ICE Magazine September 2021 by MD Publishing

SEPTEMBER 2021 | VOLUME 5 | ISSUE 9

THEICECOMMUNITY.COM

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

Feeling the Flow

THINKING THROUGH STRATEGIES FOR OPTIMIZED IMAGING WORKFLOW PAGE 32

In Focus

james frymire PAGE 12

PRODUCT FOCUS

C-ARM PAGE 29

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

PRSRT STD U.S. Postage PAID MD Publishing

WE ARE HIRING! Join our Team

Front Office Representatives

Mammography Technologists

CT Technologists

Ultrasound Technologists

Medical Imaging Assistants MRI Technologists

Radiology Technologists

MSK Ultrasound Technologist

apply today at bannerhealth.com/careers EEO/AA/Diversity/Vets. We support a tobacco-free and drug free workplace

Experts in Mammography Solutions Our focus at UMAC is on the sale, installation and service of Hologic mammography systems. Hologic 3Dimensions, Hologic Dimensions and Hologic Selenia systems are among the simplest to use and repair in the mammography field, and we are experts at delivering, installing and servicing Hologic mammography systems as well as in training radiology technicians to use them.

Systems • • • • •

Hologic Dimensions 3D Hologic Selenia 2D SecurView Workstations R2 Cenova CAD Affirm Stereostatic Biopsy

Parts • • • • •

Hologic Dimensions Detectors Hologic Selenia Detectors Tubes Multiplier/Inverter/PMC Drawers And more

Service

Nationwide service available for Hologic mammography systems, provided by our professional service engineers.

We are...

Parts Sales and Identification • ISO 13485:2016 Certified • Over 50,000 inventory parts available to ship overnight • Annual PM high failure parts kits

Summer Savings Event!!!!! We are celebrating 10 years of Business!

Save 10% **Mention this ad when placing your order for 10% off of your PM kit purchase

• Call our contrast injector specialists today to find out how we can save you money! (888)-667-1062

We are To learn more visit WeAreISS.com or call 888.667.1062

FEATURES

39 RAD HR

EMOTIONAL INTELLIGENCE

How can one effectively lead during a time of grief?

Being a leader is different than being a manager or entrepreneur.

32 COVER STORY

Reaching benchmarks help optimize a facility’s imaging workflow, but how that happens is just as important.

OFF THE CLOCK

Traumatic experience changed Rose Pauley’s life and continues to underpin her work.

ICEMAGAZINE | SEPTEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

SEPTEMBER 2021

18 PRODUCT FOCUS

Check out some of the latest devices to hit the C-arm market.

11 WWW.THEICECOMMUNITY.COM

IMAGING NEWS

The latest medical imaging news from around North America.

RISING STAR

David Dacorro strives to exceed patient expectations every day.

ICEMAGAZINE

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

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Taylor Powers

Account Executives Jayme McKelvey Megan Cabot

Events

Lisa Lisle

Circulation

Jennifer Godwin

Webinars

Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak ICE Magazine (Vol. 5, Issue #8) August 2021 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2021

ICEMAGAZINE | AUGUST 2021

CONTENTS SPOTLIGHT

Rising Star David Dacorro, Radiology Manager at U.S. Navy Hospital in Okinawa, Japan

In Focus James Frymire, Health Care Manager/Radiology Supervisor at Portsmouth Naval Hospital

Rad Idea Beneficial Interdependencies of Transformational and Transactional Leadership Styles

Off the Clock Rose Pauly, BSN, MAT, RN

NEWS

Imaging News A Look at What’s Changing in the Imaging Industry

ICE Webinars DES X-ray Webinar Sets New High

PRODUCTS

Market Report Research Groups Predict C-arm Market Growth

Product Focus C-ARM

INSIGHTS

Coding/Billing AUC Pivot – Take 5

Director’s Cut Check, Compare, Confirm

Rad HR Leading Yourself and Others in a Time of Grief

PACS/IT Perception is not always reality

Emotional Intelligence Teambuilding 301: The Responsibilities of a Leader

Roman Review They Are Just Palmetto Bugs

48 52 54

AMSP Member Directory

ICE Break Index

ADVANCING THE IMAGING PROFESSIONAL

CAP YOUR IMAGING PARTS EXPENSES Unlimited parts and glassware coverage for your imaging equipment. Why take all the parts risk on yourself when you could go to the parts experts? Call us today to learn more.

WHAT IS A CAPITATED PARTS COVERAGE (CPC)?

WHAT ARE THE BENEFITS TO OUR CUSTOMERS?

• • • • • •

• Cap risk on parts expenses • Improved access to parts & tubes • Faster access to critical parts with our forward stocking locations • Earn free training credits to use at TIS • Peace of mind for not delaying patient care

Unlimited coverage of all parts and X-ray tubes Certified Pre-Owned Glassware Includes Technical Support and System Training Forward Stocking 3-year Agreement Term Pre-site inspection may be required

SOLUTIONS Call: 855.401.4888 | Visit: triimaging.com | Email: sales@triimaging.com Located in Nashville, TN • ISO 13485:2016 certified

QA Solutions for Multi Modalities RTI offers complete QA and HTM solutions for X-ray modalities and facilities. Contact us to learn what’s new, and arrange a demo of our 100% Bluetooth Cobias and Piranhas and industry-leading Ocean software. RTI’s new CT Ion Chamber is now shipping. Ocean Next Generation - with Cloud platform and other QA upgrades - launched soon!

Remember to ask us about our Piranha Premium Kit bundle offer

+1 800-222-7537 sales.us@rtigroup.com | www.rtigroup.com 33 Jacksonville Road, Blg. 1, Towaco, NJ 07082

Continuing Education for Imaging and BioMedical Professionals

PREMIER Training in:

“MTMI has been my Go-To for continuing education for years! MTMI has a great product, always reliable.” Ben, 4/21

go to www.mtmi.net to see Fall Schedule

CT MRI PACS Mammography Ultrasound - Breast, Vascular, MSK Bone Densitometry Leadership Training Biomedical Equipment Technology- CBET exam prep

ICEMAGAZINE | SEPTEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

SPOTLIGHT

RISING STAR DAVID DACORRO

BY ERIN REGISTER

riginally from Sacramento, California, David Dacorro, 34, got into the imaging field due to the “many great influences throughout his career and the passion and drive to serve patients each and every day.” Dacorro, who has been in the imaging field for seven years, is currently the radiology manager at U.S. Navy Hospital in Okinawa, Japan.

it’s a CT, nuclear medicine or MRI scan, we as techs have a significant role in treating sick patients. Without us, there will be no high-quality images for the radiologist to read and diagnose. I also love the science behind every type of modality and how each modality has its own special way to acquire images.

“I have a sense of purpose to wake up in the morning to do a great job by exceeding patients’ expectations every time they have a procedure done,” Dacorro said. ICE learned more about this “Rising Star” in a recent interview.

Q: What has been your greatest accomplishment in your field thus far? A: I think earning both my Certified Radiology Administrator (CRA) and Project Management Professional (PMP) certifications have been the greatest accomplishments I have achieved so far in my career. I am all about professional development and getting better every day, whether it’s physical or mental. We should not stay stagnant in our field; instead, we should seek both professional and personal development opportunities in order for us to reach our full potential of being the best version of ourselves.

Q: What do you like most about your position? A: I love the interaction and problem-solving skills involved when leading and managing people. I want to unlock everyone’s potential to be the best that they can possibly be, even though they might not believe in themselves. Maximizing and recognizing everyone’s talents/abilities should be a required skill every leader should have. There is no better feeling than coaching and building up your subordinates to reach their full potential. Q: What interests you the most about the imaging field? A: I love being a part of the process in trying to figure out and ultimately diagnose what is going on with the patient whenever they get an imaging procedure done. Whether

Q: What goals do you have for yourself in the next five years? A: I would like to advance my career and further my knowledge by pursuing advanced certifications in quality management/project management/process improvement and to complete my doctorate degree program. • Nominate a Rising Star at theicecommunity.com/nominations

FUN FACTS

• Favorite hobby: I love to do powerlifting/weightlifting during my off time and try to get stronger and better each and every day.

• Favorite show to binge watch: “The Sopranos” • 1 thing on your bucket list: Skydiving • Any secret skills or talents? I can deadlift 500 pounds, squat

405 pounds and bench press 275 pounds, and for that I am very proud of myself considering how I started when I started lifting weights 4 years ago.

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

SPOTLIGHT

IN FOCUS JAMES FRYMIRE

BY JOHN WALACE

ood things really do come to those who wait as evidenced by James Frymire’s path to a career in radiology.

James Frymire is an experienced health care leader.

ICEMAGAZINE | SEPTEMBER 2021

Frymire is an experienced health care administrative leader with vast experience in cross-functional team building, adaptive leadership and talent management. His expertise includes radiology diagnostics, practice management (surgery, radiology, dental), training, development, compliance, security oversight, personnel management, schedule coordination and customer satisfaction. He explains that his unique path has equipped him with the ability to combine vision and ingenuity with well-developed project management and leadership qualities to support organizational effectiveness, reach and overall expansion. As a health care manager/radiology supervisor at Portsmouth Naval Hospital he led 48 technicians performing 12,000 routine X-rays, portable, fluoroscopic and C-arm procedures with less than a 4% repeat rate. He said that he spearheaded diagnostic assurance control program and increased staff education and training; decreased repeated exams by 20% and increased patient satisfaction by 30%.

He is currently transitioning from the military to a contracting job with Naples Community Hospital with a goal to once again serve as a radiology leader. “I’ve been in and out of the profession for a few years, and I’m looking forward to returning fulltime and taking what I’ve learned from other specialties and departments back into the imaging community,” Frymire says. “I enjoyed to attending this year’s AHRA convention in Nashville, I was able to connect with some familiar colleagues and meet some new ones as well.” So, how did it all begin? “I was in a unique situation when I joined the military, and I didn’t have the choice to become an X-ray technologist upon enlistment,” Frymire explains. “I had to serve a couple of years before I could apply for the military’s program. I was accepted to attend shortly after and thus acquired a trade (X-ray) which had always been on the top of my list.” “I’ve always been fascinated with the human body and anatomy and X-ray was the way to go to challenge myself. This passion led me to being recognized within the military’s radiology program and achieve the ‘Top Clinical Student’ award within my class,” he says. As a leader, Frymire enjoys helping others achieve success. ADVANCING THE IMAGING PROFESSIONAL

James Frymire enjoys spending time with his “beautiful” family when not working.

“I have a transformational leadership style, where I enjoy working alongside my direct reports to show them that I wouldn’t ask them to do something that I, myself, wouldn’t do or haven’t already done,” he says. “I thoroughly enjoy mentoring and teaching other techs and assisting them with developing creative and innovative ways to capture the best possible image. In the end, I believe this approach will positively change individuals by turning followers into leaders.”

