bravo Connectivity and clinical assistant research professor at Oregon Health and Science University in Portland, OR. • Damien Berg, regional manager for UCHealth in Northern Colorado and direct manager for the Medical Center of the Rockies and Poudre Valley Hospitals in Johnstown, CO. • James Caporali, senior director of clinical engineering at Erlanger Health System in Chattanooga, TN. • Mary Ann Drosnock, director of clinical education at Healthmark Industries in Bath, PA. • Larry Fennigkoh, PhD, adjunct professor of biomedical engineering at the Milwaukee School of Engineering in Milwaukee, WI. • Greg Gdowski, executive director of the Center for Medical Technology & Innovation and associate professor of biomedical engineering at the University of Rochester in Rochester, NY. • Larry Hertzler, who has worked in

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•

•

•

•

•

•

•

the clinical engineering field for 40 years, holding positions in hospitals, hospital systems, equipment insurance, and the largest service organizations in the U.S. Clark Houghtling, vice president of business development and technical affairs for Cosmed in Hickory, NC. Jim Keller, business development director for Emergo by UL in Austin, TX. James Linton, coordinator and professor of biomedical engineering at St. Clair College in Windsor, Ontario, Canada.

Alan Lipschultz, president of HealthCare Technology Consulting in Rockville, MD. David Osborn, senior manager of global regulations and standards for Philips in Salem, NH. Arif Subhan, chief biomedical engineer at VA Greater Los Angeles Healthcare System in Los Angeles, CA. Priyanka Upendra, quality and compliance program director of technology management/ENTECH at Banner Health in Chandler, AZ.

AAMI EXTENDING VIRTUAL ATTENDANCE OPTION THROUGH 2020 AAMI is transitioning all in-person courses scheduled through June 30, 2020, to a virtual-only format, and offering a virtual option for training courses through the end of 2020.

With AAMI’s robust and interactive virtual option, course attendees will receive devices by mail for needed hands-on learning. Participants will also have easy access to course content and will be able to interact live with

fellow attendees and instructors.

Existing registrants for AAMI courses have four options: • Attend the class virtually.

• Transfer your registration to any upcoming class.

• Choose to transfer your registration to a course yet to be scheduled.

• Request a refund.

If you have questions about an existing registration, please contact education@aami.org. If you are completing a new registration, you will be able to select either live or virtual attendance when you register.

AAMI, BSI RECOMMENDATIONS FOR MACHINE LEARNING Healthcare technology management (HTM) professionals are posing important questions about artificial intelligence and machine learning: • Are these technologies competent, trusted, and reliable?

• What are the data management and quality issues – including potential biases in datasets and in machine learning itself?

• How do risk management, regulatory requirements, and standards for safety and effectiveness apply to machine learning?

AAMI and BSI, the United Kingdom (UK) national standards body, have teamed up to help answer these questions in a new position paper, “Machine Learning AI in Medical Devices: Adapting Regulatory Frameworks and Standards to Ensure Safety and Performance.”

For more information and to download it for free, visit www.AAMI.org/AIPaper2020.

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INDUSTRY UPDATES

AAMI’S eSUBSCRIPTION, NOW WITH MOBILE APP AAMI will soon be offering eSubscription users the ability to access the platform via a mobile app on their smartphone or tablet. AAMI’s eSubscription is a digital service that gives users access to over 400 national, international, and Food and Drug Administration-recognized standards and technical information reports – both active and archived – for one annual fee. With the new app, access will be portable.

Users can go to the eSubscription dashboard online and search for documents by category and keyword. They can also add bookmarks, annotations, comments or tags to their digital library. The site can be viewed on a desktop, tablet or smartphone.

Individual and multi-user (enterprise) licenses for eSubscription are available, as well as the option to subscribe to the entire collection of AAMI standards and technical documents or specialized collections, including sterilization, dialysis, human factors and healthcare technology management.

For more information about AAMI’s eSubscription, go to www.aami.org/esubscription or email esubs@aami.org.

BEST OF BI&T AWARDS RECOGNIZE JOURNAL AUTHORS A new way of looking at the healthcare technology management and clinical engineering professions, a deep dive into medical device recall data, and the value of making small changes that can have a big impact on quality – these are the three articles published in AAMI’s peer-reviewed journal, BI&T (Biomedical Instrumentation and Technology), that shaped the health technology world in 2019.

“Selected by the BI&T Editorial Board, this year’s winning submissions tackled many of the most pressing issues in health technology – namely, the need to ensure that medical devices are safe and effective, the role that healthcare technology management (HTM) professionals should play in managing those devices, and ways to do so effectively using shrewd planning and management practices,” said Editor-in-Chief Gavin

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Stern. “Thank you to all of our authors, contributors, editors and peer reviewers for their role in growing health technology knowledge base.”

• Best article: “CE/HTM Professional Roles in Healthcare Delivery: Time for a Trajectory Reset?,” by Stephen Grimes • Best Research Paper: “User Interface Software Errors in Medical Devices: Study of U.S. Recall Data,” by Yi Zhang, Paolo Masci, Paul Jones, and Harold Thimbleby, • Best Column/Commentary: “Applying QMS Principles to a Medical Equipment Management Program,” by Rao Bankuru, clinical engineer, and Rachel Yarnevic.

• Bright Ideas Award (awarded by AAMI’s Technology Management Council): GE Healthcare’s Healthcare Technology Management (HTM) Program, headquartered in Chicago, IL, and led by Senior Director Donna Marie Dyer.

For more information on how to contribute an article to BI&T, visit www. aami.org/BIT.

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ECRI UPDATE

COVID-19 Strategies – Mitigating ICU Ventilator Shortages

A

s the impact of the SARS-CoV-2 virus in China and Europe came into focus – and as the realization took hold that the United States would not be spared the brunt of the burgeoning pandemic – one of the first alarms to sound from the health care community was the urgent need for ventilators.

Severe illnesses were requiring resource-intensive care, and health care organizations feared that the available supply of ventilators would be insufficient to meet a patient surge.

ECRI outlined its recommendations for mitigating intensive care ventilator shortages in a series of alerts and other resources issued in late March and April. For hospitals facing a patient surge, as well as for those updating action plans for future surges, we summarize the key guidance below.

Note: This article was developed in May 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.

OPTIMIZING YOUR SUPPLY First, find the ventilators at your disposal. Perform an inventory of available mechanical ventilation devices in your hospital, including those in service, in storage, and those that you expect to receive from purchases, rentals, donations and emergency stockpiles. Don’t forget to check ambulatory surgery centers and other facilities for intensive care ventilators,

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supplies and personnel that can be used for treating COVID-19 patients.

Make more devices available. Cancel elective surgeries and other elective procedures that could result in the use of mechanical ventilators.

Identify and rank alternatives. If an insufficient number of intensive care ventilators is available, consider alternative devices that are capable of delivering breaths or pressure support.

Rank the various alternatives according to the types of devices available in your hospital as well as the available expertise for safely operating and adapting these devices for ventilating patients with severe respiratory distress. Following is ECRI’s suggested order of preference (though yours may differ): • Intensive care ventilators • Advanced transport, sub-acute and home care ventilators that have intensive care features and are capable of treating patients with acute respiratory distress syndrome (ARDS) • Anesthesia machines – modern anesthesia ventilators have been designed to approximate the function of an ICU ventilator, and thus should be fully capable of providing the support needed for COVID-19 patients • Basic transport, sub-acute and home care ventilators • Hospital noninvasive ventilators • Modified home BiPAP sleep apnea therapy devices • Unmodified home BiPAP sleep apnea therapy devices • If all other alternatives are exhausted, care providers could consider

ventilation of two patients on a single ventilator for short-term use.

ECRI stresses, however, that there are significant limitations to this strategy. (For a discussion, see ECRI’s webcast “Strategies to Mitigate Ventilator Shortages,” which can be viewed at https://www. ecri.org/landing-covid-19-ventilator-shortages/.)

Match ventilation capabilities to the patient need. “Reserve use of more sophisticated ventilators for the sickest patients,” recommends Ismael Cordero, a senior project engineer in ECRI’s device evaluation group. That means triaging the ventilation devices at your disposal and matching the device capabilities with the severity of patient illness.

OTHER ESSENTIAL RESOURCES AND CRITICAL ACTIVITIES Remember that acquiring ventilators is only one piece of the puzzle. “A ventilator by itself won’t be much use if you don’t have trained staff to operate the device and the supplies needed for it to function properly,” cautions Brad Bonnette, a senior project officer in ECRI’s device evaluation group.

In the case of using anesthesia units in the ICU, for example, plans need to include staffing the care area with anesthesia professionals who can provide guidance and support 24/7 while a unit is being used on a patient.

This point was emphasized during ECRI’s webcast “Using Anesthesia Units for Patient Ventilators” (which can be viewed at https://www.ecri.org/ landing-covid-anesthesia-units-ventilators/.) One additional benefit of including anesthesia professionals on the care team is that you add a whole crew of highly trained people who can help during the crisis.

Just as challenging as locating

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INDUSTRY UPDATES ECRI’s Ismael Cordero discusses ventilator usage during a live-streamed ECRI lab webcast. The April 1, 2020 webcast was part of an ECRI series addressing technology challenges facing hospitals during the COVID-19 pandemic.

ventilators has been securing the accessories, supplies and medications required to provide mechanical ventilation. You’ll need a plan that addresses the needs for each of the devices on the prioritized list. Note, for instance, that some ventilators require proprietary items for their use. Also, shortages have been reported for components like filters and breathing circuits, as well as for related products, like laryngoscope blades used during intubation. In the event of shortages, you may need to consider extending the shelf life and duration of use of accessories and supplies used for ventilation, depending on the availability of resources.

Also consider the actions that are needed to mitigate risks to patients and hospital staff. Taking appropriate environmental control precautions is one key activity. That may involve using negative pressure or additional filtration, where feasible. Other actions include adding battery backup to devices or using additional viral filters.

Other key activities, as stressed by Cordero, are performing incoming inspections for newly obtained devices and completing inspection and preventive maintenance procedures for devices retrieved from storage. “Ventilators of unknown condition are being deployed from a variety of sources and after being subject to unknown conditions.

That means performance inspections and preventive maintenance are a must.”

EUAS: OK FOR NOW, BUT NOT FOREVER During the COVID-19 crisis, FDA has made available through its Emergency Use Authorization (EUA) process many ventilation devices that are not otherwise legally marketed in the U.S. for critical respiratory support. Examples of situations covered under EUAs include the following: The use of powered emergency ventilators and anesthesia gas machines for patients needing mechanical ventilation. The use of ventilators outside their cleared environment of use (e.g., using a home-care device within a health care facility). The use of devices indicated for sleep apnea to treat patients with respiratory insufficiency, provided that appropriate design mitigations are in place to minimize aerosolization. The use of breathing circuit devices beyond their indicated use. The use of ventilator support devices made by companies not previously engaged in medical device manufacturing.

