TechNation Magazine September 2021 by MD Publishing

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SEPTEMBER 2021

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14 Ribbon Cutting 35 ZRG Medical First Advisory Health 18 Professional of the Month Roundtable 46 Muhammad Hussain Radiography 50 Roundtable Equipment Disposition 73 The Other Side Celebrating an Industry 63 Cybersecurity

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CONTENTS

FEATURED

HE ROUNDTABLE: T EQUIPMENT DISPOSITION TechNation asked HTM professionals to weigh in and share insights regarding equipment disposition.

Next month’s Roundtable article: Tubes/Bulbs

TEAMWORK: ADVANTAGES OF WORKING WITH OTHERS Interdepartmental collaboration, cooperation and interaction within the hospital environment benefits patients as well as the different departments.

ext month’s Feature article: N The Age of IoMT: IT Security and Medical Devices

TechNation (Vol. 12, Issue #9) September 2021 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2021

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SEPTEMBER 2021

TECHNATION

CONTENTS

INSIDE Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley Karlee Gower Taylor Powers EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

EVENTS

Lisa Lisle

WEBINARS

Jennifer Godwin

HTMJOBS.COM

Kristen Register Sydney Krieg

ACCOUNTING

Diane Costea

EDITORIAL BOARD

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

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

Proud supporters of

P.12 SPOTLIGHT p.12 Department of the Month: The Lucile Packard Children’s Hospital Clinical Technology and Biomedical Engineering Department p.14 Company Showcase: ZRG Medical p.18 Professional of the Month: Muhammad Hussain: From Pakistan to the Lone Star State p.20 Shifting Gears: Content Creator Educating Biomeds P.24 INDUSTRY UPDATES p.24 News and Notes: Updates from the HTM Industry p.32 AAMI Update p.35 HTM Mixer Recap p.36 ECRI Update p.39 Ribbon Cutting: Imaging Diversified p.40 Welcome to TechNation P.43 p.43 p.45 p.46 p.48

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

P.58 EXPERT ADVICE p.58 Career Center p.60 20/20 Imaging Insights, sponsored by Innovatus Imaging p.63 Cybersecurity p.65 The Future p.66 Tuning your CMMS for Success: Optimizing Accuracy for Next Generation Integration and Risk Management, sponsored by First Health Advisory P.70 BREAKROOM p.70 Did You Know? p.72 The Vault p.76 HTM Mixer Scrapbook p.81 Where in the World is Ben C.? p.86 HTM Strong p.82 Service Index p.85 Alphabetical Index Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag

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SPOTLIGHT

DEPARTMENT OF THE MONTH

The Lucile Packard Children’s Hospital Clinical Technology and Biomedical Engineering Department BY K. RICHARD DOUGLAS

ne of the most fulfilling roles in the HTM profession has to be serving on a team that helps children heal. It is a specialty area in medicine that adds an additional layer of urgency and responsibility.

Northern California is home to one of the nation’s leading pediatric health care facilities. The city of Menlo Park sits on the west side of the San Francisco Bay, on the eastern edge of San Mateo County. The city is one of the original parts of Silicon Valley. That center of high-tech dominance is at least partially attributed to Stanford University and one of its former provosts, Dr. Frederick Terman, who is commonly referred to as the “father of Silicon Valley.” The Lucile Packard Children’s Hospital in Menlo Park is part of the Stanford

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SEPTEMBER 2021

Children’s Health network. The pediatric health care network provides health care services to those in northern California. It benefits through its academic affiliation with Stanford Medicine and Stanford University. The 33-member Clinical Technology and Biomedical Engineering Department manages the hospital’s medical equipment along with the medical equipment at other local facilities. In addition to the 361-bed hospital, the biomed team supports two different wings in two other local hospitals – Sequoia Hospital and El Camino Hospital – for a total of 400 beds. The team also manages medical equipment at approximately 70 clinics in the Bay Area. The HTM team is led by Director Ilir Kullolli. He reports to Vice President and Associate Chief Information Officer Lisa Grisim. Managers include Danielle Cowgill, Jeff Fahsel and

Sudhee Tumkur. The team manages more than 20,000 medical devices. “We have techs trained on servicing ventilators, anesthesia machines, surgical equipment, ultrasound, infusion and syringe pumps, patient monitoring, heart lung/ECMO machines, EEG/EMG, dialysis and mobile X-ray equipment,” Kullolli says. He adds that the department also has a team of clinical systems engineers that support over 20 different systems, including cardiology PACS. “Clinical engineering manages all service contracts for medical equipment for the organization. We may not be financially responsible for all of them (i.e., imaging contracts), however we negotiate all contracts for imaging, surgery and all other areas,” Kullolli says. He says that they manage the

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SPOTLIGHT Members of the Lucile Packard Children’s Hospital Clinical Technology and Biomedical Engineering Department utilize a cutting-edge skill set to make sure the youngest patients receive quality health care.

contracts through their Nuvolo CMMS. “Recently, we have taken over the ultrasound probes contracts as well, and we are paying for it. However, we charge back departments for each probe used. This way, we can pool the probes and get a cheaper price,” Kullolli explains. “We use Nuvolo for equipment data, service data, IT/security information, ticketing system (ServiceNOW transfers tickets to Nuvolo), knowledge base (service manuals), service contracts and parts inventory – to an extent,” Kullolli explains. The department is fully integrated with IT and has realized many benefits as a result. “We report up to IT (we call it IS here); we do our CapEx and OpEx planning through IS, and we participate in all IS team planning meetings. I also sit on the IS leadership team,” Kullolli says. A UNIQUE SURGERY CHALLENGE The well-rounded team has faced one of the biggest challenges that an HTM department can tackle; supplying and integrating medical equipment into a new hospital. They refer to it as Packard 2.0. “This new hospital was opened in different phases from 2017-2019. It included four floors of patient care units (CVICU, PICU, HemOnc and MedSurg) for a total of 200 beds. It also included our heart center, radiology, EEG and respiratory clinics,” Kullolli says. He says that on the first floor they opened brand new operating rooms, which included cath labs, IntraOp MRI operating rooms and multiple cardiovascular ORs. “Our team was heavily involved and in charge of the deployment of all clinical technologies in the new

hospital, and their integration with EMR, PACS and other systems,” Kullolli says. “We were also in charge of deploying digital OR technologies and video integration, Synaptive and BrainLab technologies (for neurosurgery), and cardiology PACS integration for cardiovascular ORs. Such technologies help decrease patient time under anesthesia, help our physicians make faster decisions – because information is now at their fingertips – and ultimately achieve better clinical outcomes for our patients,” Kullolli says. One challenge that the team faced more recently was because of the hospital’s unique reputation for performing more challenging procedures. Kullolli says that during the COVID-19 pandemic, his facility faced the same issues as everyone else; patients were limited to how many people could be in the room with them and travel was limited. “This provided us with a big challenge: How do we perform certain surgeries where we need surgeons from other parts of the country to come and assist our surgeons? Remember, we perform certain surgeries here that are not done elsewhere. In this case, we had a patient coming in with a spina bifida surgery that needed to be done on a fetus and the surgeon that was

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

going to assist us was in Texas,” Kullolli explains. He says that his team got together with the IS team, physicians and OR staff to brainstorm ideas. “We were able to come up with a solution where we could show our OR video feed (from our Stryker in room system) in a Zoom session and have the surgeon log in remotely and guide our surgeons. We did a few test runs, and when we had the confidence this would work, we decided to proceed. The surgery was a success, and we have had dozens of surgeries performed since then,” Kullolli says. Away from work, the team maintains its edge by attending training and various HTM industry functions. “We participate in all ACCE activities (webinars, symposiums, etcetera) and different AAMI activities. We also attend our local CMIA meetings,” Kullolli says. In one of the world’s most hightech environments, this HTM team utilizes a cutting-edge skill set to ascertain that the youngest patients have the best chances for great outcomes. Nominate a department at 1TechNation.com/nominations.

SEPTEMBER 2021

TECHNATION

SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE

GIVING MEDICAL EQUIPMENT A SECOND LIFE

hen it’s time to responsibly repurpose your medical equipment, turn to ZRG Medical for an easy, customer-centric asset disposal experience that is secure, cost-efficient and good for the environment.

Since 2013, ZRG has been streamlining the medical asset disposition process for its customers and eliminating the needless waste in landfills by reselling, donating and recycling surplus medical equipment. Today, ZRG is the leading medical asset disposition vendor in Southern California and is growing nationally with expanded services and customers in the North and Midwest regions of the country. The ZRG team works closely with onsite supply chain staff to remove their surplus medical equipment in the safest, most efficient and environmentally conscious manner. ZRG practices the 3Rs of sustainability by “reusing, recovering and recycling” surplus medical equipment. “We believe in giving medical equipment a second life,” says Mimi Lively, CEO and owner of ZRG Medical. “ZRG’s environmentally friendly and customer-focused approach is the future of health care

TECHNATION

SEPTEMBER 2021

asset disposition, and we continuously evolve to benefit the global economy.” ZRG is licensed by the California State Board of Pharmacy to sell medical equipment and follows all state and federal regulations to offer services such as: • Full hospital liquidations services • Inventory assessments • Sales and rental of tested and certified equipment • Equipment donation to nonprofit organizations

Ranging from new to end-of-life, ZRG receives and sells a variety of medical products from all modalities including some of the following: • Patient monitors • Infusion pumps • Endoscopy towers • Anesthesia machines • Operating room tables • Surgical microscopes • Imaging equipment like ultrasound and C-arms ZRG is also Certified Women Owned by the Women’s Business

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SPOTLIGHT

Mimi and Tony Lively are active in the bio medical community, supporting the educa tion of both existing and up-and-coming HTM professionals. Mimi spearheaded the Bio medical Technician course MiraCosta College now offers at its Technical Career Institute location in California.

Enterprise National Council (WBENC). CUSTOMIZED DISPOSAL ZRG understands that every health care facility does not have the same needs and priorities when it comes to removing its surplus assets. Because the team specializes in reselling and recycling medical equipment, ZRG can create tailored solutions for managing any surplus assets within a hospital or health care facility suited to what the customer needs. Depending on the condition, need and value, the equipment can be refurbished, resold, rented, donated or broken down for parts and responsibly recycled. Before anything is resold, rented or exported, ZRG’s Healthcare Technology Management (HTM) team methodically tests every piece of equipment received and confirms the key functions of units are working properly. If equipment does not pass the testing and confirmation phase, it is then repaired, sold to a qualified refurbisher or disposed of through licensed and permitted recycling facilities. Equipment that is ready for sale or rental is sold through our customer-centered direct sales team as well as online via ZRG’s website and other sites such as DOTmed Classifieds and eBay. ZRG’s extensive auction

offerings are available on DOTmed. ZRG has an extensive parts division focused on providing hard-tofind preowned parts so health care facilities worldwide can continue to service their older or end-of-life equipment until it can be replaced. Having worked closely with clinical engineers for many years, the team experienced first-hand the struggle HTM professionals have in getting parts for end-of-life equipment. “We saw a need in the health care community and are doing our best to fill it,” says Tony Lively, President. To support ZRG’s mission that every piece of medical equipment removed from health care facilities receives a second life for the benefit of mankind, some equipment is donated to provide economically disadvantaged people and communities access to outstanding medical care. ZRG donates medical equipment through several nonprofits such as Medshare and Adventist Health Global Missions. DATA SECURITY TOP PRIORITY Besides following a meticulous testing process, ZRG implements a rigorous security program for appropriate equipment handling and data security. ZRG follows strict recycling guidelines that ensure all assets removed are handled according to compliance standards including HIPAA. The

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

She is especially passionate about helping people throughout the world to get the medical care they deserve — she works closely with charitable organizations to provide them with medical equipment to complete their missions. ZRG Medical is certified Women Owned by the Women’s Business Enterprise National Council (WBENC), a member of the Healthcare Supplier Diversity Alliance (HSDA), and Mimi sits on the security Supplier protocol Diversity involves Council of sanitizing, the Health Indus purging try Distributors or destroying Association data (HIDA). on all hard

drives and data storage devices for

every piece of equipment that comes to the warehouse. Each piece of equipment removed is documented in ZRG’s customer portal and all confidential data and hospital identifiers are wiped clean to remove any liabilities and keep patient information secure. Through ZRG’s online customer portal, customers can view all equipment removed from their facility and access documentation with clarity and ease. Inventory lists, releases of liability and certificates of recycling are at customers’ fingertips. Designed with convenience in mind, the portal can also be used to request new liquidation jobs and review past jobs ZRG has already completed. For more information, visit zrgmedical.com.

