ICE Magazine October 2021 by MD Publishing

THEICECOMMUNITY.COM

OCTOBER 2021 | VOLUME 5 | ISSUE 10

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

COMMUNICATION STRATEGIES Benefit Patients, Employees PAGE 30

PRODUCT FOCUS

WOMEN’S HEALTH PAGE 27

In Focus BETH ALLEN PAGE 12

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FEATURES

40 RAD HR

EMOTIONAL INTELLIGENCE

Escaping the Productivity Matrix: Balance or Flow.

Sometimes employees can make a huge impact in their workplace when they learn how to “manage up.”

30 COVER STORY

Patient and employee engagement strategies may vary, but the goals remain the same for many imaging facilities.

OFF THE CLOCK

Chance discovery of musical X-ray film leads to book, documentary and touring exhibition

ICEMAGAZINE | OCTOBER 2021

ADVANCING THE IMAGING PROFESSIONAL

OCTOBER 2021

18 PRODUCT FOCUS

IMAGING NEWS

The latest medical imaging news from around North America.

The women’s health diagnostics market is projected to reach $36.6 billion by 2025.

10 RISING STAR

U.S. Navy Senior Enlisted Advisor at the Nashville Military Entrance Processing Station also serves as a part-time radiologic technologist.

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ICEMAGAZINE

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

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Taylor Powers

Account Executives Jayme McKelvey Megan Cabot

Events

Lisa Lisle

Circulation

Jennifer Godwin

Webinars

Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak ICE Magazine (Vol. 5, Issue #10) October 2021 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2021

ICEMAGAZINE | OCTOBER 2021

CONTENTS SPOTLIGHT

Rising Star Dr. Vaughn Eason, U.S. Navy Senior Enlisted Advisor at the Nashville Military Entrance Processing Station and part-time radiologic technologist

In Focus Beth Allen, director of clinical operations at Banner Imaging in Arizona.

Off the Clock Ribs and Bones: Digging Stacks of X-Ray Wax from out Behind the Iron Curtain

Rad Idea Alan L. Nager, MD, MHA

NEWS

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

ICE Webinars Presenter Asks, “Is 1 Week of Training Enough?”

PRODUCTS

Market Report Women’s Health Market Growth Continues

Product Focus Women’s Health

INSIGHTS

34 36 38 40

Coding/Billing What Category?

PACS/IT Great Follow Up Care Pays Well

Emotional Intelligence Tips For Managing Up

48 50

Diversity Upon Closer Inspection

55 56 58

AMSP Member Profile

Director’s Cut Engagement Reducing TEE Downtime Sponsored by Avante Rad HR Escaping the Productivity Matrix: Balance or Flow

Roman Review Originals ICE Break Index

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

RISING

STAR

DR. VAUGHN EASON

FUN FACTS

Favorite show to binge watch: “Chicago PD”

Favorite vacation spot: Abu Dhabi; the rich culture and architecture is absolutely beautiful. The people are nice and the local food is amazing!

Favorite food/food combination: I was introduced to Kenyan dishes while on assignment overseas. One of my favorite meals is nyama choma with ugali. It is simply grilled meat and cornmeal. It sounds simple, but it is truly a tasty meal.

Any secret skills or talents: I write poetry 10

ICEMAGAZINE | OCTOBER 2021

ADVANCING THE IMAGING PROFESSIONAL

r. Vaughn Eason, 47, started out as a “basic” radiology technician at Naval Hospital Camp Lejeune, North Carolina, where he worked in the operating room, ambulatory care clinics and performed fluoroscopy exams. “When I was promoted to Petty Officer Third Class, I was given the opportunity to work the PM shift,” said Eason. “After a year of working the PM shift, I was selected to work independently on the overnight shift.” After 23 years, Eason is now the U.S. Navy Senior Enlisted Advisor at the Nashville Military Entrance Processing Station, as well as a part-time radiologic technologist. He earned his bachelor’s degree in radiology technology and master’s in healthcare management from Trident University, as well as a doctorate (DBA) in healthcare management and leadership from California Intercontinental University. ICE learned more about this “Rising Star” in a recent interview.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: Prior to joining the Navy, I worked in a photography processing lab for three years. I didn’t see that job having career longevity since photography was moving to digital and photo processing labs were starting to lose business. I wanted a more stable career and wanted to see what life had to offer in other areas of the country, so I decided to join the military. Prior to graduating Hospital Corpsman school, my class was given the opportunity to attend specialized medical training. I selected radiology because I thought it would be similar to photography. In some ways, it is. Capturing the best possible image with as little discomfort to the customer is one of the ways the two are similar.

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Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: Currently, I am the Senior Enlisted Advisor at the Nashville MEPS. My responsibilities include regulatory compliance, personnel management and overseeing the day-to-day operations for processing military service applicants. I enjoy interacting with applicants and staff to ensure we are providing customer service excellence. In my role, I am able to talk to applicants about what to expect and provide first-hand perspective on how to be successful in the military (i.e., financial management, having a positive attitude, resilience, working as a team and accountability). I also work part-time at a local hospital as a radiologic technologist. I enjoy staying active in the field and ensuring I am up-to-date on changes in the profession. I enjoy working with and learning from fellow technologists. I’ve been in the radiology profession for 23 years and still learn new tricks on obtaining images from recently graduated technologists, as well as seasoned technologists.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: Radiology is full of opportunities. You can specialize in an advanced modality like CT or MRI, you can specialize in IT/PACS, or you can become a travel tech. There are leadership opportunities as supervisor, manager or director. I have experienced working in radiology in the theater of war, onboard Navy ships and in traditional medical facilities. Whether military or civilian, each experience is unique and provides opportunities to be creative and work closely with other health care professionals.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?

Dr. Vaughn Eason enjoys staying up to date on changes in the imaging realm.

nologist to clinical coordinator. I was the first radiologic technologist to be assigned to Fleet Surgical Team EIGHT and built their radiology program. However, I would say my greatest accomplishment in the field thus far has been watching former students and sailors I’ve led or mentored succeed in their professional goals. I’ve had staff members that have become commissioned naval officers or have transitioned out of the military and became high level leaders within other organizations. There is no greater feeling than getting that phone call or text message saying thank you for your mentorship.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: I am preparing to retire from active duty military service. My goal is to become a radiology director and stay active in the profession. I am a member of American Healthcare Radiology Administrators (AHRA), American Society of Radiologic Technologists (ASRT) and American College of Healthcare Executives (ACHE). I plan to stay active in all three and want to pursue fellow status in the near future. •

A: I have held many leadership positions in my career from chief tech-

ICEMAGAZINE

SPOTLIGHT

IN FOCUS BETH ALLEN

BY JOHN WALLACE

eth Allen’s health care career took a turn before it even started. It appears she made the correct choice advancing to her current role as the director of clinical operations at Banner Imaging in Arizona.

Beth Allen says she is “lucky” to be in imaging after a suggestion by her high school guidance counselor.

ICEMAGAZINE | OCTOBER 2021

Allen explained in a recent interview. “I had intended to be a nurse but changed my mind my senior year in high school. My guidance counselor suggested that I look into the program offered at one of our local hospitals. I didn’t know much about being an X-ray tech, but I applied and was accepted,” Allen said. “Lucky for me, it all worked out!” “I didn’t really know what I was getting into when I began in radiology, but it is proof to me that things happen for a reason. We need to listen to our gut. I loved doing CT and I love what I do now,” she added. It is a decision that continues to pay dividends with a rewarding career. “I love the creativity that goes into problem solving every day,” Allen said when asked why she loves her job. “I appreciate that I have some influence on how patients receive care.” It is also a career where she gets to impact the next generation of imaging

professionals. She takes the responsibility seriously and strives to help others achieve excellence. “I am a servant leader. I am looking for ways to make our teams’ jobs easier and be available to help solve issues by trying to think about the big picture,” she said. She learned this approach from her mentors. “I have been incredibly lucky to have the mentors that I have had. I have been challenged and encouraged to be brave. I have confidence to trust myself in my decisions, but not afraid to ask for help,” Allen explained. Looking into the future, Allen expects some turbulence for the medical imaging profession. “We will face many challenges regarding staffing and will have to do things differently than we have ever done. We better put our thinking caps on,” Allen said. Away from work, Allen recently celebrated her 23rd wedding anniversary. She and her husband have two adult sons in their early twenties. “I am so proud of my family. I love that our two boys have turned out to be people who we admire and enjoy being with,” Allen said. • Nominate a peer at theicecommunity.com/ nominations.

ADVANCING THE IMAGING PROFESSIONAL

What is something most of your coworkers don’t know about you? I ran a half marathon on a treadmill because it was August in Phoenix and running outside did not seem like an option. Tip: Don’t set a 4-month training goal in April. Who is your mentor? Kara Mayeaux and Jason Theodore What is one thing you do every morning to start your day? I always have breakfast. Best advice you ever received? Move to Arizona from North Dakota. It changed my whole life. I still like North Dakota, though. Who has had the biggest influence on your life? My husband. We are a good team.

BETH ALLEN CRA, RT (R)(CT)

What would your superpower be? To make everyone kind.

Director of Clinical Operations

What are your hobbies? Hiking, fitness, photography, cooking (well, eating really)

What is the last book you read? “Zero Harm: How to Achieve Patient and Workforce Safety in Healthcare” by Carole Stockmeier, Craig Clapper and James Merlino Favorite movie? If I have to pick just one, I think it has to be “Forrest Gump.”

What is your perfect meal? Something grilled with something fresh; a little wine; a little dessert; eaten outside with an incredible view and great company.

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ICEMAGAZINE

SPOTLIGHT

Off Clock THE

RIBS AND BONES: DIGGING STACKS OF X-RAY WAX FROM OUT BEHIND THE IRON CURTAIN BY MATT SKOUFALOS

It was a disc, about the same dimensions as a typical vinyl record, but far flimsier. There were no markings to offer any clue either, save an X-ray image of two arthritic, skeletal hands that dominated its surface. They were ghastly enough to draw the eye, but communicated no identifying information. “The guy whose store it was wasn’t interested at all,” Coates said. “He regarded it as a piece of rubbish in his stall. I bought it for the equivalent of a pound, and brought it back to London and tried to play it.” When Coates slipped the disc onto his record player at home, the speaker proclaimed, “Rock Around the Clock,” at 78 RPM. One mystery was solved, but several more presented themselves. Who made this record? Why did they do it, and how? 14

ICEMAGAZINE | OCTOBER 2021

Thus, Coates’ seven-year journey into the mystery of the musical X-ray film led him into a historical study of the musical bootleggers who cut these peculiar recordings behind the Iron Curtain during the heights of Stalinism. During the Cold War, the supremacy of the Soviet state was reinforced by a cultural clampdown. Any artistic expression that was perceived to undercut its authority – be it jazz, rock ‘n’ roll, rhythm and blues, or tango – was banned. Russian émigrés who fled the country in the aftermath of World War I were regarded as defectors and traitors, and the art that they created was condemned as a creeping poison from the decadent West. Meanwhile, those native Russians who sang in the style known as Gypsy Romance, didn’t need to flee the country to find themselves on the wrong side of the government. “The flamboyance of [Gypsy Romance], the passion of it, was regarded as unhelpful for young Soviets; as conducive to the wrong sort of emotions, the wrong sort of feelings,” Coates said. “Within the Soviet Union, there was also a whole genre, blatanaya pesnya, of which the nearest equivalent would be perhaps early blues – I call it ‘Soviet Soul’ music – songs that were written about real life in the Soviet Union. That was all forbidden, totally.”

