TechNation Magazine October 2021

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ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

OCTOBER 2021

PA G

E4

6

14 Professional of the Month

Francis Lewis, CHTM

29 Ribbon Cutting

PD1 Medical

42 Roundtable

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CONTENTS

FEATURED

42

HE ROUNDTABLE: T TUBES AND BULBS TechNation asked HTM professionals to weigh in and share insights regarding tubes and bulbs.

Next month’s Roundtable article: Asset Tracking

46

IT SECURITY AND MEDICAL DEVICES The health care space faces the challenge of developing cybersecurity standards amid a surge in ransomware attacks and other obstacles, including the advances in technology. ext month’s Feature article: N Survey Says... HTM is the top answer on the board

TechNation (Vol. 12, Issue #10) October 2021 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2021

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

OCTOBER 2021

TECHNATION

9

CONTENTS

INSIDE Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley

Karlee Gower

Taylor Powers EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

EVENTS

Lisa Lisle

WEBINARS

Jennifer Godwin

HTMJOBS.COM

Kristen Register Sydney Krieg

ACCOUNTING

Diane Costea

EDITORIAL BOARD

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

P.12 SPOTLIGHT p.12 Department of the Month: The Spring Valley Hospital HTM Department p.14 Professional of the Month: Francis Lewis p.18 Association of the Month: The Oregon Biomedical Association (OBA) P.20 INDUSTRY UPDATES p.20 News and Notes: Updates

from the HTM Industry p.26 AAMI Update p.29 Ribbon Cutting: PD1 Medical p.30 ECRI Update P.35 p.35 p.36 p.38 p.40

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

P.52 EXPERT ADVICE p.52 Career Center p.54 Protecting Your Investment, sponsored by Avante Health Solutions p.56 Cybersecurity p.58 20/20 Imaging Insights, sponsored by Innovatus Imaging p.61 The Future p.62 Accessing Device Data to Drive Efficient Clinical Asset Management, sponsored by Medigate p.65 The Other Side p.66 Protect Your Medical Devices From Cyber Threats, sponsored by Nuvolo P.70 BREAKROOM p.70 Did You Know? p.72 The Vault p.74 MedWrench Bulletin Board p.78 NCBA Scrapbook p.94 HTM Strong p.89 Service Index p.93 Alphabetical Index

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

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TECHNATION

OCTOBER 2021

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SPOTLIGHT

DEPARTMENT OF THE MONTH The Spring Valley Hospital HTM Department

BY K. RICHARD DOUGLAS

F

ew people are unfamiliar with the city of Las Vegas. It may be as well known as the nation’s capital. It has been known by many nicknames over the years, including the Entertainment Capital of the World, the Gambling Capital of the World, the Marriage Capital of the World or, along with New York City; the City that Never Sleeps.

Some of the original fame came after gambling was legalized in Nevada in 1931.

Decades later, the city moved more towards a family entertainment theme getting throngs of tourists throughout the year.

Since 2003, residents and tourists alike have been able to count on Spring Valley Hospital Medical Center in Las Vegas for their health care needs. The medical center is a part of the Valley Health System; a network of six acute care hospitals.

The healthcare technology management (HTM) department that serves the needs of Spring Valley Hospital includes Director Jim Anderson, Senior Medical Systems Engineering Technician Sam Birrer, CBET; Medical Systems Engineering Technician II Jared Pitts, CBET; Medical Systems 12

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OCTOBER 2021

Technician Tiera McCant; and Healthcare Technical Staffing LLC Contractor Mark Klein. Klein has been with the department the longest.

The HTM team provides equipment management at four facilities – 364-bed Spring Valley Hospital Medical Center, an acute care hospital; 25-bed Desert View Hospital, a critical access hospital; 64-bed Valley Health Specialty Hospital, a surgical and rehabilitation hospital; and the ER at Blue Diamond, a free-standing emergency department.

INNOVATION AND ACCOMPLISHMENT As a five-member department, the team has accomplished a number of projects beyond the scope of PMs, calibration, troubleshooting and maintenance.

“We have worked with clinical teams to improve their equipment and optimize their usage. We are working with our telemetry team to improve ergonomics, display quality and data flow; we have installed replacement displays, installed display mounting hardware and are working with the manufacturer to send reports directly to our EMR,” Anderson says.

The team recently completed the

installation of a patient monitoring system at the smaller hospital. It was a complete replacement of the previous system.

Another project saw the team put together a standardized consumable matrix with pictures and order numbers for clinical departments to help them when they place orders through supply chain.

“Departments were confused about how to order consumables, or which consumables. Some departments ordered similar but different consumables with different connectors. To help reduce confusion, downtime and service calls, we looked at what other sites have done, incorporated some of those ideas and created what we thought was best for our clinical departments,” Anderson says.

He says that the HTM team simplified the process every time it had the chance to do so. He says that they met with some departments about the standard and found out many used what they could find or what was delivered; the clinical teams were wonderful to work with.

Anderson explains how they developed the matrix.

“Our matrix is done in Microsoft Excel; Page 1 is list view sorted by model group with order system ID, description WWW.1TECHNATION.COM

SPOTLIGHT

(matching closely what is found in our order system), price, manufacturer part number, picture reference and manufacturer,” he says.

He says that Page 2 is made up of pictures with descriptions and order system ID. “Each page was designed to print on a single sheet of 8½ x 11; a two-sided print could be done and laminated if the department was inclined. We have shared these pages throughout the hospital; the service calls related to consumables have declined, uptime has increased and borrowing from unknowing departments during nights and weekends has declined,” Anderson says.

He says that the effort has given rise to equipment uptime and left more time for HTM technicians to provide more valuable services.

New hospitals or relaunched hospitals are always a challenge for an HTM department; especially a smaller one.

“We have worked on re-opening an acquired orthopedic specialty hospital, tagging equipment, completing lots of preventive maintenance and new equipment inspections, rebuilding the patient monitoring network and testing data flow to our EMR,” Anderson says.

He says that Valley Health System acquired Mountain’s Edge Hospital last year and it was renamed Valley Health Specialty Hospital. It is about three miles from Spring Valley Hospital in South-

west Las Vegas, Nevada. Anderson says that renovations were made throughout the hospital.

The five-member HTM team has accomplished much for being both a small group and a newer team; already receiving recognition for its good work.

“The team is new here, with the most tenured employee at 14 months. The team has rebuilt processes [and made] huge improvements with customer service and turnaround times. The team received the Q1 (2021) Support Services All Stars Award for the outstanding work they are doing,” Anderson says.

He says that when discussing what might be important to include in a profile of the team, the themes of customer service and hard work were routinely brought up, helping when asked, even when it was not HTM related; the fact they could help was the determining factor.

“The number of open work orders dropped by over 60 percent even with the ebb and flow of monthly PMs,” Anderson says.

He says that although he is the director, he just arrived in November of 2020. Anderson says that the team of technicians already set the culture; and that culture is one of customer-focus. He recalls some examples.

“I was on the phone explaining steps to operate a function on one of our medical devices. Tiera heard the conversation and said, ‘I am going up there to make sure she

understands the steps and help if needed.’

My approach was not wrong, but Tiera’s way was better. I now find myself asking; can I do better for our customers, and if I can, I act on it. I am very thankful for their positive energy; their wisdom and their drive to be better. Leading such a positive team is challenging and rewarding,” Anderson says.

He adds that he is enjoying the opportunity.

Anderson says that another example is that two team members joined during the pandemic.

“Jared Pitts was celebrated last week as part of the Las Vegas Healthcare Hero nominees. He is a great example of our team and how they strive to make peoples’ lives better every day. Jared came to Las Vegas last spring to help support some employee changes that were happening at Spring Valley; he enjoyed Las Vegas and moved here permanently from Amarillo, Texas. Sam Birrer followed Jared shortly after; all during COVID-19,” Anderson says.

Many people come to Vegas to gamble, but visitors and residents alike can relax knowing that the members of the HTM team at Spring Valley Hospital don’t sleep until the customer is happy.

The team’s dedication makes quality health care a sure bet.

Nominate a department at 1TechNation.com/nominations.

The Spring Valley team is pictured working hard and covering different modalities, resulting in a well-rounded department.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

OCTOBER 2021

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SPOTLIGHT

PROFESSIONAL OF THE MONTH: FRANCIS LEWIS, CHTM Grateful for Mentors and Team Members

BY K. RICHARD DOUGLAS

S

ometimes, the job precedes the training. That is the way it turned out for Francis Lewis, CHTM, healthcare technology management (HTM) director for Sodexo Clinical Technology Management in Lewiston, Maine.

Lewis didn’t exactly put the horse before the cart, but he was anxious to get into the biomed field before getting the requisite degree. He says that Tim Bowers was the person who piqued his interest in HTM and made it happen.

“I was working as a telemetry tech while going to school to eventually become a nurse. While at work, this guy kept popping in to fix any issues we had – and he was always fixing any problems nurses had on any equipment; as biomeds do. We were friendly enough, and I ended up playing on a local social kickball team with him,” Lewis says.

At a certain point, the biomed was promoted to biomed manager and his BMET position became open.

“I’d casually ask him about the position each week, mention that I had medical courses done, and that I already knew all the staff and their personalities

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(knowing the ‘game’ is crucial). Well, eventually I interviewed and was given the position – with the caveat; I complete an associates in electronics,” Lewis remembers.

That was the only component of the job requirements Lewis didn’t have.

“I had anatomy and physiology and all entry-level nursing school classes done. But when I took my original position, I had to complete an associates in electronics. Tim was very supportive throughout my pursuit (even as the classes dragged on beyond my initial deadline, due to scheduling issues). He even made sure I developed hard skills that the instructor didn’t go over in classes,” Lewis says.

PRIORITIES AND MENTORS Lewis began his current position at the height of the COVID-19 pandemic last summer. It was a time that events like job transitions and interviews were mostly on hold. The restrictions at the time made assuming a new job more of a challenge.

“Well, there was this little issue that we all faced last year. On a personal level, I interviewed for and accepted my

current role while in the middle of all of it. An opportunity came to be, as I had previously worked with the facilities director, and he suggested I apply.

Thankfully, it all worked out. The transition was definitely a challenge, but one I welcomed facing,” he says.

In his current role as a director, Lewis sees staff development as a priority along with meeting the needs of the hospital. He sees his specialty as a manager who helps direct the careers of his biomed team.

“I prefer to train my team to be the specialists. It is my job to put them in their best positions to succeed and grow.

And my job to execute deliverables, meet the needs and manage expectations of the client/hospital,” Lewis says.

“I have been to a handful of schools earlier in my career. But when I started working for vendors, I knew that management was the career path for me.

And now my specialty is to help my team find and maintain their paths,” Lewis adds.

Off hours will find Lewis engaged in hiking, camping, travel, fantasy sports, craft beers and occasionally reading and writing.

WWW.1TECHNATION.COM

SPOTLIGHT

FAVORITE BOOK: “Gulliver’s Travels”

FAVORITE MOVIE: “Moon”

FAVORITE FOOD: Bojangles! I once expensed 6 visits on a 4-day work trip. My boss told me he’d never travel with me if that’s how I ate.

My mother’s sausage gravy and biscuits (and) authentic Brunswick Stew (the real stuff, only made in the county.)

You can tell I’m a Southern transplant, missing home.

HIDDEN TALENT: I can wiggle my ears. Does that count?

WHAT’S ON MY BENCH? • • • • •

Coffee and a large water bottle Copy of our contract and MEMP Millennium Falcon over Fenway bobblehead (from a Red Sox Star Wars Night) All the pins/gifts from AAMI and hospitals in past careers Handmade bowl from the little guy

FAVORITE PART OF BEING A BIOMED? The major impacts and minor footprints that we leave, on a day-to-day basis.

A lot of time, we work in the shadows until something goes wrong. But then we are expected to solve those problems as quickly (and cheaply) as possible.

Family consists of his mother, three brothers, two sisters-in-law and six niblings (which he says is a fantastic term for nieces and nephews).

“I also have a long-term girlfriend that is expecting a ring at any moment, and her son calls me ‘Dad,’ ” Lewis says.

He says that he has been incredibly lucky throughout his career.

“I started off with a fantastic boss in Tim Bowers. He was a brand-new manager, and I was his first employee. I think we were both learning our roles at the early part of my career, and we still communicate almost weekly. He is unequivocally the best mentor I could

have imagined having,” Lewis says.

He says that when he transitioned to vendor service, he was lucky enough to meet Carl Genereux.

“He has been my confidante and helped me survive in New England all these years. And then I met John Doherty; a former manager riding off into the sunset (post-retirement). So, as I transitioned roles, I managed to find folks that helped me develop my own career path, expectations and rationale of how I would handle those transitions as they came my way,” Lewis says.

“I mention all that to say, I cannot talk about myself without mentioning the people that helped me along my

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

career – and the people that help me continue that career, even now. Not the least of which is my team; that I get to work with, and work for, every day,” Lewis adds.

“I’m just a conduit, I try to put them in their best positions to develop and grow, while managing their workflow and stressors as best I can,” he concludes.

From putting the horse before the cart to making the biomed staff’s future a priority, this HTM director went from having some things slightly out of order to putting things in perfect order.

Nominate a professional at 1TechNation.com/nominations.

OCTOBER 2021

TECHNATION

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SPOTLIGHT

ASSOCIATION OF THE MONTH The Oregon Biomedical Association (OBA)

BY K. RICHARD DOUGLAS

M

apped by the Lewis and Clark expedition in their search for the Northwest Passage in the early 1800s, Oregon was added to the map officially and became a state in 1859.

It was 126 years later that the state’s biomed association was officially registered with the state in 1985.

The Oregon Biomedical Association (OBA) has been a resource for HTM professionals across the state of Oregon ever since.

“At that time, the association’s registered address was at the Douglass Community Hospital in Roseburg, Oregon and was called the Cascade Biomedical Association. The Oregon Secretary of State document shows the president at that time to be Thomas Wickesser and the vice president as Jerry Worobey. The name of the organization changed in 1994 to the Oregon Biomedical Association but shows dissolution of the association in 1997,” says Brian Judah, current OBA president.

Judah says the OBA transitioned to the Portland area and has been meeting since about 2003.

“J.R. Reis was the president and James Steinbrink, with Samaritan Health, was the secretary. The meetings never really stopped, but the business was no longer registered with

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the state during that time. Valdez Bravo took over as president in 2012 after Reis had served more than a decade. The reinstatement of the OBA by the state of Oregon occurred in 2013,” he says.

He explains that within OBA, the term for any officer position is a two-year commitment.

Brian Judah OBA President

“We have found this helps prevent burnout and gives other members a chance to be a part of the leadership and mentor other members in business operations. When elections occur, we also can add up to six board members.

The board members assist the officers in their duties. Board members serve a one-year term to allow them an oppor-

tunity to see if this is something they want to pursue. Oftentimes, this leads to many board members running for, and taking, officer roles,” Judah says.

He says that the group currently has two executive board members and is always looking for more to assist and hopefully take the reigns as officers when positions become available every two years.

