ICE Magazine December 2021 by MD Publishing

DECEMBER 2021 | VOLUME 5 | ISSUE 12

THEICECOMMUNITY.COM

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

CLOSING THE BOOKS ON

2021 WHAT HAPPENED, WHAT DIDN’T & WHAT’S NEXT PAGE 32

PRODUCT FOCUS CONTRAST INJECTORS PAGE 25

IN FOCUS TRACI FOSTER PAGE 12

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FEATURES

EMOTIONAL INTELLIGENCE

COMPANY SHOWCASE

Injector Support and Service (ISS) hires best-in-class employees which results in providing unmatched injector service, technical support, parts and training.

The first hour of work sets the tone for the day.

COVER STORY

As difficult as 2020 was for health care workers amid the COVID-19 pandemic, the year that followed was, in many respects, even harder.

OFF THE CLOCK

Mary Dickinson leads fundraising efforts that help support the breast cancer fund at Banner Health.

ICEMAGAZINE | DECEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

DECEMBER 2021

18 PRODUCT FOCUS

A look at some of the leading contrast injectors.

IMAGING NEWS

The latest medical imaging news from around North America.

10 RISING STAR

Jill Jones, RT (R) (CT), is a site manager at Banner Imaging in Gilbert, Arizona who decided to pursue a career in X-ray after a pretty bad bicycle accident.

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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

CONTENTS SPOTLIGHT

Rising Star Jill Jones, RT(R)(CT)

In Focus Traci Foster, CRA, MSRA, RT(R)

Rad Idea Dealing with Insomnia

Off the Clock Mary Dickinson

NEWS

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

Account Executives Jayme McKelvey Megan Cabot

Events

Kristin Leavoy

Webinars

Jennifer Godwin

PRODUCTS

Market Report Contrast Injector Market Growth Expected

Product Focus Contrast Injectors

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 #12) December 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 | DECEMBER 2021

INSIGHTS

28 36 38 40

Company Showcase Injector Support and Service Coding/Billing Where in the world is Dr. Sandiego? Rad HR I Hate Onions Emotional Intelligence First Hour of Work Sets Tone for the Day

42 ARegistered Nurse in a Technologist’s World 45 Diversity Honest Chat About Diversity In Radiology 46 PACS/IT STAT Communication! 48 Departmental/Operational Issues

Finding Ourselves While Finding Solutions

50 52 54 58 59

Director’s Cut What Will 2022 Look Like? Roman Review Perception is Reality ICE Break Index AMSP Member Profile

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ALL PARTS ALL MODALITIES CT

Cath lab

R&F and Fixed X-Ray

Ultrasound

Portable X-Ray

Biomed

C-Arms

MRI

All Parts, all of the quality, all of the time AllParts Medical, a Philips company 866-507-4793 • allpartsmedical.com • apmsales@philips.com

SPOTLIGHT

IR IS NG

T S AR

JILL JONES

BY ERIN REGISTER

rom the small town of Coffeyville, Kansas, Jill Jones, RT (R) (CT), is a site manager at Banner Imaging in Gilbert, Arizona. She received an associate degree in radiology from Labette Community College in Parsons, Kansas. “I decided to pursue X-ray my senior year of high school after a pretty bad bicycle accident,” said Jones. “I had to have multiple X-rays taken after the incident to ensure that nothing was broken, and the technologist who was performing the exams was so into her job. As I began asking her questions and getting answers, it intrigued me, so I decided to pursue it. I’m so glad I did.” 10

ICEMAGAZINE | DECEMBER 2021

Beth Allen, RT (CT), CRA, director of clinical operations at Banner Imaging said, “Jill Jones is a very talented site manager on our team, and I see her doing great things in the next few years.” ICE learned more about this Rising Star in an interview.

constantly, so keeping up with that changing technology and staying in the know with the changes is important.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?

A: As a current imaging manager, I enjoy that I am learning more than just the clinical side of the business. I am interested in seeing how it all comes together and what impacts I have on improving processes to make them better for the communities that we serve. I also love that I am able to continue to keep up my skills as a technologist by assisting in the areas that I know how to and onboarding new staff. Technology changes

A: What interests me the most is the patient care perspective. I love the daily interaction with the patients. Although I have been in the field for 25 years, I still wake up and look forward to what the day has in store. You learn something new every day by just listening to the patients and staff. At the end of the day, it creates a better version of myself. ADVANCING THE IMAGING PROFESSIONAL

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

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS?

A: I have had the opportunity to be a part of many startup companies and organizations. Being a leader during the recent transition to Banner Imaging has by far exceeded my expectations in myself and others to be able to visualize the impact that we have on a community. Working together as a team, we brought several imaging companies together to form one. This brought about many changes and processes that all had to be aligned. The support that senior leadership has provided has been phenomenal and is what continues to inspire me to push myself harder so that I can have that impact on future leaders.

A: I am currently studying to sit for my Certified Radiology Administrator (CRA) license. I would love to continue to grow within Banner Imaging into a senior leadership role. The growth potential in leadership is vast, and I would like to continue to grow within our organization to push my comfort zone. • Nominate a Rising Star at theicecommunity.com/nominations.

FUN FACTS • Favorite Hobby: Spin cycle classes, reading, doing puzzles and diamond painting • Favorite Vacation Spot: Sanibel Island • Favorite Food: Mexican and Greek food • One Thing on Your Bucket List: Go exploring for a long weekend in Seattle • Any secret skills or talents? I memorize songs and music like no one I have ever met. I can sing songs that I have not heard in over 20 years and know all the lyrics! It is a crazy weird talent! WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

SPOTLIGHT

IN FOCUS TRACI FOSTER

BY JOHN WALLACE

exas Children’s Hospital Radiology Assistant Director Traci Foster, CRA, MSRA, RT(R), did not start out looking to work in radiology.

Traci Foster is a Radiology Assistant Director at Texas Children’s Hospital

ICEMAGAZINE | DECEMBER 2021

This was sort of by chance,” she explains. “My undergraduate degree is in elementary education and when I graduated with my Bachelor of Science, the teaching field was saturated. Since I was always interested in health care I decided to go back to school and thought radiography would be a good way to get my foot in the door and experience the medical field,” Foster explains. “I fully intended on continuing to pursue a career as a physician, but I enjoyed radiology so much I stuck with it. Now I have the perfect combination – working with children and in radiology!” It turned out to be a great career choice. Children’s Hospital Los Angeles Administrative Director of Imaging Services Mario Pistilli recently nominated Traci Foster as an “amazing colleague” to be featured in ICE magazine. “Traci is a respected voice in radiology leadership at the national level. She is a key contributor to AHRA and to

the Pediatric Radiology Forum of the Children’s Hospital Association,” Pistilli wrote in an email. “I have had the privilege to serve on multiple committees and workgroups with Traci, and she always brings a great perspective and thoughtful ideas to any discussion.” Foster still enjoys working in radiology. “I love making a difference in the lives of others. Whether this is with our patients (helping get the best image for a timely and correct diagnosis) or with my team (helping to remove barriers so they can perform at their best),” she says. “If I can help just one person a day and make the day a little better for that person, then it’s all worth it!” Mentors have played a key role in her career success. “I have been blessed with several informal mentors and champions throughout my life and career who were passionate about sharing their experiences and knowledge to help others learn and grow,” Foster says. “Without them, I wouldn’t be where I am today. One lesson I learned many years ago is, ‘If you’re going through hell, keep going.’ Everyone goes through tough periods and times where the struggles seem insurmountable, but you must keep moving forward.” The AHRA also serves as a support group for Foster. ADVANCING THE IMAGING PROFESSIONAL

“It definitely takes a village! I have been a CRA since 2013 and an AHRA member since 2006. AHRA has been such a phenomenal resource for information, networking, support and growth,” she says. “I have had the pleasure of serving on AHRA’s Editorial Review Board, speaking at conferences, publishing articles for the peer-reviewed journal, Radiology Management, and being an AHRA representative on the American Association of Physicist in Medicine (AAPM) CARES Committee.” Her greatest accomplishment includes building something from the dirt up. “My greatest accomplishment in my 22 years of working in imaging was when I was hired to open a brand-new facility, Texas Children’s Hospital The Woodlands. I had the amazing opportunity to build and grow the radiology team from scratch,” she explains. “Taking a group of complete strangers and helping them grow and develop into a solid, unified team has been an amazing experience and journey that I will never forget! I am also incredibly proud to be a CRA and be part of an amazing group of leaders in both AHRA and Children’s Hospital Association (CHA).” Her leadership style contributes to her success and that of others. “My personal definition of leadership is to engage, empower and encourage others through a shared vision. A leader must engage with their team get to know the team – not as MRI or X-ray technologists, but as individuals,” Foster explains. “Then, a leader must empower the team by providing resources, tools and inspiration to allow others to stretch and step outside of their comfort zone so they can grow. As we know, stretching and growing does

TRACI FOSTER

MS, MBA, CRA, FAHRA RT (R) CT MR): CRA, MSRA, RT(R) What is the last book you read? Brene Brown’s book, “The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are.” Favorite movie? “50 First Dates” with Adam Sandler and Drew Barrymore. I love a good romcom! What is something most of your coworkers don’t know about you? I am an avid runner and have completed many marathons including Boston. I have also completed several Ironman races. What is one thing you do every morning to start your day? I love to run in the early mornings when all is still quiet and the air has a new freshness to it. Listening to the birds waking up and watching the sun rise gives me inspiration and strength for the day ahead.

WWW.THEICECOMMUNITY.COM

not guarantee success but it does guarantee learning. I love the saying, ‘Sometimes you win and sometimes you learn.’ Being a leader, encouraging your team is crucial. It’s OK if something doesn’t go as planned or if there are disappointments or set-backs, as long as you learn and continue moving forward.” Foster’s path from potential elementary school teacher to radiology leader has not been without challenges. She said one challenge radiology, like lots of health care professions, will face is continuing to find new radiologists to fill spots being vacated by baby boomers. “Staffing is a huge concern for many imaging departments right now, especially in the rural areas. This is a major challenge that will take a lot of creativity and flexibility to help solve,” Foster said. “As far as advancements, radiology is technology-based, and we all know how technology changes and advances on what seems like a daily basis! Here at Texas Children’s, we are getting ready to launch Siemens Virtual Cockpit with our MRI scanners which I think can be a game changer for both staff and patients in the MRI world.” Away from work, Foster enjoys spending time with her husband, catching up with her adult children and spoiling her pets. “I am married and all four children are now out of the house, so one could argue the only kids left at home (besides my husband) are my chocolate lab and rescued kitty! My children are spread out across the country from New York, Texas, California and Hawaii,” she says.• Nominate a peer at theicecommunity.com/nominations.

Best advice you ever received? “Be brave enough to suck at something new.” New can be very scary for a butt-load of reasons but that’s how we learn, grow and experience life! Who has had the biggest influence on your life? My husband. He is my anchor and the one who is always by my side regardless of what kind of day I’ve had or struggles I’m going through. What would your superpower be? The country is so divided right now and I have seen friends and even families get torn apart from COVID, the recent political unrest, and racial tensions. If I had a superpower, it would be to help bring this country and world back together. What are your hobbies? Violin, piano and running. I also enjoy reading and long walks with my chocolate lab. What is your perfect meal? Cuddled up on the couch with my husband watching TV and eating pizza.