It’s important to note that these EUAs are effective only until FDA determines that the COVID-19 emergency is over. If you need to supplement your ventilator fleet with EUA devices, understand that the devices may need to be removed from use when the crisis is over.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

While some vendors have indicated that they intend to pursue 510(k) clearance for their products, the timing and success of such applications is far from certain. ECRI recommends that hospitals assume that all EUA devices will revert to their pre-EUA state when the EUA is terminated. That is: FDAcleared devices with EUA labelling changes will revert to their pre-EUA labelling. FDA-cleared devices with EUA modifications will be usable if the modifications are reverted or removed.

And, devices that are not FDA-cleared will not be usable until or unless they receive clearance.

This article is adapted from multiple guidance documents that ECRI developed to help health care professionals mitigate ventilator shortages during the COVID-19 pandemic.

The original articles and many additional resources are available through ECRI’s COVID-19 Resource Center, a free public resource to help hospitals protect health care workers and patients during the COVID-19 pandemic. Access that site at www.ecri.org/ coronavirus-covid-19-outbreakpreparedness-center.

For more information, visit https://www.ecri. org/solutions/device-evaluations, call (610) 825-6000, ext. 5891, or e-mail clientservices@ecri.org.

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INDUSTRY UPDATES

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Beyond COVID-19: The Three Biggest Challenges Facing BMETs Right Now

BY TRAVIS HORSTMAN

L

ike everyone else working tirelessly in health care settings these days, biomedical equipment technicians (BMETs) are on the front lines of COVID-19 patient care. They’re playing a critical, and no doubt unsung, role during this historic challenge as they maintain and repair bypass machines, diagnostic imaging, respirators and other items critical to COVID-19 patient recovery.

Every BMET knows, however, that now is not the time to take their eyes off the everyday, “routine” challenges in their world. As was the case before COVID-19 and it will still be true after the pandemic subsides, BMETs and clinical engineering departments will be challenged with teams that are spread too thin, despite the increasing complexity of the equipment they maintain and the multiple facilities to which they’re assigned.

Prior to the COVID-19 pandemic, health care facilities were tasked with maintaining rigorous, secure systems that ensure their records, databases and other important materials were always up to date with the latest developments. Since CS departments and BMETs have had to adjust to the current needs of the industry, protocols have been updated and modified to meet these demands. I suspect the effects of these changes will be felt in the biomedical field for some time to come, as facilities return to normal and governing bodies shift the priorities for each department.

Based on my experience as a BMET in the military and the private sector, I believe there are three specific areas where those ongoing challenges will be most evident.

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MAINTAINING CYBERSECURITY RELATED TO MEDICAL DEVICES More and more medical devices are wirelessly connected to the Internet and to health care facility networks. Connected medical device technology provides tremendous advantages such as increased patient mobility, improved information sharing and enabled centralized station monitoring, but it also comes with the inevitable risk of security breaches.

Manufacturers are proficient at staying one step ahead of state-of-the-art hackers, offering system patches and updates in response to, or even in anticipation of, cybersecurity vulnerabilities. BMETs also do their part by incorporating these updates, monitoring the MDS2 forms from manufacturers and maintaining robust password protocols for connected equipment. All of this activity, of course, must be coordinated with IT departments.

REMAINING FOCUSED ON PROPER PREVENTIVE MAINTENANCE This isn’t a time for shortcuts. Operational verification is important but BMETs can never stop there. No matter the circumstances, maintenance schedules must be maintained to avoid problems down the road and to extend the life of equipment.

One solution, though, is in the emerging tools related to predictive maintenance. This resource utilizes artificial intelligence, equipment sensors and other connected devices to identify potential failures before they occur.

Further, resources like oneSOURCE are essential in maintaining these protocols and providing health care professionals with the necessary tools to properly operate and maintain this advanced equipment while at

Travis Horstman oneSOURCE Document Site

the same time adhering to the highest of regulatory bodies and compliance guidelines.

Intersecting disciplines such as facilities maintenance work conjointly with BMETs to create systems and procedures that help to promote quality patient care and safety.

MAINTAINING ASSET MANAGEMENT RECORDS Yes, “data in and data out” can be a full-time job for clinical engineering staff, but information management prevents errors and increases efficiencies.

CMMS systems are indispensable for this purpose, and it’s important to choose one that meets the unique needs of each hospital system in order to track: • Medical device recalls • Incident management reports • Clinical engineering asset in-store reports • Manufacturers’ current preventive maintenance and repair documents • Work order tracking and progress • Asset, stock and spare parts inventories Patients may take BMETs for granted, even as they notice the incredible life-sustaining and life-enhancing equipment surrounding them. Rest assured, though, that care providers are inherently aware of the critical role BMETs and everyone in clinical engineering play in patient care.

They recognize the challenges BMETs confront every day.

TRAVIS HORSTMAN is a biomedical account manager and cybersecurity advisor for oneSOURCE Document Site. Before joining oneSOURCE, Horstman served as a biomedical equipment engineer in the U.S. Air Force.

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Four Informative Sessions Added to Library STAFF REPORT

T

he Webinar Wednesday series continues in 2020 amidst the COVID-19 pandemic. In fact, the webinars continue to be a popular option for continuing education as many health care professionals face travel restrictions and unusual work schedules. The webinars are available live.

They are also accessible via a library or archive where the sessions can be viewed on demand at WebinarWednesday.Live.

MAXIMIZING DEVICE, NETWORK, AND RISK AWARENESS The Webinar Wednesday presentation “Beat Webinar Fatigue with a Fun, Interactive Session on Maximizing Device, Network, and Risk Awareness” was sponsored by CyberMDX. It was eligible for 1 credit from the ACI and received rave reviews from attendees.

The webinar featured Joe Brown, CISSP, director, strategic solutions at CyberMDX. Even before COVID-19 upended everyone’s realities, hospitals already were becoming hyper-aware. But now, more than ever, clinical and biomed professionals need to maximize the onboarding, availability and visibility of key medical assets by automatically locating, smartly assigning, and optimizing managed and unmanaged devices.

Brown delivered “a different type of webinar format where attendees played an interactive role throughout the entire presentation.” More that 100 attendees tuned in for the live presentation and competed for the chance to win a $50 Uber Eats gift card. The gift card winner was

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awarded by CyberMDX and the winner was determined by the number of polls correctly answered by attendees.

A post-webinar survey resulted in positive feedback and attendees answered the question, “What Information did you learn during today’s webinar that you can apply to your role?”

“How to maximize the onboarding, availability and visibility of key medical assets by automatically locating smartly assigning and optimizing managed and unmanaged devices,” Biomed B. Hemmati said in reply to the question.

“Great tool to monitor the medical equipment traffic,” said C. Nanney, national quality manager, clinical engineering.

Equipment Specialist T. Molly summed up the session with “Best webinar ever!”

PARTS INVENTORY Nuvolo sponsored the Webinar Wednesday presentation “Managing Parts Inventory During Recovery” that was eligible for 1 credit from the ACI. The webinar featured Dustin Smith, senior solutions consultant at Nuvolo, and David Brennan, senior vice president, chief product officer at PartsSource. In this session, PartsSource shared how hospitals are working to recover from the COVID-19 crisis and move into a proactive model to get ahead of equipment management. An HTM organization’s ability to forecast parts for common events like planned maintenance is one area that hospitals typically handle without too much trouble. However, with the COVID-19 crisis, hospitals need to take

extra steps to address mission-critical parts shortcomings for the organization in a timely manner. The webinar explored how PartsSource and Nuvolo helped hospitals address these challenges and how an actively managed supply chain will improve overall equipment and parts management.

The webinar was a success with 161 individuals attending the live presentation.

A recording of the webinar is available online where more people have viewed the presentation.

Attendees provided feedback via a post-webinar survey that included the question, “How did today’s webinar meet your expectations?”

“Our hospital will be migrating to Nuvolo CMMS this year, so this content was very pertinent to my future experience,” shared Biomedical Technician II Lead W. Polcin.

“Always great information and presenters,” said A. Callender, senior biomedical technician.

“Nice presentation of the procurement system,” said F. Yasnowski, CE quality analyst.

“Great overview of PartsSource integration with Nuvolo,” stated D. Irving, manager HTM. “The presentation was well put together and the presenters seemed very knowledgeable about the systems,” said M. Keyes, Biomed II. “Learned very valuable information about parts ordering through PartsSource with integration through Nuvolo,” said M. Childers, BMET. “Interesting to see this platform is used

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by so many,” said C. Davis-Ryan, CBET III. COVID-19 INSIGHTS The recent presentation “How the COVID-19 Pandemic Requires HTM, Facilities and IT to Collaborate More Than Ever – Now and Into the Future” was sponsored by Nuvolo. Each of the 263 attendees are eligible to receive 1 credit from the ACI. The informative webinar included a number of health care organizations from across the country as members of HTM, facilities and IT departments shared how they have worked together to address the COVID-19 pandemic. The session was moderated by Heidi Horn, vice president, global enablement-healthcare at Nuvolo.

The convergence of HTM, facilities and IT departments has helped hospitals move quickly to address the needs of their patients and hospital staff. Attendees were able to learn from health care professionals as they shared their experiences, including how they believe this will impact the way their departments collaborate in the future.

The panelists participating in the webinar were Mike Busdicker from Intermountain Health, Danielle Cowgill from Stanford Children’s Health, William Mannes from Agiliti, Derek Watson from University Health Care System, John Ellis from Intermountain Healthcare, Bob Mulcahy from Hackensack Meridian Health and Joey Smith from Cleveland Clinic.

The webinar scored high in a post-webinar survey and answered the question “Give us three words to describe today’s webinar?”

“Encouraging. Hopeful. Proud,” are the words Biomedical Engineer T. Wade used to describe the webinar.

“The wealth of knowledge at [this] one webinar was one of the best I’ve seen,” said W. Richards, clinical engineering specialist.

“Good reflection of work being done by HTM,” Biomedical Supervisor B. Tocholke said.

“Insightful into the collaborative efforts put in by several teams,” said S. Sirois, BMET III.

“Informative, current and insightful,” HTM Consultant F. Trujillo said.

“Informative. Comparable to experiences we’ve had (minus an earthquake),” Director of Clinical Engineering J. Rusher said. “Reassuring to know that it works in other areas of the country as well as where we are.”

“Great panel of expertise,” said M. Manzo, BMET. “I enjoyed hearing updates from other facilities regarding COVID. It was also great to hear how assets responsibilities are determined,” Clinical Engineering Manager M. Wilke said.

“Great collaboration and sharing,” said J. Ruiz, site manager.

“Motivated me to learn more about cybersecurity,” said K. Patel, CBET. “You guys rock,” said Clinical Engineering Technician W. Doctor.

IOT CYBERSECURITY IS A TEAM SPORT The Webinar Wednesday presentation of “IoT Cybersecurity is a Team Sport” was eligible for 1 credit from the ACI. The webinar was given by Joseph Ouellette, clinical systems engineer at Yale New Haven Health. It was sponsored by Medigate and moderated by Tom Finn, director of business development at Medigate.

Health care providers continue to view operational transformation through very different lenses and IoT cybersecurity is not an exception. Despite how IT security professionals and front-line healthcare technology management (HTM) professionals share many of the same security objectives, they continue to operate in relative blinds and rarely communicate, unless an emergency occurs. This is not a sustainable approach and some of the best evidence of that is reflected in the technology gaps that persist.

