TechNation Magazine August 2020

1technation.com

Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

REVIEW OF

AUGUST 2020

Necessary Temporary Easing

HTM STANDARDS

14 Company Showcase

TTG Imaging Solutions LLC

24 Company Showcase Medigate

18 Department of the Month Advocate Christ Medical Center Healthcare Technology Management Department

83 Roman Review

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CONTENTS

FEATURED

56

HE ROUNDTABLE: T ASSET TRACKING TechNation reached out to several companies to find out the latest regarding asset tracking technology and solutions. A variety of companies responded with insights from their in-house experts.

62

REVIEW OF HTM STANDARDS: NECESSARY TEMPORARY EASING There has been activity on standards impacting medical device manufacturers and the HTM community in recent months. There also has been some temporary easing of standards because of the COVID-19 pandemic. ext month’s Feature article: N HTM’s Role in Construction Planning

Next month’s Roundtable article: CMMS

TechNation (Vol. 11, Issue #8) August 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

AUGUST 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

P.28 p.28

p.38 p.40 p.42 p.44

INDUSTRY UPDATES News and Notes: Updates from the HTM Industry Ribbon Cutting: Axial Imaging AAMI Update ECRI Update Welcome to TechNation

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Jennifer Godwin

P.47 p.47 p.48 p.50 p.52

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

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

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

10

P.12 SPOTLIGHT p.12 Professional of the Month: Lillie Oliver, CBET: Lending a Helping Hand p.14 Company Showcase: TTG Imaging Solutions LLC p.18 Department of the Month: Advocate Christ Medical Center Healthcare Technology Management Department p.20 Association of the Month:The Wisconsin

Biomedical Association (WBA) p.24 Company Showcase: Medigate

TECHNATION

AUGUST 2020

Proud supporters of

P.66 EXPERT ADVICE p.66 Career Center p.68 Remote Support: A Cure for Your Equipment

Maintenance Challenges During a Pandemic,

sponsored by Avante Health Solutions p.70 View on Value: Barriers to Change p.72 The Future p.74 20/20 Imaging Insights, sponsored by Innovatus Imaging p.77 Cybersecurity p.78 The Other Side p.80 Proper Risk Scoring is Critical for Medical

Devices, sponsored by Nuvolo p.83 Roman Review P.88 BREAKROOM p.88 Did You Know? p.90 The Vault p.92 MedWrench: Where In The World Is Ben C.? p.98 Flashback p.94 Service Index p.97 Alphabetical Index Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Lillie Oliver, CBET: Lending a Helping Hand

BY K. RICHARD DOUGLAS

L

illie Oliver, CBET, is a GE Healthcare client service technician at Thomas Jefferson University Hospital in Philadelphia. Her first exposure to mechanical and technical concepts came from her dad.

“As a child, my father kept me more to his side with technical and mechanical things; not knowing how this would play a part in my life. At 16, I had my first hospital job as a transportation aide,” Oliver says.

Oliver also worked as a transcriber of cardiologists’ dictations. She knew the hospital was where she wanted to be.

“Later in life, a friend shared how I could combine my hands-on passion and medicine by entering the study of biomedical electronics. That then started my path to become a biomed technician,” Oliver says.

Oliver works in Northeast Philadelphia for GE Healthcare U.S. & Canada Service.

Thomas Jefferson University Hospital is in Center City Philadelphia and shares a campus with Thomas Jefferson University. The main hospital was established in 1825. In addition to the main hospital, the system includes Jefferson Hospital for Neuroscience,

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Jefferson Methodist Hospital, Jefferson at the Navy Yard and Jefferson at Voorhees in South Jersey. There is a total of 908 licensed beds between the facilities.

Oliver obtained her training in the city of brotherly love.

“I attended Community College of Philadelphia and obtained my AAS degree with high honors in electronics technology–biomed option in 1997,” she says.

She began her biomed career as an equipment specialist. Years later, she became a biomedical technician I and then a technician II and then III; as well as a lead tech. She is now a client service technician (CST).

“My specialties are medical ICU, women and children as well as ultrasound,” Oliver says.

SUPPORTING THE SMALLEST PATIENTS Like most resourceful biomeds, Oliver has completed her share of special projects via the use of her unique skill set. One project that she recalls involved helping the tiniest and most vulnerable of patients.

“The one that sticks out the most was being a part of Jefferson’s neonatal ECMO program. A select few of us had the responsibility of building and blood-priming the ECMO machines that provided extended life for neonates,” Oliver says.

“This was a gratifying challenge that kept me sharp in my knowledge of such a lifesaving machine. The patient needed to have their blood pumped outside of the body, oxygenated and then recirculated back into the body. As a biomed tech, it was my responsibility to build the tubing circuits, set the pressures, prime it with blood and assist the nurses, if needed, as the patient was connected to the machine. This has truly made me feel like my job is worth every second of time,” Oliver adds.

She won the C. Delores Tucker volunteer award in 2017.

When not on the job, Oliver enjoys traveling and hiking.

She has been married to her husband, Delroy, for 30 years.

“I have six children; four sons and two daughters (four biological, two adopted), one granddaughter and one dog, Azul,” she says.

When asked, “What would you like the readers of TechNation to know about Lillie Oliver?” she provides a thoughtful reply.

“First, I believe that a great technician is one who is willing to help others, a team player, accepts corrective criticism, is willing to be taught, not afraid to fail, gives their all, plus more; just to mention a few,” Oliver says.

“I’ve worked hard to prove myself as

WWW.1TECHNATION.COM

SPOTLIGHT

FAVORITE BOOK: Bible

FAVORITE MOVIE: James Bond films

FAVORITE FOOD:

Caribbean and Colombian

HIDDEN TALENT: Emcee

FAVORITE PART OF BEING A BIOMED:

Being a significant part of the health care industry. And, seeing the smiles on clinicians’ and others faces knowing that the equipment works properly; thus, making their job a bit easier.

WHAT’S ON MY BENCH? • Computer • Tools • Green tea • Notepad • Cellphone

Oliver working on an ultrasound machine.

a great technician in this predominantly male role. I am a down-toearth person; always willing to lend a helping hand. I care a lot about the well-being of my family and friends. It’s really hard for me to say no,” Oliver says.

Oliver says that she has always been a problem solver and loves putting out fires.

“I am thankful to God for his many blessings both big and small.

As I continue in this thing called life, I pray that I will also continue to keep my customers happy as I service their equipment,” she adds.

She says that she would like to thank her family for their support, her past and present coworkers for helping her become the technician that she is and the clinicians who provide endless care to the patients; her ultimate customers.

It is safe to assume that all of those people would express their gratitude in response as well, especially the neonatal nurses.

Lillie Oliver has a supportive family including, from left to right, daughter Peaches, son James, herself, son Nicolus, husband Delroy, son Dominic, daughter Lorraine and son Daniel.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

AUGUST 2020

TECHNATION

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE TTG Imaging Solutions LLC

T

TG Imaging Solutions LLC. was formed over the past 15 months by blending nine complementary companies into an integrated delivery system specializing in nuclear medicine and molecular imaging services.

Through this consolidation, TTG brought together successful enterprises, management talent and depth in nuclear equipment/parts. The company also combined over 1,200 client sites for equipment service, diagnostic imaging and radiopharmaceutical distribution.

TTG Imaging Solutions LLC President/CEO Jack Tomayko explains that the strength of the ISO-certified company is in its service engineers who are expertly trained, system versatile and responsive to client needs. Additionally, as an integrated business model, TTG Imaging Solutions can offer clients a full menu of services in system sales/ leases, equipment service, technical staffing and radiopharmaceuticals.

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“We have a customer-centric focus and develop customized service and support solutions for our customers,” Tomayko adds. “We have a strong technical and clinical foundation with OEM-trained and certified engineers and a dedicated clinical applications team. We guarantee 24-hour phone support with on-site response within 24 hours – and in some cases – on the same day. You will receive the service commitment and uptime guarantee you deserve with the highest quality service available in the industry.”

The company’s mission is “to maximize customer satisfaction through a relentless pursuit of quality, a broad portfolio of services and a commitment to continuous improvement,” he continues.

Tomayko explains that the TTG Imaging Solutions stresses four factors to provide excellent service to customers: • R esponsiveness: Our employees support a relentless pursuit to

exceed client expectations and strive to be the one and only call our prospective and existing clients need to make.

•Q uality: We share a holistic risk management approach and believe we are the absolute best at delivering quality products and service for our clients so they can focus on what matters most – their patients.

• E fficiency: Our cost-effective programs, products and services – related to the refurbishment process – produce high-quality equipment with unmatched clinical solutions.

•T eamwork: Through a collective effort, our team believes in communication and collaboration to meet our high standards of performance excellence, which provides a quality integrated delivery system for our customers.

The company’s tremendous growth is a testament to the service it provides, but it does not come

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

JACK TOMAYKO PRESIDENT/CEO without some unique challenges.

“The biggest challenge was integrating acquisitions over a short time period into a working organization. Since TTG Imaging Solutions remains acquisitive, the focus will continue to be capitalizing on efficient and effective integrations,” Tomayko says. “The company has made a substantial upgrade in internal management and a consistent communication system. Experience and an organized management team has prepared the company to grow both organically and with strategic acquisitions.”

“The company will focus on organic growth by continuing to sell

quality refurbished nuclear, PET and PET/CT systems, adding on service contracts and hiring top field service engineers to cover a national landscape,” he adds. “TTG Imaging Solutions will also look to develop regions where it can maximize its integrated model of equipment service, staffing and radiopharmaceuticals. The company will still seek to acquire complementary businesses that have the right culture fit and partnerships with firms that enhance TTG’s opportunities in molecular imaging.

It is an exciting time for TTG Imaging Solutions. Tomayko says he is especially excited about its portfolio of services and capabilities.

“We are excited to provide a broad portfolio of hybrid imaging (PET/CT and SPECT/CT) systems that are both new and refurbished. We are the exclusive U.S. source for Mediso Medical Imaging System’s AnyScan S (headquartered in Budapest, Hungary), and are excited to distribute systems for them as they develop new hybrid scanners,” he says.

TTG Imaging Solutions has a corporate office in Pittsburgh, Pennsylvania, with two Centers of Excellence. The SPECT Center of Excellence located in Stokesdale, North Carolina is certified to both ISO 9001 and ISO 13485 international quality standards.

he T individuals who make up TTG Imaging Solutions are the most impressive aspect of the company.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

The in-house engineers and project management team at the SPECT Center of Excellence ensure TTG’s equipment is fully equipped for patient use. The PET and PET/CT Center of Excellence is located in Houston, Texas and is a highly-specialized facility dedicated to the refurbishment and clinical testing of advanced imaging equipment. Its lead-lined bays allow up to four systems to be refurbished and tested simultaneously.

The individuals who make up TTG Imaging Solutions are the most impressive aspect of the company.

“Our service department is composed of 40-plus OEM-trained and certified field service engineers that each average more than 18 years of experience across all OEMs in SPECT, CT, PET, SPECT/CT and PET/CT imaging,” Tomayko shares. “Our applications team has the experience and knowledge to train your staff when introducing a new imaging modality or equipment into your laboratory. We provide our customers with extensive on-site training and continuous clinical applications support with every equipment purchase and service agreement. We strongly believe that training and support are important components in the success of your laboratory.”

For more information, visit TTGImagingSolutions.com.

AUGUST 2020

TECHNATION

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SPOTLIGHT

DEPARTMENT OF THE MONTH Advocate Christ Medical Center Healthcare Technology Management Department

BY K. RICHARD DOUGLAS

T

he global cononavirus SARSCoV2 pandemic and the influx of COVID-19 patients has challenged hospitals and health care systems across the country. The pandemic has also tested the skill sets of healthcare technology management (HTM) professionals and departments as they have supported their clinician colleagues amid these special circumstances.

That call-to-action was experienced by a team of HTM professionals near Chicago, Illinois as Cook County became one of the nation’s hot spots for infections.

The Healthcare Technology Management Department at Advocate Christ Medical Center has 13 BMETs, three radiology service engineers and one multi-site radiation oncology specialist.

Patrick Donohue, CBET, and Freddie Leon, CBET, serve as BMET coordinators and serve as lead technicians. Greg Czajka, CBET, is the site manager and is

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supported by Multi-Site Director Joe Carli.

“The scope of our department is all clinical equipment support needs, including input on capital purchases and projects involving medical equipment with a top focus on safety,” Czajka says.

Czajka says that each team member brings a specialty to the table.

“I have four people that work in a shop located in the surgery department that primarily focus on servicing surgery and similar departments like endoscopy and PACU. Damian Lesnicki, Jose Hernandez, Tyler Morgan and Bobby Mejia specialize in anesthesia, perfusion and video integration,” he says.

Czajka says that Donohue and Leon specialize in ventilators and service the adult and pediatric respiratory departments in addition to their coordinator roles.

“With a site as large as Christ, we have dozens of Philips PIIC servers for monitoring and telemetry, so there are

several techs that are trained to service and configure those systems including Mohammad Hammoudeh. Hammoudeh has also been trained to service our balloon pumps. Colleen Kaufmann’s specialty lies in our children’s hospital and pediatrics departments,” Czajka explains.

He says that Becker Gholeh and Ryan Struble primarily manage the extensive fleet of BD infusion pumps and the sterile processing department while Leo Davalos and Ruben Cervantes maintain dialysis, CRRT and EKG carts.

Randy Ozminkowski, Dave Simpson and Adam Mazur make up the imaging team and cover all imaging modalities including MRI, CT, X-ray, nuclear medicine, cath lab and mammography.

Czajka says that Chris Monteverde serves as a multi-site LINAC engineer and specializes on the Clinac and Truebeam systems. Edwin Vasser, CBET, manages the system’s numerous off-site clinics.

The team supports Christ hospital, numerous clinics, two off-site imaging

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SPOTLIGHT

facilities and an off-site mammography site. Christ Medical Center is one of Advocate Aurora’s largest sites with 749 beds.

EPIC ACHIEVEMENT WHILE SUPPORTING COVID PATIENTS In conjunction with preparing the hospital for an influx of COVID patients, the team also has tackled the big job of transitioning its EMR platform.

“Most recently, HTM has been heavily involved with two major projects – planning for the surge due to COVID-19 and preparing the equipment for our migration from Cerner to Epic as the new electronic medical record system,” Czajka says.

“The COVID surge planning involved redistributing our monitors from non-acute areas to ICUs, effectively doubling our ICU capacity in many areas.

As with other hospitals over the past few months, elective and non-urgent procedures were deferred to accommodate the incoming COVID patients and to promote the safety of our team members by social distancing where possible. The HTM team moved dozens of monitors in a very short timeframe to the ICU rooms and configured them on the network so

Leo Davalos and Ruben Cervantes check a piece of equipment.

that the patient data flowed seamlessly into the EMR. The speed and accuracy of the team doing that was nothing short of amazing,” Czajka says.

He says that while COVID patients are still prevalent at Christ, they are seeing an encouraging decline, which has allowed the team to focus more efforts on the Epic integration.

“This includes installing devices on the walls in some departments and on some equipment such as ventilators and anesthesia machines that will allow the devices to automatically feed their data into the new EMR. This will mean less manual charting from the clinical staff so that they can spend more time caring for the patients,” Czajka says.

Czajka says that when they began to see a surge in COVID patients that required ventilators, it was quickly discovered that access to the ventilator controls was a pain point for clinicians because they had to don and doff PPE very often to make adjustments.

“We found a way to disconnect the monitor and controls from the ventilator and mount it to an IV pole outside the room, so they could make adjustments without going into a COVID room. This was a big satisfier for the clinical staff and it saved the hospital on PPE usage,” he says.

Czajka also says that during the epidemic, the HTM team was asked by nursing leaders to assist with adding a second bedside monitor to ICU rooms for the surge of COVID patients that they were seeing.

“Because of the Philips licensing restrictions that we experience at Christ, the HTM team had to get creative. That meant we had no bedside sectors for the monitors to land on for patient viewing at the nurse’s station and we had no spare monitors to distribute. Since our outpatient procedures and surgeries were put on hold, we utilized the bedside monitors and licensing from those central stations from the outpatient building to increase our ICU beds in the East Tower building,” Czajka says.

He says that after the ICUs were doubled, they were still seeing an increase

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

of COVID patients.

“We were asked by nursing for more monitoring capabilities. With the help of Philips, HTM corporate, HIT corporate and local HIT we were able to utilize our sister hospital Advocate South Suburban Hospital’s Philips primary server to increase our telemetry capacity in which we added an additional 48 telemetry sectors,” Czajka explains.

“It was then decided, by the state of Illinois, that Advocate Christ Medical Center would be the primary hospital in Illinois to treat COVID ECMO patients,” Czajka adds.

He says that they were then asked by nursing leaders to double up 15 out of the 20 ICU rooms.

“Using the available licensing from our sister hospital, we added a fully functional central station for the staff to view and monitor our patients in the department,” Czajka says.

He says that it would not have been possible without the help of Building Operations, HIT and Clinical Informatics.

“Awesome partnership,” Czajka says.

Away from the workplace, the team remains active in learning and the HTM community.

“We have a strong presence in the local Clinical Engineering Association of Illinois (CEAI). This organization promotes the HTM field and has members from many of the hospitals in the Chicagoland region,” Czajka says.

Czajka currently serves as the treasurer for the CEAI. He says that the organization holds quarterly chapter meetings and an annual conference at Drury Lane in Oak Brook, Illinois.

During a national health crisis, the HTM team at Advocate Christ Medical Center has shown the resourcefulness and value of a team of biomeds as they assisted clinicians and patients. Their efforts helped save lives, conserve important PPE and protect clinicians. All the while, they were overhauling the EMR platform and integration.

The team has shown that while 2020 is a year of challenges, it is also a year of achievements.

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SPOTLIGHT

The Wisconsin Biomed Association offers fun and educational events for members to attend.

ASSOCIATION OF THE MONTH The Wisconsin Biomedical Association (WBA)

BY K. RICHARD DOUGLAS

T

he state of Wisconsin is known for the Green Bay Packers as well as its cheese, dairy farms, beer and bratwurst. It is also a source for cranberries, high-end bicycles, yachts and flags.

The northern Midwest state is also home to many leading health care facilities and legions of biomeds.

For many years, the HTM professionals in the state were served by the Biomedical Associations of Wisconsin (BAW), which was established in 1984.

Starting last year, the organization became the Wisconsin Biomedical Association (WBA).

The board of the current organization includes Board Members Mitch VonRuden, Sheri Scudieri and Mike Smith. Leadership also includes Secretary Ron Robenhorst and Treasurer Melissa Wilke.

The origins of the predecessor organization and its founder are part of the story of HTM. “Jim Kipp was a pioneer at Marshfield Clinic in biomedical electronics, before it was even a recognized profes-

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sion. With the help of many clinic physicians, Jim learned how to apply his extensive electronics background to the medical environment. Jim was designing and building many bio-electronic devices that are now commonly manufactured. Some of Jim’s work included perfusion pumps and various nerve stimulators,” Wilke says.

She says that early on, Kipp recognized the importance of AAMI certification. He was among the first 50 to earn that distinction, and later was named to a seat on the AAMI Advisory Board.

“When the Western Wisconsin Technical College (WWTC) contemplated an educational program in biomedical technology they called on Jim – he had become an authority – to guide them in their curriculum development.

Jim always remained involved with WWTC as a program advisor. His passion for the field did not stop there,” Wilke says.

