ICE Magazine November 2020

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THEICECOMMUNITY.COM

NOVEMBER 2020 | VOLUME 4 | ISSUE 11

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

ASSET

MANAGEMENT

And scheduling downtime PAGE 34

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GUIDE T

page 30

PRODUCT FOCUS

Medical imaging software PAGE 27


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FEATURES

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EMOTIONAL INTELLIGENCE

Good mentors and coaches are powerful assets. Some think mentoring and coaching is the same thing, but differences exist and both have benefits.

10 RISING STAR

James Glasheen has two associate degrees and a desire to be an imaging leader one day soon.

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18 IMAGING NEWS

The latest industry news and updates from around the nation.

PRODUCT FOCUS

The global medical image analysis software market size is expected to reach $4.5 billion by 2027.

DIRECTOR’S CUT

Makes a great vendor and what makes a not so great vendor?

54 ADVANCING THE IMAGING PROFESSIONAL


NOVEMBER 2020

COVER STORY

A look at asset management, replacement and managing downtime at large and small health care facilities.

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30 GUIDE TO RSNA

RSNA goes virtual in 2020.

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MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090 Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Amanda Purser

Account Executives Jayme McKelvey Megan Cabot

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak

Circulation

Lisa Lisle Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

CONTENTS SPOTLIGHT 10

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NEWS 18

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Market Report Medical Image Analysis Software Market to Hit $4.5 Billion Product Focus Medical Imaging Software

INSIGHTS

For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2020

Imaging News A Look at What’s Changing in the Imaging Industry Webinar Wednesday Inaugural ICE Webinar Delivers ‘Pertinent’ Information

PRODUCTS

46 ICE Magazine (Vol. 4, Issue #11) November 2020 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

Rising Star James Glasheen, Spectrum Health Big Rapids and Reed City hospitals In Focus Kimlyn N. Queen-Weis, OhioHealth Rad Idea Find Your Pineapple Off the Clock Ernie Cerdena, The Medical Technology Management Institute

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Guide to RSNA RSNA goes virtual in 2020. Coding/Billing E/M Opportunities? Avante How to Make Your Next Mobile CT & MRI Lease a Win Emotional Intelligence Benefits of a Mentor or Coach PACS/IT Good Boss vs. Bad Boss Ampronix Cath/EP Lab and Hybrid OR Monitor Failure Rates Skyrocket Rad HR Making Remote Work “Work” Banner Imaging Why Would Anyone Want to Work Here? Department/Operational Issues A Healthy Work Environment Director’s Cut Vendor Relations: A Director’s Perspective AMSP Member Directory AMSP Member Profile Premier Imaging Medical Systems ICE Break Index ADVANCING THE IMAGING PROFESSIONAL


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SPOTLIGHT

RISING

STAR JAMES GLASHEEN BY ERIN REGISTER

FUN FACTS Favorite hobby: Kayaking and paddle boarding

Favorite show to binge watch: “Game of Thrones”

Favorite vacation spot: Northern

ICE learned more about this “Rising Star” in a question-and-answer interview with Glasheen.

Highlands of Scotland

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD?

Secret skill/talent: I used to play trombone in a concert and jazz band. I am currently teaching myself to play piano.

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rom Schoolcraft, Michigan, James Glasheen, 30, has two associate degrees, one in radiography and the other in magnetic resonance imaging (MRI), from Lake Michigan College. He has also earned two degrees from Ferris State University; a bachelor’s degree in science with a major in allied health and a master’s degree in health care administration, which he completed in 2018. Today, Glasheen is a radiology supervisor for Spectrum Health Big Rapids and Reed City hospitals.

ICEMAGAZINE | NOVEMBER 2020

A: When I was 14, I broke my left clavicle in a high school gym class. I was immediately taken to the emergency room and had X-rays taken. Back then, I was able to get a film copy of my images and was fascinated that they were able to see inside my body. The X-ray technologist taught me how the image was created, and I decided at that moment that I was going to go to school for radiography.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: In the big picture, I am thankful that I get to work with Spectrum Health and that their mission, vision and values align so closely with my own. You would be surprised what a big difference that can make in ADVANCING THE IMAGING PROFESSIONAL


workplace satisfaction. Also, every day I am thankful that I get to work with such amazing and supportive people at the Spectrum Health Big Rapids and Reed City hospitals. I have the opportunity to apply knowledge and skills I have learned to make a difference for my staff, the organization and the communities we serve and am encouraged to grow in my career to become the best leader I can be.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: The thing that interests me most about medical imaging is how dynamic it can be. We can do so many different things from every day chest X-rays to complex functional or intraoperative MRI procedures. There is always something new and exciting in any one of the several imaging modalities. With every exam we perform, there is a chance we have to make a difference in our patient’s lives.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: I have several notable accomplishments in my career. Probably the most notable, and one I am most proud of, looking back was taking on student clinical coordinator duties in my prior role. Accomplishing things for myself is always great, but there was a special feeling of success using my skills, abilities and knowledge to help others. In this case, it was to help our students achieve their goals and attain fulltime work when their education was complete.

James Glasheen loves his job as a radiology supervisor for Spectrum Health Big Rapids and Reed City hospitals. He also enjoys travelling, especially to the Northern Highlands of Scotland.

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Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: In the next five years, I want to refine my leadership style and progress further in my career toward a director of radiology role. • ICEMAGAZINE

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SPOTLIGHT

IN FOCUS KIMLYN N. QUEEN-WEIS

Family always comes first for Kimlyn N. QueenWeis. Here she is seen with her “amazing wife” Tina and her son Ryan Queen. She said she is “incredibly proud of my son.”

BY JOHN WALLACE

I

t all started with a classified ad in the local newspaper for Kimlyn N. QueenWeis, MS, MBA, CRA, FAHRA RT (R) CT MR, director of operations, patient logistics and telehealth services at OhioHealth. After passing out, she still wanted to pursue an imaging career. “You may think I am joking but technically that is how my amazing 30-plus year career all started,” Queen-Weis says. “Growing up I excelled in school. I loved math, science and I have always had a passion for helping others; unfortunately, college was not something my parents could afford so we never really talked about it or planned for it. One day, in early spring 1989, my mom was reading our local newspaper and the Marion General Hospital School of Radiology had an ad in the

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classified section. They were accepting applicants for their next session that started in August 1989. I was graduating that summer so I scheduled an appointment to shadow for a day, passed out wearing a heavy lead apron while observing a pneumoarthrogram of a knee and fell in love with the patient care side and the technology/scientific side of imaging and the rest is history.” Queen-Weis loves her job. “What’s not to love? The two most rewarding parts of my job are being able to support the growth and development of future leaders and helping to ensure my teams have the tools and resources they need to provide exceptional patient care and service for the patients, families and communities that we serve,” she says. “Another amazing part of working in health care and the field of imaging is the constant pace of change and technological advancements. It is exciting to watch the continuous evolution of how imaging technologies such as echocardiography, cardiac cath and CT combined with software technology advances, such as 3D reconstruction, can come together to help provide patients with less invasive alternative cardiac valve replacement procedures, such as TAVR, compared to the traditional open heart surgical valve replacement procedures.” Queen-Weis’s many professional accomplishments are all second to what she says is her greatest accomplishment – being a mom. “I am incredibly proud of my son Ryan Queen, 25. He graduated Cum Laude with a Bachelor of Science in Business Administration in 2017 from

ADVANCING THE IMAGING PROFESSIONAL


KIMLYN N. QUEEN-WEIS Bowling Green State University. He is a Logistics Coordinator II with Total Quality Logistics in Columbus, Ohio,” she says. Her other accomplishments include being with the same amazing organization for over 30 years. “I am proud to be a CRA and AHRA member since 2004 and AHRA Fellow since 2012,” she adds. “I am humbled and honored to have been voted president-elect of the AHRA for 2020-2021 and to have the opportunity to serve as president of the AHRA in 2021-2022.” On the job, Queen-Weis stresses the importance of each professional fulfilling their duties, roles and responsibilities. “Transformational, inclusive, coach/mentor,” are the three words Queen-Weis uses to describe her leadership style. “I am a servant leader and I have a strong passion for developing others. I enjoy helping others reach their goals. I am committed to working with my leaders and team members on their individual development plans to help support their personal, professional and career development goals. I actively look for learning opportunities and stretch projects to help support individual development and future succession planning for my teams and the organization.” “I also believe it is important for team members to feel empowered to be able to make decisions, solve problems and initiate process improvements at the frontlines. Every member of the team is important, and everyone has an equal voice,” she adds. Mentors have helped her achieve many of her goals. “I have had a variety of mentors over the years, from middle school to current day, and they have all had a hand in helping me become the person, mother, wife, leader, and friend that I am today. I was blessed to have had each of them in my life, even if only for a moment, and am forever grateful for the lessons they left behind,” Queen-Weis says. She says among the many lessons she has learned through the years is that everybody needs a helping hand from time to time. “It is OK to be vulnerable at times and ask for help. Sometimes the words “I don’t know” can actually be very powerful. Although we may think as leaders, we have to have all of the answers, all of the time, the truth is we really don’t and no one expects us to. Being a leader does not mean we have to be the expert. As leaders, we need to know how to build teams and how to bring the right experts to the table at the right time,” she explains. “And, above all else, I have learned the value and importance of pausing to develop/deepen relationships and establish trust (especially when working with new teams) before jumping in to focus on gaining buy-in and implementing change. Investing time to make connections with your team members, understand their strengths and weaknesses and getting to know your key stakeholders helps pave the way for you to lead with influence, gain buy-in and implement change. This is even more important when working with remote teams and in times of crisis.” Queen-Weis stresses the importance of family for WWW.THEICECOMMUNITY.COM

Director of Operations OhioHealth What is the last book you read? Or, what book are you reading currently? “Self as Coach, Self as Leader” by Pamela McLean Favorite movie? “Jaws” What is something most of your coworkers don’t know about you? I used to have a paralyzing fear of public speaking. Now, I only have a paralyzing fear of spiders. Best advice you ever received? From a leadership perspective: There are two important focus areas; results and relationships and you will get better results when you first take the time to develop true relationships. From a personal perspective: Give yourself grace and permission to be human. Who has had the biggest influence on your life? My parents and my son.

What would your superpower be? I am a calm thinker with the ability to diffuse volatile situations quickly! What are your hobbies? Golf, walking/biking, enjoying time with family and friends, watching college football, reading and school. (I am currently working on my doctorate in health care administration – not sure many would call that a hobby.) What is your perfect meal? Tortilla chips, salsa, fresh guacamole and queso with homemade enchiladas and rice.

herself and those she works with at OhioHealth. “Family always comes first. This is my personal value and a value I also share with my team members,” she says. “I would not be where I am today without the love and support of my amazing wife Tina, my son Ryan and my entire family. Both of my parents passed away young (another reason imaging continues to be one of my greatest passions) and I have been blessed with family that has supported me throughout every milestone – big or small – over the years. This also includes my work family and my AHRA family members.” Queen-Weis said she will always have her eye on the imaging realm and plans to do her part to continue to develop future imaging and health care leaders in support of advancing patient care in all areas.“I believe as leaders in health care, we each have a responsibility to advance the development of professional leadership and to create a strategic vision/ roadmap to proactively plan for industry changes, technology and patient care advancements, regulatory and reimbursement updates and social determinants of health,” she explains. “My long-term goal is to continue to expand my impact and influence in a health care system or hospital role that enables me to support the growth and development of future imaging and other health care leaders in alignment with these responsibilities.” • ICEMAGAZINE

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SPOTLIGHT

Rad idea FIND YOUR PINEAPPLE BY WESLEY HARDEN

M

y Rad Idea would be to find your pineapple.

As imaging leaders we face many challenges and stressful moments every day. Over time this can drain us and perhaps impede us from providing our staff with the best support and focus we can. I encourage leaders to find something that invigorates them and refreshes them, thus enabling them to be the best for their teams. For me, that is growing pineapples! I love fresh pineapple so one day I started to try and grow one. It became an outlet, a way for me

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to not think about work and its many stresses. I could focus on the plants and pull weeds, make sure they were being watered properly, getting enough sun, etc. I then can come back to work refreshed and ready to take on whatever might be facing me! I am now up to 40 pineapple plants and more focused and ready to face the daily grind better than ever. So leaders – go find your pineapple. • WESLEY “WES” HARDEN is the director of imaging services at Lexington Medical Center. Share your RAD IDEA via an email to editor@mdpublishing.com.

