ICE Magazine February 2022 by MD Publishing

FEBRUARY 2022 | VOLUME 6 | ISSUE 2

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ADVANCING MAGAZINE

IMAGING PROFESSIONALS

RIGHT TO REPAIR AND MEDICAL IMAGING DEVICE PURCHASING PAGE 34

PRODUCT FOCUS IMAGING PARTS PAGE 30

IN FOCUS BRADLEY SPIELER

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FEATURES

38 DIVERSITY

FEBRUARY 2022

PACS/IT/AI

Equality is to treat everyone evenly, but that does not mean you have treated everyone fairly. All of us have different and unique situations that we may not be able to work around.

Human-centered artificial intelligence deployment takes into consideration the system design to bring ambient intelligence to a project.

PRODUCT FOCUS Check out some solutions provided by imaging parts providers.

COVER STORY

When selecting a new piece of medical imaging equipment, the demands of cost and functionality are considered. Right to repair is another factor for many facilities.

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

14 ICE 2022

RISING STAR

Imaging Conference & Expo Brings Leaders Together

ICEMAGAZINE | FEBRUARY 2022

Catch up on the latest news from around the diagnostic imaging world.

34 ICE2022

IMAGING NEWS

ADVANCING THE IMAGING PROFESSIONAL

Kamlesh “DJ” Patel is an imaging informatics (PACS) manager and a disc jockey on the side!

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WHAT’S INSIDE MATTERS CONTENTS WHAT’S WHAT’SINSIDE INSIDEMATTERS MATTERS

SPOTLIGHT

In Focus Bradley Spieler

John M. Krieg john@mdpublishing.com

Rising Star Kamlesh Patel, (PACS) Manager

Vice President

ICE 2022 Imaging Conference & Expo Brings Leaders Together

Off the Clock John Mayes

Rad Idea 30 Second Tactic to Improve Organizational Culture

President

Kristin Leavoy kristin@mdpublishing.com

Group Publisher

Megan Strand megan@mdpublishing.com

Editorial

John Wallace

Art Department Karlee Gower Taylor Powers Kameryn Johnson

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Events

Kristin Leavoy

Webinars

Jennifer Godwin

NEWS

PRODUCTS

Market Report Medical Imaging Market Soars

Product Focus Imaging Parts

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak

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

We deliver an inside advantage you can’t get elsewhere: deliver inside advantage can’t elsewhere WeWe deliver anan inside advantage youyou can’t getget elsewhere:

INSIGHTS

Diversity Diversity, Equity, and Inclusion

Director’s Cut We Could All Use Some ‘Positivity’

42 Summit Imaging

A No Risk Cost Savings Strategy for Health Care Facilities: Ultrasound transducer repair

44 ICE Magazine (Vol. 6, Issue #2) February 2022 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.

Emotional Intelligence Be Careful When Focusing on Numbers

Rad HR Recovery Time of a Toddler

PACS/IT Human Centered AI & CAD Report Deployment

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. © 2022

Roman Review People Are Our Greatest Asset (Not)

54 58 59 62

ICE Break

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Index ADVANCING THE IMAGING PROFESSIONAL

X-ray of GE C3-10-D X-ray X-ray of GE of C3-10-D GE C3-10-D

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SPOTLIGHT

IN FOCUS BRADLEY SPIELER

BY JOHN WALLACE

r. Bradley Spieler is a native of the greater New Orleans area and completed nearly his entire education in New Orleans (including medical school at LSU in New Orleans graduating with AOA honors). The education he received away from New Orleans included his residency and his fellowship in abdominopelvic imaging, which he completed at New York University in New York City, graduating as fellow of the year, an award recognizing excellence in resident education.

Dr. Bradley Spieler, front left, loves helping people through his work and through the nonprofit he founded.

ICEMAGAZINE | FEBRUARY 2022

Prior to his medical training, he attended Tulane College where he graduated summa cum laude. He is a product of the local public school system, hailing from Bonnabel High School, where he was the valedictorian. He is an avid world traveler, music lover, devoted Saints fan and enthusiast of all things New Orleans. Spieler is board certified by the American Board of Radiology, currently serving as the vice chairman of scholarly activity and research for the LSU Department of Radiology and practicing as a member of the abdominopelvic and emergency imaging sections at LSU Health Sciences Center in New Orleans. He holds the rank of associate professor of radiology with joint appointments in the departments of internal medicine, urology, cell biology and anatomy. He had a unique answer when asked, “Why radiology?” “My challenge in choosing a career path as a third-year medical student was that I loved all my rotations. Radiology provided me the opportunity to incorporate all the things I was passionate about across a myriad of medical disciplines into one,” Spieler said. When asked to describe his greatest accomplishment, Spieler’s reply did not talk about one goal he achieved. He, instead, focused on the future. “Being in a position where I can help others achieve their

dreams,” is what he considers his greatest accomplishment. When it comes to mentors, Spieler lists several individuals who have assisted, motivated and inspired him. “Dr. Alec Megibow and the late Dr. Michael Macari are the most influential mentors of mine when it comes to radiology,” Spieler said. “They are champions of a patient-centered approach and consistently providing value to every task in radiology. Because of them, I approach every case as if it was a loved one.” “They also stressed that a team-based approach is critical to the success of our field and most importantly in providing excellent patient care. Consequently, I have made it a priority to provide mentorship to not only trainees and junior colleagues but to any health care professionals that I interact with, especially within radiology. Sharon Mohammed is currently a radiologic technologist at Memorial Sloan-Kettering in New York City. Moreover, she is a prolific author and educator. I have had the privilege of providing guidance to her and collaborating. She embodies the collective vision to workflow in diagnostic radiology that we should all strive for and has served as steadfast inspiration to me.” His list of mentors continues. “I owe success in my career to a cadre of mentors in addition to Drs. Macari and Megibow, including Dr. Neil Baum of Tulane University, Dr. Elizabeth Hecht of Weill Cornell Medicine, Dr. Janis Letourneau of Louisiana State University Health Sciences Center, Dr. Robin McGoey of University Medical Center in New Orleans, Drs. Louis Schruff and Brad Shore of Reliant Radiology LLC, and Dr. Khaled Elsayes of University of Texas MD Anderson Cancer Center,” Spieler said. Spieler is an imaging leader who serves as an active mentor to medical students and residents. He also is an active contributor to clinical literature. Spieler is the co-course director for multiple interdisciplinary conference series involving the departments of surgery and internal medicine. He is also faculty on multiple regular medical student and resident conference series particularly in the department of medicine. He also serves as a coordinator for the longitudinal radiology elective for second-year medical students and career advisor for senior medical students entering the

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radiology match. Spieler is actively involved in multiple university-based committees. Nationally, he is an active member in multiple societies including the American Roentgen Ray Society serving as an item writer for CME activities and consulting editor for the American Journal of Radiology for genitourinary imaging. He is also a manuscript reviewer for multiple journals. He is a grant reviewer for the Louisiana Biomedical Collaborative Research Program and is an active member of the Liver Reporting and Data System (LI-RADS) Tumor Response Working Group (TRWG) which is endorsed by the American College of Radiology. Spieler is also an active member of the Radiological Society of North America (RSNA) as well as the Association of University Radiologists where he has held leadership positions and regularly participates in the Radiology Research Alliance and Alliance of Leaders in Academic Affairs in Radiology. He has also founded the nonprofit Saints Fans Being Saints Program in association with the Spirit of Charity Foundation and University Medical Center New Orleans. Proceeds benefit children and immediate family members of those diagnosed with a life-threatening illness identified by the University Medical Center in New Orleans’ Palliative Care team. He also continues to serve the community through active involvement in other nonprofit organizations. Friends and family are important to Spieler. “I’ve been blessed with a wonderful wife, Catey-Batte Spieler, and three amazing children, ages 3, 2, and eight months. All of our family live here in New Orleans and for the most part within the greater New Orleans area as well as throughout Louisiana,” he said. “My mother and father always encouraged me to look for the best in people and stressed the importance of travel. We believe that friends are the family you choose and as a result I have been fortunate to develop friendships with individuals from all over the world.” It appears that Spieler is living his best life and perhaps that goes along with the reason he loves his work. “As a radiologist, I am afforded the privilege of not only caring for patients but also the opportunity to aid a range of health care professionals,” Spieler said. •

BRADLEY SPIELER

Vice Chairman of Scholarly Activity and Research LSU Department of Radiology What is the last book you read? Or, what book are you reading currently? “Green Eggs and Ham” by Dr. Seuss. “You do not like them. So you say. Try them! Try them! And you may.” Is my favorite part to read along with my children. Favorite movie? “Goodfellas” What is one thing you do every morning to start your day? Before I approach any case, I ask myself what Dr. Michael Macari would do. He was one of the best physicians I’ve ever met and the ideal radiologist. Best advice you ever received? Always express gratitude and respect for others. Who has had the biggest influence on your life? My wife Catey Batte-Spieler. She is the best person I’ve ever met, my unrelenting inspiration, love, and motivation to always aim to become better. What would your superpower be? Teleportation. What are your hobbies? Reading, running, art collection, travel, all things New Orleans. What is the perfect meal? A crawfish boil with family and friends. Mrs. Linda’s yakamein on Jazz Fest morning with my wife.

ICEMAGAZINE

SPOTLIGHT

RISING

STAR KAMLESH PATEL BY JOHN WALLACE

FUN FACTS

Favorite hobby: I love music, so I DJ on the side. Music changes people’s moods and with music, I can make memories for people at their events by making sure they have a great time. Favorite Vacation Spot: India Favorite Food: Anything my mom or wife cooks is awesome. There are too many great dishes to name.

ou are what you do? Kamlesh “DJ” Patel is an imaging informatics (PACS) manager, as well as a disc jockey on the side! Patel has his biomedical engineering technology degree, his technical management degree and will soon have his MBA. “I started in the industry as a biomed and took every opportunity to learn about medical equipment and officially got into the ultrasound/imaging side about three to four years ago,” said Patel. “I attended many different training schools offered by various vendors. I know I wanted to get into management, so I pursued the degree. An opportunity came up at Deborah Heart and Lung Center, and I applied for it and was promoted to the new imaging informatics (PACS) manager.” ICE learned more about this “Rising Star” in a recent interview. Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: I didn’t choose this field. This field chose me. An opportunity came up when we needed someone to learn ultrasound in our department, so I took the opportunity. I never thought of being in the imaging field. Once I entered the profession, it was a whole different world.

talents to help others make their jobs easier, as well as fixing issues so they can do the proper job to help our patients. The best thing about my position is making sure I bring my team along with me so that everyone is properly trained and has the information they need to do their jobs most effectively. The most rewarding thing about my job is patient safety. It’s a blessing to be part of a team that everything you do will help someone do their job to help the patients.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: I am just amazed at the innovation of advanced technology that is being developed for imaging, and how that is being used to help and treat patients.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: I have found several bugs in some of the manufacturers’ imaging systems, and I have been able to quickly correct them with the manufacturer’s help. I have also dealt with issues with manufacturer’s, where they didn’t believe me when I found an issue, and it turned out to be a recall. Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: Hopefully in the next five years, I can continue to progress upward in management, where I can help and make a difference for employees and patients. I love motivating people and listening to the ideas they can bring to the table. •

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I really enjoy learning new software and how I can use my

ICEMAGAZINE | FEBRUARY 2022

ADVANCING THE IMAGING PROFESSIONAL

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Your Partner in Healthcare Technology Management

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

IMAGING CONFERENCE & EXPO BRINGS LEADERS TOGETHER

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Annual Conference set for Napa later this month BY JOHN WALLACE

he Imaging Conference and Expo (ICE) is the only conference dedicated to imaging directors, radiology administrators, and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers valuable comprehensive educational opportunities for attendees. “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 profes14

ICEMAGAZINE | FEBRUARY 2022

sionals 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!” ICE 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.