SEPTEMBER 2021

TECHNATION

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Visit us at Nuvolo.com to learn what a modern CMMS can do for your team.

SPOTLIGHT

PROFESSIONAL OF THE MONTH: MUHAMMAD HUSSAIN From Pakistan to the Lone Star State BY K. RICHARD DOUGLAS

ga Khan University has campuses and education programs in Pakistan, Kenya, Tanzania, Uganda, the United Kingdom and Afghanistan. The university has hospitals in Nairobi and Kenya, in East Africa, clinical laboratories in Pakistan and the Aga Khan University Hospital, also in Pakistan, which is accredited by The Joint Commission.

The Aga Khan University Hospital is a full-service health care facility. One of the biomedical engineers who cut his teeth at the hospital is Muhammad Hussain, who spent seven years maintaining the medical equipment there. Today, Hussain is an HTM professional with Modern Biomedical and Imaging Inc. in Irving, Texas. It was after hearing directly from some experienced biomeds that Hussain decided to make HTM a career. “I was always good at math in high school, and medical science was the most interesting subject throughout my academic years. Surprisingly, I found it more interesting when I researched HTM and interviewed a few successful professionals prior to pursuing my career in the field of biomedical engineering,” he says. Sikandar Khadbai, who happened to be the manager of the biomedical engineering department at Aga Khan University Hospital Karachi, Pakistan, was an influential figure in Hussain’s

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SEPTEMBER 2021

HTM journey. Hussain also says that he was inspired by the application of his knowledge and the impact he was able to make in improving the lives of others. “Not long after, I began my coursework to become a biomedical engineer. Once I graduated, I too began my career at the Aga Khan University Hospital,” Hussain says. Hussain moved up through the ranks, starting as a trainee and advanced from biomedical engineer to senior biomedical engineer and then specialist biomedical engineer during a seven-year period. “All these years, I was working at Aga Khan University Hospital. After immigrating to the U.S., I began working at Modern Biomedical and Imaging Inc., where I currently practice today,” he says. While still working in Pakistan, Hussain’s area of expertise was advanced laboratory equipment. He also has experience working with high-tech robotic equipment designed for surgical use. “Currently, however; I am advancing my knowledge and specialization in other areas such as radiology, surgical and support equipment,” he says. Before receiving hands-on training, Hussain studied biomedical engineering and completed his undergraduate degree from Sir Syed University of Engineering and Technology in Karachi, Pakistan. “In my professional career, I started

as a trainee and worked under professional engineers for a year before I became a biomedical engineer in 2011. Gradually, I gained hands-on experience with a variety of advanced technological equipment and attended manufacturer training in different parts of the world,” he says. SATISFYING JOURNEY As is the case with most experienced biomeds, Hussain has faced some challenges along the way. “The most challenging part for most biomeds in this profession is a lack of manufacturer support, which lengthens the downtime and eventually effects patient care,” he says. Hussain says he vividly recalls working on a project for a hospital in Pakistan when a piece of equipment was being installed for the first time outside of North America. He said that the manufacturer was hesitant to provide service training. “At the same time, they seemed keen on negotiating an after-warranty service contract. Surprisingly, they had no local support there yet. Eventually they agreed to provide the service training and I got trained by them,” he recalls. He says that he traveled to the U.S. for the training and during that time, the manufacturer offered him a job and suggested he go back to Pakistan and work at AKUH hospital as a vendor/ employee. Hussain was surprised at the offer. He questioned the ethics of such a

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SPOTLIGHT

FAVORITE BOOK:

“Untethered Soul”

FAVORITE MOVIE: “Holidays”

FAVORITE FOOD: Indian, Thai, Italian

HIDDEN TALENT: I can sketch and cook.

WHAT’S ON MY BENCH? • • • • •

Safety analyzer Soldering station Vacuum cleaner My stationary My laptop

Muhammad Hussain’s worldly experience makes him the well-rounded biomed he is today.

practice. He also adds his voice to the right to repair movement. “This probably was only my experience and is not a common practice for most for-profit companies/ manufacturers. However, there are other areas in this business that need attention, such as local support system and tech support. Gratefully, there are now some active forums and common e-groups out there to support other technicians remotely, but still, it is difficult in current times to get access to lots of service manuals from very major manufacturers,” Hussain says. When not on the job, Hussain enjoys building and fixing things around the house. “I also volunteer at our mosque regularly on Wednesdays and help repair a variety of equipment/needs. In my spare

time, I love to bike outside, watch comedies, and I have become hooked on murder mystery podcasts,” he says. “My wife and I recently got married and we live close to her family which has been comforting. Most of my immediate family members are all in back home in Pakistan,” Hussain says. Hussain confides his biggest reward is “my client’s smile and satisfaction.” He reflects that it is rewarding “when I can fix their equipment and make them feel taken care of.” “I love what I do, and I take full pride in my profession. I go home daily content and satisfied. I carry out routine inspections and preventive maintenance to ensure a safe environment around patients and medical workers. Not just that, but my daily activities revolve around patient care; knowing that every action tends to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

make a huge difference here and collectively; it can make this world a better place,” Hussain says. He says that integrity is the most important ingredient of the profession. “That makes you a better biomed, besides all the training and technical expertise that comes with time and personal experience. It is something no one can teach you but you yourself. I still remember my mentors’ words to me; ‘Consider that patient yourself to who this piece of medical device will be used on when you inspect or perform maintenance on it. So, how would you inspect it or maintain it?’ ” Hussain recalls. With that mindset, patients in Texas can be thankful for a biomed who was first trained thousands of miles away. Nominate a professional at 1TechNation.com/nominations.

SEPTEMBER 2021

TECHNATION

SPOTLIGHT

SHIFTING GEARS

A Look at HTM Professionals Away From Work Content Creator Educating Biomeds BY K. RICHARD DOUGLAS

n interesting cultural change occurred during the past decade that has become an accepted component of everyday life for millions.

The Internet brought about many new platforms for sharing information; some of which provide entertainment and another segment that provides value as a source for learning and education. YouTube is one of the primary platforms for providing video content, offering millions of videos that are instructional alongside millions more that are purely meant to entertain. The growth of this platform for delivering information and entertainment has spawned an entire generation of content creators. For some, this is a pastime or hobby that will result in periodic videos. For others, it is a primary vocation that provides a full-time income and requires many hours of video production. In addition to YouTube, Instagram and TikTok are social media outlets that reach enormous audiences, offering the ability to post either still images or videos or both. TikTok gets nearly 100 million monthly active users in the U.S. alone and appeals to a younger demographic. Instagram, which started in 2010, has 1 billion active users. That means that one in four of the world’s Internet users will make use of the Instagram app each month. The decision to start a YouTube channel includes the purchase of some equipment along with learning the ropes. Obtaining viewers, and to be included on YouTube’s recommended video list, is competitive. Video production has to be of high quality and the content has to be

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SEPTEMBER 2021

perceived as beneficial to the viewer. Biomeds can expand their knowledge through participation in webinars as well as training through conferences and local biomed associations. For many biomeds, the experience of more veteran colleagues is also a source of information. Social media video platforms are particularly useful as a medium for rookie biomeds to ramp up their knowledge or get some specific insights on a particular piece of equipment. That was the realization of biomed Mayra Becerra, CBET, who started her YouTube channel more than two years ago. Becerra is a Biomedical Equipment Technician II at Memorial Hospital West in Pembroke Pines, Florida. She saw the need to provide an additional avenue for newer biomeds to pick up some tips through the use of YouTube and she created ‘TheBioMedGirl’ channel. “I started ‘TheBioMedGirl’ YouTube channel because I love what I do and wanted to provide helpful content to others in the field. However, my principal goal was to inspire a new generation of biomeds, and even more specifically; women,” Becerra says. Becerra created her first video in response to an HTM contest that was asking for video submissions. “I had some knowledge of creating videos personally, but of course I had, and still have, a lot to learn,” she says. “Anytime I came across a problem that I couldn’t solve or that I couldn’t learn from a service manual, I did what everyone growing up as a millennial did; I turned to the Internet to do my research. I often found gaps in the availability of useful

Mayra Becerra wants to inspire women to join this “life-saving” career field.

content; therefore, I wanted to share the work that I do in a meaningful way with an audience just like me. Where do many of us turn for information in today’s world? The Internet and social media channels,” Becerra adds. The BioMedGirl YouTube channel has addressed topics such as “Olympus printer OEP-4 - Biomedical Engineering,” “Calibrating ETC02 for Philips Monitor - M3015A” and “Servo-i Touchscreen Not Working,” just to name a few. There is also a very creative video for “Health Care Technology Management Week.” Many of the videos make good use of time-lapse photography. “I had seen it done before and thought it would work well for this type of content as well as being a good fit for my target audience,” Becerra says. INFORMATION FOR A NEW GENERATION Becerra recognized that the biomed field has to replenish its ranks and bring in new HTM professionals who will not have the same level of experience as those who are retiring. Her approach has been to take this education to the platforms that are most familiar to the younger demographics

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SPOTLIGHT

With a passion for both cycling and running, Becerra found a rewarding combination - duathlons!

who make up the new HTM rookies. “There are so many amazing biomedical engineers that have been in the field for so long, and they are always passing along useful information to me. I wanted to continue offering insight to others coming into the field as well, so putting out video content I felt was the right medium to meet millennials and Gen Z where they are. I believe Instagram and TikTok are good platforms to get this audience; this is why I have the @TheBiomedGirl account on both platforms, as well,” Becerra says. The social media channels serve a dual purpose for Becerra. “I see how this field, like many engineering fields, has traditionally been male-dominated. So, I wanted to show other women that this field exists and if, I’m lucky, inspire more women to join a field where being an engineer gets to make a difference in saving people’s lives in hospitals around the world every day,” Becerra says. She says that she tries to post content whenever she can. “I plan to post more when I finish school in the next few semesters. Currently, I work full-time at the hospital; even though I have completed a degree as a biomedical engineer and obtained my CBET, I am a few classes away from my next goal of earning a degree in technology management. Also, I am the chair of

SFAMI (South Florida Biomedical Association). Plus, I like running, so I do races and sometimes duathlons. With all of this, I keep myself very busy. As I wrap up school, I do plan on ‘shifting gears’ towards adding more content and maybe even partnering with other professionals and industry leaders to provide more useful content for the next generation of biomeds,” Becerra says Becerra has had other achievements beyond her video production efforts. She earned her CBET certification in 2019. Her work with the SFAMI has run parallel with her work towards her next degree from Broward College. “My goal is to do what I love and to be a great leader. Right now, my leadership is shown through my actions, my work, my ethics and my perpetually positive attitude as this is something we are all in control of – no degree required. I do hope that in time, I can combine this with the degree in technology management to grow into leadership positions, so I can scale my ability to make an impact on as broad an audience as possible,” Becerra says. In addition to her HTM-related work and pasttime, she also finds time for cycling and running and values fitness. “I started cycling with a group from work and did several races with them, and even my sister! My longest rides have been as much as 50 miles. Then, I got into the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

running and have competed in 5ks, 10ks and half marathons,” Becerra says. She says that she eventually combined these two activities and has completed duathlons, taking first and second place in many of them. “This has definitely been a proud accomplishment of mine and really got me to understand the value of fitness and how it carries over into so much of what we do. When I’m busy and don’t have the time to exercise, I definitely feel a lull in my energy and my plan is to always incorporate exercise into my life,” Becerra adds. All of these accomplishments have been achieved while speaking English as a second language. Becerra arrived in south Florida from Columbia nine years ago. She learned English after settling in Florida. As the HTM field works tirelessly to find and recruit new talent, the lack of real-life experience may be offset by resources like the ones that Becerra has created. The “TheBioMedGirl” channels should be added to every biomeds’ favorites or bookmarks, so that every new biomed is aware of these information sources. In the meantime, this motivated biomed has much to offer the HTM field. Visit Mayra’s YouTube channel at TheBioMedGirl.