ADVANCING THE IMAGING PROFESSIONAL


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SPOTLIGHT

Off Clock THE

ERNIE CERDENA, PRESIDENT OF MTMI: THE MEDICAL TECHNOLOGY MANAGEMENT INSTITUTE BY MATT SKOUFALOS

T

he Philippines is a nation comprising 7,000 islands and 109 million people. In the province of Laguna, about 20 miles south of its national capital, Manila, lies the city of Biñan. A regional center of commerce and education, Biñan is home to more than 330,000 people. It’s where Ernie Cerdena, president of the Medical Technology Management Institute of Milwaukee, Wisconsin, was born and raised; a place where roots run deep and family is everything. Ernie Cerdena is seen with his father. He said that his dad worked night and day to be able to support eight children. 16

ICEMAGAZINE | NOVEMBER 2020

Cerdena describes Biñan as a city “of haves and have-nots.” Like his father, Cerdena was born in the city, making them Biñanenses, as

locals are known in Tagalog. The seventh of eight children whose mother died when he was only 10 years old, Cerdena saw firsthand the necessity of hard work, the value of good education and the importance of family love. “We were not rich,” he said. “My dad really worked the whole shift, night and day, to be able to support eight children, but the nice thing about that was the importance of valuing money and education and also being able to give back.” To take some of the pressure off their father, Cerdena and his siblings were raised to be self-sufficient. The older children worked jobs while putting themselves through school, establishing a formula for success that prized scholarship as well as sweat equity. As a result, the family produced teachers, civil engineers, accountants, ADVANCING THE IMAGING PROFESSIONAL


LEFT: As a member of Biñanenses of Eastern USA, Ernie Cerdena helps collect funds to cover the costs of education for young people back home. BELOW: Ernie Cerdena was one of eight children in his family growing up in Biñan, Philippines.

nurses, imaging professionals and loving parents – many of whom left the Pacific island nation to seek opportunities across the globe. That includes Cerdena, who, after being supported to complete an associate’s degree as an X-ray technologist, was recruited to work in New York in 1989. At just 23 years old, he boarded a plane for the United States, with little command of English, a stout work ethic and a desire to carry on his family’s legacy of flourishing in a professional career. The early days weren’t especially easy. Without a bachelor’s degree, Cerdena found himself the lowest-ranking member of his team, despite having the technical skill set and diligence required of the job. He hustled for eight years before deciding to press on with his studies while maintaining a full-time job. “All the work is being pushed over to me,” he recalled. “I know for a fact that not only can I do that, but I can also do better, but I don’t have the tools to do it. That’s what motivated me to work during the day and then go to school at night and on Saturday.” Cerdena earned his bachelor’s degree in 1999, and then continued on in pursuit of his master’s degree at Mercy College in New York. He attended classes for five hours every Tuesday and Thursday evening. In 2009, “I decided I can do more,” he said, and so at 43, while working full-time and raising his own children, Cerdena took up Ph.D. studies. He didn’t complete the WWW.THEICECOMMUNITY.COM

program until he was nearly 50. “I almost quit three times, but my wife said, ‘You already invested the time and the money; continue,’ ” Cerdena said. “I made sure my Sunday, this one day a week, I spent with my family. I would go to church, to lunch after and then my kids would play soccer, and I would never miss it.” Cerdena credits his father and family upbringing with providing the motivation to start and finish his education, but in his early years in America, he also drew strength from a social group called Biñanenses of Eastern USA. Established to help uplift their fellow expatriates from the city of Biñan, the group is composed of native Filipinos living in the United States. In addition to gathering for social purposes and upholding native customs and traditions, Biñanenses of Eastern USA collects funds to cover the costs of education for young people back home. “These folks don’t have the means to go to college, even high school,” Cerdena said. “We get together as a community on the East Coast, and collect contributions. It’s really nice seeing people of your origin being able to get an education.”

“I love education,” he said. “That’s why I went and continued with my Ph.D., because I’d like to be able to take back the maximum I can, and hopefully be able to inspire other people who are here or in the Philippines.” Through the years, Cerdena rose through the ranks of the organization, eventually taking a turn as its president. Collecting even a few dollars here and there from its members, Biñanenses of Eastern USA has been able to support the high school and college educations of dozens of students in Biñan, provide them with laptops, and give them the platform they need to launch their professional careers. Even a few thousand dollars makes a big difference. “We get together, we look at our mission statement, we look at what’s happening, do a SWOT analysis, and some of the things we pay attention to are preserving the culture for future generations,” Cerdena said. “I think that’s what every member of this association thinks: Even though we’re part of western culture, we still need to preserve how we grew up.” Filipino values and traditions include solidarity and friendship, respect for the elderly, aspiration to service and leadership, Cerdena said. He hopes that the organization will continue to exemplify those virtues for the youngsters of today, so that they may carry them forward for the Biñanenses of tomorrow. “I have a better life as compared to where I grew up, so I see that it’s so important to give back, and think on where you came from and what you can do to help them out,” Cerdena said. •

Ernie Cerdena’s hometown of Biñan is a regional center of commerce and education.

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NEWS

Imaging News A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

FDA CLEARS KA IMAGING’S PORTABLE DUALENERGY X-RAY DETECTOR UC SAN DIEGO HEALTH INSTALLS 3T MRI SYSTEM WITH AI-BASED RECONSTRUCTION TECHNOLOGY Clinicians at the University of California, San Diego Health now have access to Canon Medical Systems USA Inc.’s most advanced MR technology, the Vantage Galan 3T system, with Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning Reconstruction (DLR), for innovative imaging capabilities for neurology, musculoskeletal (MSK) and non-contrast MRA exams. The Vantage Galan 3T system is designed for streamlined workflow with exceptional image quality, while maximizing patient comfort during exams. Clinicians at University of California, San Diego Health are using the system for a full range of MR exams, from breast imaging to neurology and MSK imaging. With AiCE, the system brings the power of AI to routine imaging, allowing clinicians at the facility to explore more possibilities in improving patient care than ever before, with fast exams that produce high-quality diagnostic images with increased resolution and enhanced anatomical detail. • For more information, visit https://us.medical.canon.

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KA Imaging’s portable dual-energy X-ray detector has received 510(k) clearance from the U.S. Food and Drug Administration (FDA). Reveal enables bone and soft-tissue differentiation without motion artifacts in a single X-ray exposure. In other words, with one shot, the detector simultaneously delivers DR, bone and tissue images. “We are excited to announce the clearance of Reveal, after years of dedicated work, and we will strive to apply this technology directly to help patients and medical personnel through these trying times,” said Amol Karnick, president and CEO of KA Imaging. The different applications for this technology include providing radiologists with unobstructed views of the lungs, which can aid in the visualization of pneumonia, fractures, catheters and masses with high sensitivity. Reveal is also portable, and can be taken to the bedside of patients, which is critical during these pandemic times. •

ADVANCING THE IMAGING PROFESSIONAL


GE HEALTHCARE ANNOUNCES $50 MILLION INVESTMENT GE Healthcare has announced a $50 million investment in its existing West Milwaukee facility as part of its intention (proposal only; final decision to be made after required bargaining with relevant unions) to concentrate teams and resources in key facilities across Wisconsin. The investment in its Electric Avenue facility in West Milwaukee will create a world-class, industry-leading product development and manufacturing campus for medical imaging. GE Healthcare also intends to bring 1,500+ Wisconsin-based employees to its facilities at Electric Avenue in West Milwaukee and Research Park in Wauwatosa from elsewhere across the state in the coming years. The company intends to sell portions of its Waukesha campus off I-94, with most existing teams and work based there transferred to other local sites. The magnetic resonance (MR) buildings and teams in Waukesha will remain there, including around 600 existing jobs. These moves and investment are subject to required bargaining with representative unions. “We saw an opportunity to better use existing capacity and make significant investments that would both reaffirm our commitment to manufacturing and product development in the state, and create an advanced medtech hub in metro Milwaukee,” said Tom Westrick, presidentand CEO, life care solutions, GE Healthcare. These proposed moves would create a global showcase for computed tomography (CT) wing-to-wing manufacturing and engineering by co-locating similar product and support teams to enhance collaboration and better serve health care providers and their patients. GE Healthcare recently acquired an 87,000-square-foot facility next door to its existing Electric Avenue facility to expand the foundation for this product development and manufacturing campus.

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“Electric Avenue was GE Healthcare’s very first site in Wisconsin in 1947, and today we’re cementing that 75-year legacy in the state for another generation,” said Mike Barber, GE Healthcare’s vice president and general manager for platforms and solutions. “This $50 million plus project would represent one of the largest one-time investments in a U.S.-based GE Healthcare site, and we’re excited to expand our footprint in West Milwaukee, a Federal Economic Opportunity Zone.” GE Healthcare is committed to Wisconsin, which is home to several business leadership teams including health care products like CT, MR, X-ray, services, life care solutions, engineering, supply chain and more. GE Healthcare has an $8 billion annual economic impact on the state directly and indirectly, with around 6,000 employees state-wide and more than 1,000 in-state suppliers. GE Healthcare partnered closely with Wisconsin state, county and local leadership leading up to this announcement. •

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NEWS

VAREX ADDS TO ITS BOARD OF DIRECTORS Timothy E. Guertin has been appointed to the Varex Imaging Corporation Board of Directors, effective September 2, 2020. Guertin is a member of the board of directors at Teradyne Inc., a maker of automated test equipment and industrial robotics, and chair of the Global Access to Cancer Care

Foundation (GACCF), which works to expand the availability of modern cancer care in developing countries. He is the former chief executive officer of Varian Medical Systems Inc., a cancer care technologies and solutions

company, where during his more than 35-year tenure with the company he held a number of senior management positions, including executive vice president and chief operating officer, as well as president of Varian’s Oncology business unit. In connection with this appointment, the Varex Board increased its size to eight directors. •

NEW EXA GATEWAY DELIVERS COST-EFFECTIVE REMOTE READING PLATFORM As radiology practices reopen after limiting their services because of COVID-19, remote reading and teleradiology services have become an increasingly important component to handle the expected patient surge. To address this need and the growing demand for teleradiology, Konica Minolta Healthcare is introducing Exa Gateway, a cost-effective platform for secure remote reading that connects hospital radiology departments, radiology practices and teleradiologists through technology and services. Many radiology imaging facilities are not staffed to handle the increased volume of studies and are seeking ways to supplement reading services to avoid lengthy report turn-around-times and further disruptions to patient care. It is anticipated that the use of teleradiology and remote reading services will continue to be increasingly utilized post-pandemic, particularly with a projected shortage of tens of thousands of radiologists in the United States by 2025. By utilizing a facility’s existing PACS investment, Exa Gateway minimizes costs, streamlines connectivity and enables teleradiologists to use their current PACS worklist and viewer with which they are already familiar. There is no additional strain on existing IT staff and resources. Hospital radiology departments can add to or start teleradiology services, providing the flexibility to manage fluctuating volumes. Radiology practices can implement remote reading capabilities with access to teleradiologists to handle overflow of studies or provide overreads and sub-specialty interpretations, enhancing

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their service to referring physicians and patients. Exa Gateway can be configured for existing Exa customers and non-Exa users. For the teleradiologist, as part of Exa Gateway services, Konica Minolta handles all the connection points from the hospital or radiology practice through the Exa Gateway and to the teleradiologist’s PACS with a single connection pathway. For the radiology practice, remote reading capabilities are built in. Without replacing their current PACS solution, radiologists can read remotely from existing workstations or any devices, including tablets and smartphones. Because the solution is part of the Exa platform, radiologists can take advantage of Exa‘s Zero Footprint viewer with full diagnostic toolsets and viewing capabilities. All that’s required is a browser. With Exa’s Server-Side Rendering technology, all the work being done at the server and not the workstation. So large imaging studies including 3D mammography, can be opened immediately. Exa Gateway is not only a technology platform, but a service that aligns radiology practices with teleradiologists. Konica Minolta connects the groups with one another through its sales and dealer channel. •

ADVANCING THE IMAGING PROFESSIONAL


RADIOLOGY PARTNERS TO ACQUIRE MEDNAX RADIOLOGY SOLUTIONS MEDNAX Inc. has announced a definitive agreement pursuant to which Radiology Partners will acquire MEDNAX Radiology Solutions for $885 million to create a leading provider of comprehensive radiology and teleradiology services in the United States. MEDNAX previously announced its intent to sell MEDNAX Radiology Solutions, and this agreement follows substantive discussions and due diligence with several parties before identifying Radiology Partners as the strongest partner for MEDNAX’s radiology organization. Under the terms of the agreement, Radiology Partners will pay total cash consideration at closing of $885 million, subject to customary adjustments. MEDNAX does not anticipate that there will be any material tax impact to these proceeds. As of September 1, 2020, MEDNAX had total debt of $1.75 billion, consisting solely of its senior notes, and cash on hand of approximately $260 million, resulting in net debt of approximately $1.49 billion, compared to net debt of $1.62 billion at June 30, 2020. The transaction is expected to close during the fourth quarter of 2020, subject to customary closing conditions, including regulatory review. Further details of the transaction can be found in a current report on Form 8-K filed by MEDNAX with the Securities and Exchange Commission. Pending the closing of the transaction, MEDNAX will report the operating results of MEDNAX Radiology Solutions as discontinued operations. •