The pandemic threw a wrench in the meeting schedule for the group, as it did for so many of their counterparts, yet the OBA adapted to the new normal and persevered.

“Typically, in the past – preCOVID – we held meetings in person only, usually every other month.

Meetings were held at different hospitals around the Portland metropolitan area, as well as reaching out to areas like Salem and Southwest Washington,” Judah says.

“With COVID restrictions, we were hit hard in the beginning but are doing well after a revamp of our toolkit and keeping the same schedule, but in a webinar format. We hold the same meeting twice in the same day to allow lunch time attendees from 11:30-12:30 and repeat the meeting in the evening from 6:30-7:30 p.m. to get to those who cannot pull away for an hour during the day,” Judah adds.

The OBA has teamed up with the biomed program at its local communi-

WWW.1TECHNATION.COM

SPOTLIGHT

ty college to help bring insights from HTM professionals.

“The OBA has a special relationship with Portland Community College (PCC). OBA officers typically speak to both the first and second-year students, encouraging them to join the OBA to expand their knowledge outside of school and to provide greater networking opportunities to gain a visual presence with members working in the field; many of which are recent graduates,” Judah says.

He says that once a year, when possible, the group likes to hold an in-person meeting in one of the fantastic conference rooms PCC has available.

“PCC, being centrally located to a lot of hospitals and clinics in the area, attracts not only all the students but many imaging and biomedical technicians and local leadership from the hospitals and clinics. This last year, the OBA was invited to be a part of PCC’s EET advisory board, that helps guide decisions for the biomedical program,” Judah says.

EXPO DETAILS While many annual conferences and symposiums had to be put on hold in 2020, the association did hold its annual expo in 2019.

“In 2019, we had 30 vendors from across the U.S. present their specialties at our expo; one of our largest events yet. Thanks to then OBA President Peter McNamara; he did an outstanding job of coordinating this event,” Judah says.

He says that for the past six years, the expo has been held at the Portland Holiday Inn-Portland airport.

“This is a centrally located area close to the airport, allowing easy access and shipping for each of the vendors. It is also easily accessible for the Portland metro/Southwest Washington area, as well as being accessible to all that Portland has to offer for those that are visiting from out of town,” Judah says.

The group’s expo is offered over two days and is free to members.

“Typically (Thursday/Friday), this helps allow for HTM professionals to be staggered and help manage their workloads, allowing attendance for as many as possible, while not leaving any shops vacant. Our training courses consist of vendor-provided education as well as local HTM professionals, who share their vast knowledge on various modalities,” Judah says.

He says that each day consists of nine daily training/educational courses. Three simultaneous courses are provided during each time slot, allowing partici-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

pants many topics to choose from.

“The day starts with check-in at 7:30 a.m. Oftentimes, a guest speaker in the morning for the first 30-60 minutes with a light breakfast, followed by two more hour-long educational tracks,” Judah says.

He says that by then, everyone is hungry.

“Next is lunch that includes a two-hour meet and greet with all the fantastic vendors from approximately 11:30 a.m. to 1:30 p.m., so you can connect with each of your local reps and find answers to any of the questions you may have about any of the latest technologies. At 2 p.m. is the last educational track. The day ends at about 3:30 p.m. with door prizes and final ceremonies by 4 p.m.,” Judah says.

After the first night of the expo, the group has a two-hour sponsored cocktail/appetizer networking opportunity from 5-7 p.m., followed by a repeat of the expo on the second day.

“If you are feeling adventurous, many guests often head out to see what other attractions/activities Portland has to offer,” Judah adds.

With much to offer biomeds, and others in the field, the OBA is blazing new trails much like Lewis and Clark did many years ago.

OCTOBER 2021

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INDUSTRY UPDATES

NEWS & NOTES Updates from the HTM Industry ed

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Nuvolo and First Health Advisory have announced an industry-first suite of operational technology (OT) security risk management services to protect network connected medical and facilities devices.

Network-connected medical devices (OT) – along with facilities systems like heating, ventilation and air conditioning (HVAC) controls – are increasingly at risk for external cybersecurity attacks. This partnership addresses these security threats by combining comprehensive OT security mitigation services provided by First Health Advisory with OT security orchestration and automated response (SOAR) from Nuvolo. This exciting new offering leverages industry-leading OT security monitoring and discovery tools, natively integrated with Nuvolo’s single, trusted medical and facilities device inventory system and common data model.

“Our strategic partnership with Nuvolo is an important step forward in meeting the OT security needs of the health care community we serve,” First Health Advisory CEO Carter Groome said. “By combining the capabilities of Nuvolo with First Health’s OT security risk management services, we will address crucial resource gaps and deliver on our mission to serve the security, privacy and OT orchestration needs of our clients.”

The newly combined risk management services and Nuvolo solution capabilities will reduce the workloads of HTM teams, deliver up-to-the-minute statuses for stakeholders, and help ensure that OT devices and kept safe, accessible and available at all times.

“Protection of operational technology (OT), including network connected medical and facilities devices, is mandatory for healthcare providers, OEMs and independent service organizations (ISOs). With a growing and pervasive cyber threat, OT security is now a prerequisite for ensuring patient and environmental safety,” Nuvolo CEO Tom Stanford said. “For the first time, mature solutions are available to deliver OT device discovery together with security orchestration and automated response (SOAR), coupled with expert resources to deliver on remediation and risk mitigation. Nuvolo, in partnership with First Health Advisory (FHA) can deliver expert visibility, advise, planning and remediation for OT security, on demand. This important partnership is a core tenant of our go-to-market strategy for OT security globally. We are excited to lead the market with FHA, serve the community and help address a growing cyber security threat facing our health care customers.”

In other news, Nuvolo announced an “innovative collaboration” with Mayo Clinic to offer industry-leading standards designed to enhance Nuvolo’s existing Operational Technology (OT) Security solution.

The announcement comes after Mayo Clinic’s follow-up to Nuvolo’s recent Series C funding round. • For more information, visit https://www.nuvolo.com/nuvolo-now-integrates-with-ecri/.

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INDUSTRY UPDATES MEDICAL TECHNOLOGY INDUSTRY CREATES HIGH-PAYING JOBS New data released by the Advanced Medical Technology Association (AdvaMed) found that the medical technology (medtech) industry created more, better-paying jobs than the manufacturing sector overall. AdvaMed commissioned the new economic research report by Macro Policy Advisors to study the industry’s jobs footprint and economic impact on states, and the results were overwhelmingly positive for Americans.

The report determined that: • Medtech directly employed 397,000 people, at an average annual salary of $88,096 – 49% higher than the average across all industries and 18% higher than the corresponding premium of all manufacturing jobs.

• Every 5 medtech industry jobs creates an additional 7 jobs.

• Between 2014-19, medtech employment grew by 4.1%, compared to a 3.3% increase in overall manufacturing employment.

• Of the nearly 15,000 medtech establishments, 94% were small businesses that employed fewer than 100 employees.

• Economists also found that medtech is responsible for the creation of nearly 2 million jobs in the U.S. economy.

“The COVID-19 pandemic was a stark reminder of how critical medtech is to protecting patients and improving quality of life. This new data demonstrates that the industry creates not only lifesaving medical breakthroughs but also economic benefits to workers and state governments,” said Scott Whitaker, president and CEO of AdvaMed. “Thanks to medtech, patients spend fewer days in the hospital and live longer, better-quality lives, while workers in the industry earn higher salaries than most industries.

These benefits should remain top of mind for policymakers exploring changes to the law that would affect our industry.”

The report was produced by Macro Policy Advisors – an independent nonprofit organization that partners with private think tanks, academic institutions and policy advocacy organizations to develop unbiased investigations and reasoned responses to the macroeconomic policy concerns of today. • For more information, visit www.advamed.org. .

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RPI ACQUIRED AMID CREATION OF HEALTHCARE COMPONENTS GROUP

THE INTERMED GROUP ACQUIRES MODERN BIOMEDICAL & IMAGING INC. The InterMed Group, a Granite Bridge Partners company, has acquired Modern Biomedical & Imaging Inc., an Irving, Texas-based provider of comprehensive asset management and healthcare technology management programs. Modern is an established provider of healthcare technology management services, known for quality and excellence in clinical and diagnostic equipment service and on-site maintenance.

“I am excited to bring together The InterMed Group and Modern after many s​ uccessful years​ working congruently in the industry,” The InterMed Group CHTM Chief Executive Officer Rick Staab said. “​I truly believe we are better together than apart​.

The similarity in our cultures,​strategic geographical footprint ​and talented people​that comprise both companies will undoubtedly strengthen the services we offer our clients. B ​ oth Modern and InterMed uphold reputations for delivering excellent service and together, we will continue to enhance and expand our expertise to bring the best to our partners well into the future.”

The fusion of Modern with the InterMed Group marks the start of another exciting and impactful chapter for InterMed, one that continues to bring the highest standards of service, safety and effectiveness to health care, according to a news release.

“With the Modern Biomedical team joining forces with the InterMed Group we believe this creates the ultimate healthcare technology management solution for our customers’ needs,” Modern Biomedical & Imaging Inc. CEO Randy Bullard said. “We believe InterMed’s values, ethics and Rick Staab’s strong leadership mirrors Modern’s team and will continue to offer customers the same quality of service we have provided for the past 43 years while creating increased employee growth opportunities.”

It is anticipated that Modern’s operations will be seamlessly integrated and that its customers will soon have access to InterMed’s services.• For more information, visit intermed1.com.

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RoundTable Healthcare Partners (RoundTable) has established Healthcare Components Group (HCG) through the acquisitions of American Optics (AO) and Replacement Parts Industries (RPI). American Optics and RPI focus on serving independent service organizations (ISOs) who contract with acute care facilities, ambulatory surgical centers and physician and dental offices to conduct repairs of mission critical medical devices, extending the life of these devices and lowering the overall cost for these providers.

American Optics, headquartered in Wellesley, Massachusetts, is an engineering, manufacturing, assembly and distribution business for replacement components used in the repair of flexible and rigid endoscopes and new components used by original equipment manufacturers (OEMs) in endoscope manufacturing.

RPI, headquartered in Simi Valley, California, engineers, manufactures and distributes parts for medical, hospital, dental and laboratory equipment.

Larry Hicks, the current chief executive officer of American Optics, will lead the new company and serve on the board of directors. Ira Lapides, the president and CEO of RPI, will continue to lead RPI’s day-to-day operations.

“The creation of HCG through the acquisitions of American Optics and RPI establishes an excellent foundation for us to build upon,” commented Tom Kapfer, RoundTable managing partner, and the new chairman of the board for Healthcare Components Group. “As a combined entity, HCG will provide a diverse and broad product offering to its customer base. We see a clear opportunity for growth driven by anticipated increases in procedure volumes and a focus on serving ISOs who represent the fastest growing segment of the repair market.

RoundTable looks forward to partnering with Larry Hicks and the entire management team at HCG as they embark on the company’s next phase of growth.” •

TRUASSET CMMS SOFTWARE INTEGRATES WITH ASIMILY TruAsset CMMS software is continually evolving to meet the ever-changing needs of its customers in health care. As changes occur in the industry, they continue integrating with the products their customers are using to streamline the process for HTM professionals. These integrations allow increased efficiency in the preventative maintenance process and solid reporting through the CMMS software.

Asimily Integration: TruAsset has implemented direct communications with the Asimily platform to offer a link between medical device security concerns such as FDA recalls, CVE reports and network anomalies to the assets in TruAsset. This integration allows clients of TruAsset and Asimily to seamlessly stay ahead of security issues in the ever-changing network landscape we now work. • For more information, visit truasset.com.

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INDUSTRY UPDATES BAIN CAPITAL PRIVATE EQUITY ACQUIRES PARTSSOURCE PartsSource has announced the signing of a definitive agreement to be acquired by Bain Capital Private Equity.

The investment will help PartsSource continue to accelerate its growth trajectory, broaden its solutions portfolio and expand its marketplace platform, according to a news release. PartsSource will continue to operate under its current management team, led by president and CEO Philip Settimi, MSE, MD. Financial terms of the private purchase from current owner Great Hill Partners were not disclosed.

“PartsSource was founded on the idea that an evidence-based, digital approach to the health care supply chain can unlock better health care delivery, lower costs and enhance clinical outcomes.

We are proud of the progress we have made to transform mission-critical health care operations and are excited by the opportunity to continue to expand our marketplace to serve new areas of health care,” said Settimi. “We want to thank Great Hill Partners for its help supporting the business during its ownership and positioning us for success in the next stage of our growth. We are delighted to partner with Bain Capital going forward. They share our vision for building a broader B2B health care e-commerce platform and have an excellent track-record of building leading health care technology companies.”

“PartsSource’s cloud solutions help hospitals increase the uptime of mission critical equipment, improve patient safety and maximize throughput and profitability. Additionally, its PRECISION Procurement powered analytics technology allows hospitals to optimize spend, reduce risk and improve supply chain visibility,” a news release states. “PartsSource’s platform also creates value for medtech OEMs and service providers to improve digital connectivity to the provider ecosystem, serve diverse providers more efficiently, increase access to leading health systems and ensure critical business insights so providers can more safely and reliably deliver care for patients. Last year, PartsSource expanded its marketplace network from parts into on-site and off-site repair and service solutions, a marketplace that offers curated and credentialed access to over 2,000 service engineers. This solution was recently selected by the Business Intelligence Group as a 2021 BIG Innovation Award Winner.”

Bain Capital Private Equity has a long history of partnering with companies to accelerate growth in the health care and technology sectors.

“Over the course of our four-year partnership, PartsSource scaled dramatically and established itself as the clear leader in its space,” said Mark Taber, a managing partner at Great Hill Partners. “We are proud to leave PartsSource well-positioned to thrive in the next chapter of its growth, and we wish Phil and the entire team success as they continue to grow and drive value for customers.”

The transaction is expected to close during the third quarter of 2021 and is subject to customary closing conditions, including requisite regulatory approvals. Debt financing for the transaction is being led by Blue Owl Capital. •

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CLEANAIRE ROOM FILTRATION The CleanAire Filtration Module is engineered to meet current requirements to prevent infection efficiently and effectively in labs, hospital rooms, waiting rooms, offices and more.

Particles as small 0.3 microns, including respiratory droplets, are collected with a 99.99% efficiency.

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59TH MDW: MEDICAL EDUCATION AND TRAINING CAMPUS FOR BIOMEDICAL TECHNICIANS The Medical Education and Training Campus located on Joint Base San Antonio-Fort Sam Houston, is home to the Biomedical Equipment Technician program that meets the unique mission of training, mentoring, professionally developing and qualifying the most proficient Air Force, Army and Navy biomedical equipment technicians.

This mission is carried out by the METC instructors and leadership.

“Our goal at the end of the day is to prepare them for the widest variety of medical equipment that they’re going to encounter DoD wide,” said Staff Sgt. Austin Jur, 59th Training Group METC instructor.

Each of the courses are composed into portions of lecturing, demonstration, hands-on training and evaluated performance.