PHOTO CREDIT: PAUL HEARTFIELD

n tour in Russia with his band, The Real Tuesday Weld, in 2012, English musician Stephen Coates was killing time in a St. Petersburg flea market when his eyes landed on a curiosity. Coates wasn’t quite sure what it was he was looking at. The youngsters escorting him through the city couldn’t recall having seen its like, either.

STEPHEN COATES Artists who fell out of favor with the state could see their work blacklisted, or find themselves sentenced to hard labor in Gulag. Others who weren’t admitted into the state-controlled music unions that oversaw access to the recording infrastructure within Russia simply never had the opportunity to produce their works. “Everything you produced had to be approved, had to be on-message,” Coates said. Analogous to the black market for illicit drugs, simply possessing forbidden works of art or music wasn’t as great a crime as producing or dealing in it, he said. But simply listening to a forbidden recording in the early 1940s in Russia was a risky enough ADVANCING THE IMAGING PROFESSIONAL

proposition. Any who gathered to play it would have to keep the volume low enough not to draw the attention of the neighbors. By the late 1950s, the mood had shifted enough that provocateurs could balance a portable record player on a balcony window and blast Bill Haley and His Comets to disturb the neighbors without necessarily drawing the ire of the government. “By then it became more of an antisocial issue, a punk issue, rather than being an ideological sympathizer with the capitalist aggressor,” Coates said. “After Stalin’s death, it got easier.” As for how these bootlegs were created in the first place, Coates’ research led him to believe that the process was invented or discovered in Budapest, Hungary. There, amateur engineers who, he describes as “the sort of people who might like CB radio, or love tinkering with electronics in garages,” were experimenting with devices called recording lathes. Recording lathes transfer the signal from an audio source to a secondary, physical material in real-time by vibrating a cutting needle; like a record playback in reverse. As compared with the mass-production technique by which vinyl records are stamped from a metal master, the recording lathe is much slower and more prone to variable results depending upon the media it is fed. In 1930s Eastern Europe, blank records were in short supply, but the Hungarian hobbyists upon whose ingenuity the Soviet bootleg empire was built had plenty of X-ray film. “It was difficult to come by commercial materials, and you’ve got a lot of ingenious people just trying stuff out,” Coates said. “There was a plentiful supply of old X-ray films because everybody was scanned for tuberculosis, and the radiography technicians had to get rid of it because silver nitrate film is flammable; a dangerous thing to keep around.” “When the bootleggers figured out you could record on it, they would show up at the hospital with a few rubles or some vodka,” he said. “It was a natural trade.” These records have been referred to as “bone music,” “bones,” or “ribs,” because WWW.THEICECOMMUNITY.COM

so many of the recordings were pressed onto chest X-rays in the age of diagnostic screening for tuberculosis. Coates has collected these stories in a book called “X-Ray Audio: The Strange Story of Soviet Music on the Bone.” His research has also yielded a long-form BBC documentary, “Roentgenizdat” (note the cognate “roentgen,” the legacy unit of measurement of ionizing radiation, such as is found in an X-ray), a touring exhibition, and the upcoming book, “BONE MUSIC,” a revised and expanded edition of his earlier work. Coates also has also recorded live musical performances to X-ray film to demonstrate the process, featuring prominent artists like Sonic Youth and Massive Attack as well as the philosopher Noam Chomsky. When he exhibits these works, Coates said he’s often approached by medical professionals keen to tell him which parts of the body appear on the X-ray films, or to offer diagnoses of their ailments. “I think there is a poignancy when you discover the story of these records,” he said. “There’s something very intimate about these images of the interior of somebody; they’re often images of pain.” “The combination of that with music which was deeply loved, but forbidden, and secretly enjoyed; there’s something about these things coming together that is quite poignant and poetic,” Coates said. Much has changed since the days when X-ray records were the only way to hear American rock ‘n’ roll in Russia – Coates has since been invited to exhibit the X-Ray Audio Project at the Garage Museum of Contemporary Art in Moscow – and yet hardly anyone younger than 40 or 50 knew of their existence, or of the black market that supported it. “It was unofficial, so there’s not much written record about it,” Coates said. “For all the people who do vaguely remember these, young people didn’t know about it at all. They’ve had a very big blind spot about their Soviet past, because it was seen as shameful, and that’s changing.” •

PHOTO CREDIT: THE X-RAY AUDIO PROJECT

ICEMAGAZINE

SPOTLIGHT

Rad idea BY ALAN L. NAGER

s medical professionals, we are constantly having to adapt and adjust to COVID-19 and the emotions associated with these difficult and challenging times. I believe the poem, “Unsettled While Hopeful,” will lead you to a place of reflection, inspiration, calm and perhaps even optimism to face a different and better world.

UNSETTLED WHILE HOPEFUL By Alan L. Nager

Where is the world I knew, stable I feel resistant and struggle to find

and predictable

a safe and dependable place

ions What happened to routine conversat I strive to understand words and

I engaged in used

messages, even though I feel conf

Who can I turn to with answers to I forge ahead cautiously, being open

the challenges I face to the wisdom of others

iar, I’m losing patience and hope

When will this change become famil

ring willingness may take time

I know reform is occurring, my wave

How can I process and adapt to new

and foreign circumstances late a new beginning

I ponder, alter my path and contemp Why can’t I have the world that was I use knowledge I have to plan my

logical and meaningful

future in a changing world

I crave what was, not what can be… I accept what is, not what was…

Alan L. Nager, MD, MHA, is the director of emergency and transport medicine at Children’s Hospital Los Angeles. He is also a professor of pediatrics at the Keck School of Medicine at the University of Southern California. Nager has lectured extensively worldwide, authored numerous peer-reviewed publications, written and published two children’s books and numerous poems. • Share your RAD IDEA via an email toeditor@mdpublishing.com. 16

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ICEMAGAZINE

NEWS

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

MTMI GLOBAL ADDS TO WORKFORCE, LAUNCHES PARTNERSHIP The Medical Technology Management Institute (MTMI Global) has announced two new appointments to its leadership team. Taylor Danz, director of business development, is a health care management executive with over 20 years’ experience in the health care space and will focus on increasing training options with health care employers. Jill Munce joins the team as executive director of marketing, coming to MTMI after 10 years as a senior marketing leader in the field of continuing education and professional training programs. MTMI also announced a new upskilling partnership with Cleveland Clinic Imaging Institute to provide on-site training in the wake of an increased need for breast ultrasound capacity to better support the new demand for imaging technologists. The program helped

ICEMAGAZINE | OCTOBER 2021

technologists gain eligibility to earn their ARRT certification and registration in breast sonography. It also reduces the overall need for FTEs, while increasing employee job satisfaction, and company value. Access to image training is pertinent as evidence-based medicine becomes more entrenched, fueling demand for advanced and hybrid imaging techniques and upskilling staff. “Our staff at Cleveland Clinic enjoyed working with MTMI and walked away from their dynamic training with an enormous sense of accomplishment,” said Lynn Rudin, clinical manager breast imaging, Cleveland Clinic. “MTMI is a valuable resource to help meet the health needs of our community and we look forward to using them for high-quality training as we continue to combat the pandemic.”

News FUJIFILM AWARDED U.S. NAVY CONTRACT FUJIFILM Medical Systems U.S.A. Inc. has been awarded a 10-year sole source contract for its digital radiography (DR) systems from the U.S. Navy and Defense Logistics Agency (DLA). Under the contract, Fujifilm will outfit U.S. Naval Fleet vessels with the company’s leading edge clinical DR X-ray room systems, featuring next-generation detector technology along with a high-quality compact floor mounted room with all of the latest features. The initial DR system delivery and installation is slated for a new U.S. Navy ship later this year. “Fujifilm is honored to be awarded this significant contract from the U.S. Navy as it speaks to the confidence and level of trust government officials place in our technology and our Fujifilm staff,” said Lou Cavallaro, director, government business sales, FUJIFILM Medical Systems U.S.A. Inc. “This achievement reflects Fujifilm’s ongoing commitment to developing the highest quality, innovative digital radiography technology for every application.” This Sole Source DR Standardization contract was awarded to Fujifilm after a two-year evaluation and comparison with numerous competitive DR technologies.

ADVANCING THE IMAGING PROFESSIONAL

NANOX TO ACQUIRE ZEBRA MEDICAL VISION Zebra Medical Vision, a deep-learning medical imaging analytics company, has entered into an agreement to be acquired by Nanox by a merger transaction in a deal valued at up to $200 million. The deal states that $100 million will be paid upfront and up to an additional $100 million, subject to certain deductions, will be paid upon achievement of certain milestones. “As a result of the acquisition, the medical imaging pioneers will leverage Zebra-Med’s industry-leading team, cutting-edge AI technology and cloud capabilities, and unprecedented regulatory framework to form the next-generation medtech juggernaut,” according to a news release. The agreement puts Zebra-Med on track to expand its mission of diagnosing populations at scale with its AI-based solutions, enabling IDNs and commercial payers to detect and treat patients at risk for chronic conditions while accurately adjusting their covered population risk. In support of broader adoption of AI and reimbursement policies, Zebra-Med has managed to bring value to patients and health care systems by attaining an industry-first CPT code for its AI-based product together with the American College of Radiology (ACR). In addition, Zebra-Med will support Nanox’s

medical device strategy by embedding its AI solutions into its imaging equipment, making medical imaging for diagnosis more easily accessible and affordable across the globe – especially for under-resourced communities – delivered using a scalable cloud infrastructure.