His desire to helps others can be traced back to his experiences receiving guidance from mentors. “I’ve had a couple of mentors and they’ve helped me develop into the best technologist and leader I can be. They’ve given me skills and attributes – such as setting goals, motivation and identifying resources – that I try to instill into my direct reports and/or colleagues,” he says. “A lesson that I’ve learned over the years is that you don’t always see the direct and immediate

impact you may have on someone as it can take some time before you see the results. Currently, I’m not mentoring someone within the imaging profession, but I am mentoring a couple of folks within the health care industry.” Away from work, Frymire spends time with his “beautiful” family. “I’m married and have four beautiful children ages 21, 14, 8 and 5,” he says. • Nominate a In Focus candidate at theicecommunity.com/nominations

JAMES FRYMIRE , health care manager/radiology supervisor at Portsmouth Naval Hospital What book are you reading currently? “Come Thirsty” by Max Lucado. Favorite movie? My favorite movie is “A Night at the Roxbury”, it’s kind of corny and silly, and the characters remind me of myself at times. What is something most of your coworkers don’t know about you? One thing that my coworkers don’t know about me is that I was a fashion model years ago. Who is your mentor? I currently have three mentors, it may seem uncommon, but I actually feel I get different perspectives and insight depending upon my area of need. It’s

WWW.THEICECOMMUNITY.COM

hard to just have one mentor because as great as they might be, they may not know or have all the resources I need. What is one thing you do every morning to start your day? I always have a cup of coffee. It’s hard to start the day without it. Best advice you ever received? The best advice I’ve ever received was don’t wait for things to come to you, go and get what you deserve. Who has had the biggest influence on your life? My biggest influencer is my wife, she has pushed me to be better than I am the day before.

What would your superpower be? My superpower would be to travel back in time as I would love to have met Wilhelm Roentgen and to have been there upon the discovery of X-rays. What are your hobbies? My hobbies include exercising, traveling, watching/playing sports, swimming and watching movies. What is your perfect meal? My perfect meal would be a juicy prime rib with lobster mac and cheese, collard greens and a double chocolate cake for dessert.

ICEMAGAZINE

SPOTLIGHT

Rad idea

BENEFICIAL INTERDEPENDENCIES OF TRANSFORMATIONAL AND TRANSACTIONAL LEADERSHIP STYLES

BY ERNIE ABARQUEZ CERDEŇA, PH.D.

n my nearly 35 years of experience in health care, I have personally manifested a wide array of leadership styles and behaviors based on certain types of situations that I deal with daily. However, within the past five years, the transformational and transactional leadership behaviors have become more dominant traits in my daily leadership practice. The cultivation of such leadership behaviors has developed progressively as it aligns with the constant disruptions we face as health care leaders. The following are a few differences between transformational and transactional leadership behaviors and co-manifestations. Transformational is about developing your team’s skill set to transform an organization from good to great by developing the skills that inspire people to join the organizational journey to the future. When there is a crisis situation requiring immediate attention, it is more effective to use transactional leadership by giving team members directions on how to get the job done. Transformational leaders lead by influence and by appealing to values principle. Engaging the team in the process of change but not necessarily including them in the decision-making process. Transactional leadership is the ability to shift gears during a rapid change of situation where a decision must be made. Transformational leadership is about focusing on vision and helping the people understand the change is normal and bringing that change to achieve strategies and vision. Transactional leadership is about the day-to-day management. Transformational leadership starts with building relationship, and understanding what is important to the people and organization over the long-term range. Transactional leadership is about looking at the accountability and tasks done without questions and unintended consequence for any questions. Transformational leadership requires you to be at the 30,000-foot level and be able to help steer and guide the ship. Transactional leadership deals more with being in the weeds. A transformational leader is someone who is inspirational, someone who is driving for change, looking 14

ICEMAGAZINE | SEPTEMBER 2021

for change that really starts at the core level by getting the buy-in of the most basic of the people to move in a different direction, and getting them excited about it. Transactional leadership is a necessity to be effective as a transformational leader, but transactional is more in the moment. It is one thing at a time to fix the problem in order to move forward. A transformational leader is a person who sees the light at the end of the tunnel and can describe it with such clarity that they can help others find it. This is the person that you want to be sitting next to when you are in a crisis situation. This is the leader that shows another way of handling a difficult situation and empowers the team to do it right. A transactional leadership style can be used together with transformational as a shared governance which helps take the burden out of all the decisions to be made. Transformational leadership is looking at lasting change and process that becomes hardwired whereas the transactional leadership style focuses on the here and now. A transformational leader is one who has an understanding of the business from a broader perspective and uses an inspirational style and a very high level of communication and inter-relationship skills to meet goals. Transactional leaders are good leaders but lack, in some ways, the inspirational perspective. Transformational leadership is basically talking about a model where leaders encourage workers to use their strengths and weaknesses, and inspire and motivate them about change. Transactional leaders use rewards and consequences as forms of motivation. Leaders ask people to do something in exchange for something. The manifestations of transformational and transactional behaviors help leaders to achieve organizational excellence by combatting the complexities of daily tasks while engaging the team. Simply put, the interdependence of manifesting the transformational and transactional behaviors serve as the keystones to influencing employees with the execution of the organizational mission and vision. Ernie Abarquez Cerdeňa, Ph.D., is the president/consultant at Docern Radiology Advisors. Email your RAD IDEA to editor@mdpublishing.com. ADVANCING THE IMAGING PROFESSIONAL

NEED HELP WITH

EQUIPMENT

SERVICES? FIND SERVICE PROVIDERS BY CATEGORY ON !

medwrench.com

MedWrench is your online community to ask questions, download manuals, and share information about specific medical equipment you work with every day.

Join over 100,000 members. Create your FREE account today at medwrench.com

SPOTLIGHT

Off Clock THE

ROSE PAULY, BSN, MAT, RN

BY MATT SKOUFALOS

fter entering the nursing field in 1979, Rose Pauly’s career had been underway for 14 years when she withstood the most transformative tragedy of her life. At the time, Pauly had begun a graduate program, pursuing her MBA after 14 years of working in cardiac care, neurological care, and the pediatric ICU. She returned home one day after having dropped off lunches to her kids at school, when she noticed an unfamiliar car parked outside her home. A man she didn’t recognize exited the vehicle and began following her up her driveway at a brisk pace. Instantly, her guard went up. With an armload of books, Pauly started into her garage. As she looked back, she recognized the man as a contractor who’d bid on some cabinetry work in her home. Pauly and her husband had promoted Christian rock concerts for a time, and the man told her he was there to see about some cassette tapes they’d discussed. “I dropped all my fear, and let him in the house,” she said. “He came up behind me and held a knife to my neck.” As the man attempted to force her upstairs, Pauly fought back, and began to pray, audibly, as she begged him, “Don’t do this.” 16

ICEMAGAZINE | SEPTEMBER 2021

“At that point, inside, I knew I would rather die than go upstairs with this man, so I kept fighting him,” she said. “My hands were on his wrist, and I started to pray. I said, ‘Heavenly Father, I ask that you let this man know you love him, and You don’t want him to destroy his life by doing this thing.’ And I remember looking at him and saying, ‘God loves you.’ ” In that moment, Pauly said her fear was lifted, and her heart went out to her assailant. He stopped for a moment, hung his head and sighed. Pauly then ducked under his arm and ran to the front door only to discover he’d deadbolted it behind them. “With one hand, I’m fighting with this guy, and with the other, I’m opening the deadbolt,” she said. “I still remember the words in my head: ‘Be strong.’ ” Pauly eventually grappled her way free and out the door. She headed down her porch to the curb, and sat down, and her attacker came and sat down beside her. It was high noon as Pauly just started praying aloud again in broad daylight, while the man held his head in his hands, apologizing. “I said, ‘There’s real good and there’s real evil in this world, and you’re under the control of evil right now,’ ” Pauly recalls. “I told him, ‘You need God in your life.’ He says, ‘I ADVANCING THE IMAGING PROFESSIONAL

don’t even know where to start.’ ” Pauly’s assailant was arrested, and served five-and-a-half years in Colorado’s Canyon City Prison for the incident. The overwhelming nature of the experience led Pauly to set aside her nursing career and pursue a path to ministry. She completed a master’s degree in theology, and from 1996 to 2010, worked full-time as a pastoral minister, establishing the nonprofit Tenacious Love Ministries, which she still maintains today. Perhaps even more miraculously than the event that upended her life was the way in which her attacker re-entered it a decade-and-a-half after the fact. “During that time, he had a life-changing encounter with God in prison,” Pauly said. “Sixteen years later, he and his wife reconnected with my husband and me in the same living room, and I got to hear the whole other side of the story.” From 2011 to 2012, Pauly interviewed him about the entire encounter, penning a book, “Desperate Hope,” which tells both of their stories in tandem. In it, he shares his battles with addiction and despair, and she describes the way her faith helped free her from victimhood and leveraged a tragedy into the springboard that launched a mission. Writing the book “was truly a process of letting go of fear,” Pauly said. “When you go through a traumatic event, fear is embedded in the cells of your body,” she said. “It was a journey out of that, and it was a journey of pressing in, and recognizing a God behind it all who wanted to meet me in my fear and in my trauma, and keep me out of a pit of being a victim where you’re paralyzed by your fear.” “That was what I was free from, but it was a process of a daily encounter of God meeting me there, and walking me, step by step, out of that place,” Pauly said. “Foregiveness is not denying what happened. It’s calling WWW.THEICECOMMUNITY.COM

evil and violence by its right name, but it’s surrendering your right to get even. When I surrendered my right to get even, I was set free.” Pauly said she is still in contact with her onetime assailant, who is still married. His three children are now grown, and are all thriving. And her own ministry has flourished in the meantime as well. Tenacious Love Ministries has supported Dominican Mission, a program that builds schools for Haitian refugees living in the Dominican Republic after the devastating earthquake of 2010. Her son helped alert the family to the immense needs of Haitian school children after the disaster. For the past eight years, Tenacious Love has helped build a school there, supporting its operations and staffing with Rose Pauly’s ministry has helped build a school for Haitan refugees. regular donations. As her ministry grew, Pauly spent 18 months working to reinstate her nursing license in 2015. which means the patients are very well (She hadn’t drawn a salary from her supported,” Pauly said. “It’s been just work, and wanted to generate an pure joy that part of the job is to be income to support the nonprofit.) By able to use the pastoring and those 2016, Pauly had taken a position as a kinds of experiences in my life.” breast navigator and patient education Neither has Pauly lost sight of the advocate, at the Banner Imaging McKtransformative power of her traumatic ee Breast Center in Loveland, Colorado. experience to change not only her life, “I have such a desire to pour into but the lives of those around her. It’s a people’s lives with hope and encourlesson that underpins all the work she agement, and now, I’m a breast center continues to do. navigator and educator,” she said. “I “If it hadn’t been for the intervention work with the patients to teach them of God, I wouldn’t be here,” Pauly said. about their breast biopsies. I am the “He didn’t just save my life this day, but one who notifies them when the paHe took this event, and He used it for thology comes back. I usually am the good. It opened up the door for a minone calling them to notify them, and istry to women who’ve gone through help them get set up for all the foldifficult things.” • low-up care, emotionally, and for all the physical things that have to happen.” Email your Off the Clock nomination “We have a phenomenal team here to editor@mdpublishing.com with great, exceptional practitioners, ICEMAGAZINE

NEWS

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

FDA CLEARS DL PRECISE TOOL The FDA has granted 510(k) clearance for DeepLook Inc.’s DL Precise, a oneclick software tool to automate segmentation and measurement of suspicious objects across all medical imaging modalities, delivering critical improvements in workflow and reporting precision. Leveraging deterministic algorithms rather than artificial intelligence (AI), DL Precise ensures consistent, reliable results, a news release states. “It instantly renders segmentation by contouring an object’s margins and then measures long and short dimension axes, area and estimated volume. DL Precise’s single-click activation eliminates the complex manual setup that characterizes even semi-automatic segmentation tools today and adds important data to AI region-of-interest findings. Users, however, retain full control and can modify any automated measurement as desired,” the release states. DL Precise is the first of a series of medical imaging products under development by DeepLook Inc., a Connecticut-based software firm founded by a team with a 20-year track record of success with similar patented image analysis technologies in other industries.