SEPTEMBER 2021

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NEWS & NOTES

Updates from the HTM Industry TECHNATION ASKS BIOMEDS TO SHARE RIGHT TO REPAIR ISSUES

MD EXPO HEADED TO VEGAS, ATLANTA MD Expo strives to provide healthcare technology management professionals with a unique, intimate and rewarding conference second to none. Clinical engineers, biomedical technicians, directors and managers, procurement/asset managers and others responsible for medical technology gather to network with peers, learn the latest technologies and advances in HTM. Find out what everyone has been talking about; this is one event you can’t afford to miss! Industry-leading speakers cover the hottest topics in HTM including compliance, IT, cybersecurity, management and equipment service. MD Expo also offers the industry’s most unique networking events where HTM professionals can connect and share best practices with peers. It also features a worldclass exhibit hall with the latest technology, products and services. MD Expo Las Vegas is set for November 1-2. This upcoming spring, MD Expo returns to where it all started 20 years ago with a conference in Atlanta! Find out everything you need to know about educational opportunities, networking and the exhibit hall at MDExpoShow.com. Don’t forget to register and remember that MD expo is free for all hospital employees, active military and students. •

TechNation is proud to support and be an advocate for the Right to Repair movement in the healthcare technology management and health care community. A new website (1technation.com/ right-to-repair-incident) specifically allows biomeds everywhere to report incidents when an original equipment manufacturer (OEM) declines to provide parts, technical assistance, keys or other support needed to repair or maintain a device. The goal is to provide biomeds to share their experiences to help others as well as collect data regarding right to repair issues that can be shared within the industry and with regulatory organizations, including the FDA. Share a right to repair issue today at 1technation.com/right-to-repair-incident.•

NUVOLO ANNOUNCES COLLABORATIVE PARTNERSHIP Nuvolo and ECRI have announced a collaborative partnership. The partnership integrates ECRI’s medical device data standardization with Nuvolo Connected Workplace for Healthcare. The automated process for standardization of medical device data in a customer’s computerized maintenance management system (CMMS) is designed to resolve technical and time-consuming challenges that clinical engineering teams face in managing equipment maintenance and recall notifications. Ensuring accurate information about medical device classification, model and manufacturer information across the organization is critical for efficient tracking related to device safety, security and replacement planning. Without common device data formats and normalized data, the effectiveness of maintenance programs can be difficult to measure and manage. “Accurate inventory quality and data integrity is crucial to improving the management and resolution of the more than 3,000 recall alerts issued each year,” says Michael Argentieri, ECRI’s vice president of technology and safety. “We expect our partnership with Nuvolo will drive improvements in patient safety, as well 24

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SEPTEMBER 2021

as operational efficiencies.” Nuvolo will enable automatic standardizing of device data by connecting the customer’s Nuvolo CMMS system to ECRI’s Inventory Standardization membership program. ECRI’s membership helps health care teams maintain referential integrity and increase the quality of inventory data. In addition, ECRI’s standardized device data improves the efficiency of capital planning and protects against cybersecurity threats across an entire fleet of devices. “Once enabled, the ECRI standardization integration will constantly look at new devices as an organization grows and continue to ensure standardized identification of new and existing devices. This provides the organization with the clean data it needs to operate smoothly,” says Heidi Horn, vice president of healthcare product marketing at Nuvolo, and chair of the AAMI Technology Management Council (TMC). • For more information, visit https://www.nuvolo.com/nuvolo-now-integrates-with-ecri/. WWW.1TECHNATION.COM

INDUSTRY UPDATES ECRI ANNOUNCES WINNERS OF 2021 ALERTS IMPACT AWARD ECRI has announced the winners of its inaugural 2021 Alerts Impact Award for excellence in recall management. ECRI’s annual award recognizes its Alerts Workflow members for the impact their recall management programs are having on patient safety, efficiency and compliance. “Effective and efficient tracking of important safety notifications is critical to overall patient safety,” says Michael Argentieri, ECRI’s vice president of evaluation and safety. “Our congratulations to these organizations for demonstrating improved outcomes, increased efficiencies and processes, and excellence in safety and compliance. ECRI named the following winners and finalists at its recent 2021 Alerts Workflow User Group Meeting. The 2021 Winners are Eskenazi Health (Indianapolis, IN), St. Luke’s Health System (Boise, ID) and WellSpan Health (York, PA). The 2021 Finalists were Intermountain Healthcare (Salt Lake City, UT), Baptist Memorial Health Care (Memphis, TN) and Dignity Health (Phoenix, AZ). Submissions were judged based on program impact and adherence to ECRI’s best practices for recall management, including leadership and policy, interdepartmental coverage, program compliance and oversight/reporting processes.

The three award winners were each able to achieve close to 100% compliance with their recall requirements. MaryEllen Pfeiffer, DO, a leader from one of the winning organizations, commented that WellSpan Health is proud to have accomplished that goal in the midst of a global pandemic. “One important key to our success is that our recall management process is patient safety focused, a significant driver from a clinical perspective,” adds Pfeiffer, senior director of patient safety, WellSpan Health. ECRI’s Alerts Workflow membership provides tools that enable health care providers to improve efficiency in monitoring and managing thousands of medical device and pharmaceutical alerts, in many cases weeks and months in advance of FDA recall notifications. Members report a 50 to 90% reduction in time spent managing nearly 3,000 alerts and recalls issued each year. The Alerts Workflow program can standardize and automatically match recalls to inventory, segregating and highlighting those alerts that are of highest relevance and impact. Personalized dashboards track recall activities in real time, facilitating greater collaboration across departments, facilities and health system networks. • For more information, visit ecri.org/solutions/alerts-workflow.

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SEPTEMBER 2021

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INDUSTRY UPDATES

EQ2, STANLEY HEALTHCARE TEAM UP EQ2 LLC has announced a new integration with STANLEY Healthcare’s real-time locating system (RTLS) platform to support a wide range of use cases impacting care delivery throughout the enterprise. This integration enables asset information in EQ2’s HEMS (Hospital Equipment Management System) CMMS to be updated in STANLEY Healthcare’s MobileView software, while real-time location information for individual assets

is sent to HEMS. With this integration, hospitals can more effectively manage assets. The benefits include providing the location of medical devices and equipment that can be seen through the asset record or work order in HEMS – when maintenance is needed the asset can be quickly found, corrected, and returned to service. Whenever assets are added or updated, the details are updated in HEMS, which automatically updates MobileView. When

an asset or group of assets are recalled, all items can be found and appropriate action taken. Taking inventory counts is simplified, helping to reduce shrinkage and improving accounting accuracy. Combining asset and location information provides hospitals with information to perform timely maintenance, reduce “lost equipment” and improve uptime – all of which helps to improve asset ROI. • For more information, visit www.eq2llc.com.

KA IMAGING, PREMIER SIGN GROUP PURCHASING AGREEMENT HERTZLER JOINS THE INTERMED GROUP The InterMed Group has selected Larry Hertzler as the company’s new chief operating officer (COO). Hertzler will support CEO Rick Staab in executing the company’s strategy and vision to create solutions for tomorrow’s health care industry challenges. Hertzler is passionate about health care and is driven to use his industry insight and data analytics to improve performance for customers. He brings more than 40 years of clinical engineering operations excellence to his new role. Hertzler previously was part of the senior team at TRIMEDX and assisted with the integration of the Aramark HTM business into the TRIMEDX organization. He also led the clinical engineering program for BJC Health System for 14 years during the organization’s formation, and most recently lead the facilities engineering programs for Franciscan Health. “I am thrilled to join the InterMed Group. I have followed their development for a long time and have served on committees with their leadership team. I have always appreciated their passion and the company’s approach to the market,” Hertzler said. “When I first heard about the opportunity to join The InterMed Group, I thought it was too good to be true. I am excited to be a part of this exceptional organization and help it continue to make a difference in health care.” •

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SEPTEMBER 2021

KA Imaging has been awarded a group purchasing agreement for a technology breakthrough with Premier Inc. Effective July 1, 2021, the new agreement allows Premier members, at their discretion, to take advantage of special pricing and terms pre-negotiated by Premier for Reveal 35C, in the product category of general radiography (radiography, radiography and fluoroscopy, portable radiography). “The technology program was designed to ensure that Premier’s members can access innovative products that drive high-quality and cost-effective care,” explained Amol Karnick, president and CEO of KA Imaging. “Being accepted through this program is an important step for Reveal. We made a detector that overcomes previous dual-energy technology shortfalls and is retrofittable, which means that any hospital can access the clinical and operational benefits of Reveal with minimum financial impact.” Reveal 35C is the world’s first mobile/portable FDA 510(k) cleared dual-energy X-ray detector, according to a news release. Its patented triple-layer design enables the production of three images from just one shot – traditional DR, bone, and tissue only images, with no motion artifacts. Reveal is currently being used in two clinical trials, for lung cancer and pneumonia, with initial success. • For more information, visit www.kaimaging.com.

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INDUSTRY UPDATES BAIN CAPITAL PRIVATE EQUITY ACQUIRES PARTSSOURCE PartsSource has announced the signing of a definitive agreement to be acquired by Bain Capital Private Equity. The investment will help PartsSource continue to accelerate its growth trajectory, broaden its solutions portfolio and expand its marketplace platform, according to a news release. PartsSource will continue to operate under its current management team, led by president and CEO Philip Settimi, MSE, MD. Financial terms of the private purchase from current owner Great Hill Partners were not disclosed. “PartsSource was founded on the idea that an evidence-based, digital approach to the health care supply chain can unlock better health care delivery, lower costs and enhance clinical outcomes. We are proud of the progress we have made to transform mission-critical health care operations and are excited by the opportunity to continue to expand our marketplace to serve new areas of health care,” said Settimi. “We want to thank Great Hill Partners for its help supporting the business during its ownership and positioning us for success in the next stage of our growth. We are delighted to partner with Bain Capital going forward. They share our vision for building a broader B2B health care e-commerce platform and have an excellent track-record of building leading health care technology companies.” “PartsSource’s cloud solutions help hospitals increase the uptime of mission critical equipment, improve patient safety and maximize throughput and profitability. Additionally, its PRECISION Procurement powered analytics technology allows hospitals to optimize spend, reduce risk and improve supply chain visibility,” a news release states. “PartsSource’s platform also creates value for medtech OEMs and service providers to improve digital connectivity to the provider ecosystem, serve diverse providers more efficiently, increase access to leading health systems and ensure critical business insights so providers can more safely and reliably deliver care for patients. Last year, PartsSource expanded its marketplace network from parts into on-site and off-site repair and service solutions, a marketplace that offers curated and credentialed access to over 2,000 service engineers. This solution was recently selected by the Business Intelligence Group as a 2021 BIG Innovation Award Winner.” Bain Capital Private Equity has a long history of partnering with companies to accelerate growth in the health care and technology sectors. “Over the course of our four-year partnership, PartsSource scaled dramatically and established itself as the clear leader in its space,” said Mark Taber, a managing partner at Great Hill Partners. “We are proud to leave PartsSource well-positioned to thrive in the next chapter of its growth, and we wish Phil and the entire team success as they continue to grow and drive value for customers.” The transaction is expected to close during the third quarter of 2021 and is subject to customary closing conditions, including requisite regulatory approvals. Debt financing for the transaction is being led by Blue Owl Capital. •

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SEPTEMBER 2021

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INDUSTRY UPDATES

MERCY SHIPS TAKES DELIVERY OF FIRST PURPOSE-BUILT HOSPITAL SHIP Mercy Ships, a global health charity, reports that the world’s largest civilian hospital ship, Global Mercy, has successfully been delivered and the charity has taken possession of its brand new vessel. The final handover of the newly constructed hospital ship from shipyard to owners was celebrated at the Tianjin Xingang shipyard in the presence of representatives from Mercy Ships, project managers from Stena RoRo, together with shipyard management, joined by a remote audience of Mercy Ships staff and crew from around the world. The traditional shipyard events are designed to wish happiness to the ship and its crew on the seven seas. The building phase has now been officially completed and the charity is one step closer to the first surgery onboard. “This day is a dream come true – not only for us, but for those we serve,” stated Don Stephens, Mercy Ships founder, who spoke via video to those attending. “African heads of states and ministers of health have often expressed a desire for more of their health care professionals to be trained in-country. This ship will do exactly that. Many who suffer from disability and disfigurement will have access to surgical treatment and whole-person care in health care systems that will enable them to reach their God-given potential. We hope that this

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SEPTEMBER 2021

new vessel and the volunteer crew who serve on her will bring hope, healing and transformation for the next 40-50 years.” Per Westling, CEO of Stena RoRo said, “We are very proud to take delivery of this special ship. The activities to be carried out onboard have placed special and high demands on the construction of this ship. For the yard, it was the first time this type of vessel was built – a challenge that they managed very well. For Mercy Ships, delivery means that their capacity to help more than doubles. And at Stena RoRo we are happy to be a part of their fantastic work through Global Mercy.” Mercy Ships has been working on this new ship project for more than eight years. Contracts were signed in 2013, and the keel laid in 2015. Sea trials were successfully completed in late April of this year. In July, the Global Mercy was scheduled to sail to Europe where, hosted by the Port of Antwerp from early September, the ship will be further outfitted with IT and medical equipment installations and soft furnishings. Mercy Ships volunteer crew will also begin to join the ship in stages during this phase, which concludes with open events in Rotterdam in Q1 2022 where the ship will be presented to sponsors, future volunteers, the media and other interested parties. A further Africa

welcome is being planned in Dakar, Senegal before the ship begins full operation. It is estimated that surgical conditions account for nearly one-third of all disease in the world (Lancet 2015). Building on the charity’s more than 30 years of experience in Africa delivering surgical care, the Global Mercy is equipped with first-class training facilities designed to multiply impact within the nations served. Volunteer professionals will contribute alongside local health care professionals in the host country. With 12 decks, the 37,000 GRT Global Mercy is equipped with six operating theatres, hospital beds for 200 patients, a full laboratory and simulation training areas. Swedish shipbuilders Stena RoRo have been responsible for construction supervision of this unique project. French company Barry Rogliano Salles (BRS) acted as a broker, detailed designs were completed by Deltamarin in Finland and construction has been carried out in China. The Global Mercy is classified by Lloyd’s Register in the UK and sails under the Maltese flag. Many more companies from around the globe contributed to the ship’s completion which is a first of its kind. • For more information, visit www.opportunities.mercyships.org.