SPINTECH MRI EARNS 510 CLEARANCE The U.S. Food and Drug Administration (FDA) has approved SpinTech Inc.’s latest magnetic resonance imaging software device, STAGE (Strategically Acquired Gradient Echo), a post-processing software platform that enables comprehensive, quantitative brain imaging with enhanced visualization in significantly less time than conventional approaches. STAGE allows MRI technicians to acquire 16 brain imaging contrasts, including 10 enhanced contrast qualitative outputs and 6 quantitative outputs in just 5 minutes on 3T systems. STAGE is cleared for use on both 1.5T and 3T systems across manufacturers and runs on existing equipment. “STAGE’s FDA clearance is a huge breakthrough for SpinTech,” SpinTech CEO Ward Detwiler said. “After years of developing and refining the platform through extensive research use, we are incredibly excited to make this game-changing technology available for clinical use in hospitals and imaging centers.” Aside from its enhanced contrast qualitative outputs, STAGE generates quantitative outputs such as T1 and PD maps, and is the first 510(k) cleared product to provide

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Quantitative Susceptibility Mapping (QSM). Through the company’s extensive research partnerships, they have established powerful clinical use cases across numerous diagnostic areas. When interpreted by a trained physician, STAGE-processed images may provide information useful in determining diagnosis for stroke, dementia, Parkinson’s, multiple sclerosis, tumors and more. Though STAGE is considered a comprehensive brain imaging post-processing solution, its approval does not extend outside of brain uses and should always be used in combination with at least one other conventional MR acquisition technique. The software is currently in use in over 50 hospitals, imaging centers and research facilities around the globe. In response to growing commercial interest, SpinTech is currently raising additional capital to scale their sales and services and bring a pipeline of future products to market.

ICEMAGAZINE

NEWS

STUDY: PORTABLE MRI SYSTEM DEMONSTRATES HIGH ACCURACY FOR DETECTION OF BRAIN HEMORRHAGE Hyperfine Inc. has announced results of a study of the company’s FDA-cleared portable magnetic resonance imaging (MRI) device, Swoop, published in Nature Communications. The study, which was conducted at Yale New Haven Hospital, demonstrated high accuracy for the detection of hemorrhagic stroke. “Rapid determination of stroke etiology is absolutely critical to successful treatment and ensuring optimal clinical outcomes for patients,” said Kevin Sheth, M.D., vice chair, clinical and translational research, departments of neurology and neurosurgery at the Yale School of Medicine, who served as principal investigator of the study. “This study validates Swoop as an accurate method to detect and characterize intracerebral hemorrhage. The results are exciting because Swoop is readily accessible, providing clinicians with an entirely new option for rapid and convenient assessment of patients with brain injury – which will be particularly useful for settings in which CT and MRI are not readily available, such as intensive care units.” American Heart Association (AHA) guidelines for stroke management advise that all patients receive rapid brain imaging on hospital arrival to rule out the presence

ICEMAGAZINE | OCTOBER 2021

of blood, which is contraindicated for thrombolytic (“clot busting”) drugs. Computed tomography (CT) has been the imaging method of choice for diagnosing hemorrhagic stroke, but growing evidence has shown that MRI is as accurate as CT for detecting acute brain hemorrhage, and avoids the radiation exposure associated with CT. As the world’s first FDA-cleared bedside MRI system, Hyperfine’s portable Swoop system is designed to allow physicians to rapidly understand the current state of injury to make life-saving decisions. Within minutes, the technology can acquire critical images via a wireless tablet, powered by a standard wall outlet at the patient’s bedside. Because of Swoop’s portability and magnet design, care teams and loved ones can safely stay by the patient’s side during the scan, reducing patient anxiety and providing a more comfortable experience. In the study, critically ill patients were imaged using conventional neuroimaging, either non-contrast CT or conventional MRI, and the Swoop portable MRI system. A total of 144 Swoop examinations were evaluated. For more information, visit nature.com/articles/s41467-021-25441-6.

ADVANCING THE IMAGING PROFESSIONAL

GE HEALTHCARE ASSISTS RESOURCE-CONSTRAINED IMAGING CENTERS An acute shortage of radiologists and growing demand for imaging scans has put radiology departments under increased strain – and GE Healthcare has developed a next-generation, cloud-based Picture Archive and Communication System (PACS) designed to overcome those barriers. GE Healthcare has introduced Edison True PACS, a diagnostic imaging and workflow solution designed to help enable radiologists – who are experiencing high rates of staff burnout and retirements – to be more efficient and precise, while keeping capital and IT resources under control. Currently, it is available in the U.S., with rollout expected in some other regions starting in 2022. “Radiologists are desperate for the latest tools to most effectively do their jobs. But organizations often lack the financial and IT resources required to access and implement them,” said Girish Muralidharan, senior vice president and general manager, enterprise imaging solutions, GE Healthcare. “With the launch of Edison True PACS, we have taken the first steps to provide cloud-based enterprise imaging solutions that can help transform patient care through accessible, sharable, and secure imaging data while simultaneously improving clinical and operational efficiencies.” Edison True PACS arrives at a critical time in the industry, as health care organizations struggle to keep their enterprise

and departmental solutions current as well as secure, while at the same time remotely accessible. Too often, PACS systems require constant monitoring and patching for security vulnerabilities, as well as OS and application updates; these needs also require periodic and capital-draining hardware upgrades. Further, with AI enabling new productivity and accuracy tools, many organizations lack the IT resources to adopt these changes promptly. Enter Edison True PACS, which provides innovative, AI-enabled decision-making tools that helps enhance reading speed, reduce errors, improve diagnostic precision and enable more confident diagnoses. Plus, as a cloud- hosted or subscription solution, IT budgets and resources aren’t depleted or strained. These advantages make Edison True PACS especially attractive for small imaging centers and community hospitals, removing barriers radiologists and their organizations face in acquiring cutting-edge diagnostic radiology solutions. By leveraging a market leading database and AI-enabled technologies, the solution gives them a timelier and more affordable way to access AI-enabled decision support applications and intelligent workflow automation. For more information, visit gehealthcare.com/withoutwalls.

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NEWS CHANGE HEALTHCARE RELEASES END-TO-END, CLOUD-NATIVE SOLUTION Change Healthcare has introduced Change Healthcare Stratus Imaging PACS, a new, comprehensive cloud software as a service (SaaS) solution for radiology practices, now in beta testing with plans to extend to hospitals in the future. Stratus Imaging PACS is the latest solution to be introduced by Change Healthcare’s rapidly growing cloud imaging business, which includes image archiving, analytics, universal viewers and sharing solutions. Change Healthcare Stratus Imaging PACS is a fully cloud-native Picture Archiving and Communication System (PACS) that will allow radiology practices to build customized workflows and easily adopt new functionality that will provide long-term efficiency benefits. By using cloud-native architecture, practices will be able to eliminate cumbersome upgrades while improving secu-

rity, ROI, and the ability to advance patient care. “We have worked with Change Healthcare for years and are excited to be development partners for their zero-footprint PACS,” said Eric Lacy, director of clinical applications at Central Illinois Radiology Associates (CIRA). “The speed of the viewer and the rich feature set struck me as truly game-changing from the moment I first saw it. I am truly looking forward to what the solution can do for CIRA, our partners, and our patients.” As the next step in this rapid evolution, Change Healthcare is also consolidating all of its cloud-native enterprise imaging solutions under the new category name of Change Healthcare Stratus Imaging. This suite of cloud-native solutions extends the company’s enterprise imaging portfolio.

LEXSA LINEAR PROBE RECEIVES FDA CLEARANCE EchoNous has announced that the U. S. Food and Drug Administration (FDA) has cleared Lexsa, the company’s new 128-channel linear probe, for use in all United States medical practices. Lexsa was designed specifically for the Kosmos platform, the first “hybrid” point-ofcare ultrasound (POCUS) tool – defined as an ultra-portable device capable of producing diagnostic-quality images rivaling those from larger, more expensive cart-based units. Lexsa connects to the Kosmos Bridge proprietary ultra-secure platform as well as Android S6 tablets – with S7 available soon – to produce high-level image quality for nerve, lung, vascular and musculoskeletal ultrasound at the bedside. The Kosmos platform now offers three transducer probes, enabling POCUS 22

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imaging of nearly the entire anatomy wherever needed. “FDA clearance of our Lexsa probe is not only a significant milestone for EchoNous, but a major advancement in ultraportable point-of-care ultrasound technology,” said Kevin Goodwin, CEO of EchoNous. “Lexsa will broaden the application of our Kosmos imaging platform beyond its current focus on cardiology, abdominal, and pulmonology; enabling entry into other departments that require linear capabilities for diagnosis or interventional use. Already favored for its built-in AI guidance and mapping around heart and lung structures, Kosmos will now gain traction as the ideal POCUS tool across multiple health care specialties.”

ADVANCING THE IMAGING PROFESSIONAL

DRX-EVOLUTION PLUS FEATURES ANNOUNCED Carestream Health has enhanced its premium X-ray system, the DRX-Evolution Plus. New features – designed to benefit radiology professionals and patients – help augment workflow and increase patient comfort. “Radiology professionals worldwide capture complex patient diagnostic imaging exams with our powerful DRX-Evolution Plus,” said Jing Chu, worldwide product marketing manager at Carestream. “The latest iteration of this exceptional DR room brings new features to accommodate patients of varying sizes, while performing X-ray exams faster and with ease.” The DRX-Evolution Plus now features a smaller tube head profile with a larger display, helping radiographers conduct exams with greater visibility. An extended tube-column offers greater flexibility and can accommodate sites with high ceilings.

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An upgraded tabletop has more range, making it easier and more comfortable for patients to undergo an exam. Functional LED lighting has been added in several locations – changing colors as a patient exam progresses – enabling radiographers to easily monitor the exam process from patient positioning through image capture. Optional Smart Room features for the enhanced DRX-Evolution Plus include Smart Position, Smart Technique and Smart Collimation to further streamline processes, support radiographer productivity and enhance patient care. Imaging facilities also can add Smart Noise Cancellation, an image processing option of Carestream’s ImageView Software that uses artificial intelligence (AI) technology to help reduce noise in an image. For more information, visit carestream.com.

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NEWS

ICE

A COOL SERIES FOR HOT TOPICS

PRESENTER ASKS, “IS 1 WEEK OF TRAINING ENOUGH?” STAFF REPORT

he recent ICE webinar “Imaging Training: À La Carte Versus Full Course!” was sponsored by Technical Prospects. Technical Prospects Chairman of Engineering/Vice President of Operations Sam Darweesh discussed the role of the modern training academy in building the knowledge of imaging engineers. He also explored the question, “Will attending one-week of training make you an imaging engineer?” Darweesh suggested that a oneweek training session could leave gaps. Those gaps could potentially lead to other issues and problems with a facility’s imaging devices. Among those issues are unrealistic expectations and longer downtime. He suggested that a training academy and immersion learning is a better option for training imaging service engineers. During a question-and-answer session, Darweesh provided additional insights to attendees. One question was, “We have a mixture of imaging equipment. We have new equipment that continues to be added and old equipment that still needs to be 24

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serviced, when we add a new engineer, should we train them on the new equipment or the old equipment?” “That is actually where the immersion learning comes into account,” Darweesh said. “I believe what we are doing today is most effective because we are taking both under consideration. It is not an a la carte. It is not that you have to pick one. Rather, in the training academy, we know that the old equipment are actually workhorses. They are legacy equipment. They are designed to work for 20 years. As we have a new system there, as I explained, they are extremely different in their technology.” He explained that if the new hires are taught the new equipment their troubleshooting techniques will not apply to the old systems. He said that they will not be able to service the older devices. The webinar drew a specific imaging service audience. Attendees highly rated the webinar. The session earned a 4.2 rating on a 5-point scale with 5.0

being the highest possible rating. Attendees provided feedback in a post-webinar survey that included the question, “How will today’s webinar help you improve in your role?” “We will utilize it in day-to-day practice,” Director of Radiology N. Godby said. “Help me be better versed in this technology,” J. Kennelly, a member of imaging leadership, said. For more information about the ICE webinar series, visit ICEwebinars.live. Thank you sponsor!