She says that to promote the profession further yet, he invited regional technicians and others with interest to join his new group. From this, the Biomedical Associations of Wisconsin

(BAW) was formed.

Wilke says that the BAW continued to grow over the years.

“Under the BAW, five regional associations were established. Each year, one of the five regions hosted the annual symposium. As the BAW evolved, the pioneers of the organization began to settle into retirement. They passed the torch down to a new generation of technicians in a field now known as HTM,” she says.

“Seen as an opportunity for a fresh start, a new name was chosen. To honor the namesake and those who founded the BAW, it was decided by statewide members to rearrange the letters of the BAW acronym. The new name would be the Wisconsin Biomedical Association (WBA),” Wilke explains.

The group keeps the membership up to date via the Internet.

“Currently, we hold monthly web conference board meetings open to all WBA members. This inclusive meeting keeps all members up to date as we are developing and structuring our organization. Board members are then encouraged to communicate these details at their regional meetings and

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SPOTLIGHT

bring back ideas from their region to the board meetings,” Wilke says.

To pass along the opportunity for a career in HTM to those in training, the organization offers a scholarship program.

“The WBA is carrying on the tradition of an annual golf outing where all proceeds support our scholarship program. This year the golf outing will be held at Shamrock Heights on Friday, July 24,” Wilke says.

Education is often a central focus of a biomed association. WBA also supports other projects as part of its mission.

“As our group continues to define our goals, we have found a common passion to support the biomed industry as a global initiative. Our vision is to create a resource and help send technicians on mission trips,” Wilke, who recently participated in a mission trip to Guatemala, says.

Another way to help the biomed community is to offer expertise and experience to local technical and college programs for biomeds.

“We have a long-standing relationship with the faculty of the biomedical

electronics program, now known as the HTM program, offered at Western Technical College (WTC) in La Crosse, Wisconsin,” Wilke says.

She says that many WBA members are graduates of this program.

“Many have since sat on the advisory board for WTC. A connection with Northeast Wisconsin Technical College (NWTC) was established with the inception of their biomedical electronics program in 2016. The instructor of the program, Don Cormier, has also been a long-standing member of the BAW and now the WBA,” Wilke says.

NEW NAME AND SPECIAL EVENT Under the old organization, the group held an annual conference and vendor show. With the restructuring of the organization, one of the chapters took on the task in 2019.

“In lieu of the new WBA hosting a 2019 event, local WBA chapter Eastern Wisconsin Biomedical Association (EWBA), hosted a symposium at NWTC. The event included various education tracks and a packed vendor show,” Wilke says.

An annual golf tournament is one fun WBA networking event.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

She says that highlights of the symposium were roundtable discussions that offered topics including women in HTM and today’s HTM department challenges.

“As the WBA, we are very excited to have the opportunity to partner with TechNation to host our first HTM Mixer in Milwaukee, Wisconsin,” Wilke says.

She says that this special event will be the WBA’s first organized event.

The HTM Mixer will happen on October 1-2, 2020 and include two days of networking, education and fun.

The member meeting will be held on October 1 from 4-5 p.m. It will be followed by a welcome reception.

Friday, October 2 will start out with a continental breakfast from 7:30-8:30 a.m., followed by exhibitor set-up from 8-11:45, concurrent with educational sessions from 8:30 to 11:45 a.m.

Lunch will be served at noon along with the opening of the exhibition hall.

There will be another round of educational sessions from 3-4:15 p.m. and then a Happy Hour from 5-7 p.m.

The HTM Mixer should be a welcome break for those who have been anxious to rub elbows with friends and colleagues once again. For details, visit HTMmixer.com.

The state known for cheese, dairy farms and the Green Bay Packers also offers HTM professionals tremendous opportunity. A new name and a new style of conference will allow the WBA to find a real silver lining in 2020.

As Hall of Fame Green Bay Packer Coach Vince Lombardi once said, “Individual commitment to a group effort – that is what makes a team work, a company work, a society work, a civilization work.”

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COMPANY SHOWCASE Get the Most Out of Your Clinical Assets

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ecent events have shown us just how critical good asset management is to the ongoing operations of healthcare delivery organizations everywhere. When the World Health Organization (WHO) put out a surge calculator to help governments and health care providers estimate the essential supplies they need to respond to the current pandemic of COVID-19, that was only a piece of the preparation process. The potentially harder part for many hospitals was taking those requirements and measuring them against their own inventory to identify shortfalls and needs.

LACK OF VISIBILITY CAUSES PROBLEMS AND INEFFICIENCIES The reality is that many health care

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providers don’t have the real-time visibility they need into their connected medical devices to know exactly what they have. And it is certainly a challenge for them to accurately pinpoint where each of these devices is located and how frequently they are being used. This lack of up-todate information at their fingertips can create confusion and chaos, as hospitals have to rely on best guesses and scramble to pull diagnostic and biomedical equipment together to meet needs.

This has been the case for some time now. It is not uncommon for an organization to dedicate time and money to conducting manual inventories of their facilities, with people going room by room, floor by floor,

building by building to document what devices are where. But as we know, since devices are moved around constantly, the moment that inventory is done, it is out of date.

Plus, these inventories are often incomplete, lacking details around embedded software and protocols in use that can be important when assessing vulnerabilities and making preventative maintenance decisions.

WHY MEDICAL DEVICE VISIBILITY IS SO DIFFICULT TO ACHIEVE Typical discovery techniques used to detect and profile general IT equipment don’t usually work for medical devices. One of the reasons is medical devices are typically closed systems, using proprietary operating systems

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SPOTLIGHT

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Medigate Labs has invested in documenting medical protocols and mapping clinical workflows to build out the largest, most complete medical device database in the industry. and protocols, which traditional security solutions don’t understand.

They also tend to be more fragile, with smaller computational power and simpler designs than standard IT equipment (e.g. servers and computers), so typical discovery techniques could end up stressing their processing units and disrupting their functionality. Since medical devices can be directly involved in delivering patient care, any disruption could put patients at risk.

Without prior knowledge of the device’s system architecture and standard workflows, general purpose discovery and profiling solutions can end up doing more harm than good.

As a result, traditional solutions deployed to monitor and protect hospital networks can only offer very high-level information on the medical devices in the environment. For example, they may be able to tell there is a device connecting, but they can’t tell whether it is an IV pump or an MRI machine, and they certainly can’t tell what model or app version it’s using or whether its activity is normal or potentially malicious.

But Medigate can.

Medigate Labs has invested in documenting medical protocols and mapping clinical workflows to build out the largest, most complete medical device database in the industry. As a result, Medigate can provide hospitals the details they need, including: the manufacturer, make, model, protocols, embedded software, and workflows (clinical-context) of each device, as well as its location and utilization, to make better procurement, management and maintenance decisions.

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PURPOSE BUILT ASSET MANAGEMENT PLATFORM FOR MEDICAL DEVICES Medigate developed its device security and asset management platform to address the specific problems medical devices represent for healthcare delivery organizations.

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NEWS & NOTES

Updates from the HTM Industry INDUSTRY MOURNS DEATH OF ‘GREAT CLINICAL ENGINEER’ “It is with heavy heart that we announce the loss of one of the great clinical engineers of our time, George Panagiotopoulos,” is how the American College of Clinical Engineering (ACCE) newsletter delivered the news.

Panagiotopoulos died Sunday, May 24, 2020 – just a few weeks after celebrating his 60th birthday. He is survived by his wife, Dimetra, children Alexandra and Antonio, mother Magdalini, sister Alexandra, sister-inlaw Angela, brother-in-law Michele, Kosta, and Kip, aunts, cousins, nieces and nephews in the San Francisco Area and Greece, and countless close friends and colleagues. What a gaping hole we feel for losing such a humble, valuable, and gifted son, brother, husband, father, uncle, cousin, friend and colleague.

“We will always remember George for his calm demeanor, positive attitude, his passion for the clinical engineering profession, his great analytical mind, and his wealth of wisdom,” ACCE shared. “George started his career in banking working for Charles Schwab, but soon after he jumped into Clinical Engineering and found his calling. He worked for Kaiser Permanente in different positions regionally in Northern California, and the last few years nationally.”

He was an active member of American College of Clinical Engineering, he was a past board member, helped with different advanced clinical engineering workshops and presented at sympo-

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siums/conferences on behalf of ACCE. An online obituary states, “George was a treasure to everyone that knew him. He was humble, compassionate and selfless. He channeled this innate goodness, along with his eternal curiosity and brilliant mind, to innovate and use new technologies to empower mankind.”

He worked for over 30 years in biomedical and clinical engineering. In his early career at Kaiser Permanente, he and two colleagues pioneered web-based access to clinical data. More recently, Panagiotopoulos held multiple leadership roles in Kaiser’s Permanente clinical technology organization.

He took an early medical retirement two years ago after receiving a “devastating diagnosis.”

“But he was not someone to do nothing. He focused on family and friends and deepened already strong relationships. He lived for experiences, winning cooking competitions with his wife, teaching his son to sail the bay, and advising his eldest on her college and career choices. Throughout all this, he remained active in his professional life by partnering with the many healthcare IT leaders he knew to start a new telehealth and biometric data company, AdaptivMD,” the obituary states.

Andrew Ulvenes, vice president clinical technology and device cyber security at Kaiser Permanente, shared the news on LinkedIn.

“As you may have heard earlier this week, we lost our clinical technology colleague George Panagiotopoulos.

George passed away Sunday, May 24, 2020,” he wrote.

“For those who worked with George at Kaiser Permanete, you know how special he was and how much he brought to the table. George held multiple leadership roles in Kaiser Permanente’s clinical technology organization where he has left an indelible and lasting imprint. We are sad to lose our colleague and friend and will miss him dearly,” Ulvenes adds. “To honor his memory and to keep his spirit alive with us forever, Kaiser Permanente, Clinical Technology has announced a new recognition. We are happy to let you all know that we will now have the George Panagiotopoulos Kaiser Permanente Clinical Technology Award. This award and recognition will be awarded annually and we’ll choose one Clinical Technology employee who exemplifies and embodies the behaviors that George so eloquently displayed. George had a positive spirit and an extreme passion for his work; he had deep expertise and was considered an expert in clinical technology; he took time to treat everyone with dignity and respect regardless of who you were, how busy he was and whatever else seemed to be a priority. To keep George with us in spirit and mind, we will recognize ClinTech employees who embody his spirit.” •

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INDUSTRY UPDATES

THE WORLD MOVES FAST. WE MOVE FASTER.™

626 ACQUIRES INNOVATUS CR AND DR BUSINESS ASSETS 626 Holdings LLC has announced the acquisition of the CR and DR business of Innovatus Imaging.

“While COVID-19 was a devastating event for the U.S., the world and our industry, it did provide an opportunity to appreciate and continue to grow our business. The work of our FSEs (closing in on 100) during the crisis was as impressive as the loyalty our customers showed us during this period,” 626 CEO Philip Revien said. “As we looked at areas of growth in a post-crisis space, we used the time to add the CR and DR business of Innovatus. This will be a great addition to our already successful Walsh Imaging portfolio. It provides a national reach to our established radiology service businesses in the eastern U.S. and we are thrilled with the customer alignment.”

“We are uniquely positioned to grow this business and we are eager to add a team of highly talented and soon-to-be versatile engineers from Innovatus. We are very humbled by our consistent growth and success,” Revien added.

“We are confident we can leverage this business and it

provides a great platform for other ISOs and hospitals that need this modality serviced, to look to 626/Walsh/ISS for not only CR and DR service, but for all of the solutions we can provide in the space” added Michael Fischer, CFO, 626.

“Innovatus made this move to better prepare us to grow our core businesses. We selected a partner that would take great care of our customers and would be a long-term, successful home for our engineers servicing this market … who better than 626?” stated Dave Johnson, CEO at Innovatus.

626’s purchase of Walsh Imaging two years ago, ISS in late 2019 and the Innovatus CR-DR business, follows their approach to base acquisitions on what matters most to them; family fit and customer need. This method has proven to be successful as they were able to double Walsh Imaging’s business within two years and they have already begun to scale the ISS business. We plan to do the same with the Innovatus CR-DR business. This family keeps getting bigger … and better. •

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INDUSTRY UPDATES

ALTHEA BECOMES AUTHORIZED DISTRIBUTOR OF UVD ROBOTS Althea has become an authorized distributor of UVD Robots in Tennessee, Kentucky, Ohio and Michigan.

“UVD Robots is the first autonomous ultraviolet robot designed to disinfect surfaces. Through its state-ofthe-art capability, the UVD Robot allows for quick and effective disinfection. The system is 99.99% effective at killing bacteria and can cover a standard size room within 10 minutes. The UVD Robot is used as part of the regular cleaning cycle and aims at preventing and reducing the spread of infectious diseases, virus, bacteria, and other types of harmful organic microor-

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ganisms in the environment by breaking down their DNA-structure. The robot is safe, reliable and eliminates human error,” according to a press release.

It is user friendly and is designed to be operated by every-day cleaning staff.

“It is important to reiterate that the UVD Robot’s reputation as a highly effective asset in the fight to reduce infections, comes as a result of six years intensive research, design, development, and testing by a leading, industry-recognized, award-winning organization Blue Ocean Robotics, as well as the Danish Healthcare Authority supported by leading Danish microbiologists and

hygiene specialists from Odense University Hospital,” the release states.

“UVD Robots has proven effective in multiple settings such as hospitals, clinics, universities, factories, fitness facilities, airports, stadiums and anywhere large groups of people congregate. This system allows companies both in and outside of the health care sphere a solution to bringing their staff, customers and students back together safely. We are now accepting requests for site visits and robot demonstrations to see how our new offering may assist its potential customers in achieving their disinfecting goals,” the release adds. •

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INDUSTRY UPDATES

INNOVATUS IMAGING ADDS NEW GENERAL MANAGER, LAUNCHES VIRTUAL CLASSROOM Innovatus Imaging recently added Les Edsall as the company’s director of quality and regulatory and general manager of Pittsburgh MRI Coil Center of Excellence.

Edsall will be responsible for continuous improvement of existing ISO 13485:2016 quality systems, regulatory clearances and compliance and coordination of corporate quality and regulatory activities for all Innovatus Imaging Centers of Excellence as well as operations in Pittsburgh for MRI coil repair.

Edsall comes to Innovatus with over 25 years of experience in quality and regulatory with Philips Healthcare, Philips Respironics, Bayer Pharmaceuticals, Abbott Laboratories and other organizations. He holds a Six Sigma master black belt and Malcolm Baldridge National Quality award.

Innovatus Imaging CEO Dave Johnson states, “The addition of Les Edsall to Innovatus Imaging will take our organization to yet another unparalleled level of quality, compliance and conformance. We are thrilled have him join the team.”

Innovatus Imaging also recently launched Innovatus University, a virtual classroom designed to provide live webinars relative to product services offered by the company.

Classes range from basic to advanced topics for ultrasound probes, MRI coils, and more. The company also partners with local and regional HTM organizations to host virtual meetings for their members. Also new is Innovatus University On-The-Road where Innovatus industry experts provide consulting services and in-person training for healthcare and HTM professionals. “Innovatus University was founded on the principles that students, healthcare staff, and HTM professionals are best served through live, hands-on, experiences in the real world, in real time, to more fully understand the critical nature and equipment issues associated with managing imaging devices which is essential to treating patients. Although videos and prerecorded webinars are available, sessions are designed to be live so that attendees can maximize their experience.”, states Ted Lucidi, CBET. •

COME GROW WITH US

Build Your Career at Crothall Healthcare Technology Solutions Career opportunities abound when you are part of a growing Team. Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years. With growth comes new jobs and new opportunities.

Come see why Crothall has earned Modern Healthcare’s Best Places to Work six years in a row.

ISN’T IT TIME FOR YOU TO FIND OUT MORE? Come grow with us. Please contact: Glenn Garrett Talent Acquisition Recruiter Glenn.garrett@compass-usa.com

For more information, visit innovatusimaging.com/innovatusuniversity.

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INDUSTRY UPDATES

MASTER MEDICAL EQUIPMENT, RENEW BIOMEDICAL HELP AMID PANDEMIC “When New York City Mayor Bill de Blasio ended up on the phone with me, it really hit home at that moment that this was not a politicized event and we were in a true emergency,” said Master Medical Equipment and ReNew Biomedical Co-Owner and President Mark Taylor.

“Around March 12, calls started pouring in – specifically from early virus hotspots like New York City and areas around New Orleans,” said Taylor.

“Overnight, we went from receiving approximately 2-3 requests for new ventilators a week to hundreds of orders per day!”

Taylor also said this did not include the number of frantic calls the company, and he directly, received regarding out of service ventilators needing immediate service to be recertified and moved to frontline locations.

“I specifically remember receiving a phone call at 10:30 p.m. on a Saturday night from a hospital CEO in Alabama.

His smaller community hospital was overrun with early COVID-19 patients and they were desperate for ventilators and the necessary IV pumps to facilitate the vent use,” Taylor said.

Since mid-March, the pace has not

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slowed down at MME or ReNew Biomedical, who are sister-companies – housed in the same building headed by Taylor.

Taylor mentioned, “Our team went from 10 mph to 100 mph literally overnight. For weeks, our full team pulled together, working 15-hour days, seven days a week.”

And that same team, even working 100-hour weeks, was full of ingenuity – figuring out ways to do things better, faster and more efficiently than ever.

“On March 24, the FDA issued an Emergency Use Authorization (EUA), modifying how medical devices, specifically ventilators, are approved for sale and resale. This really opened the door for different ideas and supplies for the repair of ventilators on our ReNew side,” said Taylor. “It also initiated some community partnerships for us that the Jackson Chamber connected us with.”

As a member of the Board of Directors for the Jackson Chamber, Taylor knew that the Jackson Chamber could, and should, be a resource for MME and ReNew during this time.

“Our ReNew team had some great ideas on how to expedite repairs to

ventilators with the issued EUA, but lacked either the components or engineering capabilities. The Jackson Chamber was an incredible resource for us, matching us up with local facilities like Teknor Apex, Toyota Bodine and Henderson Stamping for assistance,” said Taylor.

“We’ve called it ‘MacGyvering,’ ” Taylor said, describing their process for repairing and testing medical devices sent in for refurbishing.

Traditional “test lungs,” designed to test individual ventilators to ensure their functionality, were backordered – including new units and spare parts.

Additionally, traditional test lungs test only one unit at a time.

“Our diverse ReNew team, which has backgrounds in the armed forces, large hospital systems, and manufacturing, figured out how to use Teknor Apex hoses and a very specific size latex glove to replicate the resistance of the test lung,” mentioned Taylor. “With this creativity and ingenuity, we can now test up to 40 ventilator units at a time!”

This ingenuity helped MME and ReNew to fill order numbers all over the country in record time. While new devices can have months long back-

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INDUSTRY UPDATES orders, by using the new systems they have developed, the team has been able to receive, repair, test and ship out 80 ventilator units to Tennessee Emergency Management Agency (TEMA) in less than a week. And now, as the pandemic continues across the world, MME and ReNew continue to fill these orders – repairing and shipping certified and usable units internationally to other countries including Brazil, Argentina and Italy.

All of the resourcefulness and long hours for Taylor’s team has, understandably, taken its toll.

“We’ve had several team members become very emotional about the whole situation,” Taylor explained. “But as they’ve heard the stories and even fielded some phone calls themselves from customers and heard the emotion and thankfulness in their voices, they’ve all had a feeling of satisfaction and really a sense of relief that we can actually do something about this global

situation. We have a renewed sense of pride in ReNew!” Through this entire explosion of sales, repairs and service, Taylor said that there is nowhere that he would rather Master Medical Equipment and ReNew Biomedical be located than Jackson, Tennessee.