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INDUSTRY UPDATES NMS CAPITAL INVESTS IN DIRECTMED PARTS & SERVICE NMS Capital has partnered with company management in the recapitalization of DirectMed Parts & Service LLC. Terms of the transaction were not disclosed. Headquartered in San Diego, California, DirectMed is a large independent source for service and supply of medical imaging parts for MRI and CT machines. Leveraging its inventory of 60,000+ parts across 5,000+ unique SKUs, the company provides 24/7 solutions to major OEMs and independent service organizations (ISOs), imaging centers, hospital systems and parts suppliers across North America, Latin America and Europe. The company’s staff of electrical engineers, physicists and technicians supports customers who require an efficient, price-effective solution to getting imaging equipment back online. As the complexity and cost of repair and maintenance of technical equipment increases and budgets remain stagnant, hospitals and care providers increasingly turn to aftermarket parts and equipment providers to support continued operations. The global 2021 third-party medical imaging equipment market is estimated at $4.8 billion, and is expected to exceed $6.2 billion by 2026. It is critical for health systems and imaging

centers to leverage the independent channel and maximize the useful lives of capital-intensive equipment. “DirectMed has developed and acquired internal repair capabilities and made material investments in inventory and fixed assets to set us up for our next phase of growth,” said Brad de Koning, DirectMed’s president and CEO. “Working with NMS to analyze and finance acquisitions and to assess opportunities for expansion into new diagnostic imaging modalities will accelerate our progress. With its depth of knowledge in the medical imaging equipment industry, NMS provides tremendous benefits to our customers and to our team.” Tanner LoRusso, co-founder and vice president, sales at DirectMed, stated, “The investment from NMS will enhance DirectMed’s data-driven sales approach, breadth of inventory and engineering capabilities, furthering our customer-centric commitment to high quality parts and repairs. As a co-founder of the company, it has been rewarding to see DirectMed build its position in the marketplace. I am proud to partner with NMS – a leading healthcare services investor – to execute our next phase of expansion.”

David Peterson, NMS managing director, said, “The DirectMed management team has built an impressive business with a truly differentiated and unique model. NMS is excited to partner with the DirectMed team given our shared vision in building upon their leadership position in the imaging parts and service sector. Our investment in DirectMed is a continuation of NMS’ theme-based approach to identifying differentiated opportunities in targeted sectors. NMS has spent multiple years assessing opportunities across the medical equipment repair industry, and we were immediately impressed with DirectMed’s positioning and operating model. Their proven strategies, depth of engineering expertise, and highly experienced and knowledgeable management team make us confident in the future of DirectMed. We look forward to this next stage of the company.” The NMS deal team also included Kevin Jordan, Jonathan Spero and Jordan Shenker. Greenberg Traurig provided legal advice and TripleTree acted as financial advisor to NMS. Cypress LLP provided legal advice to DirectMed, and Madison Capital Funding provided debt financing to support the transaction. •

PRIYANKA UPENDRA JOINS ASIMILY Asimily, a provider of Internet of Medical Things (IoMT) risk management platform, has announced that Priyanka “Priya” Upendra has joined the company as its senior director of customer success. An experienced and innovative healthcare technology management (HTM) leader, Upendra will facilitate the use of Asimily’s risk management platform and ensure continuous improvement in process, product, analytics and implementation. Asimily has built an IoMT risk remediation and operations platform that secures medical and IoT devices in an efficient manner. With a large knowledgebase of IoMT and security protocols, Asimily inventories and classifies every device across the health care organization, connected and stand-alone. “Priya brings an unmatched track record when it comes to aligning healthcare technology with IoMT security, regulatory compliance and patient safety, and overall delivering a superior customer experience,” said Shankar Somasundaram, CEO, Asimily. “As more health care organizations turn to Asimily’s IoMT risk remediation and operations platform, Priya’s expertise across all aspects of the healthcare technology and security ecosystem will help drive our next growth phase.” Upendra joins Asimily with over 15 years of experience in the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

health care industry and as a steadfast advocate for patient safety and innovation. She served as a compliance program director at Banner Health, compliance manager at Intermountain Healthcare, and several HTM/ clinical engineering (CE) roles at Stanford Health Care, Stanford Children’s Health and Stanford University. Upendra has been a three-time award recipient from AAMI and is an active member of several committees, including the Technology Management Executive Council. In 2020, she received the ACCE Professional Achievement in Technology award for her contributions to the HTM/ CE profession and won the doctoral student paper for maximizing efficiency in HTM/CE workflows using lean and six sigma. She is the President-Elect of ACCE and a liaison to its membership committee; and a steering committee member of HTA, an alliance between AAMI, ACCE and HIMSS. She is a member of H-ISAC and participates in its MDSISC advisory group and PSIC. •

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SEPTEMBER 2021

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INDUSTRY UPDATES

AAMI UPDATE Survey: Open Positions and Untapped Diversity for HTM

survey of 71 health care organizations and more than 7,000 healthcare technology management (HTM) professionals has validated ongoing concerns while making some promising revelations. The first-of-its kind survey, conducted by the Association for the Advancement of Medical Instrumentation (AAMI), also clearly outlines areas where the HTM field may improve.

With just over 30 simple questions, the survey focused primarily on determining the current demographics of health care organizations, who responded anonymously. Responding groups ranged from standalone hospitals, multihospital health care systems, to large independent service organizations, and local HTM service providers. Among the surveyed U.S. organizations, 5,861 HTM professionals were identified as biomedical equipment technicians (BMETs) or clinical engineers, making up 70% of the responding organizations’ staff. Those surveyed technicians represent more than one-tenth of all BMETs or “medical equipment repairers” employed in the U.S., according to the U.S. Bureau of Labor Statistics. “We wanted to get a snapshot of the U.S. HTM community as a whole and define just how wide the field’s diversity gaps are,” explained AAMI Vice President of HTM Danielle McGeary. “By participating in this survey, the respondents are helping to identify

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SEPTEMBER 2021

where the HTM field will best benefit from improvement. This data is critical as AAMI works to strategically plan future projects and initiatives with the goal of further elevating and diversifying the field.” “We also hope this data will be useful within organizations that employ HTM professionals as well, since up until now the field generally knew there were gender and racial gaps in the field, but we never had a quantifiable number to describe the magnitude of those gaps,” she added, explaining how identifying industry averages will help organizations select areas for improvement and acknowledge their own accomplishments and areas for improvement. DIVERSITY, HTM’S UNTAPPED RESOURCE Perhaps most important was data pertaining to diversity within the HTM

field. Among the 7,037 HTM professionals surveyed, 8.5% were Black or African American, 7.7% were Hispanic/ Latinix, and just over 10% identified as female. Among the respondents holding managerial positions, 14% identified as female. Donna Marie Dyer, senior director of HTM at GE Healthcare and a mentor to many burgeoning HTM professionals, said that she’d like to see the field as a whole “be more aggressive” about introducing women and minority groups to HTM careers. She recently participated in a roundtable discussion among leaders who are working to help bring more diverse staff – and the fresh ideas and perspectives that come with them – to the HTM space. “We’re already having a problem in the HTM industry with the availability of people in general. We certainly don’t want people excluding themselves; we’ve

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got to be more welcoming than that,” said Dyer, who is a member of the AAMI Board of Directors. THE BURDEN OF JOBS NOT TAKEN Dyer echoes the thoughts of many HTM leaders, worried about a future where HTM departments are left with too many open positions – especially leadership roles – unfilled. Of those surveyed, 47% of HTM staff are 50 or older. Among 618 respondents holding managerial positions, nearly 6 in 10 reported being 50 or order, with 95 managers (15.4%) over the age of 60. Meanwhile, the organizations polled reported being 8.5% understaffed (open vacancies) on average. Explaining for vacancies, one-third of those organizations reported that it takes two to four months to fill a position while another 30% reported that it takes longer than four months to fill a position. “Across the U.S., we’re seeing job openings for BMETs not getting filled for months at a time and colleges are being forced to drop their BMET programs due to budgetary constraints,” said McGeary. “This only serves to widen a training gap between the county’s most senior and soon to be retiring BMETs and the next generation of HTM professionals.” Concerned HTM leadership speculate that the workload per BMET will only increase as experienced staff retire. AAMI’s demographic survey revealed that on average, the surveyed health care systems already have nearly 1,500 medical devices per BMET, leading to more than 1,700 total work orders per BMET every year. STEPS TOWARDS A BETTER WORKPLACE AAMI’s new BMET Apprenticeship program, approved by the U.S. Department of Labor and co-designed by McGeary and 2021 AAMI & GE Healthcare BMET of the Year Maggie Berkey,

is a step toward addressing this problem. However, it will take the support of proactive organizations such as those who participated in AAMI’s demographic survey to pave this freshly blazed trail for prospective HTM professionals. The U.S. military is also making strides toward creating HTM career opportunities for service members. The U.S. Army, for instance, offers 10 weeks of basic HTM training, 41 weeks of advanced individual training, and the support to pursue 20 relevant certifications. This career path is open not only to active-duty members, but Army reserve and the U.S. National Guard as well. The result? Of the 7,037 HTM professionals AAMI surveyed, nearly 38% reported being military veterans. Still, consultant Reginald Burrus, a U.S. Army retiree with three decades of experience in HTM, said that it was

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

only in recent years that women are being recruited for military BMET positions. “Both the Army and the technical fields are very male dominated,” he explained during AAMI’s diversity roundtable at AAMI eXchange REWIRED. “It’s important to have the conversations about the tough topics” about where your organization is lacking and recognize that diversity is critical to having a “functioning team.” “The good news is that we know the HTM community is full of people passionate about building a better field – better for HTM professionals, but also for clinicians and patients,” added McGeary. “These survey results reinforce our mission to enable a more diverse future where the next survey will hopefully leave us smiling at how far we’ve come.”

SEPTEMBER 2021

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HTM Mixer Delivers Solutions, Education & Networking BY JOHN WALLACE

D Publishing returned to Milwaukee to host an HTM Mixer for the second year in a row.