ICEMAGAZINE

SPOTLIGHT

Rad idea A

s the COVID-19 pandemic continues, health care workers are among those who are suffering the most. Demanding hours, varying schedules, workplace stresses and burnout are pushing them to their limits to the point of exhaustion. In fact, in a study of frontline health care workers in the U.S., the rate of acute insomnia among respondents increased from 44.5% before COVID-19 to 64% in the early months of the pandemic. The American Academy of Sleep Medicine (AASM) is part of a system-wide approach to help health care providers prioritize sleep and better manage onthe-job fatigue. Some easy-to-follow routine changes recommended by the AASM are: • creating a schedule that prioritizes sufficient sleep; • avoiding alcohol before bed or excessive caffeine intake; • maintaining a sleep-wake rhythm by staying active outdoors; • napping strategically throughout a long shift; • banking sleep on days off; and • using fatigue checklists or cross-checking procedures with colleagues Reference: https://jcsm.aasm.org/ doi/10.5664/jcsm.9034 Email your RAD IDEA to editor@mdpublishing.com.

ICEMAGAZINE | DECEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

Off Clock THE

BY MATT SKOUFALOS

hen diagnostic imaging patients at the Banner Health Breast Center in Greeley, Colorado get a phone call from Mary Dickinson, it’s often accompanied by the news that they will need additional follow-up from a recent screening mammogram. Whether they need additional imaging, have a finding that requires further physical study, or will require subsequent treatment planning, Dickinson is the conduit for their follow-up, education and the first person with whom they may have a deeply difficult conversation about their health. “The big themes are getting patients back for additional imaging, and then, if they have a finding that needs to be

ICEMAGAZINE | DECEMBER 2021

biopsied, I give them the education and get them scheduled for that biopsy,” Dickinson said. “When they come back to do the biopsy, I get them consented, do their post-care teaching; I will wait for their results to come a couple days later and help.” If the patient receives a breast cancer diagnosis, Dickinson is there to provide information about that pathology and its impact, and to facilitate subsequent communication with physicians, from surgeons to oncologists. “We’re always in communication with our cancer center to make sure that if they’re needing anything additional we can get them back in a timely manner,” Dickinson said. It’s a job that is difficult to do, but which Dickinson finds “very rewarding,” mainly because of the opportunity to comfort patients who need support in a moment of emotional vulnerability.

“Immediately, what does everybody think? ‘Oh my God, I’m gonna die,’ ” she said. “I love to tell patients, ‘Yes, we’re working it up because it could be something serious, but just know, a majority of the time we find out it’s nothing. We just want to guarantee that.’ ” “When I tell people what I do, they say, ‘That must be hard,’ ” Dickinson said. “It’s not. It’s quite rewarding. It’s nice to be able to be somebody that they can trust, and lean on, and if they have questions or they’re freaking out about something, they know that they can call, and I can help walk them through that.” Dickinson said the difficult moments are also some of the most rewarding precisely because she knows she’s helping to get the patients farther along on their treatments. Even when there’s difficult news to communicate, she enjoys having a lot of the answers her patients

ADVANCING THE IMAGING PROFESSIONAL

are looking for, and quickly connecting them with the next health care professional who can help them. “I can get patients in for their MRI and in to see the specialists within a week timeframe, which is way faster than some areas can do,” Dickinson said. “It’s extremely nice to know that we’re ahead of the game as far as having such a great workflow and help patients get through a lot faster.” Dickinson credits her ability to “talk for hours,” which she wields as a helpful distraction for people who are anxious about their imaging results, or about the process of the imaging study itself. Some of her favorite moments on the job come when she’s simply holding someone’s hand or rubbing their back as they prepare for an imaging study. It’s the parts of the career that she’d most hoped to be focused on when she decided to enter the health care field as a young adult. Out of high school, Dickinson thought she’d become a pediatrician, but shelved that plan when she fell in love with working the inpatient oncology floor as a young nurse. She didn’t enjoy her time in nursing leadership, however, and after returning to floor nursing, transferred over to the breast center when her current role opened up. “Even though I am in the breast center, I’m still the nurse that’s in the imaging center,” Dickinson said. “If they are having a hard time starting an IV or CT scan, I’ll help; if someone needs a catheter, I’ll help. For the most part, it’s a fun group to work with.” In addition to shepherding patients through the process that helps them navigate their health concerns, Dickin-

son also leads fundraising efforts that help support the expense of their treatment. The breast cancer fund at Banner Health generates revenues that can be used for patients who need additional diagnostic work-ups, or for grants to help patients undergoing treatment defray those costs.

Dickinson’s work helps keep those coffers full through efforts like the Tough Enough to Wear Pink rodeo and Tough Enough to Wear Pink golf tournament; together, the two events raised almost $27,000 last year. Another big fundraiser, Coffee for a Cure, is led by a couple who own a number of coffee shop locations; one Friday in October, they donate a day’s worth of sales to patient funds at Banner Health and University of Colorado Health. This year, it accounted for approximately $35,000 coming to Banner.

In support of those initiatives, Dickinson coordinates nearly 60 volunteers who help facilitate the coffee shop charity event as guest baristas, dressing up in pink and interacting with customers. The culmination of those efforts results in meaningful material support that can calm anxieties for patients to enable them to focus on healing. Dickinson recalls a patient who was struggling with personal circumstances find relief when she heard that there was some support for her situation. “She said, ‘I don’t know what to do. I’m taking care of my three grandchildren right now. I just chose to have this biopsy done, but I don’t know how I’m going to feed them for the next month because of how much it cost me,’ ” Dickinson recalled. “Being able to help her fill out the voucher and get her exams paid for, to see her body physically relax, she was so thankful and so grateful for everything,” she said. “This is why we do the fundraisers. It makes a huge difference.” When Dickinson needs to calm her own nerves, she and her family retreat to a cabin near Sand Creek, Colorado, unplug their electronic devices, and watch wild animals on a trail camera. “It’s very fun up there,” she said. “My family cabin is my grandparents’, and they used to take us every weekend. That was my escape, going to the cabin and hanging out for the weekend. I didn’t have all those worries and stresses that I did at home.” “We don’t use our phones. We use the oil lamp. Going back to the bare basics, it’s a way to get away from the hustle and bustle of life and everything.” •

NEWS

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

News

AUS ANNOUNCES 20TH ANNIVERSARY WINE COUNTRY WELCOMES 2022 IMAGING CONFERENCE & EXPO It’s official! ICE 2022 will pop a cork February 20-22 in beautiful Napa, California. “ICE is excited to make its way to Napa, California in February 2022 for our annual Imaging Conference & Expo,” MD Publishing President and Founder John Krieg said. “The beautiful Meritage Resort and Spa will be the hub for imaging professionals from across the country to gather for two days of networking, education and exhibit hall time. Get ready to soak up the sun with us in Napa!” The annual Imaging Conference & Expo is a popular destination for imaging professionals to network with colleagues, obtain continuing education credits and learn about the latest solutions via a top-flight exhibit hall. ICE 2022 is free for all hospital employees, students and active members of the military. Registration is available at AttendICE. com. Along with an exclusive ICE18 leadership summit, ICE 2022 features a jam-packed schedule. Educational opportunities include the option to add a CRES Study Group and Prep Class in addition to the free continuing education sessions. Leadership summit attendees will also participate in a reverse expo. All attendees and exhibitors are invited to the exhibit hall grand opening welcome reception, keynote address and the finale party inside the unique Estate Wine Cave! •

Advanced Ultrasound Systems (AUS) – a provider of ultrasound equipment, parts, service and training – has announced its 20th anniversary celebration with reflections on what the organization has accomplished over the past two decades. “Since 2001, AUS has grown into the most comprehensive resource for ultrasound purchasers, servicers, dealers and sonographers,” according to a news release. “Over two decades the company has provided a full spectrum of ultrasound products and services to thousands of customers.” “I am proud that AUS is not only a viable alternative to the manufacturer but also provides a ‘white-glove’ level of service in everything we do,” said John Hryshchuk, AUS president and founder. “Every service and order is treated delicately and delivered with precision. Our trusted, experienced and professional team members are experts at ultrasound and adhere to strict quality standards at every step of the process. In simple terms, our ‘white-glove’ is a premium VIP service that is delivered to all our customers through everything we do. It’s what makes AUS unique and valuable to human and veterinary medical facilities nationwide.” • For more information,

For more information, including discounted room rates, visit

visit www.advancedultrasound.com.

www.AttendICE.com and register today.

ICEMAGAZINE | DECEMBER 2021

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SAMSUNG UNVEILS HIGH-END ULTRASOUND SYSTEM NeuroLogica Corp., the U.S. health care subsidiary of Samsung, has introduced the V8; a high-end ultrasound system that provides enhanced image quality, usability and convenience for ultrasound professionals. The V8 was recently cleared by the U.S. Food and Drug Administration for commercial use in the USA. The feature-packed device includes two new artificial intelligence (AI) functions. The first is “NerveTrack,” an exciting AI technology that detects the location of nerves during live scanning. The second is “UterineAssist,” which detects tissue changes and assists the user with measurements of the uterus. “We are pleased to launch the V8. We designed it with the user in mind, from its premium imaging engine to its ergonomic design,” said David Legg, vice president, ultrasound and digital radiography, NeuroLogica. “The V in V8 stands for versatile because a wide range of departments from obstetrics to radiology and orthopedics to cardiology can make use of its complex functions. We anticipate the V8 to become a flagship product within the high-end ultrasound category.” Crystal Architecture is the core of the V8’s exceptional image clarity and penetration and is built upon the combination of innovative beamforming (CrystalBeam), sophisticated image processing (CrystalLive) and advanced S-Vue Single Crystal Transducers to produce clear, uniform and high-resolution images, according to a news release. Samsung is continuously seeking out new ways to help professionals obtain reliable answers with greater image clarity, enhanced accuracy and improved work efficiency. The press release states that the V8 is equipped with many premium technologies such as: • ShadowHDR, designed to suppress shadows and enhance the clarity of displayed grayscale images. • S-Shearwave Imaging, which provides information about tissue stiffness as a result of disease using ultrasonic transverse elasticity. • S-Fusion technology, which allows synchronous alignment of medical images of ultrasound with one or more cross-sectional studies such as MRI, which are instantly reconstructed in the corresponding plane. • MV-Flow, which enhances the visualization of low-flow blood flow states. The V8 also has various 3D, 4D and 5D technologies that allow the user to view anatomy with exceptional detail. One tool, 5D CNS+, simplifies fetal brain assessment by automatically providing nine planes simultaneously with biometric measurements. The V8 will deliver a new level of versatility and value to a wide range of diagnostic medical ultrasound departments. In other news, NeuroLogica Corp. has received Food and Drug Administration (FDA) 510(k) clearance for its Auto Lung Nodule Detection (ALND) tool. The offer-

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ing provides an on-device, computer-assisted detection (CADe) solution for detecting pulmonary nodules from 10 to 30mm in size through an artificial intelligence (AI) algorithm. ALND cannot be used on patients who have lung lesions other than abnormal nodules. It is designed to aid the physician in reviewing PA chest radiographs of adults and is part of S-Station, an operation software installed on Samsung Digital X-ray Imaging systems. “This FDA clearance is a huge milestone for Samsung and is the result of our tireless work to design diagnostic solutions that empower providers to deliver patients the absolute best care possible,” said Legg. “The fact that it delivers clinically reliable results means clinicians can present it to patients with the utmost confidence, and for that we’re very proud.” •

ICEMAGAZINE

NEWS PHILIPS LAUNCHES PEDIATRIC COACHING TO ENHANCE MR PATIENT EXPERIENCE Royal Philips recently announced the launch of Philips Pediatric Coaching, a holistic solution designed to be a less stressful experience for parents and their children undergoing MRI scans. Using gamification and “buddy system” techniques to prepare children and their parents beforehand, the solution helps guide young children through the MRI procedure to significantly enhance the patient experience. Pediatric Coaching is the latest initiative launched within the Philips Ambient Experience portfolio, featuring a wide range of dedicated solutions to help enhance the experience of patient and staff. Acquiring high-quality images in pediatric MRI can be challenging for radiologists and the child undergoing the scan. Fear of the unfamiliar environment of an MRI system can be stressful for a younger child, making them agitated and unable to lie still, which is required for good image quality. As a result, scans are often performed under sedation or general anesthesia, which according to parents, carries disadvantages such as post-scan irritability for the child and concerns of repeated anesthesia exposure. Having to resort to such measures or deal with a conscious but distressed child is challenging for hospital staff, increasing procedure time and costs. By helping to empower children during an MRI scan, the Philips Pediatric Coaching solution overcomes many of these issues. “As adults, many of us can experience anxiety and stress during an MRI exam, and this is especially true for our youngest patients. By removing factors that can trigger stress, we are enhancing the patient engagement experience for pediatric patients to help improve outcomes,” said Werner Satter, general manager Philips Healthcare Environment and Experience Design. “With Philips Pediatric Coaching, we deploy gamification to help children better prepare for their MRI scan in a 20