“It prepares the students for some of the more difficult jobs that they may experience and they’re ready to solve the problem on their own,” said Jur. The first 12 courses are instructed in a joint environment.

“We train Army, Navy, Air Force and we have quite a few friendly foreign country military members come through as well,” said Jur. “That speaks for our joint training ability.”

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While each branch has different needs, the majority of the training is joint to promote interoperability.

“The goal of our joint training is to make sure that, regardless of service, each of our BMETs is able to speak the same language,” said Master Sgt. Holli Marshall, 59th TRG METC instructor supervisor.

After students complete their joint training, they move on to a final, service-specific course.

“It’s a completely different structure,” said Jur. “The way the Air Force structures everything is so wildly different from the Army and Navy that it really does deserve its own course.”

For Air Force students, this course trains Airmen to be fully prepared for their duty station and the deployed environment.

“A great thing about the Air Force specific course is that we’re teaching the Airmen how to transition from learning the basic technical skills into being actual Air Force BMETs,” said Marshall. “We teach them how to write Air Force work orders and correctly communicate what happened with a piece of equipment from start to finish. They also go through the wide area virtual environment simulator in order to make sure they can do care

U.S. Air Force photo by Airman, Joshua Rosario under fire that way when they’re deployed they’re ready to go.”

The program conducts approximately 13 Air Force iterations per year.

“It’s been a hard course since I came in almost 20 years ago, but we’re getting faster and more proficient Airmen through the course,” said Marshall.

“When I came through the program the washout rate was 78 percent. Now we’re below three percent for the Air Force.”

The BMET program continues to carry out its mission with a vision of being recognized as the world-renowned Center of Excellence for BMET training.

“So, while the course is getting longer and more challenging, our BMETs are getting smarter and more capable,” said Marshall. “If they can survive this 11-month program, they can survive anything.” •

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INDUSTRY UPDATES

TRIMEDX AWARDED MEDICAL DEVICE QUALITY MANAGEMENT SYSTEM CERTIFICATION

BC GROUP LAUNCHES ESU-2350 ELECTROSURGICAL ANALYZER BC Group International, Inc., a leading manufacturer of test equipment for the medical industry, has launched the latest model of the BC Biomedical ESU Analyzer. The ESU-2350 is designed to complement the current family of ESU Analyzers. It is a midrange unit to compete with products similar as the Fluke QA-ES III and Rigel Uni-Therm.

The ESU-2350 is designed for customers who do not require a top-of-the-line ESU-2400 with its higher accuracy, additional loads, advanced automation, pulse mode capability, etc.

“Until now, BC Group did not have a mid-range analyzer,” said Tim Welby, national sales and marketing manager for BC Group.

The ESU-2350 is a high-accuracy (± 2% reading), true RMS RF measurement system designed to be used in the calibration and routine performance verification of electrosurgical generators. It offers a higher degree of accuracy in the mid-range category than previously attainable with conventional electrosurgical unit analyzer designs.

“As is true with all of our BC Biomedical products, the ESU-2350 is made in the USA, and is designed, manufactured and supported in St. Charles, Missouri,” said Welby.

The latest features include: Internal load bank with a range of 0 to 5500 Ω in 5 Ω increments Provides for automatic or manual activation of ESU generator during power load curve tests Is 100% compatible with Covidien/Valleylab ForceTriad, FT10, FX8 and Ligasure generators and generators by many other manufacturers.

REM/ARM/CQM testing is accomplished via a 500 Ω adjustable load in 1 Ω Increments.

“With its color touch screen, overall light weight, smaller footprint design, report generation and modest price, the ESU-2350 is the premier analyzer in the mid-range category,” said Welby.

For more information, visit bcgroupstore.com.

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TRIMEDX has been awarded the International Organization for Standardization’s Medical Device Quality Management System (MD QMS) certification ISO 13485:2016, a widely recognized international standard outlining best practices in developing an effective MD QMS that covers the safety and quality of medical devices throughout their life cycle.

TRIMEDX has demonstrated its commitment to and achievement of world-class risk management, safety and quality in the delivery of its services to clients, according to a news release.

This standard analyzes and evaluates everything TRIMEDX does from a risk perspective, in perpetuity, so risk control is included in all parts of the business, the release adds.

“In addition to verifying our core competency of clinical engineering, TRIMEDX has taken a step further to thoroughly examine and certify all of our business processes, including back-office functions and business units, to ensure compliance,” says CEO Henry Hummel. “By verifying these processes, we aim to achieve best-in-class customer satisfaction, quality service and ultimately impact clients’ ability to ensure patient safety.”

The TRIMEDX business processes have been certified as effective and compliant according to the ISO 13485 standard for all business units supporting the company. This confirms TRIMEDX, as a healthcare technology company and health system partner, meets the latest medical quality management system standards while maintaining and enforcing policies and procedures to ensure regulatory credibility and client confidence. It reaffirms the

company’s commitment to continuously improve as an organization for the clients we serve, according to a news release.

“This ISO certification journey demonstrates our commitment to support patient care by improving product service and process quality within the healthcare technology industry through the execution of our quality management system,” says Denisa Lambert, vice president of quality and regulatory compliance.

“This adds to TRIMEDX’s previously achieved certifications of ISO/IEC 27001:2016 and SOC 2 Type 2 covering world-class data security. This provides evidence the company has implemented and certified a quality management system (business policies, processes and procedures) unmatched by any in-house or other third-party service provider. Together, these certifications combine MD QMS and Information Security Management System (ISMS) standards into the TRIMEDX Quality Management System,” the news release states.

“Our Quality Management System gives confidence to clients that TRIMEDX’s core focus across the company is ensuring one of their most critical assets to deliver patient care – their medical devices – are consistently maintained in a high quality, safe and compliant manner,” says Kristi McDermott, president of clinical engineering. “To our clients, achieving ISO 13485 certification demonstrates the commitment we have in ensuring our people, processes and technology are centered around keeping their patients safe.” • For more information, visit trimedx.com.

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AAMI UPDATE New HTM Guidance Covers Compliance and Recognition ‘From the Basement to the Board Room’

T

hought leaders and subject-matter experts from the Association for the Advancement of Medical Instrumentation (AAMI) and its robust healthcare technology management (HTM) community have crafted two valuable resources that can be immediately put to use by ambitious and professional HTM departments.

COMPLETION AND COMPLIANCE The first of these resources, Planned Maintenance Compliance and Definitions Guide is a white paper developed by AAMI’s Technology Management Council (TMC) Standardization Subcommittee.

The document helps to clear up confusion surrounding The Joint Commission’s (TJC’s) medical equipment Environment of Care standards.

These standards, in support of the Centers for Medicare & Medicaid Services U.S. federal regulatory requirements, call for the 100% completion rate of manufacturer-recommended testing and maintenance, as well as 100% completion rate for alternative equipment maintenance (AEM) programs for all low- and high-risk medical device inventory.

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“To this day, HTM professionals are still debating the interpretation of this standard,” explains TMC chair Heidi Horn, AAMIF, and her team. “Is 100% completion rate the same as completing 100% of the scheduled planned maintenance (PM) activities? Are there allowable exceptions to 100% completion and, if so, what are they?”

As its title implies, the document pays particular attention to terms commonly used within an HTM department, such as “compliance,” providing example scenarios with clear definitions. The guide also provides formula for important processes, such as calculating “on-time” completion percentages.

“Most likely, the definitions and recommendations in this guide are different than the practices of many health care organizations,” the subcommittee concludes, sharing their confidence that following this guide will help HTM departments align their practices with the expectations of TJC. “Once the HTM community can begin standardizing definitions and procedures, it can begin sharing best practices, benchmarking performance, and identifying ways to improve as a collective industry,” said Danielle McGeary, vice

president of HTM at AAMI. “AAMI hopes that HTM departments will adopt these recommendations and incorporate them into their policies and procedures.”

FROM THE BASEMENT TO THE BOARDROOM Unfortunately, even if an HTM department is exceptionally efficient and rigorously compliant, they may remain among the “unseen” heroes of hospital staff. Not being recognized by health care system leadership can be a particularly troublesome burden for HTM departments as the HTM field faces staffing shortages and budgetary constraints. That’s why AAMI’s second new resource, titled Seen by the C-Suite: An HTM Guide to Emphasizing Your Value may prove essential.

“Having been involved with a few health care organizations in different capacities throughout my career, what has always surprised me was this contrast between supply and demand,” said Eliezer Kotapuri, chief clinical technology officer for Mass Technologies LLC and adjunct faculty at Indiana University-Purdue University Indianapolis. “There is often a gap between the HTM department’s ability vs. their health care organization’s readiness to receive the level of know-how

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the HTM department is capable of delivering.”

Kotapuri led a subgroup of AAMI’s Healthcare Technology Leadership Committee (HTLC) in writing the “Seen by the C-Suite” guide. The document explores in detail how a HTM department can bridge the “supply vs. demand” gap by leveraging what is called the “C-suite trifecta.”

1. Understand the C-suite’s perspective 2. Quantify your value to the organization 3. Build relationships with executives Specifically, the guide outlines how to identify telling data and craft the ideal annual reports. It also outlines more than 30 activities that will help HTM leadership better position themselves to connect with C-suite members and share their numbers.

“HTM professionals have good stories to tell about their work. To get the attention of the C-suite, though, it is important to back up the stories with numbers,” the authors write.

“Be honest and realistic with yourself,” they add. “There are many resources, such as this guide, that can help you get ready to ensure that your first impression is what you want it to be. Myers-Briggs Type Indicator personality test, books on emotional intelligence and self-reflection, the AAMI mentorship program, and executive coaches are all great resources.”

Kotapuri, who is currently collecting feedback from some of the document’s first takers, shared that one county hospital has already emailed him, praising the resource as “a recipe to go from a basement to a boardroom.”

Both new HTM resources can be found at store.aami.org and are free for AAMI members.

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RIBBON CUTTING PD1 Medical

BY ERIN REGISTER

a special security key and offers several cable lengths and types to choose from to work with any application. If you can’t find what you need, we’ll work with you directly to customize cable lengths to meet your requirements.

P

D1 started with a simple idea – help health care facilities spend less time and money searching for and replacing missing medical equipment,” said Jake Freedman, CEO and founder of PD1 Medical. “Keeping track of equipment inventory in a fast-paced and high-traffic environment is a challenge. Hospitals spend thousands each year confronting this issue with technologies, such as real-time locating systems (RTLS) and computerized maintenance management systems (CMMS). However, a large percentage of the equipment inventory doesn’t get tracked (e.g. device accessories, patient cables, probes, etc.) and when missing, can cause a possibly life threatening disruption to clinical workflow.”

Q: HOW DOES PD1 MEDICAL STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: PD1 Medical supports health care workers on and off the field by providing quality products and contributing a portion of every sale to charities who aid the families of health care workers negatively impacted by the pandemic. By doing so, we hope to have a positive impact and do our part in our joint fight against the COVID-19 virus.

Jake Freedman Founder and CEO

PD1 Medical has worked with the health care community to develop a simple yet versatile solution to this ongoing issue called the Med Tether.

The Med Tether is an easy-to-use adjustable and reusable security tether.

It provides a simple approach to securing equipment so the equipment is available to clinical staff when they need it most.

security solutions for their equipment.

We believe that simply securing equipment can help save health care facilities thousands each year and countless hours searching for missing equipment, while ultimately improving clinical workflow and the overall quality of patient care.

TechNation learned more about PD1 Medical in an interview with Freedman.

Q: WHAT PRODUCTS DOES PD1 MEDICAL OFFER?

Q: WHAT IS THE MAIN FOCUS OF PD1 MEDICAL? A: Our primary focus is providing health care workers with effective

A: We provide a unique, reusable and adjustable security tether developed specifically for the health care environment. The Med Tether utilizes

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Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT PD1 MEDICAL TO ACHIEVE IN THE NEAR FUTURE? A: We’re looking forward to growing the company and customer base and having a real impact on patient care.

We also hope to continue to raise money to give back whether it’s to aid people during the pandemic or another cause that supports the health care community.

For more information, visit pd1medical.com or email Jake@pd1medical.com.

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ECRI UPDATE

Mon Health System’s Award-Winning Collaboration Creates Opportunities for Innovation

W

hen you think about health care innovation hubs, does North Central West Virginia come to mind?

For David Goldberg, the CEO of Mon Health System, an independent community health system in that region, the answer is “absolutely.” Working with Dr. Tom McClellan, a plastic surgeon affiliated with Mon Health and also the founder of Intermed Labs, a West Virginia innovation lab and startup studio, Goldberg green-lighted a partnership between the health system and the lab.

The arrangement created a pathway for Mon Health clinicians and staff to pursue technological innovations that have the potential to improve patient care and benefit the local community.

Mon Health System’s proactive

approach to nurturing innovation earned the organization ECRI’s 2021 Health Devices Achievement Award. The annual award highlights organizations’ innovative efforts to improve patient safety, reduce costs or otherwise facilitate better strategic

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management of health technology.

(ECRI is currently accepting applications for the 2022 award.)

“Mon Health’s efforts show that you don’t need to be at a large academic medical center or in a major urban market to take a leadership position in innovation,” explains David Jamison, ECRI’s executive director of selection and evaluation. “ECRI is proud to recognize health systems that continuously look for ways to better serve their communities.”

THE CHALLENGE: FOSTERING INNOVATION Mon Health System provides advanced care in a region that is distant from major urban academic centers and that is populated with diverse communities, including remote and economically disadvantaged ones. Both Goldberg and McClellan shared the vision that fostering innovation could not only improve care for their patients but could benefit the region in other ways; and they shared the belief that the goal was attainable for a small health system.

Their shared vision led to the establishment of Intermed Labs at Mon Health. Under the arrangement, Mon Health agreed to provide Intermed Labs with space that it had available on campus, as well as some financial support, and would become a minor partner that would “stay out of the way,” as Goldberg describes it. He considers it essential to let the doctors, clinicians, engineers and students do the work of innovation without undue interference.

In exchange, individuals affiliated with

Mon Health System who have innovative ideas for improving patient outcomes would gain access to Intermed’s expertise and resources to help them turn the ideas into real-world solutions. The arrangement provides these individuals a place where the can tinker with their idea. They get access to lab space, specialized equipment and a team of individuals with relevant expertise to guide them in trying to take the idea to the next level.

For Goldberg, establishing the partnership “was a no-brainer.” Benefits he cites include that the arrangement could advance patient care; it could unlock the potential of local talent (and perhaps attract and retain talent); and it could be a source of pride, business development opportunities and economic benefit for the region. One of the exemplar projects for the partnership – the design and production of a 3D-printed prosthetic finger augmentation that was spearheaded by McClellan – illustrates how such benefits could be realized.

THE PARTNERSHIP IN ACTION Many of Mon Health System’s patients work the kinds of manual labor jobs that are associated with distal finger amputation – the loss of a fingertip. Along with the loss of sensation, amputation of one or more fingertips can create drastic functional deficits. As a plastic/reconstructive surgeon in West Virginia, McClellan saw the opportunity to address a need in the region.