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“ Help me be better versed in this technology.” – J. Kennelly, imaging leadership

ADVANCING THE IMAGING PROFESSIONAL

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Market Report Women’s Health Market Growth Continues STAFF REPORT

he women’s health diagnostics market is projected to reach $36.6 billion by 2025 from $25 Billion in 2020, at a compound annual growth rate (CAGR) of 7.9%, according to a report from Research and Markets. In the past decade, the demand for various health diagnostic tests has increased significantly across the globe. Currently, the market is mainly driven by growing awareness about various health-related disorders, rising incidence of chronic and lifestyle disorders, and the high prevalence of infectious diseases such as HIV and hepatitis in women across the globe, a news release about the report stated in February. “The increasing adoption of POC diagnostic testing and the growth in the number of diagnostic and imaging centers are also expected to support the growth of this market during the forecast period. However, the high cost of diagnostic devices, tests and procedures; shortage of skilled laboratory technicians; and insufficient reimbursements for diagnostic tests are expected to restrain this market’s growth to a certain extent,” the report said. “Based on application, the women’s health diagnostics market is divided into nine segments – osteoporosis testing, OVC testing, cervical cancer testing, breast cancer testing, pregnancy and fertility testing, prenatal genetic screening and carrier testing, infectious disease testing, STD testing, and ultrasound tests. The breast cancer testing segment accounted for the larger market share in 2019. The large share of this segment can be attributed to the increasing incidence of breast cancer and rising awareness around advanced breast cancer diagnostic techniques, such as ABUS,” according to the report. A Medtech 360 report offers additional insights. Although the U.S. women’s health imaging system market is saturated and unit sales are largely limited to replacement contracts, the growing popularity of emerging breast imaging technologies, such as DBT, will spur modest growth in this market, according to the Medtech 360 report. Mordor Intelligence issued a report on the market with 2021 to 2026 forecast period. “The women’s health diagnostics market is expected to register a CAGR of 7.5% over the forecast period,” it reported. 26

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During the pandemic, limited transportation and travel restrictions created impediments for international trade and transportation, which disrupted the supply chains for the women’s health diagnostics market, temporarily leading to decreased demand due to uncertainty in the capital market and the global economy, Mordor Intelligence said. The unfavorable changes in guidelines and regulations are impeding the growth of this sector. Major regulatory authorities identified that breast cancer patients are at greater risk of COVID-19 infection than healthy adults. Thus, screening, surgical procedures and diagnostic exams are being postponed and severely restricted at hospitals and breast centers. According to an article appearing in the JAMA Network in August 2020, there has been a significant decline in breast cancer diagnoses (by as much as 51.8 percent) in the United States from March 1, 2020, to April 18, 2020. The delay in the diagnosis of breast cancer also impacted the treatment of the same, which is expected to cause disruption in the breast cancer treatment and diagnosis market. “The market will show rapid growth due to the rising incidence of chronic and lifestyle-related disorders, the rising number of imaging and diagnostic centers, and the increased adoption of point-of-care and rapid diagnostic tests,” Mordor Intelligence reported. “The women’s health diagnostics market is growing due to the increasing prevalence of osteoarthritis, ovarian cancer, breast cancer and cervical cancer. Breast cancer is the most commonly occurring cancer in women and the second most common cancer worldwide. There were around 2 million new cases in 2018. The increasing cases resulted in increased sales of test kits for home usage, which is also expected to drive the revenue growth of the market over the forecast period. The rise in the rate of adoption of point-of-care diagnostic testing and an increase in the number of diagnostic and imaging devices worldwide are expected to fuel the market growth. However, the surge in demand for the development of miniature diagnostic devices, a rise in health care infrastructure, and new marketing initiatives by key vendors in emerging countries are expected to provide lucrative opportunities for market expansion during the forecast period.” However, the reports added that the high cost of diagnostic imaging systems and stringent regulatory guidelines are among some of the factors hampering market growth. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus Women’s Health

GE HEALTHCARE

SenoBright HD - Contrast Mammography When a traditional mammogram may not be enough in detecting breast cancer, GE Healthcare’s SenoBright HD (CESM) takes a multi-modality approach to personalized care based on the patient. Performed as a follow-up to an inconclusive mammogram or ultrasound, SenoBright HD highlights areas of unusual blood flow pattern providing high specificity to help reduce false-positives and prevent unnecessary exams. Designed to offer patients and clinicians the highest level of confidence possible, the SenoBright HD can provide the information to assist clinicians in their breast cancer diagnosis in less than seven minutes using the same equipment with the same staff in one convenient setting.

*Disclaimer: Products are listed in no particular order.

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PRODUCTS

SIEMENS HEALTHINEERS

MAMMOMAT Revelation

The MAMMOMAT Revelation mammography platform from Siemens Healthineers is engineered to make a difference in early breast cancer detection, workflow, dose and patient comfort. HD Breast Tomosynthesis offers the widest image acquisition angle available at 50 degrees, resulting in the industry’s highest in-plane resolution for improved separation of overlapping breast tissue, and 3D image-quality, improving diagnostic confidence and aiding in earlier cancer detection. HD Breast Biopsy enables one-click targeting of suspicious areas with a +/- 1mm accuracy. The InSpect integrated specimen imaging tool permits imaging and real-time review of biopsy samples at the technologist workstation to improve biopsy workflow, shorten compression time and reduce patient discomfort. Also, the MAMMOMAT Revelation is the first platform to offer automated breast density measurement during a mammogram for immediate, personalized risk stratification and more personalized care. The system’s new VC20 software includes efficiency improvements, reduced system calibration times, and an accelerated booting time, in addition to accelerated exam times via the 50-degree TomoFlow feature. New biopsy accessories include a spacer plate for easier imaging of smaller-breasted patients.

HOLOGIC

Genius AI Detection Technology Genius AI Detection Technology is a deep learning-based software designed to help radiologists detect subtle potential cancers in breast tomosynthesis images when used with Hologic’s Genius 3D Mammography exam. The use of Genius AI Detection technology resulted in a difference of +9% in observed reader sensitivity for cancer cases. The technology also delivers key metrics at the time of image acquisition to help imaging sites triage patients. Radiologists can categorize and prioritize cases by complexity and expected read time to optimize workflow and expedite patient care. For more information, visit https://www.hologic.com/ hologic-products/breast-health-solutions/genius-aidetection-technology

ICEMAGAZINE | OCTOBER 2021

ADVANCING THE IMAGING PROFESSIONAL

FUJIFILM

ASPIRE Cristalle Fujifilm’s ASPIRE Cristalle combines state-of-the-art, Hexagonal Close Pattern capture technology and intelligent image processing, optimizing dose and contrast based on individual breast composition. Patients can experience a noticeable improvement in comfort with Fujifilm’s patented, flexible comfort paddle, which provides gentle and even compression that is designed to more comfortably adapt to patient curves. The result is gentle dose and fast acquisition of exceptional images for all breast types. Fujifilm’s ASPIRE Cristalle now offers ScreenPoint’s Transpara powered by Fusion AICAD for both 2D and 3D mammography.

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ICEMAGAZINE | OCTOBER 2021

ADVANCING THE IMAGING PROFESSIONAL

COMMUNICATION STRATEGIES Benefit Patients, Employees BY MATT SKOUFALOS

f there ever was a facility purpose-built to cater to the outpatient experience, Banner Health Center Plus at New River Trails in Glendale, Arizona, is it. The 130,000-squarefoot, comprehensive health center boasts 128 exam rooms, with facilities supporting 45 providers working in 11 specialties in what is intended as a one-stop shop for non-acute care. With onsite medical imaging, laboratory services, a pharmacy, pediatric and primary care practices, surgical services and more, the health system has worked to create a single location that can consolidate a variety of typically referral-based services under one roof. At the same time, it’s also created an in-house scheduling and inter-departmental communication system that enables patients to access those services in a single day, instead of through multiple, repeat visits. “We are receiving an overwhelming amount of positive feedback from our patients as well as referring providers regarding the culture of ‘yes.’ We are saying ‘yes’ to our patients by making same day add-on imaging exams, lab and pharmacy pick up possible,” said Michele Robbins, medical imaging manager at Banner. That strategy – of cultivating long-term patient relationships by creating an environment that caters specifically to their needs, feelings and experiences – was carefully cultivated in response to another patient engagement modeling exercise that Banner created; namely, that of “Sofia,” a fictional character composite of the type of patient who would most benefit from the comprehensive convenience of a place like the New River Trails facility. Conceived in conjunction with health care brand strategist firm Worrell, of Minneapolis, Minnesota, “Sofia” was “a persona developed around the ‘sandwich generation,’ who manages the health care of her children and aging loved ones,” Worrell wrote in its case study of the project. WWW.THEICECOMMUNITY.COM

“Sofia has a large job as the health care decision maker in her family: caring for her children, aging parents and in-laws. She balances her broad workload as a caregiver while trying to cater to each generation’s differences. She is notoriously hard on herself and doesn’t always feel like a good mother. She prioritizes the care of other generations over her own. She is short on time and money and needs creative support organizing, anticipating and simplifying her care journey,” the case study reads. In its project notes, Worrell adds the insight that “an increasing number of organizations recognize that health care is becoming a competitive, consumer-focused business. Hospitals and clinics must offer technologies that make care access more convenient and the clinic experience more seamless.” The experience of arriving at a portrait of “Sofia” directly resulted in the patient-centric approach employed at Banner Health Center Plus, as decision-makers within the health system began discussing the mechanics of accommodating her potential need for same-day addon appointments, Robbins said. The solution at which they arrived was Microsoft Teams business communication software, which substitutes chat-based scheduling and communication functions for phone conversations. “It was a decision made around workflow and how to make this seamless,” she said. “You want to be able to set expectations for the patients before they walk in the door. We communicate within our own departments, front to back, but also have multiple team group chats set up with the other specialty groups: peds, OB, ortho; their staff messages my staff, and vice-versa. We’re all communicating on the same platform, leadership and staff.” In addition to creating a mechanism for facility-wide workflow, the secondary impact of establishing this communication network was its effect on staff, Robbins said. Individual departments came to coalesce more firmly around the idea of operating as a unified team of colleagues. In the health care space, where specialists often run the risk of being “siloed” in their individual disciplines, she discovered that more tightly integrating ICEMAGAZINE

their scheduling operations resulted in the dissolution of those invisible barriers that can isolate their work. Instead, she said, now “there’s no idea of ‘them versus us’ ” in the workplace. “You can feel it; it’s palpable,” Robbins said. “I’ve worked in an acute setting for most of my career and it’s not always the case. But at the end