During the webinar, attendees were able to hear how Yale New Haven Health is driving cross-functional collaboration to successfully transform its cybersecurity practice.

It was a popular presentation with 240 attendees for the live session and even more have viewed a recording of the webinar online.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

In a post-webinar survey, attendees were asked “What did you like most about today’s webinar?”

“It reminded me of the things we should be doing to protect our organization,” Senior CBET D. Edwards said.

“Very informative with up-to-date material,” Senior Biomed S. Rivera added.

“Well presented with plenty of time for questions,” Senior Biomed R. Faut replied.

“It was good information that was shared,” Program Director J. McAlister said.

Biomed Technologist O. Stephen described the webinar as “a real-world example of implementing a cybersecurity system.”

IT Security Manager C. Sosa said he liked “hearing about the same hurdles I am experiencing.”

The 2020 Webinar Wednesday series has exceeded 4,000 registration for the year with this presentation.

TO FIND OUT MORE ABOUT THE SERIES, including a calendar of upcoming webinars and recordings of previous sessions, visit WebinarWednesday.Live.

Thank you to our sponsors:

JULY 2020

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he Meriam M2004 is a portable, smart manometer designed to provide highly accurate, repeatable pressure measurement. It can be used to calibrate pressure gauges and regulators, check filter conditions, leak testing and more.

Its versatility is increased with the optional MTS Series of Tethered Modules, for additional pressure ranges and temperature measurement. This unit comes with +/-0.025% FS accuracy and is available with pressure ranges from -14.5 PSI to 3000 PSI. Pressure sensors are available to measure differential pressure, gauge pressure, vacuum or absolute pressure. All pressure and temperature sensors come with a certificate of NIST traceability. The complimentary MeriSuite CG software enables the user to configure the M2004 for their particular uses and to service and calibrate it locally and at their convenience. An available data logging option enables the M2004 to capture up to 100,000 data points or up to 128 individual data log files. These files are easily uploaded and stored through the standard USB connection and the MeriSuite CG software to the user’s computer. Luer Lock fitting is provided with low pressure range sensors. High and low pressure fitting kits, pressure sources and carry cases are available.

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THE BENCH

SHOP TALK POWERED BY

ASP STERRAD 100NX

Q:

How can you measure the output of the LFPS2 without the PVM? I want to perform the PMs on the unit, and part of the PM is to measure the output.

may have to replace one of the transducers. But there is no calibration, per se, on them. They are calibrated each use during the pre-test.

CS MEDICAL TD 100 AUTOMATED TEE PROBE DISINFECTOR

A:

Q:

A:

A:

That is a great question with a complex answer. To measure the output of the LFPS2 you need specialized test equipment that measures different values. Do you think your FFPS2 is not working correctly?

Simple answer, you can’t. And since you can only get it at the tech school, your best bet is to contract with the manufacturer or a third party to do the PM for you unless you can get into the school.

A:

You need to be trained to correctly PM the unit. iMed offers a training course and fully supports you afterwards with tech support and repair parts. If you have the background, you can call tech support for assistance.

Does anyone know if there is any preventative maintenance requirement other then changing the carbon filter?

You also need to replace the PVC filter, clean the inline screens and the water line screens on tubes entering the bottom left, clean the probe compartment and clean and flush the separate disinfectant tank (twice per year).

MEDRAD MARK V PROVIS

Q:

MAQUET SERVO-I UNIVERSAL

Where is the single pressure reading from the mechanical injector pump measured? I am actually wondering about the location of the sensor – i.e. where the pressure reported on the display comes from?

Q:

A:

A:

A:

I would like to know the procedure to calibrate the pressure transducers, inspirator and expirator – in case of replacement. Can someone help?

The calibration is done automatically during the pre-use check. If you need to do any further calibration a field service card is required to access the service menu. If your Servo-i is failing it’s pre-use check on pressure transducers I would suggest trying with another expiratory cassette at first and then removing and cleaning the inspiratory valve.

A:

Are you getting an error called “Pressure Transducer difference > 5 cm H2O” or the pressure transducer test failed? If you are, then one transducer is substantially different than the other. Either a connection is loose or you

The system interprets pressure via a current feedback loop. The circuitry is located on the PDCi board in the main box.

The system is designed to maintain flow rate and volume to the values as set. The pressure limit on the other hand is looked at as a “not to exceed.” In that, the pressure reading should never really near the pressure value as set. It should only near the pressure value as set during an occlusion event or if the flow rate is set too high for the relative tubing diameter. In such an event, the flow rate will then decrease as to not exceed the pressure limit parameter – all the way up to a stall condition should a complete blockage occur.

SHOP TALK

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

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ROUNDTABLE

ROUNDTABLE IV Pumps

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t is time once gain for TechNation’s monthly roundtable feature article to focus on IV pumps. Experts share their thoughts regarding the knowledge HTM professionals need, share cost-savings tips and more in this look at IV pumps.

While names and appearances have changed as companies change hands, there are very few “newer” models on the market. When purchasing, look to see if newer models may be compatible with your older fleet. In a lot of cases there are some backwards compatible options that may offer substantial cost savings.

Participants in the roundtable Q&A discussion include Agiliti National Director of Technical Services Bill Mannes, AIV Inc. Vice President of Sales Jeff Taltavull and Master Medical Equipment Products Manager Ryan Tomlinson.

Q: WHAT IS THE ONE THING EVERY HTM PROFESSIONAL SHOULD KNOW ABOUT IV PUMPS? MANNES: It’s important to ensure proper clinical training of the staff in regard to the utilization of the pumps. This insight can help prevent accidental or willful infusion programming. Addi-

Bill Mannes Agiliti

tionally, this will prevent false alarms on the equipment causing the unit to be removed for repair, which can result in delays to patient care.

TALTAVULL: After a decade of rapidly changing platforms, the past few years have slowed in hardware advancements.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

TOMLINSON: A well-designed IV pump is one of the most undervalued types of units in the medical equipment industry and, as all medical professionals know, they are one of the most important machines available in a compromised situation. A well-maintained IV pump delivers and maintains the flow of life-saving medications. An IV pump that has not been correctly serviced can be inaccurate. An inaccuracy could potentially be life threatening depending on the medication being delivered. IV pump veracity is one of the most important specifications to look at when deciding to purchase a new model.

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ROUNDTABLE

Q: WHAT ARE SOME COST-SAVING TIPS YOU CAN SHARE REGARDING IV PUMPS? MANNES: One simple cost-saving tip is remembering that proper equipment cleaning procedures go a long way in preventing the unit from malfunctioning. In addition to that, skipping preventative maintenance or running a loose AEM schedule can lead to a stressed unit. OEM guidelines are typically the best to follow.

Other quick tips: • More is not better; purchasing extra pumps will lead to excess cost on under-utilized equipment.

• Avoid adverse drug events by educating staff on the proper utilization of the pump.

• Ensure uniformity throughout the facility as having a mix of IV pumps can lead to higher disposable costs and repair costs.

• Use OEM parts. OEM parts generally last longer and are more durable, which leads to reduced cost of service.

TALTAVULL: Do your homework on the front end. Understand the servicing costs. Some OEMs limit parts availability to end user. Some offer proprietary tubing with higher expense. Some limit software access and force units to go back to the OEM for all service at a higher cost.

TOMLINSON: One of the most cost-effective strategies that can be utilized for larger institutions is to invest in your HTMs IV pump training. Professionals rely on these units 24/7 and due to their usage hours, they need to have maintenance often for calibration accuracy.

Uniformity is also a key strategy with IV management. Also, using OEM-suggested accessories will minimize valuable technician time and eliminate incompatibility errors. It also stream-

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ware-driven PMs. The benefit of eliminating human error when testing the accuracy of these devices cannot be understated. A tech savvy biomed is sure to reduce repair time, increase accuracy and accommodate intended drug delivery specifications which in return will improve patient’s health.

Also, smart pumps can forewarn of a risk of adverse drug interactions, or potential dosage errors.

Q: HOW IMPORTANT ARE PMS AND WHY? Jeff Taltavull AIV Inc.

lines workflow and training.

Q: WHAT ARE THE LATEST ADVANCES IN IV PUMPS THAT HTM PROFESSIONALS SHOULD BE AWARE OF IN 2020?

MANNES: This year, most manufactures are re-evaluating their system notifications to reduce confusion and errant alarms. Pump alarms – for many reasons – can add to the alarm fatigue felt by nursing. Other manufacturers are doubling down on advancing network security with better managed drug libraries, no pump programming once patient is scanned, electronic transfer of data (different software suites that the pumps integrate with) and tracking pump utilization.

TALTAVULL: Advances in IV pump hardware have been minimal. The market has been tweaking existing models with software changes to allow increased settings and integrated drug libraries. There have been no real big changes that would affect HTM professionals.

TOMLINSON: One of the more recent changes in IV pump preventive maintenance is the gradual shift to soft-

MANNES: PMs are highly important for proper function, accuracy in delivery and prevention of higher repairs or adverse events in the future. IV pumps are portable, which means they are moving throughout the hospital when not in use, typically on an IV pole or on a cart. They get dropped, bumped, slammed and abused continuously which could cause them to go out of calibration or cause parts to fail prematurely. PMs are designed at specific intervals set by the OEMs to help prevent this – and they can play a big role in catching issues sooner rather than later. PMs also maintain the quality of the pump and extend the life of the equipment.

TALTAVULL: PMs are extremely important. Proper function and reduction of nuisance alarms can come from making sure you have checked your pumps regularly. Keep those batteries changed based on the model and their specified life cycle. Recalibrate annually. Perform functional inspections to include all prescribed checks. In some cases, pumps are used in one dedicated format – problems or issues can arise when changing formats. Complete PM checks are necessary.

TOMLINSON: With IV pumps, PMs are critical and need to be conducted in a

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ROUNDTABLE

routine manner. We cannot underestimate the accuracy of these units because it can result in the life or death of a patient. Routine maintenance will ensure these units can be trusted to perform in their expected manner and with so many ways to make a mistake, this is one simple remedy that can be quickly enforced and trusted.

make sure you understand what it is you are working with before diving in.

• You are not only buying an infusion pump. You are purchasing the entire ecosystem: administration sets, tech support, parts, customer service, clinical support, etc.

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING IV PUMPS? MANNES: As stated before; purchase what you need. Excess is not success!

Additionally, research the equipment before you buy, and understand what your facility’s needs are before purchasing. Recognize the needs of the entire facility and purchase the item that best fits all the requirements. Include staff from all the departments using infusion (i.e., NICU, outpatient clinics, infusion therapy, chemo, etc.) Other key pieces of advice include:

Ryan Tomlinson Master Medical Equipment

• Utilization is key! IV pumps are designed to be utilized continuously.

When not in use, you are decreasing the life cycle.

• When servicing these devices, understand each model is unique.

Educate yourself on the pump, take OEM training courses and/or learn from an instructor. Whatever you do,

TALTAVULL: Again, understand all the pieces. What is your OEM offering?

How much is servicing through them actually going to cost? How much are the accessories and tubing going to cost?

What are the compatibility and tubing options? What third-party options are available for support and are they reputable?