The HTM Mixer is similar to the biannual MD Expo with a slightly modified, smaller, shorter-duration and less-crowded schedule that allows for continuing education, networking and vendor engagement opportunities. The HTM Mixer Milwaukee was supported by the Wisconsin Biomedical Association (WBA) with more than 200 industry professionals in attendance. Gundersen Health System Manager of Clinical Engineering Melissa Wilke, CBET, praised the opportunity to attend two HTM Mixers in two years. “The Wisconsin Biomedical Association (WBA) was very fortunate the HTM Mixer was once again in its backyard, Milwaukee,” Wilke, who serves as the WBA treasurer, said. “The success of last year’s event brought all of us back to experience the education and fun in 2021.” “My expectations are consistently exceeded each year I attend a mixer. MD Publishing brings incredibly renowned HTM speakers to enrich our education. The education tracks cover current topics that are applicable to anyone in the HTM field at any

point in their career,” she added. “The vendors put on an incredible show of support. They took time to share their expertise, answer lots of questions and build a relationship with each attendee.” ProHealth Care Director of HTM and Biomedical Engineering Rob Bundick echoed Wilke’s enthusiasm for the HTM Mixer. “The HTM Mixer was smaller allowing more time to be spent with key vendors and not having to rush like larger vendor shows. Both the educational classes and vendor show was excellent,” Bundick said. “This is an event where we network with people. We meet up with vendors, with your local reps. You are going to meet your future employers and it is a regionalized event,” Justin Barbour from the Better Biomed YouTube channel told MedWrench during an interview. “You should participate in your local HTM Mixer because it is going to be regional and very important to you,” Barbour added. Wilke applauded the MD Publishing team for its support of the HTM community. “John Krieg, Kristin Leavoy and their team are extraordinary hosts. They make everyone feel welcome to the HTM Mixer by personally greeting attendees at registration and all the way through to the happy hour

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

reception,” Wilke said. “Overall, the WBA is indebted to John and his team. The growth in the HTM field would not be possible without them. The WBA has honored MD Publishing with the 2021 Lifetime Benefactor Award for their unwavering support, commitment to growth and acknowledgment of HTM professionals everywhere. From all of us in Wisconsin, thank you for another memorable event!” Wilke stressed the value in attending an HTM Mixer and encouraged biomeds to strongly consider the next HTM Mixer being held September 9-10 in Kansas City. “Don’t waste another minute thinking about attending a mixer. Just sign up! These free events are there for you to enhance your HTM knowledge, connect with other professionals and have a great time,” Wilke said. “Be the one in your hospital to bring back the excitement from having attended a mixer.” When asked for the advice he would give anyone who is considering the Kansas City Mixer, Bundick said, “I would encourage them to attend. Both for personal and professional growth. The Mixer is an excellent opportunity to learn, network and share knowledge.” For more information, visit htmmixer.com.

SEPTEMBER 2021

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ECRI UPDATE

Top 10 Patient Safety Concerns for 2021

ach year, ECRI compiles our top 10 patient safety concerns. The list draws on our experience as a federally designated patient safety organization (PSO); ECRI and the ISMP PSO has reviewed more than 4 million reported events from acute, aging services and ambulatory care settings.

Our list reflects our review of root-cause analyses, coverage of the news, interactions with provider organizations and recommendations from an interdisciplinary expert panel. Many of the items on this year’s list relate to COVID-19. While we remain hopeful that the pandemic is in its waning days, it has disrupted health care and our daily lives. It likewise laid bare some of the most entrenched problems in health care. By learning lessons from the pandemic, we can improve safety not just for this and future pandemics, but for all patient and resident care. This year’s top 10 concerns are presented below. 1. RACIAL AND ETHNIC DISPARITIES IN HEALTH CARE Health disparities are health differences between different groups of people, such as differences in: • How many people are screened for diseases • How many people contract certain diseases • How severe the diseases are • How many people have complications related to diseases • How many people die from diseases • Whether people can access health care Racial disparities in health and health care will not disappear overnight and are

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SEPTEMBER 2021

not solely the responsibility of health care organizations, but health care organizations can begin taking actionable steps to start improving health equity. These steps include the following: • Incorporate health equity into the organization’s strategy • Create structures and processes to improve and support health equity • Establish a health equity governance committee • Devote resources to health equity efforts • Leverage health information technology resources to identify health disparities within the organization • Partner with community organizations and develop initiatives to improve health equity 2. EMERGENCY PREPAREDNESS AND RESPONSE IN AGING SERVICES Emergencies often disrupt routine resident care and facility operations in long-term care. Aging services organizations should take an integrated systems approach to implement emergency response plans that concern residents, workforce and visitors. These plans should address: • All-hazards vulnerability assessment • Shelter-in-place; evacuation; or modified admission, transfer or transition protocols • Communication plans for staff, residents, families, emergency responders and the public • Crisis standards of care, including modified visitation • Staffing and scheduling • Supplies and equipment • After action reports to identify successes and improvement opportunities

3. PANDEMIC PREPAREDNESS ACROSS THE HEALTH SYSTEM Over the years, government investigations and other reports have warned that America’s health care system is woefully unprepared for a fast-moving infectious disease outbreak. COVID-19 has proved these warnings to be true. Pandemic preparedness involves: • Surveillance • Occupational health program • Triage • Patient flow and discharge planning • Surge capacity • Mortuary management • Access to care • Promotion of outpatient care of acute respiratory infections • Limiting nosocomial spread • Mass screening • Infection prevention and control • Risk communication 4. SUPPLY CHAIN INTERRUPTIONS The COVID-19 pandemic severely strained health care supply chains, creating widespread shortages of key medical equipment and supplies, including ventilators, testing equipment and personal protective equipment such as masks, gloves and gowns. To address these shortages, health care organizations have turned to nontraditional approaches, including off-label use of existing devices, expansion of device indications for use and use of nonmedical-grade equipment. Tackling supply chain interruptions during emergencies and health crises requires planning, preparation, flexibility and cooperation with outside collaborators.

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Telehealth is adding value-based care and ensuring greater access to meet patient demand. The challenge providers now face is continued expansion of services within in a safe environment.

5. DRUG SHORTAGES During the COVID-19 pandemic, supply chain disruptions and an increasing number of critically ill patients led to shortages in almost every drug class used for mechanical ventilation. Other crises have also led to drug supply shortages – for example, in September 2017, a shortage of IV saline bags occurred after Hurricane Maria damaged a key Puerto Rican manufacturing plant. Drug shortages can result in: • Changed, delayed or canceled medical procedures • Limited treatment options • Missed or delayed therapies • Increased costs • Increased stress on health care workers • Increased medication errors Preparation, standardization, communication and monitoring are essential for safely managing drug shortages and reducing adverse events. 6. TELEHEALTH WORKFLOW CHALLENGES According to the American Hospital Association, the percentage of hospitals using telehealth increased from 35% in 2010 to 75% in 2017. ECRI and the ISMP PSO reviewed a sample of 42 telehealth-related events and found several themes, including: • Poor Wi-Fi accessibility in the health care setting • Inadequate or inappropriate monitoring • Inadequate availability of monitors and rooms with monitoring capability • Inadequate language services • Health Insurance Portability and Accountability Act (HIPAA) privacy concerns

7. IMPROVISED USE OF MEDICAL DEVICES For various reasons, providers may choose to modify or repurpose a medical device, workflow or system. However well-intended, such improvisation may lead to serious safety and regulatory compliance issues. Consider, for example, the following event submitted to ECRI and the ISMP PSO: A COVID-19 positive patient was placed in a room with the ventilator outside the room to conserve personal protective equipment. While the nurse was connecting intravenous tubing through a hole in the wall, the heater plug on the ventilator circuit became disconnected. It took several seconds to reconnect the plug, potentially exposing staff to contagions. In addition to having inspection and preventive maintenance programs, health care organizations should implement a risk management approach that documents equipment limitations, failures, user errors and improvisations that may affect patient care. Such data can better inform equipment decisions and thus alleviate the need to improvise. 8. METHOTREXATE THERAPY Methotrexate is a folic acid antagonist that was originally approved to treat various cancers and is now used to treat some autoimmune diseases. When used for immunomodulation to treat such disorders, the drug is administered weekly. Few medications are dosed weekly; thus, inadvertent daily dosing of oral methotrexate occurs in all stages of the medication use process – from prescribing to self-administration. Proper prescribing of methotrexate hinges on effective communication of instructions to patients, accurate documentation of dose and frequency, and accurate reflection of this information in computerized provider order entry systems.

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9. PERIPHERAL VASCULAR HARM Peripheral intravenous catheters (PIVCs) are the most widely used invasive devices among inpatients. Severe cases of PIVC infection require intensive care or longterm care. They can lead to extended lengths of stay and antibiotic treatments – and even death. Other forms of harm include Phlebitis, infiltration, burns, leaks, redness, erythema, swelling and drainage problems. The challenge of an effective harm prevention program is to reduce the rate of PICV infections as much as possible given a specific patient population. A multidisciplinary effort should involve leadership, those who allocate resources, infection control personnel, vascular access teams, those who insert and remove IVs, and patients themselves. Reporting these events to a PSO is essential. 10. INFECTION RISK FROM AEROSOLGENERATING PROCEDURES Aerosol-generating procedures have always posed risks to health care workers, but COVID-19 has amplified them. Comparisons with two similar viruses, SARS and MERS, suggest that aerosolization of particles – and thus potential infection of clinicians during aerosol-generating procedures – is possible. The exposure risk of performing aerosol-generating procedures on suspected COVID-19 patients is very high. Infection control leaders across the continuum of care should assess practitioners’ safety during aerosol-generating procedures and work to develop, implement and enforce appropriate precautions. To download the full Top 10 Patient Safety Concerns report, with complete recommendations for each item, visit https://www.ecri.org/top-10-patient-safety-concerns-2021/

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RIBBON CUTTING Imaging Diversified BY ERIN REGISTER

dollars. We also have financing options available, offer short-term staffing requests, virtual management solutions, daily applications support, workflow optimization, help with hiring, development and help with ACR accreditation.

athan Smith, current owner and CEO, founded Imaging Diversified in January 2020. Together with two colleagues, Smith decided to expand and grow visibility in the MRI training profession. The idea first transpired from the organic joy of teaching and helping other MRI technologists in the field.

“The thirst for knowledge and then sharing that knowledge with others to enhance their capabilities within the MRI profession ignited a passion to do more,” said Smith. Through many years and opportunities to offer training education to co-workers for employers, he noticed that trainers were as good as their passion to train. Some application specialists were great and others not so good, which led to Smith having to redo the training. The need for great application specialists, especially for third-party vendors, was needed, and Smith wanted to fill the void. With that thought, Smith reached out to a few vendors and offered his services at the market rate. The goal was to offer higher quality training, complete protocol implementation and help the technologists get a better understanding of their equipment. The idea to market and create a social media presence was presented, and the formation of Imaging Diversified LLC was created. “We have grown to employ five MRI applications specialists and two CT applications specialists,” said Smith. “We also have expanded from just doing training to fulfilling multiple services in the radiology field for both the vendor and

customer (imaging center/hospital).” TechNation learned more about this new company in an interview. Q: WHAT IS THE MAIN FOCUS OF IMAGING DIVERSIFIED? A: Our focus is to provide the easiest solutions for radiology through training of staff and management. If we can improve the knowledge of the radiology team from top to bottom, they will then in turn save more money, improve efficiencies and enhance the group as a whole. Not to mention, we offer training to vendors that can accompany upgrades and new equipment purchases. Q: WHAT SERVICES DOES IMAGING DIVERSIFIED OFFER? A: First, to all vendors, third-party and OEM, we offer our application training services. When we are out in the field, we help to ensure the customer knows how to operate the new equipment they have just purchased. We also offer support to customers that may want to figure out exactly what equipment is right for their radiology organization, as well as finding the right service contracts for these groups, sometimes saving them thousands of

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Q: HOW DOES IMAGING DIVERSIFIED STAND OUT IN THE HTM INDUSTRY? A: We stand out by being a company that offers solutions to both vendors and customers alike. We not only offer services but work with the company to overall improve the functionality in the radiology department as a whole. We have a core group of employees that currently work in radiology, from directors to technologists, that can offer their expertise with real-world knowledge. This advanced knowledge with our core helps us to bridge the gap for other imaging centers, hospitals and radiology groups that want to save money while running in the most efficient manner. Overall, improving the customer satisfaction level and enhancing the patient experience is why we stand out. Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT IMAGING DIVERSIFIED TO ACHIEVE IN THE NEAR FUTURE? A: Our future goal is to reach all imaging centers, hospitals and groups that do not have access to training or new equipment. We want to reach those groups and help them get upgraded training and equipment that is current with today’s standards while keeping their costs low. The idea is to have this reach extend internationally, as well as domestically. For more information, visit imagingdiversified.com.

SEPTEMBER 2021

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Q. WHAT DIFFERENTIATES YOUR COMPANY FROM OTHERS? InfuSystem scaled its business through organic investment and strategic acquisitions to proactively fill a need in the acute care biomedical device service market. With our national footprint of onsite and depot Matt Mitchell service stations, we meet the growing SVP Acute Care demand for more efficient biomedical Solutions device repairs, preventative maintenance, and technical support. Our biomedical device experts reduce costs for our customers, improve equipment availability and dependability, and conveniently provide online service and repair records to meet compliance standards. Our goal is to collaborate with health care facilities to provide a continuum of maintenance and repair services for their medical devices. At InfuSystem, we strive to be an extension of our customers’ existing biomedical service model. To minimize the need for additional capital equipment, we work with health care facilities to ensure their medical devices are always patient-ready. • For more information, visit infusystem.com.