ICEMAGAZINE | SEPTEMBER 2021

News

FDA CLEARS ENDOSURGICAL IMAGE ENHANCEMENT TECHNOLOGY FUJIFILM Medical Systems U.S.A. Inc. announced that the U.S. Food and Drug Administration (FDA) has granted 510(k) clearance for Fujifilm’s new image enhancement technology – the Oxygen Saturation Endoscopic Imaging System – which was developed to improve visualization during gastrointestinal, colorectal, and advanced endoscopy and surgical procedures. The new image enhancement technology enables real-time visualization of hemoglobin oxygen saturation (StO2) levels in tissue using laparoscopic and/or endoscopic imaging. Being able to detect StO2 levels helps surgeons identify potentially ischemic tissue, better positioning them to prevent tissue necrosis. “The prognosis is poor for tissue necrosis resulting from GI procedural complications and the reduction in mortality relies on early detection and intervention,” says Taisuke Fujita, vice president, endoscopy division, FUJIFILM Medical Systems U.S.A. Inc. “As long-standing leaders in endoscopic imaging, we’re thrilled to have evolved our image enhancement capabilities to address this deadly complication.” This 510(k) clearance comes six months after the FDA granted Fujifilm’s new image enhancement technology its “Breakthrough Device Designation,” which is reserved for certain medical devices that provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions. This new technology is an upgrade to Fujifilm’s ELUXEO Surgical System. Soon, physicians will have a greater suite of image enhancement tools available to them at the touch of a button- the Blue Light Imaging (BLI), Linked Color Imaging (LCI), and White Light Endoscopy modes currently available with ELUXEO, as well the new StO2 visualization mode. Each image enhancement technology provides physicians with unique data allowing them to better diagnose issues while in procedures. “Since receiving the FDA’s Breakthrough Device Designation we’ve been working to expedite the process of getting this critical technology into surgeons’ hands,” says Stephen Mariano, vice president of global endosurgical research and development, FUJIFILM Medical Systems U.S.A. Inc. “We’re excited to commercialize this new technology in the United States later this summer, and plan to launch the technology globally shortly thereafter.”

ADVANCING THE IMAGING PROFESSIONAL

ICE2022 IMAGING CONFERENCE & EXPO FEBRUARY 20-22, 2022 • NAPA, CA

ICE 2022 SEEKS PRESENTERS The Imaging Conference and Expo (ICE) heads west in 2022. The annual event will be held in Napa, California beginning February 20. Event organizers recently announced its “Call for Presenters” and are accepting applications to present. Find out more at AttendICE.com/call-for-presenters. Imaging professionals are invited to submit a proposal so they can share their experience and expertise with colleagues. ICE is the only conference dedicated to imaging directors, radiology administrators, and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers comprehensive educational opportunities for attendees.

Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, attendees will have the perfect opportunity to enhance their careers and spend time with colleagues. As an added incentive, ICE conference admission is complimentary for all hospitals, imaging centers, active military and students. ICE continues to be the only conference to combine leaders in imaging management with imaging engineers, providing an exclusive and unique community of key decision makers and influential imaging professionals. ICE is the perfect resource to grow and prosper, personally and professionally. For more information, visit AttendICE.com.

Custom-Tailored Value-added solutions for repair • MRI Coils • RF Amplifiers

• Gradient Amplifiers • Contrast Media Injectors

Component level repair and sub-assembly repair

VISIT: WWW.MITLABSUSA.COM

WWW.THEICECOMMUNITY.COM

EMAIL: INFO@MITLABSUSA.COM

CALL: JORGE LOPEZ 786-853-8448

ICEMAGAZINE

NEWS INTELERAD ACQUIRES HEART IMAGING TECHNOLOGIES Intelerad Medical Systems has acquired Heart Imaging Technologies (HeartIT). Headquartered in North Carolina, HeartIT provides web-based medical image management technology and services to health systems, large hospitals and private clinics, as well as drug and device companies sponsoring multi-center clinical trials. The acquisition will significantly expand Intelerad’s ability to provide enterprise imaging and insights while also deepening cardiovascular expertise. “Founded in 2000, HeartIT has been developing innovative medical image viewing and reporting software for more than two decades. Today, the company provides secure web browser access to over one billion medical images. Most notably, the company was one of the first to offer an FDA-cleared zero footprint medical image workstation, setting the precedent for others seeking approval,” according to a news release. “The challenges health care providers were facing prior to the pandemic are now even more critical, and technology is key to overcoming them,” said Mike

Lipps, Intelerad president and chief executive officer. “Our goal at Intelerad is to improve efficiency, productivity, and the user experience for providers. By partnering with HeartIT, we’re enabling our customers to tap into advanced visualization and reporting capabilities while increasing ROI and improving patient outcomes.” In February, Intelerad announced its acquisition of LUMEDX, a provider of health care analytics and cardiovascular information systems, which was preceded by the Digisonics acquisition in December 2020. The addition of HeartIT further supports Intelerad’s journey to provide software solutions that seamlessly manage medical images, workflows, and data, and ultimately help improve patient care. “We are thrilled to welcome HeartIT and are excited about Intelerad’s continued expansion on their path to being the global leader in medical image management,” said Jean-Baptiste Brian, Intelerad board member and Partner at HG.

PIKE COUNTY MEMORIAL REPLACES MOBILE IMAGING SYSTEM Pike County Memorial Hospital upgraded “from a Ford to a Ferrari” when it replaced its existing portable imaging system with the Carestream DRX-Revolution Mobile Imaging System. The superb image quality and maneuverability of the DRX-Revolution Mobile Imaging System is helping the hospital elevate its standard of patient care and productivity, said Rebekka Thornton, diagnostic radiology director, who made the comparison of a Ford to a Ferrari. “The mobility of the DRX-Revolution allows us to go into rooms that aren’t really set up for mobile X-ray exams yet move around the rooms with ease. The entire process is easier on our technologists and our patients,” Thornton explained. Bedside imaging is essential to the rural hospital. The mobile X-ray machine at PCMH is used in the emergency department, medical/surgery unit and surgery, conducting exams such as chest X-rays, line placements and extremity imaging. Additionally, the mobile system brings X-ray imaging to isolation rooms

ICEMAGAZINE | SEPTEMBER 2021

and to inpatients who are too ill or unstable to be transported to an X-ray room. The imaging provided by the DRX-Revolution assists surgeons when they need to complete procedures at the bedside; and helps physicians develop treatment plans. “The advanced functionality of our new mobile imaging system allows our technologists to quickly and easily produce exceptionally high-quality images of seriously ill or injured patients. Simply put, we gained a lot of features and better imaging than we had with our previous system,” said Thornton. For more information, visit carestream.com..

ADVANCING THE IMAGING PROFESSIONAL

MERCY ST. LOUIS INSTALLS MEVION PROTON THERAPY SYSTEM Mevion Medical Systems recently delivered a 15-ton compact accelerator to Mercy Hospital St. Louis in Missouri. The accelerator, the world’s smallest, is the core of the MEVION S250i Proton Therapy System which precisely delivers therapeutic doses of radiation to tumors while preserving healthy tissue and critical organs. The arrival of the accelerator commences the installation of the proton system at the David C. Pratt Cancer Center at Mercy St. Louis. The nationally accredited center provides outpatient treatment, radiation oncology and infusion services for patients throughout the Mercy network. Mevion’s unique and compact design enabled the new proton center to be embedded directly into the existing radiation oncology department. This efficient approach allows the hospital to share existing resources and offer patients all its cancer-fighting tools under one roof. “This major milestone in construction puts us one step closer to making the Mercy Proton Therapy Center a reality for our patients,” said Steve Mackin, Mercy executive vice WWW.THEICECOMMUNITY.COM

president and Mercy’s East Communities president. “Seeing the equipment before it’s enclosed in the concrete vault shows just how massive an undertaking this project has been. It’s remarkable to think of the many people who will survive – and thrive – because of this technology.” The MEVION S250i features the industry-leading HYPERSCAN pencil beam scanning technology and Adaptive Aperture pMLC, a powerful duo that provides faster and more precise dose delivery, Mevion’s natively integrated CBCT imaging, and surface-guided tracking from C-RAD for high precision patient positioning and intra-fraction motion management, according to a news release. “We are proud to partner with Mercy to provide this leading-edge technology,” said Tina Yu, Ph.D., CEO of Mevion Medical Systems. “Mevion’s mission is to make proton therapy accessible and the quality and value of the MEVION S250i has enabled more centers, like Mercy, to provide this powerful treatment modality to their patients.”

ICEMAGAZINE

NEWS MITA APPLAUDS FIND ACT The Medical Imaging & Technology Alliance (MITA) announced in a news release that it applauds Congressmen Scott Peters (D-CA), Bobby Rush (D-IL), Neal Dunn (R-FL) and Greg Murphy (R-NC) for introducing The Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2021 (H.R.4479), legislation that would significantly expand patient access to advanced nuclear diagnostic imaging technologies. The FIND Act addresses structural issues in the packaging methodology used in the Medicare outpatient setting by di-

recting the Department of Health and Human Services (HHS) to pay separately for all diagnostic radiopharmaceuticals with a cost threshold per day of $500. If passed, this bill would give patients greater access to a wide range of diagnostic radiopharmaceuticals that can better detect conditions such as heart disease, Alzheimer’s and Parkinson’s disease, breast and prostate cancer, and neuroendocrine tumors. This legislation would also help providers better manage costs while delivering more targeted and cost-efficient care.