TOMLINSON: Selecting and servicing the correct infusion pump for your clinical needs is an important task. The cost and availability of sets and intervals of PMs should be factored into your decision, and you need a reliable tech to keep you up and running.

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C O V E R S T O RY

Disposition K N O W

Y O U R

O P T I O N S

By K. Richard Douglas

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“Hey wait, don’t throw that out,” is a refrain that is much more likely to be heard today than in yesteryear. The reason is that so many items can be repurposed, resold in many secondary markets or donated to a good cause.

The options for extending the usable life of a used item are varied and sometimes creative. There is an entire movement based around the premise of maintaining used items, from clothing to cars to medical equipment.

Just as a consumer would be ill-advised to throw out or donate a personal computer with the hard drive included and intact, hospitals must be vigilant to protect non-public protected health information (PHI), and observe HIPPA regulations in the disposition of equipment.

Disposing of medical equipment can be costly and resources are required at a time when resources are in short supply.

There are both a number of considerations when disposing of used medical equipment and a number of choices as to how a particular piece of equipment is taken out of service and out of inventory.

It’s no surprise that in a time of lost revenues and profits, unwanted or unneeded equipment can be turned into a revenue source and this is an attractive option.

The recent pandemic has also changed the landscape for equipment disposition because some out-of-service equipment has been restored and put into emergency use.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

The decision process should not be left to the latter parts of the equipment life cycle, but at the time of purchase. It is also important to remember that infected medical devices must be disposed of as medical/biohazard waste.

“All hospitals have some kind of disposition process; the problem is they are poorly defined and even more poorly managed. Typically, department managers make a determination when to replace an item, put it in the budget and pray. If they are successful and their request is approved, they then decide what to do with the old item. It often gets placed in a closet as a backup, but is soon forgotten, only to be found months or years later when the department moves or some other remodel project is undertaken and the piece is discovered and now has little to no value,” says Charles “Chuck” Overeem, biomedical equipment life cycle planner in the HTM and biomedical engineering department at ProHealth Care in Waukesha County, Wisconsin.

Overeem says that some know enough to try to sell the item, but don’t have the time or contacts to get the best value for the hospital. He says that there are companies

and programs that will remove equipment from your facility and do the marketing and selling for a percentage of the sale.

“However you decide to disposition your equipment, at least formalize the process, put someone in charge of it and run all equipment through it. A formal disposition process is a revenue stream for the hospital. It also assists in the tracking of your assets and allows you to know what you actually have –which can help with inventory, taxes and planning,” Overeem says.

Overeem says that the how, when and where of disposition should be defined so that options are clearly understood.

“How – redeploy, sell, donate or scrap. ‘How’ describes the process by which an item is removed from service.

When – at what point in time is an Item dispositioned? And, where – where does the item go? Is it redeployed within the organization? Is it sold to an entity outside of the organization? Is it donated? Is it scrapped?,” Overeem says.

“I think disposition starts with ‘when.’ When should we, or I as a department manager, replace or remove a piece of equipment? Is the item no longer being used? Is there a better option for the program or treatment that we are currently using the item for?

Has the OEM stopped support? I think these are the most obvious reasons,”

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C O V E R S T O RY Overeem says.

He says that how an item is dispositioned will depend on its state/condition.

“Is it functional? I can redeploy, sell or donate depending on the needs of the organization. How old is the item? Can we still get parts and support readily? If the item is not old, and is still supported but we have determined that we do not want it for redeployment, we will put it up for sale. If it cannot be sold, we will look at donation,” Overeem says.

He points out that some items don’t sell well, likely because of the cost to ship them versus value, but local charities can often use them as long as they understand that his facility cannot warranty or support the item.

“If the item is nonfunctional, is it repairable, within reason? If so, we could strip it for parts if we have a need or sell it as a parts machine. Someone may take two or three defective units and make one good unit.

If the unit is beyond reasonable repair then it goes to scrap/e-waste where it can be recycled,” Overeem says.

“How and where we dispose of an item are closely tied together. If the item is fully functional, we first look to redeploy it within the organization. This option provides the biggest cost savings for the organization by not having to pay full price for a new piece of equipment. I look at it as free. Another department preserves their budget but still gets a working piece of equipment that they need to care for their patients,” Overeem adds.

He says that since his department does most service in-house and has all of the service history, they know exactly what the status of the item is.

“If an item has a defect, I can look to see if we could redeploy it if it worked and then weigh the cost of the repair against the cost and benefits of a new machine. When that does not pan out it becomes a candidate for sale or scrap,” he says.

If health care facilities don’t have an in-house specialist to guide the disposition process, or the person assigned this task could use some help in utilizing best practices, they can call in a third-party specialist.

“When any surplus equipment is no longer needed, the health care facility has several options for disposal. Depending on the age and condition of the equipment, facilities may either sell, donate, recycle or reutilize excess

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equipment at another facility within the health care system. Having a constant flow and regularly scheduled dates to address asset disposition helps to remove unneeded clutter in the facility while avoiding high storage costs for equipment that is end-of-life and will not be used again,” says Mimi Lively, CEO at ZRG Medical in Oceanside, California.

ZRG Medical is licensed by the California State Board of Pharmacy to sell medical equipment, allowing them to purchase and sell medical equipment. The company specializes in used medical equipment liquidation services for health care facilities that want their surplus equipment to have a second life.

“When choosing where the equipment will go, it is important to use a trusted vendor specializing in medical equipment so that you can be assured the equipment is being managed responsibly,” Lively says.

In some cases, when other options are not viable, equipment can simply be recycled.

THE ROLE OF CMMS What documentation should be included in CMMS when you decommission or dispose of equipment? Are there considerations that are not so obvious?

when,” Overeem says.

He says that in all cases of disposition, start by documenting who wants the item removed from service and why.

“The ‘why’ aids in determining if an item can be redeployed, sold or donated. When we sell or donate equipment, we do it as-iswhere-is. In short, this means the buyer pays and arranges shipping and understands that we sell it without warranty. Anyone who gets equipment from our hospital, either by donation or sale first signs a disclaimer form that essentially states that they understand the no warranty provision. I also include a copy of any payment information including a copy of the check in the records,” Overeem says.

Overeem says that other not so obvious documents they include is an approval form signed by the original owning department manager stating that he/she approves the item be removed from service and his/her department.

“This is the first step before I take possession of an item. There have been instances where a department manager stopped the disposition of an item because it was still required equipment. In most cases, I believe that there was a miscommunication regarding intentions and this step saved the

“ Charitable donation is absolutely a viable option if you have good working equipment.

It is great for the environment and can help save lives in underdeveloped countries.”

“When a piece of equipment is dispositioned, you want to include several pieces of information. How was it disposed of? Did you scrap it? Was it redeployed to another area or department? Was it donated or was it sold? With each of these states comes a need for additional documentation. If it was scrapped, documentation should show that PHI was removed and that it was scrapped/ junked/recycled. If it was redeployed, the department and location must be updated in the system so you can find it for its next PM cycle. If it was donated, document removal of PHI and also who received it and what value it has as a donation. Follow the IRS guidelines for valuation of donations. If the item was sold, again, document PHI removal, how much it was sold for, whom it was sold to and

– MIMI

Lively

hospital from purchasing an item that it should not have had to,” he says.

SECURITY CONCERNS “Security risks associated with used medical equipment that’s being removed from service are limited to confidentiality of protected health information (PHI). If the medical equipment in question has the ability to store a patient’s health information, it would constitute a violation of security regulations if the disposed equipment with intact PHI came into anyone’s possession,” says Stephen L. Grimes, FACCE, FHIMSS, FAIMBE, AAMIF, principal consultant with Strategic Healthcare Technology Associates LLC in Swampscott, Massachusetts.

Grimes says that health care providers can eliminate the confidentiality risk by perma-

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nently removing all PHI. “Removing PHI can be done by either completely overwriting media (e.g., filling the entire data space with 0s) or by physically destroying the media on which the PHI is stored. Check with the medical device manufacturer to determine how they recommend any PHI be removed (e.g., does the device have a feature that allows for completely overwriting any internal media),” he says.

Grimes says that as a growing number of medical equipment categories have the ability to store and transmit a patient’s health information, the risk of compromising the confidentiality of protected health information (PHI) in this equipment also grows.

“Unless a conscious effort is made to remove all PHI from this equipment at the time of its disposal, there is a real risk that PHI will fall into unauthorized hands.

However, losing control of PHI on disposal is sufficient to result in a violation of security regulations, whether or not the PHI is ultimately used for nefarious purposes,” he says.

“Some of the more common examples of devices containing PHI include imaging systems (e.g., MRI, CT, ultrasound, PACS), EKG and EEG systems, laboratory systems, pacemaker controllers, medication delivery (infusion pump) systems,” Grimes says.

Lively points out that if you utilize a third-party provider, it is important to ascertain that the provider is experienced at locating data that might be stored on a piece of equipment.

“Unfortunately, data may be missed.

This leads back to why it is so important to use a trusted vendor that is HIPAA compliant, holds a valid pharmacy license, and specializes in medical equipment for all assets removed from hospitals – ensuring liability is eliminated for the hospital,” she says.

PLANNING FROM THE BEGINNING Is disposition something that should be planned for when you first acquire the equipment? How can this be done?

“If you are going to have disposition program that allows you to do other than trade-in, some thought needs to be given to disposition at the time of purchase. In today’s software-driven world, a piece of

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

equipment can quickly turn into a paperweight if you do not own the software to run it or have the right to transfer ownership. That needs to be negotiated up front if possible. Just like in-house programs and third-party service providers fight for the right to repair equipment, hospitals need to fight for the right to fully own the equipment they paid for including the software so they can transfer ownership/license as needed,” Overeem says.

GUIDANCE The World Health Organization (WHO) publishes a handbook that provides further guidance on equipment disposition.

“The information on asset disposition in the WHO handbook outlines all the ways a hospital can responsibly reutilize, liquidate, and dispose of their equipment. What the World Health Organization does not mention is the time and resources it takes for hospital staff to complete the necessary steps to remove assets,” Lively says.

She points out that healthcare facilities reselling the equipment themselves can be one of the most time-consuming options.

“This takes time away from hospital staff to concentrate on more important tasks and requires ample space to store the equipment. Selecting a vendor that can provide a total disposition solution based on the hospitals needs can free up valuable resources,” Lively says.

CHARITABLE GIVING One of the very best ways to extend the useful life of a medical device is to allow it to continue to lead to better outcomes for patients. In many developing countries, new medical equipment is not an option because of costs and availability. Donated medical equipment can fill a void for health care facilities that face this reality.

“Charitable donation is absolutely a viable option if you have good working equipment. It is great for the environment and can help save lives in underdeveloped countries,” Lively says.

“Because most charitable organizations do not have the resources to repair broken equipment, it’s best to only provide equipment in good working condition, so they are able to utilize it. Also, keep in mind, some charitable organizations will not pick up equipment directly from the facility so you

ARTICLE

CONTRIBUTORS Charles “Chuck” Overeem, ProHealth Care

Mimi Lively, ZRG Medical

Stephen L. Grimes, Strategic Healthcare Technology Associates LLC

may have to use your own resources to provide for transport of the equipment to be donated or use an asset disposition vendor that works with charitable organizations that can donate on your behalf,” Lively adds.