ICE 2022 is approved for 32 ARRT Category A CE credits by AHRA. The conference has been pre-approved by the ACI for up to 6 CEUs. The CRES Study Group and Prep Class has been pre-approved by the ACI for a total of 7.5 CEUs. 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! • For more information, and to register,

theimagingacademy.com

visit AttendICE.com.

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www.TheImagingAcademy.com

844-897-9043

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SPOTLIGHT LEFT: John and Deborah Mayes smile for the camera. The two met when John taught Deboarah at Fort Sam Houston

Off Clock THE

JOHN MAYES, PRESIDENT OF CLIENT SERVICES AT SOUTH TEXAS ASSOCIATES OF RADIOLOGY LLC BY MATT SKOUFALOS

rowing up on a small farm near Greenfield, Iowa, John Mayes remembers driving tractors and doing field work from the time he was 11 years old. His family lived 3.75 miles outside of the closest town, Mayes said he “felt like we were in the middle of nowhere, but it was a good life.” “The family didn’t have much money, but there was always plenty of food on the table,” he said. “I don’t think we ever had a car that was newer than a four-yearold model until the kids were out of the house. We grew what we ate, and Mom could sew patches on top of patches on the blue jeans that Dan and I wore.” The resiliency of farm life fed Mayes’ 16

ICEMAGAZINE | FEBRUARY 2022

aptitude for learning, which itself led to new opportunities. In need of a trainer, Mayes’ high school wrestling coach invited the rising freshman to take home materials for a correspondence course from a medical supply company that would teach him the basics of sports medicine. Mayes completed the course, and became the student trainer for his high school football and wrestling teams, a role he continued at the University of Northern Iowa, and which provided the foundation for his interest in a career related to medicine. In 1971, when Mayes was graduating with a degree in secondary education, the United States was two years into a national draft lottery to enlist young men into the Vietnam War effort. Mayes’ lottery number was five, which put him at the top of the list for his Iowa county. To avoid being drafted — with no choice of military specialty — into the artillery

or infantry divisions, he chose to enlist in the U.S. Army to pursue an assignment as a combat medic. Mayes arrived early for his orientation at Fort Sam Houston, and was assigned to the motor pool for a time, learning how to drive Jeeps and two-and-ahalf-ton Army vehicles. He recalled one conversation with a colonel during which he told the senior officer of his intention to become a combat medic. “He gave me a side eye and said, ‘I suggest you go to something a bit more challenging,’ ” Mayes said. “I later learned before medic training that medics were the ones with the ‘targets’ painted on their helmets. And that’s how I got to X-ray school.” In X-ray school, Mayes wasn’t only the honor graduate of his class, but because he held a teaching degree, and the base was already critically short of military instructors, he was invited to become an ADVANCING THE IMAGING PROFESSIONAL

instructor, teaching new recruits the information he’d just learned. He remained at Fort Sam Houston for the next three years of his enlistment contract. In 1974, when several military jobs were converted to civilian positions, Mayes extended his stay another 30 years. Over the course of three decades, he educated more than 12,000 X-ray technologists, including seven sets of fathers and sons, and Deborah, the woman who would become his wife and mother to their two children. “It was a fun job,” Mayes said. “It was new people and new classes, and the Army’s X-ray program was huge. We were teaching 10 classes a year, 44 students per class, and then for a while, double-shifting to 88 students, graduating 880 techs a year. It was the biggest X-ray school in the world. It was almost like you were in college again because all the students were so young.” Along the way, Mayes expanded his own education, completing a dual master’s degree in management and human relations from Webster University in 1978, and becoming an early adopter of personal computing technology in the early 1980s. Learning programming on a Commodore 64 turned a knack for mathematics into an aptitude for database management that became “life-changing,” Mayes said. “I enjoyed numbers and making balances come out exactly right, accuracy, and grade-point averages. I subscribed to a couple of magazines, and typed in my own program to have a word processor, and my own program to have a database. Everything was stored on a cassette tape, which was the earliest storage device for the C64,” he explained. At X-ray school, Mayes and another instructor who had a personal computer would bring their Commodores into the facility to process grades and update class rankings. Eventually, he began tracking all students’ records and academic averages. But to Mayes, “I was just a cog in the wheel doing a necessary function.”

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In 2004, after his retirement, Mayes was considering the next phase of his career when he ran into Warren Parker, a former colleague from the service. He told Parker he was considering starting a company to offer continuing education seminars, and together with a third partner, the trio established a business to do just that. A month-and-a-half after their early discussions, they launched South Texas Associates of Radiology (STAR). Mayes’ role was to handle the back end needs of the business, manage its databases, keep the books, maintain its web presence and create certificates for students completing coursework. In 2015, the company expanded to offer a telepresence in addition to its in-person schooling, and during the novel coronavirus (COVID-19) pandemic, began offering webinars exclusively. Now, as he mulls a second retirement, Mayes regards the life he’s led since leaving the farm in Iowa in a much broader focus. “My goal way back then was maybe to be a high school teacher, and I didn’t really have aspirations beyond that,” he said. “Ninety percent of people change course at some point; everything happens for a reason.” Neither has he lost his loves of tinkering and service. Mayes’ quarantine project, a PVC-framed, battery-assisted pedal car, has become an amusement to share with his wife and grandchildren. Nicknamed “The Red Rocket,” the car is “a big hit with the neighbors” in his San Antonio community, but it’s not the only driving Mayes does these days. He’s also an active volunteer with North East Senior Assistance, through which Mayes spends some mornings taking ambulatory seniors to medical appointments, and organizes senior game days and luncheons for the community associated with his church, Windcrest United Methodist. It’s much-needed social connection for the people in his community, but Mayes shrugs off any praise for his efforts, saying instead, it’s just “something I can do to help.” “It’s been a good life,” he said, simply. “I have no regrets about anything.”•

ABOVE: The Red Rocket is a PVC-framed, battery-assisted pedal car John Mayes built during the COVID pandemic.

ICEMAGAZINE

Rad idea SPOTLIGHT

the organization, not to mention their perceived lack of appreciation and support. Regardless of the facts in that initial conversation with their leader, details will be skewed, usually favoring the employee. Consequently, misinformation and negative emotions wear on the existing department culture like hot water on ice. Much of what the leader or organization accomplished for employee engagement can be undone so easily. Therefore, to ensure the foundation of organizational culture remains strong, we can use simple conversations to foster a positive culture using this same wildfire strategy. Consider selecting employees to come to the office for a chat with their lead, but instead of addressing a concern, take a mere 30 seconds to let them know face to face about a recent recognition or just a pause to recognize their work or to check in and connect with them. This 30 seconds is beneficial in a multitude of ways. Can you imagine the reactions when they return to their areas after this meeting with the “boss” and answer the proverbial, “What did the boss want to see you for?”

question! Instead of spewing negativity and maybe an expletive or two of the boss, their coworkers, or the organization, they may very well answer, “Wow, would you believe the boss called me to thank me and to recognize my efforts!” If senior executives are involved, employees will feel like a human with a name, rather than a worker bee or just an employee. As leaders, we know how much conversations matter, but we overlook these simple ones. This simple 30 seconds of conversation can drive a positive culture with a significant positive impact on the team and, ultimately, the organization! So, want to try a tactic that isn’t labor-intensive and does not require consultants and academic research? Then, try the 30-second tactic rather than relying on action plans, mission statements, committees, and other complex, lengthy methods for employee engagement and cultural change. Simple conversation is a pillar in the foundation of organizational cultural change. • Share your RAD IDEA via email to editor@mdpublishing.com.

30-SECOND TACTIC TO IMPROVE ORGANIZATIONAL CULTURE BY NICOLE DHANRAJ

ost of us leaders are on the quest to attain the organizational culture that makes us the best place to work or have the best ratings with our customers. It’s been a hot topic for years. There are millions of books on the subject and countless strategies you can implement based on evidence-based best practices. In any position, you can count on every organization to have an initiative that you will be using to tackle organizational culture. As I reflected on my recent Press Ganey scores, you guessed it; organizational culture was an opportunity for us to continue to address. I pondered on strategies to help my department and developed an action plan. Like other leaders looking to improve employee engagement and organizational culture, we are participants in organizational committees or seek consultants to assist us with their expertise to “nail” the best approach. We delve into the journals and forums of various associations for a review of best practices and, in some cases, phone a colleague to discuss their strategies in the hopes of mimicking and having the same success. With all of this information, we develop

ICEMAGAZINE | FEBRUARY 2022

and implement an action plan with SMART goals to improve our organizational culture with associated metrics. Yes, we can’t forget those metrics to support our efforts! While all of these strategies have return on the effort placed, improving culture does not have to be a complex strategy. A simplistic approach can yield a significant impact. One simple and straightforward tactic is a 30-second conversation between an employee and their leader. Adding senior leaders and executives amplifies the positive impact! Yes, back to the basics of using conversation to yield results. Organizations are often viewed as a series of problems to be fixed; therefore, many conversations between a team member and their one up is negative, such as addressing a complaint from another department, or resolving conflict with other colleagues, or addressing a quality assurance concern. As a result, when the employee finishes one of these “negative” or performance management conversations and returns to their work area, they may be set loose like a fiery canon! The employee will most likely engage in a less than a favorable recount of the conversation with their colleagues. This allows ev-

eryone prime ground to chime in their opinions to include emphasizing their issues with leaders and

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A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

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626 Holdings LLC has acquired California Radiographics Inc. (CRI). “CRI could not be a better fit. From a culture standpoint, a modality strengthening, a geographic expansion and a listening to our customers’ needs, CRI hits on all objectives. We are very excited about our future with CRI,” stated Philip Revien, CEO of 626. “The core question Phil and I continue to ask ourselves is: is this the best move for our customer? If the answer is yes and it will increase our value to our customers and their patients, we have our answer,” 626 Preisdent Michael Fischer said. In business since 1977 and based in Soquel, California, CRI is a leading OEM and third-party provider in the X-ray space throughout most of California. From technical support with parts identification, to new and used equipment sales, service, installation and deinstallation, CRI delivers an end-to-end solution for medical X-ray to multiple channels.

“CRI and 626 have a lot in common. Both are family businesses, founded as a high quality, agile, cost advantageous solutions for OEM and aftermarket service and support for our varied customer base. We have been and will remain dedicated to our employees, customers and their patients. After spending time planning next steps for optimal CRI growth with Phil and Michael, there was no doubt that the best decision was an alliance with 626,” CRI General Manager Roger Buttacavoli said. 626’s purchase of Walsh Imaging in 2017, ISS in 2019, PhiGEM in 2020 and both Independence Cryogenic Engineering and Digitec Medical earlier this year, follows its approach to base acquisitions on what matters most to them; family. This method has proven to be successful as they were able to double Walsh Imaging and ISS business within two years and they plan to do the same with CRI. • For more information, visit www.weare626.com.