RSNA LAUNCHES IMAGING AI CERTIFICATE PROGRAM As artificial intelligence (AI) becomes increasingly integrated into clinical practice, the Radiological Society of North America (RSNA) is launching an Imaging AI Certificate program to deliver a pathway for radiologists to understand and learn how to apply AI to their radiology practices. The program will launch this fall. The RSNA Imaging AI Certificate program offers a convenient and structured online curriculum designed to help radiologists understand how to incorporate AI into their daily practice, especially to assist with diagnostic radiology and workflow efficiency. Customized to meet radiologists wherever they are in their AI knowledge, the RSNA Imaging AI Certificate will help radiologists learn, practice and continually refresh their AI skills. “We are at a pivotal time in the progression of radiology,” said Matthew B. Morgan, M.D., course director and associate professor and director of informatics and quality improvement in breast imaging at the University of Utah in Salt Lake City. “For the first time, we have AI that can ‘look’ for findings in the images and maybe more importantly, ‘see’ beyond what we can see to process and recognize patterns in quantitative data that is beyond human ability. This is where some of the most exciting advancements may come.” Through the RSNA Imaging AI Certificate program, radiologists will

ICEMAGAZINE | SEPTEMBER 2021

complete a curriculum of foundational-level AI education via self-paced, on-demand videos, allowing participants to learn as their schedule allows. Case-based modules will provide hands-on experience making diagnosis decisions and balancing workload with AI assistance. Radiologists won’t just “watch” how AI is integrated into a clinical setting but will use AI algorithms in realistic and interactive ways designed to demonstrate how AI is relevant to their clinical practice. “The RSNA Imaging AI Certificate will be quite impactful for all radiologists, especially those who want to be more involved with the implementation of AI algorithms in their clinical practices,” said Linda Moy, M.D., course director and professor of radiology at the NYU Grossman School of Medicine in New York City. “The certificate will provide radiologists with an understanding of how to evaluate the usefulness and accuracy of AI algorithms and allow them to develop realistic expectations of how AI software may change their clinical workflow.” The RSNA Imaging AI Certificate program offers a unique radiologist-centered approach, which makes the RSNA program unlike any other AI course. “The content is focused toward the mainstream radiologist, and the modules will be focused on the activities at which radiologists excel, such as imaging annotation and clinical evaluation of AI models,” said George

Shih, M.D., course director, associate professor of clinical radiology at Weill Cornell Medicine and vice chair for informatics in Weill Cornell’s Department of Radiology. “While a general understanding of how algorithms are built and programmed will be included, the AI algorithm itself is not the main focus of the curriculum. Instead, we’ll focus on how the data and its annotations affect the AI algorithm and how the AI performs clinically after training a neural network – all things that radiologists do better than computer scientists.” According to Moy, the value of this program is in its ability to help radiologists integrate AI as part of their role both now and in the future. “There is significant value in obtaining the RSNA Imaging AI Certificate from a hiring, promotional and job security perspective, as well as leveraging this knowledge to provide more value and better patient care in their practices,” she said. Following course completion, participants will receive an RSNA Imaging AI Certificate demonstrating the ability to understand AI algorithm development and to illustrate issues with AI algorithms within clinical practice. RSNA will offer continued education including additional coursework and a pathway toward additional certificates. For more information, visit RSNA.org/AI-certificate.

ADVANCING THE IMAGING PROFESSIONAL

FDA CLEARS MAGNETOM FREE.MAX 80 CM MR SCANNER Siemens Healthineers recently announced the Food and Drug Administration (FDA) clearance of the MAGNETOM Free.Max, a new High-V magnetic resonance (MR) scanner that combines a 0.55 Tesla (0.55T) field strength with deep learning technologies and advanced image processing. By doing so, the scanner broadens the range of MR clinical applications and provides customers with the inherent clinical benefits of a mid-field MR scanner. The first and only 80 cm wide-bore system available, the MAGNETOM Free.Max also facilitates MR scanning for extremely obese and claustrophobic patients, enhancing the patient experience. At less than 3.5 tons and less than 80 inches high, the MAGNETOM Free. Max is the most lightweight, compact whole-body scanner ever offered by Siemens Healthineers. Its reduced size permits installation with minimal structural modifications. And where MR scanners typically require several hundred liters of helium and a quench pipe for cooling purposes, the new magnet of the MAGNETOM Free.Max uses less than 1 liter of helium, reducing life cycle and infrastructure costs. For these reasons, the customer can install the MAGNE-

TOM Free.Max in areas where an MR scanner could not be housed previously. The MAGNETOM Free.Max leverages the company’s latest image processing and artificial intelligence workflow innovations. Deep Resolve is a set of algorithms that performs targeted denoising and uses deep learning to deliver sharper, higher-resolution images. myExam Companion, a comprehensive workflow solution that incorporates elements of artificial intelligence, helps the user navigate the examination to efficiently achieve consistent, high-quality results, regardless of user experience level, patient or throughput. “Siemens Healthineers is proud to offer the MAGNETOM Free.Max, which brings MR to new clinical fields with innovative digital technology, new siting features, and image quality that was once realized only at higher field strengths,” said Jane Kilkenny, vice president of magnetic resonance at Siemens Healthineers North America. “The scanner’s comparatively low weight and size can open the door to MR utilization in orthopedic centers, emergency rooms, outpatient centers, and even intensive care units.”

IMAGING SYSTEMS YOU AND YOUR PATIENTS DESERVE From adding another MRI unit to handle your patient backlog, to providing a short-term solution while upgrading your current unit, to adding a new service, KMG has the right imaging systems to keep you running efficiently and affordably.

612-757-6714 kingsmedical.com contact@kingsmedical.com

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

NEWS

TURNER IMAGING SYSTEMS ANNOUNCES INTERNATIONAL EXPANSION Turner Imaging Systems has entered a distribution agreement with MIS Healthcare to market its Smart-C fluoroscopic Mini C-Arm in the UK and Ireland. MIS Healthcare, with headquarters in London, is a large, independent medical imaging equipment supplier throughout the UK and Ireland, servicing NHS and HSE hospitals as well as private hospitals, clinics, screening centers and diagnostic departments. Having received its CE Mark for the Smart-C in May of this year, Turner Imaging Systems looks forward to partnering with MIS Healthcare for its initial Europe launch. Turner Imaging Systems also looks forward to launching the Smart-C into a number of other European markets this calendar year. “MIS Healthcare is proud and excited to be partnering with Turner Imaging Systems to market and distribute the

ICEMAGAZINE | SEPTEMBER 2021

Smart-C battery powered fluoroscopic Mini C-Arm across the UK,” said Nicholas Sykes, national sales and marketing manager for MIS Healthcare. “As a company we constantly strive to offer medical professionals the cutting-edge tools they need to improve patient outcomes. The Smart-C will offer true flexibility and portability making it an ideal solution for many different applications.” The Smart-C is finding great success across the USA in hospitals, ambulatory surgical centers, orthopedic clinics, clinical labs, pain management centers and with sports teams where the hyper-portability of the Smart-C allows it to be used virtually anywhere including on the sidelines. “The cordless, battery-powered, 16-pound Smart-C is unparalleled in its ability to provide high-quality point of care/injury extremity imaging for any application,” a news release states.

ADVANCING THE IMAGING PROFESSIONAL

ELEKTA EARNS PATENT FOR INTELLIMAX For the past several years, Elekta has invested substantially in digitized service solutions to keep critical treatment machines up and running at cancer clinics, thereby ensuring that patients receive timely radiotherapy. Among these solutions is the remote exchange of technical system data between Elekta remote service centers and linear accelerators installed at hospitals worldwide. Using Elekta IntelliMax real-time, remote system data monitoring, Elekta keeps a watchful eye on more than 80 percent of the company’s linear accelerators installed around the world. IntelliMax constantly tracks these systems’ functionality and technical status to ensure timely prevention or repair of issues. Elekta recently received its first patent for an IntelliMax capability that can help radiotherapy departments preserve the functionality of a crucial component of the technology used to treat patients. “Innovations such as IntelliMax are in harmony with our overall service strategy,” says Paul Bergström, executive vice president, global service. “As our technology advances, it is critical to ensure its serviceability and maintenance

progresses. Elekta is changing the equipment service paradigm – rather than responding reactively, our service model is centered on our strategy of lifelong partnership with our customers, proactively ensuring treatment systems are available when needed. Through IntelliMax, we can attend to systems during hours when it’s convenient to our customers and, through this, create increased access for patients.” IntelliMax enables remote as well as onsite proactive system maintenance. In 2020, IntelliMax ensured that more than 200,000 patient treatment slots could continue without interruption. “This patent for Elekta service is a fantastic milestone on our digitalization journey,” adds Bergström. “It is the first of several pending patent applications focused on improving the serviceability of our solutions. We are going to improve the ‘predictability-to-treat’ for customers – in other words, giving them the certainty that the treatment system is available for clinical use if and when they need it for life-saving, life-prolonging cancer treatments.”

VAREX ANNOUNCES LUMEN 4336W DR DETECTOR Varex Imaging Corporation has added the LUMEN 4336W digital radiography detector to Varex’s product line. The LUMEN 4336W joins the LUMEN 4343W as part of a new generation of detectors designed for increased durability and convenience for customers and end-users. The LUMEN 4336W has increased resistance to water ingress with an industry leading rating of IP68. This means that the LUMEN 4336W will be ready for real world use, from the physical challenges of the emergency department to the frequent disinfection cycles now demanded by changing standards of care. The LUMEN 4336W has been designed with reliability in mind. By simplifying the construction of the internal components, Varex has minimized potential points of failure while also improving the

WWW.THEICECOMMUNITY.COM

design of the housing to provide protection from external shocks. The LUMEN 4336W has an integrated inductive charger that allows wireless charging in a bucky, on a table-top, or in a carry case – wherever the detector may be between shots, reducing the need to remove the battery for charging The improvements in the LUMEN 4336W detector are coupled with the reliable image quality that Varex has built its reputation on. Varex’s expertise in high sensitivity, low noise designs means that these mechanical improvements can be matched with best-in-class image quality.