Overeem agrees that donation should always be an option.

“Donation is an option to dispose of equipment that we do consider. I have had equipment that I could not redeploy and could not sell. For whatever reason there is not a market for it at this time. When that is the case, and it is good equipment, donation may be the way to go. It gets the equipment out of your facility, and puts it where it can do the most good. All equipment is not viable for donation, but that should be an option to consider before disposing in a landfill,” he says.

Disposition can be a function built into the equipment planning and purchasing process. It should be considered from the start and thought through at the end of the device’s life cycle. Done properly, it can provide a rewarding outcome for the health care facility in terms of revenues or the knowledge that the equipment may be helping others through donation.

Third-party specialists can also help make the process go easier.

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EXPERT ADVICE

CAREER CENTER

What Should You Do After Sending the Wrong Resume?

BY KATHLEEN FURORE

S

o many job applications are done virtually these days; and resumes and cover letters are usually tailored specifically to each individual job listing. What happens when an applicant hits “send” and realizes soon after that they’ve attached the wrong resume or cover letter? I know someone this happened to recently, and they asked me if there was any way to “recall” the application. Is there? Should they reapply?

There’s no better example to illustrate the pros and cons of the online job application process.

“The Internet has made applying to jobs easier than ever before. In fact, 66% of working Americans, including 82% of millennials, expect every company to have a mobile-friendly career site and job application process,” reports Amy Warner, director of talent acquisitions at recruitment software company iCIMS. “While tailoring your resume and cover letter to the position you’re applying to is a great practice, it likely means you have several documents saved to your computer that are difficult to differentiate.”

The obvious advice is to slow down and double-check everything. But mistakes 58

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happen.

“Thankfully, it’s not the end of the world if you hit ‘send’ with the wrong resume or cover letter attached,” Warner says.

In most cases, applicants will receive an email confirmation once the online job application has been received.

“Sometimes, a confirmation email or popup window will allow you to view or edit your submitted application,” Warner notes. “If this is the case, you can easily edit your submission to include the correct version of your resume or cover letter.”

When that isn’t the case, contacting the recruiter you’re working with, or the company directly, as soon as possible is the best option.

“If a candidate accidentally submitted the wrong document, they should email the recruiter and let them know that they’d like to resubmit their application,” says Liz Wessel, co-founder and CEO of WayUp, a company that partners with companies to help them recruit qualified, diverse early-career candidates. “In that email, they should specify again why they are interested in the job and include the correct documents as attachments.”

When no recruiter is involved, reach out

Kathleen Furore to the company; but remember that the email confirming receipt of your application is often from an address not set up to receive incoming mail, Warner cautions.

“However, the email address for a company’s human resources department is often listed on the company’s website,” Warner explains. “Send an email to that address briefly explaining the mishap, attach the correct document and apologize for any inconvenience you may have caused.”

The email should include your full name, contact information and the job WWW.1TECHNATION.COM

EXPERT ADVICE title/ID that you applied to.

“It’s important to take responsibility for the mistake, but don’t go into too much detail about what was wrong with the original document you submitted,” Warner says. “A simple explanation that the resume you originally submitted was not the most relevant version to the position will suffice.”

You should realize, however, that mistakes can end up costing you an interview.

“Fifty-nine percent of recruiters will reject a candidate because of poor grammar or a spelling error, so candidates should expect recruiters to consider submitting the wrong document as a potentially more significant mistake,” Wessel says. “As a candidate, a good tip would be to clearly label the name of your documents for the specific company/role you’re applying for. With clear naming conventions, you’ll be less likely to attach the wrong document.”

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KATHLEEN FURORE is a writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

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MAINTENANCE AND SERVICING:

The Alaris 8100 Infusion Pump

BY DORIAN J. DAVIS AND MELISSA TAYLOR

WHAT SETS THE ALARIS 8100 APART FROM OTHER PUMPS? The Alaris 8100 is simple and easy to use. The device is lightweight and allows larger infusions. The 8100 is not a standalone, and requires an Alaris 8000 or 8015 to use, but its portability makes up for that. The only additional accessory needed for the device is an IV line. It is capable of both intermittent and continuous infusions. Another really neat feature about these units is that up to four of them can be connected to a PC unit at a time, and each run a unique program. Between the sleek design and next gen features, the Alaris 8100 can handle almost all of your infusion needs.

WHAT TYPES OF PARAMETERS DOES THE ALARIS 8100 OBSERVE? The Alaris 8100 is used to deliver fluids and medication to patients by way of intravenous therapy (IV). These devices do not provide patient monitoring, but there are some parameters we pay close attention to. Because the devices deliver fluids, one of the parameters we focus on is Rate Accuracy. What we do here is ensure the amount of fluid (volume) delivered is accurate. Let’s say, for example, a health care provider programs the 8100 to deliver 50mL of a fluid to the patient at a rate 250mL/hr.

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Our job is to ensure the 8100 does exactly that. The manufacturer does allow a little leeway of +/- 5%, but we aim to shorten the error as much as possible. We also check the downstream occlusion pressure, and make sure it alarms within the range outlined by OEM. This range is conveniently located within the maintenance software during the test.

WHAT ARE THE MOST COMMON ISSUES THESE UNITS EXPERIENCE, AND HOW CAN THESE ISSUES BE RESOLVED? Given the nature of these devices, and the number of parts within them, eventually an issue may arise. The issues can vary significantly but there are some that we do see relatively often. The most common issue with these units is centered around the Front Bezels. Due to some impurities found within the plastic, many OEM bezels were recalled between the period of April 2011 and June 2017. Another issue we see these devices come in with frequently are faulty pressure sensors. We have multiple ways we can test these such as analog sensor test and patient side occlusion tests. In some cases, a simple calibration is all it takes. Other times, some component level repairs are required. In any case, we are able to get these units back up and running to

Dorian J. Davis BMET II, Lead Technician Pumps Department, Avante Health Solutions

Melissa Taylor Technical Scribe specs, and know that no harm will befall a patient on the device.

WHEN RECEIVING THESE UNITS IN FOR SERVICE, WHAT ARE THE FIRST STEPS YOU TAKE TO EVALUATE THEM? At Avante, we receive a lot of different units for scheduled and unscheduled maintenance. The Alaris 8100 is one of the most common that we receive. These units may come in with a wide variety of problems, and our evaluation process helps us hone in and address the issues.

One of the first steps in our evaluation

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EXPERT ADVICE

COME GROW WITH US process is the visual inspection. During this inspection we are checking for physical damage, rattling in the units, serial numbers, safety labels and more. One of our next steps is to assess the device’s performance, and isolate the components that are faulty and not meeting manufacturer’s specifications. We also take time out during these steps to check the manufacture date of the OEM front bezels, in order to ensure that no recalled parts get sent back to a customer.

We can address most, if not all, errors and issues that these units may have, and our team is always ready to fulfill any specific requests by the customer.

TO ENSURE THESE UNITS ARE WORKING THEIR BEST FOR A LONG TIME, WHAT DEVICE MAINTENANCE DO YOU SUGGEST TO THE BIOMED? I recommend keeping the Alaris 8100 on an annual maintenance cycle. The 8100 is durable and reliable, but like most items in patient care we want to ensure these units are always operating at peak levels. During each PM I recommend recalibrating the device, performing visual inspections and operational checks at a minimum.

Alaris is a good company and their devices can be maintained, calibrated and serviced using Alaris’ Maintenance Software. The program organizes and directs the tech through the various tests (calibration, PM, etc.), and also lets the user isolate any test. The SW includes a lot of additional tools such as SN adjustments, Flashing the SW revision, reports, and more.

DORIAN J. DAVIS, BMET II, is Lead Technician Pumps Department, Avante Health Solutions, and MELISSA TAYLOR is a Technical Scribe.

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EXPERT ADVICE

THE FUTURE The New Future?

BY ROGER A. BOWLES, MS, EDD, CBET

T

he last couple of months have really sucked. What a way to start out a column. But, it is true.

Students and faculty have been sent home. Classes have been put online and or extended/postponed. We have lost a few students who do not want to continue in an online format. And, no one knows when things will actually get back to normal. The AAMI Exchange has been canceled. Some days, I wake up unable to remember what day it is. I am in quarantine. Watching the news, we get terms like “the new normal.”

As someone who has developed and taught classes online for several for-profit universities and even at Texas State Technical College at one time long ago, I sure hope this isn’t the case. Certain content fits online learning. Hands-on technical education doesn’t always translate well to online courses. Sure, hybrid solutions are possible, but it does take a certain type of student with certain motivations to make that happen successfully. I’m not against distance learning.

For a long time, it was my passion and I worked with several universities in teaching several online courses. I enjoyed it … for the most part and for a little while. What I didn’t like was the lack of personal interaction with the students and their lack of spontaneous interaction with each other.

What I didn’t like was the lack of immediacy and “in the moment” learning opportunities. What was lacking for me was the “fun” factor.

Teaching is fun. Going to work every

day is fun (at least for me). Sitting behind a computer all day is not fun.

However, during this time of challenges, there have been some points of light. AAMI provided our students with free access to the CBET certification course. Avante is working on ultrasound videos and solutions for our students. And, most of all, we have had to learn to be creative. With limited access to equipment and even hospitals (some hospitals are discouraging internships at this writing to prevent any unnecessary exposure to students), some activities are not possible. Yes, YouTube videos and others are nice but it is hard to learn how to do certain things by watching a video. I learned how to troubleshoot and repair my weed-eater by watching a video. But sometimes we assume a certain skill set and knowledge level when using this method of learning.

As many of you know, I also have a part-time business teaching motorcycle riding, both basic and intermediate levels. There are literally thousands of videos online to learn these methods, but it requires face-to-face and on-cycle time to really learn it and become successful at it. By the way, those have been shut down also.

On a more positive note, we have watched our health care workers shine during this time. My wife is a health care worker and several of our former students have posted on LinkedIn and Facebook about the challenges they are facing and how they are meeting these challenges. They continue to make us proud. And hey, even in

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Roger A. Bowles MS, EdD, CBET

quarantine, my employer continues to pay me.

What we are hearing from the people in charge is that life as we knew it in the past will not be returning to normal for the “foreseeable future.” Classes will take place, but the size of classes may be substantially reduced. Social distancing and PPE are a way of life, for now. Most lectures will be remote or online. Labs will take place but in spread out fashion with limited numbers of students.

Points of entrance and exits will be enforced and cleaning/disinfection will be paramount. It sounds crazy, but we got this. We will continue to produce the highest quality of graduates, there just may be fewer of them for a while. We will continue to go to work, but the place may not always be in a building. We will continue to teach, but the methods are different. It may not be as “fun,” but we will keep our sense of humor (for now).

We’ll do a great job … a fabulous job. People won’t believe how great of a job we’ll do. It will be a tremendous success … like no other success ever.

Luckily, the sense of humor is still intact. Best sense of humor ever.

