TechNation April 2022 by MD Publishing

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Vol. 11

APRIL 2022

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

ACCREDITATION L SURVEY TIPS PREPARATION RELIEVES ANXIETY PAGE 52

Professional of the Month

Department of the Month

Francesca Fam The Piedmont Atlanta Hospital Biomedical Engineering Department

Roundtable AEDs/Defibrillators

Cybersecurity HL7 Messages: Handle with Care

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CONTENTS

FEATURED

THE ROUNDTABLE: AEDS/ DEFIBRILLATORS TechNation reached out to several leading companies and experts for this roundtable article on AEDs and defibrillators.

ext month’s Feature article: N Infusion Pumps

ACCREDITATION SURVEY TIPS: PREPARATION RELIEVES ANXIETY Has anyone ever felt anxiety knowing that an accrediting organization would soon make a visit? Use these helpful tips to prepare for the next unannounced visit. ext month’s Feature article: N Analyzing Product Support Aspects Before Purchasing Medical Devices

TechNation (Vol. 13, Issue #4) April 2022 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2022

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

APRIL 2022

TECHNATION

CONTENTS

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Strand

ART DEPARTMENT

Karlee Gower Taylor Powers Kameryn Johnson

EDITORIAL

John Wallace

CONTRIBUTORS

Roger Bowles K. Richard Douglas Jim Fedele Joie Marhefka Manny Roman Connor Walsh David Witt Steven J. Yelton

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

EVENTS

Kristin Leavoy

WEBINARS

Jennifer Godwin

HTMJOBS.COM

Kristen Register Sydney Krieg

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Jim Fedele, CBET, Senior Director of Clinical Engineering, UPMC Carol Davis-Smith, CCE, FACCE, AAMIF, Owner/ President of Carol Davis-Smith & Associates, LLC David Francoeur, CBET, CHTM, Service Zone Vice President Midwest Imaging - Siemens Healthineers Jennifer DeFrancesco, DHA, MS, CHTM, System Director, Clinical Engineering, Crothall Healthcare Rob Bundick, Director HTM & Biomedical Engineering, ProHealth Care

INSIDE Departments P.12 SPOTLIGHT p.12 Professional of the Month: Francesca Fam p.14 Department of the Month: The Piedmont Atlanta Hospital Biomedical Engineering Department p.18 Shifting Gears: The Bearded Biomed Podcaster P.20 p.20 p.28 p.30 p.32 p.34

INDUSTRY UPDATES News & Notes Welcome to TechNation AAMI Update Ribbon Cutting: HERO ECRI Update

P.38 p.38 p.40 p.43 p.44

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

P.59 EXPERT ADVICE p.59 Career Center p.60 Sponsored Content: Avante p.64 Cybersecurity p.68 Sponsored Content: 20/20 Imaging Insights Innovatus Imaging p.71 The Future p.72 Sponsored Content: Nuvolo p.74 Sponsored Content: ReNew Biomedical p.77 Witt’s End P.81 p.81 p.83 p.84 p.86 p.94

BREAKROOM Did You Know? The Vault HTM Jobs Where in the World is Ben C.? HTM Strong

p.90 Service Index p.93 Alphabetical Index

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

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APRIL 2022

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SPOTLIGHT

PROFESSIONAL OF THE MONTH: FRANCESCA FAM, CBET Ensuring the Readiness of the Army’s Medical Equipment

BY: K. RICHARD DOUGLAS

he military has always been a good source for biomed training. It is also a good place to work as a biomed; whether active duty or civilian. There is ample opportunity for hands-on training and experience.

The military owns and operates an enormous amount of medical equipment in the U.S. and around the world. It needs to be maintained and calibrated when in use or when in storage, ready to be deployed. The U.S. Army Medical Materiel

TECHNATION

APRIL 2022

Agency is headquartered at Fort Detrick, Maryland. It has operations worldwide. The Medical Maintenance Operations Division of the command provides medical material maintenance and expertise. This work is carried out at three depots which cover operations in all 50 states. One can be found at Hill Air Force Base in Utah and another in Tobyhanna, Pennsylvania. The third is on the West Coast. It is the U.S. Army Medical Materiel Agency’s Medical Maintenance Operations Division at Tracy, California.

All three depots are important to Army readiness and maintenance capabilities for health care operations worldwide. Tracy, California is east of San Francisco and northeast of San Jose on the east side of the bay in San Joaquin County. Francesca Fam, CBET, is a BMET II with the U.S. Army Medical Materiel Agency in Tracy, California. She specializes in mobile X-ray units in her job at the depot. Fam’s biomed profession started with her working on infusion pumps.

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SPOTLIGHT That experience was the start of a career path. “I honestly didn’t know this field existed until I got a call from an employment agency in 2016 to be a contractor for Becton Dickinson working with the Alaris infusion pumps. I found I had a natural talent. I wanted to learn more and do more,” she says. She left Becton Dickinson in 2019 to go back to school. “I enrolled in an accelerated program at MiraCosta’s Technology Career Institute in Carlsbad,” Fam says. Her experience at the institute was immmersive. “Each cohort (class) gets better than the last one taught. The program at MiraCosta’s TCI is very hands-on. We were able to practice using test equipment. We practiced taking apart and putting devices back together. We learned basic electronics and programmed Arduino projects. I was in cohort 2 and they are now on cohort 8. I recommended this program to one of my friends and he’s now a BMET at Stanford,” Fam says. “I started my journey as a medical device technician in 2016. Then had a BMET internship during my BMET training. Shortly after receiving my technical certificate, I landed myself in Tracy, California working for the U.S. Army Medical Materiel Agency (USAMMA) at the defense depot. I’ve been here over two years now,” she says. Fam remembers that a recruiter called her about her current job. “I think she found my resume on LinkedIn. They also offered relocation assistance and paid for almost everything upfront. My background equipped me with the basics, which is really all you need. If you can read and follow a manual; you can be a BMET,” she says. Fam passed the CBET exam in November 2021. ENGLISH TO X-RAYS Taking her current job meant relocating from Southern California to Northern California, which took some adjusting. “I think the challenge for me was finding my feet when I got to Tracy. I had lived in San Diego with my parents my whole life, so when I moved, it was a culture shock. Everything from the weather to the people,” Fam says. New experiences and projects always provide an opportunity to learn, whether in the classroom, with on-the-job training or alongside OEM field service engineers. Fam got that opportunity during a project with X-ray units. “One special project I’ve been involved with was when Canon came to our depot to replace the tube heads of our Soltus 100Ms. I was able to learn from Canon field engineers how to replace a tube head and calibrate them,” Fam says. She says that the Canon field service engineers tested the tube heads to make sure that they were in fact bad; not giving out the right outputs. “We tested the power going into the X-ray units were

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

BIOMETRICS FAVORITE BOOK: “Alice’s Adventures in Wonderland”

FAVORITE MOVIE: “Breakfast at Tiffany’s”

FAVORITE FOOD: Sushi

WHAT’S ON MY BENCH? Precision screw driver set, gum, notebook, favorite pen, multimeter

FAVORITE PART OF BEING A BIOMED? Helping people/patients

sufficient. Next, we tried doing an auto-calibration of the tube heads which failed. So, we attempted manual calibrations. Those also failed. After Canon determined the tube heads were not deemed for patient use, they showed us how to replace them. We then calibrated them and went through the PM procedure,” Fam says. She says that fixing a piece of equipment is like solving a puzzle. “To me it’s very rewarding at the end when the repair is completed,” she says. Beyond her biomed training, Fam has a bachelor’s degree in English and a teaching credential because she originally wanted to be an English teacher. “But like many millennials, we weren’t able to find jobs after college and had to settle for whatever came our way. So, I worked a lot of horrible temp jobs in customer service and sales. I’m in my mid-20s. I went back to school to be a nurse and worked at a rehab facility,” Fam says. One bad experience put her off of that career path. “Some people have the strength to be doctors and nurses, but that’s when I found out that it was not me. I am so happy I finally found something I’m good at that I actually enjoy doing. And I’m still helping people because the equipment I work on could be used to save someone’s life,” Fam says. When not working at the depot, Fam enjoys spending time with her two dogs, ballroom dancing and making soap. Helping ascertain that the Army’s medical equipment is maintained, calibrated and working when needed, this biomed is an asset to all who depend on her.