AHRA ANNOUNCES IMAGING INNOVATION COUNCIL AHRA: The Association for Medical Imaging Management has formed the Imaging Innovation Council (IIC), developed to unify the voices of AHRA members and corporate stakeholders through consistent dialogue and collaboration. This entity of problem solvers and visionary leaders will pursue and promote innovative ideas and programs that address the gaps and opportunities within the imaging community. “The Imaging Innovation Council is a unique forum that brings together multi-disciplinary thought-leaders to advance the imaging field through research, dialogue, and engagement,” said Rich Dewit, vice president of sales and marketing for Bayer Radiology. “The IIC is focused on understanding the real challenges that imaging professionals are facing, and through collaboration of AHRA and corporate members, our primary goal is to develop innovative ideas that can lead to actionable outcomes and create a positive impact on the imaging community and, ultimately, patient care.” The IIC hosted its first meeting on July 23, 2020 where conversation centered upon the evolving imaging business model, AI and the patient journey. The council also held a panel at the AHRA Annual Meeting to provide a preview into the discourse and thoughts of IIC representatives. The council, chaired by Dewit, is comprised of 11 innovative, imaging leaders. •

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NEWS

RADLOGICS AI-POWERED APPLICATION RECEIVES 501(K) CLEARANCE RADLogics’s novel AI-powered chest X-ray pneumothorax application has received 510(k) clearance from the U.S. Food and Drug Administration (FDA). The clearance paves the way for health care providers, hospital networks and clinicians to have access to artificial intelligence (AI) software that is trained via pattern recognition to process chest X-rays and immediately flag scans with a suspected pneumothorax, a collapsed lung, for urgent radiologist review. The application is available immediately through the Nuance AI Marketplace for Diagnostic Imaging. Operating in parallel with existing workflow, RADLogics’ chest X-ray solution uses an artificial intelligence algorithm to analyze images for features suggestive of pneumothorax. It then makes case-level output available to a PACS workstation for worklist prioritization or triage. The AI-powered solution

integrates into a comprehensive, seamless and secure workflow to augment acute care teams with deep clinical insight and actionable data in minutes. The application was validated and trained by a multi-center study for detecting pneumothorax in hundreds of chest X-rays. In accordance with FDA guidance for imaging systems and software to address the COVID-19 public health emergency, RADLogics has made its FDA cleared X-ray and CT solutions available to hospitals and health care systems throughout the U.S. for patient triage and management. Designed for easy integration and installation both on-premise and via the cloud – RADLogics’ algorithms are supported by the company’s patented workflow software platform that enables rapid deployment at multiple hospitals, and seamless integration with existing workflows. •

AEROREMOTE INSIGHTS COMPATIBLE WITH ADDITIONAL X-RAY SYSTEMS Konica Minolta Healthcare Americas Inc. has released the latest version of AeroRemote Insights, a cloud-based, business intelligence and analytics solution that delivers detailed information on asset utilization, department efficiency, imaging system health and more. This release is compatible with Konica Minolta’s X-ray systems driven by Ultra software, expanding the reach of the service to more imaging solutions. AeroRemote Insights provides vital information on productivity, user performance and system health at a glance including image rejection rates, dose indicators and panel drops. With the ability to view data from any computer or mobile device, imaging departments will be enabled to improve workflow, accuracy and uptime. AeroRemote Insights represents Konica Minolta’s continuing investment in IoT, machine learning and artificial intelligence by creating analytic tools that increase the value of conventional hardware and software solutions.

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“The metrics provided by AeroRemote Insights have allowed us to emphasize the importance of panel safety. The metrics have also enabled us to obtain a better perspective on productivity,” says Ramiro Plascencia, administrative director at Sansum Clinic in Santa Barbara, California. Usage data also provides Konica Minolta with insight into its customers’ experiences. During the first months of the coronavirus pandemic, for example, Konica Minolta’s connected customers saw on average a 54% reduction in exam volumes in April compared to January. May saw a 28% increase in exams over April and June saw an 8% increase over May, a positive indicator for health care providers. AeroRemote Insights is available for most Konica Minolta X-ray and AeroDR Systems as part of Konica Minolta’s premium Blue Moon service plans or as a stand-alone subscription and is compatible with Ultra and CS-7 control software. •

ADVANCING THE IMAGING PROFESSIONAL


NEW VERSION OF C.CAM CARDIAC SPECT SYSTEM DEBUTS IN U.S. Siemens Healthineers has introduced a new version of its c.cam dedicated cardiac nuclear medicine system to the U.S. market. This single-photon emission computed tomography (SPECT) scanner with a reclining patient chair offers nuclear cardiology providers a low total cost of ownership, ease of installation and a high level of image quality. The c.cam has a comfortable, reclining patient chair with a 450-pound weight limit rather than a flat table. This chair improves access to care by allowing the patient to remain seated comfortably during scanning to minimize respiratory motion and cardiac image artifacts. The system’s integrated,

bi-directional camera arm permits easier patient positioning and the small field of view is optimized for cardiac procedures. The scanner’s new Windows software platform contains enhanced cybersecurity features that limit access by non-authorized personnel. With a small 8-foot by 8-foot footprint, the c.cam can be installed in just two days with minimal room modeling requirements. Applications training can be completed in only three days. The c.cam also has a standard five-year warranty.

“This new version of the c.cam SPECT scanner, which is being introduced in response to customer demand, is designed to provide an affordable, easy-to-install system that doesn’t sacrifice image quality and enhances the overall patient experience,” said John Khoury, vice president of molecular imaging at Siemens Healthineers North America. •

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NEWS

ICE WEBINARS STAFF REPORT

INAUGURAL ICE WEBINAR DELIVERS ‘PERTINENT’ INFORMATION

T

he Imaging Community Exchange (ICE) magazine continues to grow. Part of the growth is a brand-new webinar series where imaging leaders can earn valuable continuing education (CE) credits.

Registration was free via a Paragon Consulting Partners LLC sponsorship. Webinar attendees shared feedback via a post-webinar survey that included the question: “Overall, how satisfied were you with today’s webinar?” “It was great and very pertinent to the work I am doing today,” shared N. Walton-Trujillo, business coach/ imaging. “The speakers were exceptional,” said T. Molloy, equipment specialist. •

“It was great and very pertinent to the work I am doing today.”

The webinar series, dubbed “A cool series for hot topics,” began with “Engaging Your Data – Making Analytics Work for You” presented by Jef Williams, MBA, PMP, CIIP. Williams, who writes a monthly column for ICE FOR MORE INFORMATION, magazine, provided imaging including upcoming N. Waltonleaders with an overview of webinars, visit Trujillo, business value-based analytics and theicecommunity.com/webinars. coach/imaging market trends, an understanding of various data FOR INFORMATION ABOUT engagement models and information to help the 2021 ICE conference in Fort Lauderdale, measure outcomes of data management. Florida, visit AttendICE.com. Williams, managing partner of Paragon Consulting Partners LLC, was joined by Barbara THANK YOU TO OUR SPONSOR: Smith and Eric Rice of Paragon Consulting Partners LLC. The webinar was approved by AHRA for 1.0 continuing education credits (total) in the CRA domain “Asset Resource Management.” 24

ICEMAGAZINE | NOVEMBER 2020

ADVANCING THE IMAGING PROFESSIONAL


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PRODUCTS

Market Report Report: Medical Image Analysis Software Market to Hit $4.5 Billion STAFF REPORT

T

he global medical image analysis software market size is expected to reach $4.5 billion, expanding at a compound annual growth rate (CAGR) of 8.15% from 2020 to 2027, according to a report by Grand View Research Inc. An increasing incidence of chronic diseases continues to create demand for effective diagnostics solutions, which spurs demand for medical image analysis software. The high growth is majorly attributed to increased usage and uptake of image analysis solutions for diagnosis. In addition, a shift in focus to provide enhanced care has led to the incorporation of various computer-aided diagnosis systems, which is further contributing to the market growth. The introduction of technologically advanced products such as 3D/4D platforms and multimodality imaging platforms is also presumed to increase demand for the software in the near future. Various benefits such as flexibility and high-resolution images, along with convenient use of multi-modal integrated workflows, are expected to bolster demand and increase product penetration throughout the forecast period. Standalone platforms are anticipated to witness steady growth. These platforms are user-friendly and cost less as compared to integrated solutions. These solutions offer more details and features and are used by researchers, allowing them to share and access research data and analyses, thereby enhancing their ability to diagnose, research, monitor and treat disorders. For instance, GE Healthcare’s ViewPoint 6 (for MFM) is a standalone software designed for dedicated ultrasound reporting and image management. The report includes the following highlights: 26

ICEMAGAZINE | NOVEMBER 2020

• Standalone medical image analysis software segment is expected to witness lucrative CAGR of around 8.6% from 2020 to 2027 • On the basis of modality, the ultrasound segment is projected to ascend at a CAGR of 9.9% over the forecast period • 3D imaging software segment is projected to expand at a CAGR of 8.8% during the forecast period • Oncology application segment is expected to witness the fastest CAGR of 8.7% over the forecast period, owing to the increased applications of image analysis software in cancer diagnostics • In terms of end use, hospitals held the largest revenue share in 2019 owing to increasing adoption of these systems for medical imaging in diagnosis of various diseases • Asia Pacific is expected to showcase significant CAGR of around 8.9% owing to presence of unmet clinical needs • Strategies implemented by key players include collaborative agreements, new product launches, and geographical expansion A report from Mordor Intelligence also predicts continued market growth. “The medical imaging software market was valued at $3.16 billion in 2019 and is expected to reach a value of $4.86 billion by 2025, witnessing a CAGR of 9.01%, over the forecast period, 2020-2025,” according to Mordor Intelligence. “Machine learning and artificial intelligence have attracted the health care industry as these innovative analytics strategies have become more accurate and precise.” Grand View Research’s list of key players in the medical image analysis software market include Koninklijke Philips N.V., GE Healthcare, Siemens Healthineers, Agfa-Gevaert Group, Toshiba Medical Systems Corporation, Spacelabs Healthcare, MIM Software Inc., Aquilab SAS, ESAOTE SPA, Merge Healthcare Inc. (IBM), ClaroNav Inc., Xinapse Inc. and Bruker. • ADVANCING THE IMAGING PROFESSIONAL


Product Focus Medical Imaging Software

1

CARESTREAM

Dual-Energy Solution Carestream’s Dual-Energy X-ray technology, utilizing two filter materials, delivers outstanding image quality and comprehensive diagnostic information with an optimal radiation dose equivalent to that of a single chest PA X-ray. Dual-Energy automatically switches between high- and low-energy exposures to produce a soft-tissue-only image with the bone structures removed, as well as a corresponding bone-only image. This differential filter application can be used for chest X-rays on Carestream’s DRX-Evolution Plus System, and is another example of the company’s ability to integrate algorithmic results to provide better medical image quality and improve diagnostic capabilities, while keeping patient safety in mind. •

2

SIEMENS HEALTHINEERS

AI-Rad Companion family

Two new artificial intelligence-based software assistants in the Siemens Healthineers AI-Rad Companion family free radiologists from routine activities during magnetic resonance imaging (MRI) examinations. The AI-Rad Companion Brain MR for Morphometry Analysis automatically segments the brain in MRI images; measures the volume of gray matter, white matter, and cerebrospinal fluid in various segments of the brain; and compares the results to normal volumes. The AI-Rad Companion Prostate MR for Biopsy Support automatically segments the prostate on MRI images and marks the organ’s outer contour in seconds, enabling radiologists to mark lesions and facilitating targeted, MRI-supported biopsies that can help the urologist detect significant prostate carcinomas. Both new AI-Rad Companion software assistants can be used on MRI scanners from Siemens Healthineers as well as outside manufacturers, and are available on teamplay, the cloud-based digital health platform from Siemens Healthineers.¹ • 1. Teamplay is not yet commercially available in all countries. For regulatory reasons, its future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for more details.