ICEMAGAZINE | DECEMBER 2021

non-threatening environment at home, interacting with the same character and voice like Ollie the Elephant and friends, who also coaches them at the hospital, and can even coach them during the MRI procedure itself.” To prepare for their MRI scan, children are provided with a gamified mobile app that familiarizes the child and their parents with an MRI procedure in a playful way. The app also introduces the child to a virtual “buddy” they can roleplay with to perform an MRI scan – for example, pretending to be the system operator and helping their buddy to lie still in order to get the best picture. The app also uses augmented reality to allow the child to explore the MRI system at home before entering the hospital. Many parents express a willingness to help prepare their child ahead of time, and by playing alongside their child, they can also learn more about the procedure. When the family visits the radiology department, the same familiar virtual buddy interacts with the child as they play with Philips’ newly enhanced “Kitten Scanner” – a small-scale educational scanner that allows children to scan various toy animals and view what’s inside each animal for a better understanding of the upcoming procedure. When the child has their scan, their buddy’s familiar voice and image are projected onto

Philips’ Ambient Experience in-bore Connect solution, to guide the child through the scan procedure by coaching them, for example, on when and how to hold their breath. With the new Pediatric Coaching Solution, parents are reassured, and the child is empowered and well prepared, helping ensure the high-quality images needed for an accurate diagnosis of the child’s condition are captured. This announcement follows a similar child patient-centric initiative between Philips and the Walt Disney Company EMEA earlier this year to test the effects of custom-made animations, including specially made Disney stories, within Philips’ Ambient Experience hospital environments. An overview of breakthrough innovations in pediatric imaging to help improve care for younger patients, including how to reduce pediatric patients’ fear and anxiety, is also discussed in a recent blog article by Dr. Julia Dmitrieva, KOL engagement leader for precision diagnosis at Philips. The Philips Pediatric Coaching Solution was launched at the 2021 International Pediatric Radiology Congress (IPR 2021) in Rome, Italy. Next to the MRI journey, Philips also plans to make its Pediatric Coaching available in other diagnostic imaging modalities such as CT.•

ADVANCING THE IMAGING PROFESSIONAL

FUJIFILM INTEGRATES 2 MEDICAL TECHNOLOGY BUSINESSES FUJIFILM Medical Systems U.S.A. Inc. and FUJIFILM Healthcare Americas Corporation (formerly Hitachi Healthcare Americas) have announced that the two companies have merged and are operating under the name FUJIFILM Healthcare Americas Corporation. The new combined organization brings together the strengths of each company’s innovative product portfolios and talented employees to create new value for customers and advance medical care. Leading the combined organization is Henry Izawa, president and CEO of FUJIFILM Healthcare Americas Corporation. “We have built a new foundation leveraging the strengths of each organization to demonstrate the clinical value and relevance of our combined portfolio,” says Izawa. “Integrating two of Fujifilm’s key health care businesses enhances our ability to become an even more comprehensive health care partner for our customers.” Izawa announced a new FUJIFILM Healthcare Americas Corporation executive management team composed of

seasoned leaders from both legacy businesses to drive a smooth integration and business success. Fujifilm’s comprehensive product portfolio includes solutions for digital radiography, computed tomography, endoscopy, endosurgery, enterprise imaging, in-vitro diagnostics, magnetic resonance imaging, mammography and ultrasound. In addition, the company is innovating solutions for artificial intelligence (AI) as part of its AI initiative, REiLI. REiLI brings AI insights directly into health care professionals’ workflows, and more applications of REiLI were introduced at this year’s Radiological Society of North America (RSNA) conference. “This is an exciting time to be part of Fujifilm – we’re very proud of our comprehensive portfolio of health care solutions and our teams who helped make this integration a success,” says Izawa. “We look forward to leveraging the strengths of each business and product portfolio as we remain steadfast on our pursuit of growth, expansion and improving patient care in the rapidly evolving health care market.” •

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NEWS MELTZER PRESENTED DISTINGUISHED SERVICE AWARD The American Medical Association (AMA) presented Carolyn C. Meltzer, M.D., an internationally recognized imaging scientist, academic administrator, and social justice advocate from Atlanta, with the Distinguished Service Award. Established in 1938 as one of the AMA’s highest honors, the Distinguished Service Award is presented for meritorious service in the science and art of medicine. Meltzer was chosen by the AMA as an exceptional scholar whose cross-disciplinary imaging research advanced the neurobiological understanding of neuropsychiatric disorders that disproportionately affect women, such as late-life depression and Alzheimer’s disease. Her functional imaging study validated the effects of normal aging on the brain’s serotonin neurotransmitter system and evaluated the role of neurochemical mechanisms in age-related neuropsychiatric disease. “The development of innovative imaging methods by Dr. Meltzer has contributed to the science and art of medicine by advancing the assessment and treatment of age-related disorders related to brain function and chemistry,” said

AMA President Gerald E. Harmon, M.D. “She is a scholar and physician leader whose work in medical science and social advocacy has enhanced patient care and promoted equity and inclusion in the medical profession.” As a catalyst for diversity, equity, and inclusion, Meltzer has promoted social justice as a necessary element for sustained excellence in health care. Her expertise in implicit bias and systemic organizational biases that disadvantage underrepresented gender, ethnic and minoritized groups in medicine has inspired and benefitted many. Meltzer is currently the William P. Timmie Professor and chair of the department of radiology and imaging sciences, executive associate dean of faculty academic advancement, leadership and inclusion and chief diversity and inclusion officer at Emory University School of Medicine in Atlanta. She received her medical degree from The Johns Hopkins School of Medicine and completed her postdoctoral medical training at The Johns Hopkins Hospital in Baltimore. •

RSIP VISION INTRODUCES BLADDER PANORAMA GENERATOR, SPARSE RECONSTRUCTION TOOL RSIP Vision has announced a new panoramic image generator and 3D sparse reconstruction tool for bladder imagery. The tool automatically performs accurate stitching of cystoscopy images of the bladder to create a large panoramic image, according to a news release. The sparse reconstruction verifies that no areas of the bladder go unscreened and suspicious areas can be revisited. “Cystoscopy is a very useful tool for detecting abnormalities in the bladder and our new panorama tool significantly improves this procedure,” said Ron Soferman, CEO of RSIP Vision. “RSIP Vision’s tool ensures that the region of interest (ROI) is properly scanned, and the sparse reconstruction allows navigation to points-of-interest easily. Additionally, the module allows accurate measurements of the anatomy and positioning of the camera. Ultimately, this results in a safer and faster procedure.” Cystoscopies are often used to diagnose lesions and other pathologies in the bladder in symptomatic patients and for surveillance of patients with a history of urothelial carcinoma. The physician continuously re-positions

ICEMAGAZINE | DECEMBER 2021

the camera within the bladder, until he is convinced the whole bladder was scanned entirely. The new reconstruction tool utilizes “Shape-from-Motion” algorithms to get a point cloud representing key points on the cystoscopy images. It also creates a panorama of large regions in the bladder. The point-cloud allows verification of complete coverage of the ROI, as well as a method to accurately revisit specific areas. The tool can also be tailored to any part of the urinary tract through which the cystoscopy camera can pass. “When examining the bladder for lesions, it is important to completely scan it,” said Dr. Arnon Lavi, a senior urologist. “The panorama image verifies that no blind-spots remain, reducing the risk for missing a cancerous lesion. Using the sparse reconstruction, we can return precisely to areas of interest for re-examination. This can be used especially in cases of re-resection and for surveillance purposes. This tool speeds the procedure and leaves the physician with more confidence in the findings.” •

ADVANCING THE IMAGING PROFESSIONAL

FIRST U.S. INSTALL OF LUMINOS LOTUS MAX ANNOUNCED Long Island Jewish Valley Stream of Valley Stream, N.Y., recently became the first health care institution in the United States to install the LUMINOS Lotus Max, a premium 2-in-1 remote-controlled imaging system from Siemens Healthineers that seamlessly integrates fluoroscopy and radiography for increased productivity and optimized clinical operations. Designed to be operated remotely from a control room, the LUMINOS Lotus Max also can be used tableside via an optional second remote control console. It offers versatility in a wide range of clinical examinations and among diverse patient types, combining radiographic and fluoroscopic imaging with orthopedic studies such as long-leg or full-spine examinations and basic interventions. The system is highly automated for easy maneuvering, and it automatically encrypts all images and patient data. Options include a wireless footswitch; an Enhanced Care Package of software features to help minimize patient dose, improve workflow, and optimize image quality; and a multi-color MoodLight feature. “The LUMINOS Lotus Max has quickly become the system of choice for our radiologists and technologists,“ said Sean Maraj, MBA, RT(R), director of imaging services at Long Island

Jewish Valley Stream Hospital. “The system has allowed us to seamlessly improve upon the high level of imaging services and patient care we provide at LIJ Valley Stream.” “With this first U.S. installation of the LUMINOS Lotus Max, Long Island Jewish Valley Stream has the opportunity to realize more efficient workflows and enjoy greater system utilization in fluoroscopic and radiographic examinations, while providing an improved patient experience with a high level of diagnostic confidence,” said Niral Patel, vice president of X-ray products at Siemens Healthineers North America. •

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

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

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PRODUCTS

Market Report

Contrast Injector Market Growth Expected STAFF REPORT

recent MarketsandMarkets report predicts that the contrast media global market will reach $5.9 billion by 2026.

“The report states that a rising prevalence of chronic diseases, growing approvals of contrast agents, rising volume of CT and MRI examinations performed, growing number of diagnostic centers and hospitals, and availability of reimbursement are the major factors driving the growth of the contrast media/contrast agents market. The microbubble contrast media segment is expected to grow at the highest compound annual growth rate(CAGR) during the forecast period and iodinated contrast media accounted for the largest share in 2020. North America was the largest regional market for the contrast media/contrast agents market in 2020. The large share of the North American market can be attributed to presence of major players in the region, high prevalence of chronic disorders, growing geriatric population, and the increasing adoption of minimally invasive procedures. However, the Asia Pacific market is estimated to grow at the highest CAGR during the forecast period. In a separate MarketsandMarkets report, the research organization states that the global diagnostic imaging market is projected to reach $35 billion by 2026. The growth of this market is primarily driven by the increasing demand for early disease diagnosis and widening scope of clinical applications, rapidly growing geriatric population and the subsequent increase in the prevalence of associated diseases, technological advancements in diagnostic imaging industry, and increasing investments, funds and grants by public-private organizations. Grand View Research states that the global contrast media market size was valued at $2.8 billion in 2020 and is expected to expand at a CAGR of 8.6% from 2021 to 2028. An increase in the prevalence of long-term diseases and complex comorbidities has led to a rise in the number of 24

ICEMAGAZINE | DECEMBER 2021

diagnostic imaging tests, according to Grand View Research. These include ultrasound, X-rays and advanced imaging technologies such as magnetic resonance imaging (MRI) and computed tomography (CT) scans. The role of these tests in identifying the need for treatment/surgeries in interventional procedures and perioperative scans before surgeries are anticipated to boost the usage of contrast media in imaging procedures. Mordor Intelligence states that the major factors for the growth of the contrast media market include the increase in the incidences of chronic diseases, rising demand for image-guided procedures and diagnostics, and a large number of approvals for contrast agents. Image-guided procedures can help determine if a cancer is malignant or benign. With the increased prevalence and the increase in the number of cancer cases in both developing and developed economies of the world, it is necessary to provide procedures that can help patients get a diagnosis at the earlier stages. The demand for diagnostics imaging is at an all-time high, with multiple types of chronic diseases prevalent, globally. According to a report by the Medicare Payment Advisory Commission (MedPAC) to the Center for Medicare and Medicaid Services (CMS), the rise in the volume of imaging services per medicare beneficiary is highest among all other services provided by the physicians. Image-guided surgeries (IGS) are gaining acceptance with time. These procedures are useful for diagnosis as well as treatment of multiple conditions. The rising need, as well as demand, for refinement of imaging during surgeries, requires unique methods of data acquisition, processing, and display, and the full understanding of the process of imaging and its applications to therapy. This need is very well served by image-guided procedures and it has resulted in an increased demand for image-guided procedures for diagnostics, as well as treatment, and hence has served as a factor for the market growth. •

Product Focus CONTRAST INJECTORS

GUERBET

Contrast Delivery Systems Guerbet’s wide range of contrast delivery systems enables health care professionals to work efficiently, in any application. Each delivery system is built for optimal flexibility, efficiency and safety, ensuring that medical staff and equipment work together to provide excellent patient care. Guerbet offers a full line of injectors, prefilled syringes, consumables, digital solutions and service.