“Jackson is really a shining star in the Volunteer State,” said Taylor.

“Many people don’t realize that Jackson’s location directly on I-40, about halfway between Nashville and Memphis, is within a day’s drive of 76% of the U.S. population. FedEx and UPS hubs are close. We can get anything, anywhere, very quickly.”

“We are so thankful for our community and how they have helped us succeed during this time,” said Taylor. “Places like Teknor Apex, Toyota Bodine, Henderson Stamping, our local Jackson Chamber, and people like Lyn Tisdale at West Tennessee Healthcare, Tim Chapman, hose

technical manager at Teknor Apex, and Kyle Spurgeon at the Jackson Chamber.

We’ve done our best to give back a bit during this time by doing things like supporting local businesses – ordering lunch in for our employees every day from local restaurants during this busy time.”

One thing that Taylor said he hopes will come from this situation is that the value of biomedical technology and technologists will truly be understood.

“The bulk of the current biomed technologist population is beginning to age out,” Taylor explained. “There is a huge need for vocational training in this area and this pandemic has really shed a light on that. Besides the armed forces, there are only a few places to be trained.

We hope that Master Medical Equipment and ReNew BioMedical can be a leader in training for the future.” • For more information, visit mmemed.com or renewbiomedical.com.

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INDUSTRY UPDATES

MEDICAL EQUIPMENT MAINTENANCE MARKET WORTH $47.49 BILLION BY 2023 Based on a MarketsandMarkets report, the medical equipment maintenance market is expected to reach $47.4 billion by 2023 from $28.9 billion in 2018, at a CAGR of 10.4% during the forecast period. The growth of this market is mainly driven by the growth in associated equipment markets, rising focus on preventive medical equipment maintenance, adoption of innovative funding mechanism, and the growing purchase of refurbished medical equipment.

Based on the type of service provider, the medical equipment maintenance market is segmented into original equipment manufacturers (OEMs), independent service organizations (ISOs) and in-house maintenance. In 2017, the ISOs segment is expected to grow at the highest CAGR during the forecast period market, primarily due to their advantages, such as better

expertise in handling different brands of equipment as opposed to OEMs and the lower cost of services.

The market for private-sector organizations is expected to grow at the highest CAGR in the medical equipment maintenance market during the forecast period.

On the basis of end user, the medical equipment maintenance market is segmented into public-sector organizations and private-sector organizations. In 2018, private-sector organizations are expected to register the highest CAGR during the forecast period. The increasing number of public-private partnerships is expected to boost the demand for medical equipment maintenance services.

North America is expected to lead the medical equipment maintenance market in 2023. •

MEDIGATE LAUNCHES PROTECTION SOLUTION FOR CLINICAL DATA CENTERS, NETWORKS Medigate recently announced the Medigate Healthcare Protection Solution powered by Dell Technologies. The Medigate collaboration with Dell Technologies and VMware provides hospitals and health care organizations with enhanced visibility into their clinical data centers to uncover network vulnerabilities and then protect against security threats.

Today’s health care organizations face a growing security threat due to the rising number of devices connecting to their networks. According to KLAS Research, 36% of CIOs and CISOs are not confident in their medical device security due to a lack of inventory and asset management. Medigate’s collaboration with Dell Technologies and VMware provides hospitals the visibility into their networks to identify individual connected devices and then implement threat prevention and protection to reduce risks and ensure patient safety when connected to devices. The solution also provides advanced insights into device utilization to reduce overall maintenance costs.

“In teaming up with Dell Technologies and VMware, we are providing hospitals and health care systems with the integrated security capabilities they need to protect their increasingly connected networks. Our integrated solution will

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mitigate threats while allowing for the delivery of uninterrupted, high-quality patient care,” said Jonathan Langer, CEO of Medigate. “Medigate is committed to collaborating with industry-leading security firms to bring a unified set of solutions and services that address current and future needs of all healthcare organizations.”

Combining Medigate’s visibility and clinical expertise with server and security technologies from Dell Technologies and VMware’s zero-trust enforcement and micro segmentation capabilities for software-defined networks gives health care organizations a single cybersecurity solution that enables effective protection for clinical data centers, according to a press release.

“Cybersecurity solutions are more critical than ever within hospital environments as the rise of digital health care expands the number of devices that access protected health information,” said David DeAngelis, general manager, healthcare, Dell Technologies. “Our Dell EMC PowerEdge server technology, in collaboration with Medigate, enables hospitals to help create and enforce clinically vetted security policies from their data center, to the edge, to protect their patient data and operations.” •

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CYNERIO NAMED A LEADER IN CONNECTED MEDICAL DEVICE SECURITY EVALUATION Cynerio has been named a leader and received among the highest scores in the current offering and strategy categories in “The Forrester New Wave: Connected Medical Device Security, Q2 2020,” released on June 11 by Forrester Research, a leading global research and advisory firm. The New Wave report is designed to help Forrester Research clients understand which vendors they should consider in an emerging technology or services market.

The report evaluated eight vendors on a comprehensive set of criteria. In addition to being named a leader, Cynerio received a differentiated rating, the highest rating possible, in seven out of 10 criteria, the most out of the evaluated vendors, including Analytics and Reporting, Attack Response, Device Visibility, Vulnerability Management, Integrations, Vision and Roadmap.

Cynerio takes a medical-first, risk-based approach to cybersecurity and asset management to serve top-tier health care organizations with the tools and actionable insights needed to meet the unique and fast-evolving challenges of securing medical and IoT devices against current and future threats. The Cynerio platform provides full visibility into connected devices, including profiling and location, along with accurate anomaly detection and continuous risk analysis to prevent data theft, service disruption, and compliance violations.

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According to Forrester, Cynerio “leads with comprehensive threat analytics and clinical insight” and is “best for companies that value technical flexibility.” The report also states that “Cynerio offers strong insight into medical device activity and correlations between device telemetry, clinical workflow, and external threat feeds,” and that the company’s “UI is also one of the easiest to navigate.”

According to customer references cited in the report, “Device auto-segmentation was frequently cited as a useful feature of the product,” one customer commented, “Things that used to take weeks for our team to find and analyze, using Cynerio it only takes minutes to a day, comparatively no time at all.”

“We are humbled to be recognized by Forrester for our solution and customer endorsements. Being recognized today motivates us even more to continue developing solutions that help hospitals navigate the increasingly complex world of healthcare IoT security,” said Leon Lerman, CEO and co-founder of Cynerio. “Health care organizations are especially vulnerable during this pandemic and we are fully committed to providing them with the technologies, strategies, and support they need to safeguard business integrity and keep their focus on patient care.” •

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SOLUTIONS

SUMMIT IMAGING RESPONDS TO PHILIPS LAWSUIT

LAURA HAFNER JOINS TRI-IMAGING SOLUTIONS

Summit Imaging’s response to a lawsuit filed by Philips last October denies all accusations and asks the judge to dismiss the suit.

In the filing, Philips alleged that Summit built software designed to hack into its ultrasound and other devices to circumnavigate access controls that regulate how the hardware can be used.

“For 13 years, Summit Imaging has been a trusted and valued partner of thousands of North American health care providers. The patented technology and other intellectual property we have developed over many years are specifically focused on providing exceptional customer satisfaction and improving patient outcomes,” Summit Imaging CEO Lawrence Nguyen said. “Properly leveraging technology to enable health care providers to deliver their medical services in a financially viable form should be the goal of every service provider in this industry. Disturbing companies like Summit Imaging is anti-competitive and adverse to the needs of health care providers and the patients they seek to serve.”

When asked why Summit’s approach should not be considered “hacking” Nguyen said, “As a technology-enabled service provider, Summit Imaging has developed resources that enable our customers to service medical imaging equipment they own. The general lack of information and tools available to service this equipment is a problem that our solutions, including our patented technology, were developed to solve. As stated in our response to the lawsuit, Summit Imaging’s actions do not violate the intellectual property laws and Summit Imaging intends to defend itself vigorously in this regard.” •

Tri-Imaging Solutions has announced that Laura Hafner has joined the company as vice president of sales and marketing. In her new role, Hafner will be responsible for the leadership of the sales team, developing new business opportunities and creating customized solutions for customers.

“Laura’s leadership skills, creativity and customer centric mentality will further strengthen Tri-Imaging’s ability to deliver innovative imaging solutions for our customers,” said Wanda Legate, partner at Tri-Imaging. “As Laura steps into my former role, my focus will shift toward broader business development activities and operations.”

Prior to joining Tri-Imaging, Hafner held various sales and marketing leadership roles with the Dunlee division of Philips Healthcare and Varex Imaging (formerly Varian Medical Systems). With both Dunlee and Varex, she was instrumental in helping the businesses reach sales goals and introduce new and innovative products to the market.

Most recently, Hafner was self-employed, running her own marketing and strategy consulting business – Grove Integrated Marketing. At Grove, she was able to utilize her 15-plus years of medical imaging experience to support many clients in the industry.

“My work at Grove enabled me the opportunity to begin working with the Tri-Imaging team on marketing and branding initiatives many months ago as a consultant. I’m thrilled to now be able to continue this work as a full-time member of this talented team,” Hafner said. “Tri-Imaging has some exciting new products that we plan to bring to our customers very soon.”

“We are making a strategic effort to bring more talent onto our leadership team,” said Eric Wright, a partner at Tri-Imaging. “With Laura’s help, we are confident that we can meet our customers’ demands and our growth targets. We couldn’t be more thrilled to welcome her to the Tri-Imaging team.”

For more information, Summit’s filing can be found online at tinyurl.com/SummitCounter.

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RIBBON CUTTING Axial Imaging

BY ERIN REGISTER

S

cott Anderson and Scott Young met over 20 years ago when they began their industry careers at ReMedPar. After starting as a customer service representative, Young later moved into managing inside sales, logistics and inventory departments at both small and large companies.

After leaving the U.S. Army in 1997, Anderson started his career in the medical field as a bench repair tech on GE 9800 CT scanners for ReMedPar. His career spans from in-house engineer to field engineer to trainer. After seeing a need for helping customers cut costs and needing help with service himself, Anderson and two others started CT Resources in 2005, which eventually merged with AllParts Medical.

“Those of us who have been in this field for several years can relate to this being more of a lifestyle more than just a job or career,” said Anderson. “In 2019, I tried retirement for a second time. After almost a year, I still found myself giving tech support and agreeing to occasional on-site training and realized I missed the personal satisfaction of helping a customer get a system back up and running.”

During this time period, Young was contemplating a career change and made a decision to take some time away from the workplace. Eventually, Anderson and Young came to the realization that they still wanted to be involved in the industry.

“We both enjoyed working in an

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environment that has a direct impact on patient care, and by combining our skill sets, we can focus on satisfying our customer’s needs,” stated Anderson.

Q: WHAT IS THE MAIN FOCUS OF AXIAL IMAGING? A: Our focus is to be the best at what we do. We want our customers to know we will go the extra mile to get the job done. Customer service is our passion and motivation; all of the other services seem to fall in place when that’s your focus.

Q: WHAT ARE SOME OF THE SERVICES AXIAL IMAGING OFFERS? A: In simple terms, we want to be a helping hand to independent service organizations (ISOs) and in-house groups. We are here to serve with parts, technical support, onsite support and training and almost anything else our customers want, such as system installations and de-installs.

Q: HOW DOES AXIAL IMAGING STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Over the past 10 years, our industry has seen many changes with smaller companies being purchased by larger organizations and new businesses entering the market with the end goal of acquisition. Axial Imaging is a small, veteran-owned company with the sole goal of providing exceptional service to our customers.

A couple of weeks ago, I had a customer call me around 6:00 one evening. They had a system that had

Scott Anderson Training and Service, Axial Imaging been down a couple of days, and I remembered running into the same unique problem about 10 years ago. I drove three hours to the site, and we were able to get the system back up and scanning that night. This not only allowed the center to take care of its patients the next day, but it also allowed the field service engineer to gain some in-depth troubleshooting experience.

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT AXIAL IMAGING TO ACHIEVE IN THE NEAR FUTURE? A: While growth is necessary in order to continue to meet the needs of our customers, our plans are for Axial Imaging to remain a small company. One of the best lessons we have learned over the years is the importance of hiring employees whose ideals meet those of the company, providing them with optimal training and giving them the ability to have ownership in the decisions they make for our customers.

For more information about Axial Imaging, visit www.axialimaging.com.

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AAMI UPDATE

BY AAMI

AAMI PRESIDENT ROB JENSEN THANKS COMMUNITY FOR COVID-19 RESPONSE There are times in life when the words “thank you” are not enough. I am grateful to our AAMI community members’ caring and noble actions making such a profound difference during the COVID-19 pandemic. Every part of the health technology ecosystem Rob Jensen is president has answered the call. While the examand CEO of AAMI. ples are numerous and significant, I’ve listed just a handful below.

Medical device manufacturers have leaned into higher rates of production and distribution, and some have even shared their engineering drawings for ventilators publicly in an altruistic action to bootstrap additional production.

Subject-matter experts in ventilators and respirators from clinical organizations, manufacturers, and the Food and Drug Administration have developed reports and guidance documents in a matter of days – not years or months – which AAMI has published to further diffuse this critical information.

Healthcare technology management and sterilization professionals across the entire health spectrum have shared knowledge and resources for ensuring critical equipment is functional, safe and available, many participating on AAMI Connect, virtual town hall events and social media. Companies new to the AAMI community have partnered with manufacturers and venture capitalists to produce much-needed personal protective equipment and identify locations of greatest need for their distribution at no cost to the end-user.

I would be remiss to not publicly thank AAMI’s extraordinary volunteers and staff members and include them among the heroes of this community. They have been pushed well beyond their comfort zones and normal operational tempo to assist those in need. There is no doubt this community is very special. When presented with critical, life-threatening needs, the AAMI community has responded across individual and organizational boundaries to improve, over everything else, patient safety and treatment.

It is admittedly inadequate – but thank you so much for all you do.

AAMI HTM LEADERSHIP GROUPS WELCOME MEMBERS AAMI has appointed new members and offers a thank-you to members exiting their roles on the Technology Management Council (TMC) and the Healthcare Technology Leadership Committee (HTLC).

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HEALTHCARE TECHNOLOGY LEADERSHIP COMMITTEE AAMI’s HTLC is an advisory committee of healthcare technology management (HTM) thought leaders who work with AAMI’s vice president of HTM to advance and support the HTM field. This group seeks to develop the next generation of HTM leaders by nurturing leadership skills among HTM professionals and advancing the professional interests of HTM managers.

New HTLC members for 2020 are: • Christopher Jones, a biomedical computed tomography specialist at Johns Hopkins Bayview Medical Center in Baltimore, Maryland.

• Kelvin Knight, director of biomedical engineering at Children’s Hospital of Alabama in Birmingham, Alabama.

• Mark Manning, division chair of HTM at the Mayo Clinic in Rochester, Minnesota.

• Mike Powers, clinical engineering quality manager at Christiana Care Health in Newark, Delaware.

TECHNOLOGY MANAGEMENT COUNCIL AAMI’s TMC is an advisory committee of HTM thought leaders who work with AAMI to advance and support the field. It represents the interests of biomedical equipment technicians (BMETs), clinical engineers and other HTM professionals.

Priorities for the TMC include strengthening the HTM field by finding creative ways to promote HTM careers, developing materials to highlight HTM as a desirable profession to students and young professionals, creating education programs to develop the existing workforce and producing resources to promote best practices.

New TMC members for 2020 include: • Rebecca Crossley, BMET specialist at the University of Pittsburg Medical Center, Williamsport, in Jersey Shore, Pennsylvania.

• James Linton, AAMIF, professor and coordinator for biomedical engineering technology at St. Clair College in Belle River, Ontario, Canada.

• Barbara Maguire, vice president of quality and Geisinger HTM at ISS Solutions in Westfield, New Jersey.

PAUL KELLEY, TMC FOUNDING MEMBER, REFLECTS ON HIS WORK Paul Kelley, director of biomedical engineering, the Green Initiative, and Asset Redeployment at Washington Hospital in Fremont, California, is exiting the TMC chair position this year. Kelley, an AAMI Fellow, is the longest serving member of the TMC and was instrumental in its founding in 2004.

Council projects Kelley said he is particularly proud of

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include establishing HTM Week, which had its start in the TMC, as well as developing the HTM In a Box presentation and recruitment tool and helping to coin the term HTM. Kelley urges new TMC members to “get active, do things that you think are beyond your skill level and get involved with projects that are unfamiliar.”

“I am the last charter member of this group and cannot begin to mention the number of outstanding people I have met through this council,” shared Kelley. “I am proud to have been part of it for so long and I’m very happy to leave it in such good hands.”

AAMI LAUNCHES ONLINE SUMMER LEARNING SERIES AAMI has launched an interactive, online Summer Learning Series with 36 educational sessions designed to tackle many of the biggest topics facing health technology, sterilization and regulations.

“The entire health technology community has been impacted by COVID-19, including the cancellation of

in-person educational opportunities, such as the AAMI Exchange. The AAMI Summer Learning Series pulls together key speakers and topic areas to ensure professionals from all areas of health technology can get quality education and training from the comfort and safety of their home,” said MJ McLaughlin, director of education programming at AAMI. Each custom track offers four to six sessions that can be watched live or streamed later. Tracks in the AAMI Summer Learning Series include: • Cybersecurity (June 15 to July 20) • Healthcare Technology Management (June 19 to July 15) • Regulatory/Accreditation (July 10 to July 31) • Professional Development (July 22 to August 26) • AI and Augmented/Virtual Reality (July 27 to August 6) • Sterilization (August 10 to August 31) • Internet of Things (IoT) (August 21 to September 11) For more information and to register for the AAMI Summer Learning Series, visit www.aami.org/SummerLearning.

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ECRI UPDATE

Cleaning & Disinfection Practices – A Key Element in COVID-19 Facility Recovery Efforts

P

atients need to be confident that they will encounter a safe, disinfected environment when they arrive for care and throughout their stay.

Providing patients with that assurance requires proactive steps to prevent the spread of disease, particularly as facilities transition from COVID-19 crisis mode to normal operations conducted in the presence of the SARS-CoV-2 virus. In other words, cleaning and disinfection (C&D) practices will be central to recovery efforts.

ECRI’S TIPS FOR EFFECTIVE C&D Failure to properly disinfect contaminated areas and equipment can have widespread consequences, endangering patients and staff. Following are some of ECRI’s key recommendations for preventing such harm. To learn more, check out the nonprofit organization’s webcast “SARS-CoV-2 Disinfection: Killing the Spread,” available at: https:// www.ecri.org/landing-covid-19-killingthe-spread/.

CONSIDER CONTAINMENT AND COHORTING During outbreaks, consider setting up COVID-specific units, wings or hallways where COVID patients will be cared for by teams of cohorted health care personnel (HCP), including respiratory therapists, nurses, physicians and environmental services (EVS) staff.

Grouping infected patients, potentially exposed individuals and potentially contaminated equipment within a defined area can help limit the spread, and it can help ease the logistics associated with C&D.

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PROVIDE APPROPRIATE PPE AND RESTRICT ROOM ENTRY Staff entering the room of a suspected or confirmed COVID-19 patient – for patient care, cleaning or any other purpose – should use the same personal protective equipment (PPE) as that required for routine care of such patients. Typically, this will mean donning a facemask, face shield, isolation gown and gloves. If an aerosol-generating procedure (AGP) is to be performed, an N95 or higher level respirator should be worn in place of a facemask, and only essential personnel should be present in the room.