McClellan explains that current options for functional finger prostheses can be cost-prohibitive; the prostheses are often

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INDUSTRY UPDATES

NOW OFFERING created in isolated specialized centers, and they generally require additional refinement after fabrication. For economically disadvantaged patients or those living in remote regions – or for pediatric patients, who are still growing – the cost, time and travel factors can be significant obstacles.

When treating one such patient, McClellan had the idea to involve the patient in the process of designing a custom-fitted prosthetic finger augmentation that could be 3D printed. Doctor and patient worked with the engineers, designers and programmers at Intermed Labs to design a 3D-printed finger augmentation that: (1) would restore an adequate level of function to the patient, (2) could be sized and ordered from the patient’s home, (3) would require no postproduction refinement, and thus could be shipped directly to the patient, and (4) was inexpensive (could be sold for about $50).

The result of the collaboration is now a marketable product: Fingy 3D (see photo).

McClellan notes that the finger augmentation is designed for patients with amputation at the distal interphalangeal (DIP) joint. The design uses a single, flexible joint that consists of two pins molded directly into the medial and lateral aspects of the prosthesis immediately after 3D printing.

High-grade nylon material is used during the fabrication process to achieve low cost while maintaining comfort and durability.

From the patient’s perspective, the sizing and ordering process can be completed entirely from home. As McClellan explains: Patients simply use their phone to take a picture of their hand resting on an 8½ × 11-inch sheet of paper (for scale), and upload the image through a web app. Custom-designed scanning software obtains the measurements needed, which are then fed into a proprietary digital sizing model. Computer-aided design (CAD) software is used to adjust the devices for specific fitting points. Once the custom design is prepared, it is sent to a 3D printing service that fulfills the order and ships the finished product directly to the patient in a matter of days. The beta version is currently available at www.

Fingy3D.com.

With the resulting product, McClellan reports that patients experience significant return of function with quality range of motion and improved anatomical grasping of objects. He adds that additional materials, user interface improvements and new designs to address more proximal amputations are in the works.

TO LEARN MORE...

To read more about this project, visit www.ecri.org/health-devices-award-winners. If you have a project you’d like considered for the 2022 award, visit https://www.ecri.org/health-devices-achievement-award and tell ECRI about it. The award competition is a great way to gain recognition for the work you do to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology.

(Applicants must subscribe to one of ECRI’s programs or services.) You can also contact ECRI by telephone at 610-8256000, ext. 5891, or by email at clientservices@ecri.org.

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TOOLS OF THE TRADE Healthmark FIS-007

H

ealthmark Industries recently introduced the FIS-007 to its ProSys Optical Inspection product line. It is a borescope designed to visually inspect internal channels of potentially soiled or damaged items with enhanced light, vision and magnification. It also offers users the option to document with photos and videos the lumens and crevices not visible to the unaided eye. The FIS-007 features a modular design with interchangeable flexible inspection scope attachments available in diameters of 1.06mm and 1.9mm. These scopes have a working length of 110cm and attach to a 13.3W x 9.9L x 4.7H cm control box, allowing for light level adjustments, image capture* and video recording*. The 1.06mm scope is designed to inspect internal channels of 1.1mm in diameter or larger, and the 1.9mm scope is designed to inspect internal channels of 2.0mm in diameter or larger.

For more information, visit hmark.com. *These features are only available for the USB control box with FIS-007 software, which is included and installs on Windows 10 PCs.

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OCTOBER 2021

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35

THE BENCH

BIOMED 101

What is Productivity and How Do You Find It?

BY JOSEPH FISHEL

T

he task of measuring productivity in the HTM world has been a cause for discussion over the years and continues even today. I attended the MD Expo in Dallas and a lively topic of discussion was how productivity should be calculated? Some of the questions that came up were, “Do you document everything you do?”

“How do you account for lunch hours and breaks?” “What is the benchmark – 70%, 80%, 90% or 100%?” All of these are questions that have held up the true explanation of productivity which is, “How can you tell if a technician is productive?”

For years, the accepted calculation was to compare hours available to hours worked.

This is only an accounting of time not if someone was productive. In the manufacturing industry, my productivity was measured in how many “working” halogen light bulbs I could make in a shift.

In the HTM world, we have all kinds of different tasks that pull us in different directions. But, at the end of the day, it doesn’t really tell us if a technician was productive or not.

Early in my career, I oriented with a tech at another facility prior to his vacation. I was going to be covering the infusion pump desk in his absence. He instructed me to only fix eight pumps a day. His justification was there are only eight work hours in a day and it takes an

36

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OCTOBER 2021

hour to work on one. That was his standard and he did not want me to screw it up for him. When I showed up on Monday, I could not get to the desk because of all the pumps on the floor awaiting attention. I started by assessing a pump and 15 minutes later, I had identified the malfunction, cleared the error and set it up to run for volume testing. I now had 45 minutes to sit around. I could not take the inactivity. I commenced to plug in pumps to charge them, as well as turning them on to see what was going on. I was able to set up four calibration stations to verify the accuracy. By the end of the day, I had put 16 back in service. By the end of the week, I had touched 102 pumps and returned 96 back into service. I could now walk to the desk without tripping over pumps. We both worked a 40-hour week and documented our work, but the number of repaired devices was 40 to 96. Over the same time span, I was about 141% more productive.

To play a game, we always set the rules first. For determining productivity, you need to set the rules or boundaries.

• What time should we include in a work order?

• Should we include the true hours available to work?

• Do you count 15-minute breaks and lunch breaks?

• What are the true available hours to work in a day (8, 7.5, 7)?

• Do we document all our time and what we do? Do we include the time

Joseph Fishel Nuvolo Business Process Consultant/HTM to travel up to the floor and retrieve a device as well as returning the device back to the floor?

• Do you include the time to search for a part even if it is 10 to 15 minutes?

• Getting a purchase order number, either for a part or if the device needs to be sent out?

• The time to procure packing materials and boxing up a device?

• Arranging and processing a loaner?

• Identifying clearly what is admin time, project time, rounds and any other specific classification of a work?

This standardizes the documentation so everyone is doing it the same way. This is important so that you can compare apples to apples. Documenting what you do in your 8 hours is just that – documenting what you did.

The easiest way to start looking at

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Healthcare Technology Recruitment & Placement Services Nationwide productivity is to pick one model of a device that the majority of the techs do PMs on. IV pumps would be high on my list to start with. I would choose comparing PMs as the steps are already standardized by the manufacturer. There are two benchmarks you should incorporate into your computations. The first benchmark is the manufacturer’s estimated PM time. The second is to take the average PM time from a year of data. Next, separate out each technician’s average PM time for the same device model and put them on a graph. This will give you a picture of where everyone is in their productivity when it comes to that model of device. When you look at a chart below you can see that Techs 1,2,6 and 7 are performing a PM in a time shorter than both the facility average and the manufacturer’s estimate.

Tech 1................................15 Tech 2................................25 Tech 6................................29 Tech 7................................32 System Average.................39 MFR..................................45 Tech 4................................48 Tech 8................................51 Tech 3................................52 Tech 5................................59 From the chart above, we can see which one of our techs is more efficient doing pump PMs. If there is a step that takes a minimum of 15

minutes (such as a volume infused test) I would question the quality of the PM by Tech 1.

Now that you have completed productivity analysis for one device, I would look at what the top 10 devices are and do the same.

Once you have them give each tech a simple score for each device category based on where they stand. If they ranked third on an ESU then give them a 3. Then total up each technicians’ scores and this will let you see where each tech stands regarding productivity compared to the other techs.

After you have done the PM numbers for all devices then start on correctives and then look at admin time, travel time, project time and any other categories. You will only have an average benchmark from your site, but it will assist you in seeing where time is being spent. No one is 100% productive, but everyone can document how they use 100% of their time.

No matter the calculation it comes down to the need for accurate documentation. As members of the HTM community, we should share our suggestions and work together to create standards.

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THE BENCH

WEBINAR WEDNESDAY

Sessions Deliver HTM Know-How STAFF REPORT

T

he 2021 Webinar Wednesday calendar is packed with upcoming sessions designed to delivered continuing education to healthcare technology management (HTM) professionals at every career stage. The upcoming sessions will build on the knowledge already delivered this year and in years past via WebinarWednesday.live. A few of the recent webinars addressed contrast injectors, CT and the future of the profession.

CONTRACT INJECTORS PM The August 11 webinar “Basic Preventive Maintenance Procedures for Contrast Injectors” sponsored by Althea US Inc. delivered valuable insights to attendees.

In this 60-minute webinar, expert Michael Gossman, a modality manager at Althea US Inc., provided an overview and insight of preventive maintenance procedures and how to properly execute them. It was eligible for 1 credit from the ACI. He said downtime is one important reason to perform preventive maintenance procedures.

“When an injector is down, so is the modality. When the modality is down, the hospital is not creating revenue,” Gossman said. “CT, MR, cath lab, interventional – everywhere you are going to find an injector – those are major revenue generators for the hospital. They do break.

They do go down, but with proper PM procedures and techniques you will limit the time that they are down or the time that they break down.”

Gossman went on to share several tips, including one item he takes to every PM. It is so important that if he doesn’t have any, 38

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OCTOBER 2021

he stops and buys some on his way to the job site.

More than 100 health care professionals logged in for the presentation. A recording of the session is available for on-demand viewing.

Attendees provide valuable feedback in a survey that included the question, “Why did you attend today’s webinar? And, was it worth your time?”

“I wanted to learn more about common injector problems and PMs. It was valuable to have seen,” said D. Resnick, BMET I. “I can never have enough knowledge. Yes, it was well worth my time,” said Senior Technician III E. Petrea, CBET. “I was curious about the PM process and how often injectors are inoperative due to contrast spills. The presenter did an excellent job discussing the PM process and how he deals with contrast issue. Yes, this webinar was definitely worth attending,” Area Manager L. Clifford said.

“To gain knowledge about the injectors.

I enjoyed every bit of the webinar,” said D. McDougle, BMET. COMPUTED TOMOGRAPHY The session “An Introduction to Computed Tomography” was presented

by AllParts Medical (a Philips company) Multi-Vendor Modality Manager James Freeman. It was eligible for 1 credit from the ACI. During the webinar, Freeman provided an introduction to computed tomography and the cost to service CT products. He shared a description of computed tomography and discussed functionality and system components. He also talked about CT advantages over traditional radiology, provided a system overview and explained how images are made. Freeman went on to

discuss common issues for CT systems, cost to service and elements to consider.

Freeman also shared information about how CT tubes enable new service offerings

by ISO, liquid bearing technology and the new Dunlee DA200P40+LMB CT tube and CT support at AllParts Medical.

Freeman shared additional insights during an informative question-and-answer session where attendees submitted questions.

One attendee asked, “Other than not using it, is there anything users can do to extend the life of their tube?”

Freeman said it depends on how the device is used.

“They’re just things that happen with tubes, right? It’s all dependent on how the customer uses them. This becomes a challenge. Every site is a little unique.

We’ve seen sites where they do trauma ER scanning and those tubes seem to last a very long time. But then other sites that are low usage actually consume X-ray tubes sooner. Part of it has to do with thermal cycling. If we get a tube up to a certain temperature and it operates at that temperature consistently all day long, how many thermal cycles has it endured?

Realistically, not a lot. It’s gotten hotter and colder as being used, but there’s a lot of cooling capability in the gantry as well.

It tries to dissipate that heat as much as possible, whereas if you scan a couple of patients and then the tube cools down and then you scan a few more patients and it warms up or goes into deep thermal cycling. So, it used to be when we had just conventional bulbs instead of LED bulbs, when would light bulb fail? Sometimes it was just when we were turning it on. That current would rush through the tube and would actually cause the filament failure.”

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Advancing the Biomedical/HTM Professional

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FUTURE OF BIOMED The recent Webinar Wednesday session “Tech Toolbox and the Future of Biomed” was presented by Justin Barbour, BMET, and host of Better Biomed YouTube Channel; Edgardo Bautista, biomedical support engineer, and host of D.I.Y Eddie YouTube Channel; and Jason Kluttz, technician and owner of Bright Idea Dental Repair. It was sponsored by MedWrench and eligible for 1 credit from the ACI. In the webinar, the expert panel covered a variety of topics, including an outlook of the career field, examination of training methods, the benefits of a YouTube channel, as well as answered multiple questions from the engaged audience.

One attendee asked, “Where do you get inspiration for your YouTube channel?”

“Every day,” answered Barbour.

“Every single day I experience something new and something I wish I had known a couple of years ago. People are hungry for information, and that’s what drives me to make these videos.”

In regards to the future, Kluttz stated,

“And, you know, if we’re talking about the future of the biomed, the future involves bringing in people that are going to be less knowledgeable, that are going to be kind of that bright-eyed, young guy that doesn’t know anything, and we’ve got to be patient and not push them away.

But we’ve gotta really, like, embrace them.”

Other questions included, “As a biomed working in hospitals, do you think we will be replaced by companies, reps or techs in the future?” “What other websites or platforms do you use if you can’t find answers on YouTube?” “Are there any risks or liabilities that you share when you create videos?”

More than 200 individuals registered for the webinar. Attendees provided feedback via a survey after the webinar.

The survey included the question, “What did you enjoy the most about this webinar?” ”Honest content that was not selling me anything! It’s great to hear from fellow biomeds. We are often out there alone and do not get a chance to interact with our colleagues as often as we would like,” said C. Yovino, field service supervisor.

“Their interaction and knowledge.

Great presentation and explanation of experience,” added L. Clifford, area manager.

g hin Bend 30269 Publis k y, GA MD stbroo e Cit ed 18 Ea tre est Peach Requ vice ss Ser dre Ad

“Thermal cycling typically is the biggest challenge with extending tube life,” he added.

Approximately 100 attendees tuned in for the live presentation. A recording of the webinar is available for on-demand viewing.

Attendees shared feedback via a survey that included the question, “Why did you attend today’s webinar? And, was it worth your time?”

“I’m a biomedical service engineer focusing on radiology. I’m looking forward to working on CT installation, repair and maintenance in the near future either with GE, Siemens or Philips, etc.

The webinar was worthy of my time,” Field Service Engineer C. Bendian said.

“Professionally and personally study imaging. Was worth my time,” Engineering Consultant S. Alexander said.

“I attended because it was relevant to my specialty in CT as a biomedical equipment technician,” Sergeant First Class C. Jaggers said.

d 1

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TN-M

1909-

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OCTOBER 2021

TECHNATION

39

THE BENCH

SHOP TALK POWERED BY

STRYKER SECURE II

Q:

I have a Secure II bed that any time you press an articulation function, the bed automatically raises to the high position, even if I remove my hand from the footboard.

The bed will just continue to rise on its own to the highest positions. I am guessing it is a limit switch somewhere. Any suggestions?

A:

Disconnect your side rail cables. It sounds like you have a stuck key.

REPLY: Thank you for that response.