*Disclaimer: Products are listed in no particular order.

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PRODUCTS

SIEMENS HEALTHINEERS myExam Companion

The SOMATOM go. and SOMATOM X. platforms of computed tomography scanners from Siemens Healthineers feature myExam Companion, an intelligent user interface that uses clinical language and easy-to-follow visuals to enable even inexperienced users to find the optimal combination of parameters for every patient and procedure. Together with GO technologies, these CT systems deliver personalized imaging for precise dose and contrast media optimization. The combination of CARE Contrast III and pre-defined default contrast media protocols¹ with myExam Companion clinical decision trees offers a holistic contrast media management solution, increasing process efficiency and standardizing 26

ICEMAGAZINE | DECEMBER 2021

quality in contrast enhancement. The Check&GO intelligent algorithm flags problems with scan coverage and contrast distribution. The FAST ROI (Region of Interest) feature automates aortic detection to help the technologist identify the optimal moment to begin contrast administration. Additionally, an integrated, gantry-mounted injector arm addresses the cost and complexities of traditional pedestaland ceiling-mounted injector solutions. ¹ The FDA does not endorse the factory contrast protocols over the range of drug administration options provided in the drug label.

MEDRAD

Stellant FLEX CT Injection System The MEDRAD Stellant FLEX CT Injection System addresses clinical and financial challenges of today’s evolving health care environment, including reduced operational budgets for hospitals which are creating the need for institutions to work more efficiently and economically, while maintaining quality patient care. Clinically, the key features of the new Stellant FLEX were designed to drive workflow efficiencies, including: • Automated capture of contrast and injection parameters; reducing the number of manual tasks and potential errors

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• 150 mL and 200 mL syringe sizes with beacon technology for easy visualization of fluids • Barcode identification, lot and expiry date information for increased accuracy and automation of documentation via a contrast barcode reader • Streamlined training program Financially, the TechCARE program allows radiology suites to maximize their CT equipment investment with flexible options for capital equipment purchasing.

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SPONSORED CONTENT

COMPANY SHOWCASE

INJECTOR SUPPORT AND SERVICE

ith the trend of hospitals and health care facilities prioritizing the use of cost-saving service companies, Injector Support and Service (ISS) has found a home in the third-party injector space. Since the inception of ISS in 2011, it has experienced exceptional growth. Expanding from a bedroom in an apartment to a custom built 10,000-square-foot warehouse in Winter Garden, Florida, ISS has more capabilities now than ever. The warehouse serves as the central office for stocked parts and loaners, a depot center for service, a classroom training facility, and most importantly, quality people. ISS hires best-in-class employees which results in providing unmatched injector service, technical support, parts and training. Hiring quality people has been crucial to the growth and success of ISS because culture plays a key role in first-class service delivery in an industry that is essential for saving lives. If there is one word to highlight throughout the life span of ISS, it is growth.

customer relationships, in December of 2019, ISS was acquired by 626. 626 and ISS have many things in common including culture and growth. These two companies have been able to complement each other well and expand their capabilities across the board. Together, 626 and ISS can provide the most seamless service delivery to all manufacturers and modalities in the imaging equipment and injector world. ISS offers a wide variety of third-party support solutions, including on-site PM and corrective maintenance, depot PM and corrective maintenance, parts identification and sales, loaner and rental units, technical support and training. All of these services are offered at competitive pricing for all their modalities! If you need any of these services on your Bayer/ Medrad, Guerbet/Covidien/Mallinckrodt/Liebel-Flarsheim, or ACIST/Bracco/E-Z-EM equipment, ISS wants to be your first – and only phone call! ISS can customize a course of action to provide you with a unique equipment support and service solution. The team has successfully implemented simple break-fix or full-service contract solutions, as well as more complicated shared risk and parts pooling solutions.

After eight-plus years of growing exponentially and building long-lasting

ISS has professionally trained technicians available to service injectors

ICEMAGAZINE | DECEMBER 2021

ON-SITE SERVICE

in all 50 states. These technicians are equipped with the necessary tools and parts to conduct the requisite annual preventative maintenance as well as complete many corrective maintenance repairs on a first visit basis. Regional technicians are strategically located across the U.S. and are devoted to performing service fast, efficiently and effectively. Since ISS was acquired by 626 in 2019, field service technicians from the 626 family have been cross trained to service injectors as well, thus further expanding the team’s technical reach and strategic technician placement. Wherever you may need ISS, they will be there!

LOANERS & DEPOT SERVICE

Along with ready-to-commute technicians for on-site service, ISS has engineers in the warehouse ready to complete depot service. If an injector needs repair or requires an exceptional amount of attention, you can ship your injector to the ISS warehouse and ISS will simultaneously ship a loaner injector for next day delivery. The goal is to limit as much downtime as possible and allow patients to receive the essential medical care necessary – not to mention save you time and money compared to an OEM service call. ISS has over 100 next day, onsite loaner injectors readily available for multiple models, modalities, and manufacturers. ADVANCING THE IMAGING PROFESSIONAL

TECHNICAL SUPPORT

ISS provides 24/7/365 free technical support. Free technical support offers you a way to experience significant decreased downtime because ISS expert technicians can often identify and solve a problem just by the error message, or description being provided. Free technical support is the way to go!

PARTS SALES & PARTS IDENTIFICATION

In June 2020, ISS became ISO 13485:2016 certified; through dedication to high-quality standards ISS boasts a 99.4% parts reliability rate. They have over 50,000 parts and tools stocked in inventory that are available to ship overnight for next day arrival and installation. Additionally, annual PM parts

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kits have been customized for several injector models to include specific high failure parts. If you are performing a PM or your equipment needs repair, all it takes is a simple phone call or email to help identify which parts to order.

TRAINING

ISS offers an independent training alternative to the OEM. Level 1 and Level 2 training is available for Stellant, Solaris, Provis and Mark 7 Arterion injectors. These classes are taught by a technician with several years of experience and expertise in injector operations. The classes can be customized to fit your level of knowledge and include hands-on instruction. Private or group classes are available to book in the ISS training facility located in Winter Garden,

Florida. You will go home with training manuals and a thorough understanding of basic PM service as well as in-depth troubleshooting proficiency. ISS is fully committed to providing clients and partners with the proper tools, services and support necessary to truly deliver better patient care. This customer driven policy provokes the incentive for continuous quality improvement of services. With the top engineers and best processes, they offer fast, simple solutions that result in the industry’s exceptional performance. Give the ISS contrast injector specialists a call today and find out how they can save you money and provide you with the most comprehensive, efficient service and support possible! • To learn more, visit weareiss.com

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We are... • On-Site Repair • Depot Repair • Parts Sales and Parts Identification • Loaner Availability • Technical Support • Training • Injector System Sales • Preventative Maintenance Tools Call our contrast injector specialists today to find out how we can save you money! (888)-667-1062

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

LOOKING TO PURCHASE OR SELL? LOOK NO FURTHER.

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

NO FUR TH ER

GE • TOSHIBA • SIEMENS • PHILIPS

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

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

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

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

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ICEMAGAZINE

CLOSING THE BOOKS ON

2021 WHAT HAPPENED, WHAT DIDN’T & WHAT’S NEXT

BY MATT SKOUFALOS

ICEMAGAZINE | DECEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

“Good riddance to 2021.” That’s the topline reaction from Lydia Kleinschnitz, senior director of imaging services at UPMC Presbyterian Shadyside in Pittsburgh, Pennsylvania, when asked to sum up her experiences in the medical imaging space this year.

s difficult as 2020 was for health care workers and the facilities that employed them amid the novel coronavirus (COVID-19) pandemic, the year that followed was, in many respects, even harder, Kleinschnitz said. Not only was her department still tasked with handling significant volumes of COVID-19 patients who needed imaging studies performed – a workload that increased substantially with the wave of Delta variant cases that hit the United States over the summer – but also it lacked sufficient staff to handle the workload. “We were hit with the same problems that everyone was experiencing, with staff finding other opportunities, from traveling to changing their courses of life; their occupations,” Kleinschnitz said. “COVID made people really take a look inside and figure out what they wanted to do, or see how life could be when things are forced upon you,” she said. “They’re getting married, they’re moving away; I had techs that decided just to open up a coffee shop. We had folks who were living a couple states away from their family, and all this made them think, ‘We’ve got to be close to family now.’ We also lost a lot of folks just to retirement.” Typical sources of new hires were also hamstrung by the pandemic: Kleinschnitz points out that the academic pipelines that traditionally support the workplace “were basically shut off.” “The schools couldn’t get into clinicals, and there were people who maybe decided not to go into health care, and the classes weren’t as big,” she said. “You don’t have the number of people going into radiologic technology, so we’ve been working really hard to open up those pipelines, and be a support to our local schools so we can get people interested in making this a career. But that’s going to take some time.”