To limit exposure to COVID-19 patients and to conserve PPE, facilities may wish to assign routine C&D of high-touch surfaces to nurses who will already be in the room providing care to the patient. This prevents EVS staff from having to don PPE and enter the room for this purpose.

Requirements are different for terminal C&D, which is a more thorough cleaning that is performed by EVS staff after a patient has been discharged (or the room otherwise has been vacated). If an AGP had been performed in the room, staff must first allow sufficient time to elapse for potentially infectious aerosols to be removed by the air handling system.

Then, they may enter the room wearing an isolation gown and gloves as PPE. A facemask and eye protection should also be worn if the selected cleaners and disinfectants require it or if splashes/sprays during C&D are anticipated.

UPDATE YOUR POLICIES AND PROCEDURES – AND CHECKLISTS Review and update existing facility policies and procedures, including checklists, to verify compliance with CDC’s current COVID-19 infection prevention and control (IPC) guidance.

If C&D is to be performed by staff who are less familiar with these tasks, training in C&D processes and the use of an appropriate checklist are critical to ensure that steps aren’t missed. ECRI has created a checklist that you can use for routine C&D of suspected or confirmed COVID-19 patient rooms.

(See the webcast link above.)

“Education and training are needed,” notes Jim Davis, a senior infection prevention & patient safety analyst at ECRI. “But they only go so far.

Simulation in-situ and real-time auditing and feedback (within a just culture) is the whole package.”

PERFORM BOTH CLEANING AND DISINFECTION, EVEN WHEN USING ADJUNCT TECHNOLOGIES The terms cleaning and disinfection are often used interchangeably, but they are two separate processes. Cleaning is the removing of soil. Disinfection is the killing of germs left behind. Both steps are needed: soil that remains on a surface can shield microorganisms from the disinfectant, rendering disinfection ineffective.

“That’s true even if adjunct disinfection technologies are to be used,” adds Amanda Sivek, Principal Project Engineer 1 in ECRI’s device evaluation group. Technologies such as UV light, hydrogen peroxide vapor or chemical

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fogging can provide an added level of protection. “But only if the surfaces are first manually cleaned and disinfected,” warns Sivek. “Adjunct technologies shouldn’t be viewed as short cuts or time savers. Their use will add to the room turnaround time, not decrease it.”

SELECT APPROPRIATE DISINFECTANTS Successfully disinfecting surfaces that have been contaminated with the SARS-CoV-2 virus requires the use of an antimicrobial product that has been found to be effective against it. EPA has developed a list of products that meet this criterion. List N, as it is called, includes the product name, its active ingredients and the contact time required to kill the virus. (See: https://www.epa. gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19.)

See that the low-level disinfectants you’ll be using appear on EPA’s List N. You’ll also need to verify that the disinfectants are approved for use by the medical device or equipment manufacturer.

PRE-POSITION C&D SUPPLIES Provide all needed C&D materials at or near the point-of-care. These include cleaning products, disinfectant (diluted per product label instructions, if

applicable), water, containers and clean or new cloths/sponges/wipes.

KNOW THE “WET TIME” To achieve disinfection, disinfectants must remain in contact with surfaces for a specified period of time, referred to as the contact time, kill time or wet time.

The amount of time depends on the composition of the disinfectant and will be specified on the product label. It may be as little as 15 seconds or as long as 15 minutes. Users may need to rewipe the surface if it dries too quickly.

Checklists should specify that the disinfectant should be reapplied as needed to keep the surface visibly wet for the contact time.

TOWARD A NEW PREPAREDNESS The term “new normal” is used a lot these days, but it’s not a favorite of ECRI’s Jim Davis. “It’s like saying we’re willing to accept subpar levels of supplies like PPE and disinfectants; and we’re willing to tolerate situations where workers of all types are not able to protect themselves.” Instead, Davis advocates for a “new preparedness,” where lessons learned from SARSCoV-2 lead to policies and practices that ensure the availability of the supplies

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that staff need to maintain clean, sanitary and safe care areas and workplaces.

More resilient inventory management practices will be essential for that new preparedness. To help facilities source key supplies, ECRI has provided the health care community access to many of its proprietary resources throughout the early stages of the pandemic. These include ECRI’s functional equivalence data for PPE and other categories of supplies, as well as guidance documents describing measures to mitigate device or supply shortages and to safely implement COVID-driven changes in practices.

This article is adapted from multiple resources that ECRI developed to help healthcare personnel conduct effective cleaning and disinfection of patient care areas. These and many additional resources are available through ECRI’s COVID-19 Resource Center, a free public resource to help hospitals protect healthcare workers and patients during the COVID-19 pandemic. Access that site at www.ecri.org/ coronavirus-covid-19-outbreak-preparednesscenter. To learn more about ECRI’s technology decision support solutions, visit https://www.ecri. org/solutions/technology-decision-support, or contact ECRI at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

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INDUSTRY UPDATES

NEW ADVERTISERS:

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TECHNATION COMMUNITY! VIZZIA TECHNOLOGIES Q: TELL US ABOUT YOUR COMPANY. A: Vizzia Technologies is a leading provider of fully managed Real-time Location Systems (RTLS), helping hospitals cut costs, streamline complicated processes, and improve patient care. The company was founded 15 years ago, with a mission to help healthcare organizations improve their operational efficiency and patient care, through the sensible use of our technology and process improvement expertise.

Vizzia’s award winning software platform provides real-time, actionable data and process visibility that improves enterprise efficiencies, and seamlessly integrates with industry-leading RTLS, CMMS and EHR systems. Our healthcare technology solutions include: Asset Management; Contact Tracing; Environmental Monitoring; Hand Hygiene Compliance; and Patient Workflow. We also operate an IoT Lab in collaboration with a top engineering university, which

serves as an objective testing ground to independently evaluate emerging sensor technologies.

Today, the company proudly Andrew Halasz serves many Founder & CEO healthcare systems nationwide and Vizzia is recognized as one of America’s fastest-growing private companies by Inc. magazine.

Q: WHAT IS ONE QUALITY THAT DIFFERENTIATES YOUR COMPANY? A: We are a “fully managed” service provider, working onsite, collaboratively with our customers continuously throughout the engagement. We focus on partnering with our clients all the way from: reviewing business objectives; recommending process improvements, site survey; technology selection;

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installation; reporting; and ongoing maintenance to ensure optimal efficiencies.

As an additional unique feature, the company has an IoT lab located onsite at the University of New Mexico, where we test and validate location based technologies for clinical applications. This agnostic approach allows us to confidently match the best technology with our customers’ processes, budget and desired outcomes.

Vizzia’s robust managed service offering is unique and highly valued by our customers, which has positioned us as an industry thought leader and trusted service provider. This business model has served Vizzia and our customers well over 15 years, saving hospitals millions in reduced rental costs, lost equipment, staff efficiencies and increased patient workflows. • For more information, visit vizziatech.com.

TTG IMAGING SOLUTIONS, LLC Q: TELL US ABOUT YOUR COMPANY? A: TTG Imaging Solutions, headquartered in Pittsburgh, PA, was formed over the past 15 months by blending 9 complementary companies into an integrated delivery system specializing in nuclear medicine and molecular imaging services. Through this consolidation, TTG brought together successful enterprises, management talent, and depth in nuclear equipment, service, and parts.

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company is in its 40+ OEM certified service engineers who are expertly trained, system versatile, and responsive to client needs. Additionally, as an integrated business model, TTG Imaging Solutions can offer clients a full menu of services in system sales/leases, equipment service, technical staffing, and radiopharmaceuticals. •

John R. Tomayko, Ph.D. President/CEO

For more information, visit ttgimagingsolutions.com.

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Don’t Let Your Medical Devices Fall Victim to Cyber Attacks With the proliferation of smart, connected clinical devices, HTM teams are entering uncharted territory when it comes to Cyber Security risks.

Take Control with Nuvolo • Maintain an accurate inventory for all connected devices (IP/MAC address, current software version, patch levels, etc.)

• Proactively identify all devices requiring urgent security patch updates • Integrate with leading security monitoring solutions like Medigate, Asimily, CyberMDX, Ordr, and Zingbox • Generate remediation work orders automatically for all affected devices

To learn more about our Cyber Security solution for connected clinical devices, contact us at sales@nuvolo.com or visit us at nuvolo.com.

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THE BENCH

TOOLS OF THE TRADE Pelican

Dayventure Tumblers

P

elican Products recently expanded its lineup of rugged-and-ready tumblers specially designed to withstand the rigors of a busy HTM professional’s day. The new Pelican Dayventure Tumblers are available in three sizes (10-, 16- and 22-ounce) and five colors. These drinkware options feature extreme heat and cold retention, so coffee stays hot and ice water stays cold. Plus, they are guaranteed for a lifetime. Pelican’s Dayventure Tumblers fit 99% of all car cup holders. The Tritan insulated leak-proof locking lid keeps liquids safely inside, while the 18/8 pro grade stainless steel is vacuum-sealed and double-walled to withstand the regular bumps and drops of the workday. The sweat-proof powder finish, ergonomic design and built-in loop for easy backpack attachment means this tumbler looks good and feels good to the touch.

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THE BENCH

SHOP TALK POWERED BY SIEMENS ARCADIS VARIC

PURITAN BENNETT 840

Q:

Q:

What causes the computer to hibernate immediately when finished booting up and how do I solve this problem? In this case, the BIOS battery is healthy and it looks like the Syngo boots and counts and shows examination, patient registration ready and then goes to hibernate. I tried to turn on the computer and it’s the same, it goes to hibernate.

A:

I suspect the BIOS battery had a bad day and the remote power option has been corrupted/changed. On a few occasions the BIOS battery is not completely exhausted and it does strange things to the BIOS settings. During boot, select F2 or DEL to access BIOS. If you are not asked for a password, you can be sure the BIOS battery is the problem. If you remove the battery when powered-off all settings will be lost, if you have a BIOS disk then it’s easy to correct after replacing the BIOS battery. FYI: You must follow the BIOS install instructions exactly as written. If your PC is M450/M460 there is a new BIOS Version ‘E’ as I recall it has an updated install manager.

We’ve got Puritan Bennett 840 from Japan. Can anyone help to give guidance on how to change the language to English? Soldering/desoldering is not problem, but we do not know where to search for the corresponding chips.

A:

Language change is only possible with software

AGFA CR 30-X

Q:

Can anyone please provide the service log in username and password for the AGFA service configuration tool?

I have CRService and Agsrvc2ls for the PC user login but this doesn’t gain full service access for motor stall calibration.

A:

Input only the password on the service client.

FRESENIUS MULTIFILTRATE

A:

Q:

A:

A:

If the BIOS settings are lost due to a battery change Syngo will not start. You may get a “software cannot be found” or “system disk not found” message.

Very odd if the BIOS battery is good. Can you double check that the remote power open is turned on? Did this issue start on its own without any service interaction?

You could check the cart power on/off switch assembly, the power switch when pressed starts the hibernation function via software. Also have you done a FULL shutdown via browser? The software after 15 hibernations (I think) will display a message about doing a full shutdown. This cleans up some Windows temp folders.

A:

If you look at the circuit diagram M50/D50 Power supply.

On the right hand side, you will see the DVP3 board (in the PC) and X4 Site-On connections. The D50 K14 contact and green LED (D27) gives the “On” signal to the PC and to Hibernate when the system is shutdown normally from the “Off” switch. Can you check the D27 LED & X4 to DVP board?

Please can someone assist me on how to locate the setting parameters to change the language of a Fresenius multiFiltrate machine?

You must first enter the service menu. The system must be turned off via I/O. The power switch on the rear of the system must be turned on. Press and hold the Start/Reset key. Simultaneously press the I/O until the yellow status indicator lights up.

5.2.2 Selecting the Language Use the rotary selector to select the desired language and press OK. Turn off the system via the I/O key immediately thereafter. Once again turn on the system via the I/O key and restart the Service program.

Reply: Yes, I did all the above, but to progress to use the rotary selector to select the language, I need to enter a service password. That’s where I am stuck.

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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BIOMED 101

Integration is Not Only Technical: Kaiser Permanente’s Keys to Success

BY ANTHONY J. CORONADO

F

or the past 20 years, the HTM community has been dedicated in supporting the conversion of patient health information into electronic health information. The interconnection between medical devices and electronic health records helped health care organizations improve patient care by connecting different medical device modalities to diagnose patients faster, share medical history between caregivers and develop health trends that can be populated into a patient portal. In order to have a successful and compliant clinical engineering department, technical integration activities would have to be a high priority for patient flow within a health care facility today.

There is also another form of integration that is just as important: organic integration. Kaiser Permanente has perfected this form of organic integration that results in a healthy network of team members with a shared vision of success.

The integration of personnel, teams and departments can be just as complicated as designing a technical integration plan. The relationship between management and labor staff can be the difference between a high- and low-performing department. Also, the management of skill sets between team members is essential to develop an effective service delivery plan for a clinical engineering department within a medical center.

Kaiser Permanente has established tools that help with this type of integration

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by establishing unit-based teams (UBTs) to provide direction, a structured framework and motivational approach to allow departments to be efficient and effective.

THE CHALLENGE In all labor orientated organizations, effectively managing individuals to result in positive outcomes is always a huge challenge. Kaiser Permanente recognized this and established the innovative approach of the UBT in 2005 and it was written into Kaiser Permanente’s National Agreement with the partnering labor unions. The objective was to change the roles of union members and managers to create an environment that thinks critically about surfacing issues. This strategy allowed local departments to become more cohesive and work with other departments within a whole medical center on issues that have a wide range affect. The medical center can then share their experiences with other medical centers within their region to standardize their practices and solve common issues. This allows their region to share their successes within the complete Kaiser Permanente system and establish “Best Practice” approaches to their national patient care delivery plan. In essence, an innovative integration plan.

ORGANIC MIDDLEWARE Like Middleware components in a technical integration plan, a UBT serves as that purpose and it can then be integrated with other unit-based teams

developed by other departments within a health care organization. Kaiser Permanente has over 3,500 unit-based teams that are improving health care and promoting their vision. All unitbased team members are oriented to the partnership within the first 120 days of hire. They are provided with continuous education in business literacy, metrics and measurements, and improvement methodology. The training provides each team member with an understanding of the strategy within their own department’s unit-based team and within the whole organization’s mission for patient care. This form of personnel organization is just as innovative as any technical integration plan.

Unit-based teams are structured with a Charter that is approved by all team members. The Charter defines the member roles/assignments, project formation tools/trackers, and other written techniques to help team members integrate within their departments. There are two co-leads for each UBT, and they are represented by one management and one labor team member. Unit-based teams meet monthly, follow a comprehensive detailed agenda, and communicate meeting minutes with all team members.

Projects are formulated during these meetings to improve performance and solve issues within a department. UBTs can also be combined with other UBTs from other departments to solve issues that might have an impact on multiple departments. All decisions made within the teams must have the required

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THE BENCH Pictured are (top row from left to right) Michael Harlani, Mauricio Suastegui, Anthony J. Coronado, Yusuf Wasi, Alain Luque, (bottom row from left to right) Raul Lopez, Jeff Hernandez, James Cho, Milton Cortez, Po Chung, Lee Dean, Brandon Bittle and Garry Bezart.

consensus indicated in the Charter and one of the focal points is encouraging each team member to contribute to the team.

ing useful life of medical devices, and cybersecurity initiatives. The overall goal is what Kaiser Permanente calls “One KP.”

THE CLINICAL TECHNOLOGY EXAMPLE An example of a project established in a Clinical Technology UBT is limiting the amount of Unable to Locate (UTL) equipment during preventive maintenance cycles. At Kaiser Permanente we know that this is not just a clinical engineering issue, but rather a multidisciplinary issue that includes each department that owns the medical devices. A goal is established for only 1 percent of the units due for preventive maintenance be put into UTL managed status. Unit-based team representatives for each corresponding department will meet during a combined meeting to obtain clear directions and provide input to reach the goal. Progress trends will be observed in a Project Tracker and the integration of departments will be established. Once the UBT Project Plan was initiated at several Kaiser Permanente Medical Centers, there was an immediate impact on the lowering of ULT percentage. Some examples of other Clinical Engineering projects that can be used in this format include reducing cost on consumables, extend-

THE BIG PICTURE Kaiser Permanente’s “One KP” initiative provides the next step in this form of organic integration. One KP was established with the patient or member’s interest in mind by improving the patient care experience. One KP also evolved into an employee satisfaction initiative by allowing Kaiser Permanente employees to have a voice within the organization, a way to recognize their achievements, and provide the tools to help them in their daily activities.

Managers are required to perform “Direct Rounding” with their employees on a monthly basis, which consists of one-on-one meetings that focus employee’s outlook on department improvement. This promotes the interaction of departments and aligning each team member with the overall mission and vision of Kaiser. This big picture can be viewed as the portal for UBTs that connects each department to form a multidisciplinary mindset.

THE OUTCOME When it comes to technical integration

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

for a clinical engineering department, the activities necessary to help an organization operate effectively include the utilization and connection of different types of medical devices. In order to accomplish this, technical plans and diverse forms of engineering must be integrated to formulate a secure efficient network. Organic integration assures that various personnel modalities or departments throughout the medical center are also integrated to ensure the organization operates effectively. Using framework established in a unit-based team and with the mindset of “One KP,” a healthy network of team members can be established.

The combination of technical and organic integration plans can allow hospitals and clinical technology departments to flourish in all aspects.

Performance improvement, compliance, team building and other department attributes will have a structured plan that involves all members’ input.

Technology is great and constantly evolving, but the integration of the personnel behind the technology places health care organizations in a position to thrive. An effective team can be compared to an effective IT network.

The integration of multiple systems, communication between different departments and the integrity of information shared is key for a healthy network. Kaiser Permanente believes that both forms of integration are essential to our mission of excellence and every plan requires individuals that are integrated in the network of care.

Anthony J Coronado, MBA, is Area Clinical Technology Manager, Kaiser Permanente, Baldwin Park and West Los Angeles Medical Centers. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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WEBINAR WEDNESDAY

New Attendee Record Set STAFF REPORT

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he wildly popular Webinar Wednesday Series from TechNation continues to provide topnotch education and valuable ACI-approved credits to HTM professionals in the United States and worldwide.

The most recent sessions included a variety of topics and one set a new record high for attendees. Also, more than 6,000 registrations were logged before the end of June.

NIBP TESTING BEST PRACTICES The June 10 session “NIBP Testing Best Practices” achieved the highest registration and attendance numbers for 2020.

The Fluke-sponsored webinar resulted in 696 registrations and 424 attendees for the live presentation. A recording of the webinar is available for on-demand viewing at WebinarWednesday.Live.

The 60-minute webinar featured Jerry Zion, global training manager at Fluke Biomedical. Zion discussed NIBP Testing Best Practices. The webinar provided attendees the opportunity to achieve the following: • Learn the intended use of NIBP measurement • Understand the technology and function of traditional and new innovation NIBP • Learn the difference between testing accuracy and testing repeatability • Learn the legal metrology for calibrating NIBP Every attendee was a winner thanks to the valuable information contained in the presentation, but a couple of lucky attendees also won a prize. Carol Burke

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of Kimball, Utah won a Webinar Wednesday T-shirt and Doug Fletcher of Spectrum Healthcare, Michigan won a gift card.

Attendees provided feedback via a post-webinar survey that included the question “How would you describe Webinar Wednesday to your colleagues?”