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NEWS DIRECTOR OF OPERATIONS RETIRES AFTER 47-YEARS IN RADIOLOGY

PHILIPS INTRODUCES FULLY INTEGRATED ECHOCARDIOGRAPHY EXPERIENCE Royal Philips has expanded its ultrasound portfolio with new robust imaging tools and features for cardiology to increase diagnostic confidence and workflow efficiency. At the EuroEcho 2021 Virtual Congress, Philips showcased how its cardiac ultrasound solutions support cardiology patients and clinicians, from early detection, diagnosis and treatment, through ongoing assessment and long-term follow-up. Philips brings together the latest release of the EPIQ CVx and Affiniti CVx ultrasound platforms, automated analysis, Collaboration Live remote diagnosis and Cardiovascular Workspace – IntelliSpace Cardiovascular – end-to-end workflow, for a fully integrated experience in echocardiography. Advanced technology is helping to foster first-time-right diagnosis and timely treatment. Philips nSIGHT Plus is a proprietary imaging architecture that touches all aspects of image acquisition and processing, creating images with optimal resolution down to the pixel level, in contrast with conventional systems that form the image line by line. In addition, the new Philips X5-1c transducer facilitates easier access to imaging windows between the ribs. Clinician feedback showed that diagnostic confidence in 3D left ventricular function quantification was improved in 80% of patients undergoing transthoracic echo (TTE) exams using the X5-1c transducer. Philips’ AI-enhanced Auto Measure application delivers fast and consistent measurements in half the time of manual methods. Using Auto Measure on Philips EPIQ CVx and Affiniti CVx ultrasound systems can reduce the time for standard 2D echo measurements by 51%. Auto Measure AI and AutoStrain Left Atrium (LA) and Right Ventricle (RV) are now available across the Philips CVx portfolio. Enabling remote access and limiting risk of COVID-19

exposure, Philips echocardiography suite also includes Collaboration Live, an integrated tele-ultrasound solution providing remote access to clinical staff in real-time during exams. “With echocardiography the first imaging modality utilized for a greater volume of patients, clinicians are relying on ultrasound to provide care more than ever before,” said Jeff Cohen, general manager of ultrasound at Philips. “Cardiac imaging workflows need to be streamlined at every step to address the volume and complexity of cases. Philips echocardiography provides a connected ecosystem of integrated workflow solutions for cardiology. Combined with advanced diagnostic tools, our integrated solutions deliver clear insights on the patient’s condition quickly. These recent introductions also reinforce how our ultrasound capabilities bring strong clinical value to areas outside of echocardiography, including liver disease management, to help improve decision support and care at each step in the patient journey.” “Imaging performance is the most important attribute to allow me to be confident in my diagnosis and treatment planning,” said Dr. Roberto Lang, Director, Noninvasive Cardiac Imaging Laboratory, University of Chicago. During the European Society of Cardiology virtual symposium, “Transthoracic echo like you’ve never seen before,” Lang explains how the new X5-1c echo transducer and AI-enhanced quantification are designed to improve clinical confidence in everyday patient care. Philips Ultrasound System – EPIQ CVx – and Ultrasound System – Affiniti CVx – provide a suite of features that can help reduce exam times, from the echo lab to the patient bedside, all while providing the confidence clinicians need to help enhance decision-making to inform the best treatment plan. •

GE HEALTHCARE COMPLETES ACQUISITION OF BK MEDICAL GE has completed its previously announced acquisition of BK Medical, a leader in advanced surgical visualization, from Altaris Capital Partners LLC. The companies entered into a definitive agreement for GE to purchase BK Medical for a cash purchase price of $1.45 billion on September 22, 2021. With this acquisition, GE Healthcare adds the fast-growing and relatively new field of real-time surgical visualization to GE’s pre- and post-operative ultrasound capabilities, creating an end-to-end offering through the full continuum of care – from diagnosis through therapy and beyond. Through significant synergies with the benefit of GE’s technology and commercial scale, BK Medical will be able to reach new

ICEMAGAZINE | FEBRUARY 2022

customers and markets around the world. Under the leadership of current CEO Brooks West, BK Medical will join GE, reporting into Roland Rott, president and CEO of GE Healthcare Ultrasound, and will continue to best serve its customers in the intraoperative ultrasound space in the U.S., Europe and beyond. Rott said, “We are thrilled to bring our extraordinary teams together, learn from each other and continue to build on our deep, shared expertise as we grow our portfolio that our customers turn to and trust. Now together as one family we are looking forward to an even brighter future.” •

ADVANCING THE IMAGING PROFESSIONAL

Claudia Kraly retired as the director of operations in radiology at University Hospital Cleveland on January 7, 2022. She began her work at UH Cleveland Medical Center on June 2, 1974. After a 47-year career, she admits that she never intended to work in diagnostic imaging. “Interestingly, I did not originally plan a career in health care,” she explained. “I had applied to several colleges and intended on a teaching career. My best friend’s sister talked us both into applying to radiology programs. As I look back, it was probably one of the best decisions I could have made. I have had a long and what I feel was a successful 47-year career, that has afforded me many opportunities.” Kraly was the first in her family to graduate from college and credits her education for the opportunity to move from a nuclear medicine tech into a leadership position. One reason she found her career highly rewarding is because it offers variety. “Each day is different, there is always something new to learn or something out of the ordinary to deal with. I enjoy the challenge,” Kraly said. “I enjoy the people I work with. Many have been co-workers for a while and we are like a family. Most important, it is satisfying to know that what we do truly helps people.” Change is inevitable, especially over more than 40 years in one area. Kraly said she has seen many changes since

embarking on her career in the 1970s. “When we started imaging with our first CT, it took hours to process the data for a simple head scan, now it is in some cases seconds. We see nuclear medicine moving from a diagnostic, not always very specific tool, to theranostics; diagnosing and treating cancers. It has been an incredible journey,” she said. Her 40-plus years in radiology came with lots of love and support from her spouse. “My husband, Jim, and I have been married 43 years. We have two daughters, both in health care related IT jobs. I have an awesome 5-year-old grandson, who keeps us very busy,” she said. •

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NEWS

NEW OFFERING COMBINES LENOVO WORK STATIONS AND LG MONITORS

SENTINEL CAPITAL PARTNERS, TTG TEAM UP TTG Imaging Solutions LLC (TTG) has announced a partnership with Sentinel Capital Partners, a private equity firm that invests in promising midmarket companies. The partnership between Sentinel and TTG’s management team will drive the company’s next phase of growth. Sentinel invests in management buyouts, acquisitions of family businesses, corporate divestitures, industry consolidations and going-private transactions in the United States and Canada. TTG was founded by Jack Tomayko in 2004, and has been highly acquisitive in recent years, completing nine transactions across each of its business units since March 2019. “TTG has achieved significant organic and acquisition growth over the past several years. Our differentiated level of service across all business units, coupled with a customer-centric philosophy, attracts acquisition targets and customers alike,” said Matt Mastarone, president and CEO of TTG. Mastarone continued, “It was our goal to find a partner who shared our vision of TTG within the broader medical imaging industry. We aim to provide the highest quality equipment and service and to deliver value to our customers through turnkey staffing and radiopharmaceutical solutions in our end-to-end model. Sentinel is the right partner to help us grow while maintaining our focus on this goal.” “Since its founding, TTG has built a reputation of providing best-in-class services that allow physicians, imaging

centers, and hospitals to offer top-quality patient care,” said Paul Murphy, a Sentinel Partner. “The TTG team has developed an impressive growth playbook and we are thrilled to provide them the capital and support to significantly expand the business. We look forward to working with TTG’s talented team as they enter their next chapter of growth.” The TTG end-to-end Solution is comprised of: TTG Imaging Solutions – new and refurbished equipment sales, clinical applications support, parts, and nationwide service that help the marketplace extend the useful life of its valuable medical imaging equipment Cardiac Imaging Solutions – turnkey nuclear, echo, and vascular testing programs that offer physician practices and health systems the flexibility and efficiency of an outsourced model TTG Isotopes – radiopharmaceuticals that include cardiac imaging agents, custom-compounded iodine therapy, and a complete line of products used in general imaging TTG was honored in 2021 by the Pittsburgh Business Times as the fastest growing organization in the region for the $25-$100 million revenue category. •

Lenovo and LG Electronics are working together to advance new medical imaging solutions for the radiology community. The offering bundles LG’s high-performance medical monitors with the Lenovo OEM Solutions commercial third-party portfolio of offerings. The Lenovo-LG bundle will provide diagnostic and clinical solutions in key imaging areas through the combination of Lenovo ThinkStation workstations and LG Medical Monitors. The global pandemic has become a catalyst for digital transformation and accelerated the push to develop new solutions that operate efficiently in dynamic technology ecosystems. The radiology information systems market is expected to be worth over $979 million by 2025. “Proven technologies that can support the most advanced AI-enhanced medical imaging solutions, including object detection and segmentation, are being increasingly adopted by health care systems. Lenovo workstations combined with LG medical

monitors are rising to the opportunity to advance healthcare,” said Tom Hurlbut, Lenovo OEM business general manager and global executive. “LG’s clinical and diagnostic medical monitors are designed to empower health care professionals to make informed life-saving decisions,” said Brian Fabrizio, medical information displays team leader at LG Business Solutions USA. “Working with Lenovo helps streamline the purchase process for LG medical monitors.” Complementing Lenovo’s ThinkStation workstations, LG’s health care monitors enable improved quality of medical services, providing consistent, high-quality images. “As we expand our third-party offerings, this LG medical monitor collaboration is a timely decision for powering what’s next in healthcare and radiology. The predictability and reliability of our ThinkStation portfolio matched with the quality and performance of LG monitors is the perfect match for medical solution developers,” said Hurlbut. •

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NEWS

NFL STADIUM ADDS MRI SCANNER

MOBILE IMAGING SYSTEMS BOOST WORKFLOW Carestream Health’s mobile diagnostic X-ray systems help Franciscan Health Crawfordsville, a 103-bed hospital in Indiana, provide its community with advanced medical imaging and patient-centric care, while boosting workflow and productivity. The hospital has three Carestream DRX-Revolution Mobile X-Ray Systems and one retrofitted portable unit that typically function as independent X-ray rooms. One unit is dedicated for imaging patients at their bedside in the emergency room. The other units support surgery along with a wide range of inpatient needs. Franciscan Health Crawfordsville conducts 40 to 70 X-rays a day, and half are performed in the emergency room with the DRX-Revolution. “The DRX-Revolution is so fast and easy,” said Cheryl Cody, imaging manager at Franciscan Health Crawfordsville. “We’re able to go to the emergency room and conduct exams quickly, which is essential because we’re busier than ever. This technology helps us get patients in and out, and our turnaround time is fast.” “The mobile system is network driven, so after we scan our paperwork, it displays the correct patient with the correct medical record number and connects to the PACS seamlessly,” Cody said. “Everybody loves it, it’s very easy to use.” As the industry’s first mobile X-ray unit with a collapsible column, the DRX-Revolution Mobile X-ray delivers high-quality diagnostic images in tight spaces. The system helps limit the spread of infection by providing critical imaging services whenever and wherever needed, especially important during the COVID-19 pandemic. It has additional features that help reduce contamination, including