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ICEMAGAZINE

CLOSING THE BOOKS ON 2021

WHAT HAPPENED, WHAT DIDN’T & WHAT’S NEXT

“Fatigue is huge,” she said, especially when everyone on staff is battling back feelings of being overworked in order to better support their peers. Kleinschnitz said her remaining team members pulled through as best they could under the circumstances, and UPMC found ways to incentivize and reward them; however, these challenges seemed to become compounded in an international labor market struggling against the same forces. In short, “2020 was COVID, 2021 now is staffing and COVID,” she said. “I’m looking forward to 2022 having some solutions.” Whereas elective procedures were curtailed for a few months in 2020, creating a backlog of patients who required diagnostic imaging, no such circumstance presented itself in 2021. Despite short-staffing concerns, Kleinschnitz said her department nonetheless managed to facilitate the needs of its patients who were receiving imaging studies. The one, major side-effect of thsee staffing concerns, however, is that addressing them occupied so much of her time that Kleinschnitz lost hours she typically would have dedicated to strategic and long-range planning. Shifting her focus entirely on the short-term to the neglect of long-term considerations put her into unfamiliar territory. “This year has really forced me to spend so much time figuring out, ‘How am I going to make it through this month?’ Or, on a week-to-week basis, making sure you have plans in place to meet those needs,” Kleinschnitz said. “We’ve done it, but it has prevented me from being as strategic as I would usually be. I feel like in 2022 we’re going to be able to get back to that a little bit more.” Nicole Dhanraj, systems director at Northern Arizona Healthcare in Flagstaff, Arizona, said her biggest takeaways from 2021 also involved navigating an ongoing staffing crisis. Whether organizations lost employees via the “Great Resignation” – the phenomenon 34

ICEMAGAZINE | DECEMBER 2021

of otherwise employed people quitting their jobs amid the COVID-19 pandemic – or ran the risk of overtaxing the staff they retained, they also faced the reverberations of those effects in terms of supply chain and logistical concerns, or simply in effectively communicating their management strategies during the crisis. “Sometimes we struggle to learn what is the organization doing about

“ Sometimes we struggle to learn what is the organization doing about the current crisis; what does it mean to being ahead of it.” NICOLE DHANRAI the current crisis; what does it mean to being ahead of it,” Dhanraj said. “Some organizations were delayed in their response, and because it took too long, employees were left to their own assumptions, to talk amongst themselves.” In an environment full of unknowns, what keeps the system running is clear, direct and precise internal communication, whether it’s managing the return of remote workers to their in-person assignments, keeping frontline workers current on regulatory concerns and policy changes (institutional initiatives or government mandates), or addressing open positions, and maintaining operations while short-staffed. Although, as Kleinschnitz described, strategic planning may have suffered amid the rush to address those labor concerns, Dhanraj said that’s ironically when it’s needed the most. “I feel like we need to see strategic direction almost on a monthly basis,” she said. “The content has to be where are we going and how are we managing things at the same time; even just an update on where are we, dealing

with hiring, dealing with the supply-chain crisis.” For remote health care providers like Northern Arizona Healthcare, Dhanraj described the effects of other economic factors – remote location, wages, costs of living, housing availability and pricing – as playing havoc with the employment recruitment and retention processes as well. “I have lost potential employees and travelers because they couldn’t find housing,” she said. “Now we have the location, the housing crisis, and additional factors that just amplify that crisis, and the impact is that we don’t have a pool of other applicants to pull from.” In addition to recruiting new hires to fill open positions, engaging with current staffers remains a critical priority, Dhanraj said. Employee satisfaction, incentivization and retention all have risen to become as important as bidding for the services of new workers. “As we try to navigate through [The Great Resignation], how do we get our current staff to stay, and what other creative marketing strategies can we use to entice people to come and work for us permanently?” she said. The operational limitations that have been foisted upon health care during the pandemic represent the value and necessity of operating within lean methodology, Dhanraj said, embracing automation technologies wherever possible, seeking to reduce the time physicians must spend on the phone, or eliminating any other inefficiencies throughout the institution. “Either we really maximize what the vendors offer, or look at additional solutions to overcome these inefficiencies,” Dhanraj said. “From the PACS perspective, we are using traditional practices in the 21st century, but are not able to get everybody onboard to change their [individual] practices. Longer organizations take a while to implement changes, but we need to reduce waste and expenses, discover what automated tools there are, or what solutions we have from current ADVANCING THE IMAGING PROFESSIONAL

ARTICLE CONTRIBUTORS vendors that we can employ.” Lean methodology and crisis communication also support other critical demands of the imaging workspace, Dhanraj said; namely, ensuring patient safety and turnaround time and system quality of service. Eliminating system delays and inefficiencies is another way to address the hard practicalities of the current labor market, in which patients still must meet their health care needs. She foresees staffing and supply chain issues will persist for as long as six or nine months, and into 2022, translating into higher costs and routine logistical delays that smaller operations may not be able to manage as easily as their larger counterparts. “Those supply challenges are scary to think about in the coming months,” Dhanraj said. “I’m concerned for those private practices.” For Nathan Smith, founder and CEO of the Atlanta, Georgia-based radiology training and consultancy company Imaging Diversified, one of the biggest storylines for 2021 was how inpatient medical imaging utilization ramped up from 2020 lows to levels seen prior to the pandemic. Outpatient practices, by Smith’s reckoning, still battle throughput and patient scheduling concerns that necessarily incorporate COVID-19 safety and screening precautions, and that’s before they faced Medicare Physician Fee Schedule (MPFS) reimbursement rate cuts to the professional component of radiology procedures from the federal Center for Medicare and Medicaid Services (CMS). According to VMG Health, a health care strategy and valuation group based in Dallas, Texas, freestanding operators that rely on government payors stand to face “the most severe impact” of these cuts. In an April 2021 briefing on the impact and outlook of rate changes for diagnostic imaging services, the group identified “two WWW.THEICECOMMUNITY.COM

Nicole Dhanraj

Lydia Kleinschnitz

potential options to combat reimbursement pressure: invest more heavily in advertisement and marketing, or renegotiate rates with commercial payors.” The brief also noted, however, that both tacks require either the flexibility to carry out such negotiations, or the supplemental income to elevate awareness of their brands. Those entities that operate multiple business locations may fare better by leveraging economies of scale or operational efficiencies across a number of sites. The result of those pressures, the firm concludes, is presumed, continued market consolidation, including “joint venture models or outright buyouts by MPOs, health systems or management companies.” “We’re looking at busier centers, busier places,” Smith said, “and we’re looking at reimbursement going down at the same time.” Smith said radiology professionals are also looking toward different technological advances that might be built upon across the market in 2022, whether it’s the helium-free BlueSeal magnet from Philips or the low-helium Siemens Magnetom Free.Max, which both seek to obviate the complications of relying upon dwindling reserves of the nonrenewable gaseous element. Other advances are more market-driven, like the “all-in” perspective embraced by United Imaging of Houston, Texas, which turned heads at AHRA by announcing that its imaging scanners would be sold “fully configured, with all available software and functionality from the outset,” in a nod to “clinical flexibility and also investment transparency,” the company said in a press release, “because the health care provider does not have all of the hidden costs of future upgrades to add new services down the road.”

Nathan Smith

“What we’re seeing is everyone position themselves for the future,” Smith said. “I think with the newer scanners and newer technology coming out, it’s really making it easier to use. Two years from now, your average X-ray or MRI is going to be sub-20 minutes, and the image quality is going up with it. “I think each vendor’s advances are pushing the other vendors to stay up,” he said. “One may create something really cool, technology-wise, and the other vendors come up with something to match that.” While Smith agrees that the biggest throughline for medical imaging in 2021 remains staffing concerns, he also foresees a cooling-off in the market for travel positions in the coming months. “There’s so many jobs that right now, I could leave my profession, go into traveling, and I’d be set,” he said. “I’d always have a job ready to go as soon as I’d finished. I think it’s a temporary bubble. I really feel like once everything levels itself out, those positions are going to get filled; there’ll be less jobs, and people will want to tie themselves to some sort of stability.” Even if the job market corrects itself in the coming months, Smith also knows that new hires won’t necessarily command the same level of institutional knowledge that a veteran employee does. He’s an advocate of additional training for technologists, whenever possible, “to get the right type of imaging out to the right people, so they can be the most cost-efficient and get everything they need.” “I want to be able to work more hand-in-hand with customers across North America to make sure that’s happening all the way around,” Smith said. “If that happens, we can get prepared for things like the lower reimbursement rate.” • ICEMAGAZINE

INSIGHTS

CODING/BILLING BY MELODY W. MULAIK

WHERE IN THE WORLD IS DR. SANDIEGO?

f your radiologists perform reads in a different geographic location from where the patient received their service, you may have more credentialling requirements than you realize. For example, if your practice is located in state A and you have a radiologist reading images from his summer home in state B, does the radiologist have to be licensed in state B in addition to state A? The answer depends on the state and its specific requirements. Before we discuss the specifics on how to bill for Medicare services, remember that final reads rendered outside the United States cannot be billed. Also, billing for commercial payers depends on each payer’s policies. The address listed in Block 32 of the CMS-1500 claim form plays a very important role in reimbursement. Medicare payment rates vary according to the geographic location where the service was performed, and Medicare contractors use the ZIP code in Block 32 to determine which payment rate applies. Additionally, the Centers for Medicare and Medicaid Services (CMS) requires the provider to file the claim to whichever Medicare contractor has jurisdiction over the location in Block 32. The address listed in Block 32 of a professional component claim is supposed to represent the “interpreting 36

ICEMAGAZINE | DECEMBER 2021

physician’s location” – i.e., the specific address where the physician was sitting when he or she interpreted the study. Often this will be an established practice location such as a hospital, imaging center or private office. But with digital imaging and high-speed Internet service, physicians can perform interpretations virtually anywhere. The Medicare Claims Processing Manual (Chapter 13, Section 150) states, “If the professional interpretation was furnished at an unusual and infrequent location, for example, a hotel, the locality of the professional interpretation is determined based on the Medicare enrolled location where the interpreting physician most commonly practices.” In this situation the radiology group can enter its usual practice location on the claim instead of the radiologist’s actual physical location.1 If the radiologist performs interpretations at a location that does not qualify as “unusual and infrequent,” the group will need to add it as an additional practice location on its Medicare 855 enrollment form. If the location is in a different contractor jurisdiction, the group will also need to enroll with the contractor for that jurisdiction. For global billing, the Medicare Claims Processing Manual (Chapter 13, Section 150) states: “If the same physician or other supplier entity does not furnish both the TC and PC of the diagnostic service, or if the same physician or other supplier entity furnishes both the TC and PC

but the professional interpretation was furnished in a different payment locality from where the TC was furnished, the professional interpretation of a diagnostic test must be separately billed with modifier -26 by the interpreting physician.” In other words, global billing is permitted when the same physician or supplier furnishes both the technical component (TC) and the professional component (PC). This requirement is met when the same physician both supervises and interprets the study, or when the interpreting physician has an employment relationship with the entity that provided the TC AND the TC and the PC are provided in the same payment locality. When a service meets the requirements for global billing, Block 32 of the global claim should contain the name, address and National Provider Identifier (NPI) of the location where the test was furnished. • For more information about Place of Service (POS) reporting, please review the CMS FAQs, the Claims Processing Manual and your local Medicare contractor’s publications. Melody Mulaik, MSHS, CRA, RCC, RCCIR, CPC, COC, FAHRA, is the president of Revenue Cycle Coding Strategies. 1. http://www.cms.gov/Medicare/ Medicare-Fee-for-Service-Payment/ PhysicianFeeSched/Downloads/FAQsCR7631-4-25-13.pdf ADVANCING THE IMAGING PROFESSIONAL

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I HATE ONIONS

BY KIAHNNA PATTON

he holiday season can be pretty nostalgic. It reminds us of the warmth of fall and winter spices and beverages. It reminds us of being close to our loved ones and missing those we have lost. The dishes we wait all year to eat are on our minds. And for those of us who like it, the taste of turkey-everything is already on our tongues. For me, the holiday season reminds me that I hate onions. There are certainly wonderful things about onions, which I will not deny, as well as pretty terrible things about them. Most of this article will focus on onions, but I promise to connect to human resources.