“Great information for the novice and experienced tech alike. Always learn something new, and replace legend with facts, and reinforce good practices,” Biomedical Technician Analyst D. Fletcher said.

“A great way to keep up with the HTM industry and a great way to earn CEUs,” Clinical Engineer J. Wilkolak shared.

“This was one of the most educational ones I have attended,” stated Lead Biomed R. Naranjo.

“Best online learning platform for healthcare technology management professionals,” Senior BMET S. Nadupparambath said.

“I always learn something that helps with my day to day. The mention of using a stethoscope by the clinician to verify the vitals monitor is an excellent example of what I learn from different folks in the biomed industry. Great idea and well presented,” said L. Shelman, BMET III. “This webinar series is the most valuable resource for the HTM field. We learn new techniques, standard, testing methods, and etc. through this webinar series. You should not miss any single one if you want to be one of the best in your team,” T. Koh, MET, said.

“Very informative on the methods of

blood pressure measurement and what steps to take during planned maintenance,” said B. Pierce, CBET 5 Team Lead.

“An excellent way to learn more about the medical devices field from the perspective of an actual medical devices company,” said M. Ferdinez, student.

“Valuable information shared with a mindfulness to reach BMETs of various backgrounds and experience,” said Clinical Engineering Manager J. Higgins.

“Awesome training and refresher,” said C. Hardenstein, BMET. MEDICAL DEVICE RISK SCORING The presentation “Don’t Take Risks With Medical Device Risk Scoring” made 255 individual eligible to receive 1 credit from the ACI. The webinar, sponsored by Nuvolo, pushed Webinar Wednesday past the 5,000 mark for registration in 2020!

In the webinar, HTM-industry experts Matt Baretich, PE, PhD, and Carol Davis-Smith, CCE, FACCE, AAMIF, discussed the need for an industry-wide methodology to accurately determine the risk of medical devices.

Determining the risk a medical device poses to patients or staff should it malfunction is not only a regulatory requirement. However, it can be used to determine work order prioritization, hazard alert response, AEM eligibility and equipment replacement needs.

With so many medical equipment management plan decisions being based on this important safety metric, it’s necessary for HTM organizations to use a risk scoring method that accurately

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THE BENCH determines risk at a point in time as it tracks changes in risk over time.

The presenters also discussed the need for organizations to standardize how they determine risk so that there is a universal understanding of the safety implications of classes of devices, and improved ability to audit and benchmark.

The winner of a Webinar Wednesday T-shirt given away during the live webinar was Scott Gillett of Baylor, Scott & White in Texas. Another lucky attendee, Kevin Davis of ERD LLC, won a gift card.

The 255 attendees provided feedback via a post-webinar survey that included the question, “How will today’s webinar help you improve in your role?”

“It was interesting to get a different take on risk scoring,” said M. Hoffman, CBET. “We are migrating to a new CMMS right now. This will help me assess the way we’ve been assigning risk to devices and decide if we should do something new,” Clinical Engineer M. Van Donsil said.

“I agree that we need to be constantly evaluating all equipment for current risk assessment levels. Many merits, as mentioned, are still based on a 30-yearold system. We need to rethink potential risk and hazards on not only the older machines, but the newer technology that is constantly changing is very important. The presentation was an eye opener for sure, and I liked the simple format used as an example that we all can use. I personally feel that if we do not step up that things will eventually bite us,” said B. Hayes, CBET III. “It will provide a good introductory resource to help explain our AEM and risk assessment policies to team members,” said J. Walsh, operations manager.

“It is very important that everyone in our industry stays up to date with ever-evolving guidelines, standards and best practices. This webinar covered some key elements regarding risk and AEM programs,” Owner/BMET K. Davis said.

“It gave me a better understanding of the challenges that HTM faces, and the

logic that is used regarding risk factors and PM completion rates,” said H. Tucker, principal FES Technical Services.

“Puts many things in perspective as related to risk assessing our medical equipment. I always enjoy hearing the visionary perspective of Matt and Carol. They have a way to find gems that I can take back and apply in my position,” Clinical Engineering Director G. Schneider said.

STREAMLINED PREVENTATIVE MAINTENANCE PROCESSES The presentation “Cutting Through the Clutter: Improving Patient Safety Through Streamlined Preventative Maintenance Processes” was eligible for 1 credit from the ACI. The session was presented by Travis Horstman, CBET, CCAF, and sponsored by oneSOURCE Document Site.

Horstman, a biomedical advisor at oneSOURCE Document Site, shared how utilizing new technologies and products can reduce variation. He also discussed how it can increase efficiency while improving the quality of work and the safety of patients. He explained how oneSOURCE Document Site can be an important part of the clinical engineering department.

The webinar was popular with 168 attendees for the live presentation.

Attendees had the opportunity to win prizes. Brett Hayes of Lafayette General Orthopedic Hospital in Louisiana won an Amazon gift card. The winner of a Webinar Wednesday T-shirt was Stanley Strzalkowski of Charles Rivers Laboratories in Michigan. A recording of the webinar is available online where HTM professionals from around the world can view the complete presentation.

Attendees shared feedback regarding the webinar via a survey which included the question, “How useful was the information presented in today’s webinar?”

“Streamlined PM is important. I didn’t realize 30% of critical incidents were attributed to equipment failure,” Biomedical Technician T. Smith said.

“Great, we’ve set-up the same type of database for our system, but without the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

bells and whistles,” Senior Biomedical Electronics Specialist P. Lindquist said.

“The information was relevant in today’s challenging technology environment,” said R. Quist, CBET. “The OneSource Document Site and its database explanation were great.

Thank you for presenting a useful webinar for biomedical engineering,” Biomed B. Hemmati said.

“Great information related to standardized procedures for the HTM community,” HTM Director K. Forsythe said.

“This was an excellent presentation. oneSOURCE offering a one go to place for manuals, updates and cloud personalized storage is absolutely needed this day we are in. Obtaining documents and keeping procedures up to date is very time consuming, wasting resources that could allow biomed to be doing actual work. Additionally, from a liability standpoint, this would take pressure off of an organization knowing the data is up to date. I know there are other companies offering similar services, but I am impressed with the layout and simple search box. Very user friendly,” said B. Hayes, CBET III. “Very useful, particularly if you will be searching for reference service manuals,” Biomedical Engineer E. Gonzales stated.

“Useful. I have used oneSOURCE before, but still learned a couple tricks,” Senior BMET J. Troutner said.

For more information about Webinar Wednesday, including upcoming webinars and recordings of previous sessions, visit WebinarWednesday.Live.

Thank you to our sponsors:

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LEARN, GROW

AND BE INSPIRED. TechNation has the resources you need to sharpen your skills and stay in the know, no matter where you’re working from.

LIVE WEBINARS:

AUGUST 5 | ZULAFLY Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

AUGUST 12 | PRONK TECHNOLOGIES Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

ON-DEMAND WEBINARS:

sponsored by ACCRUENT Developing and Sustaining an AEM Program & Connectiv - Al Gresch & Mike Zimmer

sponsored by TECH KNOWLEDGE ASSOCIATES (TKA) Updates to Servicing and Re-manufacturing Through the Medical Device Servicing Collaborative Community - Dave Francoeur

sponsored by EQ2 AUGUST 19 | RPI

Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

Inter Department Information Visibility and Lifecycle Management Decisions - Jon Kocurek, Michael Brilling and Vishal Malhotra & Cradle to Grave Asset Management Using Best Practices, Benchmarking, and Standardization - David Chambers and Rich Sable

AUGUST 26 | NUVOLO Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

sponsored by ordr How Leading Healthcare Organizations are Securing Connected Medical Devices with Ordr Russell Rice

ON-DEMAND PODCASTS: SERIES 1 EPISODE 1 In this episode Summit Imaging’s CEO, Larry Nguyen sits down with Randy Snelling, Chief Physical Environment Officer at DNV Healthcare, to discuss Hospital Standards and how ISO, Vendor QMS and Engineers play a roll in the future of accreditation to increase the quality of care and reduce total cost of ownership.

webinarwednesday.live

SERIES 1 EPISODE 2 In this episode Al Gresch, VP of Healthcare Strategy, Accruent and Mike Zimmer, Senior Solutions Engineer Accruent, sit down with Jason Tessari, Senior Client Success Manager at Accruent, to discuss how automating the Request Management process transforms risk management, safety management and the delivery of care.

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ROUNDTABLE

ROUNDTABLE Asset Tracking

T

echNation reached out to several companies to find out the latest regarding asset tracking technology and solutions. A variety of companies responded with insights from their in-house experts to shed light on the different types of asset tracking technology, benefits of these systems, what HTM professionals should know when purchasing and more.

Participating in the roundtable article are ZulaFly CEO Stephanie Andersen, Sonitor Technologies Inc. President and CEO Anne Bugge, CyberMDX Vice President of Product Ido Geffen, Nuvolo Senior Solution Consultant Dustin Smith, Medigate Director of Pre-Sales Engineering Simeon Utubor and Vizzia Technologies Chief Commercial Officer Dave Wiedman.

Q: WHAT ARE SOME OF THE DIFFERENT TYPES OF ASSET TRACKING SYSTEMS FOR THE HEALTH CARE SPACE? ANDERSEN: ZulaFly is partnering with multiple different asset tracking

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Stephanie Andersen ZulaFly

systems that are available in the market today, such as Wi-Fi, BLE, ultrasound, RFID and RTLS technologies. The primary advantage of ZulaFly is that the platform can take in data from any technology, or multiple technologies, that the customer has chosen. It’s important to select a hardware vendor that can fulfill the goals that the customer has in mind.

BUGGE: Facilities often consider both passive and active tracking technologies depending on what assets they want to track. RTLS is an active technology and continuously emits signals so that moveable equipment, such as IV pumps, bladder scanners, workstations on wheels (WOWs), etc., can be tracked in real-time and with situational context – how long the asset was in a location, it’s disposition, what else or who else was in that same location at the same time or over time, etc. Active, RTLS asset tracking solutions include ultrasound, infra-red (IR), Wi-Fi, ultrawide band (UWB) and Bluetooth low energy (BLE). RTLS technology selection is dependent on accuracy requirements, use cases, total cost of ownership, scalability, ease of deployment and customer support. In contrast, passive technology such as RFID, as its name implies, does not report in real-time, typically requires bar-coding and mainly captures individual data points. This technology is often used for small specialized assets such as surgical instruments and consumables.

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ROUNDTABLE

actionable record of the asset’s identity, configuration and utilization specifics. For example, maintaining assets that connect to patients and constantly move is challenging, as these devices present safety risks and entirely different management challenges than devices that don’t.

Therefore, the ability to identify and track the location of an asset, while very important, is only one aspect of the information that biomed and clinical engineering professionals need to be effective.

Anne Bugge Sonitor Technologies Inc. GEFFEN: For healthcare delivery organizations (HDOs), an asset tracking system is a must-have in order to be able to monitor and manage equipment and supplies with the aim of improving efficiency. It’s critical for HDOs to adopt the right management system in order to really improve efficiency, asset optimization and cybersecurity posture. The four most prevalent types of asset tracking systems in the health care space are: Traditional pen-and-paper approach (not recommended and only works for very very small facilities); spreadsheet-based tracking methods (only suggested if the organization is limited with budgets and resources); barcode-based asset tracking systems (the basic suggested one for really starting to manage more than a small size inventory; and radio frequency identification (RFID) tagging.

WIEDMAN: “Tracking” has evolved into “management,” as simply locating a device isn’t adequate. Stakeholders need systems that alert and direct personnel based on business rules and streamlined processes. Health care executives want service providers who can offer hardware agnostic solutions that support traditional RTLS (infrared and ultrasound) infrastructures as well as new IoT technologies that use Bluetooth Low Energy (BLE), especially as their facility’s needs change over time.

SMITH: RFID Passive and Active, Bluetooth, AP connections, etc.

UTUBOR: Health care asset tracking technologies (RFID, RTLS, Scanning, Wi-Fi, etc.) are typically integrated with some degree of inventory management, maintenance support and, if the devices are networked, cybersecurity functionalities. Obviously, there’s not much value in tracking the location of an asset without having an up-to-date and

Ido Geffen CyberMDX

Q: WHAT ARE SOME OF THE BENEFITS AND CHALLENGES OF THE DIFFERENT TECHNOLOGIES? ANDERSEN: It’s imperative that the technology that is chosen can fulfill the goal of the asset tracking imple-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

mentation. Different use cases can require different technologies.

BUGGE: Wi-Fi and BLE, 2.4 GHz technologies, are predominantly communication tools and were not designed for navigation or accurate positioning and location. Based on radio frequency (RF), they use received signal strength for triangulation and are absorbed and reflected by building material and therefore can give unpredictable and inconsistent results. Wi-Fi and BLE are not recommended when room or sub room (bay, bed or chair) accuracy is needed or for use cases such as PAR level management, contact tracing (including assets), patient or staff safety or workflow automation.

IR also penetrates walls, floors and ceilings, requires line of site for accurate positioning and can affected by light, so can be challenged by the same interferences and can give the same unpredictable and inconsistent results such as Wi-Fi and BLE. To compensate, these technologies require a significant number of devices to contain the signal and block any interferences for positioning. This can add significant cost and have a negative impact on the aesthetics of the healing environment – something that is very important for patient satisfaction. In addition, when battery powered, IR devices require expensive and non-environmentally friendly lithium batteries.

Sonitor’s ultrasound-based RTLS, unlike any of the above technologies, does not penetrate walls, glass or floors, and therefore its signals are contained. Therefore, only a single device is required to provide the most reliable and consistent accuracy at room and sub-room (bay, bed and chair) levels. When battery powered, ultrasound location transmitters use four, D cell, alkaline batteries that are both cost effective and environmentally conscious.

GEFFEN: The biggest challenge is determining what asset management

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system suits your organization in terms of needs as well as resources.

One must first enlist goals that he/she want to accomplish with it. Most HDOs aim to realize the following objectives and subsequent benefits by implementing an asset tracking system: streamlined equipment maintenance processes; consumables management; and regulatory compliance.

Dustin Smith Nuvolo

SMITH: RFID can become costly and it would require readers in the appropriate areas for a passive set up.

Active RFID would require a high outlay and battery replacements would likely be needed every 2 to 5 years. A lot of strategy needs to be discussed when it comes to determining everything you’d like to track.

Bluetooth would have some similar battery concerns. Oftentimes this would be combined with upgraded access points. AP connections are not going to be extremely accurate, but can often get locations within 30 yards. However, you’d have to have all devices tracked on the network.

Certain devices that you’d like to track may not be on the device.

UTUBOR: For connected assets in health care (i.e. IoHT devices), clinical network specialized asset management software integrated with cybersecurity capabilities are proving

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to be game-changers. Because the data can now be captured directly from the host networks, essential asset management and cybersecurity workflows (e.g. preventative maintenance, remediation, vulnerability management, threat detection/ response and replenishment) can be integrated and, where appropriate, outdated routines can be safely automated. For non-connected assets, tracking systems can also be automated, along with time-based triggers/ alerts for maintenance and replenishment. These processes tend to rely more on disciplined on-boarding processes for initial inventory, including scanning devices, otherwise, it tends to be based on manual data entry.

WIEDMAN: Great accuracy comes with traditional RTLS solutions, however along with a higher price point.

Newer IoT offerings provide general zone level accuracy with a reduced infrastructure cost. Advanced IoT technologies are empowering “smart hospitals,” that integrates location tracking, lighting, HVAC and building automation. This intelligent, connected IoT platform provides a compelling ROI model that yields increased savings and productivity.

Q: WHAT FACTORS SHOULD BIOMEDS CONSIDER TO DETERMINE WHICH TYPE OF ASSET TRACKING SYSTEM IS BEST FOR THEIR FACILITY’S NEEDS? ANDERSEN: Ease of use of the dashboard! Biomed staff gets asked for equipment that is needed now, so the ability to quickly find equipment, and understand if it’s available for use, is vital. Real-time PAR level and rental management are extremely beneficial for biomed groups to help control inventory costs. A mobile app that can provide search capabilities while moving around a facility is also valuable.

BUGGE: There are a number of factors to consider when selecting the best

tracking system for a facility. These include: I. Location accuracy – what are the use cases?

A . Many use cases require consistent room and sub-room level accuracy II. Total cost of ownership – over the lifetime, what will it cost to maintain?

A. Batteries B. Resources C. Maintenance D. Effort/time to support III. Scalability and flexibility – can the technology grow with the facility’s needs?

A. Adding more use cases B. Adding more sites GEFFEN: Key aspects that are important to take into consideration: • Manual versus automation: For most HDOs, the ability to track and update device attributes in a manual process is an insurmountable task. Fortunately, there are multiple technologies today that are helping with that. HTM professionals should choose the key aspects of asset tracking that need to be automated and invest in it.

• Open API and flexible data model: Today, the importance of the integration of data from multiple systems is a basic requirement (i.e. update device risk level based on location, open recalls, known vulnerabilities, etc.). It is important to choose a solution that exposes the data from the CMMS to other systems or integrates complementary information into the CMMS. This is a built-in capability that doesn’t require a lot of investment from the biomed team (such as a dedicated change request from the vendor for supporting specific integration.)

• Ease of deployment: As a software solution, biomed professionals should factor in how quick and easy deployment architecture is for the solution.

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ROUNDTABLE

SMITH: First it needs to be determined what is in scope of the tracking: beds, stretchers, pumps, monitors, modules, will you go as far as thermometers? What is available in terms of funds? Do you want an active or passive system? What is the object of tracking: loss mitigation, utilization, preventing excess capital purchases?

UTUBOR: As mentioned, the first question stakeholders must answer is what types of assets they’re responsible for managing. Connected and non-connected landscapes are entirely different, as asset management nuances vary across asset categories, subcategories and classes.

Additional considerations should be equally practical and include questions around the numbers of facilities involved, how the assets are distributed geographically, what service lines they support, the potential consequence of failure to patients and the operational costs if the asset is taken out of service.

Regardless, disciplined asset onboarding processes that are as mobile, automated and “open” as possible (from an integration perspective) should be a major consideration for non-connected assets. And for connected assets, passive, network-based asset profiling (i.e. real time, dynamic inventory capability) must be integrated with cybersecurity capabilities that detect, alert and support security policy enforcement.

WIEDMAN: Effective asset management systems start with service providers who understand process improvement, change management and apply technology that supports the health care system’s needs and budget.

Biomeds should understand the importance of a managed service that includes ongoing support, training and on-site maintenance, which will save them time and labor costs.

Finally, don’t underestimate the importance of a robust rental equipment module that can lead to addi-

tional savings and allows a health care system to become their own rental company without the rental costs.

Q: WHAT ARE SOME OF THE NEWEST FEATURES AVAILABLE? ANDERSEN: One feature is the ability to take in data on assets from multiple data sources. For example, we can provide accurate utilization rate of IV pumps by knowing when they are actually running compared to just being in a location. PAR level locations can also be grouped as needed to help reduce overstocking of supply closets. Proactive alerts on rental equipment that is no longer in use will also quickly help with a return on investment.

unplanned downtime and lost availability. Another benefit is to match recalls to the right devices based on real-time data.

• Device error and configuration detection that will automatically detect devices that suffer from operating and configuration errors.

SMITH: Really the newest “feature” is that these technologies are coming down in price and integrations with other systems have become more prevalent.

BUGGE: Sonitor continues to advance its ultrasound technology to improve tag and device battery life and by combining multiple technologies into a single device in order to be able to reduce the number of devices required to support even the most complex indoor environments and use cases.