APRIL 2022

TECHNATION

SPOTLIGHT

DEPARTMENT OF THE MONTH: The Piedmont Atlanta Hospital Biomedical Engineering Department

BY: K. RICHARD DOUGLAS

ot many people know that Atlanta has one of the largest permanent trade centers in the world, with the largest collection of home, gift, area rug and merchandise in the world.

The city, at the crossroads of Interstate 75 and Interstate 85 and encircled by Interstate 285 (a.k.a. the Perimeter) is a fashion hub and home to many professional sports teams. Historically, the city played an important role in the Civil War and the Civil Rights Movement. With a population approaching 500,000, the need for competent medical facilities across the city is imperative. One of those facilities is the Piedmont Atlanta Hospital. Piedmont Atlanta Hospital (PAH) is a 643-bed acute-care community hospital offering all major medical, surgical and diagnostic services, including 24-hour emergency services, transplantation and comprehensive care. Managing the medical equipment at the hospital, as well as at the Piedmont Heart Institute (PHI) and Piedmont

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APRIL 2022

Medical Care Corporation (PMCC) offices on campus, is the system’s biomedical engineering department. The department’s leadership team includes Executive Director Jeff Allen, Regional Director Dan Harrison, Manager Jim Arnold and Equipment Distribution Supervisor Poplela Sikod. The Piedmont Atlanta Hospital Biomedical Engineering Department also includes 13 BMETs and four equipment technicians on the equipment distribution team. Arnold says that the biomed department provides preventative maintenance, troubleshooting and repair of biomedical devices. They also provide in-service training, as needed, when they find opportunities to better the understanding of the users of biomedical equipment. “We participate in committees such as our Physical Environment Committee, LIT Committee [and] Water Management Committee,” Arnold says. “Additionally, we collaborate with clinical departments in pre-purchase reviews and decision making when considering the purchase of new medical

equipment. As a system, we seek to standardize biomedical equipment when feasible. In such cases, we involve our biomedical leadership at the system level to aide in negotiations that impact multiple Piedmont facilities,” he adds. Beyond several team members who have focused areas of assignment, Arnold says that the department works to cross-train where feasible and is constantly exposing technicians to units and biomedical equipment outside of their main scope of responsibility. “Some of the most recent training we have obtained for our team members are: infusion systems, sterile processing equipment, anesthesia machines, patient physiological bedside and telemetry monitoring system, cardiac cath lab physiological monitoring system, ventilators, intra-aortic balloon pumps, ECMO machines and CRRT dialysis machines,” Arnold says. WHEN CONSTRUCTION CALLS With a major recent construction project, the biomed team has been extra busy tackling projects in addition to its more routine duties.

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SPOTLIGHT

Members of the Biomedical Engineering Team at Piedmont Atlanta Hospital include: Back row from left: Ryan Moore, Kellie Langley, Mackie Bowden, Claudia Lara, Scott Willoughby, Louis Pritchett, Randolph Jackson, Willie Briggs, Alex Conrad-Lynch Front row from left: Romeo Casurao, Jessica Marchand, Jim Arnold, Mituki Omori, and Mario Guardado

“We are constantly involved in projects at PAH. Over the past two years we have launched multiple units in our new 14-story Marcus Tower that opened in 2020,” Arnold says. He says, that to date, the team has moved and expanded the following units into the new tower. These projects involved biomed’s engagement with planning, checking in, inventorying, moving and expanding existing services to the new tower, including cardiac intensive care, cardiac acute care, cardiac cath and EP labs, Piedmont Heart Institute surgery suites and the sterile processing department. “We also opened our neuro procedures suites in our original facility and are currently involved with projects that will involve moving and expanding other units to the Marcus Tower as well as remodeling and expanding other units within our existing tower,” Arnold says. The task of biomed departments as problem solvers is often best addressed by avoiding those situations altogether. “This issue is really around problem avoidance. After moving and expanding our sterile processing department (SPD) into our new Marcus Tower, we knew we had a unique opportunity to start fresh with brand new equipment. Knowing the wear and tear that can occur on equipment in a sterile process-

ing department, we implemented a proactive approach to maintaining the equipment. Instead of waiting for SPD to report troubles, we began performing proactive daily rounding in the department,” Arnold says. He says that anyone familiar with SPD, recognizes that there are many moving parts with rolling carts, spinning wash arms, running pumps, actuating valves, automated conveyors, ultrasonic sinks, large cart washers, sterilizers, boilers and instrument dryers. “Our equipment is in use 24x7x365, so it is subject to much wear and tear. Oftentimes, little things break that don’t necessarily impede operation, but left to sit over time, can lead to larger problems. If such issues are left unattended, you can quickly find yourself with an abundance of issues to address and not enough time in the day to address them all,” Arnold says. He says that the biomed team’s approach is to stay in front of troubles. “We look for those small things on a daily basis and address them before they grow into larger issues that might negatively impact SPD’s operation. On occasion, we discover issues that, if not addressed, will grow into situations that will diminish the department’s ability to keep pace with their production. These are often ‘behind the scenes’ compo-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

nents that the user would never know was a problem until their sterilizers report an alarm such as low steam pressure or their washers report an alarm such as no water flow,” Arnold adds. He adds that the Piedmont Atlanta Hospital Biomedical Engineering Department often discovers and repairs issues without the client ever experiencing a negative impact to their operation. “We pride ourselves on our success at keeping our SPD department running at a high capacity, allowing them to adequately provide surgery with the appropriate instruments on time, which in turn, allows surgery to maintain an on-time schedule. We know patients and their families have had to prepare for surgery both mentally and physically and with that often comes stress and worry,” Arnold says. He says that the department recognizes the negative impact to the patients and their families when surgeries have to be delayed or cancelled, so they make every effort to keep SPD running smoothly. In one of the South’s largest cities, the important behind-the-scenes work of medical equipment management is performed every day by the experienced professionals that make up the Piedmont Atlanta Hospital Biomedical Engineering Department.

APRIL 2022

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SPOTLIGHT

SHIFTING GEARS

The Bearded Biomed Podcaster BY: K. RICHARD DOUGLAS

he healthcare technology management (HTM) career field will see a need for growth and a need for replacements as it continues to lose retiring biomeds in the coming years. Increases in the use of technology will accelerate this need.