The bed will go down while operating the down button, but when you release it raises back up. In fact, if I take the cowl off the underside of the bed it will stop going down if I press the down limit switch, but then the bed goes back up, even without touching the controls.

SAKURA TISSUE TEK TEC 5

Q:

What would cause the left/right arrow keys on display to not work? I can turn on the embedder and can turn on into service mode.

All buttons seem to work. The light turned on when pressing the “light” key and all double beeped. I can’t move the cursor left or right to select the test run, I can only select “program version” because that is where the cursor starts when turning it on in service mode.

A:

“All buttons seem to work.”

Including the arrow keys? I would try cleaning the contacts on the flat flex cable from the front panel, and carefully reinserting it into the connector on the main board.

MEDRAD STELLANT

Q: A:

What does error code (Errnum) 1818 pertain to? Sym code ENCB

Encoder B error. I’d check the encoder connections, verify that the volumes haven’t fallen out of calibration to that on the display.

Make sure there is no contrast leakage onto the power drive card.

PURITAN BENNETT 840

Q:

stopped working. The display is working only the touch is not. I checked the cable assembly touch frame and it does work. Where else should I start looking for the problem?

A:

Screen lock key. It may be activated. Try to disable or try cleaning the screen with alcohol-free liquid.

REPLY: The screen lock key is not activated. I cleaned it and it is still not working.

A:

You need to replace the GUI touch board, if it’s not working after cleaning. Make sure no stickers or damage is on the screen or black housing.

A:

The touchscreen board is a square board that is held on with plastic pins. Also check the ribbon cable. The newer boards have a different ribbon cable than the old ones. That causes issues as well. A defective keyboard can also cause issues that may look like a touchscreen as mentioned above. Test it before putting everything back together.

I have a Puritan Bennett 840 ventilator and the touchscreen

SHOP TALK

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

40

TECHNATION

OCTOBER 2021

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TechNation is proud to support and be an advocate for the Right to Repair movement in the healthcare technology management and health care community. A new web form specifically allows biomeds everywhere to report incidents when an original equipment manufacturer (OEM) declines to provide parts, technical assistance, keys or other support needed to repair or maintain a device.

The goal is to provide biomeds a place to share their experiences to help others as well as collect data regarding right to repair issues that can be shared within the industry and with regulatory organizations, including the FDA.

Share a right to repair issue today.

1technation.com/right-to-repair-incident/

ROUNDTABLE

ROUNDTABLE Tubes & Bulbs

T

echNation contacted industry experts for the latest information regarding tubes and bulbs for imaging equipment. Participating in the roundtable article on tubes and bulbs are GE Healthcare Imaging Service Portfolio Product Manager (U.S. and Canada) Adolfo Ivonnet, W7 Global President Wayne Kramer and Richardson Healthcare Vice President of Healthcare Sales and Operations Jerald L. Olsen.

Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN PURCHASING REPLACEMENT TUBES AND BULBS FOR IMAGING DEVICES? IVONNET: When purchasing replacement X-ray tubes, customers often value what is most critical for their health care facility. They should partner with a supplier that has manufacturing and engineering expertise, and a proven track record for delivering high quality, innovative and reliable products. Make sure the X-ray tubes you purchase are backed

42

TECHNATION

OCTOBER 2021

something goes wrong.

Adolfo Ivonnet GE Healthcare by a warranty provided by the supplier. X-ray tubes should be designed to provide exceptional image quality and optimal service life, while mitigating unplanned downtime and providing optimum system performance and reliability.

KRAMER: You want confidence in your supplier. Are X-ray tubes a regular part of their business? Do they have a good reputation? Develop a level of comfort that you will be supported if

OLSEN: When purchasing a replacement X-ray tube, the first thing you need to verify is if the replacement you are buying is a drop-in replacement for the existing tube? Replacement X-ray tubes need to be a form, fit and function equivalent to the OEM tube. New tubes must have high voltage stability testing documentation, and radiation leak check values verifying the tube will be stable and safe in a clinical environment. It is important to note that harvested tubes are sold as-is, and not all are tested and certified the same depending on who harvested and sold the tube.

Q: WHAT ARE SOME OPTIONS CUSTOMERS SHOULD INQUIRE ABOUT? IVONNET: Several options are available to customers including new, refurbished or available low-cost alternatives. Customers should inquire about offerings that will help improve their clinical, operational and financial

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ROUNDTABLE

outcomes: Does your supplier have flexible tube coverage alternatives that help to reduce cost? Does your supplier have proactive/predictive remote monitoring capabilities that your health care facility can benefit from? Customers should be aware of additional options that can improve their system performance and cost structure that extends beyond the X-ray tube that also benefits the critical components in the imaging chain.

Q: CAN YOU DISCUSS THE PROS AND CONS OF PURCHASING A NEW PRODUCT VERSUS A REFURBISHED PRODUCT? IVONNET: Customers may prefer the purchase of a new tube, as it has never been used and often has a comprehensive warranty. Refurbished tubes are a less expensive alternative, and it is important for the customer to understand the supplier’s criteria and definition of a refurbished tube and the warranty differences between a new tube and a refurbished one.

KRAMER: Pre-owned and refurbished tubes can be a great option for cost savings. Past usage and date of manufacture are the primary factors driving the price. You want confidence that the tube has been fully tested and will be supported if there’s a problem, and the supplier should give a reasonable warranty to back that up. For new tubes, the first thing to understand is that you might have more cost-effective options than going direct to the OEM. It’s worthwhile to check for available options from aftermarket dealers and suppliers.

OLSEN: Before buying a replacement X-ray tube, you need to understand if it is new or previously used. New and previously used tubes have a place in the market, but you need to know what you require before asking for a supplier quote. Ask yourself if you want a slightly higher-cost new tube with maximum life or deal with unplanned equipment downtime and higher risk with a used tube.

Wayne Kramer W7 Global

KRAMER: New tubes are often associated with lower risk and higher cost, and usually they have a longer warranty than used tubes. It’s not always the case that a new tube will last longer than a good preowned one. If you’re spending the money for a new tube, make sure you’re getting an OEM-level warranty, or at least a warranty that suits the pricing being offered. Buy such tubes from reliable

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

sources, such as a dealer or seller with an established track record.

OLSEN: X-ray tubes have finite wear components inside them, such as bearings, anodes and filaments. New tubes will use new components or components that are reconditioned to new tube performance. Typically, a refurbished tube has used parts and may have a shorter life than a new tube. When an X-ray tube is refurbished, most suppliers can only replace or repair high voltage and cooling system components outside of the vacuum envelope in and around the housing assembly. Another differentiator is the dielectric oil.

This oil can be reprocessed or replaced in various tube types, improving the tube’s high voltage stability and performance. New tubes come with dielectric oil that has little to no moisture or air in it. The dielectric oil in refurbished tubes is subject to a company’s oil reprocessing capabilities.

Q: WHAT TYPES OF WARRANTY AND PRODUCT SUPPORT SHOULD CUSTOMERS BE AWARE OF WHEN PURCHASING TUBES AND BULBS FOR IMAGING DEVICES? IVONNET: Warranties can differ between suppliers. Customers should have a clear understanding of the supplier’s warranty coverage that is applicable to the X-ray tube, detailing the terms and conditions, and have it in writing. Product support extends beyond the tube and it is important to understand the technical knowledge and expertise available with the supplier to ensure optimal system quality and performance.

OCTOBER 2021

TECHNATION

43

ROUNDTABLE

KRAMER: X-ray tubes should always be purchased with a warranty and be sure it’s from a reputable company that will actually support it. Generally speaking, quality used and refurbished tubes will have warranties of at least 90 days on a prorated basis.

Some more extreme budget options might carry a lesser warranty. New tubes typically come with 12 months and might vary between full replacement and prorated. Some also come with usage limits, such as a max number of patient exams or scan seconds for CT tubes. All of this is standard in the industry. Don’t assume that buying a brand-new tube automatically means you’re avoiding the risk of warranty failure. We have seen plenty of warranty cases reported from tubes that came directly from the OEM. At W7 Global, we now offer an extended warranty option for brand-new tubes under our TubeAssurance program, which provides 6 and 12-month prorated warranty options in addition to the factory warranty, giving even more added value and peace of mind to the customer.

OLSEN: New tubes usually come with a minimum of a one-year prorated warranty and/or finite slice or scan second count. Finite slice or scan second count warranties are more common in high-use ER environments given the constant use of the CT scanner. Refurbished tubes may come without any warranty, but most

trustworthy suppliers will warranty refurbished X-ray tubes from 90 to 180 days, with some extending longer depending on the X-ray tube type and application. It is important to read the fine print before making a buying decision.

Q: WHAT TYPES OF WARRANTY AND PRODUCT SUPPORT SHOULD CUSTOMERS BE AWARE OF WHEN PURCHASING TUBES AND BULBS FOR IMAGING DEVICES? IVONNET: It’s important to understand the tube is one of many components to consider when considering a supplier to establish a partnership with. While the tube may be the key element, customers should also evaluate the solutions a supplier can provide beyond the tube itself that prioritizes the management and performance of the overall system to focus on helping reduce the amount of service calls and dollars spent on repair costs, and delivering reliability, productivity and financial stability.

Jerald L. Olsen Richardson Healthcare OLSEN: If you want to see how a new X-ray tube is made from start to stock, please contact me directly: Jerald Olsen jolsen@rell.com. We can do a virtual or in-person tour at our Chicago area facility. You will come away with a deeper understanding and appreciation for what it takes to manufacture or refurbish an X-ray tube.

KRAMER: One of the most important things to remember is that, whether purchasing new or preowned, you have options. Don’t assume that you have to go to the OEM and pay their asking price, even if you want to buy brand new. Check around with companies in the industry to find the most cost-effective, reliable solution that fits your specific needs and budget.

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

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COVER BREAKROOM STORY

IT SECURITY

MEDICAL DEVICES

BY K. RICHARD DOUGLAS

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BREAKROOM

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tandards for cybersecurity have been developed across many industries to standardize and create more efficient technologies, practices, connectivity and security.

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tions. The consumer has not been spared from the impact of these attacks on business. In May, a ransomware attack on Colonial Pipeline caused a panic on the East Coast as drivers flooded gas stations before pumps ran dry.

Ransomware attacks on SolarWinds, Microsoft, JBS, the Republican National Committee and Kaseya caused varying degrees of response.

While Kaseya claims not to have paid out any ransom for a decryption key, Colonial Pipeline was not so lucky.

In the health care setting, there arises a number of concerns related to the threat surface that are related to the mishmash of consumer devices brought into the health care space, including voice assistants, electric vehicles, security systems and vending machines. HVAC controls are another vulnerability.

In addition to concerns about the growing number of devices communicating with the network are the legacy operating systems with no support or updates. This was a problem with most ATM machines at one time. This is true of many IoT devices and nearly a fifth of medical devices.

If the pneumatic tube systems in hospitals are vulnerable; then what else is?

Yes, even those systems that transport blood, medication, urine samples or tissue could be hijacked.

The big wakeup call came in 2017 for the health care sector with the WannaCry ransomware attack in the United Kingdom. In September of 2020, the death of a

Vice President of

This last element in standards has taken on a life of its own as more items in the home and workplace become connected to the Internet. The Internet of Things (IoT) has birthed a smorgasbord of devices that are designed to be more user-friendly through two-way communications, the capacity to monitor and the ability to perform remote diagnosis or troubleshooting.

This universe of connected devices is growing at a blistering rate and most of these devices are “unmanaged.” This presents many opportunities for cybercriminals. It also produces just as many challenges for those tasked with protecting consumers, patients, non-public and proprietary information.

The focus today is to develop technologies that will allow consumers, businesses and developers to connect to, and build, reliable and secure IoT ecosystems.

Concurrent with these ramped up efforts to fortify an increasing number of devices that are vulnerable to hacking and cyberattack, has been an increase in the sophistication and brazenness of attacks carried out by intruders and infiltrators.

During the second half of 2020, the Microsoft email accounts in the offices of 27 federal prosecutors were hacked. Some believe that the incursions were connected to the SolarWinds cyberespionage campaign.

During this year and last year, the increase in cybersecurity threats to all industries has increased significantly. This treat continues to escalate against health care as well. In the interest of providing the most current information on the topic, thought leadership cybersecurity experts share their insights.

In particular, ransomware attacks have had a devastating impact on businesses, municipalities and health care organiza-

78-yearold patient in Germany was attributed to a ransomware attack that prevented her transport to the closest hospital.

An alert posted by the National Cyber Awareness System in October of 2020 warned, in part, of “an increased and imminent cybercrime threat to U.S. hospitals and health care providers.”

The U.S. Food and Drug Administration’s (FDA’s) Center for Devices and Radiological Health (CDRH) published the discussion paper “Strengthening Cybersecurity Practices Associated with Servicing of Medical Devices: Challenges and Opportunities” to seek input from stakeholders. HTM professionals have many areas of focus as a result of cybersecurity that didn’t exist even five years ago.

One focus is mitigating risks. There are many stakeholders in this effort, including IT, compliance and biomed. Patching and OCTOBER 2021

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COVER BREAKROOM STORY

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updates have never been more important, for example. This means being aware of risks in order to stay ahead of them with updates.

There are devices that use out-of-date operating systems that are no longer supported by manufacturers. Old, out-of-date, unpatched devices can be the Achilles heel of a system. What do you do with legacy devices that can no longer be patched? This needs to be another focus for HTM. Segmentation is a necessity. This may be the last resort with these devices if replacement isn’t in the cards.

A straight line has to be drawn between the effort to harden the system against cyberthreats and patient safety. An awareness of every device in the inventory that may present a vulnerability, its status and location, are instrumental in the HTM professional’s ability to keep one step ahead of the bad guys.

For this reason, it is beneficial for HTM departments to include specialists who spend most of their time focused on cybersecurity efforts.

Knowing every device that is on the network is important and often surprising.

Often, evaluation tools are required.

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HTM’S ROLE APART FROM IT One of the limitations in the past to monitor and detect unusual activity in medical devices has been the methods employed.

“If you are looking for threats, I would say it is malicious network traffic. This is very difficult to spot, especially in health care. Standard IT devices communicate in TCP/IP and DICOM. Medical devices and OT technology have their own protocols so traditional security tools can’t understand IoMT device communications,” says Ty Greenhalgh, HCISPP, senior account executive, OT security with Nuvolo, headquartered in Paramus, New Jersey.

He says that the problem with traditional methods is that they can’t shut down the communication because it could impact patient care.

“New medical device security monitoring tools can perform deep packet inspection on the network communication of these devices and identify anomalous behavior,” Greenhalgh says.

There are technical and business risks involved in keeping devices available to clinicians and a cyberthreat can knock devices out of use. It is important that HTM has contingency plans in place when a cyberattack takes place.

“From the HTM perspective, I broadly consider two actions to promote medical device cybersecurity,” says Dennis Fridrich, vice president of information security, compliance and disaster recovery at TRIMEDX.