ICEMAGAZINE

NEWS

ICE

A COOL SERIES FOR HOT TOPICS

DES X-ray Webinar Sets New High STAFF REPORT

he July 27 ICE webinar “Improving Department Results with Single Exposure Dual-Energy Subtraction X-Ray: Clinical, Operational and Financial Benefits” was sponsored by KA Imaging. It was also approved by AHRA for 1.0 Category A ARRT (AHRA Reference: LEC11337, Expiration Date: 07/28/2022). The webinar was popular setting a new high in registrations with 147 individuals signed up for the session. In the 60-minute webinar, experts Dr. Karim Karim and Jay Potipcoe reviewed the clinical, operation and financial benefits of Single Exposure Dual-Energy Subtraction (DES) X-ray. After viewing the presentation, attendees now understand dual-energy subtraction (DES) X-ray and the clinical benefits enabled by dual-energy in the early detection of small nodules identification, pneumonia, pneumothorax and coronary calcifications. Attendees also now understand the limitations of the old DES techniques and how a single-exposure detector can overcome those limitations. The presenters also explained the operational and economic benefits that come from using the dual-energy technique; and shared information about current hospital implementations of single exposure dual-energy X-ray. Karim and Potipcoe opened the floor to attendees during a question-and-answer session that provided additional knowledge to participants. One question asked, “Are dual energy radiography and phase contrast X-ray imaging, essentially the same thing?” “No, they’re not,” Karim explained. “Phase contrast X-ray imaging tries to look at the refraction in the X-ray. So, when an X-ray passes through an object it’s going to deviate slightly from its path because of the interaction in that material. Phase contrast X-ray has not really been clini26

ICEMAGAZINE | SEPTEMBER 2021

cally demonstrated on full-sized patients. I think it’s still in clinical study for breast cancer. It may not work as well for chest X-ray because the patient volumes are too large. Dual energy, on the other hand, is very different.” “It’s been around for 40 years and it’s looking at, as I mentioned earlier, the attenuation of different energy X-rays in different materials. So, in dual energy use of materials, separation technique. Phase contrast is a technique that can highlight soft tissue, but they are very different techniques.” Attendees provided positive feedback in a post-webinar survey that included the question, “How much new information did you receive from today’s webinar?” • “Good amount of good new information was shared, specifically about the technology on old and new detector design. Very interesting,” Director of Radiology P. Mosebach said. • “Very good information, impressive topic for discussion,” said J. Harwood, imaging equipment specialist. • “It was all new to me, I have only reviewed DE X-ray in the past,” Director S. Morris said.

For more information, including on-demand webinars and a calendar of upcoming presentations, visit ICEwebinars.live.

Thank you sponsor!

ADVANCING THE IMAGING PROFESSIONAL

1 2 3 Register online to view our live webinars each month.

ARRT Category A CE credit is pending approval by the AHRA.

Watch recorded webinars online.

IT ALL STARTS ONLINE

ICEWEBINARS.LIVE

PRODUCTS

Market Report Research Groups Predict C-arm Market Growth STAFF REPORT

he C-arms market is expected to register a compound annual growth rate (CAGR) of nearly 4.12% during the forecast period and reach $2.5 billion by 2026, according to a Mordor Intelligence report. Data Bridge Market Research reports that the market is growing and expects it to reach $3.9 billion by 2027. A report from Market Data Forecast states that the C-arm market was worth $3.32 billion in 2021 and is estimated to reach $4 billion by 2026. “The COVID-19 pandemic is expected to have an impact on the C-arm market. C-arms are used in image-guided procedures that are mostly elective, which were postponed due to COVID 19. This may have also resulted in hospitals deterring the investments in high-cost capital equipment during the current pandemic, as they focus more on ventilators or other COVID-19 treatment supporting equipment,” the Mordor Intelligence report states. “According to a study published in the British Journal of Surgery, in May 2020, based on a 12-week period of peak disruption to hospital services due to COVID-19, around 28.4 million elective surgeries worldwide were expected to be canceled or postponed in 2020. More than 580,000 planned surgeries in India have been canceled or delayed as a result of the COVID-19 pandemic. However, according to the European Association of Urology guideline, while handling COVID-19 positive patients needing surgery, a specially equipped operating room needs to be designed, where a mobile C-arm fluoroscopic X-ray system for radiology and health care professionals will be needed for operating. Hence, consid28

ICEMAGAZINE | SEPTEMBER 2021

ering the rising cases of COVID-19 and its significant effect on health care systems across the region, it is estimated that the market will continue the steady growth rate trajectory during the forecast period.” Major factors driving the growth of the market include the rising geriatric population and the increasing incidence of chronic diseases, advancements in maneuverability and imaging capabilities, and an increasing demand for imaging technologies from emerging economies. Imaging systems are becoming an essential technology and are present in nearly all well-equipped hospitals. Specialists in fields – such as surgery, orthopedics, traumatology, vascular surgery and cardiology – use C-arms for intraoperative imaging. The devices provide high-resolution X-ray images in real-time, which helps physicians to monitor progress at any point during the operation and immediately make necessary corrections. As a result, treatment results are better and the patient’s recovery is also faster. C-arms are currently being used in several areas of medicine and their applications are expected to increase over time. These factors, along with the increasing demand for health care infrastructure in developing countries, are driving the C-arm market. North America is expected to hold a major market share during the forecast period, according to Mordor Intelligence. Also, it reports, that the United States holds the largest market share within the North American region, owing to the high standards of health care infrastructure in the United States, along with the high frequency of diagnostic examination, rising geriatric population and increasing prevalence of chronic diseases. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus C-ARM

TURNER IMAGING SYSTEMS Smart-C mini C-arm

Turner Imaging Systems, developers of the Smart-C X-ray imaging system, has entered into a Sponsored Research Project with Massachusetts General Hospital to investigate the use of the Smart-C for weight-bearing radiographs of the foot and ankle. The Smart-C mini C-arm has a unique 16-pound portable design that is battery operated and hand-transportable, potentially improving where and how fluoroscopy is performed. The C-arm uses the latest imaging technologies including a 6-by-6-inch flat panel detector and novel compact X-ray source in a package that can be placed directly on the floor, and thus can be used to make weight-bearing fluoroscopic and radiographic images of the foot and ankle.

*Disclaimer: Products are listed in no particular order.

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

PRODUCTS

SIEMENS HEALTHINEERS Cios Flow

GE HEALTHCARE OEC 3D Surgical Imaging C-arm

The new Cios Flow mobile C-arm from Siemens Healthineers is designed for use by multiple disciplines in the operating room – including orthopedics, trauma surgery, spinal surgery, vascular surgery and pain therapy – to increase the ease and efficiency of everyday imaging workflows for surgical interventions. Its low weight, maneuverability and intuitive touch-gesture interface simplify operation. The SpotAdapt function on the Touch User interface can optimize relevant imaging for challenging anatomical areas. Additionally, Windows 10 security functions help minimize cyberattacks targeting the system or patient data.

The OEC 3D is a new surgical imaging C-arm that provides precise 3D and 2D imaging to surgical suites while enabling efficient imaging every day. Based on GE Healthcare’s proven AW image fabric technology, the OEC 3D C-arm now enables surgeons to quickly capture and analyze 2D as well as precise 3D volumetric images with a C-arm, bringing CT-like images into the operating room. OEC 3D also includes the recognizable OEC C-arm 2D imaging experience and versatility for all types of procedures from general surgery to interventional cardiovascular procedures for everyday procedures. For more information, visit gehealthcare.com/oed3d.

ICEMAGAZINE | SEPTEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

FUJIFILM

Persona C Mobile Surgical C-arm

Persona C Mobile Fluoroscopy System is an advanced C-arm solution engineered for fast, precise positioning and advanced image quality. The system is designed to make surgical imaging easier with a simplified user interface and an automated organ program to minimize dose to both the patient and staff. The C-arm system is available with 21×21 cm or 30×30 cm amorphous Silicon (aSi) flat panel detector options for ultra-low dose fluoroscopy and vascular imaging. Its dedicated radiography mode captures high quality static X-ray images to simplify procedure time acquiring pre and postoperative imaging with one system. For more information, visit: https://healthcaresolutions-us.fujifilm.com/diagnosticimaging/persona-c-mobile-fluoroscopy-system.

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

ICEMAGAZINE | SEPTEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

Feeling the Flow

THINKING THROUGH STRATEGIES FOR OPTIMIZED IMAGING WORKFLOW BY MATT SKOUFALOS

or Josh Laberee of Advanced Imaging in Orange City, Florida, administering an independent medical imaging center means constantly evaluating its performance, from the conventional metrics around cost controls to those harder-to-pin-down details around patient satisfaction. Advanced Imaging is a privately operated, standalone facility that competes on a throughput advantage, marketing a 15-minute turnaround time for its walk-in patients. Delivering on that experience absolutely turns on analysis of mechanical performance data and in-house benchmarking, which Laberee sees as ultimately in service to those cost controls. Yet despite that information, some of the most valuable data is qualitative; an itch that’s far more difficult to scratch. “People are so concerned with making everything fit within benchmark; if you dissect that another layer, what are they doing within that category?” he asked. “You have all your C-suite people who are focused on the numbers, but how is that being executed?“ “We’re all about making the number, but I don’t think people are focused on how we get there,” Laberee said. “People on the ground can most tell you what’s working and what’s not. At the end of the day, we can’t lose sight on the biggest competitive advantage: how do you still meet your numbers but not take away the personal human WWW.THEICECOMMUNITY.COM

experience? I think there’s going to be a ton of value if you do meet your numbers without losing touch.” Part of the reason for Laberee’s conclusion is that many of the imaging workflow benchmarks that are published in studies of corporate America are based around patient experiences and departmental performance in multisite or hospital settings, and the data won’t necessarily capture the experience of a facility like Advanced Imaging. To generate maximum efficiency from his operation – and guarantee positive word-of-mouth, which leads to repeat business – Laberee’s workflow processes are anchored in the performance of staff with clearly defined roles and an ear to the ground on patient feedback. “What creates our biggest competitive advantage is we’re not corporate,” he said. “We have a processing system in place, but as we’ve been able to grow the business by advertising that we can turn around a walk-in X-ray in 15 minutes, I’ve been able to staff accordingly. You can’t become efficient unless you know where you’re deficient. That’s hard to determine with benchmarks.” To get at some of the most insightful patient experience data requires independent benchmarking, Laberee said, which in his case, means “secret-shopping” competitors “very tightly.” When staff, family and friends need to get imaging studies done, Laberee sends them to a competitor’s facility and covers the cost in exchange for detailed feedback on their experi-

ences there. “I want to know everything,” he said. “How long did you sit in the lobby? Did you like the taste of their coffee? What was the bathroom like? Did they support bilingual patients?” In addition, Laberee said he pays close attention to the customer reviews he receives in direct response to patient feedback surveys as well as those reviews that show up on social media sites. Sometimes the lessons learned are painful, but informative; and in at least one case, expensive to correct. The ultimate example he described came from a place he least expected it: the front door. “We have these beautiful automated doors, one of a kind, custom, that open at the front,” Laberee said. “But guess what? Patients are creatures of habit. Your typical door slides from right to left as you walk through. Ours came at you. People were pulling at door handles. Fast-forward, and we spend thousands to put in a conventional door.” “Sometimes you try to do something unique, and sometimes you do have to conform with the masses and what’s expected,” he said. Although workflow performance metrics are difficult to define, institutions nonetheless continue to seek artful ways to capture them, said Dr. Christopher Austin, chief medical officer at the U.K.-based Kheiron Medical Technologies. Independent of modality, all imaging workflow begins with scheduling, and, according to Austin, the fundamental way to conceive of ICEMAGAZINE

scheduling efficiency is by measuring system performance in terms of time elapsed from the next available appointment until that appointment is completed. Some of that comes down to the type of study being performed: chest X-rays and mammograms are among the highest-volume studies that go through an imaging department, Austin said, while MR and CT studies “have their own complexities” when it comes to scheduling. “Schedulers are looking to see if there’s any more information that would prioritize that patient over another,” he said. “They’ll have some ability to say, ‘This is a high priority,’ and they do some triage in that function.” From when an appointment is scheduled, some organizations will measure elapsed time from check-in to the start of the procedure, which can include time spent preparing the patient for the exam, performance of the study itself, and any time spent preparing the room for the next patient. After that, the next question is how long does it take for that image to be put on a work list, where it can be read and reported by a radiologist? And finally, when does that information make it into the hands of the referring physician and, eventually, the patient? “All these little steps are timestamps that organizations are trying to optimize for clinical and economic efficiency, and ultimately, for the patient,” Austin said. “The challenge of all of that is standardizing how they measure those times and metrics and how to remove human error from those measurements.” Some of the variability in taking these measurements is related to the manual entry of these timestamps by staff as the process rolls itself out; because of it, these data points may not always be reflective of actual turnaround times, which can muddy the results as they’re analyzed. Moreover, Austin said some PACS and RIS vendors have not been able to automate 34