ICEMAGAZINE | DECEMBER 2021

I have a love and mostly hate relationship with onions. I hate the taste but, in many respects, love what they represent and what they bring to the table. Pun intended. They represent love, connection and progress. Would it surprise you to know there is a National Onion Association (NOA)? According to NOA, “World onion production is approximately 105 billion pounds per year. That is roughly 13.67 pounds per person across the world.” Within the United States, we eat about 20 pounds of onions each year per person. Maybe I eat 5. I still pick out the visible onions from my cooked food and refuse to eat raw onions of any kind in any food. I would rather be hungry for a short time than eat something like onion-ladened guacamole. Onions are quite interesting. Onions add flavor and make you cry, they have health benefits, and they are spicy,

crunchy and juicy. There are three main varieties – red, yellow, and white. And the primary flavor profiles are sweet, pungent, spicy. Pungent? No, thank you. I wanted to insert data that show how many people hate onions but after an extensive search, I only found blogs and articles dedicated to the disdain of the onion. For all the disdain, onions have antioxidants, fight inflammation, reduce cholesterol and more. There are even claims that onions can help people lose weight. But, eating lots of them can cause some people to experience gas, bloating, diarrhea, constipation and, the one thing that’s hard to hide, bad breath. I wrote that onions represent love. As a child, I used onions to measure the love others had for me. If you remembered how much I hate them, you held a special place in my heart. ADVANCING THE IMAGING PROFESSIONAL

My dad would make separate dishes for me, like his holiday turkey salad. He always set aside a small portion for me without the onions. It made me feel like the most special person because he took the time to make sure I could still enjoy the dishes everyone else had. My mom would do the same. She loves onions. By her own account, she ate a massive amount of them while pregnant with me and thinks that’s probably why I hate them. When I was a child, she would prepare a separate dish of enchiladas for me. Even today she makes my guacamole without onions. But I do remember years ago when the golden arches took 10 minutes to prepare a special order. No one wanted to pull to the side and wait that long when everybody in the car was starving. Oh, the sadness and disgust I felt when mom ordered a cheeseburger and the nasty onions were perched on the cheese side of the burger, and the tiny specks of torture couldn’t be scraped off without losing almost all of the cheese. For me, onions also represent change and progress. They can enhance and destroy the flavor of a dish. Slip me a raw onion, especially a red one, and my entire meal is ruined. There is no getting that flavor off of the meat and bread of your sandwich. But make spaghetti sauce without the onion, and there is a whole flavor profile missing. Alas, I have progressed. I will eat the sauce and pick out the larger onions. And as another sign of major progress, I graduated from eating only the crunchy crusty outer layer of onion rings to eating the onion, with a caveat, of course. The onion, preferably Vidalia, has to be super soft or super thin and crispy. No in-between. I’ve also grown quite fond of shallots. Well, they’re not the same as onions, but they both belong to the Allium genus, so I give myself credit. Onions also represent connection. I was very close to my paternal grandWWW.THEICECOMMUNITY.COM

mother. She lived to be 90 years old. One of my most fond and cringe-worthy memories was of her eating a whole raw onion. She bit right into it. I don’t know how she did it but she was a superhero, not only for staring down the face of an onion and winning but for being born in 1913 and surviving a very despicable time in American history. I connected to her on so many levels. Now is the time to connect to human resources. Onions bring to mind organizational culture. I won’t offer solutions today, but food for thought and questions to ask yourself. People’s energy can be like raw onion. When you walk into a room or join a virtual meeting, does your (or a teammate’s) energy ruin the whole vibe with tiny onions on the cheese side? What can you do to change that energy? Do you add good or bad flavor to your team? Are you the immovable raw onion flavor stuck on the sandwich? Or are you the onion in the spaghetti sauce that adds just the right flavor profile? As a leader or teammate, are you making people cry tears of joy or disdain? How have you made connections with people with whom you initially thought you had little in common? How have you allowed your first impressions of others to guide how you interact with them? Have you discovered that what you thought was an onion is a shallot, and you really like it a lot? Even though I hate onions, I don’t judge those who love them. Just don’t breathe in my direction after you’ve eaten a big pile of those nasty bits. Happy holidays! • Kiahnna D. Patton is senior human resources business partner at Children’s Hospital Los Angeles (CHLA) and a nonprofit founder.

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FIRST HOUR OF WORK SETS TONE FOR THE DAY

W EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

hile driving through the American Southwest in the early 1980s, I found myself in the small town of Winslow, Arizona. Yes, Eagles fans, that Winslow, Arizona. Because my dad was an Eagles fan, I decided to buy him a souvenir. He ended up getting two T-shirts; one proudly displaying the town’s name, and another which said, “Eat a live toad for breakfast, and nothing worse can happen to you the rest of the day.” The latter was rather quirky, but my dad enjoyed quirky humor. The interesting thing is that the phrase stayed with me. The saying may be quirky, but the principle is spot on – get the hard stuff done first, everything else is easy.

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“What are some of the ‘hard things?’” Great question. After all, if we’re going to be productive, being industrious right out of the gate is great because it sets the tone for the entire day. In her book, “Never Check Email In The Morning,” Julie Morgenstern is an advocate of getting tough stuff done first. She Is not anti-email. Instead, she’s pro-action. From Morgenstern’s perspective, and I tend to agree, jumping into email first thing in the morning tends to make us reactive. As an alternative, Morgenstern says it’s important that our first tasks of the day have us “dancing close to the revenue line.” What she means is that we should identify the tasks which will bring revenue to the organization and make sure those action items get put at the top of the day’s work list.

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In his best-selling book, “Seven Habits of Highly Effective People,” management guru Stephen Covey said it’s important that we not prioritize our schedule, but rather schedule our priorities. The fun and easy things are just that – fun and easy. Many people get to work and want to check off the simpler, more enjoyable tasks first. The problem is that fun and easy action items often sidetrack us from the important work that needs to be done – work that isn’t always fun.

PLANNING YOUR DAY In line with scheduling our priorities, I also want to refer to a book that changed my life in my early twenties. The book is titled, “Success! The Glenn Bland Method,” and it was originally published in 1983, but an updated 2010 version is now available. The book is subtitled, “How to set goals and really make them work,” and I will say that I found much value in Bland’s suggestions. One chapter in Bland’s book is titled, “30 golden minutes.” In that chapter, Bland describes his method for getting focused and establishing priorities at the beginning of each day. Over the years, I’ve personally retitled this practice to be “15 golden minutes,” but the concept remains the same. Spend time each morning reviewing the day’s priorities, and wrap your mind around what’s required to achieve each one. By the way, I’m a strong advocate of estimating approximately how much time it will take to accomplish each task – or at least how much time you will devote to that task for the day – and scheduling your day accordingly. That said, emergencies inevitably crop up, so I’ve also learned to allocate extra

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time for projects. That way, when someone brings a problem that needs your attention, you have flexibility in your schedule to address that concern.

START WITH A VERB In his book titled, “Getting Things Done,” David Allen advocates using a verb to start each action item on our to do lists. For example, instead of, “letter to Matt,” the action item should be, “write letter to Matt.” Instead of, “meeting room,” the action item should be, “schedule meeting room,” or, “confirm meeting room reservation,” or, “inquire about meeting room availability.” It may seem like a little thing, but research shows that by starting each task with a specific action, the likelihood of the action getting done increases. To me, it’s important to be specific. It’s kind of like what Mel Gibson said in the film, “The Patriot,” “Aim small, miss small.” In keeping with that concept, the book “Getting Things Done” also suggests that if you seem to be procrastinating on specific task, break the task down into smaller, more bite-size chunks. It might sound pedantic, but if you’re putting off writing that letter to Matt, identify an overtly simple task to help get the ball rolling. For example, one could create a task that says, “Open word processing document to write letter to Matt.” Opening a new document is an easily achievable task, one that most people would be eager to check off. The magic is that once the word processing doc is open, we are much more likely to start drafting the letter. The key for better success in all task lists is that each action item

starts with a verb. Verbs are something we must do. Breaking larger tasks into smaller tasks has long been a method for getting things done, but sometimes we must break small tasks into even smaller tasks. As the saying goes, “How do you eat an elephant? One bite at a time.”

BE OF SERVICE TO OTHERS Finally, allow me to reference Zig Ziglar’s book, “Goals; How to get the most out of your life.” In that book, Ziglar states that one of the best ways to get what you want is to help others get what they want. In other words, if we really want to be effective and productive, we need to do things throughout our day that help other people be productive and effective. In closing, you’ll notice I covered a topic in December one would normally write in January. I hope you also noticed that I referenced many books in this piece. This was done on purpose. If any of the tips or suggestions in this column interests you, now would be a great time to order one or more of the books mentioned and get a head start on refocusing before the new year begins. Instead of “running down the road” with a world of trouble on your mind, you might find your days more fulfilling. • Daniel Bobinski, M.Ed. is a bestselling 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) 3757606, or through his website, www. MyWorkplaceExcellence.com.

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A REGISTERED NURSE IN A TECHNOLOGIST’S WORLD

hen I came out of nursing school, I never thought I would work in medical imaging with technologists. I was dubious about how my role partnered with theirs, but I was also intrigued. How would – and could – this work? I quickly realized that putting myself in this environment was the best decision I could’ve ever made in my career. BY MARY SCHEID

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I’m proud to share that I’ve worked for Banner for more than 27 years as a registered nurse, 16 of which were explicitly in radiology. I’ve learned a lot throughout my journey and realized that pivots in your career are opportunities to learn and experience more. My “pivot moment” came when I realized I wanted to get off the floor and get away from working nights and weekends. I looked at some open positions and found a breast care nursing position in mammography. The job was all-day shifts, no nights or weekends and working with breast cancer patients, and it was just up my alley as the job was still in oncology and was coupled with my

passion for nursing. After I was awarded the job, I was told that I was the first nurse in Northern Colorado to have this role – working alongside technologists. They were a bit like me in the sense that we were all a bit dubious as to how my role would “work” with theirs. The technologists quickly realized that my role was helpful and could help them be more efficient in theirs. They were extremely kind and helped me learn and grow as a nurse. They also furthered my understanding of mammography, ultrasound and MRI. I stayed in that role, working with these talented technologists, for 11 years working, side by side. The entire experience lent itself to my next steps. I was asked to transition my role solely into mammography – an area I wasn’t experienced in and didn’t understand the detailed work involved. As always, though, there was a learning curve, process, and Banner allowed me to learn and grow with the team. And, so I did. My journey didn’t end there. Next, X-ray services were added to our team. I’d helped them with IVs and Foley catheters in the past but knew very little about X-ray or fluADVANCING THE IMAGING PROFESSIONAL

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“Being a registered nurse in a technologist’s world is possible, especially with the amazing team I have had the opportunity to work with.” - MARY SCHEID, RN, MSN, OCN, CBCN

oroscopy. They helped me learn what was needed to manage the department and how to grow it in a way that benefitted the patient in the best possible way and our team. Now, I’ve had the great opportunity to be a part of Banner Imaging and work with mammography, ultrasound, CT, MRI, PET and X-ray, our front desk staff, film files, nursing staff and other office managers. There’s no way that a nurse could know all of what a technologist knows or does, but technologists are a kind and caring group. They allow me to ask questions and learn more about their art. They have worked

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with me to help manage their teams. I’ve learned and grown so much in the field of radiology, and it’s been a fantastic journey that I continue to learn from daily. It’s been a blessing to have great teachers (technologists) to guide me and lean on for support. So, being a registered nurse in a technologist’s world is possible, especially with the amazing team I have had the opportunity to work with.• Mary Scheid, RN, MSN, OCN, CBCN, is a senior manager for Banner Imaging Services Colorado.