*Disclaimer: Products are listed in no particular order.

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PRODUCTS

KONICA MINOLTA Exa Enterprise Imaging

Konica Minolta’s Exa Platform offers a unique and unparalleled solution for medical image and patient data management across the enterprise. A single integrated databased unifies the patient record across all modules – PACS, RIS, billing and specialty viewers. Exa’s Server-side Rendering means the server, not individual workstations, do all the work, eliminating pre-fetching and delivering fast access to all relevant data. Exa’s Zero Footprint viewer delivers full diagnostic toolsets and viewing from any computer with no downloads, plugins or installation necessary. Performance dashboards, a custom workflow engine, enhanced cybersecurity, referring physician and patient portals, and Exa Gateway for teleradiology/ remote reading are some of the added features of the Exa Platform. •

3

For more information, visit www.konicaminolta.com/medicalusa.

LANDAUER OPTIMIZE

Landauer Optimize services ensure you get more from your radiation dose data by delivering personalized data assessments and recommendations. We help by reducing risk, achieving and maintaining compliance, which saves you time. We add an expert, and a partner, to your team. Our radiation dose management software collects the data from your imaging equipment, uses a neural network for automatic protocol mapping and artificial intelligence to detect outliers. We also compare your scans to national benchmarks. Optimize covers both CT and fluoroscopy. With landauer optimize, health care providers focus on caring for patients rather than crunching numbers so you can serve more patients and get actionable insights to standardize care and stay compliant. • For more information, visit landauer.com/ product/optimize.

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ADVANCING THE IMAGING PROFESSIONAL


4

5

GE HEALTHCARE Edison Open AI Orchestrator

Radiologists are often challenged with determining which cases to prioritize in their reading workflow. With GE Healthcare’s Edison Open AI Orchestrator, institutions can help ensure each patient exam is read by the right radiologist at the right time. The Edison Open AI Orchestrator automatically selects and applies AI-based clinical applications then incorporates the results directly into the reading workflow, providing intelligent decision support that can be used to determine a faster and narrower diagnosis. Part of the Centricity Open PACS AI reading experience, the Edison Open AI Orchestrator provides an integrated, and unified user experience that can empower radiologists with a range of vital information for a more confident diagnosis and faster treatment potential. •

RADLOGICS

AI-Powered Solutions In accordance with FDA guidance for imaging systems and software to address the COVID-19 public health emergency, RADLogics is committed to making the company’s CT and X-ray AI-Powered solutions available to hospitals and health care systems for patient triage and management. RADLogics’ AI-Powered solutions provide quantitative analysis to clinical teams that perform testing and measurement of patients with severe or worsening respiratory conditions. This provides care givers with a consistent, quantifiable information to accurately assess the seriousness of the illness, thus allowing doctors to better triage patients based on those that urgently need intensive care such as ventilator support. •

6

7

HOLOGIC

Unifi Analytics Unifi Analytics is a breakthrough business intelligence tool that allows health care facilities to manage their mammography devices, monitor technologist performance and reduce unplanned downtime via predictive end-of-life tube replacement algorithm. The web-based platform tracks a facility’s install base of mammography devices and provides statistical analysis of device efficiency and technologist quality, benchmarks their performance against the national average of Hologic users, identifies potential risks and challenges and maximizes device utilization. Using advanced machine intelligence, the technology can also predict end-of-life tube failures before they occur, allowing facilities to avoid costly unplanned downtime. •

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RSNA

GUIDE TO RSNA RSNA Goes Virtual in 2020

STAFF REPORT

A

s everyone knowns by now, the Radiological Society of North America (RSNA) announced earlier this year that its 106th Scientific Assembly and Annual Meeting will be an all-virtual event from November 29 through December 5. “As RSNA holds the world’s largest radiology meeting with over 50,000 attendees from 137 countries, our ability to conduct RSNA 2020 in Chicago is impacted by global public health considerations,” said RSNA President James P. Borgstede, M.D. “With a mission that focuses on health and patient care, the primary consideration for RSNA is the health and safety of attendees, presenters, exhibitors, staff, and by extension, the global community. Therefore, we concluded it would be impossible to safely conduct RSNA 2020 in person and have decided to hold RSNA 2020: Human Insight/ Visionary Medicine as an exclusively virtual event. While we are disappointed we could not safely meet in Chicago this year, we continue to stand proudly in partnership with the many physicians, health care professionals, researchers and companies doing their part to stop the pandemic and preserve public health, and we look forward to a successful virtual program.” As a virtual event, RSNA 2020 promises to deliver an outstanding program for radiology professionals from around the world. RSNA has enhanced its already successful virtual meeting 30

ICEMAGAZINE | NOVEMBER 2020

to offer a rewarding experience for attendees, presenters and exhibitors. With more than 11,000 scientific and educational abstract submissions, the radiology community is looking to RSNA as its anchor for learning and sharing science and education this year, despite the pandemic. “We proudly recognize that our attendees rely on the RSNA annual meeting as a source for the latest research, premier professional education and cutting-edge radiologic innovation,” Borgstede said. “Connecting medical imaging professionals from around the world is more important than ever during this time, and RSNA is doing this in the best and safest way possible.” The RSNA 2020 Virtual Meeting will ensure the opportunity for participation for all of those who have been impacted by institutional, corporate or national travel restrictions. Featured programming for RSNA 2020 is now available. Attendees can select educational and scientific sessions as well as corporate programming online and start blocking off time on one’s calendar to attend sessions. The full 350+ hours of programming will be announced November 2. Exciting program details include: • Lunch & Learns, find out who is hosting products demos and exhibiting. • Featured education courses and science sessions. • A breakdown of how the days will be structured with the Program at a Glance. • View programming and block off time to attend the sessions you’re most interested in.

Attendees can check out Featured Programming and Industry Programming online at rsna.org/annual-meeting/program-at-a-glance. “We’re excited to bring you access to exceptional educational and scientific programming that you can participate in any time, from anywhere. This is your destination to stay up-to-date with all RSNA 2020 has to offer,” the website states. “With 350+ hours of comprehensive educational refresher courses, featured science sessions and education exhibits that showcase a wide breadth of innovative research across all subspecialties, Cases of the Day, and 190+ additional on-demand sessions. RSNA’s high-quality education keeps you informed, engaged and inspired,” it adds. “Whatever your subspecialty – from breast imaging and cardiac radiology to neuroradiology and nuclear medicine, our program features a wide selection of world-class education to fit your needs. In addition, you won’t want to miss the five Hot Topic sessions related to COVID-19, two sessions related to radiology department readiness and resilience, a variety of Special Interest Sessions and a two-part Imaging Symposium where attendees can review imaging cases covering the entire body.” The pre-event site will open on November 2. In the meantime, browse the featured programming and exhibitor list. The Radiological Society of North America (RSNA) has also offered a variety of special packages and opportunities for exhibitors and corporate sponsors to connect with attendees at ADVANCING THE IMAGING PROFESSIONAL


RSNA’s 106th Scientific Assembly and Annual Meeting will be an all-virtual event this year.

the Society’s 106th Scientific Assembly and Annual Meeting. RSNA 2020: Human Insight/Visionary Medicine will allow thousands of attendees to experience RSNA 2020 – including the all-important technical exhibition – in a new and compelling way from the comfort of their homes or offices. RSNA 2020’s robust virtual platform will offer exhibitors five ways to customize their meeting experience, more than 350 opportunities to expand their reach, seven days to connect live with prospective customers and 21 additional weeks to exhibit on-demand. “Our technical exhibition has always been a huge draw for attendees, and we appreciate the technological advances and innovative solutions our exhibiting companies bring to the RSNA meeting each year,” said Curtis P. Langlotz, M.D., Ph.D., RSNA Board Liaison for Information Technology and Annual Meeting. “In planning this virtual event, we took the time to listen to our exhibitors’ needs. We’ve developed a wide variety of engagement opportunities to establish and strengthen relationships between companies and potential customers. This virtual event, just like our meeting every year, will enable our industry partners to showcase products that help our attendees enhance their practices and improve patient care.” As the largest annual medical imWWW.THEICECOMMUNITY.COM

aging meeting in the world, the RSNA meeting attracts tens of thousands of attendees, including radiologists, allied health professionals, health care executives and key decision makers. The all-virtual platform will also allow exhibitors to connect with new attendees who have been unable to travel to the physical meeting in the past. The impressive technical exhibition will have an expansive lineup of the leading vendors in medical imaging with dedicated industry programming throughout the week. To optimize the exhibitor experience and potential for success, RSNA will take a break from live scientific and educational programming to focus on an exclusive Industry Hour each day, so that attendees have the time to fully explore the virtual exhibits. Through engaging features like one-on-one meeting scheduling, matchmaking and live chat, exhibitors can easily connect with top prospects. With its on-demand Virtual Meeting, RSNA 2020 offers all exhibitors an additional advantage, as virtual exhibits will be available for attendees to explore until April 30, 2021. The virtual platform also provides new and enticing sponsorship opportunities. Sponsoring companies can gain more exposure and a competitive edge before, during and after the meeting through virtual product demonstrations, educational presentations, net-

working events, theater presentations, digital banners, e-blasts and more. RSNA 2020’s suite of promotional opportunities will enable companies to get their messages to the right audience. Find a list of exhibitors at https:// www.rsna.org/en/annual-meeting/exhibitor-list-industry-presentations. And there is good news for those who always enjoy the annual RSNA 5k Fun Run. Everyone is invited to participate in a virtual run. “Get energized the week of RSNA 2020 and join your colleagues for a good cause in the virtual 5k Fun Run! Your participation helps improve patient care by supporting research and education in radiology through the RSNA Research & Education Foundation,” the website states. “The Foundation funds grants and awards to individuals and institutions that advance radiologic research, education and practice.” “Whether you run or walk, you can complete the Fun Run at any point during the 7 days of the annual meeting. Have fun, enjoy some exercise and be sure to share your selfies with us on social media using #RSNA20,” it adds. The race location is any 5k course of your choice, indoors or outdoors. • FOR UPDATES AND MORE INFORMATION on the RSNA 2020 Virtual Meeting, visit rsna. org/annual-meeting.

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ASSET

MANAGEMENT And scheduling downtime

BY MATT SKOUFALOS

A

t Banner Imaging and Telehealth of Phoenix, Arizona, Diagnostic Imaging Support Services Director Sherman Abernathy oversees a multi-modality array of medical imaging systems across dozens of sites in six states, as well as a staff of technicians and engineers who maintain them. In addition to keeping all those moving parts running smoothly, Abernathy also contributes to the long-range planning decisions around replacement of that medical imaging equipment when it’s time – decisions that, in the midst of the novel coronavirus (COVID-19) pandemic of 2020, have been delayed or deferred. “We’ve had to become a little more creative and hold off on what we would normally do,” Abernathy said. “Our plan is to get that back in place next year.” 34

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ADVANCING THE IMAGING PROFESSIONAL


Cover story “ If you know what you’re looking for ahead of time and you agree on what those definitions are going to be, your site visits have more meaning. If you’re always evaluating against that defined criteria, you’re going to have much better odds at creating a ranked result.” – Perry Kirwan