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EXPERT ADVICE

VIEW ON VALUE Parts Wars: HTM Strikes Back

BY JOSEPH HADUCH AND PATRICK FLAHERTY

T

he struggle for objectivity, transparency and basic engineering data between medical parts providers, historically dominated by the original equipment manufacturers (OEM), and clinical equipment service providers pre-dates all of us. The foundation of this dysfunctional relationship no doubt started around the time Roentgen replaced an X-ray tube for Madame Curie. Pity poor Marie, brilliant by all accounts, was no match for the nascent shell game soon to become the hallmark of clinical equipment manufacturers for the next century.

Though she didn’t have a service contract, Mdm. Curie likely thought she negotiated a significant parts discounts just weeks earlier, only to be shocked when Roentgen, without cause or notification, increased his parts prices by 25%. Sound familiar? Perhaps Roentgen, in a burst of human kindness, offered her an additional discount but only if she would purchase two more rooms, commit to a minimum service spend and execute these commitments prior to the end of Roentgen’s Fiscal Quarter. Sound ridiculous? Fast forward 120 years and it’s the accepted norm, but no less ridiculous.

The relationship described above is self-evidently based on one-side dominating a buyer/seller relationship with no thought or attempt at collaborative and proportional contracting.

Unfortunately, by the time that health care providers had consolidated enough to have economic leverage, their clinical

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equipment had fallen into its current trench. The primary tenets of this trench were fee-for-service (clearly this has been a driving force over time) and the commonplace use of the 510K process to continually introduce new equipment at premium prices with absolutely no systematic research evidence of material outcome (clinical and economic) benefit. In the early years of this era, parts were less of an issue as equipment turned over more consistently with the OEM’s seven-year replacement targets based on the simple equation of volume equals profitable revenue.

For a time, the mantra of diagnostic imaging marketeers was “throughput, throughput and throughput.” Even though parts performance and rational pricing was an issue for providers and a high-margin proposition for manufacturer’s then, it was not quite as apparent when volume, based on fee-for-service reimbursements, could cure everything and the only thing that mattered was the equipment turned-on when needed.

Fast-forward to 2020, the age of low- to no-margin providers, value-based penalties (only applied to providers), sky-rocketing personal financial responsibility for patients and a pandemic precipitated depression, and this fee-for-service based business model has become an oppressive yoke that threatens the very existence of many providers.

In the move to value-based health care and government and payer demanded material contraction of health care expenses (as charged by providers)

providers had no choice but to maintain equipment for longer periods of time. In response, the manufacturers doubled-down on service, parts, and training monopolies, duopolies, and oligopolies to create a cartel-like environment which kept prices consistently high in order to drive high-margin revenue as an off-set to the decreased frequency of capital purchases.

However, some of the blame for the ridiculous way we manage parts also lies with the service providers. Service providers have erroneously viewed parts from a service perspective, not from the perspective of the manufacturer. Given the high and increasingly higher economic pressure, for too many cost has always been king with little regard to availability, warranty, objective performance or equivalency, and predicted (and contracted) useful life.

OEMs rigorously approach parts from a manufacturer’s perspective. What’s the difference? Manufacturers demand specific performance standards, with guarantees from their internal manufacturing teams as well as from the many sub-contracting manufacturing companies they use to produce parts and sub-assemblies. Manufacturers, in the interest of lowering costs, or increasing margins, try to use the same part across their entire inventory but for only as long as it is the best economic alternative, switching SKUs frequently enough within the large volume manufacturers to never produce a stable parts catalog.

Manufacturers require their suppliers to transparently negotiate margin-based cost-plus pricing and are not willing to

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EXPERT ADVICE

play the volume discount games they peddle as the exclusive purchase options to their customers. In an OEM’s world, engineering quality and performance is based on objective operational metrics defined by the manufacturer and includes contracted fulfillment rates and timelines; any defect caused by the OEM’s supplier will be paid for by that supplier, in contrast to the shifting of defect-related costs away from the OEM and to their customers (think recalls, cybersecurity, etc.). In order to fairly reorient the relationship between OEMs and providers, HTM professionals need to change their perspective when acquiring parts. In this regard they need to learn from their manufacturing colleagues and apply OEM best practices in parts acquisition and management.

All of the preceding is a foundation

toward a future that should allow us to target the removal of as much of the labor-intensive preventative maintenance work and costs as possible as we migrate to the predictive failure approach used for so long by other complex equipment industries. In many non-medical industries parts performance is monitored individually and in combination and compared to a digital twin. A digital twin is a virtual duplicate of your device that performs to maximum engineering specifications.

The performance of any given device is continuously measured against the virtual device to assure optimal performance, minimize downtime and identify opportunities for equipment improvement. Why is this technology missing from health care?

While we’re beginning to see some predictive tube monitoring solutions,

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

the tens of thousands of other parts in your system are absent from any predictive process despite their performance being equally critical to the overall uptime of your device. Clearly the OEMs control the access to this kind of solution as well as the basic building blocks from which it grows … objective and transparent parts performance expectations. OEMs must stop focusing their collaborative efforts with the cartel goals of MITA and AdvaMed and start to practice the contracting transparency they demand from their suppliers.

PATRICK FLAHERTY is the vice president of operations for UPMC BioTronics.

JOSEPH HADUCH, MBA, MS, is the senior director of clinical engineering for UPMC BioTronics.

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EXPERT ADVICE

SPONSORED CONTENT

20/20 IMAGING INSIGHTS Taking a Closer Look

BY TED LUCIDI, CBET

Y

ou may be surprised to learn that many of the probes evaluated at our Ultrasound Center of Excellent have failed as a result of damage that may be considered fully preventable. A significant portion of those probes have experienced failures as a result of indirect chemical or fluid intrusion at the scan head. Most would agree that no one would ever purposely expose an ultrasound probe to damaging chemicals or somehow allow fluid to gain access to delicate electronics.

The truth is that items such as seams, seals, acoustic lenses and strain reliefs will experience wear and degrade as a natural result of repeated exposure to chemicals such as gels, cleaners and disinfectants.

Even OEM-approved chemicals have the potential to have long-term affects to these components. Using a chemical which is not approved by the OEM or using an OEM-approved chemical improperly can result in highly varied long-term effects and may even result in some in the short-term.

For example, the seams that join the various sections of a probe housing will, over time, begin to separate and create very slight openings. The seals surrounding the acoustic lens will eventually deteriorate resulting in potential points of entry for foreign substances. Once a seam or seal has been compromised, chances are that every time the probe is subsequently wiped

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down or exposed to some type of liquid or gel, some of that chemical will find its way inside of the probe.

Fluid entry can lead to a multitude of problems, some being hard failures and others resulting in performance degradation over time. When it comes to ultrasound probes, it’s hard to find an OEM that does not recommend that end-users, specifically sonographers, visually inspect each probe prior to each use. That being said, OEMs differ on their messaging, where that messaging is located, exactly what should be inspected, and what defines good versus bad. It’s also up for interpretation as to just how bad is bad and what are the repercussions of using a probe with, what may appear to be, only minor cosmetic issues.

There really is extremely strong value in performing frequent visual inspections.

From a cost perspective, resealing a lens or a probe housing may only cost a few hundred dollars. Contrast that to having to repair complex electronics, replacing the acoustic array or even the entire probe at a cost of thousands. Although over 200 years old, Ben Franklin’s quote still proves true in today’s digital world. “An ounce of prevention is better than a pound of cure.”

Special Note: Repairs made to ultrasound probes need to be performed using adhesives and materials consistent with the OEM design and must be ISO 10993 compliant. However simple the process may seem, repairs should not be made

Ted Lucidi, CBET Innovatus Imaging using standard, over-the-counter sealants and adhesives.

The responsibility of visually inspecting each probe does need to fall upon the sonographer or end-user, but it is that of the service engineer to advocate for its happening. In my 30 years working in the ultrasound industry, I’ve found that very few sonographers actually inspect their probes daily, weekly or even semi-annually.

Inspections are usually left to the service team in clinical engineering or the OEM during the annual or semi-annual PM check. Even semi-annual inspections may not be frequent enough to identify the little things that can lead to costly failures.

Partnering with end-users and taking the time to educate them to the why’s and what-if’s is the key to reducing costs.

At Innovatus, our plan for success begins with engaging the individual department managers. We explain the concepts and benefits of prevention and early detection and show the potential savings and how it can contribute to lowering overall service costs for the facility. Next steps involve attending a weekly, or monthly, department meeting and explaining the concepts to the staff.

We’ve created a visual inspection guide that provides examples of what sonographers should be inspecting and centers on the what if’s. Spending just 5 to 10 minutes

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EXPERT ADVICE

raising awareness and educating end-users builds a reliable partnership.

Posting the visual inspection guide in each scan room helps to keep the concept top-of-mind.

One success story comes from a customer who made it department policy that a different sonographer would inspect every probe in their department every Friday. If something of interest was identified, such as a worn lens or damaged strain relief, the sonographer would have clinical engineering take a closer look. If deemed severe enough, the engineer would arrange for a loaner and send the probe in for repair. Over time, that department began to have fewer and fewer costly, catastrophic failures.

We’d encourage readers to download our visual inspection guide for standard probes on the “Resources” tab of our website – www.innovatusimaging.com.

The guide is also available in hardcopy on

Gel intrusion as a result on an open seal.

heavy stock, upon request, which is ideal for posting. We also invite you to have us host a quick webinar for your end-users where we’d talk live and provide a live demonstration on visual inspections. Let us help you lower your bottom line and increase the life cycle of your ultrasound investment.

For more information or to arrange for a live demo or webinar, reach out to TedL@innovatusimaging.com TED LUCIDI, CBET, Customer Experience and Clinical Insights, Centers of Excellence for Ultrasound and MRI Coil Repair, Radiography, Design and Manufacturing, Innovatus Imaging.

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CYBERSECURITY Virus vs. Virus

BY JOSEPH E. FISHEL, CBET, MBA

G

rowing up I read Mad magazine. One of my favorite cartoons was Spy vs.

Spy. It was a wordless comic strip.

One Spy was dressed in white and the other Spy wore black. One was supposedly good and the other evil. It was easy to identify which Spy was which. Sometimes one Spy won and the other lost. For the past year and a half, I have been writing about viruses in the network and computer world. I have been trying to help identify the good from the bad. The good is what you can do to limit your exposure. The bad is what they can do to your systems should they get in.

In recent months, we have had a different virus to deal – COVID-19. I hope that by the time this is published, we will be coming out of this pandemic. This biological virus has pulled assets, finances and visibility away from the electronic world, but attacks haven’t stopped. It opened the way for cyberattacks to increase with everyone’s attention drawn away. In the news, we heard that several hospitals had their networks/servers held ransom during this critical time of treating and diagnosing patients. Being unable to see patient results, they could not treat patients.

This put lives at risk and ransoms were probably paid.

Many ask how could this happen?

Some say this can’t or couldn’t happen to us, we have firewalls, virus protection, access control lists and so on. Many working remotely found out their computers and files all of a sudden were being held ransom as well. In desperation, hospitals were looking for equipment to meet the threat. Hospitals were hit with emails about ventilators,

monitors and IV pumps for sale as well as COVID-19 reports with information about the virus. Many of these were Phishing emails. During this time, they increased and amid an atmosphere of urgency many were accepted because they looked legitimate.