I think it’s also important that we connect with each other on a human level, truly being interested in each other as people, and creating an environment of satisfaction. – MICHELE ROBINS

of the day, they’re all our patients if they’re in this building, and the staff really enjoys that.” “I can see these messages going back and forth with the different departments, and it helps them get to know each other and feel like they’re on the same team,” she said. “In a lot of meetings, we’re talking about process improvement and patient satisfaction. One of the biggest dissatisfiers is being in the dark about wait times. By using Teams, my techs can message them and let them know MRI is running 20 minutes behind, and then the front desk can let patients know when they come in. It’s the little changes in the process that really make a big difference.” Nobody at the facility is solely re32

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sponsible for managing all the incoming and outgoing communication for an entire department, which means that all staffers have the added, secondary duty of effective communication among their primary tasks, making it a shared responsibility facility-wide. That’s improved not only the accommodations made to improve the patient experience, but also the quality of interactions among staff at all levels of the facility. Robbins, who’s spent 23 years in medical imaging, 18 of them in leadership, said the general effect of those changes has been to energize staff to perform to the best of their abilities while also deepening their connection to the workplace, and to each other. “The culture here really is something that’s evolved,” she said. “We learn a lot from each other. Nobody here is more or less important than any other, no matter what their role is. I think it’s also important that we connect with each other on a human level, truly being interested in each other as people, and creating an environment of satisfaction. When we make those connections with our team members, it creates a sense of family; feeling mutual respect and appreciation for each other, no matter what your role is.” “The idea of one team, so that everybody is on the same playing field and appreciates each other’s roles; if we can accomplish that, we’re really accomplishing something great,” Robbins said. “People are more productive, willing to help each other, appreciative, willing to come to work. When our employees are happy, our patients are happy. And that will translate across so many other different areas of our business.” Thus far, that approach has given New Rivers the highest patient satisfaction scores of all 31 Banner imaging sites, according to reports from Medallia, its institutional customer feedback management software platform, Robbins said. Comments have centered on the convenience of seeing physicians and getting imaging studies and lab work completed on the same day, avoiding taking another day off from work. Remarks about the facility’s “short wait time,” “pleasant experience,”

People want to know that you genuinely care and that you’re implementing the changes to make a better workplace – DEVON PERRY

and “friendly employees” have created a positive public conversation that she believes will carry forward as other “Sofias” share their experiences with the health care decision-makers in their families. For facilities that don’t have the resources or external support to profile their own “Sofia,” there are other, lower-cost methods they can leverage to generate patient and employee engagement to deliver improved results. Devon Perry, CEO of Segel Associates, a branding and communication firm in Haddonfield, New Jersey, points out that there’s a lot of fundamental work that can be done in-house before even contracting with a marketing agency. “A lot of people know how to work within social media for personal reasons; it doesn’t mean that defining a target audience and implementing an ad strategy is something you can do, or that it’s the highest and best use of your time,” Perry said. “One of the most important things to do before engaging with an agency is to write a list of things that you need help with. Make that list exhaustive, and categorize your needs.” Once that list of wants and needs is completed, then entities can begin the work of sourcing potential agencies. Perry recommends an approach of total transparency with prospective marketing partners, so that they can be clear on how to best match their services with the needs of the client. ADVANCING THE IMAGING PROFESSIONAL

“The agency doesn’t want to disappoint you, and you certainly don’t want to be disappointed,” she said. “Communicating is so hard. Be as clear as you can be before you start a conversation with an agency. Learn what your options are and make a decision as to whether you want to do all things with one agency, or if you can have the time to find the best agency in PR, social, marketing, because sometimes full-service agencies don’t do a very good job with one of those three categories. It may be better to handle something in-house rather than them underperforming.” When contracting with a new marketing firm or trialing a new engagement strategy, Perry recommends a testing phase so that both parties can learn more about one another and ensure that they’re the best fit for the work to be done. Just as important is establishing a monthly or quarterly touchpoint to ensure that the broad strokes of the plan are being followed. Similarly, she recommends that advertising clients requesting weekly or monthly plain-language performance reports, written free of advertising jargon, to help keep the program on course. For those facilities that may not have the budgets to outsource their engagement strategies to a third-party provider, Perry recommends a handful of simple, inexpensive approaches to increase the visibility of their businesses in their local areas of operation. Even basic social media outreach strategies can help imaging center operators establish a fundamental understanding of their markets and clientele. “You don’t have to put all your eggs in one basket, reaching everybody,” she said. “What you need to do is identify how far a prospective patient is willing to travel to your office, and target people closest to your location. Defining your ZIP code radius, age range and other demographics will help you turn the water in a small pond as opposed to trying to fish in the ocean. One of the most liberating things is that anybody can do it.” It’s also time-consuming, although WWW.THEICECOMMUNITY.COM

not necessarily costly, to study what strategies are being employed by similar facilities in your area, Perry said, noting, “sometimes it’s easier to find out what you are by defining what you are not.” She also reminds decision-makers not to squander the in-house knowledge they already possess. By circulating a simple survey among people who understand the facility, its audience, and others who are “close enough to the brand, but far enough away” to offer perspective, including staffers, their friends, and family, entities can learn more about how they are seen from the outside. There’s also valuable information to be gleaned from reviewing prior marketing and branding efforts to pull out keywords, colors and thematic elements that can provide a useful reference point for moving forward. Perry points out that the same, inward-looking exercise can yield dividends for improving internal communication, as well. She recommends using

“As a physician, the greatest impact I have is the one-on-one.” – HARRIET BOROFSKY

the same opportunity of reconsidering public messaging be leveraged to regard ways in which employers speak to, with and about their workers. “Whatever any one of us produces for the public to consume, we should use the same type of diligence and strategic alignment and care when speaking to our employees,” she said. “Acknowledging the environment and affording staff the opportunity to provide feedback can help. People want to know that you genuinely care and that you’re implementing the changes to make a better workplace,” she added. Finally, whether engaging with

employees or prospective patients, Dr. Harriet Borofsky, medical director of breast imaging and radiologist at Hackensack Meridian Health in Red Bank, New Jersey, suggests recognizing that all communication turns on establishing mutual trust. Sometimes, to connect with patient populations who are harder to reach, that means finding community members who already have the trust of their audiences, and establishing meaningful relationships with them. When Borofsky needed to reach ethnic audiences and communities of color to notify them about breast health and mammography, she forged connections with community and religious groups, women’s groups and even high-school audiences to make inroads. “Affluent, educated women come in [for breast health screenings],” Borofsky said. “We’ve got to reach other women who have some obstacles to coming in. We’ve got to break down some of those barriers and have foundation support for women who are uninsured or underinsured. If you’re worried about putting food on the table for your children, it’s going to seem way less important to have a mammogram.” “If you can get one woman in, and she can bring a friend, women are networkers,” who will spread that positive message. Once she’s gained the attention of her audience, Borofsky said she also designs her messaging to be clear, concise and to address concerns up-front. Given her expertise in breast health, she often speaks on patient risk factors, the value of screening and early detection to better health outcomes, and the variety of treatment options that exist beyond radical surgeries or radiation therapy. And once she has earned the trust of those she’s seeking to reach, Borofsky said it can become a lifelong relationship. “As a physician, the greatest impact I have is the one-on-one,” Borofsky said. “In the office, I am hopefully establishing a relationship of mutual trust that has a follow-up. I really have known some patients for 26 years that are very beloved to me.” • ICEMAGAZINE

INSIGHTS

WHAT CATEGORY? CODING/BILLING By Melody W. Mulaik, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA

hen you hear the word category, especially at this time of year, most people will immediately think of the strength of a hurricane, but this word does have its place in coding. Just because there is a procedure code for a service does not mean that it is accepted and/or reimbursed for all payers. Category I CPT® codes are five-digit numeric codes developed by the American Medical Association (AMA) that identify a procedure or service that is approved by the Food and Drug Administration (FDA), performed by health care professionals nationwide, and clinically proven to be effective. For example, 71045 (Radiologic examination, chest; single view) is a Category I. Most services are submitted with these codes. The American Medical Association (AMA) developed Category III CPT® procedure codes to track the utilization of emerging technologies, services and procedures. Category III codes are 5-digits as well, but the last digit is always a “T.” For example, 0559T (Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure) is a Category III code. These codes are temporary codes that are intended for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration (FDA) approval process. These code descriptions do not establish a service or procedure as safe, effective or applicable to the clinical practice of medicine. Unlike Category I codes, which are released only once a year, Category III codes are released in January and July. I frequently refer to Category III codes as “Pinocchio” code – they want to be real

ICEMAGAZINE | OCTOBER 2021

codes, but they aren’t yet. Sometimes these codes are ultimately granted Category I status. As an example, the “virtual colonoscopy” CT codes (74261-74263) have their origins as Category III codes. In recent years there has been a substantial increase in the number of Category III codes for radiology or radiology-related services. In most cases these codes reflect emerging technologies and create a way to bill for services that previously either were submitted with an unlisted procedure code (e.g., 76498) or not billed at all. Current examples of Category III codes that have been in place for many years include: 0042T (CT Cerebral perfusion), 0075T-0076T (Extracranial vertebral stent placement), 0174T-0175T (CAD for chest X-ray), 0200T-0201T (Sacroplasty), 0234T-0238T (Atherectomy). Newer codes include 0213T-0218T (US guided facet joint injections) and 0559T-0562T (3-D printing) but there are many more that may apply depending upon your organization’s scope of service. There are no assigned Relative Value Units (RVUs) or established payments for Category III codes and they will typically be denied as not medically necessary by Medicare and commercial payers, unless a Local Coverage Decision (LCD) or coverage article specifically extending coverage to a particular Category III code has been published. That said, it may be possible to be reimbursed for certain procedures if medical necessity can be proven to the payer. Each payer has their own requirements to justify medical necessity. Each organization needs to evaluate their volume of Category III procedures and determine if it is worth the time and effort to seek reimbursement from the payers. Melody Mulaik, CRA, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle Coding Strategies. ADVANCING THE IMAGING PROFESSIONAL

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INSIGHTS

ENGAGEMENT E

ngagement is becoming more and more challenging. It is difficult as a leader to come up with creative solutions to keep our teams fired up about the important work they are doing. We have always had similar struggles, but it seems to just be worse.