Equipment longevity can vary depending upon its setting; at Banner Health medical centers, CT and MR scanners are used “a little bit heavier” than at its freestanding sites, Abernathy said, and can require more frequent replacement. About 45 percent of the $80-million Banner Imaging centralized operating expenses budget is allocated to medical imaging, said Perry Kirwan, Banner’s vice-president of technology management. In a typical year, overall capital renewal allocations can range from $60 million to $90 million, but in the revenue-depleted conditions established by COVID-19 in 2020, “everything got pulled back down to minimums,” Kirwan said. But before the pandemic hit, Banner had begun planning an enterprise-wide upgrade of mammography systems across all 24 of its freestanding imaging centers; in all, the purchase included 15 to 20 CT scanners on a two-tothree-year timeline. When it was time to make those wide-scale changes, the company began an intensive, inclusive process that would shape the future of its women’s health service line for the foreseeable future. To begin, staffers at each of its sites, from high-volume university settings to rural imaging centers, were asked to participate in the process. As heavily as physicians’ preferences contributed to the conversation, so, too, did input from Abernathy’s department, WWW.THEICECOMMUNITY.COM

including its ability to support the technologies involved and its experience working with the vendors in question. “What was really amazing to see was the collaboration that went on across all the parties at the table, and how we drove that process to a preferred vendor status,” said Banner Health Senior Director Todd Lowe. It didn’t happen overnight: from the moment Abernathy’s team was tasked with evaluating the status of its current mammography inventory to the point of purchasing new devices lasted about 12 months. In some places, the rollout is still ongoing. But it began with circulating “a very detailed questionnaire” among the in-house staff that would interact with the imaging systems, from which a request for proposals was issued to a variety of medical imaging equipment vendors. From there, a select number of Banner employees traveled to five different sites across the country, in a variety of health care settings, to ask questions and get answers from customers who’d already selected the same equipment Banner was considering. They conferred among clinicians and executive leaders at those sites to evaluate vendor performance, then combed through the insights gleaned from those visits according to a set of internally established criteria. These provided the means by which to evaluate the viability of the technologies along a variety of measurements,

from clinician preference to executive satisfaction to workflow and more. Committee members were asked to rank each vendor’s devices along a scale of ranged responses designed to eliminate favoritism, Lowe said. “Every member that sat on that evaluation panel, everybody’s voice was equal,” he said. “Everybody got one vote. Everyone’s evaluation was statistically relevant.” Those objective standards also helped to give committee members a consistent set of metrics by which to consider their experiences at the site visits, Kirwan said. By removing variation from the responses, committee members were able to create a relative ranking that compiled the net results of all perspectives considered in the process. “If you want to get a lot of people to agree on something, you can’t have a lot of subjective measures,” he said. “Almost two-thirds of the time spent in the process is on requirements, definitions and criteria.” “If you know what you’re looking for ahead of time and you agree on what those definitions are going to be, your site visits have more meaning,” Kirwan said. “If you’re always evaluating against that defined criteria, you’re going to have much better odds at creating a ranked result.” At the end of the evaluations, one vendor had separated itself from the others in the field, Lowe said; the ICEMAGAZINE

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Cover story

ASSET MANAGEMENT And scheduling downtime

second and third choices were quite close to one another, and all three had pulled past the remaining candidates. In narrowing down the results along a weighted scale, Banner decision-makers had everything they needed to begin negotiations with their chosen vendor; they were also able to keep the second and third choices close at hand in case those discussions collapsed. “We do not treat our suppliers as adversaries,” Kirwan said, “but we spend a lot of effort making sure that the value of Sherman and Todd’s team is commensurate to what we’re paying [when we negotiate service contracts]. That’s probably where we spend the

vice contract that builds in costs for high-end repairs and replacement of expensive parts, such as X-ray tubes and coils. Additional cost savings can be driven by trading in legacy equipment to the manufacturer, who will refurbish it and handle the labor and headaches associated with its removal as well as the installation of the replacement devices. Most Banner Imaging sites have multiple CT and MR scanners, Abernathy said, which makes it easier to balance the workload when it’s time to take any one of them offline. To absorb a manageable amount of repair costs in its service agreements,

“ I think it’s really important to set up a really good working relationship with the vendors that you choose for your equipment.” – Sherman Abernathy

most time negotiating, evaluating where we stand so we can use our quarterly performance reports to decide where to adjust.” When building the support contracts that accompany new equipment purchases, Banner seeks to define a shared-risk relationship, whereupon cost savings can be related directly to the degree of responsibility for equipment maintenance borne by each party. The most expensive devices, like MR machines, often include a ser36

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Banner staffers typically take responsibility for the first evaluation of all in-house requests, and leverage remote service options from vendors wherever possible. When a replacement part is needed, “We want it to come in overnight, before the first shift comes in,” Abernathy said. “I think it’s really important to set up a really good working relationship with the vendors that you choose for your equipment,” he said. “Down the line, it becomes really important to reach out

for technical support and parts, and without that relationship in place, it can be costly.” “We build our [technician] training model directly from our equipment purchases in the expectation that we’re going to be supporting [the devices] internally,” Abernathy said. “We have service keys, documentation and support that allows us to stretch our use of equipment right up to endof-life service, which can be around 10 years.” “Even then, we can still go out to the third-party market and gather parts and support for those systems,” he said. “Once we hit the 15- to 20-year range, we start allocating funds for the replacement of equipment.” Cost management is ever an ongoing concern, but never more so than amid the COVID-19 pandemic. Given the uncertainty most health systems face as the months roll on and the northern hemisphere heads into flu season, budgets have to recalculate expected patient volumes, adjust hospital capacity for handling any delayed or deferred care that might have been pushed back during the earlier part of the year, and manage financial gaps brought on by governmental shutdowns. “COVID is still with us,” Kirwan said. “Most health systems are not thriving. If you’re making your budget, you’re likely only making your budget because of the CARES Act. For certain things, people come back, mainly because of medical necessity, but how elective is ‘elective’ moving forward?” “We don’t know, and anything related to capital is based upon it,” he said. “If we bounce back quick, we could move to something approaching a normal season.” ADVANCING THE IMAGING PROFESSIONAL


Sam Maxfield, Banner’s senior director of finance, said that its outpatient ambulatory centers “have the benefit of larger parking lots and retail settings” that can support the addition of a short-term mobile imaging option to supplement any equipment that might be replaced or taken offline for service. Those choices can also help avoid extensive capital outlays at a time when revenues are threatened. “Instead of making a long-term capital investment, we can go the route of putting things up in the parking lot where we can still see patients and when the short-term contract is up, we can re-evaluate,” Maxfield said. “It’s an option that we’re giving a lot of thought to at existing centers where we’re at capacity, or equipment is on its last legs, or areas where we were planning on growing and expanding, and COVID brought that to a screeching halt. This allows us to test those markets without making a large capital investment up front and over-committing ourselves.” Those settings that might be less well capitalized than an enterprise system like that of Banner Imaging and Health would do well to consider the implications of taking even a single scanner offline, said Mark Watts, the imaging director at Fountain Hills Medical Center in Fountain Hills, Arizona. Watts urged those decision-makers responsible for managing repairs, replacements and preventive maintenance to keep a few things in mind before acting. “You do have to be concerned with uptime, but it’s also about understanding what current and future requirements look like,” Watts said. “If you have 136 hospitals in your system, and 90 of them have only one scanner, the WWW.THEICECOMMUNITY.COM

replacement has to be coordinated so you don’t lose revenue.” For example, he said, a hospital that must take its only CT unit offline for repair or replacement may end up forfeiting significantly more revenue than its rescheduled caseload. Loss of that imaging modality may mean diverting emergency neurology cases and all the accordant business that could have come in through the ambulance service, which accounts for six to eight admissions per hospital. “There’s ramifications for taking down the sole CT scanner within the hospital, and it goes beyond whether you’re providing services for imaging,” Watts said; “it goes to the reputation of the hospital.” “You have to do whatever’s in your power to make sure that you have business continuity and uptime,” he said. The careful replacement of even a single CT scanner with a mobile unit requires planning out its location, connections for IT equipment, an installation plan and even the degree of familiarity your technicians have with its replacement device. “It can take a week to replace the CT scanner, but you have to plan out

for a week on either side, so you end up renting the mobile [unit] for a month at a time,” Watts said. A better move might be seeing whether a scanner could be replaced in its existent location versus bringing in a mobile unit. As Watts points out, “there isn’t any room in a mobile unit to bring gurneys in, there’s no additional space, and when you’re doing work in an unusual environment, there’s greater risk for a sentinel event. “Every time you change out to a mobile unit, the incident rate for a sentinel event goes up 50 percent,” he said. “This goes for all critical access to systems. If your PACS system goes down, if your CT scanner goes down, these unusual circumstances really do have an effect on your normal operations. But you also have to mitigate the risk that’s associated with not having your normal systems operational. “Outpatients, ER patients, inpatients; it’s a juggling act,” Watts said. “When you don’t have that one asset, then it doesn’t matter. You put the trust of the public at risk by continuously rescheduling them. Perception is a problem if you need a procedure and you can’t have it done.” •

“ You have to do whatever’s in your power to make sure that you have business continuity and uptime.” – Mark Watts

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INSIGHTS

E/M OPPORTUNITIES? O CODING/BILLING

ne of the big items of discussion this year are the upcoming changes to Evaluation & Management (E/M) coding documentation and reimbursement. All radiology practices should be evaluating their practices’ patterns to determine if the new changes could yield new opportunities to bill for outpatient patient visits.

BY MELODY W. MULAIK In short, the changes for 2021 include the deletion of 99201 (new patient visit level 1), creation of a new add-on code for extended visits (+99417), creation of a new complexity of service code (GPC1X), elimination of history and/or physician exam in determining the billable code level, and code assignment for new (99202-99205) and established (99211-99215) patient visits based on time or Medical Decision Making (MDM). The American Medical Association (AMA) states that the definition of time is the minimum time, not the typical time, and represents total physician/qualified health care professional (QHP) time on the date of services. The use of these codes requires a face-to-face encounter by the radiologist or other QHP and includes the total of face-to-face and non-face-to-face time. The total time does not include time for activities normally performed by clinical staff. A qualified health care professional is defined as an individual who by education, training, licensure/regulation and facility privileging can perform a professional service within his/her scope of practice and independently report a professional service for reim38

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bursement. If the visit is a split/shared visit, only distinct time should be summed when two or more individuals meet with or discuss the patient so that only the time of one individual is counted. Typical activities that can be used toward total time include: Preparing to see the patient (eg, review of tests); counseling and education for the patient/family/caregiver; documenting clinical information in the electronic health record; obtaining and/ or reviewing separately obtain history; ordering medications, tests, or procedures; independently interpreting results (not separately reported) and communicating results to patient/family/caregiver; performing a medically appropriate examination and/or evaluation; referring and communicating with other health care professionals (when not separately reported); and care coordination (not separately reported). If MDM is the deciding factor for the visit level the existing guidelines that have been in place since 1995 must still be followed. Radiology practices should review how their physicians interact with patients to identify when an E/M service could be reported, what documentation requirement would need to be met to bill for the service, and how to appropriately capture and communicate the visit level to the billing office/company. For many practices, the revised guidelines could represent a new revenue opportunity which would be some good news in the midst of pending revenue reductions for imaging services in 2021. • MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.

ADVANCING THE IMAGING PROFESSIONAL


TECHNOLOGY THAT DELIVERS ON DEMAND C

OVID or no COVID, the demands on imaging departments and professionals are heating up. Your ability to meet those demands are only as good as the technology behind each of your devices.

At Innovatus Imaging, we’ve been fine-tuning probe repair technology for nearly 40 years, leading the way for accuracy, first-time fixes, and sustainable repairs you can trust to keep your departments up and running. Our methods are built upon processes developed by our FDA registered Center of Excellence for Design, Manufacturing and Engineering, and nearly 40 years of testing to assure accuracy, efficiency and reliability. Our leaders have dedicated lifelong careers to identifying pioneering technologies, best practices and executing them with utmost efficiencies. We call it Our Purpose. You can call it Life. Visit our website for a Technology Journey via video of our engineering and repair centers – Innovatusimaging.com. Or call us at 844-687-5100 for details about what we can do to help you meet current and future demands.

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INSIGHTS SPONSORED CONTENT

HOW TO MAKE YOUR NEXT MOBILE CT & MRI LEASE A WIN BY ERIC DAVIS

W

ith so much on the line to maintain patient care and continuity of clinical services, choosing a high- quality mobile provider when the need arises is paramount. Whether your project entails the replacement of your existing CT or MRI, adding capacity to manage your existing patient load, or as a long-term solution for your scanning needs, a quality mobile provider, like Avante Health Solutions, can contribute to making your project progress smoothly. Just as installing a replacement system requires prior planning, there are several things to consider when leasing a mobile. You should choose a provider that can provide site planning services. Mobiles are large and heavy with specific space and power requirements. Your mobile provider will need to help you navigate those issues. They will be well-versed with what is needed and can quickly let you know what upgrades or changes to your facility are required to ensure that your next lease is a success. Choosing the right type of provider will have positive effects beyond helping you choose the correct mobile for your needs. Dealing directly with the mobile owner eases the process as they will have the documentation, such as physicist reports and system options, available so you can quickly determine if the mobile meets your requirements. Does your mobile provider also provide other services? Inquire if your mobile provider can service your other medical equipment, and you could possibly help the bottom line of your budget. If the provider also deals with capital equipment, you will find that they are able to present a bundle that

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includes the mobile lease packaged with the purchase of replacement equipment. Not only will having your mobile provider sell you the replacement equipment save you money, it will eliminate scheduling challenges as they will be coordinating two major portions of your project. Explore purchasing as many services and equipment as possible, including the mobile lease, from one provider. Bundling as much as possible pays large dividends through a volume discount, but also takes out a lot of the work of coordinating multiple vendors with various details of your project. Make sure the mobile provider has complete control over the unit to be able to guarantee on-time delivery. Delays can occur during shipping or if the previous facility extended their lease. A late arrival will cause a domino effect to the next steps of your project, delaying installation of your new equipment and coincidentally the day you can start using your new equipment. In extreme cases, it may even require you to lease the mobile for a longer period of time than what was initially contemplated. The old adage, “time is money� rings true with CT and MRI projects. The availability of service delivery is important to ensuring your mobile unit performs to the best of its abilities. You will want to know where service personnel are located, and how quickly they will be able to respond to service requests. An equipment provider with a national presence will allow you to keep your patient throughput in place while you upgrade your equipment not wait for an equipment repair or have a maintenance issue addressed. Applications training is also a big help. Technologists unfamiliar with the mobile will need training to be successful. Most mobile ADVANCING THE IMAGING PROFESSIONAL


ROVED

providers will provide applications training for an additional fee, and it is well-worth the money spent to ensure high-quality patient care. However, applications training lasts three to four days and prohibits a full patient load. If training is needed, you will want to plan early to ensure that your regular CT or MRI is available while applications training is underway. Choose your mobile provider carefully. Do not hesitate to ask as many questions as necessary to ensure that your project progresses with the least amount of interruption. You want a mobile provider that partners with you and your facility to understand your needs and concerns. Quality service starts with an open discussion of your needs, and when they are met, you will appreciate how smoothly your project reaches completion. Avante Health Solutions will stand by your side through the entire mobile leasing process. We have a large national presence giving us the ability to offer a full range of diagnostic imaging solutions, while still offering the customized personal attention of a smaller company. We hope you will consider us for your next mobile lease so you can put a win NEEDED inCHANGES your column.