ICEMAGAZINE | FEBRUARY 2022

flush-mounted displays that provide a smooth surface for better disinfecting and wristband barcode scanners for easier workflow and limited equipment interaction. Like other Carestream digital radiography (DR) systems, the DRX-Revolution includes the ImageView Software platform that optimizes workflow with advanced features for exceptional diagnostic image quality. For instance, the Tube and Line Visualization option delivers a companion image with enhanced processing for clearer, easier visualization of PICC lines and tubes to help with accurate placement. At Franciscan Health Crawfordsville, this feature aids healthcare providers as they insert lines in a patient. “If we’re putting a line in and need to ensure correct placement, we simply push a button that changes the contrast on the image to instantly see if adjustments are needed,” Cody said. The high-quality images are a big advantage, Cody said, adding that DR has helped the hospital offer cutting-edge technologies to the community it serves. The only hospital in a farming community, Franciscan Health Crawfordsville has a full radiology department that provides a suite of diagnostic imaging services. The DRX-Revolution is one way Franciscan Health Crawfordsville uses digital imaging systems to serve its patients. Recently, the hospital invested in the Carestream DRX-Excel Plus System, which combines fluoroscopy and general radiology capabilities in one unit to further accelerate workflow. With Carestream’s diagnostic imaging systems, physicians and radiographers alike have experienced an uptick in productivity and efficiency across the hospital. “All of our X-ray rooms are Carestream rooms,” Cody said. •

FUJIFILM Healthcare Americas Corporation, a leading innovator of diagnostic and enterprise imaging solutions, announced today it has installed an advanced Fujifilm Oasis Magnetic Resonance Imaging (MRI) system at ProScan Imaging, the medical clinic in the Paul Brown Stadium, home to the Cincinnati Bengals. “Quality imaging expedites diagnosis and treatment for complicated fractures, soft tissue tears, concussions, and other injuries football players experience,” said Shawn Etheridge, executive director marketing, FUJIFILM Healthcare Americas Corporation. “With Fujifilm’s open MRI system on-site, injured players will have access to rapid, high-resolution exams, which can make all the difference in an athlete’s recovery.” The Fujifilm Oasis MRI system is now installed and operational in the ProScan medical offices at the Paul Brown Stadium. It provides a state-of-the-art high-field open MRI experience, creating three-dimensional images of the body, which help radiologists precisely visualize and accurately analyze injury and disease. The system features an open design and a patient management system (82cm wide table and 660lb capacity) to accommodate patients of almost any size – even the largest lineman. “We’re thrilled to work with FUJIFILM Healthcare Americas to

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provide our patients with access to an open scanner with capabilities that mirror that of a high field closed bore 1.5 tesla,” said Stephen Pomeranz, MD founder of ProScan Imaging. “The Fujifilm Oasis MRI system is designed to enhance comfort for patients of every size and engineered to improve image quality. This novel and exceptional capability is a healthcare-market differentiator for ProScan.” Fujifilm’s innovative products align with ProScan Imaging’s mission to enhance patients’ lives with the most advanced and capable imaging technologies, promoting early diagnosis and prevention that can save lives. Said Dr. Pomeranz: “The Fujifilm Oasis has decisively rounded out the technical portfolio in our statewide practice and either dovetails with a 3.0T or stands alone in the outpatient setting. Since MRI is typically a closed cylinder that sometimes requires that already-anxious patients lie in uncomfortable positions, having an Oasis Open MRI at the ready enhances our ability to provide quality patient care.” In addition to its healthcare services for the Cincinnati Bengals, ProScan accepts general patient referrals to its stadium facility from local healthcare providers and physicians in the greater Cincinnati metropolitan area Monday through Saturday. •

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Medical Imaging Market Soars STAFF REPORT

ccording to various research firms and their reports, the medical imaging market is likely to grow in the coming years because of the increasing incidence of chronic diseases. According to a report published by Fortune Business Insights, the market is likely to reach $43.33 billion by 2027. The market was valued at $33.69 billion in 2019, and the value will increase at a compound annual growth rate (CAGR) of 5.1% during the forecast period. This growth will most likely facilitate the growth of the imaging parts market.

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The increasing investment by government and public organizations to the diagnosis and treatment of cancer has paved the way for innovations and advancements in the global imaging market. The increasing awareness about effects of major diseases such as cancer and orthopedic diseases has fueled the demand for early detection of these diseases and immediate diagnosis methods. Furthermore, research initiatives by leading companies are aiding the growth of the market in the U.S. New products continue to be hits with the health care personnel. The increasing demand had a direct impact on the overall market in the U.S. Besides the U.S., the market in Asia Pacific is likely to grow in the coming years because of high investments in the research and development of medical imaging by private organizations and leading investor firms. To suffice the constantly increasing demand and growing expectations from end users, health care manufacturers are putting in more efforts to come up with new products. Along with new products, health care manufacturers are also under the pressure of improving product and device efficiencies. There is an increasing demand for ultrasound imaging equipment arising from health care settings in emerging countries. The major reason for this rising demand is the improved efficiency of new ultrasound imaging equipment introduced in the market. Grand View Research is another firm predicting market growth in coming years. WWW.THEICECOMMUNITY.COM

“The global medical imaging market size was valued at $15.9 billion in 2020 and is expected to expand at a compound annual growth rate (CAGR) of 5.2% from 2021 to 2028,” Grand View Research reported. “Major factors driving the industry are the increasing demand for early-stage diagnosis of chronic disease and rising aging demographics, which is expected to boost the demand for diagnostic imaging across the globe. Technological advancements, coupled with supportive investments and funds by the government, especially in developing countries, such as India and China, are also expected to contribute to market growth. For instance, in January 2020, Allengers launched India’s first locally manufactured 32 slice CT scanner. The system was developed in collaboration with Canon Medical Systems.” Grand View Research also stated that hospitals captured the largest market share (43.1%) in 2020. Rising demand for advanced imaging modalities and the integration of surgical suites with imaging technologies are some of the factors driving the segment. Some of the countries in developed regions have shown a sharp rise in demand for these modalities in teaching hospitals as compared to general or special hospitals. However, developing countries in the Asia Pacific region have shown a steep rise in the number of new hospitals. This can be attributed to the entry of multinational health care service providers. Health care service in these countries is dominated by private players. New hospitals generally provide dedicated space for imaging modalities. Rising competition and increasing demand for world-class health care services are the factors expected to fuel the segment growth in upcoming years. Growing trends of ambulatory imaging are expected to drive the ambulatory imaging centers segment at the fastest rate in upcoming years. Government initiatives to expand the reach of advanced care in rural parts are one of the prime factors driving the segment. The adoption of ambulatory imaging centers is prominent in Southeast Asian countries, such as Thailand and Malaysia. •

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DUNLEE

DA200P40+LMB Dunlee, a trusted partner for CT replacement tubes, offers the first replacement tube with Dunlee’s CoolGlide liquid metal bearing technology: the DA200P40+LMB. CT tubes with CoolGlide are prized for their long life, made possible because the liquid metal bearing doesn’t create friction, so there is virtually no wear. The DA200P40+LMB tube also features a quieter sound pattern for smooth operation and a pleasant patient experience. It has been specifically designed as a replacement tube for the GE Revolution Evo and Optima CT660 CT scanner. Launched in 2020, the tube has been successfully installed at sites in the United States and Europe. For more information, visit dunlee.com.

BLOCK IMAGING

Performix MX 240 X-ray Tube

ALLPARTS MEDICAL Jedi 60 High Voltage Tank

Available at AllParts Medical, the Jedi 60 High Voltage Tank is used on the GE LightSpeed 5X CT, BrightSpeed CT and versions of the HV Tank are also used on the Optima 660 CT/Revolution EVO CT systems. The HV Tank is attached to the Inverter/Control chassis as the Power Pack assembly. At AllParts the HV Tanks are repaired, new fresh processed oil is used and the HV Tanks are verified not only by bench testing, but installed on a CT system QA bay and fully tested using rotating scans and full X-ray generator calibration to verify successful operation. For more information, allpartsmedical.com.

This Performix MX 240 X-ray tube for GE LightSpeed VCT 64, LightSpeed Pro and Discovery VCT 64 CT scanners is just one of over 35,000 replacement parts in stock at Block Imaging, from all imaging modalities, makes and models. With an 8 MHU heat rating, this tube is a workhorse for facilities with high patient volumes and demanding procedures. The Performix MX 240 is produced by several manufacturers, making it readily available and competitively priced, both new and used. For more information, visit blockimaging.com.

AVANTE HEALTH SOLUTIONS Imaging Parts

Avante Health Solutions is a global leader in providing oncology and imaging equipment, parts and service, including linear accelerators, cath/ angio, MRI, CT and ultrasound. As a major parts supplier, Avante maximizes customer value by accessing new OEM parts, OEM equivalent parts and quality refurbished replacement parts. Its OEM parts are individually tested on fully functioning equipment and prepared for fast and dependable delivery. Avante Health Solutions also offers free parts identification, technical support and remote services to it customers. For more information, visit us at avantehs.com.

*Disclaimer: Products are listed in no particular order.

ICEMAGAZINE | FEBRUARY 2022

ADVANCING THE IMAGING PROFESSIONAL

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RAY-PAC

X-Ray Tubes With over 33 years of experience in the same day X-ray tube replacement business, RayPac offers replacements for Toshiba E7886, E7239, E7242 and E7884. Available are both 90-degree and 270-degee orientations, all focal point and target angle options, and multiple shipping options. Including blind shipping. Ray-Pac assembles most tubes in house and fully tests them before filling a customer’s purchase order. Ray-Pac’s products come with a prorated one-year warranty and can be shipped the same day. For more information, visit ray-pac.com.

INNOVATUS IMAGING

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As an FDA-registered manufacturer of ultrasound probes, and strong heritage in MRI coil manufacturing, Innovatus has unparalleled expertise to test an entire cable harness and diagnose problems accurately. Unlike traditional solutions, where a single wire is spliced or a used, harvested cable is installed, Innovatus can fully restore cable performance and provide full cable replacement solutions. We are trusted by OEMs based upon our understanding of the full device and track-record for sustainable results. As a result, we deliver sustainable solutions and performance that renew the product’s life cycle at a fraction of the cost. For more information, visit innovatusimaging.com.

*Disclaimer: Products are listed in no particular order.

ICEMAGAZINE | FEBRUARY 2022

7 8

ADVANCING THE IMAGING PROFESSIONAL

W7 Global offers this brand-new S532Q Akron-Q Replacement Tube for various models of Siemens and Philips CT scanner systems. W7 Global has new and preowned X-ray tubes in stock, especially for CT and cath/angio systems. Options are available for brand-new, discounted OEM and aftermarket replacement tubes. Detectors and other replacement parts, both new and used, are also available from the company. For more information, visit W7Global.com.

RICHARDSON HEALTHCARE ALTA750 CT Tube

The ALTA750 CT tube is specifically designed for use as a form-fit-function replacement tube for the Toshiba/Canon Medical Systems CXB-750D/4A* tube, also known as the Varex Imaging MCS-7078.* It is compatible on OEM platforms, including the Aquilion 4- through 64-slice and the PRIME (Gen. 1). Richardson Healthcare sells the ALTA750 tube housing assembly as part of an installation kit that includes a fully refurbished heat exchanger and a new high-voltage cable. The ALTA750 is CE approved and is available with a prorated 12-month or 200,000 slice warranty (certain restrictions apply). Stocked in six locations around the world and ready to ship today! For more information, visit rellhealthcare.com. *CXB-750D/4A and MCS-7078 are the product names of Toshiba/Canon Medical Systems and Varex Imaging respectively.