The wealth of knowledge and on-thejob experience garnered by so many baby-boom generation biomeds will evaporate as experienced biomeds retire and leave PMs, calibrations and repairs behind. One of the biggest challenges for the profession is attracting new recruits into the field. This is especially challenging because few people outside of health care even know the job is an option. This challenge requires creative thinking and newer platforms and technology to reach a younger audience of potential candidates. That was the impetus for an innovative podcast called the “Bearded Biomed,” that brings interesting insights to biomeds, while piquing interest in the biomed field for prospective biomeds. For the uninitiated, a podcast is

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APRIL 2022

an episodic series of digital audio files usually presented by one or more individuals and often focused on a central theme. The term originated from people using the Apple iPod to listen to podcasts and “cast” comes from “broadcast.” Podcasts are popular because they can be accessed at the listener’s convenience using several platforms or using several different apps. One member of the HTM community who recognized the power of this platform is Chace Torres, a lead field service technician for SPBS in the Dallas-Ft.Worth area. Torres is the creator of the “Bearded Biomed” podcast. “The primary reason I started the podcast was to build awareness and educate society about the existence of the HTM professional. Speaking with people and explaining what I do became frustrating, and I imagine many of my colleagues out there experience the same. I love our field and what I get to contribute to patient safety is rewarding. I want to share that with the world,” Torres says. He says that the other reason he created the podcast is because the

“field is aging itself out and the numbers we require for a future generation of biomed is not up to snuff.” He says that the idea for the podcast came from his need to do something productive with his off time while also finding a way to contribute to the biomed field. “If I can do my part in marketing and spreading the word about this profession then I will feel I was successful in contributing something meaningful to the field,” Torres says. He says that the podcast started at the beginning of December 2021. New episodes come out each week on all the major listening platforms such as Spotify, Apple, Google, and just about anywhere people like to take in a podcast. To make the podcast enjoyable and informative, Torres spends some time in pre-podcast preparation. “Preparation usually involves writing down different topics I want to cover and asking my listeners what they would be interested in me speaking about. Episodes are posted on Thursday, and usually that weekend, I’m planning out next week’s content,” he says. He says that on Monday and

WWW.1TECHNATION.COM

SPOTLIGHT

Chace Torres created the “Bearded Biomed” podcast to promote HTM.

Tuesday, he writes either a draft or a script, then records and edits on Wednesday. “I just recently did my first interview with David Braeutigam to which I just provided a general template of topics we can discuss, but just naturally let the conversation move to where it may,” Torres says. Interviews will be a recurring part of the Bearded Biomed podcasts in the future. “For future interviews, it’s just as simple as scheduling a day to do a video call, at which point I record the episode utilizing SquadCast, and get to work editing the sound shortly after it’s done,” Torres adds. Potential interviewees will be referred through Torres’ “vast network of contacts from both the civilian and military realm.” “Not to mention, the HTM field is such a tight knit community, if you don’t know someone firsthand, you might know another that knows them. Networking/building relationships is something I love doing and am relatively good at. Also, with the assistance of social media, it is a lot easier to reach out to folks through platforms such as LinkedIn or Facebook to find future interviewees,” Torres says. INSPIRING A NEW GENERATION OF BIOMEDS One recent podcast was aimed

directly at the aspiring biomed or the high school graduate trying to decide if they should attend college or a technical training program and enter the biomed field. “Hopefully, even I can assist in inspiring a new wave of generational talent to enter the workforce wanting to make a difference in patient safety as a biomed. If you consider the amount of media available to the world showcasing nurses and doctors through TV shows, radio, books and movies, it’s no wonder people seek out to become one,” Torres says. He says that if we had a biomed show like “Scrubs,” or movies depicting biomeds swooping in to stop a major medical device failure to help save a patient’s life that kids would think, “Wow, that’s awesome!” “I didn’t even know about the biomed field until I joined the U.S. Army and my recruiter gave me the single greatest tap on the shoulder for one hell of a profession. My goal with this podcast is to grow the field, showcase incredible technicians and perhaps spark a movement to where we don’t remain the unknown, unsung heroes of the medical realm,” Torres says. He is leaving no rock unturned in coming up with ideas for reaching future biomeds. “I really have cultivated a stream-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

lined approach of distribution to every streaming platform for podcasts. If you can think of a place to listen to one, the Bearded Biomed is available on it. I’m collaborating with TechNation and MedWrench and gearing up to do a show at this year’s MD Expo in Atlanta. I am not dependent on referrals, but if there is someone I should interview, let me know” Torres says. Torres isn’t only working to help further the careers of aspiring biomeds. He is actively working on adding more education to his many years of biomed experience. “I recently obtained my B.S. in management and will be taking the CHTM this year,” he says. In addition to those endeavors, he is beginning work on an MBA later this year. The “Bearded Biomed” holds a lot of value for those exploring the biomed field. It also is entertaining and informative for those already in the field. You can find the “Bearded Biomed” podcasts on Spotify at: 1technation.com/category/podcasts or at any of the platforms mentioned above.

APRIL 2022

TECHNATION

INDUSTRY UPDATES

NEWS & NOTES Updates from the HTM Industry

TEMPLE UNIVERSITY HOSPITAL ADOPTS MASIMO CENTROID Masimo and Temple Health announced that Temple University Hospital (TUH), a 722-bed academic medical center located in Philadelphia, is expanding its use of Masimo technologies with Centroid, an advanced wireless patient position, orientation, activity, and respiration rate sensor, at 100 beds across its ICU units Centroid helps clinicians monitor patient position to avoid preventable pressure injuries and can alert clinicians to sudden movements such as fall-like events. In addition, Centroid detects chest movements to continuously provide respiration rate, assisting clinicians with additional data that may inform care decisions. Centroid pairs with the Root Patient Monitoring and Connectivity Platform using Bluetooth to track a patient’s posture, orientation and activity, providing the ability to monitor patient position and detect changes in position. The data transmitted by Centroid can be displayed in various formats on Root, giving clinicians multiple ways to assess adherence to protocols

TECHNATION

APRIL 2022

regarding tissue stress and to tailor care to the specific needs of each patient. In addition, Centroid data can be relayed via the Masimo Hospital Automation platform to Patient SafetyNet, Masimo’s centralized remote patient supplemental monitoring platform, and Replica, a mobile application that allows clinicians to view continuous data regardless of location. At TUH, all ICU beds are being equipped with Root and with Centroid, including the Trauma ICU, Cardiothoracic ICU, Burn ICU, Neurological ICU and Medical Respiratory ICU. Angelo Venditti, DNP, RN, executive vice president for patient care and chief nursing executive at Temple Health, said, “We are pleased to expand our relationship with Masimo, which has already proven itself as a key technology partner in our efforts to improve patient outcomes. When we trialed Centroid, we found it helped our teams prioritize workflows more effectively, with increased focus on following turn protocols and decreased incidence of pressure injuries.”

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INDUSTRY UPDATES

PRIORITY HEALTH ANNOUNCES CYBERSECURITY INCIDENT Priority Health discovered a cybersecurity incident on Dec. 16, 2021, involving its member rewards program in which an unauthorized individual accessed several Priority Health Member Portal (PHMP) accounts. After conducting a thorough investigation, the company has determined that the unauthorized individual was able to view information within PHMP accounts that may have included names, dates of birth, addresses, phone numbers, email addresses, insurance information, claims information and limited medical information. There is no evidence that Social Security Numbers were accessed, and the investigation has not revealed any misuse. However, out of an abundance of caution, Priority Health has alerted all members and employers who were potentially impacted by this incident and is providing a variety of services and measures to help safeguard those individuals. Upon learning of the incident, Priority Health immediately disabled access to the PHMP and all member accounts were

put on hold to ensure affected accounts were secure. Additional steps were then taken to strengthen account security, including requiring members to reset their passwords with high complexity. Priority Health has been working closely with external cyber security professionals experienced in handling these types of incidents. The company also implemented multifactor authentication (MFA) for all PHMP accounts on January 18, 2022, providing a secondary level of security for members. While no evidence of misuse has been found, Priority Health is offering impacted members a complimentary 24-month membership of Experian’s IdentityWorksSM as an additional layer of protection. The product will provide members with superior identity detection and resolution of identity theft. Information about this incident will also be available online at www.priorityhealth.com.