GEFFEN: The most advanced solutions have innovative new features such as: • Automated identification and classification that provides dynamic inventory of all assets with granular, context-aware asset classification including model number, MAC address and serial number.

• Asset utilization and asset purchase expenses so that HTM can now know exactly where and when critical devices such as ventilators and infusion pumps are being used, and therefore which are available for redistribution to other departments as demand fluctuates.

• Optimized service, patch scheduling and recalls that allows staff to identify ideal maintenance windows for updates or patch installs, helping streamline maintenance schedules based on actual device usage. This also helps avoid

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Simeon Utubor Medigate

UTUBOR: Biomed professionals should be thinking in terms of their workflows and how accurately the vendor’s featured use-cases map to their particular needs. Finding data-driven ways to enhance workflows and automate outdated routines is where all of the vendors are focused. This is why solutions that capture the right data and drive connections between asset location histories, status/ utilization and inventory management/maintenance are seeing rapid adoption. These innovations are generally evaluated based on how the data capture is accomplished, what additional enrichments are available and how meaningfully they integrate this data with other systems and processes that can benefit (e.g. network security and procurement).

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WIEDMAN: Contact tracing is an easy and flexible add-on if your system utilizes a powerful business intelligence (BI) engine for reporting. The key metrics include not only who but what devices have been exposed to an infectious person and the duration of exposure. Quarantining rooms or areas to ensure proper device cleaning processes are followed enhance patient safety as well.

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND USING A ASSET TRACKING SYSTEM? ANDERSEN: If producing a return on investment is part of the project plan, have a plan in place prior to deployment so that can be accomplished.

Find an easy-to-use and flexible software solution that staff can easily adapt with minimal training. And, lastly, find a hardware solution that can provide the level of accuracy that is required to fulfill the goal of a RTLS system.

BUGGE: When evaluating and comparing technologies, not all solutions behave the same way. It is imperative to understand how the technologies work and to understand all of the use cases that will need to be supported.

Engage with your vendor and ask for specific floor plans and designs that support the facility needs so that you can verify exactly what coverage is being provided and how many devices will be required. If there are discrep-

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ancies or concerns, ask for a side-byside comparison. This will confirm that its performance will support your objectives and justify your investment.

SMITH: Have a plan. Oftentimes RTLS implementations are not guided sufficiently and the data is not appropriately managed. It is likely that the system would ideally be linked to the CMMS. Make sure that ideal linkage is a possibility before committing. Also be sure to factor in the maintenance costs when choosing your technology. As for building out a solid ROI, think through alternate use cases the technology could be used for simultaneously once infrastructure is in place i.e. newborn tracking (prevent code pinks), hand sanitation and be sure to factor in clinical time saved when thinking through cost savings.

UTUBOR: HTM professionals should have a clear vision of what newly available data will be used for, how they fit into their current programs, the programs they hope to implement and what success looks like to the other stakeholders who can benefit.

The ready availability and good working order of health care assets has a direct impact on patient outcomes, so the job is highly important. That’s why many providers of traditional asset tracking solutions have expanded their functional footprints and are deeply

integrated with emerging complementary asset inventory management/ maintenance and cybersecurity systems. That said, solution evaluators should be wary of the differences between systems that simply exchange data via APIs and those which meaningfully integrate and enhance their workflows with use-cases that genuinely solve the business problems they’re facing.

Dave Wiedman Vizzia Technologies

WIEDMAN: Asset management solutions should have a proven ROI of a year or less with multiple “Go Live” references that can speak to the ongoing support, scalability and responsiveness of the service provider. Experience and on-site resources matter and lead to a higher probability of reaching your desired outcomes.

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REVIEW OF

Ne

HTM STAND

cessary Temporary Easing

DARDS

BY K. RICHARD DOUGLAS

T

he world could not run without benchmarks. In engineering, science, drafting, quality control, manufacturing and in environmental regulations, benchmarks provide a standard that can be used as a point of reference in evaluating a level of quality.

A standard can emerge from a consensus of stakeholders and can often provide a target or comparison that provides a good measuring stick for how something can be assessed.

There is a set pattern to the development of a standard. This is how one organization approaches the task.

According to the Project Management Institute, standards development follows six steps.

A standard development team is assembled and subject matter experts are solicited as first reviewers. During meetings, over several months, team members draft and refine the new standard. The draft version is then presented to the subject matter experts for review, feedback and possible changes.

The revised draft is made available for public comment. After this period, if there are compelling comments that would make revisions necessary, those revisions are made.

The new standard then goes to a standards consensus committee for approval. This committee is made up of independent volunteers. If the committee votes to approve the new standard, it is adopted.

While standards can go through a very deliberate and calculated development process, there are also times when standards may need to be modified or relaxed.

During the spread of the SARS-CoV2 coronavirus, the FDA issued several authorizations of guidance to address the extraordinary circumstances that the pandemic has

posed to health care workers and facilities.

Examples include information published by the agency on the use of blood antibody tests to identify exposed persons, and emergency use authorization that recognized the insufficient supply of face masks. They also announced a program that would “move new treatments to patients as soon as possible.”

These standards have been modified in response to the rapidly changing needs and requirements caused by the coronavirus pandemic.

AAMI STANDARDS OF HTM While there haven’t been any updates to standards impacting the HTM community in recent months, there has been activity with regards to standards that impact medical device manufacturers.

There also has been some temporary easing of standards because of the coronavirus pandemic.

There remain a number of standards that regulatory agencies and surveyors review when visiting a health care facility and these standards have been developed to protect patients, standardize procedures and maintain baselines.

There are approximately 17 organizations that can accredit hospitals, many with “deeming” power for Medicare and Medicaid. The Joint Commission accredits more than 4,000 hospitals. The FDA regulates medical device manufacturers.

Many standards that HTM professionals are familiar with, especially quality standards, have broad application across several industries. The ISO 9001 standard is an example.

AAMI has worked to help formulate a definition, in conjunction with the FDA, that sets a standard for terms used in HTM;

“ Implemented changes need to be formally documented along with any deviations and recovery plans.”

- Mike Busdicker, CHTM, FACHE, system director of Clinical Engineering at Intermountain Healthcare in Midvale, Utah

specifically defining servicing versus remanufacturing.

According to AAMI, their EQ – Medical Equipment Management Committee develops standards on aspects of medical equipment management for healthcare technology managers.

Further, AAMI’s website states that “AAMI’s standards committees and working groups develop and maintain all AAMI standards, technical information reports (TIRs), consensus reports and other guidance documents. These committees and associated working groups also provide input into international (ISO/IEC) standards.”

Also, AAMI’s website explains the significance of an American National Standard. The website states, “An American National Standard (ANS) is a document that has been sponsored by an ANSI-Accredited Standards Developer (e.g., AAMI), achieved consensus, met ANSI’s Essential Requirements, and been approved by the Institute. AAMI may choose to submit its standards or TIRs to ANSI to be designated as an American National Standard (ANS).”

EQ56 STANDARD According to The Joint Commission, “all medical equipment is required to be on the medical equipment inventory,” if the facility is accredited through The Joint Commission.

The original ANSI/AAMI EQ56:2013 Standard has been in a process of revision, although that process has been slowed because of the impact of the coronavirus pandemic on the workplaces of many of the committee members involved with the EQ documents, according to AAMI. For instance, a scheduled meeting of the EQ-Medical Equipment Management committee that was scheduled for June 10 and 11, 2020 had to be postponed. This meeting would have been just ahead of the 64

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2020 AAMI Exchange, which was cancelled.

A call for comments by AAMI on EQ56 were due by early January. Committee members are reviewing those comments and that feedback will be considered as part of the updating process when the committee is able to reconvene and return to its work.

In our July 2019 story about the current state of standards, we looked at an update of AAMI’s progress on the standard at that time.

At the time, AAMI’s Director of HTM Standards, Patrick Bernat, shared an update. “The scope of the previous EQ56 did not include quality management principles or processes. Recently, the FDA report on device servicing recommended that service providers adopt quality management principles and systems. This NWIP is proposing to include these principles in the new standard’s scope, including an effort to align with concepts in ISO 20000,” Bernat said at the time.

“Additionally, the EQ Committee conducted a gap analysis to identify other gaps that need to be addressed in an EQ56 revision. As a result of that exercise, the EQ Committee is also proposing to address the items below in a revision,” he added. At that time, Bernat outlined six “critical gaps in the existing EQ56 document.” He also outlined five additional “secondary gaps” which needed additional attention.

These updates are still in the process of being revised and bringing the EQ56 Standard to a place where it recognizes current technology and the convergence of IT and HTM. AAMI released the original EQ56 standard, “Recommended practice for a medical equipment management program,” in 2013. That is when the recommended practice was developed by the AAMI Medical Equipment Management Committee and then approved by the

American National Standards Institute Inc. At that time, the standard, a baseline for medical equipment management programs, had been in the works for three years.

Stephen Grimes, principal consultant with Strategic Healthcare Technology Associates LLC, says that COVID has slowed the progress on standards recently.

Grimes has served on the AAMI committee updating EQ56 since the original 2013 version was developed.

“We’ve made some progress in EQ56, incorporating some additional elements that align us more effectively with other QMS and IT service standards (necessary because we’re more often dealing with hybrid medical and information technology systems). With reduced frequency of meetings and cancellation of the on-site meeting this month, I’m not sure where we are in developing a version for ballot,” he says.

Grimes has proposed that the HTM field adopt its own QMS standard. He outlined his proposal in a 2019 AAMI Biomedical Instrumentation and Technology (BI&T) article.

“The point I raised about the need for a QMS, and the absence of a health technology related quality management system for the CE/HTM community, I believe remains a major issue. Our community needs a QMS standard appropriate for the spectrum of work we do – servicing is currently the concern of FDA and manufacturers, but there remain many other things we do in technology life cycle management that should be represented in a relevant QMS,” Grimes says.

PAUSING STANDARDS Can the national standards of a regulatory body be waived or modified? The short answer is; yes.

Sometimes a temporary adjustment to a standard is required based on extraordiWWW.1TECHNATION.COM

nary circumstances. The coronavirus pandemic created a national crisis that required an extraordinary response by health care facilities nationwide.

Hospitals could not wait casually on the sidelines in order to respond to the growing threat of overflowing ICUs and ERs, but needed the regulators to work with them to address the unique circumstances that they faced. This included the ad-hoc erection of additional patient ICU beds or beds for displaced non-COVID patients to accommodate a surge in hospital admissions nationwide.

As a result, many federal agencies that publish standards for health care responded quickly with changes to established standards.

According to CMS, “under section 1135 of the Social Security Act, [the HHS Secretary] may temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements.”

CMS also states; “When there’s an emergency, sections 1135 or 1812(f) of the SSA allow us to issue blanket waivers to help beneficiaries access care. When a blanket waiver is issued, providers don’t have to apply for an individual 1135 waiver.

When there’s an emergency, we can also offer health care providers other flexibilities to make sure Americans continue to have access to the health care they need.”

It would be a temporary adjustment to a standard based on the Medicare Conditions of Participation or the Emergency Medical Treatment and Labor Act (EMTALA) waiver. These waivers recognize the

restraints have been waived and requirements for providing medical records, patient visitation of patients in isolation and seclusion, in high impact areas, are waived.

Another waiver, that recognized the limited supply of PPE, allows “used face masks to be removed and retained in the compounding area to be re-donned and reused during the same work shift in the compounding area only.”

The Centers for Disease Control and Prevention (CDC) issued its “Crisis Standards of Care Decontamination Recommendations” which address the reuse of respirators and suggested decontamination methods, which include ultraviolet germicidal irradiation, vaporous hydrogen peroxide and moist heat.

Medical staff, who previously may have been restricted from practicing at a hospital because their privileges will expire or the requirements of a new physician to begin practice at a hospital without governing board review, are waived so that doctors can more easily treat COVID-19 patients.

“On April 29, 2020, CMS issued a formal communication granting 1,135 blanket waivers that permit health care facilities to adjust scheduled inspection, testing, maintenance frequencies, and activities for facility and medical equipment,” says Mike Busdicker, CHTM, FACHE, system director of Clinical Engineering at Intermountain Healthcare in Midvale, Utah.

“Utilization of the waiver allows an organization, like Intermountain Healthcare, to evaluate current pandemic status and adjust PM frequencies to reduce

viral pandemic is unknown. This is also true for geographic areas.

The National Fire Protection Association (NFPA) has had to modify many standards because of the many temporary structures or non-traditional spaces that were hastily erected to respond to the coronavirus pandemic and the expected surge of COVID patients.

In an NFPA press release, the organization explained; “At NFPA, we fully recognize that it will be impossible to modify or construct spaces in strict compliance with fire and life safety codes while getting ready to treat critically ill patients with the best possible care,” said Robert Solomon, PE, fire protection engineer at NFPA. “At the same time, there are measures that can be taken to help keep people safe from fire in light of the current situation.”

This waiver of a standard by NFPA is in line with another waiver by CMS which stated: “CMS will permit facility and non-facility space that is not normally used for patient care to be utilized for patient care or quarantine, provided the location is approved by the state (ensuring that safety and comfort for patients and staff are sufficiently addressed) and is consistent with the state’s emergency preparedness or pandemic plan.”

New standards will be available to the HTM community in the near future to better define a medical equipment management program. There may be modifications to standards that HTM professionals recognize, that result from the coronavirus

“We’ve made some progress in EQ56, incorporating some additional elements that align us more effectively with other QMS and IT service standards (necessary because we’re more often dealing with hybrid medical and information technology systems). “ - Stephen Grimes, principal consultant with Strategic Healthcare Technology Associates LLC increased necessity for services like telemedicine and allow clinicians who may not have been eligible to bill Medicare for telehealth services.

Also, the waiver allows hospitals to screen patients offsite to prevent the spread of COVID-19. Rules related to verbal orders are waived. Reporting requirements on patients in ICUs who require soft wrist

disrupting patient care and reduce possible exposure/transmission of COVID-19.

Implemented changes need to be formally documented along with any deviations and recovery plans,” Busdicker says.

To some degree, with a viral pandemic, a waiver has to be flexible because, unlike a hurricane or tornado, where the duration of the event is predictable, the lifespan of a

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

pandemic. Both will impact the field in ways that are either anticipated or unknown. Maybe a new QMS standard will emerge as well.

For now, a pandemic has put efforts on hold and reshaped the health care landscape into the foreseeable future.

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EXPERT ADVICE

CAREER CENTER

How to Approach Political Conversations at Work

BY KATHLEEN FURORE

P

olitical conversation is fraught with potential conflict. The fact that people are starting to return to their workplaces as the pandemic seemingly gets better and as protests take place makes the likelihood of tempers flaring even more likely.

In these particularly turbulent times, how can everyone, no matter their political persuasion, handle situations that arise if co-workers and supervisors with very different views start expressing them in inflammatory, non-constructive ways?

Guidelines and “safe words” are two things experts say can tame political discourse.

“Employees need guidelines for handling political conversations, and even more importantly, employers need to be clear on their policies regarding political debate in the workplace,” says Ximena Hartsock, Ph.D., co-founder of Washington, D.C.-based Phone2Action, a platform for digital advocacy and public affairs technology. “If there are no guidelines, employees at least need a reference point to guide their dialogue: the company’s values, the company’s mission, something.”

“There will always be people on opposing sides, and never in equal measure,” Hartsock continues. “Those who hold minority points of view can feel isolated and it is a company’s job to prevent this feeling of isolation.”

That doesn’t mean squelching honest debate.

“We always say, ‘You can be honest and open about your position but think of how you deliver your point of view,’ “ Hartsock says. “One of our five values is, ‘Take care of each other’ – and that means having empathy for others’ feelings.

Political debate is healthy, but employees

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can get carried away. When people are passionate, they can say things that result in hurt feelings or make their colleagues feel disrespected.”

Executive career coach Terry B. McDougall, author of “Winning the Game of Work: Career Happiness and Success on Your Own Terms,” adds that it is important to be as neutral as possible during the course of a political debate.

“When people are emotional it’s hard for emotions not to escalate the situation,” says McDougall, who suggests using something she calls “acknowledgement and validation – an approach that takes each person’s individual experiences into account.”

She stresses, “Recognize that their opinion is perfectly natural for them, just as your perspective is perfectly natural for you,” suggesting having a conversation that goes something like this: “I respect your right to feel the way that you do given your experience, and I would appreciate you understanding that my experience is different, and that my feelings are natural given what I’ve gone through. It would be more productive if we focused on the work that we need to do together and perhaps leave the politics out of the workplace. Can we agree to that?”

Perhaps the simplest suggestion I’ve heard for tamping things down when tempers flare comes from David Taffet, chief executive officer of Fort Worthbased Petal LLC, a high-tech consumer goods company, whose team members’ beliefs, “span the political spectrum from libertarian to communitarian – and so do our team’s conversations,” Taffet says.

His solution: “To prevent inflammatory, non-constructive discourse, we have all agreed to a simple mechanism for defusing political conversations before they cause harm: a safe word. When the

Kathleen Furore

safe word ‘Magna Carta’ is uttered, all conversation immediately ceases, we take a moment to acknowledge our mutual respect for one another, embrace the need to move on, and continue with a productive, joyful day.”

And what did his employees think of the solution? Everyone agreed.

“It has proven effective in calming even the most charged of conversations,” Taffet reports. “I have the distinct privilege of presiding over an early stage-company that is majority-owned by women and deeply committed to diversity, equity, inclusion and belonging. From this, one would probably assume that our company’s definition of diversity stems from a conventional liberal paradigm.

However, we believe that diversity of thought, including one’s political beliefs, can enrich a company’s culture.”

KATHLEEN FURORE is a Chicago-based 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 career questions at kfurore@yahoo. com. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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“FLATTEN THE CURVE” WITH REMOTE MONITORING Doesn’t it seem that service demands always come in spikes, with equipment failures somehow occurring all at once?

With the right remote monitoring solutions, you can stay on top of potential failure points to prevent emergency calls from stacking up on you. Remote monitoring systems measure and track critical data points and report back to you. While these systems are especially critical when monitoring cryogen and cooling systems on MRI, remote monitoring provides significant value in other imaging modalities as well. Make sure that your potential solution monitors the full range of data points and equipment that you will need. Feature-rich systems, such as Avante’s OnSite remote, go beyond environmental sensors and monitor equipment technical data and performance. Combined with years of expert service know-how, the systems can even use data analytics to suggest recommended actions and parts, displaying all your imaging modality data in one user-friendly interface.

INCREASE SOCIAL DISTANCING WITH REMOTE DIAGNOSTICS AND SERVICE Currently, many hospital departments

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are still limiting the number of people in work areas. Even when essential service must be performed, technicians are faced with increased risk as well as screening and PPE requirements that slow the service delivery process.

Remote diagnostics can help by offering a safe and efficient tool to complete many troubleshooting steps remotely. A trained engineer at one site, can efficiently view errors elsewhere within their healthcare system to triage those problems and be more well-equipped once they arrive. Systems like Avante’s Onsite can even replicate a service environment as if the technician was sitting at the console. The increased efficiency also helps to offset the increased demand on technicians as hospital systems and service departments will be squeezed for resources now and in the future.

ISOLATE PROBLEMS WITH TECHNICAL SUPPORT It is likely that service departments will be challenged and run thin due to the COVID-19 crisis, and they will be expected to do more with less. The current shutdown will likely lead to pent-up demand and longer working hours for the equipment (and technicians) in the future. Potential seasonal

Andy Wheeler President, Avante Health Solutions Charlotte Center of Excellence outbreak cycles could also pose this very same challenge. When the need to solve problems most effectively and efficiently arises, expert technical support can be a tremendous time saver, potentially reducing the need for outside service.