DIRECTOR’S CUT By Beth Allen

ICEMAGAZINE | OCTOBER 2021

We have patient experience expectations to maintain while still trying to meet budget and volume goals, supply chain challenges and staffing shortages. We are all competing for team members that are not only qualified, but have the attitude, focus and personality that will help us deliver the type of patient experience we would expect. Many employers are pulling out all stops to bring in talent to fill their open seats. It is tempting for any worker to want to explore what opportunities are out there and consider what financial benefits can be gained from a move. Health care is tough. It is really only due to a pandemic that our health care heroes have gotten the recognition that they deserve. Because of this we are not only competing with other health care jobs, but some may choose to leave our industry completely.

If we can find a way to empower our teams to be invested in our success, they hopefully would have no reason to look elsewhere. Banner Imaging created an engagement team made up of folks across all of our centers, with representatives from all job descriptions. Initially, we met in person. We threw out all kinds of ideas that would help our teams get to know each other and become excited about this new Banner Imaging company. It was interesting to hear all the creative ideas and make big plans for the future. Just like everything else, these in-person meetings went away after March 2020. We adapted to TEAMS meetings which just didn’t have quite the same energy, but we still had stellar participation with as many team members showing up as before. It is a little bit more challenging to have as much interaction as in person, but we were still able to be creative. We came up with ideas for each month or holiday. We had door decorating contests, crazy sock days, Banner T-shirt day, scavenger hunts, pot lucks (done in a COVID safe way), ice cream socials (same), chili cook offs, salsa contests, a thank you tree and lots of other ideas. None of them were expensive but it amazed me how ADVANCING THE IMAGING PROFESSIONAL

appreciative our teams were for something to lighten the mood and bring us together. I cannot be prouder of the incredible creativity that works at Banner Imaging. We currently are in the midst of a T-shirt design contest for Rad Tech week and the entries are incredible. All of these fun activities really give us something to look forward to when one day just seems to turn into another. The real engagement comes when we bring each member of our team up to a standard of expectation that they represent our company. “When we talk about engaging the team, it is empowering each and every team member to be bold, share their ideas and leaders listening and understanding that we are only as strong as our team,” said Kara Mayeaux, senior director of operations for Banner Imaging and the leader of our engagement team. Of course, we will also need to be creative in the way we compensate our team members to stay in line with the trend. Salary, benefit packages and other perks obviously will play the biggest part in where our teams choose to work. To be engaged is something that is not demonstrated in your paycheck. The people we work with that are truly invested are the ones that we cannot afford to lose. We currently have a program in place that allows anyone that works within our system to send an electronic MVP to recognize someone who has gone above and beyond in pretty much any capacity. To elevate those that really have stepped up in a way that will affect our entire team in some capacity, there is an MVP+ program that is tied to a monetary reward. This is reviewed and approved by a committee of senior directors, CEOs and vice presidents, so it is impressive to receive. During October, there are many campaigns to encourage women to get their annual mammogram. Some companies offer small pink gifts or trinkets as a reward for completing the test. Because we were unable to see patients for these screening exams last year because of the pandemic it is more important than ever to get these patients in efficiently and identify who will need further testing. I know that our mammographers and support teams work overtime and extra hard to make sure we can find room to “squeeze” in as many patients as we can without causing a disruption to great customer service. I would argue that the small pink gift really has nothing to do with why patients choose anyone to do their mammogram. It is the engagement of the women’s imaging team and the passion for breast health that they exhibit that brings them in to our centers. Amy Peronace, director of women’s imaging for Banner Imaging, has brought her team together to plan for the increase in volume. They have been creative in identifying changes to be made in our schedule that will prepare them to offer more openings. “I am lucky to have a dedicated group of professionals whose priority is patient care. However, they never lose track of being able to recognize and appreciate the hard work and toll that providing this care takes on their staff. I am impressed every day on their commitment to doing the best that they can,” Peronace said. It will take leaders across the country to work together to find solutions to keep people interested in choosing health care for their career. Let me know if you have a good idea! • Beth Allen is the director of clinical operations at Banner Imaging. She may be reached at Beth.Allen@BannerHealth.com. WWW.THEICECOMMUNITY.COM

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REDUCING TEE DOWNTIME

T By Kevin Murphy

ransesophageal Echo (TEE) probes are a vital part of cardiac departments. TEEs allow cardiologist to have a less obstructed view of the heart by placing a transducer on the tip of a flexible scope to be inserted in the esophagus and perform a 2D/3D ultrasonic study. TEEs are much more complex than general imaging probes, as they have a control housing, insertion tube, articulation controls and motors to control the movement of the device and transducer. TEEs also require a higher level of disinfection and electrical leakage and safety testing before each use and can decrease the lifespan of these assets. IAC (Intersocietal Accreditation Commission) requires that each TEE pass electrical leakage and safety testing as well as high-level disinfection (HLD) before each use. The responsibility for these procedures has always raised the question of who is responsible for these procedures. Responsibility has primarily been on the end user at the department level. There

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has been a shift in recent years with facilities have turning those duties over to sterile processing as they have personnel, equipment and procedures in place to handle the disinfection and testing. The move to sterile processing has added handoffs, transportation and procedural difficulties. Typically, the cardiac department would perform the HLD and leakage testing within the department to minimize movement of these fragile assets. In some instances, that process now involves transporting the TEE through the facility where it is handed off to sterile processing. Unfortunately, we have seen the transport take place in pillowcases, storage bins and by hand. Improper transportation can lead to unintended damage to the TEE. We recommend having a procedure in place to document the current disinfection stage in conjunction with a TEE specific storage and transportation container. The process protects both the asset and the employees who handle it. It’s also recommended that the end user perform low-level disinfection (LLD) within the originating department. Performing LLD allows the department to

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inspect the TEE for any damage and perform corrective actions, preventing further damage. Understanding TEEs will help establish the proper cleaning and disinfection protocol and reduce damage. Let’s identify the components of a TEE. 1. Tip – end of the scope with transducer 2. Bending Neck Rubber – flexible rubber that allows for articulation 3. Insertion Tube – black coated tube with depth markers 4. Strain Relief – flexible rubber alleviates strain at the housing 5. Control Housing – contains controls for motor manipulation and articulation 6. Cable – multiple wires inside sheath 7. Connector – physical connection to ultrasound machine When performing leakage testing or HLD soak, the solution should not reach the end of the insertion tube at the strain relief end. Insertion beyond the strain relief can cause catastrophic damage to the internal components. TEEs should never be completely submerged in any liquid. Leakage and safety testing should be completed after LLD and before HLD. Leakage testing ensures the electrical integrity of the device and verifies that the device is safe to use on patients. Testing can be completed with the use of a stand-alone ultrasound leakage tester with pass/fail indications, numerical value of <100µA (IEC 60601) or alternate

value provided by manufacturer. In the event of a leakage failure, test again to confirm. If there is a confirmed failure, remove from solution and perform corrective action. Passing TEEs can proceed to the HLD process recommended by the manufacturer. HLD consists of a timed soak in an approved disinfection solution, followed by a rinse and proper storage. Consult the manufacturer for an approved list of solutions and recommended soak times. Exceeding the recommended soak times may lead to damage of the TEE. The control housing, strain reliefs, cable and connector should be cleaned with an approved cleaning solution. Once HLD is complete, perform a rinse to remove any residue and dry with a clean dry cloth. When possible, store the probe in a TEE specific storage container or vertical hanging storage cabinet. Initiating a standard process and educating all departments involved will reduce cost of ownership, minimize downtime, increase efficiency and allow your department to provide outstanding care to your patients. Kevin Murphy is a senior ultrasound support specialist for Avante Health Solutions. For more information about comprehensive ultrasound solutions from Avante, visit avantehs.com.

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INSIGHTS

ESCAPING THE PRODUCTIVITY MATRIX: BALANCE OR FLOW

s productivity a trigger word for you? Do you feel a slight pinch or huge weight when you think about how to get the most out of each day? Some believe balance is the key. I like the idea of flow.

RAD HR By Kiahnna Patton

ICEMAGAZINE | OCTOBER 2021

Balance is “a state in which different things occur in equal or proper amounts or have an equal or proper amount of importance.” It tends to feel pretty regimented, and everything is assigned a similar weight. Flow, on the other hand, is described as “moving smoothly and continuously.” It feels more flexible and opens space for continuous change depending on the tasks. How do you feel when you reach your flow? Energized, excited, ready for more, ready to win!? How do you feel when you achieve balance? Done!? What does the effort look and feel like to get to each? Balance – attempts to establish order may lead to constant re-working, feeling limited, stress, etc. Flow – may leave you feeling like you can do your best, taking the time you need to accomplish what you want, etc. Whether balance or flow, what are we attempting to have? You probably aspire to have it all and be as productive as possible, whatever that means for us individually.

With that in mind, if you have a 7 a.m.-10 p.m. schedule (or 15 waking hours on each weekday), how do you approach those days? Getting caught up in the productivity matrix, being still and thinking, or falling into that deep, uninterrupted, restful sleep every parent imagines? You have to incorporate a paying gig, volunteer efforts, extracurriculars, raising children, starting a business, going to school and, of course, exercise and sleep into your day. With balance, you may attempt to regiment your day and feel compelled to use every minute to accomplish your checklist. In the strictest sense, you dedicate 8.5 hours to work and 8.5 hours to personal tasks and interests. With flow, you may decide to spend 4 hours toward work on one day and 12 hours another day, depending on the demands of your personal life and work life. Flow is not a new concept; however, the idea of balance has been so ingrained in our work-speak and culture that some folks schedule their lives into complete failure, the productivity matrix. They have a list for this, a list for that. A time for this, a time for that. I’m guilty of it myself and have been on a path to recovery. A sliver of empty time on my calendar? Amplify my efforts and fill it with a to-do that still needs ADVANCING THE IMAGING PROFESSIONAL