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INDUSTRY UPDATES OLYMPUS AWARDED VIZIENT CONTRACT FOR SINGLE-USE BRONCHOSCOPES Olympus has been awarded the new Vizient single-use visualization devices contract for its single-use bronchoscope portfolio. The Olympus single-use bronchoscope portfolio is made up of the five premium H-SteriScope single-use bronchoscopes that can be used in complement with Olympus’ leading re-usable bronchoscope portfolio already available within Vizient’s contract portfolio. Vizient is the largest GPO in the U.S. serving more than half of the health care organizations nationwide. Vizient members represent a diverse base of integrated delivery networks, academic medical centers, pediatric facilities, community hospitals and non-acute health care providers that collectively have more than $110 billion in annual purchasing volume. “Olympus is thrilled to be chosen as a supplier in bronchoscopy by Vizient,” said Kevin Mancini, vice president for the respiratory business unit at Olympus America Inc. “Our leadership in endoscopy allows us to provide a full portfolio of endoscopes with attributes that can match physician needs for each specific case.” The total Olympus portfolio of premium single-use bronchoscopes, available through this new agreement, and re-usable bronchoscopes, available through earlier Vizient contracts, give physicians access at contracted pricing to a comprehensive selection of bronchoscopes for any procedure and site of care. A full and robust portfolio ensures the right bronchoscope is available when and where needed for both basic and advanced diagnostic and therapeutic pulmonary procedures.

The advanced H-SteriScope portfolio includes five single-use bronchoscopes that offer efficiency, control and variety to health care providers. The H-SteriScopes range in size from ultra-thin to extra-large with working channels up to 3.2 mm to fulfill a variety of clinical needs. Differentiating features of the H-SteriScopes that are useful in respiratory care include 90-degree rotation left and right, 210-degree angulation up and down, and passive bending for enhanced maneuverability. The new Olympus single-use bronchoscope portfolio complies with the latest safety recommendations from the FDA to advance performance in the bronchoscopy suite. For more information, visit the medical.olympusamerica.com/single-use-bronchoscopes.

THE AFRICA MERCY RETURNS TO DAKAR TO RESUME SURGERY The President of the Republic of Senegal, His Excellency Macky Sall has announced that the Africa Mercy has returned as promised to continue the surgical operations and training that were interrupted in March 2020 by the onset of the COVID-19 pandemic. The ship’s presence is expected to last until November 2022. The Minister of Health and Social Action presided over the arrival ceremony and welcomed the return of the hospital ship to contribute to the state’s efforts to strengthen the provision of surgical services. “Human beings are at the heart of development, and it is imperative that they enjoy a better state of health for their full development and for their contribution to the development of our country. Therefore, the interventions of the Mercy Ships are an opportunity to achieve this goal, thus complementing the many efforts made by the state. To this end, I renew my confidence in all the members of the ship’s crew. I am convinced that the quality of human resources involved in this cooperation will enable us to give back hope,” stated M. Abdoulaye Diouf Sarr, Minister of Health and Social Action. Between October 2021 and January 2022, the Mercy Ships patient selection team visited all 14 regions of the country. With the participation of the chief medical officers of these regions, more than 900 patients have been selected for consultation with a surgeon with the hope to provide free surgery. Mercy Ships wishes to honor its promises to the people of Senegal and priority has been given to 22

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patients already identified in 2019/20 by the chief medical officers of each region. The selection of patients is now closed. At the same time, nearly 750 health care providers will receive medical training in various specialties. Mercy Ships has worked with the Ministry of Health and Social Action to develop protocols that ensure all activities are undertaken as safely as possible. These protocols are aligned with those in place in Senegal and Mercy Ships emphasizes that the plans may require further modification in response to the global and local coronavirus situation and will be updated regularly. “Although Mercy Ships has never really left Senegal, it is an honor and a blessing to return in 2022. This return would not be possible without the partnership of the Senegalese government, which has continued to walk closely with us through a difficult season. On behalf of Mercy Ships, I would like to extend a special thank you to President Macky Sall for his friendship and support, which has enabled us to once again bring hope and healing to Senegal,” said Gert van der Weerdhof, CEO of Mercy Ships. Thanks to donations from partner organizations and individuals, shipboard consultations, surgery, training and mentoring are provided free of charge to local patients and professionals. For more information, visit mercyships.org. WWW.1TECHNATION.COM

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RPI CELEBRATES 50TH ANNIVERSARY Replacement Parts Industries Inc. (RPI), the original aftermarket parts company for health care equipment, is celebrating its 50th anniversary this year, according to a news release. RPI is an industry leader in providing quality replacement and repair parts for medical and dental equipment. The company’s strong commitment to its customers and the health care industry is the focal point of its continued success. When RPI opened it doors back on February 29, 1972, quality was its first concern as it introduced its original 19 parts for autoclaves. It was imperative to RPI that their parts were as good or better than the manufacturer’s original equipment parts. And that holds true even more so in today’s quality conscience marketplace. In fact, throughout its 50-year history, RPI has always maintained that its parts are guaranteed to each customer’s 100% complete satisfaction. Several milestones have marked the success of RPI over these 50 years. In 1999, the founders of RPI, Sherry and Al Lapides, passed the baton to their son, Ira Lapides, who was asked by the board of directors to become the company’s vice president, and later president and CEO. It was under Ira’s leadership that RPI soared to even greater heights. It’s incredible how RPI stills caters to the needs of the industry. The company’s secret, according to Lapides, “is communicating with our customers on a regular basis and incorporating their feedback into our product development plan.” RPI expanded its goal of manufacturing parts that meet or exceed the OEM’s performance. As of this year, RPI boasts of more than 4,500 parts to fit more than 50 lines of health care equipment including more than 100 different models for medical and dental equipment. The company continues to develop a vast array of one-of-a-kind parts, value added parts and kits, as well as end-user friendly parts to assist biomedical equipment technicians and service professionals with their own goal of ensuring the highest level of service. What’s more, two of RPI’s engineers invented a catalytic converter for a hydrogen peroxide sterilizer vacuum pump assembly, and as a result, RPI became the proud owner of U.S. Patent 10,610,828. In addition, RPI is dedicated to offering the health care industry an extensive knowledge base of information about servicing and maintaining equipment. From being the first company in the health care industry to offer a website dedicated to repair and replacement parts including a comprehensive Technical Assistance Center compiled of informative “how-to” videos and presentations, trouble-shooting guides, technical assistance articles complete with diagrams and photos, to offering free technical assistance via the phone with an experienced RPI Tech, RPI’s commitment to the industry is ever expanding. RPI also introduced Planned Maintenance (PM) Month, and it is celebrated by its customers every June with a free PM poster from RPI. The poster is developed and designed by RPI with the intention of reminding the industry of the importance that regular PM programs play in the well-being of their equipment. Posters are created using lively themes to present PM information and service tips. It has become a valuable resource and work tool for health care service professionals. This year also marks RPI’s 22nd year as being ISO 9001 certified. One of the primary tenants of ISO 9001, the international standard for quality

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management systems, is continuous improvement. This concept requires the certified company to put in place processes that allow the company to always be looking for ways to improve itself, be it in service, products, internal processes or any other aspect of the business. “RPI has been ISO 9001 certified since the year 2000, but I think we have always had a philosophy of continuous improvement. Questioning, searching for answers, and better ways of doing things was instilled in the company’s value system long ago, and has helped RPI to continue to grow throughout our history. While we have consistently produced high-quality parts and established excellent systems, ISO prompts us to do even better. We believe that ISO helps RPI maintain the level of excellence required in today’s marketplace,” stated Lapides. “Looking to the future, we always strive to do what is best for our customers, so after 50 years of tremendous success, I am pleased that we are now an integral part of the Healthcare Components Group (HCG). It was our choice to sell RPI and to become a vital part of the newly formed HCG family of brands dedicated to providing quality components and replacement parts to the health care industry. Our HCG affiliate companies, American Optics (AOERP), Micro Optics Europe (MOE), and Endoscopy Development Company (EDC), are global leaders in the flexible and rigid endoscope replacement parts and components parts industry. RPI’s commitment to our customers remain as strong as it always has been since opening our doors in 1972, and our focus will continue to be on providing them with what they have come to expect from us – quality parts, excellent technical support and outstanding customer service. We are proud of our 50 years of excellence, and look forward to many more years of success as part of the HCG family,” Lapides stated. For more information, visit rpiparts.com.