Frontline engineers are often required to work on multiple brands and modalities and their equipment exposure time is limited only to service events. As demand picks up service availability times will be limited even further.

Having access to a technical support hotline like we provide at Avante Health Solutions empowers the service technician by providing direct access to a modality expert who can work alongside them, shortening the troubleshooting process by providing access to extensive knowledgebases and decades of system experience.

KEEP UP WITH DISTANCE LEARNING Due to ongoing travel restrictions and likely decreased travel opportunities in the future, some companies have

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EXPERT ADVICE

transitioned their training and clinical application programs to be accessible via virtual platforms. Instructors are leveraging today’s connected technologies to bring the classroom to you and there are even customizable offerings allowing the technician to work with equipment onsite while the instructor works with the very same equipment at the training facility. This approach has already been leveraged by Avante Health Solutions to continue to deliver ultrasound systems and provide clinical in-service without having to jump on a plane. These innovative new approaches to training, are available with Avante Academy, allowing technical and clinical staff to work safely within the COVID-19 restrictions without falling behind.

The SARS-CoV-2 outbreak and resulting COVID-19 crisis have impacted our lives and the nation’s healthcare system in unprecedented ways. Evolving and ever-shifting challenges have created the need for innovative, flexible, and dynamic service solutions. Partners such as Avante Health Solutions can assist your team with the tools and solutions to continue and improve your critical services with increased capability, efficiency, and safety.

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EXPERT ADVICE

VIEW ON VALUE Barriers to Change

BY JOSEPH HADUCH AND PATRICK FLAHERTY

O

ver the course of the past several months this column has touched on several topics that influence and affect, in our opinion negatively, provider’s individual and collective ability to transform the expense and value from manufacturers of clinical equipment for both service and equipment acquisition.

While we fully acknowledge that providers share in the responsibility of bringing new and innovative solutions to address many of health care’s problems and inefficiencies our collective attention has been on the inequities of the process currently in place that drives the relationships between the manufacturer and the provider. We believe it is a relationship that is disproportionately designed to meet one party’s objective business requirements while leaving the provider’s value delivered more nebulously defined. This is clearly defined by the drastically different margins each party enjoys.

While it may not seem obvious given the tone of some of these columns, we stridently believe that a new and more objectively collaborative relationship between manufacturers and providers is a practical and moral imperative if we are to have any hope of lowering the cost and increasing the accessibility of care while at the same time elevating the quality and value delivered to patients.

Some of the practices used by manufacturers to maintain the current counterproductive imbalance of benefits are

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obvious and some are subtle, all of them get in the way of creating meaningful and sustainable collaboration. What follows are some areas that we believe are in desperate need of transformation.

DIVIDE AND CONQUER Divide and conquer is one of the first places we will visit among the places we wish would go away. Equipment manufacturers focus a great deal of effort in being “the vendor of choice.”

Translating this means simply that the manufacturer has chosen to isolate the physician or administrator they believe is the most politically powerful in the supplier selection and isolating them from the provider’s wholistic decision support process; this typically involves direct marketing, phones calls from supplier senior executives, and can even include site visits conveniently couched as something not overtly connected to the specific decision. The end-result of this type of engagement is to get the physician and administrator to add internal pressure against its own internal departments’ process for selection, frequently causing a great deal of redundant activity to re-channel the work into an objective and fair process.

This antiquated sales strategy has absolutely no place in any value-based care or patient affordability discussion.

While it has no place in 21st century health care negotiations, it is currently not going away. It remains a major part of the tool set of one of the most onerous departments of all manufacturers … the marketing department.

MARKETING The clinical equipment manufacturer marketing department occupies an inner ring of Dante’s inferno as it frequently distorts and manipulates critical information which is used to make objective decisions for patients. Marketing rarely, if ever, highlights the qualitative differences in research studies and never points out conflicting information. Marketing will use whatever “study” supports their efforts to persuade a sale, including statistically insignificant data and data where the clinical end-points are “no-worse” than the existing control groups. When there is an ostensible claim of improvement identified in the marketing material, it conveniently is unable to be included in a contract as a measurable and guaranteed deliverable, it is almost always a “hope it works” moment for the provider, fully at its own risk. Marketing perpetuates the notion that sales and performance are not aligned. This misalignment prevents the translation of promise by manufacturer into guaranteed practice improvement. A similar issue to marketing is created by the research and development (R&D) teams of manufacturers.

RESEARCH AND DEVELOPMENT R&D is supposed to be completely separate from commercial sales and decision making but, as many of us know, this is a practical fallacy. The reality in this space is one that involves direct access to physicians, most often with no one from the business side of

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the provider, describing the next level of equipment. In many situations, the physician would like to have first or early access to the equipment when it is eventually released or, for academic medical centers, be a principal or co-principal investigator for industry sponsored trials. This off-grid set of discussions clearly influences physician’s thought processes, just like the manufacturer intended. If anyone struggles to believe this is a reality, simply ask or recall how many times a sales representative not currently successfully positioned to win a sale says something like, “Can we arrange a site visit for you and your physician to our design center (frequently in a foreign country) so you can see what is coming?” This all too frequent pitch is clearly evidence that the use of R&D vapor ware as a sales tactic is alive and well.

GPOS AND GOVERNMENT Another barrier is the convenient use of a third party as a shield to prevent good faith negotiation. There are two classic shields used constantly by manufacturers … the U.S. government and group purchasing organizations (GPOs). In both scenarios the manufacturer negotiates an agreement with the third party and then subsequently claims that the price(s) included in the agreement are the indexed “floor” pricing from which all other agreements must be negotiated and evaluated for compliance. This convenient tactic permits the supplier to set a basement price they can hide-behind when confronted with a provider negotiating from its own objective margin position. When using the government, the manufacturer will frequently claim they are bound to provide the lowest price to the government and cannot move from the

position for the provider; this is not true, government contracts only involve like to like transactional comparisons, if the provider’s contract has any strategic elements where commercial feedback or other value is provided, then the control comparison with the government is vacated. The GPO as the control is even more problematic; the GPO is an aggregator of purchasing volume, not an agent to drive strategic compliance or practice. The GPO also makes more money when the equipment is higher-priced; the GPO also inconsistently incorporates service and support into the full contractual set of benefits.

Manufacturers who hide behind GPO negotiations are choosing to avoid goodfaith negotiations from providers whose bottom line is driven differently than the GPOs. Many of you have first-hand experience with some, if not all, of the examples discussed. As long as these, and other barriers, are commonly utilized, our hope and need to transform will be blocked by an edifice of brick. Walls, whether of brick or of words, have no place in 21st century health care … the ones cited above need to be relegated to the same graveyard as the barrier that divided Berlin and whose collapse was a harbinger of a new era. In next month’s article “Breaking Down Barriers” we’ll discuss how HTM can be at the forefront of a and what can be done to counter these current “Barriers to Change.”

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. The views expressed here are those of the authors and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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THE FUTURE

How are we Dealing with the COVID-19 Pandemic?

BY STEVEN J. YELTON, P.E.

I

’m sure that everyone reading this has spent many hours dealing with the COVID-19 outbreak and its effects on business. This is true if you are an educator, an industry person or working in a health care institution.

We have had to come up with new and innovative ways to “do business.”

I’m currently working at a college and a hospital. This arrangement allows me to see what is happening from different angles. It also helps me to understand the ramifications of what is happening.

When the strategy to combat COVID-19 started to ramp up, I was working to adapt with respect to both of my responsibilities. At the college, we immediately went to a totally virtual environment. I haven’t set foot on campus since March. I have a biomedical laboratory that has a delivery of equipment lying everywhere that there is a flat surface. I feel lucky since my courses were always hybrid – a combination of live and virtual. I have many colleagues at the college who have very limited experience with virtual education and the learning management system that is in place at Cincinnati State. Many of them struggled to get their courses up and running virtually. I have to say that I’ve been very impressed with how well they have done with the transition and for the most part this was transparent to the students.

At the time of writing this article, we are planning to run the HTM courses

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totally virtually in the fall semester. Our college will allow very limited laboratory access in the fall. We also teach several laboratory experiences at a local hospital. It is yet to be determined if that will be possible in the fall. Regardless, I know that we will provide a great educational experience for our students.

HTM students tend to be hard-working students who want to learn and that will be instrumental to their success.

Another challenge that we have is placing cooperative education (co-op) students in HTM-related positions.

Some employers were able to retain all of their co-op students, but others were required to eliminate those positions for (hopefully) the short term. As a cooperative education (co-op) school, Cincinnati State requires students to have work experience directly related to their field of study in order to graduate. Our program requires a minimum of one semester (15 weeks of 40 hour/week work) of cooperative education to graduate in addition to the academic requirements. Most employers would prefer at least two semesters of co-op experience prior to hiring them full time. We realize that we may have to be somewhat flexible on this requirement in the near future.

The challenges of placing and retaining co-op students may come back to hurt the college, the student and the employers. We all count on co-ops for different reasons. The college is hurt since this is an integral part of the education process, the student gains

Steven J. Yelton P.E.

experience and income to pay for college and the employer uses the co-op as a productive employee while they are in school and as a source of potential full-time employees upon graduation.

I am extremely impressed by how the HTM community has banded together to help everyone get through this troubling time. The AAMI online communities have been extremely active with help and suggestions for dealing with every kind of situation you could imagine. AAMI, as well as other organizations, has made resources available free of charge. For example, if a student was registered for a college course that was affected by COVID-19, they received access to the AAMI CBET review course online free of charge. My students took advantage of this and we used it as part of our course. My hope is that this will encourage students to sit for the CBET certification exam. In Cincinnati, many HTM departments are sharing information and ideas with each other to help get through this period effectively.

Many of the HTM departments within hospitals have gone to a partially remote operation. This was interesting to me from the standpoint of having to

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EXPERT ADVICE touch the equipment to fix it for the most part. This is obviously still true.

The following are a few strategies that I heard have been implemented. One is that technicians in certain areas are dispatched to departments within the hospital from home rather than gathering in the HTM department prior to going to the effected department. This makes sense since many companies who provide field service do it. This is possible in certain situations but not all. Some departments are staggering the work schedules of technicians so that a limited number are in the department at one time and appropriate social distancing is achieved. Many managers are working remotely part of the time while assuring that at least one manager is on-site at all times during standard business hours. Finally, I have to wonder how many of the innovative approaches that are put in place, and not just the ones that I’ve mentioned, will remain after the pandemic subsides?

Finally, thanks for all that you do!

STEVEN J. YELTON, P.E.; is a senior HTM engineer for a large health network in Cincinnati, Ohio and is a professor emeritus at Cincinnati State Technical and Community College where he teaches biomedical instrumentation (HTM) courses. He is the chair of AAMI’s board of directors, vice-chair of the AAMI Foundation board of directors, previous chair of AAMI’s Technology Management Council (TMC), chair of AAMI’s HTAC Committee and is a member of the Accreditation Board for Engineering and Technology (ABET), area delegation.

The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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20/20 IMAGING INSIGHTS So Many Choices

BY TED LUCIDI, CBET

I

n the past, health care facilities used terms such as biomedical engineering and clinical engineering.

These, once small, departments have evolved and now can span entire health care enterprises and come complete with their own supply chains. Service decisions once made by individual technicians are now guided by large cross-functional teams. We now refer to these highly specialized departments as healthcare technology management (HTM). HTM has become big business and there are thousands of suppliers ready, willing and able to assist. The questions are, whom should I choose and why should they be chosen.

Each supplier, vendor, or provider (including OEMs) has its own pros, cons and areas in which they choose to prioritize and focus. Very few excel at delivering all things to all customers.

Developing a vendor scorecard helps to normalize all the variables and helps to define what’s most important to you, your department and your customers.

Over the years, our team of industry experts have assisted many health care organizations with qualifying suppliers with respect to due diligence and research in developing effective request for proposal (RFPs). Following are four areas on which to focus from a repair provider perspective.

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PROVIDER-RELATED QUESTIONS How long has the provider been in business and how long have they provided the specific service? How many technicians or engineers are employed and what training do they receive? How and why is the provider qualified to work on the specific device(s)? Are you able to tour their facility and will they allow you to interact with their teams? Would you be able to observe a repair being performed? Being able to thoroughly answer these questions and provide openness and transparency should be the minimum criteria you accept.

SUPPORT-RELATED QUESTIONS What are the provider’s specialties/ capabilities, and do they guarantee any capabilities? What is their annual repair volume, and do they perform ALL repairs in-house? If not, how much and exactly what is outsourced and is that important to you? Are loaners available, what is the cost and what fulfillment rate can be expected? What is included in the repair and what’s the typical turn-around time? With respect to ultrasound probes and MRI coils, typically, turn-around time is a function of the complexity of the device and invasiveness of the repair. A provider only performing low-level repairs at a low volume, no doubt, can promote a much faster repair time than a provider

Ted Lucidi, CBET Innovatus Imaging performing a thorough, fully invasive comprehensive repair.

QUALITY-RELATED QUESTIONS What warranty period is offered and what is the current warranty rate on a specific product? Is the provider able to supply a service history or work history? You may not know it, but typically OEMs do not provide parts or materials to independent service organizations (ISOs) and many of the parts/components used in ultrasound probes are unable to be harvested for secondary usage. Knowing this, a good question to ask is, how are replacement parts and materials qualified? What is the process, what testing is performed, and how does the provider ensure the repaired/replaced device performs consistently with the OEM design? One type of testing used by Innovatus Imaging relative to material compatibility is to the ISO 10993 standard (which certifies biocompatibility). At a minimum, when issuing an RFP, insist that a repair provider be ISO 13485:2016 certified in order to qualify.

KEY PERFORMANCE INDICATORS First things first, establish what is important to you and your customers.

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Consider rating vendors based on overall quality of work, quality of communication, follow-up, call-back rate, warranty rate, response time, cost of downtime, etc. It is important to weight each criterion because your facility is unique as well as your customers’ needs and expectations.

There is no universal model; however, price should never be the primary driver. Eventually decisions will be based upon price, but when choosing between repair providers, be sure to do an apples-to-apples comparison.

Develop one or more very detailed scenarios, provide very specific details and require very specific answers that all lead to the bottom line.

As an FDA registered medical device manufacturer and ISO 13485:2016

certified repair provider for ultrasound probes and MRI coils, developing successful partnerships with suppliers is integral to our quality management system. Part 7 of the 13485:2016 standard states that an organization SHALL establish criteria for the evaluation of suppliers which is based on 1) the suppliers’ ability to provide a product (or service) that meets the organization’s requirements, 2) is based on the performance of the supplier, 3) is based on the effect of the purchased product (or service) on the quality of the medical device and 4) is proportionate to the risk associated with the medical device. In short, Innovatus Imaging develops a vendor scorecard for our suppliers. The beauty of the ISO:13485 standard is that, even though it may not

need to be totally implemented in an in-house clinical engineering department, the standard can provide guidance and best practices to elevate any HTM department.

Getting the most of your time, effort and budget are important now, more than ever. Knowing what to ask, why it is important and how to frame the questions are key to writing effective RFPs. Reach out to the team of industry experts at Innovatus Imaging for assistance with adopting ISO 13485:2016 or before drafting your next RFP. 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 Bridging the Gap

BY JOSEPH FISHEL, CBET, MBA

M

y great-grandfather was born unable to hear. In those days, he was referred to as deaf and dumb. During his life, he was able to find work at Bethlehem Steel in Steelton, Pennsylvania. His job was to run a stamp mill where a hot piece of steel rod was inserted into the stamp mill and formed into steel rivets. This was a very noisy operation, but his handicap was a benefit in this position. Being able to speak sign language in a noisy environment had its advantages. These rivets were then shipped to San Francisco where they were used to join the girders that created the Golden Gate Bridge. A small contribution, but without the rivets the bridge couldn’t have been built.

What does this have to do with cybersecurity you ask? I have had to build bridges with different groups in the IS/IT arena to include cybersecurity, networking, applications, office of general council and the list of groups goes on. Because there was no real communication it was often assumed that the healthcare technology management (HTM) group wasn’t knowledgeable about networking. The lack of the HTM’s involvement gave a false impression.

Where to start? What I found was that in a large enterprise the IS side of the house didn’t know who to go to and often went to the local HTM site technician who very often wasn’t the right person. To the IS/IT group a biomed was a biomed. They didn’t understand that imaging was a different group within HTM and that we had specialists for MRIs and CTs as well as for different manufacturers. To start getting the right people involved, we designated one HTM manager as the go-to person for all IS/IT questions. That was me.

I found that I needed to educate the IS/ IT project managers on how to engage the

HTM department. I set up a meeting that all project managers attended and showed them how our organizational chart worked.

Many were surprised that the people they were contacting had nothing to do with the areas they were contacting them about.

Also, it explained the lack of engagement. If it was Tech A’s area and Tech B was being contacted the IS/IT team felt they were being sidetracked. In reality, they were being directed to the person responsible for the area. Again, they didn’t understand that a project that covered several hospitals meant different teams. In their model, a team is assigned to the project and that’s all they do.

I found that the HTM group often was not involved in project planning and were not notified of enterprise or local changes that often affected medical devices in a negative way. I found that there was an enterprise architecture team that looked at proposed projects and evaluated them for compliance with enterprise standards. It also looked at duplication of services or applications that the enterprise already had a standard for. I asked to join this group to present the HTM side. Asking questions of how this would affect biomedical equipment all of a sudden brought issues to the forefront. The medical equipment issues were never addressed before because no one was at the table to present them. IS/IT is often only 3 to 4 years behind on operating systems, yet the medical devices were often 8 to 12 years behind. I found that the IS/IT teams were often unaware of the cost of new devices and that “buying” a new one wasn’t going to solve the problem. The new one was often 3 to 5 years behind current operating systems and cost $1 million to $3 million.

I also had issues where changes/ upgrades were made to applications without my knowledge. To get the inside knowledge about what changes were being made I found that the requests for changes

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Joseph Fishel, CBET, MBA Nuvolo Business Process Consultant, Healthcare IT Leaders LLC

were going through a Change Advisory Board (CAB). I found that I could ask questions such as: What day was this occurring? What time of day? How long would things be down? What was their back up plan should something not work? What sites would be affected? What application would be affected? Once I started asking these questions, I was able to relate the affect on the clinical side should things fail.

The board started seeing the other side and how changes could affect patient care.

Several years ago, when cybersecurity started to become a hot topic assigning the HTM manager as the go to person assisted in keeping things aligned with enterprise standards and upcoming changes. We were able to use the established communication with the IS/IT teams to pull different areas together into a conjoined program.

So, what helped me bridge the gaps?

Communication and education were the main things that helped me build the bridge between my HTM department and the IS/ IT team. Often the IS/IT team members had questions about medical equipment. I took the stance that there were no dumb questions. I told them that if they had a question they should ask me and I would get them an answer. Answering questions for the IS/IT team was like my great-grandfather’s rivets. It was not anything big, but it built bridges.

JOSEPH “JOE” FISHEL, CBET, MBA, is a Nuvolo Business Process Consultant, Healthcare IT Leaders LLC. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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THE OTHER SIDE Purchasing New Equipment?

What is on the Quote?

BY JIM FEDELE, CBET

I

am lucky that I now have supply chain support that reviews quotes for pricing and standard configuration.