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COVER STORY

RIGHT TO REPAIR AND MEDICAL IMAGING DEVICE PURCHASING

BY MATT SKOUFALOS

hen selecting a new piece of medical imaging equipment, the demands of cost, functionality, and lifetime upkeep and maintenance are all taken into consideration. Those health care workers who will interact with the technologies involved want devices with the most expansive, up-to-date feature sets. Those who must maintain the equipment want the ability to do so cost-effectively. And those responsible for budgeting want to bring the entire project in with maximum value per dollar spent over the useful life of the device. Purchasing teams are challenged to balance these competing interests in such a way as to deliver what everyone wants. But as these devices become more complex to maintain and operate, is the likelihood of being able to support their upkeep in-house diminishing? And if they want to repair the equipment they purchase with onsite or third-party independent service provider (ISO) staff, can they do so safely and affordably? Peter Weems, senior director of policy and strategy at the Washington, D.C.-based Medical Imaging & Technology Alliance (MITA), a trade group representing medical imaging original equipment manufacturers (OEMs), said that chief among OEM concerns is guaranteeing the safe and effective performance of their equipment. From their perspective, the best way to ensure that’s the case is by the U.S. Food and Drug Administration (FDA) regulating those organizations that service medical equipment. With an FDA-estimated 16,000 to 20,000 servicers in busi-

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ness today, and a complex variety of hybrid and tiered service agreements in play, “there is a lot of competition and choice out there,” Weems said. “The medical device servicing industry is thriving,” he said. “There’s all sorts of different arrangements and models that manufacturers, servicers, and others are working to service devices: OEMs, ISOs, health care facilities, tiered partnerships, even OEMs servicing another manufacturer’s device.” “From our perspective, there is no single, valid model,” Weems continued. “Manufacturers, ISOs, facilities; they’re out there entering into business relationships with each other. What we think would be best for patient safety, and the ongoing performance of medical devices, is for there to be a higher level of oversight and accountability in this industry. We have seen numerous instances of devices being improperly repaired by third-party servicers.” Although OEMs are required to report to the FDA adverse patient effects from the improper functioning of their devices, ISOs aren’t bound by any such requirements, making it difficult to define the scope of the problem, Weems said. The lack of a specific data set identifying how frequently ISOs improperly repair OEM medical devices, is “a huge blind spot for industry, FDA, health care providers, and patients,” he said. Without a reporting process through which regulators can trace maintenance logs and the servicers performing the repairs, he argued that patients – and the expensive medical equipment that supports their care – are at risk. “What we’re also talking about here is a wide range of things that could go wrong,” Weems said, from “catastrophic events” like electrical shock or device collapse, to improper calibration that yields subpar im-

age capture, to cybersecurity risks, to simply sidelining a device, which results in delayed patient care. “We’re not trying to put anybody out of business,” Weems said. “Servicers who have adopted the appropriate best practices and implemented a quality management system should be well-prepared to service medical devices.” “What we’re trying to do is ensure that everybody who is engaged in that business has the proper oversight and accountability and is performing high-quality work,” he said. “There’s not a robust process for surveilling the quality and safety from the third-party industry, and this is a problem we’d like to see addressed.” James Nestel, CEO of Americas and Asia Pacific operations at Simon Hegele Healthcare Solutions, a global supply chain and logistics services provider, said that the very broad variety of medical device servicing agreements among OEMs, ISOs and their customers is why greater transparency into the repair process is needed. “I’ve seen the gauntlet of providers,” Nestel said. “I’ve been on the OEM inside, and now I’m on the OEM outside, supporting the OEMs. I’ve seen a wide variety of players out there, and I think that we at times see some players in the market get too risky with what they’re dealing with, and we need better guardrails along the way.” Nestel argued that the complexity and variety of medical imaging devices in use at health care institutions across the country, compounded by the rapidly changing nature of the industry, requires standardized processes for their maintenance and repair, as well as for the training and continuing education of servicing personnel who perform that work. “We’re working on a wide variety ICEMAGAZINE

COVER STORY

James Nestel CEO of Americas & Asia Pacific Operations at Simon Hegele Healthcare Solutions

Wayne Moore CEO of the Longmont, CO based Acertara Acoustic Labs

Peter Weems Senior Director of Policy & Strategy at the MITA in Washington, D.C.

ICEMAGAZINE | FEBRUARY FEBRUARY2022 2022

COVER STORY of equipment, all of them significantly different across modalities and manufacturers,” Nestel said. “I can’t put technicians in a classroom and train them in a week or two weeks or two months. There’s a lot of complexity to it and a tremendous cost to doing it.” “Some of the technology is the same and doesn’t change, but the machines change, and if you’re not up-to-date with the technical support – people who know the equipment now and are on the equipment today – that’s when you see the problems. At my company, we have an ISO-certified training process, and that’s visible to my customers. If people don’t do that job regularly, they lose their qualifications.” Like Weems, Nestel said his biggest concerns center on the qualifications of the service providers who repair and maintain those complex medical imaging devices as well as establishing a traceable process for charting their work. ISOs may say that they’re hamstrung by OEM proprietary processes whereby they are denied access to device technical manuals and service codes, but to Nestel, a sufficient training regimen takes weeks and months to develop in the classroom before a technician is field-ready. “When I bring a new employee onboard, it takes a year and a half to get them trained up, and all that training’s done on the road,” he said. “That’s tens of thousands of dollars if I want to make them a lead, and every time I lose an employee, that’s an investment walking out the door. Anybody who says, ‘I just need the manual to be able to do it’ on this equipment is oversimplifying the process. The manuals are good; they’re there for a reason, but you can’t learn some of this stuff from reading a manual.” For many health care providers in rural and low-income communities, however, the cost of contracting with OEM service teams may be financially prohibitive, or response may only be available on a longer timeline than

a local ISO or in-house service team could offer. Plus, in some cases, OEMs may themselves contract with local ISOs for the last legs of their service contracts. Nestel said that many concerns about accessibility are being obviated with the advent of remote service consultations: OEM-certified technicians can dial in to the work site, providing a telepresence for diagnosing problems, guiding maintenance jobs or parts consultations. “The ability to do video connections is great, and it’s there,” he said. “Those programs are growing and developing and thriving along the way. If you’ve got a person who has a general overview of the equipment, and a highly experienced person looking over their shoulder virtually, you can get a lot done until you have to get pieces and parts onsite, and most of the major players can have parts onsite within hours.” “I foresee the OEMs building more partnerships with rural service providers so they can offer that support,” Nestel said. Finding a way to “get over this us-versus-them stuff” is the fastest way to building the necessary bridges among ISOs, OEMs and customers who need their equipment serviced reliably and safely, said G. Wayne Moore, CEO of the Longmont, Colorado-based Acertara Acoustic Labs. “You can buy a bucketful of hyperbole, but what problem are we trying to solve, and how do we solve the problem?” Moore said. “There’s a responsibility associated with rightto-repair, and everybody should take care to make sure that they’re doing the right thing. The simplicity evaporates beyond the simplicity of saying it versus doing it.” Moore, who chairs the MITA Ultrasound and Service Committees, on which he represents the smallest of the organization’s member companies, said the market for medical imaging device sales, service and replacement parts is inherently mutualistic amid industry-wide institutional consolidation, hybrid service agreeADVANCING THE IMAGING PROFESSIONAL

ments, and a general desire to support the equipment that plays a critical function in patient care. The best way to get there, he argued, is by doing away with artificial divisions between OEMs and ISOs, and instead devising standards for equipment functionality and repair that best meets the needs of its customers. “There are a lot of medical devices that lend themselves to fixing in-house; there are some that lend to challenges,” Moore said. “Would hospitals like lower service costs? Sure, but not at the expense of higher downtime or taking a greater risk of downtime. We do a lot of work for hospitals and OEMS, but they really don’t have a clear understanding of what technical capabilities they actually have in-house – how to measure them, what does it cost if it’s down for a while – and so looking at that opportunity cost is not taken with the degree of seriousness that it should be. “We’re an ISO, so we’re all in for servicing the equipment, but how much does it cost me to build a third-party infrastructure that can support an MRI system and all the things I’m going to need to cover?” Moore said. “There are ISOs out there that are capable of doing great work, and I like to think we’re one of them. But the issue is knowing your limitations.” Moore believes that knowledge in any specialty “has a shelf life,” and that although a general, fundamental understanding of how to service medical imaging equipment isn’t something that evaporates after years on the job, “what you’ve known in the past may not benefit you today.” “ISOs need to maintain a quality management system like we do,” he said. “What’s the ongoing training, what do we have access to in terms of intellectual properties, and how do we design and develop our own test devices? We’re not beholden to the OEM for much, but that changes as you get higher up in the scale and complexity of the systems.” For purchasers who aren’t sure they can afford the OEM service contract WWW.THEICECOMMUNITY.COM

associated with a new piece of medical imaging equipment, or don’t want to perform all aspects of repair and maintenance through their own service teams, Moore reminds them that the power to create an agreement that best meets their needs remains in their hands until they sign on the dotted line. “Biomeds, you have a lot of authority to get this stuff in the purchasing agreement,” he said, “and purchasing guys, buck up. If one company doesn’t have what you want, go deal with one who does. The power that the hospital has is extraordinary at the time of purchase. The question is, do they exercise it? It’s all open to them, they just lack the will, the energy, the time, to get that stuff written into the purchasing agreement.” Much like medical equipment purchasing considerations are an interdepartmental effort in a health care setting, Rick Staab, CEO of the InterMed Group, an ISO out of Alachua, Florida, said that “everybody’s supposed to be at the table” when it comes time to define the parameters of safety, access, and affordability as relates to servicing those devices.” Staab, who participates on the FDA steering committee for medical device servicing, said the best way to resolve industry concerns about the quality and efficacy of equipment maintenance is to create “a collaborative community” to guarantee that work is done within a quality management system (QMS) that’s bound by constant process improvement. “Everybody has blemishes; it’s how you respond to them,” Staab said. “You bring a diverse opinion and datasets to the table, and you figure out what the best solution is. The patient should be the sun, and everything else revolves around them. It’s not ‘us against you.’ ” Staab said that FDA explorations of ISO work histories (fda.gov/ media/113431/download) haven’t revealed any evidence that third-party providers cause any additional risks to patient safety with their procedures; moreover, during the novel

coronavirus (COVID-19) pandemic, when OEM support teams were depleted or unable to access the facilities that had contracted with them, it was their ISO partnerships that delivered onsite service in areas where it was critically needed. The effectiveness of those relationships underscores what’s possible when all interested parties work together for the benefit of the patient, Staab said. “InterMed Group received calls to work for certain manufacturers,” he said. “They got rid of that rhetoric about ISOs not being able to service things right because they could not service their own equipment in the places that needed it right away. They gave us access codes and parts availability.” Before any equipment purchase, Staab recommends that health care institutions perform a pre-purchase equipment evaluation and some degree of capital planning that involves calculating pricing, service, and ongoing costs to better educate themselves on how to plan for the useful life of their equipment. “If you’re part of that pre-purchase evaluation, then you always negotiate for training on that device up-front because it’s the only leverage point you have,” Staab said. “It should be the same way for cybersecurity information, preventive maintenance, etc.” Staab also argued that ISOs play an important role of extending the useful life of OEM medical imaging equipment by servicing it affordably, often in areas and for clients who are not the primary OEM customer focus anyway. “Not everyone is actually going after the newest, most expensive technologies,” he said. “Rural areas want the same level of imaging; sometimes it doesn’t have the bells and whistles, but it gives you the same results. If they don’t have training or available parts, they’re not going to keep the older equipment going.” • ICEMAGAZINE