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DIVERSITY BY VERLON E. SALLEY

ot everyone can say that they are working in the field they went to school for, and/or are enjoying it. I am one of the lucky ones. That does not mean my path did not come without challenges. One of those challenges included enduring prejudices, racism and a lack of diversity around me. Though I have had my own challenges, I know others in my career field who have endured more. One includes a colleague of mine that works at a large academic medical center. Being Black and female in radiology administration was something she has endured since the 1980s. I had an honest conversation with her about her challenges and asked if I could document it in this column. Me: How do feel about diversity in radiology? Her answer: I do not believe there is enough diversity of any sorts within radiology. Most organizations grow supervisors and managers from an internal pool of tech candidates. We do not get to see diversity in radiology management, because the radiology tech pool is not diverse. Me: So, why do you think the schools are to blame? WWW.THEICECOMMUNITY.COM

HONEST CHAT ABOUT DIVERSITY IN RADIOLOGY Her: Well, the rad tech schools targeted potential students from high schools that were in the suburbs and nicer areas of the city. They did not recruit from the schools in high diversity and/or minority areas. Me: Do you think we need to recruit high school kids? Her: Yes, we need diverse radiology leaders to go into highly populated minority high schools for career day and let them know about a career in radiology. We need to speak to the kids about our backgrounds and let them know how we evolved and achieved through education. They need to see us to visualize that they can do it, too. Me: What are some of the challenges you faced when you started your career? Her: One was my name. Looking at my name on a resume most people thought I was a white male. Then, when I showed up, they saw a Black female. After getting through the interviews, I had to win over the staff. I won them over because I walked the walk and talked the talk. I would get my hands dirty working alongside my subordinates. That instantly won them over because I performed strong and led strong. Me: What are some of the things you felt you had to do to excel? Her: I knew I had to get buy-in from everyone before I made chang-

es. I knew we needed to better our patient experiences, so I would ask different stakeholders (techs, supervisors, radiologists and referring physicians) three questions? As for our current processes and procedures – What do you like? Dislike? Feel is unsafe? After presenting these findings in a presentation, I resolved the top five issues within my first 90 days. Me: What advice would you give your younger self? Her: To be more honest with asking for help and to be more courageous when opportunity knocks. I had opportunities in the past that I passed up. Others had more faith in my abilities and were proposing opportunities that they thought were good for me. The conversation ended with her telling me of an initiative they have implemented at her facility to recruit more rad techs. They are sending recruiters to career days at local high schools to recruit students as tech aids. Then, if a student chooses to go to rad tech school they can get a tuition reimbursement and a retention bonus. She has insured that minority high schools are a part of the pool, now. • Verlon E. Salley is Vice President of Community Health Equity at UAB Health System.

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PACS/IT/AI

STAT COMMUNICATION!

BY MARK WATTS

iming is everything! When a person says a witty comeback at just the right time, the room will erupt in laughter. When a coach gives a halftime talk a team can be inspired to higher performance. In the case of a stroke patient, timing can lead to a successful and full recovery or a life sentence of debilitation. I have been working with an IT solution that compresses the timeline for the stroke workflow. Artificial Intelligence was used to enhance multiple steps, but it was the thoughtful construction, like the iPhone, and intuitive usefulness of this clinical communication and collaboration (CC&C) platform that inspired this article.

WHAT IS A CC&C PLATFORM? A CC&C platform connects physicians, nurses and other care team members with the people and hospital systems they rely on to provide patient care. It’s a consolidated software application that optimizes how care teams interact and enhances clinical workflows. The key is to understand the functional capabilities of a best-inclass solution. First, having a central source of easily updated, accurate directory and on-call schedule information means these critical details can be built into every interaction.

ICEMAGAZINE | DECEMBER 2021

Second, secure messaging capabilities involving the entire care team, including nonclinical staff like transport and environmental services, speed collaboration across smartphones, pagers, hospital-issued devices and desktop computers. This leverages existing tech investments and enables staff to use the best device for their roles. Third, a cloud-based software as a service (SaaS) platform keeps everyone on the latest version of the software and reduces infrastructure and personnel requirements for your IT team. The three ways a CC&C platform can elevate the level of care at your organization include the following.

1. IMPROVE ROUTINE CARE TEAM COMMUNICATION The Joint Commission’s 2021 National Patient Safety Goal #2 is to improve the effectiveness of communication among caregivers. More specifically, NPSG.02.03.01 states that organizations need to report critical results of tests and diagnostic procedures on a timely basis. Simply put, how effectively care teams communicate every minute of the day directly impacts the quality of care they’re able to deliver to their patients. These routine interactions span admit, discharge, and transfer (ADT) activities, patient handoffs, consult requests, transport scheduling, the sharing of test results, and more. Done well, they can make all the difference. Done poorly, the on-

going waste of time is frustrating, costly – and even deadly. One study found communication issues were a factor in 1,744 deaths over a fouryear period and cost hospitals $1.7 billion. Unfortunately, communication inefficiencies are common in health care with the rise of different mobile devices, inaccurate on-call schedules, and outdated or missing contact information, as well as disparate technologies that can’t effectively share critical updates. All of these factors hinder swift, effective care communication. If a nurse can’t contact a physician quickly to help a patient manage pain, or a physician can’t find the right on-call specialist for a consult, everyone loses. Likewise, when critical test results are involved, the inability of radiologists and laboratorians to connect with the responsible physician means nurses waste time as go-betweens, which can delay care. With a cloud-based clinical communication platform, you have a single solution connecting your entire care network and simplifying the process of finding people, groups, resources and data. Having accurate contact and schedule information auto-populating in messages and being able to connect to the EHR for care updates is key to reducing administrative burden. This means messaging for individuals and groups, rapid response notifications, ADT processes and

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critical test result communication can occur without wasting time. For example, mobilizing consult order notifications means physicians receive these requests securely on their smartphones and can acknowledge the receipt and close the loop for faster patient evaluation.

2. SWIFTLY ACTIVATE RAPID RESPONSE TEAMS When a patient care emergency occurs, every minute counts. These situations can include critical codes such as Code STEMI for heart attacks and Code Blue for cardiac or respiratory arrest, as well as sepsis. COVID-19 prone positioning teams are now emerging too. But the process of notifying dozens or even hundreds of staff goes far beyond what can be accomplished with overhead announcements or calling trees. Lock-step communication is essential to an effective rapid response team and ultimately the patient’s health outcome. Refining every step of these workflows and creating well-documented, well-understood protocols requires the right technology to alert the appropriate providers and staff on their mobile devices and stay on top of emerging requirements. A clinical communication platform provides the tools needed to keep everyone on task and accountable with secure group messaging capabilities, response and escalation tracking, and EHR integration that sends physicians actionable information that informs treatment. These situations can also involve the contact center, which often plays a central role in launching and monitoring the progress of codes from beginning to end.

3. REDUCE IT INFRASTRUCTURE AND EXTEND THE EHR The vast internal IT infrastructures spanning today’s hospitals and

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health systems are becoming difficult for internal teams to administer and protect. IT teams tasked with being heavily involved in supporting and maintaining new software implementations as well as the associated security policies may find themselves strapped for resources and even expertise. This is a key reason cloud-based systems are gaining traction. It’s time to alleviate the burden on IT teams, physicians, and nurses, and move to a clinical communication platform that can easily scale as the needs of your health system change. Cloud-native software helps ensure high availability and resiliency without draining IT resources. Plus, with continuous updates, you’ll always have the most reliable, most secure technology to support your patients. With a consolidated platform, you can focus on interoperability and extend the role of the EHR in care team collaboration with actionable information in physician’s messages. So instead of having disconnected applications for on-call scheduling, staff directories, secure messaging and clinical alerting, you have a centralized approach. This means less IT infrastructure and hassle as well as the associated cost of managing too many disparate systems.

IMPROVED PATIENT OUTCOMES, SAFETY AND SATISFACTION The common goal of hospitals and health systems is delivering the best-possible patient care. Well-coordinated workflows rooted in smooth, secure communication are the foundation of better outcomes and satisfaction rates.

HIGHER STAFF EFFICIENCY Looking at clinical workflows through the lens of efficiency often reveals opportunities for refinement, particularly when it comes to communication. Eliminating time

wasted calling the wrong on-call provider or hunting for an updated phone number seems simple, but will pay major dividends for all involved, particularly patients.

BETTER CLINICIAN SATISFACTION AND LOWER BURNOUT Eliminating longstanding inefficiencies and communication challenges goes a long way toward improving all aspects of care coordination and delivery. Lowering the administrative burden with EHR integration, fewer point systems, and highly effective secure messaging are essential.

REDUCED COSTS Improving the clinician experience can reduce costly turnover, while consolidating point solutions decreases IT expenditures. All-around better care team collaboration improves bed turnover rates. Effective clinical alerting that enables nurses to reach patients faster can also minimize fall risks and the associated costs. The health care environment is likely to remain unpredictable for some time as organizations struggle to treat the influx of COVID-19 patients. The months and years ahead will contain many uncertainties, but technology that takes a holistic and enterprise-wide approach to communication is an important step toward providing the support care teams require. The stakes have never been higher for patients, providers and hospitals. A clinical communication platform provides the path forward for hospitals and health networks eager for a fresh approach to protecting patients as well as their financial futures. Is a communication platform the best solution for your health care organization?.• MARK A. WATTS is the enterprise imaging director at Fountain Hills Medical Center.

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FINDING OURSELVES WHILE FINDING SOLUTIONS

BY JEF WILLIAMS

endor selection processes abound in the imaging space. For nearly 20 years I have participated in, and led, dozens. Whether it be for modalities, facilities or technology, health care has always taken a systematic approach to determining best-fit solutions for its problems. This could be because of the evidenced-based culture within health care. Most of the processes I’ve participated in have included technology, usually large-scale solutions. I have learned some important lessons along the way. The first is that there is never a silver bullet solution. When determining a replacement technology, there should always be a full self-discovery process that identifies gaps in the current state environment. These gaps, once identified, inform the problem statements and use cases that will be critical in framing the selection process whether it be a request for proposal (RFP), proof of concept (PoC), or some other codified methodology that provides empirical data in making your vendor of choice. Moving through the demos, observations, questions and answers, and references it always becomes apparent that none of the top vendors can fulfill all the functional and technical needs and requirements. This is where I have found weighting to be an enlightening effort. By prioritizing the 48

ICEMAGAZINE | DECEMBER 2021

needs and requirements, the picture of which vendor may best fit the need can become much clearer. The delta between most top-performing vendors has closed over recent years so finding the key differentiators is crucial to making a final decision. Second, understand that the process takes time and requires many more hours than most people expect. As mentioned earlier, a well-crafted framework for selection should always begin with a full self-discovery effort. This includes taking the time to meet with clinical, technical and operational stakeholders and identifying where deficiencies lie in workflow, performance, support, analytics and cost – just to begin with. This current state analysis should be coupled with lengthy and thoughtful discussions about the future state. Often organizations frame the future as “what we do now, but better.” The most successful organizations take a digital transformational approach and ask, “If we could do it the best possible way, regardless of how we do it now, what would that look like?” These are important and difficult dialogues to have and thus having sufficient time to work through is critical to its success. Finally, politics are real, and they aren’t going away. While most selection processes use metrics, math and surveys to quantify the vendors and their solutions, the ultimate decision should not be based on this data alone, and in my experience it never is. Keeping the process unadulterated from back door

dealings and handshake conversations between vendors and decision-makers is well understood. But even this does not eliminate the politics that will ultimately play a key role in the outcome of the selection process. Politics are often perceived as inherently negative, but they do play an important role in organizational initiatives, especially those that carry the level of interest, cost, resources and long-term commitment as these types of selections. Understanding that people with influence may wield that influence in the process will help mitigate what can feel like the sense of being undermined. At times, their reasoning may make sense, at others it may not. The most important thing to remember is that the selection is not a moral decision, it’s a personal preference. And while the “math” may lead to one solution, that math may not convince key leadership if they have other criteria they are considering in making the final determination. Vendor selection is nothing anyone gets too excited about. For many, it’s a necessary evil. But if you take the perspective that it will teach you new things about your organization, allow for creative strategies for future planning and coalesce the team participating in the process to be best positioned for an implementation and adoption cycle, it can be quite rewarding. Jef Williams, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners. ADVANCING THE IMAGING PROFESSIONAL