“The first takes into account planning, training and communication needs. It’s critical to have business continuity and disaster recovery plans in place to make sure certain devices can be restored to the environment of care quickly and with the correct configurations. Equally important is making sure HTM team members are well trained and aware of their responsibilities in case of a cyber event,” he says.

Fridrich says that, lastly, consider creating a direct line from the HTM team to the CIO/CISO to streamline communication and avoid preventable missteps.

“The second action is to ensure understanding of the medical device technology that’s in use. The HTM team members are the medical device experts, and technicians should familiarize themselves with device configurations and capabilities published on manufacturers’ MDS2 forms. Keeping devices properly configured and patched helps mitigate future cyber risk,” he says.

As mentioned earlier, knowledge of every connected device and its location is essential.

“Denial of service and/or compromising the integrity of the device should be a top concern for HTM professionals,” Greenhalgh says.

He says that if security is penetrated, ultimately it is the patient’s safety and outcome that is paramount.

“While it sounds rudimentary, establishing and maintaining a complete and accurate inventory of all connected and non-connected devices is a baseline for addressing cyberthreats. You can’t detect, protect or respond to attacks on devices you don’t know you have,” Greenhalgh adds.

Beyond an up-to-date list of every connected device in inventory, it is also important for HTM to coordinate with IT to fully visualize the threat surface.

“HTM is often siloed and operates as its own ecosystem to the point of operating outside of IT and enterprise security policies and standards,” says Frank Black, CISA, CISM, CISSP, principal consultant with Clearwater Compliance in Nashville, Tennessee.

He says that often HIT devices are violating enterprise standards and are not on the radar of enterprise cybersecurity risk management.

“Communication between WWW.1TECHNATION.COM

COVER STORY HTM owners, IT and IT security is the single most important first step in identifying the organizational risk that HTM devices bring. In concert with communication, HIT devices must be included in the enterprise risk analysis to identify and mitigate the risks associated with these devices to an acceptable level,” Black adds.

He also points out that the move to the cloud presents unique challenges (as well as benefits) and requires a different security mindset than the traditional “hosted on site” mindset.

In July, Black wrote a post titled; “The Paradigm Shift from ‘If’ to ‘When’: Ransomware Prevention and Mitigation Strategies for Your Healthcare Organization” for Clearwater Compliance’s blog. The post was replete with facts, stats and tips for hardening the health care environment.

Black points out that employee education is key because every employee potentially accesses the Internet and can be a vector for an incursion.

In the post, he says that “Spam and phishing emails lead the top of the list as a successful attack pathway, opening the door to some 67 percent of successful

NEW CONSIDERATIONS BIRTHED BY THE PANDEMIC While cyberattacks increased in 2020, the pandemic had already instigated changes to health care delivery, which included more reliance on technology, including consulting with patients remotely.

“COVID required the relaxation of certain regulations which allowed telehealth. This has created a larger attack surface with components that did not necessarily undergo traditional cybersecurity scrutiny,” Greenhalgh says.

He says that it seems that the bad actors out there are capitalizing on the COVID-19 pandemic as an opportunity to attack these vulnerabilities while health care is in a state of emergency.

“Ransomware attacks are increasing.

The health care sector leads all other industries in ransomware attacks and breaches. There does Greenhalg y not appear to be h T any slowdown in these attacks.

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more thorough risk assessments on the devices and components that have been recently added to support telehealth,” Greenhalgh says.

Fridrich says that a number of new cybersecurity considerations have resulted from the pandemic.

“The use of personal devices that do not meet commercial security standards is on the rise. While these are necessary for telehealth, since they don’t always meet security requirements, they’re more susceptible to adware, spyware and phishing attacks,” he says.

He says that cybercriminals have also begun to target applications as an entryway for device hacking, raising concerns over application security within hospitals.

“Health care providers should encourage telehealth patients to update to the latest versions of the application and operating system software to be as secure as possible,” Fridrich says.

In addition to patient communications, the changes created by the pandemic created an impact on health care workers.

“Bad actors, especially in the ransomware area, have been taking advantage of the changes in health care operations brought by the pandemic. We have seen the shift to a remote workforce and an increase in telemedicine create a more complex security problem and the furloughs/lay-offs of IT and IT security personnel contribute exponentially to that challenge,” Black says.

HTM departments can address this escalating threat to business operations and patient safety by engaging in as many training opportunities as they can. Besides the services provided by vendors who specialize in cybersecurity, many of those same companies offer blog articles and webinars on securing the health care environment. The TechNation Webinar Wednesday series also provide insights into this complex topic from time to time. Find out more at WebinarWednesday.live.

HTM professionals also have a variety of professional certifications they can earn that will prepare them for a more specialized role on their teams as network and cybersecurity specialists.

When the government warns that the threat is increasing; HTM must respond with knowledge and action.

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The health care sector leads all other industries in ransomware attacks and breaches.

attacks followed by: lack of security training: 36 percent, weak passwords: 30 percent, poor user practices: 25 percent and malicious websites: 16 percent.”

In addition to knowing what devices are on the network and the location of those devices, Black also points out that it is important to know where sensitive data is and where it flows and who has access to it.

“It’s also more than just knowing where the data lives. You also have to look at transmission and data at rest. Where does the data go as it moves from one application to another? Is it shared with a third-party vendor? Where is it and how is it handled there?”

With regards to that data, Black says; “You must know where your sensitive data is in order to provide reasonable and appropriate data protection. Maps of sensitive data flows should include all of its paths, entry and exit points, and storage locations.

Include security devices and applications such as firewalls, routers, IDS/IPS. Update the map whenever you add a new data flow or you change a security feature.”

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count exe

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EXPERT ADVICE

CAREER CENTER

Time Management and the Home Office

BY JENIFER BROWN

D

ue to all the effects of COVID-19, there are more people than ever working out of a home office or at least home based if in field service.

Adapting to that change and managing your time is even more crucial to achieving your goals and moving up in your career.

Personally, I have worked out of a home office for 25 years. I can relate with those who are getting used to working in this environment. I always found it interesting that many would say to me that “you have it made” since I am working from home and scheduling my own hours.

To me, the opposite was the case. It was difficult for me to put down my work and stop for the day. However, we all need a “work and life” balance. Here are the top five time management tips that I have found to be successful.

1. Have a designated “yours only” office space where household distractions won’t interfere!

have reliable connections with a good reception and are working properly.

3. Plan out your day, and even week, ahead of time if possible, to avoid stress and duplication.

4. Learn to and practice prioritizing your daily tasks! Note: The night before make a list of the top 10 things you must do the next day!

These can be phone calls, service events that have to occur, client or team meetings, etc.

Jenifer Brown

5. Set boundaries for your valuable time and learn to say no. For example, with so much work being done virtually, there are tons of conference calls and/or video meetings that can be time consuming and take you away from your “real” work. Perhaps you do not need to be on each one or ask the coordinator to get it down to a 30-minute session instead of an hour.

Jenifer Brown is the president and owner of Health Tech Talent Management, LLC.

2. Make sure all of your communication devices (laptop/desktop/phone)

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PROTECTING YOUR INVESTMENT: Proper Care and Maintenance for Telemetry Transmitters

BY GADIER RODRIGUEZ AND MICHELE PAYLOR

T

elemetry transmitters provide vital data. They are also one of the most important devices within the recovery suite following surgical procedures … and one of the most expensive. Many of the devices that do come in for repair are a result of physical damage and/or fluid intrusion. However, proper cleaning and care of these devices, post use by patients, could prolong the life of this very costly piece of equipment..

Gadier Rodriguez

One of the first, and best, ways to ensure that the telemetry transmitter is protected is for the patient to always wear the device in a pouch-like holder.

Case damage and broken battery doors

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are in constant need of replacement from being dropped. The importance of the pouch-holder is to eliminate fluid intrusion and other debris from contact with the device. If a pouch-holder is not an option, there are other holsters that are available. Please check with the device manufacturer to find one what is suitable for the environment.

The telemetry transmitter is a delicate piece of equipment. Fluid intrusion is the second most common repair issue this device is prone to. It can cause corrosion throughout the device and will cause intermittent functionality. Given how important this unit is to the patient and the health care providers monitoring vitals, it is imperative that the unit function to the standard for which it was designed.

Again, the pouch-like holder can assist with keeping the device clean and dry.

However, there will be times when the device getting wet or submerged cannot be avoided. For example, patient showers. It is recommended that patient showers be limited to 10 minutes.

Anything above 10 minutes could impede device functionality.

Keeping the telemetry transmitter clean is not only a sanitary function, it also will keep the unit in proper working order longer. Prior to cleaning the device, please make sure to remove any batteries and lead wires from the

Michele Paylor transmitter. Only use the approved cleaners that the OEM recommends.

For example: • Isopropyl Alcohol (> 70%) • Hydrogen Peroxide (3%) • CaviWipes Do not use antibacterial soap or abrasive cleaners/solvents of any kind.

Saturating the device in cleaning solvents is not advised, nor is getting solution around the ECG pins, wells and service ports. It is best to use a lint-free cloth to wipe the unit down.

You may use an ESD brush to get into hard-to-reach crevices of the device.

Cotton swabs and paper towels are appropriate to use on the connectors.

Once you’ve cleaned/sanitized the unit, allow necessary time to air dry and prepare your device for functionality testing.

It is important to make sure the

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telemetry transmitter is operating properly after cleaning. Each manufacturer should provide instruction for a “self-test” to determine if the device is patient ready. However, if the device fails the “power on self-test,” do not use the transceiver for patient monitoring.

If there are issues with your device failing the self-test by the manufacturer, it is always recommended to send it for evaluation and repair (if needed).

– Gadier Rodriguez is a biomedical technician and Michele Paylor is tech administrator for Avante Health Solutions’ Center of Excellence in San Clemente, California. For more information on patient monitoring equipment sourcing, repair and parts contact Avante Health Solutions or visit avantehs.com/monitoring.

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CYBERSECURITY Decommissioning Networked Medical Endpoints: A Look into the More Overlooked Media Types Andrew Aiken, VISN 9

BY ANDREW AIKEN

S

o, we’ve reached the end of the road in the life cycle and are preparing to retire a system to the great beyond … or worse yet, an auction site. Before doing so, we need to take appropriate measures to safeguard our data and most certainly that of our patients. While we have standard procedures for workstations and server platter drives, some items may be less obvious in the modern era of memory and storage. In this column, I plan to focus on the current landscape and less so on specific disposal and erasure standards.

The implementation of media sanitization standards can vary significantly between organizations and I’ll defer you to your local security and privacy officers for your specific standard operating procedures. That being said, we should be aware that “one-size-fits-all” policies are often not intended for a broad array of media types.

Let’s start with the traditional fare of personal computers (PCs) and servers, many technicians are accustomed to hard drive disposal practices which focus on the aforementioned platter drives. Many people, however, may not be aware of the varied formats that modern storage can take. The second

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most-common type of hard drives are enclosed solid-state drives (SSDs). These are smaller, lightweight drives that can easily be obscured within a PC enclosure. Even for SSDs that assume the form of the more traditional 2.5-inch HDD enclosure, the practice of drilling a hole through a drive, one which many organizations still rely on, can literally miss the mark (Figure 1).

Figure 1”Drilled” SSD

Another prevalent and commonly overlooked solid-state media type is the NVMe (Non-Volatile Memory Express) variety (Figure 2). Due to its size and shape, it can often be confused with RAM or can blend in with other motherboard components. Usually, these drives are mounted flat on the motherboard, but can also be attached to a riser card (Figure 3) and may be dismissed as a secondary peripheral.

Also, don’t forsake removable media types such as optical, tape and flash. It can be easy to overlook these drives for media during the decommissioning process and miss media that could easily contain significant amounts of patient data – always check and eject removable drives prior to disposal (Figure 4). And even though they may seem like a relic destined for the dust bin of history, don’t think that tape drives are dead; they are often still in the mix and can even store up to 45TB of data on a single cartridge (Figure 5 – tape drive with cartridge). Furthermore, while Universal Serial Bus (USB) media can be easy to spot externally, be wary of internal USB media as well.

Some servers utilize an internal USB slot that vendors can use to either insert a licensing dongle or for additional storage (Figure 6).

Figure 2 NVMe Module

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Figure 3NVME Riser Card

Figure 4 All-In-One Media Bay

Figure 5 Modern LTO Tape Drive

Now that we have discussed the screening procedures for traditional PCs and servers, we must shift our focus to discrete medical devices which often lack the same level of scrutiny and can be just as likely to contain “vital” information. This is particularly true of our wireless devices that run the gamut from glucometers to vital signs to infusion pumps. These can store sensitive patient data on internal storage as well as the security keys to your enterprise mobile networks, which is the juicier target. In a recent case, some of these devices sent to an auction site for resale still contained the organizational identifiers as well as the SSID and WPA2 key for the organization’s wireless network. In fact, the organization’s name was clearly visible on the auction pictures, which can be a major signal to potential bad actors. These devices typically have either onboard flash or compact flash memory, and in some cases contain both. You should check with the manufacturer for memory-erasure procedures and confirm with your local security officers to confirm that these procedures meet your organization’s guidance for reuse and/or destruction. This holds true for devices at every stage of their life cycle, whether they are end-of-life and preparing for disposal or

simply out on loan or shipped for repair.

In order to prepare yourself and your organization from potential data loss, it is important to stay informed of the ever-evolving landscape of storage technologies and make use of locally available reference material such as life cycle desk guides and information security policies. If you do not have guides or checklists available in your organization, I highly encourage you to take the steps toward developing these to serve as stepby-step guides covering procurement, implementation, sustainment and decommission of your devices.

The retirement of a single system can involve so many tasks from logistical (asset management) to logical (HL7, DICOM, VLAN/ACL) that it is increasingly likely for a small SD card or DVD to be overlooked. Having clearly defined guides of your local procedures will allow you and your organization to remain vigilant. Threat actors prey on opportunity – don’t make it easy for them by A) doing something you aren’t supposed to do or B) failing to do something you were supposed to do.

Andrew Aiken is a VISN 9 Information Systems BESS at VA MidSouth Healthcare Network.

Figure 6 Internal USB

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20/20 IMAGING INSIGHTS Innovatus Imaging Inside

BY MATT TOMORY

I

f I’ve learned anything over the years that applies to the Right to Repair issue that we face now, it’s that what’s inside a repair matters.

Back in 1991, Intel Corporation began placing “intel inside” stickers on PCs built with its processors so that consumers would know that their computer contained a genuine Intel microprocessor and not a knockoff and possibly inferior CPU. Skeptics claimed the general public did not care about the “ingredients” – only if the overall product appeared to perform. Lately I have had many conversations with our clients and partners which include multiple OEMs, independent service organizations, asset managers, E-retailers and health care providers about the recent activity with the FDA regarding right to repair and the ever-present clarifications on the definitions of repair, servicing, remanufacturing and restoring.

It has become very clear that the medical device repair market is rotating and de-commoditizing.