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DIVERSITY

BY VERLON E. SALLEY

DIVERSITY, EQUITY, AND INCLUSION

iversity, Equity and Inclusion (DE&I): It seems like a theme that we all are agreeable with, until a situation presents itself and we realize we may engage it differently. The term I want to focus on today is “equity.” A Google search will define equity as, “the quality of being fair and impartial.” Many have confused the term “equality” with the term “equity.” The image to the right shows a visual difference between the two at a sporting event. Equality is to treat everyone evenly, but that does not mean you have treated everyone fairly. Why? Because all of us have different and unique situations that we may not be able to work around. Let’s consider these unique situations as “social determinants.” Now, let’s make this situation relatable to a radiology operations situation. Let’s say we are running a busy imaging center. We have MRI, CT, ultrasound and X-ray at our center. We are scheduling five days out in ultrasound. To prevent tardiness in our schedule, we institute a new policy. Any ultrasound patient that shows up more than 15 minutes late we will try to work them in at the end of the day or reschedule them for another day. (Note: It may be five days out). After a year of the policy’s installation, we review our data. Let’s say in 280 annual operational days, we had to reschedule 110 patients. Not bad, right? Less

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than 1 patient a day, but let’s dig deeper. Upon further analysis we see that 80% of the patients came from three Zip codes. My first question would be, “What are the demographics of the patients?” My next would be, “What are the social determinants of those three Zip codes?” (Example: Are there transportation concerns? What are the median incomes of those Zip codes? Etc.) My last question, “Did a policy we applied equally to all, create an inequitable situation for a particular cohort of people?” When you apply the investigative analysis, it makes you a good manager. To have the desire to want to solve this problem makes you a DE&I leader. •

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DIRECTOR’S CUT BY BETH ALLEN

WE COULD ALL USE SOME ‘POSITIVITY’ W

e have a PET/CT technologist at Banner Imaging that has a fan club. Her name is Alexa Greer and she gets mentioned on our Medallia surveys pretty much every week. We have many team members that are mentioned by name and have impressive survey scores, but Alexa has had her name included on the survey more than anyone. Examples of the impact she has made on her patients are reflected in the comment section of the survey. “Alexa was so attentive, friendly and was OUTSTANDING!!” “Alexa did my imaging and she is just awesome. Could not have had anyone better do the work. Thanks!” “I love Alexa! She is so nice and smart and professional.” “Alexa was MARVELOUS. She had a great personality and made my procedure a little less frightening.” Seeing her name week after week made me think that sharing her customer service philosophy may be worthwhile. Prior to achieving her degree in nuclear medicine, Alexa worked as a phlebotomist and as a bartender/ server. She has been in imaging for 15

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her patients know what to expect during the exam. She explains the process of the PET/CT and how long it will take. It is important that the patient is relaxed and still for the uptake portion of the PET/CT so she works hard to make the patient comfortable and that she has answered all of their questions. This comes easily for Alexa. Her personality is perfect for the type of work she does. For some, customer service is something that must be taught. Each of us has different strengths and Alexa has some advice for those who have to work a little harder at it. “Always keep a smile on your face and always have good eye contact. This will give the patient clues that you are listening and paying attention.” She also reiterates that tone and patience are also important. Alexa makes sure that she is consistent. When her patients return, they will have the same positive experience they had the last time. She has made her attitude a habit. It is something she does not have to think about. How does she do that? She is motivated by knowing that her patients are pleased with their imaging experience. She added, “Loving where I work and the people I work with keeps me going.” Alexa illustrates just how much of a difference

one person can make for a team. When there is one team member that truly embraces the impact that can be made for each patient by giving them our full attention, that can spread to others and soon it is a culture. It reminds me of the Starfish Story by Loren Eiseley. It explains how there are hundreds of starfish that were washed up on a beach after the tide rolled out. The starfish would die out of the water. A young boy was gently throwing them back into the ocean. An old man walking by asked why he was doing that. There were so many starfish he did not see how this would possibly make a difference. The boy threw one out into the water and said, “I made a difference to that one.” We can create a successful patient experience and a positive supportive culture, one patient at a time. Alexa’s patients share how they feel important during their time with her. That is how we do it. One at a time. Thanks for all you do! • – Beth Allen, RT(R)(CT), CRA, is the director, clinical operations at Banner Imaging.

years and with Banner since 2008. She performs PET/CT at our Banner Imaging Lakes location in Sun City, Arizona. She credits her positivity for all the kudos she receives from patients and her co-workers. Alexa exhibits a special type of enthusiasm while doing her job. She explains that she is a happy person by nature, and it is easy to be enthusiastic because she loves her job. “I love helping people and being a part of their planning and recovery. There is nothing like seeing cancer patients going into remission.” Her goal is for each patient to want to return to her location for any imaging they need. She likes to break the ice with a little humor to start. “Most of my patients like the fact that my name is Alexa because they have one at home. It really helps break the ice when people are really upset and scared.” Alexa states that she has learned over the years that it is always best to look at the bright side. “Things might get hard at times, but they always work out for the best in the end.” A successful workday for Alexa is to have all her patients smiling when they leave. She does her best to let

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BY LAWRENCE NGUYEN Founder & CEO of Summit Imaging

A NO RISK COST SAVINGS STRATEGY FOR HEALTH CARE FACILITIES ULTRASOUND TRANSDUCER REPAIR

very physician and sonographer understands the importance of image quality when performing ultrasound exams. Without a high-quality image, identifying abnormalities is not only difficult, but also less reliable. This makes image quality critically important for proper diagnosis and to guide patient care. This global pandemic is a challenging time, especially for health care facilities that are navigating a massive amount of uncertainty from the halting of elective procedures to hallways overflowing with patients. Health care facilities are aggressively searching for ways to effectively extend the life of their equipment by partnering strategically with domain experts that repair equipment to an electronic component level. A strategy that is now common for health care facilities is to utilize transducer repair services to avoid costly replacements. To give perspective, a basic repair of a transducer can cost as little as 5% of the replacement price. With this potentially large savings, health care facilities are now consistently attempting to have their faulty transducer repaired at a fraction of the cost of a replacement. This extraordinarily low-risk strategy typically produces high reward savings. The old service model was to replace the transducer at a high replacement price. The new strategy of attempting the repair first and, if the device can be repaired, massive replacement costs are avoided. This method guarantees the attempt to save on transducer life cycle cost at virtually no risk to health care facilities. There are certain transducer operating states that sonographers and clinical engineers can look for to identify anything out of the ordinary. Any image noise and color artifact, such as unintended variation in the brightness, color, saturation, or contrast of an image, is cause for suspicion. Some

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signs clearly indicate an equipment problem, such as image distortion (rearranged material) or color stripes or noise in a non-physiologic pattern. In extreme cases, an image may appear too bright/white or too dark – a sure sign of malfunction. The most difficult problem is when a change is subtle. The sonographer must then decide whether the artifact is clinically feasible or not – in other words, whether it is due to patient pathology or data error. Dropout (missing signal) in the image is a good example. Ultrasound is famous for having dropouts, but judgment and experience are required to determine whether the dropout observed is unnatural. The objective is to identify if there is any missing image data or if there is excess data or noise that is present in the image. The missing or excess data are likely failures in the electronics of the transducer and can often be repaired. Once a problem is identified, clinical engineers and hospital administrators are now commonly considering a repair of faulty ultrasound transducers. The cost of repairing faulty equipment is much lower than the alternative cost of replacement and is a fruitful savings opportunity with virtually no risk. If the transducer is repaired, there is a significant savings. However, if the damage is beyond repair, a replacement would be necessary. Opting to repair first rather than immediately replace the technology can maximize its useful life and save health care facilities as much as 95 percent relative to the cost of original equipment manufacturer replacements. Reputable ultrasound transducer repair facilities such as Summit Imaging perform at high levels with successful repair yields ranging from 50 to 90 percent success depending on the transducer application type. Partnerships with health care facilities have dramatically lowered total cost of ownership on ultrasound transducers. During this chaotic pandemic for health care facilities, it has become a vital strategy for cost savings and patient care improvements. •

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EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

BE CAREFUL WHEN FOCUSING ON NUMBERS

e hear it all the time: “If you can measure it, you can manage it.” Unfortunately, a danger exists in focusing only on numbers, as this philosophy ignores the intangibles of human nature. After all, it’s people that make a workplace function. It seems that society has become obsessed with measuring and managing just about everything. Obviously, good things do come from tracking numbers. We can analyze a salesperson’s closing ratio based on multiple factors and then adjust how we make assignments to that person to get better sales. We can measure trends and patterns in atmospheric conditions and make predictions about the weather that help us when planning events. But not all decisions based on number-monitoring produce improved results. As just one example, some people believe that merely increasing the number of dollars spent per student in education will result in improved student learning outcomes. All we need to do is compare U.S. Census data information on per-pupil spending by state with K-12 educational performance and we see this is not true. Many factors impact student success, such as teacher engagement, parental encouragement and even schoolyard bullies. Some factors help, others hurt, but the point is that many intangible human factors that don’t get measured affect student achievement. Similarly, many hospital administrators look at numbers like “door-to-doc,” the time it takes for someone to get checked into an emergency room until the time they see a doctor. They also look at patient satisfaction scores. More than one emergency department doctor has described the Catch-22 that comes with this, stating that they must sometimes cut short the time they spend with a patient so that they can improve door-to-doc time. They say the ripple-effect of that can result in lower patient satisfaction scores because patients don’t think their doctors have 44

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spent enough time with them. Another problem is that not every patient responds to customer satisfaction surveys. We know the presence or absence of certain factors impacts productivity, effectiveness, and profitability, and by all means, we should measure and manage what we can if we know doing so will make a difference. But we also know improved effectiveness and efficiency can be the result of factors beyond that which can be measured.

LOOKING AT THE INTANGIBLES Let’s start by considering management skills. The standard answer for helping someone be a better manager is providing him or her more or better management training. Yes, that can help, but what if a manager is hiding an insecurity? Insecurities are intangible, and they reside in every person – some more, some less – but it’s not usually something that gets measured or assigned a number. When insecure people get placed in management positions, bad decisions can be made out of self-protection, and the results can be frustrating for all concerned. Employee attitude is another intangible. All it takes is one employee with a bad attitude to inject poison into team camaraderie, and that can have a significant impact on productivity or effectiveness. I’ve seen workplace morale nosedive in a matter of months just from one key player bringing a boatload of negativity to work each day. Manners are another intangible. The use of phrases like “please” and “thank you” are difficult to measure, but their lack of use can lead to sterile, cold workplaces where people do only what’s expected and no more.