ICEMAGAZINE | SEPTEMBER 2021

“All these little steps are timestamps that organizations are trying to optimize for clinical and economic efficiency, and ultimately, for the patient.” - Christopher Austin

timestamping through their software. Instead, he believes that analytical workflow processes aided by machine learning or artificial intelligence (AI) may be used to flag automatically those moments when radiologists review a study, taking away the guesswork. “You do have a timestamp for when the study gets pulled, but I think where AI is being used, or will be used, alongside a radiologist, is a great way to timestamp what’s happening,” he said. “I think we’re going to see a lot more automation there, and a lot more accurate reporting of turnaround time.” “In the radiologist’s workflow, it’s getting patients into the room and the reporting turnaround that are your biggest bottlenecks,” Austin said. “All these things take time, and AI will be able to help us understand those trends better.” Austin believes that AI, which can support radiologists in managing complex imaging studies, including those of cancerous growths, can also improve workflow and patient throughput overall by helping prioritize those studies that may take more time to complete, or which may need to be conducted because of the severity of the potential findings. “The decisions that are being made throughout the course of their staging and their follow-up is a precise art, and those are the studies that take the most time for radiologists,” Austin said. “If you allow AI to provide a lot more accuracy, you remove some of the subjectivity that’s in the hands of a radiologist. That’s where a lot of new efficiencies are going to happen.” “As we create more and better diagnostic technology, it has an impact on the radiologist in terms of the time it takes,” he said. “That’s the tension:

high volume, new technologies, and legacy imaging protocols. That’s the stuff that’s putting radiologists on the hamster wheels. Can AI actually help remove some of that fatigue? Definitely it can. We’re not there yet because the humans are doing a lot of the work to check what the machines are doing.” There are, of course, bottlenecks to any multi-stage process, including those far less complicated than medical imaging. One such issue in organizations that offer multiple imaging modalities may simply be the challenge of additional variables. Maximizing usage of one imaging system may be complicated enough; factor in multiple suites with various modalities at multiple locations, and the problem becomes far more complex, even under normal conditions, to say nothing of times of stress. During the novel coronavirus (COVID-19) pandemic, for example, imaging throughput stalled for a number of reasons. Even discounting the government-mandated shutdown of non-essential operations, once facilities reopened, enhanced sanitization procedures were required to clean work environments between patients. Yet Austin argues that AI-based workflow solutions can help here, too, in prioritizing which patients should be seen first based on information analyzed from prior studies. “You’re talking about as many as 10 million patients who missed their cancer screening appointments” during the pandemic, he said, citing an April 2021 investigation from the Journal of the American Medical Association. “It’s a scheduling as well as a workflow nightmare. How do we bring these patients back? We’re using AI to look at the previous exams of these patients, and generate a scheduling list based ADVANCING THE IMAGING PROFESSIONAL

on features the AI saw in previous images that might suggest that someone is at greater risk of evolving into a more progressive cancer. I think that’s a really exciting development that really is putting a different tool into the hands of the schedulers.” Imaging workflow efficiency can also be derailed by technical recalls; those circumstances in which imaging studies must be repeated because of staff errors in their initial execution. Although such circumstances account for maybe just 2 or 3 percent of all studies, Austin argues that AI-powered algorithms can aid throughput here again by tagging images at the time of the study and certifying that they’re of sufficient diagnostic quality. “You’re not going to get paid for that repeat exam in this model, and you’re refining lower-quality images and causing consternation for the radiologist,” he said. “When it does happen, it’s an added burden, and an added cost for the patient. In a large organization, that can have a lot of financial consequences and certainly interrupt your scheduling.” Payers also have an interest in improving radiology workflow efficiencies because processes that deliver better results – fewer technical recalls, optimized scheduling, faster turnaround times – can lead to better health outcomes for patients (and therefore, less expensive interventions are necessary to treat them). Payer-providers especially also rely on the kinds of data that can help optimize the patient experience for positioning their practices in the markets they serve. But like with all metrics, the pursuit of excellence can expose facilities to different pitfalls. “Radiologists are looking for tools that would help them be more efficient and safer,” Austin said. “The challenge is that they don’t want to make mistakes, or push the productivity to a place where they’re sacrificing clinical quality. I think they really just want to be able to work smarter.” Working smarter is especially critical when imaging stroke patients, said Rachel Witalec, vice president of product WWW.THEICECOMMUNITY.COM

at the Menlo Park, California-based Rapid AI. The company was founded by Stanford University physicians who were looking to improve clinical decision support in order to better identify and diagnose cerebrovascular disorders that require the fastest possible treatment responses. The workflow problem to solve used to be finding ways to improve patient selection for treatment, Witalec said; then it shifted to finding the best places for them to receive necessary care as quickly as possible. “In the world of stroke, you’ve got 6,000 hospitals, and only a subset of them have the resources to treat stroke,” she said. “Patients show up, but they have to be transferred. Every second you have that clot in your brain, your brain is withering away; if you have a clot in your brain for three

To Witalec, stroke imaging workflow is less about optimizing throughput performance from a revenue perspective and more about aligning the discrete segments that comprise a rapid response to patient needs, from transport to treatment. That means understanding more about the health network itself, its transfer protocols, and the technologies available to practitioners there. In her experience, the best processes are derived in environments with institutional champions for workflow efficiency. “For us it’s important to make these hospitals feel like they’re supported,” she said. “These are complex things; these are people’s lives, so it’s important to do that hand-holding, support the team and help them understand what changes with the new process.”

“Our sweet spot is fusing AI and workflow to help teams understand how they help patients.” - Rachel Witalec hours, you’ve aged up 10 to 20 years. The problem becomes workflow.” The RapidAI stroke mobile app tries to coordinate the various elements of imaging workflow by providing notifications for different stages of the patient journey, from their arrival in the facility to when imaging results are available to be viewed. Timer functionality shows where patients are throughout the process, counting up from the last known condition. Relevant personnel can communicate within the app, all with the aim of getting the best possible response within the shortest amount of time. “Our sweet spot is fusing AI and workflow to help teams understand how they help patients,” Witalec said. “Hospitals get more patients to treat who need that treatment, which means reimbursement, and the team centralizes that tool, which minimizes burnout.”

“As I’ve talked to more and more physicians and hospital teams, the pain points are very similar,” Witalec said. “They say, ‘I don’t know that an EMS team is going to arrive with a patient. Maybe I’m on-call, and I’m not even at the hospital. Maybe EMS didn’t take that patient to the most appropriate point of care. Maybe the ED, EMS and specialist teams are all using different tools.’ You then have very disconnected teams, and then the specialist team is often late to the party, and they have to mobilize to take care of the patient.” “I think people are logjams naturally,” she said. “I think we’re really in the business of change management. That’s a psychological thing because people don’t like change, and technology is scary, and we’ve used the same process flow diagram for 10 years. How do we help train people so that they feel comfortable?” • ICEMAGAZINE

INSIGHTS

CODING/BILLING

AUC PIVOT – TAKE 5

BY MELODY W. MULAIK

he implementation of Appropriate Use Criteria (AUC) consultation has been delayed many times since its original implementation date of January 1, 2017 set forth in the Protecting Access to Medicare Act of 2014 (PAMA). Everyone in the radiology industry is aware of the high-level requirements of the legislation. The devil is in the details at this point. In the 2018 Medicare Physician Fee Schedule (MPFS) Final Rule, CMS announced the consultation requirement would go into effect January 1, 2020. In January 2020 a one year “educational and operations testing period” began which CMS extended to two years by posting an update on its AUC webpage in August, 2020. In the 2022 MPFS Proposed Rule, CMS expressed concerns around the complexities, scope and application of AUC program claims processing edits and is requesting stakeholder feedback regarding the implementation and claims processing issues and the start date of the payment penalty phase. Additionally, CMS acknowledges that due to the challenges and practice disruptions experienced during the Public Health Emergency (PHE) for COVID-19, additional time may be needed to prepare for the payment penalty phase. CMS believes that the earliest that its claims processing system can begin screening claims using the AUC program claims processing edits for the payment penalty phase is October 2022. Since this 36

ICEMAGAZINE | SEPTEMBER 2021

timing does not align with the typical CMS annual update cycle, CMS believes that the earliest practicable effective date for the AUC program claims processing edits and payment penalty phase would be January 1, 2023. Therefore, CMS’s proposal is a flexible effective date for AUC program claims processing edits and payment penalty phase to begin the later of January 1, 2023, or the January 1 that follows the declared end of the PHE for COVID-19. While the proposed delay is certainly the most noteworthy item associated with AUC in the proposed rule, there are also some other proposed clarifications and/or charges that are noteworthy. CMS proposes that when the furnishing professional for a study that required AUC consultation needs to modify an order and/or perform additional studies (in compliance with CMS guidelines) then neither the ordering provider nor the furnishing professional are required to perform an additional AUC consultation. This is technically not new information, but it is good to have this clarification should it be set forth in the MPFS Final Rule. The exemption of Critical Access Hospitals (CAHs) has been stated by CMS in the past but there remained the lingering question for some as to whether this exemption would also apply to the interpreting radiologist. To address this, CMS proposes to clearly define an exception that claims submitted by providers for the professional component of an advanced diagnostic study in a CAH would not be subject to the AUC program. There are two important scenarios

that CMS is seeking feedback on that have a very substantial impact on all stakeholders responsible for submitting claims with AUC information. The first is inpatients who are converted to outpatient status and the second is patients who have Medicare as their secondary payer. Both scenarios can create operational challenges for both the technical and professional sides to ensure correct billing. CMS’s proposal to exclude these claims would be welcomed by everyone in the industry. There are also proposed changes to the existing modifiers utilized to report adherence to the AUC consultation requirements. CMS proposes to keep the MH modifier and expand its definition from communicating only that it is unknown whether or not an ordering provider performed the AUC consultation to also include situations where the ordering providers is not required to consult AUC (CAH, etc.). There are other elements that CMS includes in the proposed rule language regarding AUC so all of the information should be reviewed in its entirety. With all of the delays, CMS’s admitted challenges with processing claims and, most importantly, greater priorities for health care providers during this Public Health Emergency (PHE) perhaps it is time for bigger discussion as to whether or not the current program structure really addresses the originally defined goals. • MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.