The support is very helpful in ensuring we are getting all the discounts and benefits that are due to us as part of our purchasing agreements. However, even with this layer of support, there is still a “jagged line” between what the user expects to get and what the vendor is supplying.

Users are excited to be getting new equipment and salespeople are happy to make the sale. There is a certain euphoria during the quoting phase. In my mind, the salesperson’s job is to match the quote to the user’s expectations. There is often a lot more needed than just the device, like how it will be mounted, does it connect to the network? These items, if not included, can be costly and will delay the purchase or install. I have tried avoiding the situation where the users expected something, and it did not ship. Calling the salesperson will typically kill the euphoria of getting new equipment when they state, “Sorry that was not on the quote it will be an extra <insert exorbitant amount here>.” New equipment purchase advice and facilitation are part of my job. Recently, no matter how much pre-work I do there is always a surprise, especially with quote issues. Here is what I have learned. I hope it helps you minimize your pain.

It has been my experience, that

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biomedical engineering departments may or may not (it is about 50/50 based on the people I have spoken to) be involved with the quote process when it comes to new equipment. After all, isn’t that what purchasing is supposed to do with assistance from the department head? I learned the hard way a long time ago that knowing what’s on the quote will avoid problems for me. Since the biomedical department is “responsible” for the medical equipment, any and all issues end up in my lap. Although reviewing quotes are not my favorite task, it is a preventive measure I take to keep unplanned issues from spoiling my day. In addition, it has become quite a valuable service for my customers too.

Reviewing a new equipment quote can be time consuming; I rarely have seen any two that are alike. Especially lately, quotes seem to be complicated build lists with terms and words that do not match easily to what a customer wants. This makes it very difficult to know if there are omissions or extra items. I find it much like looking at a new car quote, to get a certain feature, you must by package A, to get that feature you must buy package A and B, it almost seems purposefully complicated.

A simple example I have is we recently purchased a telemetry system, when we trialed the units, every telemetry pack had an ECG cable, a Spo2 cable, a bed clamp and a battery charger. To me, this looked like five items. On the quote it was 10 lines because they listed every part of the

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

cable and charger, then they add software revisions, etcetera. It is really kind of crazy.

The salesperson can alleviate a lot of the confusion. If the salesperson is knowledgeable and motivated, they typically are very helpful in understanding the quote. However, there are multiple obstacles that seem to get in the way of this solution. Since many salespeople are self-employed contractors for the OEM, they do not actually write the quote. It is written at the corporate office. This creates another opportunity for mistakes and problems.

I have had salespeople admit that they find the quote documents cumbersome and confusing too. Also, contracted salespeople usually sell multiple devices and are rarely an expert on any of them. That being said, I have had my issues with dedicated OEM salespeople too. As long as you are dealing with people there are going to be good ones and bad ones, you just have to work through that.

What can a biomed do to ensure quotes are accurate and complete? The

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first thing I ask the salesperson to provide is a simplified quote or document that summarizes all the parts and systems. I meet with the users without the salesperson present to discuss openly what is needed. I ask them questions like how they envision the room lay out and how is the workflow going to change? My goal is to identify mounting issues and operational expectations that need to be addressed.

Then, I meet with the salesperson to go over the quote line by line with the simplified document to ensure everything is included. This part can be the most challenging. Do not be afraid to ask questions about items that do not seem to belong. Recently, we got a quote on an imaging suite and the vendor included a complete hemodynamic monitoring system even though there was another system in the room. When asked about the addition, they told me

they were asked to quote everything.

After verifying with the users, we were able to strike the system from the quote.

It saved us $124,000.

Another pitfall is that once the quote is completed, purchasing will negotiate the final price down. This can cause unexpected changes to the quote as the salesperson feels the pressure of meeting his margin and making the sale. I once had a salesperson convert half the equipment on a quote to a one-year warranty – from the five-year warranty they were touting as an edge over the competition. I never knew the change was made until we needed a repair and was informed that it only had a oneyear warranty. We were going to have to pay for the repair. When I questioned the salesperson, he said he did it because of purchasing and could not undo it. At that time, (a year and a half later) he wasn’t too motivated to help. Needless

to say, we never bought another device from that salesperson again.

I suggest that every biomedical manager be actively involved with the equipment quote process. I think your customers will find it very valuable to have another set of eyes looking over the quotes to ensure it is accurate. Also, once you get good at reviewing them; it is fun to find those opportunities to save your facility money and avoid trouble for your department.

JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He magazines six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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PROPER RISK SCORING IS CRITICAL FOR MEDICAL DEVICES

T

he Risk Scoring System for Medical Devices (RSS-MD) provides a methodology to catalog critical vulnerabilities and numerically score the potential severity of a failure with any clinical device. The Association for the Advancement of Medical Instrumentation (AAMI) published an Alternative Equipment Maintenance (AEM) guidebook in 2018 that recommended a risk scoring methodology that is now also being used to identify a medical device’s overall risk for potentially causing staff and patient harm. The two main components of this methodology include the probability of functional failure multiplied by the severity of the consequences for that harm. The scoring algorithm was developed using academic research principles in coordination with medical professionals and health care providers. The scoring algorithm uses a weighted scale to focus on the impact to patient safety, while incorporating the attributes of vulnerability characterization. The overall score (as shown in the chart below) provides a measurement that can be used for making Healthcare Technology Management (HTM) decisions and help prioritize mitigation efforts in a consistent and measurable manner for any hospital. These include determining corrective work order prioritization, hazard alert response, AEM eligibility and equipment replacement needs.

RISK SCORING TABLE

With so many medical equipment management decisions being based on this important safety metric, it’s necessary for HTM organizations to use a risk scoring method that not only accurately determines risk at a point in time, but tracks changes in risk over time. A recent TechNation webinar on June presented a model for health care organizations to standardize how they determine risk calculations and generate a universal understanding of the safety implication for different classes of clinical devices. This will help drive

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or staff should it fail.” In addition, the webinar described a necessary life-cycle approach to monitoring and managing the ongoing analysis and actions to control risk. This included the following process steps which should be made part of the computerized maintenance management system (CMMS) solution supported by the hospital HTM group: • risk analysis • risk evaluation • risk control • production and post-production information [analytics]

improvements for HTM audits and benchmarking of equipment performance.

The webinar covered the history of risk scoring for clinical devices along with definitions from both The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS).

Both have similar descriptions for risk scoring that underlines the importance of tracking high-risk devices. The TJC definition states, “Identify high-risk medical equipment for which there is a risk of serious injury or death to patient

RISK SCORING FOR AEM PROGRAMS The final topic discussed during the TechNation webinar was an overview of how risk scoring plays a key role in the allowance of AEM schedules. With some exceptions, an AEM program allows a health care facility to “adjust its maintenance, inspection, and testing frequency and activities for facility and medical equipment from what is recommended by the manufacturer, based on a risk-based assessment by qualified personnel” (CMS 2013). For many types of equipment, health care facilities find that the manufacturer-rec-

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Kyle Holetz Nuvolo ommended maintenance activities are more onerous than is warranted, based on their own history of using and maintaining the device. This means that HTM groups can reduce (or increase if warranted) the number of maintenance checks and tasks required for clinical devices to save time, effort and the associated costs. These AEM schedules are authorized under TJC compliance models and can drive considerable cost savings for HTM teams.

However, to change the manufacturer-recommended maintenance require-

ments, the equipment must meet certain criteria and HTM organizations must adhere to specific guidelines. Therefore, tracking PM-related failures of equipment is very important. These should be monitored closely and allowed to trigger the removal of any device from an AEM schedule. Categories of these types of device failures include the following: â&#x20AC;˘ Failures that could have been prevented by a better PM (Example: Early failure of infusion pump battery) â&#x20AC;˘ Hidden failures that could have been discovered by a better PM (Example: Low defibrillator output) Additional tracking recommended for risk scoring of devices on AEM schedules comes from the average, or mean time between failures (MTBF). This is calculated by using the model below: For successful tracking and management of an AEM program, including risk scoring, a modernized CMMS solution is highly recommended to help organizations validate and manage the entire process, and to pass CMS accreditation surveys.

EXAMPLE: Clinical Device Risk Scoring in Nuvolo

CONCLUSION The Risk Scoring for Medical Devices was developed in response to gaps for evaluating associated risks of identified vulnerabilities in medical devices. The RSS-MD has been validated by a myriad of health care professionals and is currently being leveraged by major medical device manufacturers to assist in their risk assessment frameworks.

The process of tracking and managing the life cycle of risk scoring for every clinical device is a daunting task. The more your CMMS can simplify the risk scoring calculations, data entry, tracking and management for your technicians, the more accurate your risk scoring data will be over time. Fortunately, newer, more nimble CMMS providers have emerged in recent years and are able to more easily configure their platforms to adhere to the changing regulations.

For more information about the clinical device risk scoring and AEM schedule management capabilities in Nuvolo, please reference our web page for clinical asset management at https://www.nuvolo.com/industry/healthcare.

Clinical Device Risk Scoring in Nuvolo

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EXPERT ADVICE

ROMAN REVIEW On Value System

BY MANNY ROMAN, CRES

I

was enjoying a few cold ones with a dear friend the other evening and the conversation turned to business, as it usually does. The particular subject was the manner in which some people conduct business, especially the apparent lack of ethics, honor and integrity. I, of course, have an opinion about this.

I attempted to explain how a package of experiences, beliefs and a value system affects how we journey through business and life. Since my excellent presentation of the subject was somewhat impaired by the few cold ones, my friend had some difficulty grasping the subtle and important points that I thought I was making. So, I decided to put the explanation in writing. I am killing two birds by boring you readers with the topic as well.

Let’s first discuss what a value system is. A value system is shaped by the person’s virtues and vices. A personal value system is a set of beliefs, principles, concepts, assumptions and ground rules which drive our behavior.

This value system, especially when it is well-defined, provides a compass and a highway on which we travel. We generally will not allow ourselves to deviate far from this path. The value system determines what we will do when confronted with alternate options.

For example, if your value system requires that you will not steal, you would return an overpayment. You would not even think about keeping it.

A well-defined value system makes decisions easy. If it is within your value system, go for it. If it is outside the system, don’t do it. A new employee

once asked me what to do about a request she had received that she thought was wrong. My advice: If you stray from your value system once, it becomes easier to do twice and three times until it is now a new system.

So, how do we acquire this value system? Over our lifetime, we are molded by nature, nurture, chance and choice. As our experiences accumulate, both good and bad, they become part of our belief system. We internalize the particular conduct that we believe to be socially, morally and personally acceptable. This is our value system and it determines how we will respond and what we will value in life, what is meaningful and important.

The problem is that we all have different life experiences and have been shaped by how they affected us and how we responded. Therefore, as my father would say, “Every head contains a different world.” We all value money differently. Some are always chasing one more dollar. We value family differently.

Some abuse their family members. We even value life differently. Some have no issue with murder.

In the discussion with my friend, the ethics, honor and integrity issues in question were from our perspectives.

Our own beliefs and values modified by our own experiences had to be defined in order to establish perspective and common ground.

When we just can’t understand how someone could do what they do, it is because we have a different value system. It is important to understand that, to that individual, there is probably nothing out of the ordinary because

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager that is their ordinary. That is the value system that they have developed and nurtured over their lifetime.

I will say it again: “Communication is key.” When someone does something that does not make sense to me I attribute it to my not having enough information. To achieve understanding, I will need to investigate their value system. I may still not get it, but at least now I know why.

I suggest that you investigate your own value system to see if you should be making modifications to it. It takes courage to conduct this exploration.

You may find a glitch or two, however after the exercise you will at least have your own system well-defined.

A well-defined value system, in my opinion, is invaluable in decision-making. A great question to always ask yourself is: “What would I like to see happen?” This ensures that you are prepared to have the emotional courage to move in the right direction.

My friend and I have decided that our friendship is more important than comparing our value systems – especially since comparison is the thief of joy and we do enjoy our cold ones.

The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

AUGUST 2020

TECHNATION

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61

P P P

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P P

P P

17

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82 46

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P P

82

P

67 79

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79

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

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P P

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

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Defibrillator

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Contrast Media Injectors

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Computed Tomography

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P P

CMMS

AllParts Medical

39

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

26

P P

82 41 82 44

P

P P P P P P

79

P

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

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6702

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www.ozarkbiomedical.com • 800-457-7576

26 41 82

P P P P P P

23 7

P

P P

www.ampronix.com • 800-400-7972

www.selectpos.com • 866-559-3500

75

P P

www.ampronix.com • 800-400-7972

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

www.innovatusimaging.com • 844-687-5100

4

P P

www.intermed1.com • 386-462-5220

www.1technation.com/webinars • 800-906-3373

54, 85

AIV aiv-inc.com • 888-656-0755

Ampronix, Inc. www.ampronix.com • 800-400-7972

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

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

Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809

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

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

P

7

P P

4

P P

76

P P

73

P P

82

P

69

P P

6

P P

27

P P

7

P P P

Radiology 4

P P

Recruiting www.bmets-usa.com/ • 870-431-5485

P P

P P

IBC

Stephens International Recruiting Inc. 4

26

Power System Components

www.ampronix.com • 800-400-7972

23

P

Patient Monitoring

Ampronix, Inc.

91

Refurbish AIV

26

aiv-inc.com • 888-656-0755

Rental/Leasing 8

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703

41

P

Repair

Nuclear Medicine InterMed Group

Webinar Wednesday

www.interpower.com • 800-662-2290

MRI Innovatus Imaging

29

oneSOURCEdocs.com • 1-800-701-3560

Interpower

Monitors/CRTs Ampronix, Inc.

oneSOURCE

www.usocmedical.com • 855-888-8762

Monitors Select BioMedical

55

www.MedWrench.com • 866-989-7057

USOC Bio-Medical Services

Mammography Ampronix, Inc.

MedWrench

www.betabiomed.com/ • 800-315-7551

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Biomedical Support Systems

SERVICE

aiv-inc.com • 888-656-0755

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AD PAGE

TRAINING

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23

P P P

ALCO Sales & Service Co.

91

www.alcosales.com • 800-323-4282

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41

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95

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

ZRG Medical zrgmedical.com • 760-438-8835

41

P P

16

P

97

P

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

Pronk Technologies, Inc. www.pronktech.com • 800-609-9802 www.seaward-groupusa.com • 813-886-2775

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

A.M. Bickford

69

www.ambickford.com • 800-795-3062

P

www.cbet.edu • 866-866-9027

Midmark RTLS www.midmark.com • 1-877-9VERSUS

Vizzia Technologies vizziatech.com • 855.849.9421

2

ECRI Institute

35

Tri-Imaging Solutions

www.ecri.org • 1-610-825-6000.

Software

69 BC

P P

5 3 6

P P

Training College of Biomedical Equipment Technology

RTLS

www.triimaging.com • 855-401-4888

11

P

84

P

61

P

Tubes/Bulbs

CyberMDX

26

www.cybermdx.com •

Medigate

24-25, 49

www.medigate.io •

Midmark RTLS www.midmark.com • 1-877-9VERSUS

Nuvolo nuvolo.com • 844-468-8656

Phoenix Data Systems www.goaims.com • 800-541-2467

2 46 33

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

Healthmark Industries HMARK.COM • 800-521-6224

AllParts Medical www.allpartsmedical.com • 866-507-4793

Ampronix, Inc. www.ampronix.com • 800-400-7972

CIRS, Inc. www.cirsinc.com • admin@cirsinc.com www.innovatusimaging.com • 844-687-5100

67

www.allpartsmedical.com • 866-507-4793

AIV aiv-inc.com • 888-656-0755

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

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

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

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

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

AUGUST 2020

26

P P

Engineering Services, KCS Inc

73

P P

Innovatus Imaging

41

P P

InterMed Group

79

P

27

P P

7

P P

P P

37

P P

4

P P

73

P

8

X-Ray AllParts Medical

Telemetry

61

Ultrasound

Innovatus Imaging

Surgical

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A.M. Bickford

Rigel Medical, Seaward Group

Respiratory

TRAINING

elitebiomedicalsolutions.com • 855-291-6701

96

Test Equipment www.ambickford.com • 800-795-3062

Elite Biomedical Solutions

SERVICE

Replacement Parts

PARTS

P P

Company Info

AD PAGE

TRAINING

69

www.jetmedical.com • 714-937-0809

SERVICE

Jet Medical Electronics Inc

PARTS

AD PAGE

Company Info

www.eng-services.com • 888-364-7782x11 www.innovatusimaging.com • 844-687-5100 www.intermed1.com • 386-462-5220

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

37

P P

16

P

8 23

P P P

61

P P P

WWW.1TECHNATION.COM

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

69

Elite Biomedical Solutions……………

41

oneSOURCE…………………………

29

AIV……………………………………

26

Engineering Services, KCS Inc………

16

Ozark Biomedical……………………

75

ALCO Sales & Service Co.……………

91

Healthmark Industries………………

67

Phoenix Data Systems………………

33

AllParts Medical………………………

37

Infusion Pump Repair…………………

82

Pronk Technologies, Inc. ……………… 5

Ampronix, Inc.…………………………… 4

Injector Support and Service…………

22

Rigel Medical, Seaward Group………… 3

Asset Services…………………………

Innovatus Imaging……………………… 8

SalesMaker Carts……………………

71

BC Group International, Inc………… BC

InterMed Group………………………

Select BioMedical……………………

23

BETA Biomed Services………………

Interpower…………………………… IBC

Southeastern Biomedical, Inc………… 6

Biomedical Repair & Consulting Services, Inc.…………………………………… 73

Jet Medical Electronics Inc…………

69

Southwestern Biomedical Electronics, Inc.…27

Biomedical Support Systems…………

82

Master Medical Equipment…………

46

Stephens International Recruiting Inc.… 91

CIRS, Inc.……………………………

73

Maull Biomedical Training……………

17

Tri-Imaging Solutions…………………

College of Biomedical Equipment Technology……………………………

39 76

11

Crothall Healthcare Technology Solutions…31 CyberMDX……………………………

26

ECRI Institute…………………………

84

Medigate………………………

23

24-25, 49

MedWrench…………………………

55

61

TTG Imaging Solutions LLC ……… 14-15 USOC Bio-Medical Services…………… 7

Midmark RTLS………………………… 2

Vizzia Technologies…………………

Multimedical Systems………………

79

Webinar Wednesday……………… 54, 85

Nuvolo…………………………………

46

ZRG Medical…………………………

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

AUGUST 2020

TECHNATION

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97

BREAKROOM

FLASHBACK The fall of 2013 took the MD Expo to the Music City once again. The conference took place in the newlyopened Omni Nashville Hotel and featured great entertainment and networking from start to finish!

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succ essful as ever The exhibit hall proved as atte ndees and for nity ortu opp the with exhibitors to connec t.

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1-Week U.S. manufacturing Lead-Time on non-stock Interpower products Same Day Shipping on in-stock products Quantity price breaks available with blanket or scheduled orders No minimum order or dollar requirements

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Order Online! www.interpower.com

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

INTERPOWER | P.O. Box 115 | 100 Interpower Ave | Oskaloosa, IA 52577 | Toll-Free Phone: (800) 662-2290 | Toll-Free Fax: (800) 645-5360 | sales@interpower.com

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

A Standalone Unit with Bluetooth Compatibility - Control Directly From Your Smartphone!

Upgrade your Anesthetic Agent Testing with the NEW AA-8100!

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

AA-8100

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

SCREEN VIEWS

Manual Data Reading of Isoflurane

Automatic Agent Selection: Sevoflurane

Download myBC_Mobile for your iOS or Android Device

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