THE ROLE OF EMOTIONAL INTELLIGENCE Emotional intelligence is also an intangible, although we are getting better at measuring it. Strong emotional intelligence (EQ) is the ability to perceive and assess one’s own and others’ emotions, desires, and tendencies, and then ADVANCING THE IMAGING PROFESSIONAL

make the best decision for a win-win result. This includes being able to acknowledge and value feelings in oneself and others and respond in ways that keep the gears of communication moving with minimal impedance. It’s one thing to learn how to do it, it’s another thing to put it into practice and it’s something else to be able to do it well. Thankfully, emotional intelligence can be learned, and over the last 15 years human resource development specialists have figured out the type of questions to ask to determine one’s knowledge of the core components required to exercise good EQ. Naturally, assessments have been created, and now people can get a general idea about their level of EQ and which areas may still need improvement. However, it should be noted that just because someone has acquired knowledge on a subject, it doesn’t mean the person is putting that knowledge into practice. In other words, if we trust a set of numbers instead of also looking at intangibles, we run the risk of miscalculating capabilities and thus making inaccurate conclusions about reality. Still, those possibilities should not stop us from studying EQ, because high emotional intelligence helps make a workplace more effective and efficient. Even if we can’t measure and manage everything, learning EQ can still bring significant workplace improvements. I’ll close with a quick story. Nearly 20 years ago I was teaching emotional intelligence at a production plant that WWW.THEICECOMMUNITY.COM

employed 600 people. Senior management had already gone through the course the previous year, and I was then teaching EQ to a group of middle managers. One day a senior manager came into the training room and stated that their budgeting process is highly accurate, and every month they know exactly where they should be financially. But this year, something was different. They were millions of dollars in the black, ahead of where they thought they’d be, “and the only thing we’re doing differently is teaching this course,” he said. In essence, the senior manager was crediting the intangibles of EQ with helping the company be immensely more profitable. Bottom line, too often we look at results and attribute them to incorrect causes because we focus too much on the measurables. Sometimes it is the intangibles of management that can be the biggest factors of all. • – Daniel Bobinski, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach Daniel on his office phone, (208) 375-7606, or through his website, www.MyWorkplaceExcellence.com.

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INSIGHTS

RECOVERY TIME OF A TODDLER RAD HR

BY KIAHNNA D. PATTON

find myself envious that my toddler can have an utter and complete meltdown, and moments later, it’s as if it never happened. What magic do these little beings possess that allows them to so quickly let go of a thing that was so monumental at the time and move on? I’m sure most of us have had that magic at one point in our lives because we all were once toddlers. How did we lose the magic? Oh, to have the recovery time of a toddler rather than the long memories and emotional baggage we carry as adults, particularly in the workplace. I’ve heard so many times over the years at various companies that, “This organization has people with long memories.” In some cases, those memories are super helpful. They’re wonderful to help build connections to a place’s history and mission or build a healthy relationship with a coworker over time. And in other cases, it might serve the greater good for people to have the recovery time of a toddler by releasing old thoughts and creating new and powerful ones. While I’m almost positive, our little ones are not thinking that deeply, what they’re doing is, in effect, letting go of that old stuff and moving on to more exciting things. They’re focused on mindboggling things like discovering how high she can jump, how far he can tilt the rocking chair before it tips over, or exactly how much they can write on the wall before mommy notices. Those who have retained the magic, I envy you! I would love to know how you continue to move on. I have a friend who simply takes a nap, and then all is well. He’s got the magic. But others of us need to talk

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about the thing repeatedly until it stops squatting rent-free in our brains. Recovery may happen in one conversation or a series of conversations over many days. The thing is, we consciously know that so many of the things we allow to upset us likely don’t matter as much as the “good time” we spend on them. So we go back-and-forth with these things that trouble us and think about how we shouldn’t spend so much time thinking about them. Ironic, right? We can’t stop because we have a process that we must follow. Feel – think – talk – feel – think – talk – remember it doesn’t matter that much – feel – think – talk – resolve – move on – recover. How do we disrupt that process and move on and recover much more quickly? The answer likely varies from person to person. So, if you have one, check in with your toddler? What can I learn by observing them? I think mine skips everything and goes from feeling to moving on. I should do that with most things I encounter. Check back in with me to see how that goes. One of my favorite lines (and most valued advice) comes from a wise woman named Vivian Lee, a retired history teacher and an elder I greatly admire. Years ago, we were having a conversation about something that seemed meaningful at the time – relationship stuff – and after a couple of minutes back and forth, she abruptly said, “And we’re not going to spend any more good time on that.” It knocked me off balance for a good 5 seconds, and when I recovered, I realized how right she was. And how profound a statement! “We’re not going to spend any more good time on that.” Talk about a disruptor to my process. It completely changed how I thought about the value of my time, not to mention how I’d wasted time venting

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and thinking about something meaningless that could have been used on something else. How much good time do we waste on things that don’t matter so much? Toddlers seem to get it. As a human resources professional, I am not short of opportunities to incorporate lessons learned from my toddler and Mrs. Lee. I recently conversed with an employee I’ll call Golden, who experienced the virtual version of overhearing someone talking behind his back. Two employees exchanged messages during a video conference, unaware that all participants could view their comments. The one comment Golden saw was benign by all accounts but insulted him. He spent days talking to his manager, his manager’s manager, two people in human resources, writing emails, and spent an unmentionable amount of time thinking about what happened. I think we all realize that people in this world talk about us, good and bad, behind our backs. When they inadvertently speak about the bad in front of us, we have to determine how much good time we spend on it.

There is no one way to handle it. I certainly encourage you to document it, just in case. Then decide whether you’re going to have the recovery time of a toddler or if you are going to stew in the upset. It’s an individual choice. After I walked Golden through the amount of headspace he’d allotted to this situation, he decided to let it go. He decided the problem didn’t deserve the good time he gave to it. It helps to have someone shift our paradigm. Witnessing a little person skillfully push past a challenging moment, and having Mrs. Lee stop me from spending good time on menial things, has undoubtedly shifted mine on many occasions. I’ve also been able to pay that gift forward to people like Golden. And with that, I wish you the recovery time of a toddler and the ability to spend very little good time on things that don’t deserve it. • – Kiahnna D. Patton is senior human resources business partner at Children’s Hospital Los Angeles (CHLA) and a nonprofit founder.

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PACS/IT

BY MARK WATTS

HUMAN CENTERED AI & CAD REPORT DEPLOYMENT

uman-centered artificial intelligence deployment takes into consideration the system design to bring ambient intelligence to a project. I would like to use the computer assisted diagnostic (CAD) report as an example of how frictionless value can be added to the radiologist’s workflow. Traditional textbased radiology reports may be significantly improved by incorporating multimedia elements and interactive functionality, including hyperlinks between report text and specific findings on images. Such advanced reporting was developed to improve clinical care, but the hyperlinks can also be leveraged to speed up the development and clinical deployment of regulatory-compliant AI. An example of a scheme of interactive reporting is when a radiologist annotates the location of an abnormality on an image with a measurement, an arrow, a bounding box, or a freehand region of interest, and dictates, “There is a focal liver lesion near the posterior branch of the left portal vein.” Giving a verbal command to the reporting software (such as the word hyperlink), triggering automatic insertion after the word vein of a hyperlink “2.1 cm (series 9, image 67)” linking to the abnormality location. A multisite implementation of feedback and monitoring for artificial intelligence development and clinical deployment using a centralized, cloudbased infrastructure may look like the following example.

4) silently testing algorithm prototypes against production data and receiving feedback 5) iteratively retraining until clinical deployment; and monitoring clinically deployed algorithms For accuracy degradation, alerting and notifying regulatory bodies should occur as needed. A report consumer, such as a referring physician, clicking on an embedded hyperlink, invokes a viewer to display the relevant images, with annotations marking the specific findings mentioned in the text. Referrers and other radiologists appreciate this functionality, and the benefits to patient care can be substantial. Hyperlink creation does not significantly disrupt the process of dictation; at sites where it is available, hyperlinking quickly gains traction. Hyperlinks embedded in interactive reports connect report text with lesion locations on images. We propose that NLP applied to report text containing hyperlinks can produce stronger labels than NLP alone. Analysis of the text associated with hyperlinks can establish their significance and meaning. Because hyperlinks inserted to benefit clinical care are repurposed, there is no loss in reporting efficiency, and large numbers of strong labels can automatically be collected during routine interpretation. This provides the necessary foundation to collect large, reliably labeled cohorts of training data and an automatic feedback loop for algorithm development and monitoring by: 1. 2.

MAIN PROCESSES INCLUDE: 1) generation of hyperlinks to findings in radiology reports during routine interpretation 2) storing the images, reports and labels in the cloud 3) developing algorithms based on the stored data 48

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3. 4.

automatically classifying examinations by their findings automatically preparing cohorts of examinations for training AI algorithms that detect, locate, measure and segment certain findings deploying such algorithms into radiologists’ routine reporting workflow for testing silently (without disturbing the radiologists), autoADVANCING THE IMAGING PROFESSIONAL

6. 7. 8.

matically obtaining feedback on algorithm accuracy, by comparing their output with the hyperlinked findings of the radiologists retraining the algorithms by using the original training data combined with the new test data to improve accuracy repeating steps 3 to 5 with the retrained algorithms, until necessary accuracy is achieved monitoring approved algorithms using the same process; and for surveilling accuracy and producing alerts, resulting in automatic feedback to users, administrators and manufacturers.

This process can be deployed across multiple sites with a cloud-based implementation, with appropriate privacy protection. Documentation produced by this process would support the FDA proposed total product life cycle approach to AI and ML development, feedback, monitoring, failure detection, and ongoing retraining. Implementation at diverse sites may provide the data to produce generalized, less brittle algorithms. Analysis of feedback may suggest factors that adversely affect performance. Multiple commercial vendors of PACS, reporting and image sharing tools have already developed platforms that provide many of the capabilities necessary to implement interactive reports, and standards exist to encode and transfer the structured content. The Healthcare Information and Management Systems Society and the Society for Imaging Informatics in Medicine have also established a working group supporting interactive multimedia reporting. Integrating the Healthcare Enterprise profiles are being considWWW.THEICECOMMUNITY.COM

ered for supporting interactive multimedia reporting. The ACR has developed and deployed a powerful infrastructure including registries, Certify-AI, Assess-AI, and the AI-Lab, which facilitate algorithm evaluation. The application of AI and ML in clinical practice requires a more rigorous approach than is currently used. Scalable, efficient collection and the use of curated, labeled medical images is urgently needed to support the development and improvement of algorithms, and ongoing monitoring of performance. Our proposed approach will accelerate the development and clinical deployment of regulatory compliant AI algorithms by leveraging hyperlinks produced in routine clinical reporting to provide reliable labels, a source of feedback, and data for monitoring of algorithms. Continuous feedback from radiologists allows detection and correction of degradation, protecting patient safety, satisfying upcoming regulatory requirements, promoting trust, and increasing the value of radiology reports in a manner respectful of radiologists’ time. We are on a journey and the challenges of human-centered artificial intelligence can seem difficult. The focus is on the radiologist and adding ambient intelligence to their workflow. To do this we must design a frictionless information technology platform that provides all shareholders with value. One step at a time we can move forward. • – Mark Watts is the enterprise imaging director at Fountain Hills Medical Center. Editor’s Note: This is Part II of a two-part series.