Kiahnna D. Patton is senior human resources business partner at Children’s

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time! In the end, I walked away feeling like I failed because I didn’t manage to balance everything. Maybe it’s a matter of changing my paradigm and not viewing it as a failure but as progress. Or, I need to think again, as Adam Grant encourages in his book “Think Again: The Power of Knowing What You Don’t Know.” He writes, “When we dedicate ourselves to a plan and it isn’t going as we hoped, our first instinct isn’t usually to rethink it. Instead, we tend to double down and sink more resources in the plan. This pattern is called escalation of commitment.” Let go of balance and go with the flow. Women are often congratulated for being superheroes and asked how they do it all. Surely no one spends equal amounts of time on each activity or area of life, which the concept of balance will dupe you into attempting. How exhausting does that even sound when you read it out loud? And, I say that from the perspective of being a neurotypical person. I contend that these women and others who have “fifty ‘leven” (reference the Urban Dictionary website if you’re a little lost on that reference) things on their plates find a flow, a space where effectiveness is a higher priority than equally distributed time. How can you create flow? Here are a few ideas: • Think about how your work-life intertwines with your personal life, and incorporate those things into your day. • Schedule meetings at times when you’re apt to be engaged. For you, it may be morning hours. • Be flexible and incorporate some play into your day. • Most of all, free your mind and focus on your wellbeing. • And for goodness’ sake, buy a robot vacuum if you have the means. Increased my effectiveness by 1000%. Of course, I’m exaggerating, but much less of my brain space is stolen by scheduling and rescheduling time to vacuum to erase the signs that a toddler has left his mark in every room. For a perspective on flow in action, I spoke with Christopher Lee, Georgia State University MBA candidate and leader at the largest golf retailer in the U.S. “I would say time management and organization go hand-inhand. Having a productive life doesn’t mean splitting up tasks and responsibilities evenly every day. If you have work, school, a side business, health goals, and family responsibilities, they all can’t get 20% of your time every day. Some days areas get 40% of your time or more, while some areas will get 10% or less time on that day. Just like Franklin-Covey, I’ve found that one of the most viable ways to have real flow as it relates to time management is to prioritize the tasks at hand, give letter grades to each task (A being the highest), and complete the highest priority items first. For example, if you have 10 tasks and 3 are A’s, knocking those off the list will reduce a lot of the stress and anxiety you have related to your list. The lower letter items usually could be done immediately but their low importance relegates them to be completed later.” Creating life flow may help you to feel a little less pressure to enter the matrix, or a little more incentive to avoid it. Whichever paradigm you choose, flow with it.

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GREAT FOLLOW UP CARE PAYS WELL PACS/IT/AI By Mark Watts

ICEMAGAZINE | OCTOBER 2021

e should change the medical imaging conversation from reactive to proactive.

If lung cancer is detected and treated before it grows to more than one centimeter, it is 90 percent curable. If the tumor has grown to more that 2 cm, it is 10 percent curable. If an abdominal aortic aneurysm is found early and referred for treatment, it is 90 percent survivable. If it ruptures without intervention, the patient survival rate drops to less than 4 percent. If a radiologist sees something (incidental findings), they should say something and follow up. Adhering to the radiologist follow-up recommendations is a long-standing problem that impacts outcomes, liabilities and revenue. Unfortunately, less than 40% of the referring providers adhere to the radiologist recommendations around incidental findings. Lapses in communication were cited as the primary factor causing low adherence rates.

Alert: Missed recommendations and follow-ups are responsible for one out of three malpractice claims. As well as billions in unnecessary services and substantial missed hospital revenue There is clear evidence that by tracking, communicating and closing the loop on follow-ups, radiology departments can significantly improve outcomes, liability and revenue. In fact, several studies have been published regarding such follow-up tracking A team at Penn State Milton Medical Center has developed a program that closes the gaps and follows up on incidental findings for emergency department patients. Participants in the program receive a letter and a phone call about their incidental findings and were encouraged to follow up with the primary care provider. This program not only improved intent to schedule follow-up visits with the PCPs by 21% but also improved patient satisfaction. At the University of Rochester Medical Center, tracking and communicating follow-up improved completion rates by as ADVANCING THE IMAGING PROFESSIONAL

much as 29% and increased the volume of high reimbursable exams (such as CT and MRI) by up to 15% in the first 13 months. They tracked 589 recommendations – 86% of which were satisfactorily closed – through the program. It reduced the risk of delayed diagnosis by 74% and early diagnosis leads to improved patient care and better outcomes. It can even result in lower cost of care. Others have conducted a study on the impact of direct committee patient communication on the follow-up adherence of patients with unscheduled follow-ups. They were contacted as their follow-up care came due and we’re encouraged to speak to their referring physicians about the findings of the study showed. The follow-up compliance rate for patients that received a reminder message improved by 49% relative to the control group. Given the lack of historical tracking of follow-ups and recent studies showing the positive benefits of follow-up tracking, the American College of Radiology has recently proposed nine new quality measures regarding follow-ups in radiology. These measures are still in the works as they undergo commenting, scrutiny and testing. • A measure proposed by the ACR is to close the loop on the completion of follow-up recommendations with actionable incidental findings. This measure aims to increase the number of patients with actionable non-emergent findings receiving radiological recommendations for a follow up. It tracks the percentage of patients who receive follow-up imaging within the recommended time interval. • Closing the loop on the completion of follow-up recommendations with actionable incidental findings for abdominal aortic aneurysm. This measure aims to increase the number of patients receiving a follow-up for abdominal aortic aneurysm imaging findings. Specifically, it intends to improve the odds of early detection. • Closing the loop on the completion of a follow-up recommendation for actionable incidental findings on WWW.THEICECOMMUNITY.COM

pulmonary nodules. The goal is to also increase the percentage of patients with a single 6-millimeter pulmonary nodule finding who received follow-up imaging within the recommended time interval. • Specificity of the follow-up imaging recommendations for the actionable incidental findings. This measure aims to ensure that recommendations that are given contain key pieces of information such as the locations of the findings, modality and timeframe associated with the follow up. This measure

We can transform the practice of radiology by changing the medical imaging conversation from reactive to proactive and communicating findings.

tracks the percentage of reports with recommended follow-ups that contain these key pieces of information. • Evidence documentation in follow-up imaging recommendations for actionable incidental finds. This measure aims to ensure that the radiologists include the source of evidence-based guidelines supporting the recommendations. It looks at the percentage of all final reports with a recommendation for follow-up imaging that include evidence-based guidelines in the interpretation or conclusion section. • Communication to the practice managing ongoing care. This measure aims to ensure that there is communication between radiologists and physicians managing follow-up care. It tracks the percentage of reports containing

recommendations that provide documentation of direct communication to the referring physician or the patient’s care team within five business days of the exam interpretation. • Communication of the actionable incidental findings to the patient. This measure seeks to ensure that patients are made aware of incidental findings and documentation of the communication taking place within 30 days of the findings. • Tracking and reminder systems for incidental findings. The goal is to ensure that a tracking system is in place to remind patients of incidental findings and track follow-up completion. It measures the number of reports that contain recommendations for which information was entered into a tracking system. • Patient’s cancer detection rate with follow-up imaging (surveillance measure). The intent of this measure is to track and document cancer rates based on follow-up imaging recommendation. This tracks the percentage of patients with imaging recommendations that lead to a diagnosis of cancer. The expectation of this new quality measure is to try better tracking of recommendations, follow-up completion rates, communication and, ultimately, outcomes. The next logical question is how these measures can be implemented into a practice. The ACR is currently seeking and working with alpha sites to test the proposed measures. The major roadblocks for implementation are the additional time, resources, money and specialized digital health knowledge required to implement these measures. For these reasons, various practices (including academic, corporate, governmental and private practice) may have difficulty implementing some or all these measures. We can transform the practice of radiology by changing the medical imaging conversation from reactive to proactive and communicating findings. • Mark Watts is the enterprise imaging director at Foundation Hills Medical Center.

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INSIGHTS

TIPS FOR MANAGING UP EMOTIONAL INTELLIGENCE By Daniel Bobinski

f you’ve ever read about why people quit their jobs, you know it rarely has to do with pay and almost always has to do with having a bad boss. If I’m doing a workshop and ask for a show of hands for how many people have been mismanaged, invariably, almost every hand goes up. This means the problem is fairly universal, but quitting doesn’t have to be the only option. Sometimes you can make a huge impact in your workplace if you learn how to manage up. Definitions vary, but I describe managing up as creating an environment in which your supervisor or boss is comfortable taking action based on your input. That said, to be successful at it, one must know and apply emotional intelligence. In fact, being able to manage up is one of the great benefits that comes from learning emotional intelligence. Consider Rick, a nurse practitioner on the West Coast. Rick has observed that his supervising doctor is more concerned

ICEMAGAZINE | OCTOBER 2021

about people liking him than he is about following company policy. The doctor makes exceptions to rules whenever someone asks him to. This has happened so much that some of Rick’s peers and other employees are now taking advantage of the doctor’s kindness, and adherence to policy has pretty much gone out the window. Can those requests be accommodated? “Yes,” Rick says, “but managing all the work-arounds steals energy that we should be using to take care of patients. Those policies are in place for a reason, and it places a burden on management when we are constantly making exceptions.” Rick refers to this trend in his workplace as sloppy management, and he fears it will lead to patients not getting proper care. Or, worse yet, it will lead to an overall relaxed attitude toward policies that could create serious mistakes.

TAKE NOTE OF WHAT YOU OBSERVE As I mentioned, managing up is much easier if one understands emotional intelADVANCING THE IMAGING PROFESSIONAL

ligence. One of the first steps is take note of what you observe. Is your boss a mover and shaker or a deliberate rule follower? Is he or she a talkative people person or more reserved and analytical? This is a powerful starting point, because if your boss has a style that is significantly different from yours, you will need to learn how to adapt. The above observations have to do with behavior, and if you become a student of the DISC language, you can become adept at identifying behavioral styles and their tendencies. DISC stands for Dominant, Influencing, Steady, and Conscientious, and learning the language is a good first step in learning emotional intelligence. Another thing to observe is motivators. This, too, requires study, but learning what drives a person allows you to understand what they want. Rick studied motivators and realized that his boss had a “collaborative” internal driver. This meant Rick’s boss preferred to be supporting the team rather than leading it. With this knowledge, Rick connected with his boss on a fundamental level when talking about policy enforcement and helped him see the larger picture – and how making exceptions about policies was actually placing a burden on the rest of the team.

SUPPORT THEM WHERE THEY’RE WEAK Anyone following this column for any length of time knows that every strength has a corresponding weakness. For example, people who make fast decisions bring a great strength to the team, but the corresponding weakness is they can overlook key details and make an ineffective decision. Conversely, people who analyze everything to make the best possible decision also bring a strength to the team, but the downside for them is they can get stuck in analysis paralysis. You can “manage up” if you recognize the strengths and weaknesses of your boss and come alongside to help in his or her areas of weakness.

UNDERSTAND YOUR BOSS’S PRIORITIES When you understand your boss’s goals and objectives you can decide which information is best to share during meetings or when having face-to-face conversations. Sharing information that is of little importance to his or her goals tends to build walls instead of a WWW.THEICECOMMUNITY.COM

bridge. If you want your boss’s attention and an ability to influence his or her decisions, you need bridges, not barriers.