THE CONFERENCE FOR IMAGING PROFESSIONALS

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INSIGHTS

WHAT WILL 2022 LOOK LIKE? I DIRECTOR’S CUT BY BETH ALLEN

t is that time of year that we look back at all that has transpired over the last 12 months. I would like to think we have learned a lot. We have learned that we can make a political argument out of anything. We have learned that we can fight a pandemic head on. We have learned that some things are possible that we thought were not. We learned that we are able to solve problems quickly and efficiently when we are forced to do so. I would like to focus on where we go from here. What does 2022 look like? Hopefully, the pandemic settles down and this can just be a bad memory. The way we do things has changed. I would propose that we have possibilities now that we maybe didn’t have before. If we strategize and are creative, how can health care be better? How can working in imaging be better? One thing is constant and that is change. We can’t always prepare for what changes, but we know for sure that something will change. When you visualize the future of your department or team, what does it look like in a perfect world? What steps can you take to work towards that goal? It is worth it to spend time thinking about that. I know for me; I am so busy just trying to complete my tasks and work on projects that I don’t

ICEMAGAZINE | DECEMBER 2021

spend enough time dreaming about anything that isn’t a current problem. We become reactive instead of proactive. You have to be able to let your mind wander but be purposeful about it. What would you like to accomplish? If we all just take a few minutes a day and visualize the best possible way to manage imaging I think we can come up with some fantastic ideas. To start, let’s focus on what we are doing right? Have we offered staff schedules that allow for a balance of work and home for our teams? Do we have great ideas that engage our teams and make them happy to come to work? Have we tried to identify challenges that may cause stress while dealing with patients? Have we created processes and systems that don’t cause extra work and decreases the likelihood of an error? If the answer is yes to any of those, let’s dissect why those things work. How can we apply those successes to any of those questions that we cannot answer yes? What carries over to our patient experience? Some people write down three things they want to accomplish personally and three things professionally before bed so they can set the focus for the next day. It sounds like a great plan, which I hope I can stick to. The first step is to just do it. You focus on what is in front of you. I did set a goal to run a half mara-

ADVANCING THE IMAGING PROFESSIONAL

thon, and a fitness journal really helped me do that. It made me accountable to have to write down what miles I ran and how I felt. It was a four-month journal, so it had a hard-set completion date. I know if I apply the same principles to whatever we are looking to accomplish within our company I am more likely to be successful. I have written about it before, but we are going to have to market our imaging field to a new generation of people making career choices. When I was growing up, a large percentage of people my age wanted to go into health care in one form or another. My high school anatomy class was full of those of us excited for the possibility of a rewarding and challenging career helping people. Imaging attracted me when I saw the technology and science. It is so much more exciting now. We have a new fluoro unit that was designed to be more intuitive for gamers to use. WWW.THEICECOMMUNITY.COM

That is just a simple thing. There is amazing technology in all areas of imaging with more to come. People need to know what we are working with these days. To me, it just gets cooler and cooler all the time. We need to be sharing the technological advances and the miracles that come from them. Think of recent events and how that affects the impression of what these types of careers are like. There are stories on the news and in social media everyday about burnout, exposure to potentially life-threatening viruses and low compensation for long, stress-filled hours. We have staffing shortages now and we will need to solve that problem. Those topics are true, but I believe it will not be that way forever. We can offer the intangibles. Imaging has something for everyone. There is room for advancement, whether it is into leadership or to learn a new skill. Everyone has

different priorities and we can most likely offer a position that can fulfill those needs. It is never too early to start recruiting. I have worked with technologists over the years that had an encounter at a very young age with an imaging professional that set them on their career path. As a leadership group, I think we can work together to promote imaging as a solid career choice. Maybe 2022 will be the “Year of the Tech.” I am going to try this plan and see if I can come up with some new ideas. I hope you join me. As said, “We cannot become what we want by remaining what we are.” Thanks for all you do! • Beth Allen, RT(R)(CT), CRA, is the director, clinical operations at Banner Imaging.

ICEMAGAZINE

INSIGHTS

PERCEPTION IS REALITY THE ROMAN REVIEW

BY MANNY ROMAN, CRES

recently heard this, “If you think you can do a better job, go for it.” I mentioned that when presented in those words, with that tone, people will likely get the wrong impression. The reply, “I cannot control your perception.” I strongly disagree with this. I feel that the purpose of good communication is precisely to influence perception. What is the benefit to either party when neither believes that their statements and presentations have any influence in how they are perceived? Why even bother to attempt communication if you are not consciously striving to understand and be understood? How can you blame the recipient of your presentation for improper unraveling of your intent and meaning? People say that perception is reality. If this is true, why leave perception to chance? People also say that what you see depends on where you sit. I prefer to say,

ICEMAGAZINE | DECEMBER 2021

“What you see depends on where you choose to sit.” We each bring our own choice of a chair with us. This means that how we perceive things depends on a multitude of things that make up that chair. We all carry a mindset of values, ideas, understandings, misconceptions, preconceptions, personality, needs, wants, lions, tigers and bears. Our “Head World” causes us to forcefit new information into what we already believe. We tend to ignore facts and figures and emotionally attach our own meaning to what we see and hear. Our first reaction is always emotional. This is why people think, “I cannot control your perception.” It is this “Head World” that chooses the chair. We bring this variable chair with us to every encounter with others. We change the chair often during the interaction as understanding and perception changes. Have you ever had a great thought or idea, developed it and presented it only to find that others just don’t get it? How is it possible that those idiots cannot see what a ADVANCING THE IMAGING PROFESSIONAL

great idea it is? How can they not understand the brilliance in the concept and the value in the implementation? The combination of our “Head World” and the variable chair appear to be insurmountable obstacles to influencing perception. So how is it that we can realistically influence perception? Change the chair. When we present a new idea or concept to others, we must realize that our brilliant presentation is very likely falling on emotional, prejudging eyes and ears. Ineffective presenters, as well as ineffective leaders, think that it is all about telling the story and message. This does not work. The presentation must begin with the end in mind and be tailored to the desires and needs of the recipient. To effectively do this, we must use communication framing. Communication framing begins with the realization that we are communicating with different “Head Worlds.” Communication is a two-way street. It comprises the encoding of the idea into words and body language appropriate for the recipient, the minimizing of external and internal noise and the opportunity for feedback. To properly frame the message, we must anticipate the “Head World” and chair of our recipient and tailor the presentation to that “Head World.” What we are doing is providing a new chair to sit in. A chair that causes the recipient to exchange the chair he brought for the one we are offering. This is not as difficult as

it may sound. If we prepare what we will say, how we will say it and take into consideration the needs and wants of the recipient, we will be a long way into influencing perception. See last month’s column, “The plumber” and study the “7 Triggers to Yes” by Russell Granger for excellent suggestions on how to frame presentations. So … if perception is reality, then we can influence perception by providing the presentation that will guide the perception in the desired direction. If what you see depends on where you choose to sit, and if I can provide the chair that I want you to sit in, I can influence your perception and, thus your reality. This, of course, requires that I do more than make the chair available. I must also guide you to sit in it. How do I do that? Glad you asked. You do that by providing an effective presentation. So, it follows that presentation determines reality, therefore presentation is everything. All that said, it is best to do all this face-to-face. You did not hear how I said all of the above, and did not see my nonverbal cues, and did not have the opportunity to provide and request feedback. Sine we did not conduct good communication I am not responsible for your current chair and, therefore, I cannot control your perception. Ruth and I wish everyone happy holidays and a great New Year. •

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Science Matters

Why she tilts her head when you speak to her Human or other animal behavior that tends to one side or the other often stems from some asymmetry in the nervous system – such as the brain’s having two hemispheres. Because no research has been carried out on dogs’ familiar head-tilting behavior, Hungarian scientists conducted a controlled experiment on why they do it.

A test for clever dogs Some dogs (”gifted learners”) very often tilted their head upon hearing the owner’s naming and asking for a toy

7 ‘Gifted learner’ dogs

33 ’Typical’ dogs

Typical dogs rarely learn that behavior

An individual trait: some go left, some go right

These gifted dogs were

collie-types – herding breeds well-known for verbal intelligence

MAX tilts right

WHISKY tilts left

GAIA tilts left

What made the dog tilt its head

Among the gifted dogs, the human naming a toy that the dog was trained to recognize would make the dog tilt its head If the human spoke nonsense words, the gifted dog did not tilt its head as it processed the sound

WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

Imaging Jobs

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Universal Medical Resources, Inc., Associated Imaging Services, Mayo Clinic, Medical Imaging Solutions, Draeger, Trinity Health-Holy Cross Health, Banner Health

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Field Service Engineer

Universal Medical Resources, a leader in Nuclear Medicine Sales, Service, and Parts has openings for experienced Field Service Engineers throughout the United States. Field Service Engineers are assigned a territory where they are responsible for maintaining nuclear medicine equipment at customer’s sites. The position requires frequent travel within the territory as well as occasional travel outside the assigned territory.

VIEW FULL DETAILS www.htmjobs.com Customer Support Engineer II/III - X-Ray

The Customer Support Engineer II/ III installs, inspects, troubleshoots, repairs, calibrates and verifies the performance of medical imaging equipment including, but not limited to:, general radiographic rooms, portables, mammography, ultrasound, bone density and supporting equipment.

Field Service Engineer Nuclear Medicine

FSE job is for Wichita, KS. Hours of operation are 8:30am to 5:00pm Monday thru Friday (excluding Holidays). The territory you will be responsible for will primarily be Kansas and occasionally a few neighboring states. This job includes many benefits including health insurance, 401k investment plans, company car, PTO, bonus programs and more.

VIEW FULL DETAILS www.htmjobs.com Customer Support Engineer II/III - MRI/CT

The Customer Support Engineer II / III installs, inspects, troubleshoots, repairs, calibrates and verifies the performance of medical imaging equipment including, but not limited to: MRI and CT systems.

HTM Imaging Technician 2

Ensures that medical imaging equipment is repaired in a timely manner, works reliably, is safe to operate and functions properly. Consistently demonstrates a mastery of the skills necessary to perform preventive maintenance, quality assurance testing, equipment calibrations, installations, and corrective maintenance on a variety of imaging equipment. The individual may be required to support several technologies types including MRI, CT, PET, ultrasound, general and interventional X-ray, mammography, nuclear imaging, and linear accelerators.

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Under supervision, the Imaging Equipment Technician calibrates, repairs and maintains medical equipment used for diagnostics procedures.

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Technical Service Specialist III - Field Technician

Imaging Equipment Specialist II

Diagnostic Imaging Equipment Technician

Provides direct technical field service support for medical equipment at the customer site including installation, maintenance, repair and technical support.

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Trinity Health is one of the largest multi-institutional Trinity Health includes 94 hospitals, as well as 109 continuing care locations. Trinity Health Clinical Engineering (THCE) program supports each Health ministry location To work as partners, in an equal stakeholder environment, toward reducing Trinity system-wide clinical equipment life cycle costs, while improving customer satisfaction, reducing equipment downtime, sharing best practices, and creating Clinical Engineering core competency.

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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.

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INDEX

ADVERTISER INDEX AllParts Medical p. 9

Association of Medical Service Providers (AMSP) p. 59

Beekley Medical p. 31

Diagnostic Solutions p. 39

KMG p. 23

PM Imaging Management p. 31

Ray-Pac® The Trusted Name in Women’s Health Mammo

p. 2 You’ve long trusted to provide you with radiology services, parts, and supportnow we have a team fully committed to digital Maull Biomedical mammography with more p. 53 than a decade of experience powering it. Want to explore 's end-to-end mammography solutions further? Medical Imaging Let us know how weSolutions can help. p. 21

Ray-Pac p. 60

Richardson Electronics Healthcare p. 44

TransAmerican Medical p. 37

HTMjobs.com p. 56-57

855-3D-Mammo Hello@mammo.com

MedWrench p. 4

mammo.com

SOLUTIONS

TriImaging Solutions p. 3

ICE Webinars p. 15

Metropolis International p. 44 W7 Global, LLC. p. 37

Injector Support and Service p. 30

KEI Medical Imaging p. 31

ICEMAGAZINE | DECEMBER 2021

MW Imaging Corp. p. 5

ADVANCING THE IMAGING PROFESSIONAL

AMSP