PROOF SHEET

OFF: ERIC DAVIS is vice president of operations for the Avante Health

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INSIGHTS

EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

BENEFITS OF A MENTOR OR COACH A

wise man once told me, “Unless your name is God, you need a mentor or a coach.” He was right. No man is an island, and nobody goes through life without the need for objective input. Good mentors and coaches are powerful assets. Some think mentoring and coaching is the same thing, but differences exist. A mentor helps you grow in various aspects of your life, with an agenda set by you. In other words, you are more involved in setting the pace and direction. A mentor often asks probing questions, facilitating 42

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your discovery of how you can improve in the areas you want to address. Think of a mentor as someone who facilitates personal or professional development. “Coach” is a term for someone who focuses more on your performance. A coach usually operates with an organizational focus and helps you improve specific skills or interpersonal relationships that pertain to your job and how your performance impacts your company’s bottom line. Think of a coach as someone who helps you achieve specific workplace objectives and goals. Some people use the terms interchangeably and, personally, I don’t think it matters which term you use, so long as you underADVANCING THE IMAGING PROFESSIONAL


stand what you want from the relationship. I think it’s more important to realize that no matter what you call the person helping you, distinct benefits exist for having mentors and coaches. One question people ask is, “Does your mentor or coach need to be an expert in your field?” The answer is no, your mentor or coach simply needs to be able to help you where you want or need help. For example, a colleague and I were once asked to meet with the leadership team of a high-profile company that manufactures golf equipment. There had been some growing tension in the executive suite and they wanted someone from outside the organization to provide 1:1 coaching to team members with the goal of improving interpersonal skills. At the initial meeting, a senior vice president arrogantly sat back and challenged us with “So, what do you guys know about golf clubs?” Without batting an eye, my colleague responded: “Nothing. And we don’t want to know anything about golf clubs. We’re experts in workplace relationships.” Similarly, a company recently hired me to help a senior vice president develop better interpersonal skills (for privacy’s sake, let’s say they sell widgets). Again, during the vetting process, someone from the leadership team asked what I knew about widgets. I gave a similar answer. That said, sometimes you want a coach who knows something about your field. A friend of mine used to be on the leadership team for a public utility. He got out of that organization 10 years ago and now works as either a coach or a mentor to other executives in that field, depending on their need. You might say I’m a little biased, but I believe clear benefits exist for having a mentor or a coach. Here are just a few: 1. You gain clarity. Often, we are too close to a situation to see it clearly. Think of it this way: it’s difficult to see your nose because it’s too close to your eyes. But with a trustworthy person sharing insights about what he or she observes, you gain useful perspectives on how to improve. If you value that person’s perspective and are motivated to make improvements, you’re more likely to put forth the effort to make the improvement. 2. You have accountability. Without accountability we sometimes end up offering up blame or excuses when things don’t get done. Sometimes both. Because it can be difficult to keep yourself on track, having someone to whom you’re accountable helps you stay on top of those non-urgent but important actions which lead to personal and professional growth. WWW.THEICECOMMUNITY.COM

3. Coaching and mentoring is custom tailored to you. You can attend all the workshops and read all the books you want, but they will forever be delivered to a bell curve of people, not specifically to you. With coaching and mentoring relationships, everything is customized to meet your individual needs. With that, a little vulnerability will be necessary so you can acknowledge and get past some of your weaknesses, but thankfully, it’s not all on your shoulders. A good mentor or coach strives to create a trusting environment. And, through the whole process, your mentor or coach will be helping you capitalize on your unique strengths – something that doesn’t happen in a workshop.

HOW TO FIND A GOOD MENTOR OR COACH Whether you’re looking for a mentor or coach for yourself or for someone else, start by clarifying in your mind exactly what you want from the relationship. Is it more mentoring, with a focus on personal or professional development, or is it more coaching, where help is needed to achieve specific goals? The better you can clarify what you want, the easier it will be to identify the right person. As far as where to look, you can check with people you already know and trust – such as coworkers or a supervisor – and ask if they know anyone. If that produces no results or if you’d prefer working with someone outside your existing circles, coaching organizations may be of help. These companies train and equip people in coaching processes and principles, and their websites usually offer “find a coach” databases. The nice thing about our modern age is your coach can live in Timbuktu because coaching can happen via telephone or video conference. Two final pieces of advice. First, anyone can claim the title of coach, so take the time to vet a person’s experience. Second, I recommend finding someone who shares your values. All other things being equal, a mentor or coach who shares your values has a better chance of understanding your mindset and your motivations, which often leads to better results. • DANIEL BOBINSKI, M.Ed. is a best-selling author and a popular trainer on workplace issues. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach Daniel on his office phone, 208-375-7606, or through his website, www.MyWorkplaceExcellence.com.

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INSIGHTS

PACS/IT BY MARK WATTS

GOOD BOSS VS. BAD BOSS A

former chief information officer of mine once told me, “If the project was successful I did it, if it fails you did it.” From that point on, there was no need to pay attention to him. It becomes difficult to continue to feel passion for the job once you see a lapse in integrity in your boss. It only got worse from there, so I knew it was time to start planning my exit strategy.

I was recently given the opportunity to help create a leadership development program for radiologic technologists. This first move from tech to supervisor or lead is, in my option, the most difficult step in advancing up the career ladder. The skill set to lead is not made up of technical tools taught in most radiology programs. Having a Ph.D. does not make you a great leader. My key words of advice are first learning from the mistakes your bosses have made with you. Second, copy the best practices of good leaders. I will start with what I call the power of a negative example. Do not be a bad boss. Bad boss behaviors lead to poor employee engagement and high turnover. When you have a manager who treats you with respect and has your back, you are more likely to give your best and stay longer in a company, but when you have a bad boss, you’re much more likely to be disengaged, suffer from anxiety and want to leave. 44

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BAD BOSS BEHAVIORS

Good leaders do not fall into these seven bad behaviors: • Micromanaging: This is the number 1 killer of creativity and innovation in the workplace. It fosters an environment of distrust as employees feel suffocated and confined. If you hired someone for a job, give them room to get it done. • Picking favorites: Hiring and/or promoting the wrong people. They only recommend employees in their “inner circle” for assignments or growth opportunities. They surround themselves with sycophants or “yes” employees. • Taking the credit for employees’ work or successes: Bad bosses will do anything to look good including taking credit for the employees work or ideas. Self-promotion is their top priority. There is nothing more demotivating than working hard to earn something only to have it unfairly taken away. This causes employee engagement to plummet. • Ignoring feedback/not listening: Some bosses do not admit mistakes. They take negative feedback personally and treat those poorly who give such. So employees learn not to say anything. Worse than asking for feedback is not doing anything about it. • Not standing up for employees: Some leaders throw employees under the bus. It is demotivating to work for a manager who does not stand up for their team. If someone makes a mistake they turn into ADVANCING THE IMAGING PROFESSIONAL


INTERNATIONAL X-RAY BROKERS IS NOW AN AUTHORIZED DISTRIBUTOR FOR CUSTOM BUILT SURGICAL TABLES!

judge, jury and executioner. They are quick to point fingers. • Overworking employees: It is demoralizing working for such a boss as this. They have unrealistic expectations about what is possible from employees. Their focus is on the bottom line. They hesitate to authorize personal days, or they question the need for sick days. • Overlooking or not recognizing employees’ contributions: Two of the most basic human desires are validation and appreciation. People want to feel appreciated, respected and included. Lots of managers think that they have fulfilled their duty by providing a paycheck, but that is not enough if you want engaged and productive employees. A manager’s job is to facilitate a good working environment for his/her employees. Bad bosses create toxic work environments. Toxic environments drain employees emotionally, mentally and physically. I have seen many employees in these circumstances become disengaged to the point that they are only at work for a paycheck – until they quit. Good bosses are few and far in between, and employees long for such bosses who will support, inspire and help them to grow. A recent study from Harvard Business Review found that 65% of employees would rather have a better boss than a salary increase. There is nothing like having a boss who has your back. It is time that companies realize that all the money and perks will not retain good employees if they have a bad boss. A good boss is, without a doubt, one of the best incentives to keeping employees happy and engaged. If you do not currently have good leadership become a great leader yourself. •

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MARK WATTS is the enterprise imaging director at Fountain Hills Medical Center.

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INSIGHTS SPONSORED CONTENT

BY MIKE THOMAS

CATH/EP LAB AND HYBRID OR MONITOR FAILURE RATES SKYROCKET

A

hospital or health care facility can be composed of dozens of departments. A catheterization lab, commonly referred to as cath lab or EP lab, is instrumentally vital to one of the busiest departments – cardiology. Hybrid ORs are equipped with diagnostic imaging technology to give physicians visual access to chambers and arteries of the heart. In these areas, physicians perform life-saving procedures including coronary artery bypass graft surgery, balloon angioplasty, congenital heart defect closure, stenotic heart valve and pacemaker implantations. These acute procedures would not be possible without the appropriate technology to facilitate the imaging process. Cath lab operations are dependent on medical displays, as these monitors allow physicians to visualize a patient internally and perform the necessary procedure. In a single medical procedure, up to 4-6 monitors can be utilized at any time for enhanced visibility. Although many monumental advancements have been made in the efficiency of cath labs, the dependence on X-rays for imaging has persisted through every upgrade. From purchasing analog or digital modalities to choosing a single or bi-plane system, there are endless customization possibilities. Typically, the rooms consist of an image intensifier, C-arm, X-ray tubes and several displays. Advantageously, the digital age ushered 46

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in an era of improvements to imaging technology, which emitted less radiation, and displayed visual clarity. The adoption of CRT monitors in the cath lab inherently changed how labs run. In the early cath labs, all information was conveyed through film. The X-rays utilized produced high-doses of radiation and low-quality images and were printed on 16mm or 35-mm film. Then, radiologists spent many hours in darkrooms to process images and ample storage space was wasted holding boxes of film. With the implementation of picture archiving and communication systems (PACS), the transition from analog to digital technology was concretized. PACS is an all-in-one program that provides electronic storage, retrieval, distribution and presentation of radiology images. In the cath lab, there are typically four to six CRT or LCDs in use. One image is always utilized for monitoring physiological attributes like a patient’s heart rate or blood oxygen level. Following CRT displays, was the adaptation of LCD monitors. Many physicians upgraded to these monitors since they are slimmer, more portable and offer higher resolution images. “We are witnessing yet another transition in cath lab, hybrid OR monitors as many physicians are upgrading from CCFL HD displays to ultra-high-definition 4K/8MP technology,” says Michael Thomas, director of business development and marketing at Ampronix. Many health care facilities have upgraded or are currently in the process of upgrading ADVANCING THE IMAGING PROFESSIONAL


Example of how a Cath Lab Monitor is being used within the EP Lab.

rendered obsolete until a replacement or repair solution is provided. Unfortunately, the turn around time for either of those protocols can take over a week.