While price is always a concern, more and more we are discussing processes, materials, verifications, validations, quality management

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Matt Tomory Vice President of Sales and Marketing systems and other aspects of proper repairs which can demonstrate that a repair event has returned a medical device to perform as the OEM intended and is safe and effective versus just functioning again. Think about that last statement for a moment: What is the difference between functionality and performing as the OEM intended?

Since I lead the marketing department here at Innovatus Imaging, I am constantly trying to find ways to communicate to health care providers and those that serve them about what we do and how we do it because what goes into a repair holistically is so critical to patient care, sustainability, long-term value

and safety. We do not just fix medical devices – we return ultrasound probes and MRI coils which are sophisticated, Class II medical devices back to OEM intent and are proven to be safe and effective.

Let’s use an ultrasound transducer as an example and something seemingly as simple as a lens. To the untrained eye, it is just a rubber membrane separating the transducer array from the patient’s body but there is much more to it than that.

This component is called a lens for a reason: it is partially responsible for focusing the acoustic beam from the acoustic stack within the probe, it protects acoustic matching layer(s), scan head electronics, and the array itself while also electrically isolating the probe from the patient. The material itself must have exact dimensions regarding shape and thickness to perform as the OEM intended. If the shape is incorrect by a minute amount, you will lose focus in your image. If the thickness is incorrect, you will affect the amount of energy transmitted to the patient as well as the sensitivity of the probe (especially in Doppler).

The cable harness in an ultrasound probe or MRI coil is another seemingly simple assembly – just a

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bunch of wires which transmit and receive, right? Not even close.

Different makes and models of probes and coils have specific lengths, diameters, electrical characteristics including impedance, capacitance, reactive capacitance, inductance, stranded or solid center conductor, shielded or unshielded and even cable sheath colors. These harnesses must be engineered to perform as the OEM intended or you may compromise the performance of the device.

Looking at materials in general, besides functioning as the OEM intended, we must also look at biological and chemical compatibility. If a medical device contains materials which may contact patients, the manufacturers should be in compliance with ISO 10993 which is specific to biocompatibility. In

other words, the materials are tested to ensure biological safety. This may include (in the case of probes and coils but extends to other medical devices) lenses, plastics, housings and even adhesives. When performing repairs on these devices, a quality provider will ensure their materials are also ISO 10993 compliant.

Chemical compatibility is an entirely different matter: Have you ever looked at the user manuals for the various OEMs and all the various chemicals that are approved for cleaning? Disapproved? Even some approved chemicals may only be used on certain portions of devices and there are hundreds of probes and coils and hundreds of chemicals in circulation today. In the case of ultrasound probes, devices are subjected to submersion, harsh

chemicals and, in some cases, high heat and vaporized chemicals. If all the materials have not been tested, you will likely get discoloration, degradation and, in some cases, the materials will distort or disintegrate.

All materials used in repair should be tested to ensure compatibility with OEM recommended cleaners and disinfectants.

These are just a couple of items as examples in proper MRI coil and ultrasound probe repairs – this list is much longer. When you think about sending out your next repair, check with your repair provider about what may be “inside” to ensure you and your patients get what you should expect and deserve from your repair provider.

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THE FUTURE It Continues

BY ROGER A BOWLES, MS, EdD, CBET

T

his week we are wrapping up the summer semester and preparing for the fall semester. The fall semester will be a lot lighter than it usually is because of fewer students and fewer faculty. We have over 20 fewer students beginning the program this fall than in a normal year because of a variety of factors. I suspect COVID-19 and online learning mandates are among those factors. Two faculty members have resigned their positions, so the medical imaging systems program is temporarily suspended.

And just when it looked like the pandemic was loosening its grip, well, here we go again. Texas does not have a mask mandate, and many have chosen not to be vaccinated. This vaccination status is starting to change a bit, at least with students, as many health care facilities are now requiring proof of vaccination before a student can start an internship.

One thing is certain, we will continue to stress the online component of lecture while coming into a classroom setting for labs. The sections have been divided into groups of 10 to keep exposure at a minimum. We continue to update our courses to accommodate the online component. At this point, I will not express my opinion on the effectiveness of our efforts toward self-directed learning. I believe we have a long way to go. I do know that our school and many others have shifted its mindset and do not intend to go back to a purely

Roger A Bowles, MS, EdD, CBET face-to-face format. I’m sure that the intent was there before, and the pandemic has only hastened the changes.

As of now, we need to find a way to better lay out the expectations and resources so that students will take it upon themselves to immerse themselves in the content. As of right now, it is difficult to get them to read anything assigned in person, much less on a learning platform task list. However, I will say that thanks to the efforts of Justin Barbour (big shout out to Justin!) and the Better Biomed YouTube channel, as well as other online resources, there is some light at the end of the tunnel. I’ve long heard that someone can either be part of the problem or part of the solution. As much as I would rather resist change and dig my heels into the old way, I must adapt and try to make things better for our students and future graduates. Change will happen with or without me.

Since we have a biomedical equipment technology program at two TSTC

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

campuses, Waco and Harlingen, we have been told to appoint a content matter expert (CME) for every class offered. This person is predominantly responsible for the online content for his/her assigned courses. This will help keep the courses consistent across the state.

In the next few years, we will be converting to a performance-based education model. It looks different for every program, so I do not know yet how it will look for us. However, I have been told that every program will be “deconstructed” and each task and area of required knowledge will be broken down.

It sounds a lot like competency-based education, but I am not sure how our version will go. Right now, we don’t know what we don’t know.

On another note, we will be looking for someone to teach medical imaging service (X-ray, CT, etc.) full-time. This person will need to be quite experienced in the field. More than likely, since the pay will be about half of what a field service technician with experience would make, this person would likely be a “pre-tiree” or soon to be retiree. The position will be in Waco, Texas. It will be posted soon at www.tstc.edu. We are hoping this person will be able to start in enough time to start teaching in January 2022 at the beginning of the spring semester.

Roger A Bowels, MS, EDD, CBET, is a BMET instructor at Texas State Technical College (TSTC) Waco and a freelance writer.

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EXPERT ADVICE

ACCESSING DEVICE DATA TO DRIVE EFFICIENT CLINICAL ASSET MANAGEMENT AND BETTER PATIENT CARE

BY TREVOR MCGOVERN

E

very day, in every hospital, a nurse is looking for an infusion pump. It is a universal and ubiquitous experience, one that nurses and staff just workaround to accomplish their mission of providing exceptional patient care. But this common issue is more dangerous than is realized, and it is time for clinical engineering to access the data latent within their connected devices to solve this problem, once and for all.

Delay in care has a cascade effect on many different systems within a healthcare delivery organization (HDO). While the most obvious effect is an adverse patient outcome, many others bring high-stress levels to the HDO system. Suppose a front-line nurse cannot find a needed device to deliver care. In that case, that patient’s room stays occupied longer, and when the radiology department backs up with studies, the delay in imaging stalls the diagnosis. Typically, when a department lacks a needed device, they will take it from somewhere else and shift the shortage to another unit.

Clinical engineering has systems to manage the deployment, updating and repair of valuable connected medical devices. But these systems struggle to keep up with the dynamic nature of both front-line care and the device regulatory agencies. While they may know when a device needs preventative maintenance or learn of a recall that affects a portion of their fleet, they may not know the location of that specific device in the hospital.

However, with better visibility into the

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device data from the wired and wireless network, clinical engineering can know exactly which devices in its fleet they need to maintain or remediate, and it can quickly respond.

While there may be thousands of devices across an HDO, actual utilization metrics are difficult to come by. With better utilization data from the wired and wireless network, clinical engineering can ascertain which devices are being used,

Trevor McGovern Medigate

when they are operational and where they are being “stored.” With many nursing units pre-empting a device shortage by storing them in a closet for use later, the par-level can get out of balance very quickly. Should clinical engineering not find the device when it comes time for preventative maintenance, they can mark it as “lost” in the CMMS, triggering a potential need to replace that device by purchasing or leasing another. Since a

nurse hid the device for later use and is not actually “lost,” it can miss preventative maintenance and fall out of compliance.

When the need arises for a device to be maintained or a recall is issued, it is incumbent on clinical engineering to find the affected devices quickly to take the correct steps. With better location data, clinical engineering can locate the specific devices affected with certainty and remove them from service until the needed work has been completed. Additionally, location data from the network connection can help ensure that par-leveling is maintained for each unit, and stock can be dynamically allocated from units with abundance to those needing more devices to care for their patients.

The data needed to solve this problem exists within the connected devices and the traffic they send across the network.

Clinical engineering needs to deploy additional tools to bring relevant insights from that data to solve these complicated issues for front-line care providers. In the end, a nurse deploys the majority of connected devices in the course of patient care, so the work of ensuring their availability and performance takes on a new layer of importance. It is time for clinical engineering to solve a problem for the front-lines of care that they have been consistently working around, making their lives easier and improving the efficiency of clinical engineering and the HDO overall.

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EXPERT ADVICE

THE OTHER SIDE

Break the Mold for Annual Evaluation

BY JIM FEDELE

T

echnician performance reviews are a necessary part of my job as a manager. I find technicians to be difficult to convince they need to follow the general protocols of talent management and really be active in their development. Frankly, some days I feel like I am beating my head against the wall.

While searching the Internet for ideas (best ways to hide a body, ha!), I found an article that helped me understand what I was doing wrong. Although it is a little dated, I feel the principles are still applicable. The article was written in Fast Company magazine and can be found online at tinyurl.com/3gt8z. It is about author Marcus Buckingham’s philosophy for getting the most out of people and the organization.The article is a “must read” for any manager and his or her boss.

I am a firm believer in empowerment. I believe you tell people what is expected of them, give them the tools they need and then get out of the way. Buckingham’s “five attitude adjustments” essentially, in my opinion, can be boiled down to pure empowerment. However, there are some points he makes that are worthy of discussion here.

My experience working in many different jobs has afforded me some unique opportunities to experience many different levels of employee motivation (including my own). I have gone from from gas station attendant to cable TV technician to consumer electronics retail store service manager all the way to biomed tech turned director. I have seen the same struggles appear in each of these different occupations. A common issue is motivation, specifically engaging employees to give 100

Jim Fedele

UPMC and BioTronics

percent to the company to help it grow and prosper. However, at every place where motivation was a problem, there was a control issue. The manager or owner could not let employees do things the way they wanted to even though they achieved the same result. They got so caught up in the details of the tasks that they ended up squelching productivity by being more of a hindrance than a help.

The more management tried to help, the worse the team performed.

I never was sure of the root issue to this phenomenon until I read this article.

Buckingham’s attitude adjustment No. 2 brought it together for me. He says “Stop trying to change people. Start trying to help them become more of who they already are.” Then, he discusses how one person’s strengths can be maximized while minimizing their weeknesses. He talks about “standardized processes” and “a one-size-fits-all” fallacy. I have experienced many well intentioned “universal” tools that were nearly impossible to apply to our department. Buckingham’s advice is stop trying to fit everyone into the same mold.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

I found this article to be full of common-sense ideals that I have heard expressed by employees during informal gatherings. I was surprised to see Buckingham’s attitude adjustment No. 5 – “Don’t assume that everyone wants your job – or that great people want to be promoted out of what they do best.” He explains that promoting great performers out of what they do best is wrong. And that the paradigm of rewarding these top performers with promotions to new levels does more harm than good.

I know most of my techinicians love what they do. They want to be the best in their field, but most do not have aspirations to be a manager. They choose their profession because the daily work is interesting and challenging. It requires continuous education and commitment.

Should they be forced to move to a different position? I agree with Buckingham when he says no. We should be rewarding them for being masters of their jobs, not moving them out of that role. If a great tech wants to move up into management, he/she can be given the opportunity.

If they don’t want to be managers, that is OK. They can build on their strengths and be awesome in their existing role.

I hope you can take some time to read the Fast Company article (tinyurl. com/3gt8z). I have only touched on a couple of Buckingham’s ideas here. I think you will find it to be a refreshing look at what the future could be in your organization if these attitudes were adopted.

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

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EXPERT ADVICE

SPONSORED CONTENT

OVERWHELMED WITH HOW TO PROTECT YOUR MEDICAL DEVICES FROM CYBER THREATS? Time to Add Some New Tools to Your Toolbox

L

et’s talk about the elephant in the room: there are many people in healthcare technology management (HTM) that don’t know a lot about protecting medical devices from cyber threats. You may be one of them, and that’s OK. However, that’s no excuse for ignoring the very real cybersecurity risk your hospital and its patients are exposed to every day from your medical devices – aka your operational technology (OT). Ignoring the risks won’t lesson them. The good news is that with the right tools, you don’t have to be a

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cyber expert to create and manage an effective OT cybersecurity program.

The FDA also has recently been looking into what constitutes an effective medical device cybersecurity program. In June, the agency published a discussion paper on its website titled “Strengthening Cybersecurity Practices Associated with Servicing of Medical Devices: Challenges and Opportunities.” While the paper was written for discussion purposes only, and was not intended to communicate the

FDA’s proposed (or final) regulatory expectations regarding the cybersecurity of serviced devices, it does signal the FDA is taking more interest in the topic. The FDA wrote, “Entities that service medical devices are well positioned to help identify cyber exploits and vulnerabilities, and to participate in the continued deployment and maintenance of devices. Cybersecurity is a shared responsibility among stakeholders, including OEMs, healthcare establishments, healthcare providers, and independent service organizations (ISOs).”

WWW.1TECHNATION.COM

EXPERT ADVICE It is clear from the points made in the discussion paper that the FDA is seeking to better understand how HTM teams within the hospital (including ISOs) can play a more active role in identifying post-market vulnerabilities and responding efficiently and effectively to them. The paper addresses four key areas: 1. Privileged access – developing solutions to mitigate unauthorized access to medical devices without compromising their safe and effective use.

2. Identification of cybersecurity vulnerabilities and incidents – and sharing them with the OEM, FDA, Information Sharing and Analysis Organizations, and/or the Department of Homeland Security (DHS).

3. Prevention and mitigation of cybersecurity vulnerabilities – through the deployment of OEM-provided and authorized cybersecurity updates and upgrades.

4. Product life cycle challenges and opportunities – related to legacy devices with unsupported operating systems and third-party software.

Even if you’re not an OT cyber expert, anyone with a few years in HTM realizes each of these four areas represents many challenges. For example, how can your HTM organization identify all cybersecurity vulnerabilities and incidents AND prevent and mitigate them? How will you know which of your thousands of networked devices have the latest approved cybersecurity updates/upgrades, and which have unsupported operating systems? If there is a cyber-attack, how will you know what devices are impacted, where they’re located, who supports them and what needs to be done if all you have are their IP

addresses from the IT department? The answer to all these questions is that you can’t without the right tools.

This is why today’s HTM departments must have modern-day computerized maintenance management software (CMMS), such as the Nuvolo Connected Workplace for Healthcare solution.

Integrating Nuvolo with an OT network discovery and monitoring tool allows your organization to quickly identify a cybersecurity vulnerability and incident on your networked medical devices.