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TECHNATION ANNOUNCES HTM WEEK CONTEST TechNation has announced its annual HTM Week Contest. The popular event is just one way the magazine and parent company MD Publishing support the heroes of healthcare technology management (HTM) each year. This year HTM Week is set for May 15-22. Check out TechNation’s website for a chance to enter the contest! Daily winners will earn a prize valued at up to $250 with a grand prize winner collecting a trip to MD Expo

SoCal at the Pechanga Casino & Resort this October. The grand prize includes up to $400 in travel expenses along with 3 room nights at the host hotel. Prizes are made available through sponsorships from some of the top HTM companies. Find out more at 1technation.com/htm-week-contest/.

VIZZIA TECHNOLOGIES CONTINUES GROWTH Vizzia Technologies, a software and managed service provider of real-time location systems (RTLS) for health care organizations, announced significant company-wide growth in 2021. Vizzia was recognized as one of America’s fastest-growing private companies on the Inc. 5000 list for the fourth year in a row and named a top 100 healthcare technology company. “We are proud to help our ever-growing client base of

health care customers to reduce costs, streamline processes and improve patient care,” said Andrew L. Halasz, founder and CEO of Vizzia Technologies. “It’s clear that the pandemic has accelerated the need for digitization in the health care industry.” According to a recent HIMSS report, 80% of health care providers plan to increase investment in technology and digital solutions over the next five years.

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DIRECTMED PARTS & SERVICE ACQUIRES LBN MEDICAL DirectMed Parts & Service has acquired LBN. Terms of the transaction were not disclosed. Headquartered in Aalborg, Denmark, LBN is a leading global reseller of aftermarket diagnostic imaging equipment. LBN sells complete systems and parts covering more than 15 brands, including major original equipment manufacturers (OEMs) such as Canon, GE, Hologic, Siemens and Philips. The company was founded in 2003 by CEO Lars Braun Nielsen and has since grown to more than 50 employees at facilities in Denmark and Egypt. “Brad and the DirectMed team have outlined their mission to extend the life of medical imaging equipment to improve access, reduce waste and lower health care costs,” LBN CEO and Founder Lars Braun Nielsen stated. “We are thrilled to be a part of this endeavor, and to work with the DirectMed team and NMS to accelerate our growth. The partnership with DirectMed provides LBN with tremendous resources to provide an even higher level of service and expertise to our customers, including a greater breadth and depth of parts and technical support.” “We have known LBN Medical for several years and believe they are the logical company to help DirectMed expand our parts business outside of North America. Their distribution team – which speaks 21 different languages, with sales history in over 60 countries, and employs experts across seven modalities – is the perfect complement to our business,” DirectMed President & CEO Brad de Koning said. “Acquiring LBN Medical begins an exciting new chapter for DirectMed, with the addition of system sales to our customer base, and for LBN Medical, who will now stock and have access to over 10,000 unique part numbers to support theirs.” “Providers around the world are looking for cost-effective solutions to acquire and maintain equipment as they continue to grow their practice. The combination of DirectMed and LBN supports that exact need in the marketplace,” DirectMed Vice President of Sales Tanner LoRusso said. “Moreover, we can now supply our North America customers with complete diagnostic imaging solutions, with ready to ship ultrasound, mammography, X-ray, MRI and CT machines.” For more information, visit directmedparts.com or LBNmedical.com.

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LIFE SPARK MEDICAL Q: WHAT PRODUCT, SERVICE, OR SOLUTION DOES YOUR COMPANY PROVIDE TO THE INDUSTRY? At Life Spark Medical, we have spent the last several years innovating and developing The SmartTank, the most innovative and straightforward way to accurately test capnometers and anesthesia gas monitors. Respiratory Gas monitors can fail in several ways that traditional testing methods simply can’t detect. The SmartTank can detect these through a series of quick dynamic tests and simulations.

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AAMI UPDATE New Leader Takes the Helm

AMI recently announced a new president and CEO. In other news, the organization announced an addition to its editorial board.

AAMI’S NEW PRESIDENT AND CEO Following an eight-month search, the AAMI Board of Directors announced Pamela Arora, a respected health care leader, as its next president and CEO. Arora, who serves on the AAMI Board, most recently served as senior vice president of strategic technology at Children’s Health System of Texas, where she was chief information officer for 14 years. “I’m honored to lead AAMI as its next president and CEO. I first moved into the healthcare technology field for several reasons, including the industry’s readiness to adopt technological transformation. But the most important reason is the mission of using technology to improve the health and livelihood of those around us. That’s the goal of AAMI’s many stakeholders, and it’s at the very heart of AAMI’s role as a trusted, neutral convener,” Arora said. At Children’s Health, Arora was responsible for directing technology efforts to support capital projects planned and underway at the system.

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Pamela Arora, CEO & President of AAMI

Before joining Children’s Health in 2007, Arora served as senior vice president and chief information officer at UMass Memorial Health Care in Worcester, Massachusetts; CEO of LiquidAgents Healthcare; and chief information officer of Perot Systems in Dallas, Texas. She holds a bachelor’s degree in computer science from Wayne State University and an MBA from Southern Methodist University. “As a leader, the most important lesson I’ve learned is that you can’t do it all by yourself – you must surround yourself with team members who work well together toward a common goal. I am very much looking forward

to working with AAMI staff, volunteers and members in our shared mission,” Arora added. An avid traveler and music enthusiast, Arora currently resides in Dallas, Texas, with her partner, Roy, and daughter, Madison, who will be attending medical school in the fall. Arora looks forward to returning to the Washington, D.C, area to be closer to AAMI’s offices as well as to family on the East Coast, including her father, William Kerr, and her sister in North Carolina. “Over the past several years, AAMI has invested in the people and systems necessary to support the needs of our members as we continue to advance the field of health technology. With Pamela on board, we are poised to begin an era of greater growth and extraordinary possibility,” said Steve Yelton, chair of the AAMI Board of Directors and professor emeritus at Cincinnati State Technical and Community College. “I also want to extend our appreciation and gratitude to Steve Campbell, who served as acting president and ensured that AAMI continued to dutifully fulfill its mission.” In choosing Arora, the AAMI Executive Search Committee hired consulting firm Staffing Advisors, which evaluated more than 300

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candidates. The search committee was led by Yelton and included Chair-Elect Janet Prust (3M Health Care), Walt Rosebrough (STERIS), Kurt Finke, Joyce Hansen (Johnson and Johnson), Jeff Eggleston (Medtronic), Donna Marie Dyer (GE Healthcare), and Larry Hertzler (The InterMed Group). Arora’s history as a longtime supporter and active AAMI participant was a major benefit in her selection as AAMI’s next president, “as well as her impressive record of leading both health care and nonhealth care related technology organizations as an executive,” said Prust, global standards director with 3M Health Care. “I am excitedly looking forward to collaborating with her and the AAMI team to evolve the organization and lead the way for safe and effective use of healthcare technology.” After more than a year serving as acting president, Campbell plans to remain engaged with AAMI, where he will work on the transition and his roles as AAMI’s COO and executive director of the AAMI Foundation. “Despite the challenges that all organizations have faced the past year, AAMI is financially strong, our membership is growing, and our mission is as important as ever. I’m confident that this organization is on the right path and – with its new CEO – in good hands,” Campbell said. AAMI members can look for more ways