THE SOLUTION

their medical displays to this resolution. These monitors provide a level of visibility previously unknown to physicians. During critical surgeries and procedures, increased clarity and sharper details can mean the difference between saving or losing a life. These 4K/8MP large medical-grade displays are considered to be the new “gold standard” for surgical applications allowing multiple screens to be viewed on a single monitor while taking up a minimal amount of space. When a 4K/8MP display is combined with a video manager, it can be customized with a variety of layout options and editing tools like magnification. The design is easier to use and provides a higher resolution, making its adoption an easy choice as it facilitates precise procedures and minimally invasive surgeries. Although the advancement of this technology has improved patient care, WWW.THEICECOMMUNITY.COM

the transition could prove to be detrimental and may demand considerable attention. With four to six displays in the cath lab previously, there are preventative measures in place that guarantee a backup option should a monitor burn out. In critical imaging procedures like angioplasty, mere seconds without visibility become crucial moments, and a single display makes cath labs extremely susceptible to all the associated risks. To solve this issue, some displays are equipped with a secondary backup monitor that folds out, if needed. However, this is a sacrifice that presents limited visual acuity. When this situation unravels, the entire procedure must be halted and the patient sutured up, as technicians attempt to remedy the problem. Furthermore, any display failure amounts to an entire cath lab being

Ampronix has been repairing and selling 4K monitors with 56-inch, 58-inch and 60-inch screens for cath labs and hybrid ORs for years. Ampronix is also able to sell, service and repair cath lab monitors manufactured by Philips, GE, Siemens, Shimadzu, Toshiba, Hitachi, Eizo, Barco, Chilin and Optik View. Some benfits of using Ampronix for monitor needs include: • Cost savings • Reduced downtime • Huge inventory • Low prices • Fast delivery Ampronix services include preventive maintenance, replacement of LCD, backlights, reflectors and power supplies as well as remote adjustments. “We know how important your cath lab is and want to ensure you have zero downtime in the event your monitor will need service or replacement,” Thomas said. “Nationwide requests received by 2 p.m. PST will receive same or next day delivery. Ampronix also offers a readily available response team to assist and answer questions for urgent repairs, ESD- and ASQ-certified technicians and capable and competent customer service representatives for all your medical technology questions and concerns.” FOR MORE INFORMATION, visit www.ampronix.com or email contact@ampronix.com.

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MAKING REMOTE WORK “WORK” W

hile initially a response to the COVID-19 pandemic, remote work has become the status quo for many of us – even in the “essential service” that is health care. Remote work may be considered a temporary solution for your employees; however as this pandemic continues, so too does the timeline of temporary. As your organization may be evaluating the long-term effects of remote work operations, it’s important to be proactive and diligent in optimizing the remote work environment. The transition from working in an office or hospital with colleagues to working remotely is different for everyone. While working remotely may be a great experience for you and your employees, others may find it to be a major adjustment. Factors that can make remote working especially challenging include: • Lack of face-to-face interaction: Many employees may struggle with reduced access to onsite support and communication. They may feel isolated from the organization, leading to disengagement and lower productivity. • Increased screen fatigue: In addition to lacking face-to-face interactions, you and your employees are most likely participating in an increased amount of video confer48

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RAD HR BY KELLY PRAY ences and interactions. While technology is an incredible tool for us to stay connected during these times, this may cause more fatigue at the end of the day. • Distractions at home: While under normal remote circumstances, best practices encourage a dedicated working space at home to minimize distractions. During the COVID-19 pandemic, schools and daycare closures may make dedicated working spaces unachievable. There are quick, inexpensive and easy action steps you can take to alleviate these challenges and optimize remote work success. This begins with the notion that if any of your employees are working remotely, you should approach your team or organization with a “Remote First” mindset. Because of the variety in onsite, hybrid and virtual employees at Children’s Hospital Los Angeles, we have dedicated our remote work strategy under the veil of a “Virtual Workplace.” Having a Virtual Workplace allows for inclusive considerations for

all employees, regardless of location. It is the virtual equivalent to the physical workplace, led to prioritize employee productivity, engagement and wellness. Action steps to support virtual workplace success: • Create opportunity for virtual workplace interaction: • Create a cameras-on norm that is encouraging (but not mandatory). Encourage all employees to keep their cameras on and explain why. Seeing each other matters most- research shows that seeing each other’s image promotes trust, liking and social belonging. • If you have a hybrid of onsite and remote staff, create a “one person, one camera” policy. Even if a few people are in the same room, have each person dial in from a separate laptop with their camera on. (Ensure everyone but one person in the room is muted.) This enables those who are working remotely to see everyone in the room’s faces and promotes inclusivity of all working arrangements. • As a leader, reach out daily. When it comes to social connection in the virtual workplace, frequency trumps length of time. Schedule daily check-ins with your team in the form of one-on-one calls, team huddles and/or chats. Whichever method you choose, make it regular, structured and predictable. ADVANCING THE IMAGING PROFESSIONAL


• Promote social interaction opportunities. Examples of these may include: » Building in 5 minutes during a meeting for small-talk » Creating optional “Study Hall” times with your staff where employees can remotely work in the same virtual room together » Hold virtual events for teams to join such as morning coffee sessions or happy hours • Don’t forget to interact with your colleagues and peers, too. Check in on other leaders you would normally interact with on a daily basis. Schedule a virtual coffee or lunch to promote social engagement and support for yourself during this time. • Alleviate screen fatigue: • Avoid multitasking. As tempting as it may be, multitasking during virtual meetings can lead to increased risk for exhaustion. Close tabs that may distract you, put your phone away and stay present. • Focus on the speaker. As exciting as it can be to have a gallery view of everyone’s faces on a call, this counteracts our natural focus on WWW.THEICECOMMUNITY.COM

a single person during in-person interactions. Protect your energy by keeping calls on speaker view. Another step during calls is to minimize your video camera feed – it is exhausting to have what feels like a tiny mirror throughout calls. These steps will allow you to have a more natural visual sensation during meetings. • Build in breaks. It’s easy to schedule back-to-back meetings when you aren’t leaving your desk. The same grace period of 5 minutes for traveling to onsite meetings should be allotted for virtual settings. Take 5 minutes to step away from your computer, using the time to stretch, step outside or simply give your eyes a rest. • Normalize distractions at home: • As a leader, normalize sounds and distractions that may occur in the background as to not alienate employees with kids or pets at home. Acknowledge the strain of distributed attention and greater stress both at work and at home. • Create resource groups for employees with at-home considerations such as children or pets. • If encouraging employees to

share photos or keep cameras on, be mindful that some people working remotely may not feel comfortable sharing their living environment. • Lastly, with so much focus on families and pets, it can be easy to overlook employees who are living alone. Employees who live alone during COVID-19 may be at higher risk for loneliness and isolation. Be sure to address this in one-on-one conversations and identify opportunities for connection. Working remotely is going to look different for each individual person. I encourage you to work directly with your employees to come up with the communication approaches that will work best for your team’s operational and engagement needs. Regardless of how you chose to lead with a remote workforce, you should ensure you are proactively and consistently providing equal opportunities for remote workers to contribute, succeed and advance within your organization. • KELLY PRAY is the enterprise change management lead at Children’s Hospital Los Angeles.

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INSIGHTS SPONSORED CONTENT

WHY WOULD ANYONE WANT TO WORK HERE? BY BETH ALLEN

B

anner Imaging began when Banner Health acquired two successful previously radiologist-owned companies to establish a presence in the outpatient radiology arena. This would increase convenience and decrease cost for Banner Health patients. Together with three Banner hospital outpatient departments, we were commissioned to bring together best practices to provide an efficient, productive and successful outpatient medical imaging model to build upon.

and integration into the system – just to name a few. Change management was on everybody’s daily to-do list. In order to balance this, we formed an Employee Engagement Task Force, made up of team members from across Banner Imaging from all departments and levels of staff. We asked ourselves why people would want to work here. We identified opportunities beyond the necessities that would make Banner Imaging attractive to talented individuals looking for more than a place to collect a paycheck. Of course, the obvious way to be able to recruit the caliber of team members we are seeking is to offer a competitive compensation and benefits package. Banner Health has an entire department that has already taken care of that for us. We wanted to go beyond that and offer more intangible benefits that create a loyal and engaged team, committed to our shared goals and principles. Opportunity for career development is an example of what we wanted to offer. When possible, we offer cross training positions for CT, DXA, mammography and MRI. If a technologist has done preliminary work to be prepared for one of these positions, they are eligible to apply when those positions become available. Candidates are chosen based on the how they will fit into the current team in that modality as well as their performance in their current role. Once training is completed, the candi-

Every position and every team member are critical to our success.

Before our company was even “born,” the senior leadership team met to identify which key performance indicators we would use to determine our success. One of these key indicators was to be in the top decile of employee engagement. We made a commitment to be the place people chose to work right from the onset. We did not want to lose sight of employee engagement as we sorted through all the complicated dynamics of bringing our systems together. There were a multitude of stress-generating tasks that need to be completed in order to become one system; RIS, PACS, policies and procedures, workflow, a new telephone platform, patient experience expectations 50

ICEMAGAZINE | NOVEMBER 2020

ADVANCING THE IMAGING PROFESSIONAL


date will successfully pass the ARRT registry in this modality. Leadership positions follow the same game plan. As we are rapidly growing beyond our current 24 locations, there will be many opportunities for those looking to expand their responsibilities into a leadership role. Again, we ask for preliminary groundwork to be done to be prepared when the opportunity comes up. We do succession planning to identify those individuals that are ready for more responsibility and assign tasks that will help to grow their leadership skills. There are education resources such as college classes, the ASRT, ARRT, AHRA among others that can enable future leaders to be prepared. We also offer challenges to grow to our ancillary and support staff. Historically, we have team members who have started at our front desk or as a medical imaging assistant who have gone on to become radiographers. We also have leadership positions within our patient access team. Every position and every team member are critical to our success. To offer opportunity to grow is a win for everyone. Most of us who have chosen a career in health care have done so because we want to help people. When you get down to the basics that is what it is about. We wanted to create a culture that expects that we will do what is best for the patient. This gets more and more difficult to decipher through rules, regulations, a litigious environment and efficiency expectations. Taking care of people is where we get our career satisfaction. It is important that we don’t lose sight of what makes health care rewarding and enjoyable. Going above and beyond for our patients is the expectation and a daily occurrence for our staff. Because of that we, as leaders, need to not only recognize our staff, but to appreciate them as well. When we “recognize” we value the product or service they proWWW.THEICECOMMUNITY.COM

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vide. When we “appreciate,” we value the person behind the task. By distinNO FUR LOOK TH guishing this, we are able ER . to connect deeper with our teams. We keep an open line of communication to our front-line teams. By taking a positive, proactive approach to problem solving, we work to identify best practices and innovative solutions as new challenges arise. Often, we find the answer amongst the people doing the work. Our workflows have been designed with both patient and staff in mind. We use AIDET as a guideline across all of our departments. GE • TOSHIBA • SIEMENS • PHILIPS We all had great plans for Banner Imaging and our teams. When the COVID-19 crisis hit, we had to find a GE • TOSHIBA way to support our dedicated employees in a way that we were not SIEMENS • PHILIPS expecting. We were mindful about staffing, doing everything we could to Give us a call at 213-276-8209 avoid a reduction in workforce. Like (844-PMIM-MRI) imaging practices across the country or visit www.pmimagingmgmt.com our volumes dropped dramatically. We redeployed team members to help in urgent care locations, to make masks, to help at COVID testing sites. Many volunteered to take flex time, sabbatJoin the ICE Community today to: ical or leave of absence. Our priority was to support our team members through this crisis in order to preserve Receive a FREE our ability to come out of it. subscription to Fortunately, we are building back toward our pre-COVID volume exICE Magazine pectations and our team is stronger than ever. We will need more of these incredible health care heroes to meet Stay up to date on our goals as we rev up our capacity news about the and open new locations. Why would anyone want to work ICE Conference here? Our goal is to have our team ask, “Why wouldn’t you want to work Learn about here?” •

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INSIGHTS

A HEALTHY WORK ENVIRONMENT

O An important component of a healthy ergonomic environment is the position of the monitors to a correct height and distance.