Some even looked like they were from within one’s own organization. An example of this was one I saw that stated since you have been so busy treating patients we went out and arranged a Mother’s Day special discount with XYZ Florist. Another was an advertisement for medical equipment from companies I had never heard of before.

These fake emails are called Phishing emails. So, how can you tell if they are real or fake?

1. The message is sent from a public email domain. No major legitimate organization will contact you from an address that ends in “gmail.com, hotmail.com or YAHOO.com.”

When I received emails offering ventilators at fire sale prices from companies, I searched the companies to see if they had an Internet presence. A very primitive website or only a paragraph saying what they do is a sign to use caution.

2. The domain name is misspelled.

Often this is the addition of a letter or substituting a letter such as an N for an M. Quite often people are confused by the .IRS suffix because it looks legitimate, but it should be IRS.gov. Hackers can buy a domain name and try to have it similar to a legitimate business.

3. The subject line often has a sense of urgency. This is your Last Notification, Urgent, Final Notice. Limited supply of COVID-19 ventilators.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Joseph E. Fishel, CBET, MBA Healthcare Technology Systems Manager Sutter Health eQuip Services Sound familiar? It’s to get your attention away from being focused and rattle you into thinking you are in trouble.

4. How is the sentence structure in the email? Are words misspelled? Does it use wrong words such as “their” for “there” or “are” for “our”?

Often the wording doesn’t contain the words we normally use. This is a clue that the email probably isn’t legitimate.

5. Does it contain attachments or links? Phishing emails contain attachments. When opened, they take you to a site where the hacker has malware or a virus waiting to infect your machine and take control. Remember you chose to go there. The computer follows instructions. Virus protection may stop you with a message suchs as “Are you sure you want to open this site?” and when you select “Yes” it acknowledges that you know what you are doing.

When receiving an email from an unknown source, look it over for any of these signs. If you have a SPAM detection department at your organization you should send it to them to see if it is a legitimate email.

JOSEPH E. FISHEL CBET, MBA is the Healthcare Technology Systems Manager for Sutter Health eQuip Services.

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Improving the safety, quality, and cost-effectiveness of care across all settings.

Patient Safety

Evidence-based Medicine

Technology Decision Support

EXPERT ADVICE

THE OTHER SIDE The Silver lining. HB2326

BY JIM FEDELE, CBET

M

y articles are written a few months before they are published so the timing of when you read them may be late. As I write this article, we are still dealing with the COVID-19 pandemic and an important week is on the horizon. Since this article is written for the July issue of TechNation, I feel like everything will have been written and discussed about the current pandemic we are living through. I personally am ready for a break from it. Hopefully by the time you read this we will be living a more normal life knowing this virus will be around for a while. Given the challenges to daily life the pandemic has caused there are good things that have occurred because of it as well. One issue is the right to repair medical equipment.

Life during these times has certainly changed, I think about the Super Bowl party I had with friends just a few months ago. How we sat close together, and shared food and drinks. Hopefully, we will be returning to that carefree life soon. Given everything the pandemic has taken from us, it has also put a light on a battle we fight everyday as biomed techs. The right to repair equipment has been an issue for our industry as long as it has existed.

I remember when I started my career as a biomed (30 years ago). I was surprised to discover that a company that sold a product that my employer owned would prevent me from fixing it.

I came from the consumer electronics industry, we were permitted to repair

everything; we could get the tools, training and diagnostics necessary to fix TVs, radios, VCRs, etc. I couldn’t understand why the same support did not occur for medical equipment.

However, I soon realized what was really going on. Keeping us from repairing equipment wasn’t about patients, or doctors, it was about service contracts and money. A former CFO at my facility used to call service contracts “the gift that keeps giving” one pays the initial cost for the equipment and then pays for it again over the next three to five years. It has always felt wrong to me how the OEMs have held us hostage. They have unchecked control of every aspect of service. They even get to make their own formula for “uptime” which can rarely be cashed in on. When OEMs are pressed for their reasoning regarding this, they dodge the question and say it is a business decision. They hide behind words like intellectual property, patient safety and quality. Insinuating and stating that only their trained technicians can safely work on the equipment.

Thankfully, due to the pandemic, the right to repair issue is gaining popularity/notoriety and has prompted a national discussion about the issue.

So much so that Pennsylvania State Representative Austin Davis of Allegheny County, is the prime sponsor of House Bill 2326 (HB2326) aimed at requiring manufacturers to give hospitals the information they need to repair their own devices. The bill has bipartisan support and we are hopeful

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

it can get passed. If you are from Pennsylvania, please take a moment to reach out to your state representative and ask them to support this bill.

Finally, I am writing this article in May, this information is important because during the month of May we celebrate HTM week. I would just like to recognize and congratulate all who work in and support this industry.

Everyday we are doing great work that supports clinicians and helps patients.

We are problem solvers, advocates, planners and the go-to department for every “gray-area” issue. When nobody works on it, we will. We do this because we know better than most that at the end of every activity in our field is a patient that needs our help. So, to all my colleagues I say please take a moment to pat yourself on the back and reflect on the good you do.

JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He manages six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations.

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EXPERT ADVICE

SPONSORED CONTENT

TOP 7 REASONS A BIOMED TECH IS ONE OF THE BEST JOBS IN HEALTH CARE

BY JOHN POLLARD, REGIONAL DIRECTOR OF NORTHERN CALIFORNIA AT TECH KNOWLEDGE ASSOCIATES

I

t’s a job with a promising future.

One that welcomes all ages and stages – from young people starting careers to mid-career professionals looking for a change. It’s a job focused on maintaining critical skills and building new ones. An exciting job that’s different every day. And a job that makes a real difference.

Sound too good to be true? It’s not!

Being a biomed tech is all this – and more! – making it one of the very best jobs on the planet, in my humble opinion, and definitely one of the best jobs in health care today.

Want to learn more? Read on!

Top 7 Reasons a Biomed Tech Is One of the Best Jobs in Health Care 1. PROMISING FUTURE. Biomed techs are in demand. The employment outlook for biomed techs is positive. Jobs are expected to grow over the next decade, and likely beyond as health care itself continues to grow and change. The aging U.S. population, expansion of outpatient treatment centers and advancing technology innovation are all driving changes in health care delivery. At the same time, today’s biomed workforce is shrinking due to

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committed to growth and change, to keep pace with the growth and change in health care and healthcare technology. If you want a job focused on helping you be all you can be, then being a biomed tech is for you.

John Pollard Tech Knowledge Associates

retirement, meaning biomed techs will continue to be in high demand as these vacancies are created – in addition to the new positions that will be created.

2. ON-THE-JOB TRAINING. Learning is constant for biomed techs. Imagine a job committed to ensuring you have the skills you need to excel. Employers of biomed techs invest in critical ongoing training, both in-house and off-site, through mentoring and traditional settings like seminars, to help techs stay up to date on the knowledge and skills they need to be their best. It’s a job

3. OPEN TO ALL. The ranks of biomed techs are filled with professionals who made mid-career changes. I’m one of them!

Following an injury nearly 30 years ago, I left my career as a journeyman carpenter to become a biomed tech.

And I’ve never looked back. Others are attracted to the field from a variety of careers because they seek change and a new challenge. Of course, the field is also open to young people who are looking to get their career start – high school graduates as well as those with two- and four-year degrees. In fact, biomed desperately needs more young people to join the field. Read more in TKA President George Hampton’s recent blog on the topic.

4. HEAD AND HANDS. Biomed techs put both head and hands to work every day. The field requires people who are mechanically curious about how and why things work. Biomed techs need an under-

WWW.1TECHNATION.COM

EXPERT ADVICE

standing of math, physics, chemistry and basic mechanics — all of those laws of math and science you learned in high school. Biomed techs also exercise their brains by considering logic, applying critical thinking and putting their problem-solving skills to work. Then, they get hands-on to bring it all together.

5. NEVER THE SAME. Every day is a new day in the world of a biomed tech. If variety is the spice of life, then biomed techs are extra spicy! What new advances will challenge you? What new solutions need to be discovered? What problems need to be solved? Which clinician will need your help? What needs to be repaired – preventatively or on the fly in a crisis? Will you work independently or as part of a team? How will you need to adapt?

What will you learn? Bottom line: Biomed techs need to be skilled at

being both proactive and reactive.

The job definitely keeps you on your toes!

6. 21ST CENTURY SKILLS. Think biomed techs just need hard knowledge and a nimble pair of hands?

Think again. Biomed techs need to be empathetic, open-minded and curious self-starters with high personal accountability. Many of the 21st century skills in demand by employers today are also critical to success in biomed.

LinkedIn just released a list of soft skills in demand for 2020 and they include skills critical for biomed techs, such as creativity, adaptability and collaboration. Forbes also created a skills wish list for 2020, which also features critical thinking, tech savviness, flexibility, judgment and emotional intelligence – all essential skills for biomed techs. Personally, I believe a candidate’s soft skills are the primary criteria for hiring.

7. SATISFACTION. There is nothing more rewarding than knowing you’ve made a difference in someone’s day – and, more importantly, you’ve made a difference in someone’s life. Biomed techs empower clinicians to change lives every day, by giving nurses and doctors the essential tools they need to treat patients. Whether it’s a sterilizer, an MRI scanner or a heart-lung bypass machine, making equipment safe and functional for patients is a biomed tech’s #1 priority.

If you want to learn more about the field of biomed – and why being a biomed tech is one of the best jobs in health care – just ask! You can reach me at john.pollard@ii-techknow.com.

For more information, visit ii-techknow.com.

JOHN POLLARD is the Regional Director of Northern California at Tech Knowledge Associates.

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EXPERT ADVICE

ROMAN REVIEW The Curse

BY MANNY ROMAN, CRES

A

s is usually the case, what I write about is brought on by an event that transpires in my daily activities. The topic of this writing is no different.

I have hearing loss due to my Army experience, and to old age of course. I rarely wear hearing aids. I expect that people who know me will compensate for my hearing loss by speaking more loudly and clearly since they are aware of this. Last week, my lovely wife Ruth and I came home from a small socially distanced gathering of neighbors. As we came in the door she said something. I replied with my usual, “What?” Being very sensitive to her feelings, I noticed that she was a little irritated at having to repeat what she said, especially three times. Rather than say “What?” for a fourth time, I said, “You have the curse of hearing.” She has no problem hearing and understanding so she has difficulty accepting that I cannot. This is the curse of hearing.

Let me explain. I have spoken about the curse of knowledge before. This curse essentially states that what we know gets in the way of communication because we just cannot imagine that the other person does not possess the same knowledge.

Even when we are attempting to “teach” that knowledge, the fact that we already know it influences how we present the information. Our presentation is already biased toward the knowledge and we underestimate what is actually required to transfer that knowledge. We overestimate understanding and move on.

In my opinion, the curse of knowledge is actually a two-way street. In one direction, we assign our knowledge onto

others and assume that they understand from our knowledge perspective. If you have ever played charades you understand this very well. As we mime what is obvious to us, we can’t believe that others don’t see what we see. In experiments, one group was assigned to tap out well-known songs and predict the percentage of the other group that would name the song correctly. The tappers guessed that 50% of the guessing group would get it right. The actual correct percentage was 2.5%. The tappers knew the songs so they assigned that knowledge unto the guessers.