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Q. WHAT DIFFERENTIATES YOUR COMPANY FROM OTHERS? R&D Batteries provides the most extensive line of replacement batteries for all medical applications, combined with utilizing only the highest quality components thereby guaranteeing quality control levels that Randall Noddings continue to meet or exceed OEM specificaPresident/CEO tions. We maintain a very large inventory level of all battery chemistries within our own 15,000 sq. ft. manufacturing and distribution facility, which also includes a state of the art production department in house. Being centrally located in the Twin Cities area of Minnesota offers the opportunity to service delivery to all areas of the globe via multiple carriers on a moment’s notice. To insure quality control measures are always cutting edge, R&D Batteries is in the final stages of ISO Certification 13485:2016, which is the highest medical certification process available • For more information, visit rdbatteries.com.

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How To Hack-Proof Medical Devices BY OLIVER NOBLE

espite the complexity of health care, there are many measures to mitigate the risks of cyberattacks on medical equipment.

A hospital bed, on average, has up to 20 medical devices connected to it. Each of those devices has a digital component that transmits patient data to a hospital’s computer network. This means there’s always a risk of a compromised system, as all it takes is one vulnerable endpoint. • “Like other industries, health care is undergoing digital transformation. Medical technology is evolving, so more and more computerized devices get installed and connected to a health care facility’s network. The downside of this improvement is that it might become easier for hackers to intercept the system because unprotected devices accelerate vulnerabilities. • A health care organization’s network is a very complex environment to control as it consists of a massive variety of equipment, databases and systems that often include connections to external sources and third-party providers. On top of that, there are personal devices, like smartphones and laptops, brought in and used by the staff and patients. • “Health care providers have a large attack surface, and the complexity of the industry makes it extremely difficult for them to come up with effective defensive mechanisms, cybersecurity policies and procedures. • Outdated systems and practices are one part of the problem. Underinvestment in cybersecurity, which leads to the inability of health care practitioners to identify and deal with persistent cyber threats, is another big issue. • “Add a vast array of substantial medical records a hospital stores, and we have a ticking bomb. Deliberately tampering with stolen patient data could facilitate

identity theft, extortion or even put human lives in danger. Even though vendors providing hospitals with medical equipment and services have to comply with various standards and regulations, the staff can also contribute to making sure the technologies are used securely. Everything starts from breaking cybersecurity down into smaller parts and taking it one step at a time. Potential measures to mitigate the risks of cyberattacks on medical devices include: • Training employees on what information is collected on what devices and how it’s stored, and what the risks and threats are. • Enabling encryption between picture archiving and communications system (PACS) and the hosts in the hospital’s radiology network. • Installing digital signatures to sign every critical action with a secure mark of authenticity. • Putting the right protection around each device individually, as different devices have different configurations. • Creating a centralized view of all devices connected to a network to monitor their expected behavior and look for red flags if any of the activities deviate from the norm. • Using a custodial provider to protect medical records. This means that an agency safeguards the data and third parties, like clinics, need to request temporary access. • Storing data backups in an encrypted cloud in case a ransomware hits. This ensures the data doesn’t get leaked and access to it isn’t lost. • Controlling access to information. Employees should be able to access only the information necessary to do their jobs. Limiting personal devices connected to the network should be considered too. • Investing in multi-layer detection and recovery systems. Installing such a system helps to identify and prevent malware installation.

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Oliver Noble NordLocker • Halt the use of File Transfer Protocol (FTP) servers operating in anonymous mode. Malicious actors can use the anonymous flaw in such servers to steal sensitive information or launch a targeted cyberattack. • Adding security requirements to purchase agreements with vendors. The latter should make sure the firmware is up to date and keep hospitals notified of the ways their equipment could be exploited. • Adding strong firewalls and using a virtual private network (VPN) can offset some of the risks that come with additional connected devices. There’s a great need for reform within the health care industry as it is still lacking the initiative to prioritize cybersecurity. However, a lot can be done, starting from within an organization. As a part of risk management, contingency plans for different scenarios should be set up in advance. Oliver Noble is a cybersecurity expert at NordLocker, an encryption-powered data protection solution.

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re you tired of “misplaced” patient cables and medical equipment? PD1 Medical’s Med Tether is a perfect solution for securing patient care equipment and helping to eliminate the need for continuous and expensive replacements. Forget heavy-duty crimping equipment and install the Med Tether in seconds using the security key while maintaining access to equipment at all times. PD1 Medical’s mission is to support fellow health care workers on and off the field which is why we are pledging a percentage of every sale to charities who aid the families of health care workers negatively impacted by COVID-19. For more information, visit pd1medical.com.

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Webinar Explores Technology Assessment Process STAFF REPORT

he recent “Healthcare Technology Assessment” webinar presented by expert Matt Dummert provided a meaningful structure for evaluating healthcare technology for investment or purchase through a technical, financial and strategic assessment. The webinar was sponsored by MTMI.

Dummert provided a brief overview of what “technology assessment” is and why it is important. He discussed how to evaluate the clinical or technical research to make decisions based on “real science;” he examined financial criteria related to the technology purchase, including both capital and operations costs, as well as revenue assumption. Lastly, Dummert discussed the strategic assessment that can influence decisions. During a question-and-answer session, Dummert shared additional insights with attendees. One question was, “How do you handle unplanned urgent replacement request when a system is down and there is no time to do a full assessment?” “That’s a key point, that I did not touch on. So, I did mention that often we’re making decisions from, from emotion, and from kind of split-second decisions. I think the key is that you need to establish a technology assessment methodology ahead of time, so that as these requests come in, you’re able to swiftly evaluate them in the timeframe that’s reasonable,” Dummert said. “But the one thing that I will mention is that with emergency requests for replace-

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SEPTEMBER 2021

ment of equipment, let’s take that example,” he said. “Just because you have the equipment now, and it’s down and you no longer can use it, it doesn’t necessarily mean that you have to replace it. I know that’s a tough concept to swallow sometimes, especially if you say that to somebody who is requesting it.” “But if you step back just from a logical perspective, is we looked at that utilization assessment,” he added. “You know, if you have three of them, and one goes down, and now you’re saying I need another, well, do you really still need three of them? Can you get by with two? Is it really necessary to replace it?” “The other point to make on this is if you think it’s really important, you need to replace it. Yeah. Bring it in for a request,” he added. “But then as a committee, the committee needs to look at whoever’s making the decision. The committee needs to look at, what are all the requests that are sitting in the queue. There might be some routine requests that are sitting in the queue that just have not been approved yet – that are actually more urgent than the urgent request that was just provided. It might just be a difference in emotion or just kind of like the squeaky wheel syndrome.” “I think those are key concepts to think of. Establish your technology assessment methodology upfront, and always ask the question, ‘Do I really need to replace this?’ And, ‘Do I have other priorities that might be just as much of an emergency? They just aren’t getting the attention.’ ” Attendees provided feedback in a survey that included the question, “How

will today’s webinar help you improve in your role?” “Think much deeper when buying and handling biotech equipment,” Engineering Consultant S. Alexander said. “Better insight into equipment planning and procurement. Knowing the questions to ask when looking at new or replacement equipment,” said B. Pierce, CBET. “I am a true believer in the technology assessment process and to one of Matt’s points, evaluating the utilization of the equipment should be incorporated in the process. Matt did an outstanding job of breaking down the sometimes complicated steps of a solid technology assessment process,” Perioperative Clinical Engineering Supervisor T. Cordes said. “The content is directly applicable to my consulting work. Matt provided some great ways of explaining complex concepts in very approachable ways,” said C. Davis-Smith, company president. More than 100 people registered for the webinar with 82 attendees logged in for the live presentation. An on-demand version of the webinar is available online. ‘PERFECT’ WEBINAR The recent Webinar Wednesday session “Top Three Unforced Errors in Connected Asset Management” was presented by First Health Advisory CEO Carter Groome and Medigate’s Director of Market Development Thomas Finn. It was sponsored by Medigate and eligible for 1 credit from the ACI. In the webinar, Groome and Finn shared a candid conversation about not-so-obvious capability deficits that are

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increasingly connected care delivery risks. Health care’s investments in protections against headline-grabbing cyberattacks are now understood and well justified. But when our focus turns to securing IoT from the impact of asset management and security workflow inefficiencies − those born of poor cross-departmental collaboration − do we also acknowledge them as risks to the enterprise? The duo identified three stunning “misses” whose negative effects are compounding. More than 100 individuals registered for the webinar. Attendees provided feedback via a survey after the webinar. The survey included the questions, “How well did the content that was delivered match what you were promised when you registered?” “This webinar gave me more information than I expected,” Biomedical Engineering Director K. Knight said. “It was presented well and easy to understand,” shared B. Pierce, CBET Tech 5. “It was perfect, thanks,” said K. Waters, BMET.

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SEPTEMBER 2021

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SHOP TALK POWERED BY

GETINGE 400/500HC SERIES

I have a 433 HC with the following problem: When the steam boiler starts to fill, the height probe stops and the contactor is energized and starts to heat up. At this point, everything works normal. The problem starts a few minutes after when suddenly the “FAULT” LED in the control board of the boiler lights up and turns off the contactor. Next, the light goes off and the contactor is energized, and then the FAULT LED lights up and cuts off the contactor. The situation goes on and the steam is not produced. What do you think the problem is?

Try disconnecting the leak detection probe from the board and see if it clears the issue. REPLY: The leak detection probe, is that what the service manual calls a spill probe? The one that is connected to the pan, or is the lowest probe which is connected to the little board? The steam boiler is a CAS 30 (the one with the vertical water deposit).

Yes, the short probe mounted just above the drip pan. It is there to detect a leak and shut down to prevent flooding. I’ve had them short in the wiring or have a piece of

the foil insulation ground out the probe and cause the fault light. TUTTNAUER EX11 PLUS

“NO WATER ERROR” keeps popping up once out of five cycles. I checked the electrode. It still keeps popping up and tech support said to replace the electrode. I did, so this is a new electrode. Now, the tech says to replace the pump, but the pump is working.

If this error occurs within the first few minutes, it means that the water level sensor did not detect water within the first three minutes of beginning pump activity. This could be due to a lack of water delivery to the chamber from the reservoir or a leak (such as an incomplete door closure). It could also mean that there is an obstruction in the water delivery path, such as an occlusion at the white filter located between the reservoir and the pump or at the strainer at the rear of the unit. Another possibility might be if the solenoid located at the back of the reservoir does not open/energize during the filling process, then the unit is attempting to pump water into the chamber against a backpressure. Finally, if the unit is being “short cycled” ie: beginning a new cycle within 20

minutes of a prior cycle completion, then it is possible to overheat the water pump (due to pumping hot water from the reservoir as a result of the heating effect of the condensing coil from the prior cycle) and cause intermittent failure and/or water pump damage. The foregoing assumes that you have the unit properly levelled, the correct water inlet time programmed and the door closing device tightened sufficiently. If the error occurs during the heating or sterilizing part of the cycle, you have a different issue: whatever water was correctly dispensed from the reservoir into the chamber was either refluxed through a leaky solenoid back to the reservoir, the door bellows is leaking or, most commonly (especially with multiple operators), the door closing device is insufficiently tightened allowing steam to escape (subtle) and stop the pressure rise prior to reaching the set point.

SHOP TALK

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

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TechNation is proud to support and be an advocate for the Right to Repair movement in the healthcare technology management and health care community. A new web form specifically allows biomeds everywhere to report incidents when an original equipment manufacturer (OEM) declines to provide parts, technical assistance, keys or other support needed to repair or maintain a device. The goal is to provide biomeds a place to share their experiences to help others as well as collect data regarding right to repair issues that can be shared within the industry and with regulatory organizations, including the FDA.

Share a right to repair issue today. 1technation.com/right-to-repair-incident/

ROUNDTABLE

ROUNDTABLE Equipment Disposition

very healthcare technology management (HTM) professional has at least one story about a nurse, doctors or even another biomed secreting away a favorite device or an extra “emergency” spare. Yet, there comes a time when a device or fleet of devices must be retired. TechNation asked a some HTM professionals to weigh in on the topic and share insights regarding equipment disposition.

Participants in the roundtable question-and-answer article are Stephen L. Grimes, FACCE, FAIMBE, FHIMSS, AAMIF, from Strategic Healthcare Technology Associates LLC; ZRG Medical Director of Business Development Sydney Humes; ProHealth Care Biomedical Equipment Lifecycle Planner Chuck Overeem; and Medical Equipment Doctor Sales Manager Austin Violette. Q: HOW CAN AN HTM PROFESSIONAL HELP A FACILITY DECIDE WHEN IT IS TIME TO RETIRE A MEDICAL DEVICE? GRIMES: There are a variety of factors that should be considered when deciding whether it is time to retire a medical device. These include the device’s current condition, its current utilization level, the device’s clinical acceptability (i.e., does the device represent the latest and/or most accepted form of technology for diagnosis and/or therapy), the status of manufactur-

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equipment has been sitting untouched in storage for years collecting dust. But, the best rule to get financial return that many facilities practice, is to retire medical devices when they have replaced the current equipment. This way they are liquidating the equipment when it has the most value and returning capital to the hospital.