ADVANCING THE IMAGING PROFESSIONAL

iFIX Patient Stabilization System Versatile • Comfortable • Sanitary • Disposable iFIX Fleece stretches and gently “hugs” the contours of the patient’s body for gentle, yet secure stabilization.

• Reusable iFIX Patches and Adapters strongly secure the iFIX Fleece to ensure optimal patient stabilization and minimize motion artifact.

Ideal for CT • MRI • Fluoroscopy • Interventional Radiology Call 1.800.233.5539 or visit Beekley.com/iFIX to learn more Distributed in the U.S. and U.S. territories by Beekley Corporation One Prestige Lane, Bristol, CT 06010 USA • Tel: 1.800.233.5539 or +1.860.583.4700 Fax: 1.800.735.1234 beekley.com BEEKLEY, BEEKLEY MEDICAL, and WHEN YOUR DIAGNOSIS MUST BE RIGHT are Reg. U.S. Pat. & Tm. Off. BEEKLEY is a Registered Community Trademark. BEEKLEY is a registered trademark in Canada. © 2021 Beekley Corporation. All rights reserved. All other trademarks are the property of their respective owners. Visit beekley.com/ifix for product safety information.

REV: iFIX_AD-ICE_0721

INSIGHTS

CHECK, COMPARE, CONFIRM

T DIRECTOR’S CUT BY LYDIA KLEINSCHNITZ

ICEMAGAZINE | SEPTEMBER 2021

wo years ago, which now feels like a lifetime ago, we had a couple of near misses in our imaging department. Those misses comprised of patients with the same name or just before completing an exam, discovering that there was another part of the patient’s body that needed to be added to the scan. Every imaging department wants to avoid a wrong patient or a wrong exam scenario. If a patient’s safety is in question, one occurrence of wrong exam or wrong patient is one too many. In order to prevent any of these mistakes from happening, our leadership team worked with frontline staff to see what could be done to help streamline patient and order confirmation. The first thing we tackled was our requisition. The requisition is what our imaging software displays once an order is entered into the patient’s electronic record. It is a paper or electronic screen that the technologist uses to identify the patient and the exam to be done. Our team updated the req by removing unnecessary information and making it easier to read. It now allows your eye to go directly to the patient and exam order. With less clutter and with use of shading, whether using the paper or just accessing the computer screen, the tech has a much easier time finding what he or she needs before proceeding with the patient care. Next the team developed a pneumonic device to help staff remember the process of positive patient identification. They unveiled the three Cs to patient ID; check, compare and confirm. Checking is always the first step. In a private area ask the patient to state their name and date of birth. This is critical that a patient state their name and not the tech asking by reading the name to the patient.

We also use two identifiers, so we ask the date of birth along with the name. Compare is next and that is when the staff will review the patient’s information on their identification band and the information that is on the requisition. Lastly confirm, this is done by asking the patient to state what exam they believe they are to receive and to confirm with the order in hand. If a patient is unable to communicate, two staff members conduct this process together. Once all staff were trained, we thought our near miss issues were out of the way. We thought this, until the pandemic hit us. Our imaging volumes dropped and life in our department slowed. As the pandemic started to slow, life started to return to normal. That normal feeling didn’t last long as our patient exam volume and staff turnover increased to levels not seen in some time. Suddenly we found ourselves with tighter staffing schedules, a less experienced team and many patients to care for. Although we have an annual positive patient ID competency, a few near misses occurred. The leadership team immediately decided it was time to once again remind staff to go back to the basics and revisit the three Cs to patient ID. We initiated an online review course, a checklist to the requisition with in-person practice. We are currently working to find an IT patient identification solution that is compatible with our radiology applications. We hope that as we continue to build and mentor our team, that combining technology and our three Cs that the near miss will become a thing of the past. Until then the three Cs to patient ID – check, compare and confirm – will remain front and center. Thanks for all you do. • Lydia Kleinschnitz, MHA, BSN, RN, is the senior director of imaging services at UPMC Presbyterian Shadyside.

ADVANCING THE IMAGING PROFESSIONAL

LEADING YOURSELF AND OTHERS IN A TIME OF GRIEF

N RAD HR

BY ALANA EPSTEIN

ot many of us will get through life without experiencing grief. Sometimes that grief can be isolating, and sometimes the grief is shared among a group of people. Many of us are experiencing grief right now because of the pandemic. We’ve lost loved ones, homes and jobs. We’ve also lost our freedom in many ways. Most likely everyone in your professional and social circles are dealing with grief and loss right now. How can you effectively lead them and yourself through these challenging times?

ACKNOWLEDGE THE GRIEF

Acknowledging grief and validating others’ feelings is paramount. David Kessler, author and foremost expert on grief and loss, often says that it’s important for a grieving person to be fully present within their pain and grief and not try to put a silver lining on it. It is equally important for a leader to be present in the space of grief, to not try and suppress their emotions or others’ emotions, but to validate them and move through them with grace and understanding.

SHOW UP

There’s a lyric in an old blues song that goes, “Nobody knows you when you’re down and out.” And that tends to be true. It’s easy to be

WWW.THEICECOMMUNITY.COM

around others when they are happy and their life is going well. It’s not so easy when they are down and out or suffering in some way. As a leader, it’s important that you show up in those times your people need you, not just when it’s convenient. A leader shows up during life’s trials and tribulations.

HARNESS YOUR EMOTIONS

Harvard Medical School professor Susan David states that people tend to revel in positive emotions while apologizing for negative ones. In her book, “Emotional Agility: Get Unstuck, Embrace Change and Thrive in Work and Life,” David proposes that our emotions can be our greatest teachers, revealing what we value most. When we harness ALL of our emotions, we can become our best selves and help others to do the same.

RESET EXPECTATIONS

When a team is experiencing grief, they cannot perform the same. It is important for leaders to understand the full situation and reset their expectations. This is not a time to demand a specific performance level, but rather, guide your team to do the very best they can under the circumstances. As leaders, the question we need to ask ourselves is not, “Will I ever need to lead during a time of grief?” but instead, “How can I make the greatest impact in the face of adversity?” •

ICEMAGAZINE

INSIGHTS

PACS/IT/AI

BY MARK WATTS

PERCEPTION IS NOT ALWAYS REALITY

he sun was setting as we were driving across the desert on a long stretch of highway on a hot night. As the road dipped in front of us there appeared to be a pool of water in the road. As we drove closer the mirage disappeared and only the dry pavement greeted us. In this case the mirage was an additive to the surroundings. For radiologists it is difficult to appreciate all that is visible. When they are looking for one abnormality they can completely miss another. Researchers call this phenomenon “inattentional blindness.” In 2013, Trafton Drew, Ph.D., conducted research and published a study on the topic. The study was “The invisible gorilla strikes again; Sustained inattentional blindness in expert observations” and it was published in Psychological Science. You can do a web search for “CT and Gorilla” to find it online. In the study, the researchers asked 24 radiologists to look for lung nodules in five chest CTs that had an average of 10 nodules. In the last case they presented, the researchers inserted a gorilla that was 48 times the size of the average nodule. Eighty-three percent of the radiologist did not notice the gorilla. The researchers blamed the misses largely on “inherent limitations of human attention and perception.” I think the fact that after reading a patient’s notes for a referring physician it is possible that focusing narrowly on one task – such as looking for lung nodules – could lead radiologists to miss a significant breast mass or abnormal lymph node. Inattentional blindness is one of many biases that come into the reading room. Satisfaction of search or conformational bias is where you come up with an idea for what the patient has and evidence to support it. Once this bias is formed you do not keep looking for any other evidence than to support your 40

ICEMAGAZINE | SEPTEMBER 2021

original hypothesis. An example would be if a patient had chest pain and you find a left lobe mass you could be blinded to the true emergency of a perforated ulcer in the abdomen. I was recently asked by a radiologist to invent a lung screening artificial intelligence algorithm that would screen out the normal chest X-rays and present the ones with findings. He estimated that 80 percent of the chest X-rays could be diverted to a lower priority list of “Computer Assisted Normal.” While it’s true that AI does not have the same cognitive limitations that humans do, AI is only as good as its training, programming and area of application. The use of CAD in mammography has helped improve accuracy and consistence of treatment. The diagnostic error rates for radiologist have been consistent since the 1940s when it was first measured by Dr. Henry Garland. A striking fact is that just about everything about medical imaging has changed since the study yet the error rate has stayed the same (3 to 4%). When faced with a long-standing error rate, I ask myself what Dr. Edwards Deming would do. Deming, a renown instructor of quality principles of management, thought errors should be studied and that organizations can increase quality and simultaneously reduce costs (by reducing waste, rework, staff attrition and litigation) while increasing customer loyalty. All these are worthy goals for radiologists, but I feel that we are dealing with a fundamental, neurobiological and phycological mechanism. Our human visual systems, including our eyes and brain, evolved over millions of years before radiology was ever invented. I think a human’s visual system is not optimized for radiology. With years of training, a radiologist can perform the task at an impressively high level. This in no way reflects poorly on radiologist. The critical point is that the phenomenon of inattentional blindness is experienced by everyone, and we need to better understand the situations that lead to ADVANCING THE IMAGING PROFESSIONAL

these misses in order to avoid them. I think that 97% is an impressive success rate, but this is health care not baseball. Radiologists face a number of challenges, including sorting through the vast amount of information available to them. The growing reliance on cross-sectional imaging easily translates into thousands of images per day that the radiologist is confronted with. When radiologists have access to accurate clinical information and specific exam indications, it can help narrow their focus and make their tasks more manageable. The original gorilla study demonstrated that focusing on a specific task can lead to significant costs, even when the unexpected findings are highly unusual. Radiologists do not actually need to keep an eye out for gorillas at their clinical practices. I would encourage additional follow-up studies, because it is important to demonstrate that unintentional blindness phenomenon applies to more realistic circumstances as well. The heat created a perceived pool of water on the highway, it was a harmless mirage. For radiologists it is the human visual system and the known limitations that could put patients at risk and are worthy of a “sharp curve ahead” sign.• MARK A. WATTS is the enterprise imaging director at Fountain Hills Medical Center.