The other direction of the curse of knowledge is the curse of lack of knowledge. Not knowing and understanding something limits our ability to sympathize and empathize. As I write this in mid May, the loss of life and economic turbulence caused by the COVID-19 pandemic does not feel real to me. We have been in self-isolation for more than two months. However, we are mostly retired in a “NORC” – a naturally occurring retirement community. The outside world is something that we see and hear about on TV. The suffering that must be occurring in our country is incomprehensible to me because I have not actually experienced it. I can almost believe those who say, “As long as it doesn’t affect me, there is no problem.”

What can we do to better interface and connect with others while we all suffer from the two-way street of the curse of knowledge?

We must acknowledge the existence of this curse in all of us. We must acknowledge that it is in fact a two-way street. We must acknowledge that real communication requires work and attention to details. We must ensure to always

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager

communicate as if we will be misunderstood and we will misunderstand.

I have been in the training business most of my life. A prerequisite for every instructor should always be to know the audience and frame the presentation from the knowledge perspective of that audience. As trainers we were always aware of the need to take our audience from the known to the unknown, not from the unknown to the incomprehensible. Communication is always key and presentation is extremely important to comprehension. If you actually read these things, you know that I often state that there is no communication without feedback. Ask for feedback and demand the opportunity to provide feedback to ensure understanding.

On another note, my hearing loss can also be a blessing. In crowds and loud environments such as restaurants I just nod and smile as if I understand. I may even make a body language gesture of agreement. The speaker will either be satisfied that no more words are needed or frown and move on to someone else leaving me to enjoy my wine.

By the way, I also lost peripheral vision in my right eye due to a detached retina. Ruth often magically appears on my right side and startles me. She also has the curse of appearing.

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BREAKROOM

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911$ Rescue Drone

How one rescuer can outrun a team A new system lets one rescue worker – aided by a hovering stretcher drone – can outperform a rescue group in reaching and moving an accident victim over rough terrain.

Battery pack moves with rescuer, contains sensors

Rescuer can run on rough ground

‘Follow-me’ feature Drone senses motions of the power cable from the battery pack and follows the human’s movements

Eight compact propellers lift drone, fit through narrow spaces

Cable supplies power to motors, steers drone

Speed is crucial Medical care delivered in the first 24 hours after trauma is most likely to save a person’s life

Source: Yunwoo Jeong of Ulsan National Institute of Science and Technology (South Korea) Graphic: Helen Lee McComas, Tribune News Service

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Lights show location as patent is moved

Patient carried fast and stably on dry or wet ground

Safety belts secure patient

Gyroscope keeps stretcher horizontal

Rotors pivot; drone folds

1 2 3 4

Changes shape for storage or putting patient into an ambulance

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BREAKROOM

THE VAULT

D

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

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

JUNE PHOTO

MAY WINNER

Medtronic Atrial pacemaker circa mid 1990s

Tim McClelland, BMET, US Air Force

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2020

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BREAKROOM

BULLETIN BOARD

A

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

Career Opportunities CONTINUING EDUCA TION

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9-10 ecember TEC ber 1-2, D po to c O HNI , 0 -2 x CAL Expe August 19 TM Mixers by MD E rts in S PRO H ieme SPE ns M Augu edic CTS al I st 3-7 magi ng - Tec Siem hnica ens D lP efinit ion A rospects S Cou : rse Beca use Qua lity Matt ers.

Au Augus gust t12 4 -23 - Co-nq RS ues TI:tAd Imvan aging: ced RadiographicUlt Sysras tem oun Ma d inte Basic nan s ce (Phase II)

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CTS ROSPE A L MePdical Imaging C I N H s TEC Siemen s in

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Company: Edge Biomedical ISS Position Title: Edge Servicing Field Biomedical Engineer is hiring a BMET II in the Edison NJ Territory Description:

Onsite field service install, diagnosis, and Description: Edge Biomedical is repair of medical imaging lookingequipment; for a highlyremote motivated Biomedical Equipment troubleshooting capabilities; Technician ability to BMET complete for FieldonService PM imaging work equipment; in the NJ/NY/Philly submit field area . service We are looking reports; communicate for a person with that account enjoys managers different projects and workand staff. working with a nationwide team of Technicians. candidate More info on The howideal to apply here: has hands on experience with medical equipment repair https://bit.ly/ISSCareers and calibration.

More info on how to apply here: http://bit.ly/Edge_jobpost

WWW.1TECHNATION.COM

BREAKROOM

Follow Ben Calibrating!

RIGHT TO REPAIR MedWrench Guru, Tony Cody, Technology Mana gement Director at Banner Health, weighs in on the importanc e of the right to repair movement.

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

I have been fortunate enough to be in a state that is on the other side of the Covid-19 peak. Since the start of the pandemic and the necessary equipment build up at hospitals, I have noticed some of the leaders in the HTM community weigh in on the importance of the right to repair movement.

Read more here: https://bit.ly/MWBlogRightTo Repair

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BC Group International, Inc www.BCGroupStore.com • 314-638-3800

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

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73 www.biomedicalsupportsystems.com • 1-800-290-1345 www.crothall.com • (800) 447-4476

InterMed Group www.intermed1.com • 386-462-5220

Master Medical Equipment MMEMed.com • 866-468-9558

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

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

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

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

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Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010

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

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Computed Tomography Injector Support and Service www.injectorsupport.com • 888-667-1062 JULY 2020

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International X-Ray Brokers internationalxraybrokers.com/ •

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Endoscopy Biomedical Support Systems www.biomedicalsupportsystems.com • 1-800-290-1345

Healthmark Industries HMARK.COM • 800-521-6224

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Multimedical Systems www.multimedicalsystems.com • 888-532-8056

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Gas Monitors Biomedical Repair & Consulting Services, Inc.

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General ALCO Sales & Service Co. www.alcosales.com • 800-323-4282

SalesMaker Carts salesmakercarts.com • 800-821-4140

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Cardiology

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www.maullbiomedicaltraining.com • 440-724-7511

Master Medical Equipment 27

Biomedical Support Systems

Crothall Healthcare Technology Solutions

Maull Biomedical Training

59

Defibrillator

Biomedical ALCO Sales & Service Co.

www.triimaging.com • 855-401-4888

Injector Support and Service

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Infusion Pumps AIV aiv-inc.com • 888-656-0755

Biomedical Support Systems www.biomedicalsupportsystems.com • 1-800-290-1345

Infusion Pump Repair www.infusionpumprepair.com • 855-477-8866

Master Medical Equipment MMEMed.com • 866-468-9558

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

aiv-inc.com • 888-656-0755

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Select BioMedical www.selectpos.com • 866-559-3500

USOC Bio-Medical Services www.usocmedical.com • 855-888-8762

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International X-Ray Brokers internationalxraybrokers.com/ •

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

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multidiagnostic.com • 800-400-4549

Select BioMedical www.selectpos.com • 866-559-3500

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

USOC Bio-Medical Services www.usocmedical.com • 855-888-8762

InterMed Group

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www.intermed1.com • 386-462-5220

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USOC Bio-Medical Services

Monitors/CRTs Ampronix, Inc.

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

Monitors Multi Diagnostic Imaging

Multi Diagnostic Imaging

Biomedical Repair & Consulting Services, Inc.

Mammography Ampronix, Inc.

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Labratory Ozark Biomedical

Innovatus Imaging

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BC Group International, Inc www.BCGroupStore.com • 314-638-3800

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Repair ALCO Sales & Service Co. www.alcosales.com • 800-323-4282

Pronk Technologies, Inc. 27

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ZRG Medical zrgmedical.com • 760-438-8835

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Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010

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

College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027

ECRI Institute www.ecri.org • 1-610-825-6000.

Fluke Biomedical

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Software

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TECHNATION

83

A NEW MEETING

EXPERIENCE The scheduled MD Expo Irvine has been replaced with three (3) smaller, regional HTM Mixers.

Think of them as MD Expo 2.0 – a slightly modified, smaller, shorter-duration, less-crowded and safer-environment event that still provides valuable continuing education, networking and vendor engagement opportunities.

ABOUT

SCHEDULE

We continue to monitor COVID-19 very closely.

This is an unprecedented and fluid situation, and we are planning our future events with the well-being and safety of all as our top priority.

MD Publishing wants to be a leader in restoring conferences to the HTM community.

DAY 1

DAY 2

4-5 PM Association Members Meeting

8-9 AM Breakfast

5-6:30 PM Welcome Reception

9-10:15 AM & 10:45 AM-12 PM Education

We are moving forward with our events in 2020 but in a new, safer format and by supporting state HTM associations.

12-3 PM Exhibit Hall Open, with lunch 3-4:15 PM Education 4:30-6 PM Happy Hour

W W W. H T M M I X E R . C O M

SMALLER. SHORTER. SAFER. TRAVELING IS AS EASY AS...

1

2

3

HTM Mixer COLORADO

HTM Mixer WISCONSIN

HTM Mixer CALIFORNIA

AUGUST 19-20

OCTOBER 1-2

Broomfield, CO (Denver) Omni Interlocken

DECEMBER 9-10

Milwaukee, WI Potawatomi Hotel & Casino

Orange County, CA (Costa Mesa) The Westin South Coast Plaza

A SAFE & CLEAN EXPERIENCE. SAFETY Masks are suggested for participants and staff.

Masks will be provided for any conference participant who needs one.

Daily health screening, including temperature checks for all hotel staff in addition to frequent sanitization of all associate common areas and thorough re-training on proper hygiene and best practices.

CLEANLINESS

FOOD & BEVERAGE

Hand sanitizer stations will be available throughout the event, on the trade show floor and in common areas.

F&B will be provided in a no-contact way (i.e. pre-packaged food, no self-serve buffets, etc).

The hotel will implement increased frequency of sanitization with EPA-certified cleansers that are CDC-compliant of public spaces.

OUTDOOR SPACE

SOCIAL DISTANCING Larger aisle ways with dedicated travel lanes in the trade show to help manage traffic. This will keep attendees from bumping into each other or crowding in certain areas on the trade show floor.

Indoor/outdoor spaces will be used as much as possible for receptions, education sessions and other breakouts during the conference.

Education sessions will be set up to allow for 6’ space between chairs.

W W W. H T M M I X E R . C O M

BREAKROOM

FLASHBACK The spring MD Expo of 2011 was an event like no other. The conference took to the hills of wine country in beautiful Napa, California.

Ve n do rs a n d at t e n d mingle ee s d at re gistra tion .

a his ssion in d his se te n e s . ty re w pre p ro pe r John D on the c ha p e l

toric

R umor ha s

it whe n fello w presente Rom an pres r M anny ented in this sam e room collection ba a sket was pa ssed .

inte ntly to the A captive audienc e liste ns Estate Win e the in held g bein tion presenta ide ben eath hills Cave which is built into the . yard vine e -acr a nine

86

TECHNATION

JULY 2020

e n d ee s an d att Ve n dors tration . at regis mingled

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