ICEMAGAZINE

INSIGHTS

THE ROMAN REVIEW BY MANNY ROMAN, CRES

PEOPLE ARE OUR GREATEST ASSET (NOT)

hat blanket statement has been the mantra for so many years that we have come to accept it and even believe it. True, people are a great asset for an organization, however, it really should be said: “The right people are our greatest asset.” The “right” people must possess the right skills to do the right job. More importantly, they must possess the right attitude. It is the attitude that makes people the right people. Skilled people with the wrong attitude will be the wrong people. Look around your organization to see who has technical skills yet does not quite fit in. You will find that it is the attitude that makes the difference. The wrong people will hurt the organization, sometimes in minor ways, yet still causing damage. They may be a demotivating factor, a stressful drain on the energies of others, or a negative influence that tends to reduce the oxygen in the room. Worse, they can affect customers’ perceptions of the organization and negatively influence external relationships. The above describes the effects of the wrong people in an organization. So, what does it mean to be the right people? The right people fit well into the culture of the organization. The key is to create a well-understood and accepted organizational culture. Although the different departments of a larger organization may have separate and distinct cultures of their own, it is important to have an overall corporate culture that is well-defined and understood. The departmental culture must not clash with the organizational culture. Peter Drucker said, “Culture eats strategy for breakfast.” In other words, all the strategy in the world will fail if the organization has a flawed culture. Some of the elements contained in the culture are vision, WWW.THEICECOMMUNITY.COM

values, norms, systems, beliefs, patterns of collective behaviors, assumptions, etc. In short, culture is how members of an organization think, behave and feel about the organization, each other and clients. It is a way of life within the organization. The corporate culture must be carefully created around the value system and the mission and vision of the organization. So, how do we ensure that our people are in tune with our organizational culture? First, make sure that the culture really is well-defined and understood. Second make sure that all people in the organization have a sense of ownership of the culture by continuous training and education. Only when all people are “on board” the culture, will the organization run smoothly (assuming good practices in the other aspects of conducting successful business). When hiring, leadership and management must be sure that prospective employees possess an attitude that will fit the defined corporate culture. Since attitude is a choice, we must make sure that the people possess the appropriate mentality to make the desired choice. We normally hire for skills. Skills can be learned. I’m suggesting we place a high priority on proper attitude. The correct attitude goes a long way toward success. It is a courageous supervisor who will admit making a bad hiring choice, especially if the issue is attitude, not technical competence. Yet the people with the wrong “culture attitude” cause the most damage. We just say that there are personality conflicts, accept the damage and move on. The right person will hit the ground running. The wrong person will not only fall but also trip others on the way down. • – Manny Roman, CRES, is association business operations manager at Association of Medical Service Providers.

ICEMAGAZINE

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ICE Break –Elbert Hubbard

False fossils could fool Mars search

[QUOTE OF THE MONTH]

One machine can do the work of fifty ordinary men. No machine can do the work of one extraordinary man.”

Science Matters

Missions looking on Mars for signs of past or present life may well be fooled by false fossils – non-organic structures that look like the remains of life forms.

Critical skill for Mars study: Spotting ‘false fossils’ Algae?

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Organs?

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Chemical reactions that exist on Mars created these fossil-like specimens on Earth

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4 billion years ago

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3 billion years ago

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ICEMAGAZINE

Imaging Jobs

Imaging Field Service Engineer III

NOW AVAILABLE htmjobs.com

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

”

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X-Ray Service Engineer

Field Service Engineer Nuclear Medicine

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

First Call Parts has been providing customers with quality replacement imaging parts since 2009. We pride ourselves in developing a top-notch reputation in the imaging industry as delivering the best in diagnostic imaging replacement parts. We specialize in the sale of refurbished/tested and used, Philips, Siemens, and GE in the Cath/Angio, R/F, and RAD modalities.

VIEW FULL DETAILS www.htmjobs.com

Customer Support Engineer II/III - X-Ray

Customer Support Engineer II/III - MRI/CT

Field Service Engineer

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 ben fits including health insurance, 401k investment plans, company car, PTO, bonus programs and more.

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.

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.

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.

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Imaging Service Engineer 3

Imaging Service Engineer 2

Imaging Field Service Engineer

The main role of the position will be to ensure all related diagnostic imaging medical equipment is maintained in a quality and timely manner. The ideal candidate will have outstanding customer service and communications skill as well as a strong technical skills and commitment to deliver excellent repair service in an expedient manner.

Inspect, troubleshoot, repair, maintain, and calibrate a broad range of basic diagnostic imaging and/or therapeutic radiation equipment, devices, system, and instruments. Interact on a routine basis with other clinical health providers in the identification of technology-based problems and solution development.

These roles will provide local support to the field service teams at these locations within Chicagoland. This includes installing, maintaining, servicing, troubleshooting, and repairing MR, CT and general diagnostic imaging equipment at various clinical sites both locally and nationally. This position will provide extensive technical support to ISEs, FSEs and our greater sales and business development efforts.

VIEW FULL DETAILS www.htmjobs.com

Visit htmjobs.com/start-posting/ to post a job. Companies that post with us:

First Call Parts, Associated Imaging Services, Medical Imaging Solutions, Universal Medical Resources Inc, Banner Health, Cal-Ray, Sodexo, and many more!

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Contact us at: HTMJOBS@MDPUBLISHING.COM to learn more about our various posting options and low flat-rate recruiting services!

AMSP

AMSP MEMBER DIRECTORY I M A G I N G Brandywine Imaging, Inc. www.brandywineimaging.com 800-541-0632

KMG www.kingsmedical.com 612-757-6714

Interstate Imaging www.interstateimaging.com 800-421-2402

Maull Biomedical www.maullbiomedical.com 440-724-7511

MEMBER PROFILE

MAULL BIOMEDICAL TRAINING, LLC

he evolution of contrast injector training for HTM/ clinical engineering professionals mirrors the growth of Maull Biomedical Training LLC. In 2008, Founder and Owner Stephen Maull was doing some industry research into what clinical engineering training was in demand. He came to realize that the contrast injector industry was completely unrepresented in the training sector. He found this odd because he had worked on contrast injectors while serving in the United States Air Force as a BMET and BMET instructor for 11 years. He realized his expert military training could benefit others and have a positive impact on patient outcomes throughout the nation. In the summer of 2008, Maull Biomedical Training was created. ICE learned more about the company via an interview with Maull.

Medlink Imaging www.medlinkimaging.com 800-456-7800

Preferred Diagnostic Equipment Service, Inc. www.pdiagnostic.net 951-340-0760

Radon Medical Imaging www.radonmedicalimaging.com 800-722-1991

The Association of Medical Service Providers (AMSP) is the premier national association of independent service and products providers to the health care technology industry. Our large pool of modality specialists provide for lower costs and higher quality services for our customers throughout the U.S. Learn more at www.amsp.net.

ICEMAGAZINE | FEBRUARY 2022

ADVANCING THE IMAGING PROFESSIONAL

Q: HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL IMAGING FIELD?

A: We were the first independent com-

pany to provide operation and service training on contrast injectors. Before we opened our doors (metaphorically speaking) in 2008, hospitals were beholden to the manufacturer for maintenance on their contrast injectors; the training for hospital personnel just didn’t exist at a reasonable price. The OEMs did “offer” training to in-house BMETs, but in many instances the cost of training on just one model was over $10,000. We offer that training for a little over $1,000.

Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER?

A: We are strictly a training company.

Training on contrast injectors is all we do, so we are able to put all of our attention on just that task – providing the best posWWW.THEICECOMMUNITY.COM

sible training to the clinical engineering field. Through our courses, both online and in-person, we teach the BMET the basics of contrast injectors, proper model specific operation, maintenance and troubleshooting of all the most common contrast injectors in the North American market. We have also provided training in Canada and even overseas in China and Italy. Along with the training, we also sell toolkits, needed for the proper maintenance of the contrast injectors the students get trained on, as well as PM kits for most of the models we provide training for. We also have 2-3 new models we are striving to get the training ready for in 2022 to add to our library of courses.

Q: WHAT HAS BEEN YOUR COMPANY’S BIGGEST ACHIEVEMENT?

A: By far it has been the development

of our proprietary MIST (Maull Injector Service Tool) software. As far as we are aware, no other biomed training company in the world has developed a training and service tool this robust, regardless of modality. Our software, which has videos for every single step of the operation and PM training, takes the student through the entire operation of the contrast injector and the complete PM and calibration/ verification procedures. It leaves nothing to the imagination; it shows in great detail each and every step of the PM procedure and when finished, it produces a PM report in PDF format. So, everything that gets performed and annotated during the PM, while following along in the software, is added to the completed PM report. Our MIST software also has, by far, the most troubleshooting help available in the contrast injector market with over 1,000 error codes and messages, all model specific, to help the BMET when needed, and most of the errors covered in MIST software also have an accompanying how-to video. Nobody else has anything like that.

STEPHEN MAULL FOUNDER AND OWNER Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY?

A: We are working diligently on adding

the MRExperion and the EZEM Empower CTA/CTA+ to our training library. We are also currently working on expanding more into Europe and eventually seeing if we can’t get a training presence in India. With the growth of the contrast injector market, we feel we are in a great position to move into those markets with our online training and, eventually, partner with a training company in those regions.

Q: IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW?

A: I became an Air Force BMET in 1991

and then an Air Force and DoD BMET instructor in 1997. I’m not just some former BMET who will show you the ropes. Maull Biomedical has trained nearly 2,000 BMETs since we opened our doors on the proper operation, maintenance and troubleshooting of contrast injectors. Our training is broken down into three parts: Introduction to Contrast Injectors; Model Specific Operation; and Model Specific Maintenance. The first two parts are free and available to anyone who goes to our website and we invite anyone to come try out our free training if you have any thoughts at all about taking over the maintenance of your contrast injectors. We can provide the best contrast injector training in the world to your personnel virtually or in person. We can also bring the training to you; if you have at least four students we can provide the training on-site and we bring everything with us. All you have to provide is the students. • For more information, visit maullbiomedical.com. ICEMAGAZINE

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ICEMAGAZINE

INDEX

ADVERTISER INDEX Ray-Pac® Association of Medical Service Providers (AMSP) p. 58

Avante Health Imaging p. 63

Banner Imaging p. 3

CM Parts Plus p. 61

Innovatus Imaging p. 9

KEI Medical Imaging p. 41

KMG p. 23

Maull Biomedical p. 25

Ray-Pac p. BC

RTI Group North American p. 53

Summit Imaging, Inc. p. 50

Technical Prospects p. 4

Medical Imaging Solutions p. 15 Diagnostic Solutions p. 27

TransAmerican Medical p. 19 Metropolis International p. 61

Health Tech Talent Management p. 47

SOLUTIONS

TriImaging Solutions p. 28 MTMI p. 52

HTMJobs.com p. 56

ICE Webinars p. 43

Mammo.com p. 2

MW Imaging Corp. p. 5 USOC p. 20

Injector Support and Service p. 39

ICEMAGAZINE | FEBRUARY 2022

PM Imaging Management p. 53

W7 Global, LLC. p. 60 ADVANCING THE IMAGING PROFESSIONAL

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