Chuck Overeem ProHealth Care er’s support (i.e., are technical support, parts, updates/patches still available?), its annual maintenance costs relative to new technologies and its reliability (i.e., does age, condition and service history give an indication of whether the device can be depended upon). Of these factors, HTM is in the best position to give input on the device’s condition, state of manufacturer’s support, annual maintenance costs and reliability. Clinicians can speak to utilization level and clinical acceptability. Together their input can help an organization make informed replacement decisions. HUMES: There are a few ways to know when a piece of equipment is ready to be retired. The easiest way to know is if the

OVEREEM: It’s a matter of reliability and data. Since we fix the equipment and then write the reports to document our service, we can easily look at the history to see that a device not only seems to break down a lot but it actually does break down a lot. With that information, along with knowing the age of the equipment, whether or not it is end of life or past support, we can bring all of that to the attention of the proper parties to make the case for replacement. VIOLETTE: This depends on the goals of the facility as well as the availability of parts and repairs in the marketplace. The HTM professional would need to determine if the manufacturer or a third party can provide support for the device, as well as if there are parts available. They should also ask themselves if the technology is current and if the device provides reliable patient care. The last piece of the puzzle to evaluate is how frequently the device is breaking/malfunctioning.

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ROUNDTABLE

Q: WHAT IS THE MOST IMPORTANT THING TO KEEP IN MIND WHEN REMOVING MEDICAL EQUIPMENT FROM SERVICE? GRIMES: When contemplating the removal or replacement of medical equipment, an organization should fully understand the effect such actions will have on the availability, quality and safety of patient services, and as well as the implications on clinical workflows. Any contemplated removal of medical equipment should be planned in a manner that minimizes the adverse effects and maximizes the positive effects on relevant patient services and clinical workflows. This also includes the effect on other devices and systems that may have been integrated with the device being removed. When removing medical equipment, organizations should also ensure equipment is “sanitized” of any patient (or otherwise sensitive) data.

Sydney Humes ZRG Medical

HUMES: The number one thing to remember when removing medical equipment from service is to remove all confidential data. It is also important to have the equipment stored safely even after it is decommissioned, so that you can get the most return on the equipment when it is ready to be removed from the facility. OVEREEM: That question is a little more complicated than it first appears because it really depends on what the equipment is and your point of view. From one perspective, the most important thing is making sure that the device does not leave contain-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

ing patient data. From another perspective (like an imaging department), it could be when will it be removed and how will it affect the workflow and the comfort and safety of our patients. Also, how will we continue to provide services without the device and how soon can it be replaced? From yet another perspective, do we take a trade-in if we are replacing it or do we try to sell it outright and how does that affect the timing of the project? VIOLETTE: I cannot confidently say one thing is more important than another but the most important factors to consider are: • removing all patient data stored on devices • ensuring devices are properly disposed of according to state and federal laws • completing the removal of all hospital asset tags from the equipment • document all serial numbers of the equipment being removed from service in an asset management system Q: HOW CAN FACILITIES BEST CAPITALIZE FINANCIALLY DURING THE EQUIPMENT DISPOSITION PROCESS? GRIMES: Organizations should consider their trade-in options if planning to acquire replacement equipment. If looking to sell old equipment, make sure to deal with reputable third-party buyers. Consider dealing with one of the organizations that are members of the International Association of Medical Equipment Remarketers and Servicers (IAMERS). As a condition of IAMERS membership, organizations must have adopted a quality management system (e.g., ISO 13485, ISO 9001). Have a written agreement detailing schedules, responsibilities and financial terms. HUMES: Hospitals tend to hold on to equipment for years after the equipment is decommissioned. To get the best financial return, it is important to remember that equipment typically depreciates in value year after year. So, the longer a hospital stores the unused equipment, the less value the equipment will have when the hospital is ready to liquidate it. OVEREEM: You need to know your options. Get a trade-in value from the vendor(s) you are

working with for the replacement. Also obtain values from potential buyers. Give yourself enough time to properly market the system and let buyers know the timeline. There appears to be a sweet spot that maximizes profit. Too much time or not enough time can cause your profits to be less. Buyers need enough time to plan for a removal. Given enough time they can minimize their costs thus maximizing your profit. VIOLETTE: In most cases, a third-party biomed company will pay a higher price for retired equipment that an OEM would for a direct trade-in. Ideally, a facility would retrieve multiple bids for their equipment in order to get the most value and capitalize on their investment. Q: WHAT ARE KEY STEPS HTM PROFESSIONALS MUST TAKE WHEN IT IS TIME TO REMOVE A MEDICAL DEVICE FROM SERVICE? GRIMES: Establish an appropriately detailed plan including activities, schedules and assigned responsibilities for removing medical equipment from service. In developing the plan, be sure to consider the implication of removal steps and timing on the availability, quality and safety of patient services and on clinical workflows. HUMES: The steps to removing a medical device are very simple. First, make sure there is no one else in your system that needs the device being removed (there is no sense buying something the health system already has somewhere else). Second, make sure all confidential information is removed from the device. Third, document the removal of the device in the hospital’s internal system. Last, call your liquidation vendor that specializes in medical equipment to ensure the device is removed safely and responsibly. OVEREEM: Make sure everyone is on board with the removal and get appropriate signatures documenting that fact. Remove patient data if any. If the equipment is being replaced, get trade-in values if any. Get multiple offers when you try to sell an item, don’t just take the first offer. Have the buyer sign a document stating the terms of the sale, that makes sure everyone knows what to expect.

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ROUNDTABLE VIOLETTE: A lot of the steps required are also listed as answers in Question No. 2, but an additional item to factor is to have the HTM professionals prepared and trained to service the new/replacement equipment as well as the staff prepared to use the new equipment. Q: HOW CAN FACILITIES BEST DONATE USED MEDICAL EQUIPMENT/DEVICES TO A CHARITY ORGANIZATION? GRIMES: Organizations considering donations of their used medical equipment to charities should proceed with some caution. There have been some significant criminal activities associated with organization staff facilitating the “donation” to those claiming to represent “charities.” Before deciding to donate, organizations should research to verify the legitimacy of the charity. Consider the World Health Organization (WHO) or the American College of Surgeons (ACS) websites. Be sure to have a signed agreement that releases the donating organization of liability, stating the equipment is provided “as is” and the equipment recipient assumes sole responsibility for the equipment’s removal, transport, safety, operation and maintenance. HUMES: What many do not know is that charitable organizations do not usually have HTM staff that can repair the medical equipment that is being donated, so it is very important to only donate equipment that is in good working condition. Also, be sure to vet the charitable partner to ensure they are providing the equipment to where it is needed most. Unfortunately, there are some charities that think sending equipment to developing countries in crates is the best solution but if the country has no need for that specific equipment, there is no training on how to use it, or they don’t have supplies to use the equipment, it ends up creating a landfill of unutilized equipment. OVEREEM: Here at ProHealth, we have several charities that we work with. If we have something that we cannot redeploy

Stephen L Grimes Strategic Healthcare Technology Associates LLC and cannot sell but is still functional, we contact the charities with the equipment list to ask if they have need for any of the items on the list. If they do, we make the required arrangements and do the paperwork needed to process the donation and arrange for a pick-up.

Austin Violette Medical Equipment Doctor

VIOLETTE: There are many charitable organizations that will give your old medical equipment a new home, sometimes in a less privileged country or region. For-profit hospitals may benefit more as they can utilize the donations as a tax deduction.

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT RADIOGRAPHY EQUIPMENT? GRIMES: Radiology and imaging systems continue to represent the largest investment most health care providers make in medical technology. Through 2024, a recent P&S Intelligence report predicts imaging equipment maintenance services will see a 10.1% compound annual growth rate (CAGR) due to high cost of equipment and increasing adoption of various imaging modalities. To better exercise control over the timeliness, quality, safety and cost of services, health care providers will need to have access to more service options. Some major imaging manufacturers have been making it increasingly difficult for in-house and third-party servicers to provide maintenance servicers on their products. Many suspect these manufacturers are attempting to protect their service revenue streams. Right-to-repair will continue to be an issue until all stakeholders can collaborate and achieve an acceptable compromise. OVEREEM: There are a few things to remember, including: • Remember to remove all PHI from the system. • Make sure that your sales agreement spells out who is responsible for what. Who pays for removal, rigging, protecting the floors, opening doors or walls if needed? • Make sure that you are paid before the equipment is removed. Although most people are trustworthy, there are bad actors out there and it is hard to compel someone to pay you when they already have your equipment in another state or another country. • Arrange for an inspection, if needed, ahead of time to allow you to find another buyer if needed and minimize delays to your equipment replacement project. These really apply not only to radiology but also to any imaging modality or any equipment that requires outside de-installation.

For an informative video on training, visit 1TechNation.com/roundtable and select this month’s article! 52

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w m a e T COVER STORY

uch has been written about team collaboration. After all, the team is one of the molecules that holds an organization together. Just above the individual employee is the team. This team can be an autonomous unit or an actual department.

There is often a common vernacular and esoteric language that is used among team members and it is not uncommon for those on a team in the workplace to know some away-fromwork information about each other. This synergy or gelling of team members helps keep the team in synch, focused on common goals and objectives and more productive.

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With all of this collaboration within teams, there often remains challenges for the team unit to find ways to collaborate with other teams or departments. Managers frequently serve this function, but there are many interactions that don’t involve a manager that have to be facilitated. Those interdepartmental interactions will determine the reputation of a team by their colleagues in other units, and that reputation can be won or lost on the image of just one team member. For that reason, a concerted effort by every individual in one department is necessary to maintain a reputation of

cooperation and support throughout the organization. As mentioned already, much has been written about teamwork, but not as much about interdepartmental or inter-team collaboration, cooperation and interaction. Within the hospital environment, that cooperation is ultimately beneficial to the patient. It also helps when various departments are not butting heads but instead finding ways to assist each other. “Building and maintaining relationships is critical to our role in clinical

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ro k engineering (CE) and is one of the differentiators between departments well regarded within their organization and those not so,” says Samantha Jacques, Ph.D., FACHE, AAMIF, vice president of McLaren Clinical Engineering Services (MCES) at McLaren Health Care headquartered in Grand Blanc, Michigan. “As a support service, our department does not have direct authority in many areas including – but not limited to – capital replacement, user training and cybersecurity. We often have to work with other departments such as finance, supply chain, nursing and IT in a capacity where our influence is the

Advantages of Working with Others BY K. RICHARD DOUGLAS

only thing we have,” she says. HTM has the opportunity to put protocols in place that will help smooth over relationships with other departments while keeping all of their metrics on target. “At North Colorado Medical Center, we have a roundup in key departments throughout different times of the year — one or two depending on need. This is an opportunity for the staff to bring clinical engineering any broken equipment that they have ‘lived with’ as they are more focused on the patient,” says Tony Cody, CHTM, Tech Management/ENTECH director

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

at Banner Health in Colorado. He says that the HTM team will align this with their PM schedule when possible and have them bring those items needing to be checked by HTM as well. “We will have several technicians available for several hours to address any issue they have. This has been well received by the staff, their leaders, and it helps us get to some high usage items that are due for a PM,” Cody says.