ASK QUESTIONS THAT MOVE THINGS FORWARD Unless one is analyzing for what went wrong to determine how to do things differently in the future, discussing the past or trivial matters has little innate value. Rick tells the story of a coworker assigned to conduct an icebreaker for a regional meeting, and her discussion about the best toppings for an ice cream sundae went on for more than 15 minutes. Rick’s boss wasn’t doing anything to reel in the conversation, and the subject of ice cream toppings didn’t appear to have an end in sight. Wanting to help his boss get things back on track, Rick said, “I now have a cool catalog of ideas for ice cream sundaes. I’m curious though, can we find a way to segue this into the purpose of our meeting?” Rick was sure to keep a smile on his face and some joviality in his voice, but he helped his boss by helping get things back on track. The idea behind managing up is to create a mutual benefit. Think of it this way. You want to get a win, but you also want your boss to win. As outlined in Stephen Covey’s best-selling book, “The Seven Habits of Highly Effective People,” the habit of win-win thinking involves creating a mental framework with two components. First, have the consideration to seek the other person’s point of view – in this case, your boss. Second component is having the courage to stand up for your own point of view. This second component requires tact and timing, not brashness. By thinking win-win and coming alongside to help, we can assist our bosses in being more effective and not letting their weaknesses get the best of them. Such are some of the mechanics of managing up. • Daniel Bobinski, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him on his office phone, 208-375-7606, or through his website, www. MyWorkplaceExcellence.com.

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INSIGHTS

DIVERSITY UPON CLOSER INSPECTION

VERLON E. SALLEY VP of Community Health Equity at UAB Health System

here is a movement going on in our society that requires all of us to take a closer internal look at the makeup of our respected organizations. The word organization can be defined as an organized body of people with a particular purpose, especially a business, society, association, etc. Therefore, the closer look that may be required by our consciousness should be towards the demographics of the people within our organization. More specifically, our staffs. Can you say your staff represents the population it serves? You cannot unless you have performed the research. Find the ZIP codes of your primary market area. A simple demographic Google search of those ZIP codes can give you the gender, age ranges and racial profiles of your primary market area. Next, compare that to the demographic makeup of your staff. Why is this exercise even worth the undertaking? Because research has shown that patients respond positive and have more trust when cared for by caregivers that look like them. Your staff, at a minimum, would at least have to reflect the community it serves to achieve this goal. Think I am overreaching? Then consider this … U.S. News & World Report released an article on July 27, 2021, entitled, “U.S. hospitals struggle to reduce health disparities: Minority patients underrepresented in 4 of 5 hospitals.” The article stated that the representation of nonwhite patients at the top three ranked hospitals in 2021 were all “lower than the community.” Point is, if

ICEMAGAZINE | OCTOBER 2021

you are going to adhere to the movement within our society you at least must reflect the community you serve within the ranks of your staff. I am a Black man that has been at every level of management within radiology (manager, director, executive director, etc.). Throughout my career, I have always seen myself demographically, as one of few. I also felt that the patient care amongst my staff and departments was better, because I gave labor opportunities to all demographics which in turn provided a more comprehensive patient experience. Allow me to give you an example. The demographics of the city of my employer’s primary market area is as followed: 65+% Black, 25+% White, 52% female, and the median age of females is 38. I thought was wise to ensure our mammography department gave opportunities to the most qualified minority candidates that presented. It did not mean we only hired Black people, but I was equitable with our hiring choices. The patient satisfaction scores from this department are amongst the best in our health system and it is not a coincidence that the staff is diverse. Providing labor opportunities for diversity should not stop at ethnic diversity. Ensuring opportunities for disabled persons, veterans and women should be among the things we look at in our departments as well. Now, more than ever, we have a responsibility to provide opportunities in our labor ranks as well as a better patient experience to our communities. • – Verlon E. Salley is the vice president of community health equity at UAB Health System. ADVANCING THE IMAGING PROFESSIONAL

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ORIGINALS THE ROMAN REVIEW BY MANNY ROMAN, CRES

ICEMAGAZINE | OCTOBER 2021

n the January issue of this wonderful publication, I discussed why procrastination is a good thing. I said, “I have convinced myself that I work better under the pressure of expiring time constraints. My focus is sharper and clearer.” I delight when I find confirming scientific evidence that it is good to procrastinate. On Ted. com, Organizational Psychologist Adam Grant provides me with this confirming testimony with his presentation titled “The Surprising Habits of Original Thinkers.” The presentation discusses common traits of what he calls “Originals.” Originals are procrastinators and nonconformists. He states that originals share three common traits.

Originals are moderate procrastinators. While others might get right to work on a task, originals work in the sweet spot between getting right to it and waiting until the last possible minute. Moderate procrastinators are 16% more creative than those at either end of the curve. Procrastination allows the mind to incubate the task while new, nonlinear ideas and creativity are explored. While procrastination may be a vice to productivity, it is a virtue for creativity. Playwright Aaron Sorkin states, “You call it procrastination. I call it thinking.” Originals know that it is easier to improve on ideas than to start from scratch. There is no need to be first, just be different and better. I am sure that you can name quite a few organizations that became successful by improving the products and ideas of others.

ONE: ORIGINALS ARE LATE TO THE PARTY.

TWO: ORIGINALS FEEL DOUBT AND FEAR.

Grant also highlights that originals are quick to start, but slow to finish.

He also points out that originals experience the same doubts and fears as ADVANCING THE IMAGING PROFESSIONAL

others. They know that self-doubt is paralyzing while idea doubt is energizing. They realize that the first drafts will be inadequate and that they are just not finished yet. They know that in the long run, our greatest regrets are not our actions. They are our inactions, the chances not taken, the missed opportunities. Originals doubt the default and look for better options. According to Grant, the web browser you choose is indicative of your performance. Firefox and Chrome users significantly outperform Safari and Internet Explorer users. They also stay on their jobs 15% longer. These people are those who doubt the default, preinstalled browser and search for better options. I admit that I use the Apple commanded browser. So, the important takeaway is that originals look at things they have seen many times and look for improvements. When you feel doubt, don’t let it go. Embrace it.

THREE: ORIGINALS HAVE LOTS OF BAD IDEAS. They realize that they will not be judged on their bad ideas. They will be judged on their good, successful ideas. The chances of a good outcome from many ideas is better than a good outcome from only one idea. The Wright brothers, Thomas Edison, Nikola Tesla and the other numerous originals who built America and the world had many bad ideas. Songwriters compose many, many songs to find a few golden nuggets. The point is to continue producing, improving and creating ideas – even bad ones. With all that said, I come away with a couple of personal observations. I am a procrastinator for sure. However, I do not live in the sweet spot of creativity. I am controlled by the Instant Gratification Monkey until the deadline Panic Monster appears. (See the January issue) I do not generate many original ideas, however I do love to say, “It seemed like a good idea at the time.” I suppose that does not count. •

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Imaging Jobs

NOW AVAILABLE htmjobs.com

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ompanies like ours have such a difficult C time finding qualified candidates for field service roles that it just made sense to publish our opening with HTMJobs. – K. White, HR/Compliance Manager

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LOOKING TO FILL A POSITION? Visit htmjobs.com/start-posting/ to post a job. Companies that post with us:

Medical Imaging Solutions, Tri-Imaging Solutions, American Medical Imaging, Agiliti, Banner Health, Crothall Healthcare, Samaritan Health Services, Alpha Source Group, Draeger

Imaging Field Service Engineer III

Field service on medical equipment, installation of x-ray equipment, Diagnostic Imaging field service engineer servicing multi-vendor/multi-modality equipment in hospital and other environments. Focusing on c-arms, Digital R/F, Digital Mobiles, x-ray systems and digital capture DR and CR modalities. Growth opportunities to include CT, MRI, Ultrasound and others. Position advancement possibilities will be available when appropriate.

CT Special Imaging Tech

Performs high-quality computerized axial tomography procedures within the scope of state licensure at a technical and professional level that does not require direct supervision. Performs appropriate patient evaluation and uses proper technical factors for diagnostic image production.

Field Customer Service Technician The Field Customer Service Technician will be required to travel to customer sites to test and evaluate medical equipment. A majority of your time will be spent on your feet navigating the customer’s facility. This position requires strong customer service skills to negotiate and work with hospital staff to locate devices and perform preventative maintenance on the products. Medical device experience and electronics familiarity is preferred, but not required, we will provide training on maintenance and repairs of the devices. You must be willing to travel anywhere within the United States for 2-6 weeks continuously, including weekends.

Diagnostic Imaging Equipment Services Engineer II

Senior Field Service Technician, Medical Device

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. Teamwork is key in this department and you will be empowered to utilize resources and collaborate to ensure consistent service delivery. Some travel may be required depending on the facilities you support. Future career growth includes opportunities in medical imaging, planning, security, integration and quality areas. In addition, tuition reimbursement and tuition discounts are available for continuing education costs.

In this role you will provide field services to all Vyaire respiratory customers in a timely manner, including, but not limited to, installations, training, in-servicing, repair, preventative maintenance, calibration and sales support. Maintain an organized, proactive system of territory management, utilizing current management reports and data provided. Demonstrate the ability to develop contingency and effective support plans for most situations. Continually evaluate and implement efficiency improvements in territory operation. Responsible for promoting and maintaining high customer satisfaction levels and consistently achieving results across all key areas of the business with little supervision or direction. Focused on growing the business, treating every service event as a growth or lead generation opportunity. Maintain a positive attitude and demeanor, embracing change and influencing peers and team to do the same. Join our team as we as we drive innovation and work together on our mission to save and sustain lives around the world and become the world leader in respiratory care.

Imaging Specialist I, II, or III

Imaging Service Engineer

ADM-Radiology

Our team of professionals communicates with you to clearly and effectively address your health care in the most appropriate setting: whether that is a clinic, a hospital or at home. Our 32,000 employees, including home care experts, our hospital teams and more than 1,100 doctors and specialists, focus on your care, your concerns and your health. We are constantly looking for better ways to work together to improve the way health care is delivered.

The Imaging Service Engineer repairs and maintains imaging related medical equipment. The Imaging Service Engineer performs project management duties. Proactively contributes to Eskenazi’s mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi values of Professionalism, Respect, Innovation, Development and Excellence

Assists the department manager in monitoring the operation and productivity of imaging services. Assists the department manager in the management and supervision of department personnel. Provides technical support for the effective and efficient delivery of imaging services under the supervision of the department manager and attending radiologist.

Imaging Field Service Engineer II (X-Ray)

The Field Service Engineer is responsible for maintaining the customer’s high‐end medical imaging equipment, including systems applications, quality control, calibration, operating system support, applications support, software support, technical support, and troubleshooting. This position will be part of an onsite team and cover general imaging.

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