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ICEMAGAZINE | NOVEMBER 2020

ur work environment is critical to our success, yet we spend so little time considering the conditions and ergonomics of that space. This has been exacerbated by the shift to working from home.

correct distance and angle or wedged into a corner, dictate how the body is positioned. A person naturally moves her eyes to the most comfortable position for viewing the screen. If the desktop position is not configured optimally, the body will DEPARTMENT/ contort in such a way to OPERATIONAL ISSUES support the eyes and its BY JEF WILLIAMS ability to best focus on In many cases the home the object. This leads to office is pieced together or wedged into a neck and back pain and over time can cause corner of an existing space. There are signifsignificant health issues. icant implications to how we are positioned, Setting up the workspace, whether it especially if we spend much of our day in be for a radiologist or not, there are three front of a computer. There are numerous things to consider. First, the need to be able studies that show that more than 50% of to both sit and stand while working at a sinradiologists, who spend a majority of their gle location. There are many solutions now time in front of a computer, are experioffering desks that move almost effortlessly encing musculoskeletal issues because of allowing people to alternate between these poor work environments. Recently I spent two positions, which is important for lower some time on a podcast with Greg Patback health. This means moving the desk rick, founder of Redrick Technologies. He so that in either position forearms are at a is an ergonomics expert and we discussed 90-degree angle, which promotes the ability some common issues and ways to improve for one to be relaxed from the shoulders to working conditions for radiologists and for the hands. I recently saw a poster at my gym anyone who spends hours at a time in front (when I was still able to use it) that demonof a computer. strated the various problems of a sedentary When one considers the role of a rasitting work life. The human body was not diologist, the screen is the most important designed to sit. Standing is an important interface. We spend a lot of money on mofunction physically in a work environment. dalities and technology, but it is a radioloMost people’s workload continues to gist’s eyes looking at a screen that ultimately increase. The number of hours spent in front determines the diagnosis. Consider how one of a computer monitor does not typically acworks in front of the computer. The eyes commodate for frequent breaks. Introducing always follow the body. The way desktops a sit-stand option is one step toward improvand monitors are configured, whether at the ing physical movement and reducing lower ADVANCING THE IMAGING PROFESSIONAL


back strain. There are many employers that are now integrating personal device information and tying it to their employees’ insurance premiums. By demonstrating that one walks a certain number of steps or is active a certain amount of time can reduce their pre-premiums. Some organizations have now included standing during the workday as a metric because they see the health benefits. Another important component of a healthy ergonomic environment is the

position of the monitors to a correct height and distance. One is physically most comfortable when the monitor is positioned slightly lower than the eyes. This ensures that one’s head is not too far back or forward but rather maintains a neutral position. If you are struggling with neck pain, you may consider repositioning your monitor either higher or lower. And finally, the distance of the monitor from the eyes should be optimized. There is a natural

MRI & CT Services

focal depth that varies for each person. Most common is arm’s length to the center of the monitor. All of us are being asked to do more with less. We are constantly reviewing our workflow and operational models. For radiologists, volumes continue to grow and studies continue to become more complex which requires more screen time. While technology can play a critical role in helping us automate, there is a human element that is not going away. The best way to be efficient is to stay healthy. Yet many of us are working in conditions that will have long-term effects on our eyes, necks and backs. While many of us may not be in a position to design a state-ofthe-art desktop, we can take some simple steps to improve our working environment in a way that accommodates better posture and ergonomics. •

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JEF WILLIAMS, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners.

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INSIGHTS

DIRECTOR’S CUT BY MARIO PISTILLI

VENDOR RELATIONS: A DIRECTOR’S PERSPECTIVE I

was asked to write this article by a vendor colleague of mine. She shared with me that a good deal of her mental energy is spent trying to “figure us out.” We had a great discussion about what I think makes a great vendor and what makes a not so great vendor. I also seem to get these types of questions frequently from new leaders and mentees. Vendor relations is a hot topic among my colleagues, and I am sure vendors have much to say about radiology leaders also. In my experience, I have worked with some amazingly talented vendors that add real value. Some of the advice that I can offer my vendor friends are: • Know your product. The very best reps know their product line intimately, not only the specs and features, but what they are used for. I have had some vendors that could not even tell me what the difference was between CT Model A and CT Model B that cost $500,000 more. If you cannot tell me that, then chances are I would not buy either. Get to learn how your customers are actually using these features in the field. Experienced Radiology Directors know that there are 54

ICEMAGAZINE | NOVEMBER 2020

sometimes disconnects between equipment designers and technologists and that fancy new costly features may be impractical and rarely used. • Get to know my clinical needs and how your product can solve them. The very best vendors take the time to really learn and understand our patient populations, the types of work we do and the unique challenges we face. I want a partner in a vendor, who is passionate in our patients getting the very best care. I am not the one who is benefitting from this machine it is our patients. I have had wonderfully productive relationships with vendors that were great sources of knowledge and information. • Realize that although I may not be your customer today, how you treat me matters for tomorrow. I have had many vendors react very unprofessionally to losing a sale. It is your responsibility to sell your product, not mine to buy it. If I chose to go with another vendor, don’t tell me I am making a mistake or that I don’t know what I’m doing. It is better to take the high road, and responding with, “ I understand, and I hope that you and your patients get what you need.” In speaking to my director friends, every one of them said that vendors trashing other vendors is never received well. ADVANCING THE IMAGING PROFESSIONAL


• Make it easy for us with the little things. For example, one of my biggest pet peeves with vendors is when they do not put their full contact information when they sign an email. I thought I was the only one, until I vented in a group text to other directors and everyone chimed in that it also drives them nuts. We deal with many different vendors and many different people from each vendor. If I want to call you, I do not want to have to find your business card or search through a bunch of contacts. I am going to pull up the last email. Also, we may not remember all the people and roles within your company, so signing an email “Jim” does not help me remember. Was Jim the apps guy, or the sales rep, or the vice president of sales? Also, ask what good follow-up timing looks like. Giving a presentation today and calling tomorrow to ask if I made a decision is not helpful. It is an art to gauge how much is too much communication and what is too little. If in doubt, just WWW.THEICECOMMUNITY.COM

ask us what would work best. • Do not ever try and do an end around or circumvent the radiology director. Trash talking the director to a radiologist, vice president or anyone else will not gain you support. I have actually had a vendor email my boss to say that I was making a huge mistake, and was being unfair because I had a favorite in mind already. I was not happy having to show that every vendor had equal presenting time and access and that it was a group decision. • My buying decision is not based on whether I like or dislike the vendor personally. If I do not buy from you it is not personal, it is only because I did not feel it was the best equipment at the best price. • Yes, we will pressure you on price. No, most of us do not get a bonus if we save money on the purchase. Capital dollars are very scarce in health care and we are competing with everyone else in the hospital for needs. Every dollar spent on radiology is a dollar that is not

going to support some other need of the hospital. For many of us the prime motivation is to support our organizational mission by being the best stewards of the capital money we do get and for the hospital to maximize their capital spend across all needs. Work hard for us to get us the very best pricing possible with that in mind. In summary, the vendors that do it right can be a valuable teammate in providing patients the very best care. Lead with your heart, be honest and keep the patients’ needs at the center of what you do. If you start there, (oh! and sign emails with your contact information) you may see your sales and relationships grow. • MARIO PISTILLI, CRA, MBA, FACHE, FAHRA, is administrative director for imaging and imaging research at Children’s Hospital Los Angeles. He is an active member and volunteers time for ACHE and HFMA organizations. He is currently serving on the AHRA national Board of Directors. He can be contacted at mpistiili@chla.usc.edu.

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AMSP

SPONSORED CONTENT

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ADVANCING THE IMAGING PROFESSIONAL


SPONSORED CONTENT

MEMBER PROFILE

PREMIER IMAGING MEDICAL SYSTEMS BY ERIN REGISTER

P

remier Imaging Medical Systems (PIMS) has been in business for more than 30 years. The company started with processor service and has continuously grown into a full service, 27,000-plus square foot facility in Rome, Georgia. PIMS is an ISO 9001 facility that specializes in refurbished GE equipment. The company also provides full service biomed support of new and used equipment. The PIMS staff includes engineers with a combined work experience of 100+ years in the field. The average engineer has been with the company for 10+ years, resulting in stability and knowledge that is passed on to customers. Premier Imaging is a member of the Association of Medical Service Providers (AMSP), the premier national association of independent service and products providers to the healthcare technology industry. ICE magazine learned more about PIMS in a recent interview.

Q:

How does PIMS stand out in the medical imaging field?

A: A few years ago, we saw an opportunity due to GE Legacy camera tubes

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no longer being available. Therefore, PIMS developed an imaging system to allow for a Windows 10 update with a CMOS camera or dynamic flat panel. We have progressed to the Precision 500, which has some key discontinued components and designed an imaging system to install a dynamic flat panel. These workhorse systems have been installed in hospitals and imaging centers for years. PIMS is bringing these systems up to current technology. Our exclusive imaging system offers new features including the ability to record 30-minute fluoro loops, network security and also auto dose reporting, with typically 50% dose reduction. Can any facility say that their reimbursement for fluoro is going up? Can any facility say they are making a profit on fluoro exams? The answer to both is unequivocally no! PIMS allows you to meet your fluoroscopy imaging commitment and preserve your capital budget for more profitable modalities. We are the only company in the world doing GE fluoro upgrades for Legacy and P500s.

Q:

What are some of the services and products you offer?

A: PIMS provides a full range of both imaging and biomedical sales and services, including refurbishment of

equipment. We distribute nationwide through a dealer network. We are excited that we can bring products to market that keep health care affordable.

Q:

What has been your company’s biggest achievement?

A: It is achieving ISO quality standards and expanding nationwide.

Q:

What is on the horizon for your company?

A: Building off our current imaging systems, we plan on developing some very unique modalities.

Q:

Is there anything else you would like our readers to know?

A: PIMS does refurbishment of OEC C-arms, GE CT scanners, GE cath labs, GE R&F rooms and almost any manufacturer’s radiographic rooms. • For more information about Premier Imaging Medical Systems, Inc., visit www.premierims.com.

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“The role of a leader is not to come up with all the great ideas. The role of a leader is to create an environment in which great ideas can happen.” – Simon Sinek

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Science Matters

At last, X chromosome fully decoded The human X sex chromosome, which both males and females carry, has been fully decoded from end to end, and many mysteries may lie in that genome data.

DNA hides coiled away

CELL Nucleus

What are sex chromosomes? Humans have

CHROMOSOME

23 pairs of chromosomes, half of each pair came from their mother and half from their father

The 23 chromosome pairs Human DNA molecule is 2m (6 ft.) long

Note: These came from a male

Genetic code

of any organism lies on its DNA molecules

Gene: Section

or sections of DNA giving instructions for making proteins or carrying out essential biological functions

GENE

DNA MOLECULE

(DNA unit)

Y

The two sex chromosomes

Female has XX Gene expression:

Whether, and how, a gene does its work Base pair

X

Genome: Full genetic

One of a female’s two X chromosomes is “silenced” Only the genetic code on the other X is active

Male has XY Both of a male’s sex chromosomes are active, but tiny Y has a limited function

Genetic code on the X includes about 800 protein-

making genes; many are related to the immune system

code of a organism Sequencing: Decoding some or all of a genome in the lab

Diseases involving the X include many with a clear

Graphic: Helen Lee McComas, Tribune News Service

Source: Karen Miga of University of California Santa Cruz Genomics Institute; Nature journal; Human Genomics journal

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sex bias, affecting females and males differently

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INDEX

ADVERTISER INDEX AllParts Medical Back Cover

Health Tech Talent Management, LLC p. 61

Ampronix, Inc. p. 3

ULTRASOUND QA & TRAINING PHANTOMS Association of Medical Service Providers (AMSP) p. 56

MedWrench p. 60

Leading the Industry in Biomedical Solutions

Summit Imaging, Inc. p. 15

iMed Biomedical p. 25 MW Imaging Corp. p. 5

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Sodexo CTM p. 41

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RTI Group p. 23

ICE Webinar p. 32

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KEI Medical Imaging p. 53

PROSPECTS

Experts in Siemens Medical Imaging

Injector Support and Service p. 63

PartsSource, Inc. p. 9

Innovatus Imaging p. 39

Technical Prospects p. 61

SOLUTIONS

Diagnostic Solutions p. 21 TriImaging Solutions p. 4

E.L. Parts, LLC p. 41

InterMed Group p. 33

PM Imaging Management p. 51 W7 Global LLC p. 33

Fluke/Landauer/RaySafe p. 2

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International X-Ray p. 45

Richardson Electronics Healthcare p. 25

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Cath-Labs and C-Arms

Always available. Always ready to ship. • Cost effective alternative for high quality medical imaging parts • OEM owned since 2011 • Access to both new and recovered Philips parts

• Multivendor parts (GE, Siemens, Dunlee, OEC) remains at the core of our business • Still here for you, 24/7/365. On call customer service, technical support and shipping

Order by calling 866-507-4793 or email apmsales@philips.com


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