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COVER STORY One hospital in Texas discovered that opening lines of communications between departments could have dramatic results. MENDING RELATIONSHIPS; PRACTICING BASICS While technical knowledge is the more obvious prerequisite for work as an HTM professional, it is also the “soft skills” that are the hallmark of a well-rounded biomed. They are key to interdepartmental tranquility. “It can never be reinforced enough by HTM leaders that anything related to the delivery of health care is a high-touch business. This is particularly true of our business in the management of medical device assets. Just as cost to service ratio (COSR) is a common indicator of HTM program sophistication and maturity, a less common but equally important indicator is how a program connects with its constituents and how wide a net that the HTM program casts,” says Perry Kirwan, vice president of technology management at Banner Health. He says that the first point implies that whatever the net is; do what you do very well. It doesn’t make a lot of sense to go casting for larger fish if the basics aren’t done well and to the very best of your ability. “Basics are things like regulatory compliance, patient safety and service delivery. For HTM departments to really excel at these – we need to understand that HTM professionals are first and foremost an extension of care delivery teams,” Kirwan adds. He says that even if biomeds don’t believe that they are; that’s how they are perceived by patient care technicians, nursing and physicians. “And, delivering service in the direct patient care space doesn’t differ much to any other service in terms of what’s really valued. Yes, we have a product (support) and we’re expected to do it competently, however many times, we are judged by the experience we create in the act of delivery,” he says. 56

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One hospital in Texas discovered that opening lines of communications between departments could have dramatic results. “I am fortunate to have spent my career in the same hospital. I started here in 2010 and have worked my way up the ranks. This has allowed for a very unique vantage point to the evolution of our communication and collaborative approach that we cherish in my hospital,” says Courtney Haschke, CBET, biomedical engineering supervisor with BSA Health System in Amarillo, Texas. She says that 11 years ago, the communication between biomed and IT, and biomed and nursing, was practically nonexistent. “Projects were impossible to complete without major issues getting in our way and medical equipment repairs, preventative maintenance and implementation was a nightmare. The most we would get on our ‘red tags’ was ‘broke again’ or ‘keeps beeping.’ Sometimes all we would get was a piece of nurse’s tape stuck on the screen with a skull and cross bones drawn on it,” Haschke says. She says that the last six years or so have seen drastic changes. “Biomed and IT are now on weekly calls for any project/device implementation that requires network access. There is also a weekly meeting with biomed, IT, and corporate IT to identify and resolve any potential cyber threats with our devices on our network. The lines of communication have definitely opened up completely. Biomed knows what IT is trying to accomplish, and IT knows what biomed is working on,” Haschke says. METRICS FOR BUILDING GOOD RELATIONSHIPS “In order to gain influence, you have to start with a good relationship. In our organi-

zation, we even include this skill in our annual technician competency assessments. Here are the specific skills/tasks that we measure so that we can assure we’re building and maintaining good relationships,” Jacques says. She says that one of those skills that is assessed is whether or not the staff member “seeks opportunities to build effective working relationships proactively. Connects easily with new people. Puts others at ease.” Other metrics look at whether or not a staff member “develops others and own ideas to resolve issues. Helps others have a personal win – recognizes and supports others’ objectives.” “Reinforces others self-worth – treats people with dignity, respect and fairness. Complements others’ contributions. Shows empathy and understanding. Offers assurances about issues/concerns.” Also, the assessment asks if the staff member shows that they can be trusted – “demonstrates openness in dealing with others, shares personal agenda, acts in a manner consistent with organizational, social and moral values, keeps words and actions consistent and keeps commitments to agreed-upon actions.” Jacques says that “although these are quite specific, they have helped us drive the behaviors within our organization to help us build and maintain the relationships within our organization that is the foundation of our success.” Along with metrics for biomed, there may also be a metric for nurses that relies on the HTM department’s participation. “About three years ago, we had a wake-up call with a surveyor in our hospital. The surveyor asked one of the clinical staff, ‘How do you know that piece of equipment is safe for your patient to use?’ The nurse could not answer them. We of course have a policy in place, but the education of the policy was not reaching all staff. Soon after this incident, biomed leadership approached clinical education about joining forces and presenting at nurse competencies and speaking on key biomed safety

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elements to staff,” Haschke says. She says that nurse competencies are required annually for every nurse in the hospital. “Biomed literally gets to speak to every working nurse in our hospital on an annual basis. This has done two key things for our department. 1) We educate on how to read our PM stickers and how to properly fill out our defective tags. 2) It puts a biomed representative in front of the clinical staff to answer any question, field any complaints, and makes biomed more approachable as a department. We even offer a reward for any past due PM sticker that is found by anyone other than biomed,” Haschke says. “This process has worked out so great for biomed. We get approached before a problem becomes a major issue, clinical staff is educated on PM stickers and are helping us find those devices that get hidden, or could not be located last PM cycle,” she adds. Haschke says that biomed has even been asked to go to outside clinics and participate in their competency days and even just for general department education. “We are now the department that is thought of first when problems present themselves instead of just being an afterthought,” Haschke says. EXCEEDING HIGH EXPECTATIONS Another way that HTM can build and maintain high-level relationships with other departments is simply to provide a level of service that matches expectations. These expectations have emerged out of the competitive nature of the high-tech age we live in. “You can have the best wrench turner in the world on your team. However, if that person doesn’t show when expected, doesn’t communicate well in the moment as well as keeping the customers informed about status, and does take ownership of an issue until the problem is resolved – many times you’ll fail before you start,” Kirwan says.

Kirwan says that we are in a day and age that people expect to be delighted. “Companies like Amazon have created the template for this. People want ease of access to service, they expect when they access it that the service will be fulfilled regardless of difficulty/coordination that has to happen behind the scenes and they want to be fully informed of what’s going on with the delivery all the way up to fulfillment,” he says. Kirwan says that other industries have taken note and followed suit. He says that one can typically get more up to date information from UPS getting a packaged shipped to you than most HTM organizations provide. That’s the atmosphere that we must endeavor to create. “So, how do we do it?, “ Kirwan asks. “Does your department have metrics on what the customer can expect in terms of a response when there is a need for service? How detailed is it? Is it even written? Do you measure the performance of it and, most importantly, share the results with your customers?” Kirwan adds. He says that measurement and the sharing of results is an important step in creating and cementing a relationship with those that you serve. “It establishes professionality of your program and that you care about how well you’re delivering the results. Another attribute in relationship building is empathy. Patient care is an emotional business as much as it is about technical results and skills. If we don’t think about our business in both contexts, we miss an important part of the delivery. The third attribute is that we need to understand as much as we can about how our service delivery impacts the patient and those that serve the patient. This can not only be applied to service that has to happen in real-time but also in the way that we plan service, e.g. think scheduled maintenance,” Kirwan says.

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As an example, he asks “Does it really make sense to PM that imaging modality during business hours and down the room when our customers need to be seen during those hours or challenging those trying to run the business and stay productive to lose resources in the prime time of their business?” “Lastly, as we reimagine our business – we should ask what do we need to do to delight the customer? Delighting the customer is incorporating the unexpected to the service delivery to drive a greater result. We can do that in the way that we round. Looking at the environment, talking with customers, observing for unmet need and then adapting and adjusting service accordingly,” Kirwan says. He also says that HTM can either lead or serve on committees within an organization to solidify relationships. Within his health care system, HTM is involved with a laundry list of committees from the fall reduction team to the surgical robotics utilization team, ventilator associated pneumonia task force to the mergers and acquisition team. The development of great working relations among disparate departments must be a deliberate and proactive exercise. In an age of high service expectations, the HTM department has an opportunity to exceed expectations and strengthen relationships with clinicians and other ancillary support providers. That begins with establishing internal metrics for this purpose and then giving every customer the confidence that HTM is the easiest and most satisfying team to work with.

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EXPERT ADVICE

CAREER CENTER

How to Use Tiktok During Job Search BY KATHLEEN FURORE

’ve written a lot about the important role LinkedIn can play in the career search. But recently, I’ve learned that TikTok is becoming a key part of that process. In fact, a recent story in The Washington Post said TikTok “is fast emerging as a force in the job search ecosystem.” With that in mind, I asked some industry experts to weigh in on how anyone (no matter their generation) can use TikTok to their advantage in a job search.

“When people think of TikTok, they think of 15-year-old girls dancing. However, there is a wide variety of groups on TikTok, including professional communities in many industries,” says Chloe Sisson, outreach coordinator at digital marketing and PR agency Zen Media. “TikTok can be a great tool to get your name out there. There definitely is an opportunity to network and build professional relationships via TikTok. Just because it’s a more fun platform doesn’t mean people don’t take the content seriously.” Phil Strazzulla, CEO of SelectSoftware Reviews, agrees. “TikTok really has taken the world by storm in ways that we didn’t think possible. Not only is it an excellent marketing platform, its changing how many businesses network with new employment candidates,” Strazzulla says. “While most TikTok users use it for short, silly videos, it’s also a place where thought leaders can connect with their audiences in a way that feels more genuine than Facebook or Instagram. That authentic reception makes it perfect for businesses to reach out and connect with potential job candidates.” Caroline Vernon, career transition practice leader at Intoo USA, says TikTok is replacing video CVs in the application process. “Creating video CVs is no longer on

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Kathleen Furore the cutting edge of job-search strategies. Sharing your value to a prospective employer in 60 seconds or less has become an increasingly popular way to make yourself stand out – for all age groups,” Vernon says. “Some companies have even ditched the long, monotonous application process, asking job seekers to instead share why they are the ‘perfect fit’ via a video post accompanied by a specific hashtag for increased searchability. With the over 689 million monthly users monthly of TikTok alone, companies are increasingly trying to tap into this vast audience to source open positions in even more creative ways.” So how can you or a job seeker you know start using TikTok? Here are some tips: • Catch your desired employers’ attention. “Are you looking for voiceover work? Show your skills in action on your profile. Looking to break into the tech industry? Dazzle your heroes with impressive skills in a TikTok video,” says Justin Kline, co-founder of the influencer marketing firm Markerly. “Sometimes the best way to get work is to show you can already do it.” • Be brief. “TikTok is all about brevity, so you would want to use it to illustrate a

job-related skill or experience as succinctly and creatively as possible,” says Trevor Larson, CEO of HR software developer Nectar. “If you are a talented graphic designer, for example, you could show off a time lapse video of you completing a project from scratch. TikTok is a visual medium, so it is ideal for industries where you need to showcase a portfolio of work in order for hiring managers to even consider you.” • Make sure your content is clean and devoid of controversy. “This has been tried and true advice since the rise of Facebook in the late 2000s,” says Kline. “Of course, there are some industries where bold rhetoric is appropriate, but that’s a tightrope one must walk carefully.” • Follow and interact with your desired employers. “It’s important to know you can’t just put the content out there and twiddle your thumbs, waiting for a bigwig at Pixar to take notice,” Kline says. “Use the right hashtags. Follow the right hashtags. LinkedIn isn’t the only social media platform where you can network: Try to collaborate with content creators in your space who have a little more of a following than you. Duet their videos, stitch their videos; whatever you can do to catch more eyeballs.” The way TikTok is designed means the more you interact the better. “Your feed is curated toward what you like, so the more you interact with videos from people within your industry, the more you’ll see their videos on your feed,” Sisson says. Kathleen Furore is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

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SEPTEMBER 2021

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EXPERT ADVICE

20/20 IMAGING INSIGHTS Warning, Fragile BY TED LUCIDI, CBET

’ve often been asked, “Are there certain types of ultrasound probes that are more fragile than others?” or, “Are there certain probes that are more prone to damage than others?” I can confidently say, “It’s a firm maybe.” A better way to frame my response would be to say, “There are certain probe types that pose greater challenges for proper care and handling than others.” For this article, let’s focus on standard probes, versus TEE, as standard probe types comprise about 90% of all probes in a facility, and TEE probes have their own challenges when it comes to proper care and handling. Asked that same question, I would now reply. “No matter the make or model, endo-cavity probes pose some of the greatest challenges related to longevity, rates of failure and severity of failure.”

A common failure related to endo-cavity probes is image dropout in the center of the scan image. Image dropout is anything from a well-defined vertical line to a blurry, shadowy area of no information (hypoechoic artifact) within the scan image. The root cause of most of these failures is traumatic damage to the acoustic array. The words “traumatic damage” typically evoke thoughts of cracks, fractures, crushes or some type of physical damage. With endo-cavity probes, many times there are no outward

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SEPTEMBER 2021

Ted Lucidi, CBET Innovatus Imaging signs of trauma whatsoever. None! At one time, what is now referred to as the acoustic array, was called “the crystals” because primitive technologies used quartz for its piezoelectric qualities. Some sonographers still, to this day, refer to the array as such. Pause to think for a minute. Dropping a ceramic mug or similar item typically results in shattered glass all over the floor, and the weight of an ultrasound scan-

head is about that of a mug or glass. Inherent to their design, the arrays in endo-cavity probes are extremely thin, just about 0.5mm. They also have an extremely fine pitch meaning there may be up to 192 individual acoustic elements within a 1-inch space. Even though the array is covered by the silicone rubber lens and encased within the plastic probe housing, many non-traumatic events over-time or just one accidental fall from a scanner could shatter the elements within the array. Although there may be no, or minimal, signs of external trauma, electronic and acoustic testing can confirm that impact(s) have catastrophically damaged the acoustic array. This is analogous to a patient who complains of severe headaches. Physical examination may not reveal head trauma, but a CT or MRI can confirm that a

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