Take that functionality even further and add the Nuvolo OT Security solution to your toolbox, and now you can identify in real-time any new devices added to the network, all their required OT Security-related data that is matched with the asset data in the Nuvolo CMMS (including manufacturer/model, equipment type, location, assigned group/technician, maintenance history, etc.), as well as pre-configured response workflows for fast response to cyber threats.

Adding the following tools to your HTM department’s “toolbox” will allow you to easily create and efficiently manage an effective medical device cybersecurity program: • Nuvolo Connected Workplace for Healthcare (CMMS) • Nuvolo OT Security solution • OT network discovery and monitoring software (Nuvolo integrates with all major vendors) Learn more by registering for a free TechNation webinar on 10/13/21 at 2 p.m. ET: “Five Lessons Learned to Implement OT Security.” The webinar also will be available after 10/13/21 on the TechNation website (WebinarWednesday.live).

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o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights.

Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-october-2021. Good luck!

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

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AUGUST WINNER Joe Howe, Manager, Biomed, Lexington Medical Center

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BREAKROOM

BULLETIN BOARD

A

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

Follow MedWrench on twitter @medwrench, facebook.com/medwrench & linkedin.com/company/medwrench!

Career Opportunities CONTINUING EDUCA TION

Visit www.MedWrench.c om/BulletinBoard for m ore details and to register for these upcoming classes .

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Reference the career section: https://www.medwrench.com/bulletin-board/careers

Company: Edge Jobs HTM Biomedical Welcome Title: Position to the future Edge of HTM Biomedical careers! is hiring a BMET II in the Edison NJ Territory Description:

From the leader in providing news and Description: Edge Biomedical is information to the HTM looking community, for a highly TechNation motivated Biomedical is excited toEquipment provide a new Technician industry career BMET for Field Service center; a simple, workstreamlined in the NJ/NY/Philly and effective area .way to We are looking connect qualified forcandidates a person that with enjoys opendifferent jobs and projects help findand yourworking next opportunity. with a nationwide team of Technicians.

The ideal candidate has hands More info: http://bit.ly/htm-jobs on experience with medical equipment repair and calibration.

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

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BREAKROOM

librating! a C n e B w o ll Fo ere whC alibrating! wn oe knB to t n w a o W ll o F s ? Follow u is re Ben Ct. to know whe Wan cebo ok w us a F n o ? Follo Ben C. isre nch, @MedaW ook rench b on F rce @MedcW Twitte ren h,m/ d e M @ nkW edin.cdoW rench! and lite Me wre nch Twit arn@ d e m complinky/ .com/ in d e and h! medwrenc company/

INVESTING TIME INTO CREATING GOOGLE FORMS Justin Barbour, MedWrench guru and Better Biomed, gives his monthly tip on investing time into creating google forms.

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Is Your Security Toolbox Complete?

Today’s HTM teams play an important role in medical device cybersecurity—but to do the job well, you need the right tools.

See how the Nuvolo OT Security solution can help protect your hospital: nuvolo.com/solution/security

Register for the free TechNation webinar “Five Lessons Learned to Implement OT Security” on 10/13/21 at 2:00PM ET https://1technation.com/webinar-calendar/

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LEARN, GROW AND BE INSPIRED.

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

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“Reducing the BMET to Imaging Service Gap”

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WE’LL KEEP YOU CONNECTED.

BREAKROOM

NCBA SCRAPBOOK

T

he North Carolina Biomedical Association (NCBA) held its 43rd symposium at Pinehurst in August with about 200 healthcare technology management (HTM) professionals in attendance. The event included the popular Mike McCoy Golf Tournament and $9,000 in scholarships were awarded. Also, 2020 NCBA President Brian Lefler presented Aaron Watts with the presidential gavel. Codi Nelson said the symposium was a success with positive feedback from attendees who were eager to attend an in-person conference after the 2020 symposium was canceled because of the COVID-19 pandemic. TechNation was on hand to share free copies of the magazine with attendees and hosted a networking event at the Pinehurst Brewing Company.

1. Aaron Watts accepts the presidential gavel from last year’s president (current Ex-Officio) Brian Lefler.

2. Simon Mejia accepts the Norman “Red” Reeves Scholarship from President Aaron Watts and Board Member and Scholarship Coordinator Matt Woods.

3. Association members and vendors gathered for Wednesday’s luncheon and award ceremony.

4. Attendees smile for a picture during lunch.

1

5. NCBA attendees were able to take part in several educational classes offered by leading companies and individuals in the medical equipment industry.

6. TechNation was happy to participate in the door prize giveaways. Pictured are winners of two TechNaiton prize packs, containing gift cards, T-shirts, dopp kits and more..

7. The exhibit hall was filled with many quality vendors, including Rigel Medical and IMT Analytics.

8. In-person events are the best way to network within the industry. The NCBA Symposium was a chance for the TechNation team to meet up with friends from Tri-Imaging Solutions and USOC Medical.

9. TechNation hosted a happy hour at the Pinehurst Brewing Company, where over 50 attendees enjoyed networking with colleagues.

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Biomed Technician III:

Biomedical Equipment Technician

Clinical Engineering Supervisor

In your role as a Banner Health Biomed Technician III, you will work in a faced-paced, and rewarding environment with state-of-the-art technology that directly impacts the patient experience. We provide a robust orientation program to set you up for success. Opportunities for employee development include project and time management, temperament training, leadership academy topics, and vendor-provided technical training.

In 2019, the company will be expanding our services to include in-house repair and refurbishment of medical equipment, namely infusion IV pumps. This will give the hire the unique opportunity to help build a biomed repair department from the ground up. We are looking for individuals who fit our culture of making the customer our number one priority. The Biomedical Equipment Technician performs operational verification, preventive maintenance and corrective repair service, and completes all associated documentation and communication in a timely manner.

The primary role of a TSS is the maintenance of clinical equipment through the effective use of the program. Responsibilities include: equipment repair, equipment calibration, preventive maintenance, supervising and directing team personnel, planning and organizing workload, creating and maintaining open lines of communication, customer satisfaction and responsiveness, financial resourcefulness and personal and team development.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

Biomedical/Electronics Technician I

Biomed Tech II

BMET I

Responsible for the installation, calibration, testing, inspection, inventory assessment, preventive maintenance and repair of biomedical equipment throughout assigned facilities. Trains clinical staff in use of existing and new biomedical equipment and maintains knowledge of trends and upgrades.

DEPARTMENT DESCRIPTION: Plant engineering oversees maintaining a safe environment for staff, patients and visitors through the installation, preventative maintenance and repair of building and grounds infrastructure and equipment.

Performs planned maintenance and electrical safety inspections on a broad range of patient care and selected support equipment in compliance with established standards. Manages all assigned equipment and schedules service. Performs pre-acceptance inspections and develops PM procedures on equipment; maintains files on procedures and manuals.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

Biomedical Technician

Clinical Engineer - Asset Administrator

Biomedical Technician II

The Biomedical Technician I is responsible for testing, evaluating and performing routine repairs on medical equipment. They will accurately document service actions in a digital work order and demonstrate our customer is 1st” culture by taking ownership, doing the right thing and solving their problems.

Southeastern Biomedical is seeking an experienced Biomedical Technician with a strong work ethic who would like to join a growing company. Candidates must have a degree in Biomedical Technology or military equivalent. This position also requires a minimum of one year hospital experience as a biomedical technician. Certification is preferred but not required.

This field service position will be based out of the Raleigh, Durham, Chapel Hill area of NC. The candidate must be willing to travel overnight and be able to work independently as well as part of a team.

VIEW FULL DETAILS www.htmjobs.com

Supports Mayo’s Division of Healthcare Technology Management; Mayo Clinic, METS leadership, Enterprise and Local Equipment Committees and clinical leadership to develop and support lifecycle management plans for medical devices used throughout Mayo Clinic; especially devices that are used in multiple clinical departments and ensures alignment with strategic Mayo goals. Serves as HTM liaison to local and enterprise capital committees, and Supply Chain Management on issues related to capital asset management.

Repair, calibrate, and maintain medical equipment, instrumentation and support systems of moderate complexity used in healthcare delivery. Research and participate in pre-purchase decisions of medical equipment. Knowledge of technical aspects of electronic equipment and its operation, repair and maintenance.

Knowledge of current regulatory requirements. Ability to troubleshoot, analyze, repair and test electronic equipment. Ability to interpret schematics, wiring diagrams and manuals. Follow proper safety practices and procedures while working on electrical equipment.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

SPECIAL REPORT RELEASE

Top 10 Health Technology Hazards for 2021 Prevent dangerous device hazards and improve patient safety DOWNLOAD THE EXECUTIVE BRIEF | ECRI.ORG/2021HAZARDS

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Elite Biomedical Solutions

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www.somatechnology.com • 1-800-438-7662

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Monitors/CRTs

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www.cure-us.com • 775.750.7070

Health Tech Talent Management, Inc.

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USOC Bio-Medical Services

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MRI Innovatus Imaging

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www.HealthTechTM.com • 757-563-0448

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Repair ALCO Sales & Service Co.

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Engineering Services, KCS Inc

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www.ambickford.com • 800-795-3062

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www.radcal.com • 800-423-7169

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

68

Infusion Pump Repair…………………

64

Nuvolo…………………………………

76

AIV……………………………………… 3

Infusystem……………………………

32

Ozark Biomedical……………………

32

ALCO Sales & Service Co.……………

37

Injector Support and Service…………… 4

PD1 Medical…………………………

93

AllParts Medical………………………

45

Innovatus Imaging……………………… 8

Phoenix Data Systems………………

60

Asset Services…………………………

71

Insight HTM…………………………

83

Prescotts………………………………

76

BC Group International, Inc…………

96

International X-Ray Brokers…………

28

Pronk Technologies, Inc. ………… 2, 86

BMES…………………………………

83

Interpower……………………………

95

R&D Batteries…………………………

31

Cadmet………………………………

53

Jet Medical Electronics Inc…………

27

Radcal Corporation……………………

60

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

11

ReNew Biomedical……………………

68

RepairMED……………………………

71

Cure Biomedical………………………

34

Maull Biomedical Training……………

59

SalesMaker Carts……………………

27

ECRI Institute…………………………

82

MedEquip Biomedical………………

73

Soma Technology, Inc………………

21

Medical Equipment Doctor, INC.……

92

Southeastern Biomedical, Inc………

50

Medical Imaging Solutions……………

67

Southwestern Biomedical Electronics.…… 69

53

Elite Biomedical Solutions……………… 6 Engineering Services, KCS Inc………

33

First Health Advisory …………………

87

Medical Technology Management Institute……………………………

FOBI…………………………………

88

Medigate……………………………… 7,85

Health Tech Talent Management, Inc.… 28

MedWrench…………………………

84

Healthmark Industries………………

63

Multimedical Systems………………

73

HTM Jobs………………………… 80-81

MW Imaging…………………………

16

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Stephens International Recruiting Inc.… 37 Summit Imaging………………………

17

Tri-Imaging Solutions…………………

51

TruAsset, LLC…………………………

23

USOC Bio-Medical Services…………… 5 Webinar Wednesday…………………

OCTOBER 2021

TECHNATION

77

93

BREAKROOM

E

ach month, TechNation magazine will feature photos from throughout the industry on this page. Be sure to tag your posts with #HTMStrong and check the magazine each month to see which photos are included and what is happening in the HTM community.

Nana O d Manag om, Clinical E er at C levelan ngineering d Clinic Londo n

Project C.U.R.E.

Bob Grzeskowiak, MW Imaging President and his daughter, Maggie

Biomed interns at Project C.U.R.E. Chicago were really proud of this monito r that they were able to successfully rebuild and test in one day! They enjoy getting hands on exp erience and like that they’re learning so much wh ile also helping send medical equipment all ove r the world (Interns are L to R: Vanessa, Easa, Rafael , and Akhil) MW Imaging President, Bob Grzeskowiak, along with his daughter, Maggie, installed a Phillips Affinity 70 ultrasound for the school’s Diagnostic Medical Sonography department!

Without acc meet tim ess to hospital fa elines, N ana Odo cility and wantin testing o m le g to fm and then edical devices to d the connectivit y further s th e ir midd ending th e data to leware, the EMR .

Diana Bendall, Biomedical Engineering Technologist at NAIT (Northern Alberta Institute of Technology)

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TECHNATION

OCTOBER 2021

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The Cure For Hospital-Grade Power— NEMA 5-15, 5-20, 6-15, & 6-20 Cords!

Interpower® NEMA 5-15, 5-20, 6-15, and 6-20 Hospital-Grade cord sets provide the correct amperages and voltages for medical devices.

The Green Dot NEMA 5-15, 5-20, 6-15, and 6-20 Hospital-Grade plugs and receptacles bear the green dot, signifying the plugs have been rigorously tested to meet the UL 817 Abrupt Removal Test (UL 817, 18.2.4.1) and C22.2 No. 21-14 requirements for Hospital-Grade power cords and cord sets. All Interpower Hospital-Grade cords are tested in design and production phases and ready right out of the box.

Interpower Hospital-Grade molded cords and cord sets are made in Lamoni and Oskaloosa, Iowa, and arrive when and where you need them. In-stock cords ship the Same Day! Interpower provides the end user with the correct connections to the local mains power which reduces production bottlenecks. Order 1 cord or 5,000.

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Value-added options are available such as lengths, colors, packaging, and labeling Same Day Shipping on in-stock products No minimum order requirements Products are 100% tested

Whether 1 cord or 5,000, Interpower provides customized solutions.

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Order Online! www.interpower.com

BC Group Announces Their NEW

ESU-2350 Mid-Range Electrosurgical Analyzer CALL US today for more info!

The ESU-2350 Electrosurgical Unit Analyzer is a high-accuracy, True RMS RF measurement system using DFA technology, designed to be used in the calibration and routine performance verification of Electrosurgical Generators.

It is a midrange unit to compete with other products at this level like the Fluke QA-ES IIITM and Rigel Uni-ThermTM, for those customers who do not require a top-of-the-line ESU-2400 with its higher accuracy, additional loads, advanced automation, pulse mode capability, etc.

• Industry Standard RF Current Measurement • Displays Up to 9 Different Measurement Parameters with User Selectable and Definable Screens • Internal Precision Test Loads From 0 Ω to 5500 Ω in 5 Ω Increments • Power Load Curves with Multiple Power Settings Per Load Setting • User-Definable Testing Sequences • Print test Reports to PDF format

1-314-638-3800 sales@bcgroupintl.com

bcgroupstore.com

ISO 9001:2015 Registered and Certified ISO/IEC 17025:2017 Accredited ISO 13485:2016 Certified

• Automatic or Manual Activation of ESU Generator During Power Load Curve Tests • 100% Compatible with Covidien/ Valleylab ForceTriadTM, FT10TM and LigasureTM Generators, and All Legacy Generators by Other Manufacturers • REM/ARM/CQM Testing Via 500 Ω Adjustable Load in 1 Ω Increments • RF Leakage Current Measurement

SERVICING DEFIBRILLATORS, VITAL SIGN MONITORS, EKG/ECG’S, VENTILATORS, PUMPS, AED’S, & MANY MORE!