MIS IS LOOKING TO GROW OUR ENGINEERING TEAM. COME JOIN OUR FAST GROWING, TECHNICALLY DRIVEN TEAM

NATIONWIDE FIELD SERVICE & CUSTOMER SUPPORT POSITIONS APPLY ONLINE AT HTTPS://MEDICALIMAGINGGROUP.COM/CAREERS EMAIL US AT RECRUITING@MEDICALIMAGINGGROUP.COM

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

INSIGHTS

TEAM BUILDING 301: THE RESPONSIBILITIES OF A LEADER

W EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

ICEMAGAZINE | SEPTEMBER 2021

ant to be a leader? It’s different than being a manager, or even an entrepreneur. Someone I know recently said, “Entrepreneurs are inspired, but leaders inspire.” I rather like that quote. Leaders do much more than that, but overall, that statement serves as a springboard for conversation. I believe it’s important for aspiring leaders to realize that leadership involves its own skill set and some very distinct characteristics. Some people come by these naturally, other people learn them, and some people try to learn them but regularly struggle with implementation. Of course, some don’t want to learn them at all. I don’t have a problem with people not wanting to be leaders, especially if they don’t feel called to be one. One problem I’ve seen in people who have natural leadership skills is sometimes they don’t apply those skills consistently. Hence, they may experience tremendous success on one project but “flail and fail” on another. It’s been my experience that a little coaching or mentoring helps these people identify the skills that work well so they can start using them with determined purpose.

Another problem emerges when people blur the lines between management and leadership. At the core of it all, the role of a manager is first to understand the strengths, blind spots and capabilities of the people on his or her team. From there, managers must work to equip people with the skills and resources they need to do their jobs. Their ultimate goal is efficiency of operations. The ultimate goal for a leader is organizational effectiveness. That is, working so that the organization is doing the right thing and moving in the optimal direction. Whether you’re already in a leadership role, want to aspire to leadership, or just want to be able to recognize a good leader when you see one, what follows are some of my thoughts on the essential attributes of an effective leader. In any organization, a leader is responsible for casting and spreading the vision. Remember that “Leaders inspire” quote from earlier? Here’s where that comes into play. Inspiring others with the organization’s vision includes the ideas of where the organization could or should be going. This is not to say that other people can’t contribute to those ideas, but ultimately it’s the leaders who are responsible for them. The next attribute for leaders is being ADVANCING THE IMAGING PROFESSIONAL

aware of what I call the horizon, or what we can expect to happen in the near and/or distant future. This includes the economic horizon, the political horizon, business trends, etc. Again, this isn’t to say people who aren’t in leadership roles shouldn’t be looking at the horizon, but ultimately it’s those in leadership who are responsible for being aware of what’s coming down the pike. The third attribute is understanding the organization’s capabilities. In other words, leaders are ultimately responsible for what their organizations can do, so they must be aware of the limitations and capabilities of just about everything: Equipment, personnel, and even policies and procedures. The above list forms the core of what a leader is given, but to be effective, leaders must do something with all of that. To start, let’s talk about coalescing ideas while keeping an eye on the horizon. Effective leaders don’t hold their vision and ideas close to their chest. They share them with people throughout the organization. Whether that happens one-on-one or in small groups, formally or informally, leaders should discuss the horizon and the ideas of where the company could or should be going. Then they should actively solicit feedback from others. An analogy might help. Picture the leader as the pilot of the plane, flying at 35,000 feet. At that height, the leader sees a lot of forests, so his/her perspective is generally “forest.” What’s tough to figure out at that altitude is what’s going on down in the forest, and that’s why it’s so critical that a leader collect and evaluate feedback from all levels. Think of it this way: Just because someone is in a leadership role doesn’t mean he or she is omniscient. Effective leaders seek feedback, and then, based on what they learn, make adjustments as needed. If leaders fail to seek feedback or fail to make adjustments when they’re necessary, the result is often a non-responsive organization that falls behind – and maybe even fails. Next, I mentioned organizational caWWW.THEICECOMMUNITY.COM

pabilities. An effective leader actively seeks to enable and advance what his or her teams can do, and then provides the right conditions for them to be able to do it. In most cases, this means approving and funding such efforts. Think of it this way. When seeking feedback, leaders often learn about new equipment, processes or skills that could help advance the organization toward its goals. An effective leader considers these opportunities – usually by way of a cost-benefit analysis – and then acts to increase operational efficiency when feasible. If you desire to be an effective leader and these skills do not come naturally to you (and rarely do they come naturally to anybody), I recommend becoming a student of these skills. Obviously, these are only the core of what it means to be an effective leader. Much more must also be learned, and for that I refer you to the plethora of leadership books on the market. But be warned. There’s a lot of “leadership fluff” out there, so beware what you buy. No need to waste your time and money. Here are a couple of books to get you started. “Six Disciplines Execution Revolution” by Gary Harpst and “Purpose: The Starting Point of Great Companies” by Nikos Mourkogiannis. Both books are more than a decade old, but each point out timeless truths for anyone seeking to lead or inspire an organization. Consider what I outlined above as personal practices and the content of the books I recommended as corporate practices. Put it all together and you’re on the road to being an effective leader. •

When time isn’t on your side,

we are.

Diagnostic Solutions was created to offer a cost effective and time saving solution for the procurement of imaging replacement parts.

Daniel Bobinski, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years, he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him on his office phone, 208-375-7606, or through his website, www. MyWorkplaceExcellence.com.

C O N TA C T U S T O D AY !

330.296.9729

diagnostic-solutions.com ICEMAGAZINE

INSIGHTS

THEY ARE JUST PALMETTO BUGS

THE ROMAN REVIEW BY MANNY ROMAN, CRES

everal years ago, Ruth and I attended the MD Expo in Pine Mountain, Georgia. It was as great an educational and relationships-building gathering as all the MD Publishing events are today. The resort accommodations were the private-entry type which means the door led directly to the outside world. One night as we were preparing to sleep away the day’s festivities, I entered the bathroom to find a giant cockroach wandering around the bathtub. I immediately realized that Ruth would freak out and we would be on a plane that night if she saw the intruder. Armed with some tissue and courage, for I also fear these monsters, I chased the cucaracha around the bathroom without success. It must have been quite a sight, me in my underwear chasing Manuelito around the bathroom. Manuelito was making his escape into the bedroom area. This would let the cucaracha out of the bag if you will. Ruth would see him, and we would not even pack our luggage before leaving. I performed a beautiful dive and met with success. I now had the squirming three-inch monster in my tissued hand. Manuelito fought valiantly and in vain to stay afloat in the toilet. I have never seen Ruth’s green eyes so wide open before or since. I assured her that all was well, and I 44

ICEMAGAZINE | SEPTEMBER 2021

would call the desk to take care of things. The lady at the other end of the line had the usual Southern accent and welcoming voice. I explained that I had just evicted a giant cockroach and asked that someone come in the morning and do whatever they do for these situations. She said, “Oh no, Mr. Roman. That is not a cockroach. That is just a Palmetto bug that we have here because of all the beautiful and lush vegetation.” This is like saying, “Oh no Mr. Roman. That is not a burglar. That is just cousin Billy.” She then said, “Is this your first time in the South?” This caused me to defend the fact that I am a world traveler and have visited the South many times. A beautiful redirection on her part. She assured me that all would be well and we shared a pleasant “Good night.” As I hung up the phone it occurred to me that she used a technique that I discuss in my customer relations seminars to redirect a conversation away from possible confrontation. I realized how powerful this is. So, why am I taking valuable space in this wonderful publication to share that dumb incident? Because it surprisingly happened again just last week in San Diego, California. The situation was quite similar: Private entry, lush foliage, wonderful and friendly staff. It was the last morning at the resort. We came out of the door onto a small private first floor patio. We were greeted by 1 million cockroaches of all possible sizes ADVANCING THE IMAGING PROFESSIONAL

and colors. OK, maybe not a million but certainly at least over 100 on the patio and 20 feet either way on the walkway and the adjacent wall. One thought it was small and thin enough that it was attempting to gain access to the room under the door. We informed a nearby service person of the situation and he quickly grabbed a broom and dust pan and went to work. Luckily, we had already packed everything. We made our way to the lobby to check out, dancing around the bugs and ignoring the crunching under the luggage wheels. We approached the very friendly host at the desk with the intention of making them aware of the situation so they could take appropriate actions. And then it happened. Guess what the host said. “Oh no, Mr. Roman. Those are not cockroaches. They are just Palmetto bugs that we have here because of

all the beautiful and lush vegetation.” Ruth and I could not believe it! Is there a front desk school training program to disguise a cockroach infestation into a swarm of magical benevolent fairies just arrived from strawberry fields? I was almost amused until I felt a little insulted. I informed the young lady that “Palmetto bug” is a Southern term for a very large member of the cockroach family. Really, it is. Look it up. She replied that she would reduce our invoice by $100. It was not my intent to receive compensation for anything, however the money reduced the insult to zero. Upon arrival at home, Ruth insisted that all luggage be left in the garage so that all items could be washed before entering the home. I must admit that I now feel sorry for those bugs. Their primary offense is that they are unattractive and can’t bring you your slippers. •

LOOKING TO PURCHASE OR SELL AN MRI, PET/CT, CT, OR X-RAY?

LOOKING TO PURCHASE OR SELL? LOOK

NO FUR TH ER .

LOOK NO FURTH ER.

GE • TOSHIBA • SIEMENS • PHILIPS

213-276-8209 GE • TOSHIBA (844-PMIM-MRI)

PMIMAGINGMGMT.COM SIEMENS • PHILIPS Give us a call at 213-276-8209 (844-PMIM-MRI) or visit www.pmimagingmgmt.com

Save The Date! THE CONFERENCE FOR IMAGING PROFESSIONALS

ICE2022 IMAGING CONFERENCE & EXPO FEBRUARY 20-22, 2022 • NAPA, CA

WWW.ATTENDICE.COM

AHRA SCRAPBOOOK

2021 AHRA

SCRAPBOOK

HRA, the Association for Medical Imaging Management, hosted its 49th annual Meeting and Exposition at the Music City Center on August 1-4 in downtown Nashville, Tennessee. Attendees benefitted from continuing education opportunities and an exhibit hall with companies offering a range of

products and solutions that will make their jobs easier. A CRA Exam Workshop was among the many educational offerings made available to attendees. The annual event drew more than 100 companies from throughout the nation as well as 500 attendees. ICE magazine was among the companies with a booth in the exhibit hall and enjoyed the opportunity to connect with readers and interact with imaging leaders.

1 46

ICEMAGAZINE | SEPTEMBER 2021

3 ADVANCING THE IMAGING PROFESSIONAL

1. Tricia Trammell was the winner of the ICE prize pack, including ICE’s mascot “Chill!” 2. Approximately 80 imaging professionals attended “Drinks on ICE” and enjoyed networking with colleagues as well as complimentary food and drink. 3. B eekley Medical showed off its products in the exhibit hall. 4. King Medical Group (KMG) representatives travelled from Ohio to educate attendees about their different mobile modalities.

5. Brandywine Imaging and Associated X-Ray experts talk shop at the happy hour. 6. ICE hosted a unique “Drinks on ICE” networking event. 7. The MD Publishing sales team enjoyed a successful trip to the Music City. 8. I CE magazine was one of the more than 100 companies to exhibit at AHRA 2021 in Nashville, Tennessee.

5 WWW.THEICECOMMUNITY.COM

8 ICEMAGAZINE

AMSP