Kevin Fu, AAMI Editorial Board

to get to know the organization’s CEO, including a meet-and-greet at the AAMI eXchange in San Antonio this June. CYBERSECURITY EXPERT KEVIN FU JOINS AAMI EDITORIAL BOARD Kevin Fu, a renowned cybersecurity expert, University of Michigan professor and the FDA’s first medical device cybersecurity director, has joined AAMI’s Publications Editorial Board, where he will advise AAMI’s award-winning publications. AAMI’s publications include BI&T, the peer-reviewed journal of health technology and sterilization, and AAMI News. Both serve as primary sources of updates, practical guidance, research and analysis for those working with medical devices. “With both the rise of telehealth and the increasing connectivity of medical devices, cybersecurity represents an area of great

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concern for AAMI’s members and stakeholders, as well as a new regulatory frontier. We’re thrilled to welcome Kevin Fu as the latest voice to join AAMI’s Editorial Board and look forward to him sharing his expertise,” said Gavin Stern, MPH, MS, editor in chief at AAMI director of publication and media relations. Fu, an associate professor of electrical engineering and computer science at the University of Michigan (U-M), is also the founder of the Archimedes Center for Healthcare and Device Security at U-M. Fu has served on several AAMI standards committees. In 2020, the FDA’s Center for Devices and Radiological health (CDRH) named Fu as its Acting Director of Medical Device Cybersecurity, a new position for the agency. Fu’s tenure as FDA acting director of medical device cybersecurity has been extended into 2022. He has shown enthusiasm for promoting rarely considered or unappreciated ideas for cybersecurity, which will prove a boon for AAMI’s Publications Editorial Board. “You can’t simply sprinkle magic security pixie dust after designing a device,” Fu said, adding that manufacturers and end users alike need to “accept that security problems exist, and that threat actors will not follow your rules.” That’s why an emphasis on research such as meaningful cybersecurity threat modeling may prove particularly important, he noted, “to reduce the impact of both known and yet-unknown vulnerabilities.”

APRIL 2022

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RIBBON RIBBON CUTTING CUTTING HERO HERO

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Q: IS A SPECIFIC OR OR NEW ONEONE YOUYOU AREARE Q: THERE IS THERE A SPECIFIC NEW EXCITED ABOUT RIGHT NOW? EXCITED ABOUT RIGHT NOW? A: A: Hero Biomed Staffing is something eroero was created to optimize re-reHero Biomed Staffing is something was created to optimize that has the laser-focused attention of of sources and improve patient care in that has the laser-focused attention sources and improve patient care in the entire Hero working family. thethe hospital and medical facility enthe entire Hero working family. hospital and medical facility enproprietary cutting-edge vironment. In fact, thethe Hero name stands Utilizing proprietary cutting-edge vironment. In fact, Hero name stands Utilizing technology, we are offering cost saving forfor Healthcare Engineering Resources technology, we are offering cost saving Healthcare Engineering Resources compliance solutions that get; the right Optimized. The company boasts more compliance solutions that get; the right Optimized. The company boasts more people, doing the right job, in the right than 70 years of combined experience people, doing the right job, in the right than 70 years of combined experience place. working with acute care andand surgery place. working with acute care surgery centers. This includes capital planning, centers. This includes capital planning, Peter Bonin, CEO, Founder - HERO Peter Bonin, CEO, Founder - HERO DOES YOUR COMPANY STAND OUTOUT IN IN Q: HOW DOES YOUR COMPANY STAND equipment acquisition andand comprehenequipment acquisition comprehen- Q: HOW THE MEDICAL EQUIPMENT FIELD? THE MEDICAL EQUIPMENT FIELD? sive repair solutions. TechNation Editor sive repair solutions. TechNation Editor A: A: At At Hero, wewe understand that Hero, understand that John Wallace recently found outout more software solution forfor ourour client experiJohn Wallace recently found more software solution client expericompliance, safety and asset managecompliance, safety and asset manageabout the company from founder and ence andand allowing ourour biomed staff thethe about the company from founder and ence allowing biomed staff ment areare all all items of of high importance ment items high importance CEO Peter Bonin. ability to to earn an an additional 50% or or CEO Peter Bonin. ability earn additional 50% forfor hospital administrators. The Hero hospital administrators. The Hero more taking advantage of our non-ceilmore taking advantage of our non-ceilmatrix of services alleviates both thethe matrix of services alleviates both inging bonus structure. WeWe areare planning bonus structure. planning stress andand liability of of asset management stress liability asset management for our Hero Hospital Staffing Educafor our Hero Hospital Staffing Educawhile providing go-to solutions saving while providing go-to solutions saving tion Centers offering our Hero Biomed Q: WHAT AREARE SOME OF OF THETHE SERVICES AND Q: WHAT SOME SERVICES AND tion Centers offering our Hero Biomed hospitals, clinics and surgery centers onon PRODUCTS YOUYOU OFFER? hospitals, clinics and surgery centers PRODUCTS OFFER? professional’s continuous training andand professional’s continuous training expenditures. A: A: At At Hero wewe offer three integral andand their their expenditures. Hero offer three integral up-level of of their skills. up-level their skills. is aisnimble enterprise andand quick interconnected services; biomed staffing, Hero a nimble enterprise quick interconnected services; biomed staffing, Hero to act upon our clients ever-changing hospital bedbed services andand equipment to act upon our clients ever-changing hospital services equipment Q: IS ANYTHING ELSE YOUYOU WOULD LIKE Q: THERE IS THERE ANYTHING ELSE WOULD LIKE needs. FeeFee perper services, long term rentals. needs. services, long term OUR READERS TO TO KNOW? rentals. OUR READERS KNOW? contracts, equipment repair, rent to to At At Hero Biomed Staffing wewe hire, contracts, equipment repair, rent A: A: At At Hero wewe areare a close-knit family. Hero Biomed Staffing hire, Hero a close-knit family. own, or short-term rental programs, wewe Our train andand place thethe best biomed profesown, or short-term rental programs, positioning statement is supporttrain place best biomed profesOur positioning statement is supportareare focused onon saving ourour clients onon sionals in the industry. Better pay, focused saving clients inging health care heroes every day. The sionals in the industry. Better pay, health care heroes every day. The their spending and budgets. flexible hours andand respect is our mantra. biomed community trusts us,us, and flexible hours respect is our mantra. their spending and budgets. biomed community trusts and Hero Hospital Beds specializes in in hospitals contract with us us because Hero Hospital Beds specializes hospitals contract with because YOUYOU HAVE ANYANY GOALS YOUYOU WOULD LIKE Q: DO HAVE GOALS WOULD LIKE they hospital bedbed services, being oneone of of thethe Q: DO want to to work with thethe best-ofhospital services, being they want work with best-ofTO TO ACHIEVE IN THE FUTURE? ACHIEVE IN THE FUTURE? most overlooked aspects of of thethe patient class. So,So, getget in in touch and wewe will most overlooked aspects patient class. touch and will A: A: Our number oneone goal at Hero is to Our number goal at Hero is to care/ experience algorithms. WeWe keep welcome you onon board with open arms care/ experience algorithms. keep welcome you board with open arms attract toptop biomed talent to to ourour roster. attract biomed talent roster. as we build our national footprint in ourour client’s hospital beds in top condiclient’s hospital beds in top condias we build our national footprint in WeWe want to to addadd top-tier biomed want top-tier biomed tion andand always patient-ready. hospital staffing. tion always patient-ready. hospital staffing. candidates that want the opportunity to to candidates that want the opportunity Hero Equipment Rentals significantHero Equipment Rentals significantwork within a stellar working environwork within a stellar working environ- For more information: visit HeroBiz.com, ly reduces downtime and increases ly reduces downtime and increases For more information: visit HeroBiz.com, ment with an unparalleled industry ment with an unparalleled industry ROI forfor allall ourour asset management ROI asset management HeroHospitalStaffing.com or or HeroHospitalStaffing.com bonus structure. bonus structure. clients. WeWe provide flexibility as as clients. provide flexibility HeroHospitalBeds.com. General inquiries may HeroHospitalBeds.com. General inquiries may Our goal is to be be a category leader in in Our goal is to a category leader facilities deal with unforeseen expanfacilities deal with unforeseen expanbe be emailed to Info@HeroBiz.com. emailed to Info@HeroBiz.com. thethe biomed staffing space within 3-53-5 biomed staffing space within sion and contraction of of their equipsion and contraction their equipyears. To achieve this, we are all-handsyears. To achieve this, we are all-handsment needs. ment needs. on-deck working onon a proprietary on-deck working a proprietary

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ECRI UPDATE Expert Panel Discusses Cybersecurity as a Top Health Technology Hazard

ach year, ECRI produces its Top 10 Health Technology Hazards report to help health care organizations direct their time and energy toward technology management activities that can have the greatest impact on patient safety. The No. 1 topic for 2022, “Cybersecurity Attacks Can Disrupt Healthcare Delivery, Impacting Patient Safety,” addresses what has become a critical challenge for all health care delivery organizations. The topic also was featured during a January 2022 ECRI webcast with experts from the U.S. Food and Drug Administration (FDA) and the University of University of California (UC) San Diego.

“It’s not if, but when.” That’s how health care delivery organizations need to think about cybersecurity incidents, cautions Chad Waters, senior cybersecurity engineer in ECRI’s device evaluation group. Virtually all organizations today are subject to cybersecurity incidents, “so you need to be prepared.” “And it’s not just privacy breaches or business functions that you need to worry about,” adds Juuso Leinonen, a principal project engineer at ECRI. “Cybersecurity incidents can disrupt health care delivery − and

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that puts patients at risk.” The risks to patients, the increase in incidents affecting health care organizations, and the desire to raise awareness about cybersecurity as a patient safety issue were key factors motivating ECRI to place the subject atop its 2022 Top 10 Health Technology Hazards list. Following publication of the report, Waters and Leinonen expanded on these issues during an ECRI webcast with two experts in this field of study: • Dr. Christian Dameff, medical director of cybersecurity and assistant professor of emergency medicine, biomedical informatics and computer science (affiliate), UC San Diego • Dr. Kevin Fu, acting director of medical device cybersecurity at FDA’s Center for Devices and Radiological Health (CDRH) and program director for cybersecurity, Digital Health Center of Excellence (DHCoE) The panel discussed the nature of the hazard, the real-world clinical impacts, nascent industry efforts to improve medical device security, and the importance of planning − not just to prevent an attack, but to respond to any incident that could affect clinical care.

CYBERSECURITY AS A PATIENT SAFETY HAZARD As ECRI explains in its report, network-connected medical devices and data systems are integral to how patients are diagnosed, treated and kept safe within health care environments. A cybersecurity incident, or even the process required to remediate or respond to a security vulnerability, could render these systems unavailable. For example, a successful ransomware attack could encrypt patient data on a critical clinical system, disable user access or otherwise compromise system operation. This in turn can disrupt operations and clinical workflows, putting patients at risk. The specific implications of a security incident can vary significantly depending on the type, target and breadth of an incident. Consequences can include unavailability of a device or system, altered clinical and administrative workflows, the need to reschedule appointments and surgeries, the diversion of emergency vehicles, and even the closure of care units or entire organizations. All of these have to potential to delay or compromise patient care. Although cybersecurity incidents are inevitable in today’s technological environment, many can be thwarted − or their effects can be

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minimized − if appropriate measures are implemented before an incident, or in response to one. Managing cybersecurity risks in a health care environment, however, is uniquely challenging: It requires an understanding of the clinical implications of the protective measures being considered. Actions that might be commonplace in other IT environments could themselves cause problems if their potential impact on patient care is not assessed. THE CLINICAL PERSPECTIVE When educating clinical staff about cybersecurity risks, Dameff stresses the need to “speak the language that clinicians understand.” That means focusing on patient safety, not PHI. Frontline health care workers are most concerned about caring for their patients, so showing how a security incident could directly lead to patient harm can bring them into the conversation. For example, clinicians will grasp how an incident that takes out a CT scanner could have immediate and tragic consequences for a hospital’s trauma patients. Dameff also stresses the need to “prepare for failure,” advising that “engaging clinical staff in disaster preparedness and swift recovery processes is just as important, if not more important,” as efforts to prevent cybersecurity incidents from occurring in the first place. Fending off all attacks may be impractical, both from a technological standpoint and a resource perspective, so recovery plans may become essential.

And even a well-secured facility can be impacted by the “ecosystem effects” associated with these types of attacks. That is, an attack at one facility could cause patients to be diverted to nearby institutions, overwhelming those facilities as well. HELP ON THE HORIZON? Combatting threats to the availability, confidentiality and integrity of medical devices will remain a challenge for years to come; but Fu does see some hopeful signs for the future. One is that manufacturers more often are “building in security to medical device design in the premarket phase.” The effort is not yet universal, but it is a start. Other positive developments include initiatives related to: • SBoMs (software bills of materials) − to help health care delivery organizations better understand what’s on the inside of a medical device • Threat modeling − for example, to characterize cybersecurity threats and the security properties that will be required • Education and career development − to help the biomedical engineering community incorporate principles from the cybersecurity discipline into their own work. THE IMPORTANCE OF A RESPONSE PLAN Dameff’s call to “prepare for failure” echoes one of the key recommendations from ECRI’s report: facilities need to develop an incident response

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plan that takes into consideration medical devices and the continued delivery of patient care. As ECRI’s Waters explains: “If a device you rely on for some kind of clinical functionality is lost, you need to know what alternatives will allow you to continue providing care.” ECRI recommends that response plans include steps such as: identifying mission-critical processes and systems; determining the clinical impact of the device or system being unavailable, and developing strategies for continuing operations in such cases; educating clinicians about the response strategies, to minimize care disruptions; and implementing backup and recovery mechanisms for each system. TO LEARN MORE . . . This article is adapted from ECRI’s Top 10 Health Technology Hazards for 2022 and related content, including the January 2022 ECRI webcast “Cybersecurity Incidents − A Threat to Patient Safety and Healthcare Delivery.” (ECRI members can access the recording at https://ly.ecri.org/cyber_webinar.) An Executive Brief version of the Top 10 report is available for complimentary download at www.ecri.org/2022hazards. The full report, accessible to ECRI members, provides detailed steps that organizations can take to prevent adverse incidents. To learn more, contact ECRI at 610-825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

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MORTARA ELI 280

Q: A:

What is SymCode PRSSRA and what does Errnum 1811 mean?

The most likely issues and their fixes: reseat/replace fiber optic cable. (probably not this one), replace base Interface card, replace Syringe Sensor assembly, or replace head Switch card.

Pressure fault on the A-side. Possible connection issue – reseat all cable connections inside the head and at the brass box in the base of the pedestal. Then, look at replacing the sensor interconnect card inside the head. Elsewise, I suspect the issue would be best with either an on-site service call or be brought into a depot center for a more thorough evaluation.

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My Drystar 5300 gives me this problem “Error self test failure” on 96%. How do I resolve this problem?

Install a new compact flash card and reload software. Takes about 20 minutes.

In most of cases, you should replace the devil board.

I have an ELI-280 unit that does not advance paper and it makes a grinding noise. I have interchanged the tray (that also houses the motors, paper detector and thermal printer) from a working unit into the faulty one and the error persists. This leads me to believe it is a faulty board. But I inspected it thoroughly, even cross-referencing measurements with the other working unit, and everything seems fine at a hardware level. I tried every calibration possible described in the service manual. Any ideas?

I had the same thing happen to me. I found cleaning the inside with alcohol pads fixed it. I removed all the paper dust or lint that collected over the years. However, your issue leads me to believe the feed assembly is not aligned correctly. Are you able to watch it to see where it binds up?

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I have a Clinifuge that gets up to speed then decelerates about 15 seconds into a 5 minute spin. No break indicator, the unit just seems to cut power to the motor. I have replaced the motor, starter cap and main board. There is nothing else. Any thoughts on what might be causing this?

That is normal operation for the instrument due to the fact it has no tachometer feedback.

REPLY:

I found out that the spin count is maxed out. The Unit will not do a full time spin due to needing a new NV-RAM chip. Since it is no longer offered, this 1996 unit is being scrapped. Thank you.

REPLY:

Everything is clean and lined up properly. I also installed a tray from a working unit into the faulty one, and the problem persisted. This narrows it down to a main board issue, either hardware or software.

Then, I would agree with you, the board issue would be the next in line to try.

SHOP TALK

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

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BIOMED 101 Leakage Current Measurements Have Nothing to do with Electrical Safety BY LARRY FENNIGKOH

“All great truths start as blasphemies.” – George Bernard Shaw

linical engineering and the entire healthcare technology management (HTM) community has been faithfully and obediently measuring medical device leakage currents since its beginnings over 50 years ago. Arguably, the very birth of our profession was fueled by the fear, ignorance and misinformation surrounding these shadowy microamps. So much so, that leakage current testing has become not only synonymous with “electrical safety” and an integral task within device periodic maintenance inspections, that to suggest they be eliminated approaches the blasphemous. Nonetheless, the elimination of routine leakage current testing is precisely what is being proposed here; the collective labor hours spent making these useless measurements can be better utilized elsewhere. Here’s why.

THE ORIGIN OF 60 HZ DEVICE LEAKAGE CURRENTS As illustrated in Figure 1, all AC line-operated devices with an electrically conductive case, or conductive surface(s) capable of being energized from within, will likely have a measurable 60 Hz leakage current from this case to ground. The origin of this leakage current, of course, is the incoming power line voltage (nominally 120 Vrms) with the conductive pathway, being represented by an equivalent series-connected resistor and capacitor. Here, this capacitor may be physically present (as seen within incoming power line RF filters) or, and more often, due to parasitic or stray capacitance that exists anytime two conductors are separated by an insulator; any conductive case or surface effectively becoming one of the plates of this “stray” or virtual capacitor. Experimentally, the effective values of this resistor-capacitor (RC) circuit can be determined by the simultaneous oscilloscope measurements of the AC line voltage and leakage current (as a voltage across a 1K ohm resistor). If the leakage current waveform “leads” the line voltage waveform, this then implies that the impedance (ZLeakage) of this conductive pathway is capacitive in nature. From an actual electrosurgi-

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APRIL 2022

V 120� 0°V = = 1.48� � 84°Megohm I 81� 84°mA = 155 K � j1.47 Mohm

Z Leakage = Z Leakage

from : X c

1 , 2p fC

C = 1.8nF cal unit possessing 81 microamps of leakage current, this equivalent R-C network is determined from the equivalent circuit, therefore, from the “hot” side of the power line to the equipment’s case being a 155K ohm resistor in series with this 1.8nF capacitor. While this equivalent R-C network does not represent discrete components, it does effectively determine the magnitude of the measured leakage current. It is this R-C equivalent pathway and coupling to the device’s conductive case (or surfaces) that also dictates and limits measurable leakage currents.

Figure 1. Stray capacitance from energized conductors to a conductive case is the primary source of device leakage current.

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Figure 2. Necessary conditions before an electrical device can deliver a shock.

ESSENTIAL REQUIREMENTS FOR DELIVERING A MACRO- OR MICROSHOCK FROM A MEDICAL DEVICE For this now available and maximum leakage current to deliver either a macro- (from outside of the body) or microshock (to within), there are five independent and necessary conditions – all of which must be present – for a shock to occur. Namely, and as illustrated in Figure 2, these include: • The device must have an electrically conductive case or surface(s) capable of being energized from within. • The actual or virtual impedance from the “hot” side of the incoming power line (or other AC signals) to these conductive surface(s) is low enough to allow a stimulating current, i.e., one above physiological thresholds, to flow. • There must be a defective (i.e., open or high resistance) ground connection between the equipment case and earth ground. • The patient, or staff, must have a reasonably-low impedance connection to the case or conductive surface of the device.

•

The patient, or staff, must also have a reasonably-low impedance connection to earth ground.

Since all five of these conditions must exist before a shock can be delivered, eliminating any one them also eliminates the shock risk. For example, if the device case is non-conductive or has no conductive surfaces capable of being energized from within, there is no shock hazard; even with a conductive case, if it has a reliable low-impedance connection to earth ground, there is no shock hazard. Even if any event cannot be eliminated, the chance or compound probability of getting a shock from the presence of these five independent events is so ridiculously low as to approach the near impossible. As such, leakage current measurements, aka “safety testing,” do nothing to prevent a shock or ensure the electrical safety of a device. Verifying and continuing to routinely inspect the device’s line cord, strain relief, plug cap, however, remain most important and necessary. Similarly, ground cord-to-case continuity and resistance checks and

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outlet tension testing remain useful as well. Since device leakage currents will always follow a low-resistance pathway to earth ground, maintaining and ensuring ground cord integrity makes leakage currents – of any magnitude – a moot issue; further supporting the elimination of their routine and time-consuming measurement. Clearly, none of us within the HTM community would ever condone, support or encourage any action that puts our patients or staff at risk. The more real risk, perhaps, is continuing to perpetuate the illusion that electrical safety is somehow being assessed and ensured by measurements that have no ability to do so. We can and should be using our limited time and resources more wisely. – Larry Fennigkoh, Ph.D., PE, CCE, is an adjunct professor of biomedical engineering at Milwaukee School of Engineering.

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WEBINAR WEDNESDAY

Experts Discuss IoMT Devices, Cybersecurity STAFF REPORT

ecent Webinar Wednesday presentations “Maximizing Investment in Your IoMT Devices” was presented by Asimily Senior Director of Product Management Jeremy Linden and Renovo Vice President of Information Technology Greg Scott. It was sponsored by Asimily and eligible for 1 credit from the ACI.

Health care delivery organizations (HDOs) make significant investments in their Internet of Medical Things (IoMT) devices, but how do they know if they’re getting their money’s worth? Linden and Scott shared how individuals can learn to build efficiency into the procurement process. One key is to purchase devices without major cybersecurity liabilities and configure them securely. Once devices are deployed, discover how to use utilization monitoring to track where, when and how they are being used in the field, allowing HTM professionals to plan capacity accurately and avoid buying more devices than needed. Linden and Scott also fielded questions from attendees to provide additional insights. One question asked, “We have noticed that we often have MDS2 forms that don’t seem to exactly match the devices in our environment. What is the best way to handle this issue?” “Yeah, that’s a good question, and that’s actually something that we

TECHNATION

APRIL 2022

noticed, too, right? It’s a difficult technical challenge, and it’s actually a technical challenge that we’ve worked on ourselves,” Linden said. “In many cases, what the manufacturer puts in the MDS2 is often vague, or it’s not clear, which versions it actually applies to. And, it’s often not clear what version you even have, right, depending on the device and the device type. So, that’s work that has been done in software platforms like ours.” “You actually can go in and you can actually see the differences between different versions,” he added. He went on to say that there are different ways to handle it and some are easier than others. The presenters answered more questions, and the Q&A session is included in the on-demand version of the webinar available at WebinarWednesday.live. Attendees provided feedback in a post-webinar survey that included the question, “What do you like best about the Webinar Wednesday webinar series?” “I am a new biomed tech, so this information is very informative for me, especially today’s topic,” Biomedical Engineering Technician A. McCray said. “Gathering information and seeing things from other people’s perspective,” said J. Vrabel, CBET.

“Very helpful to clinical engineering teams across the country to learn, grow and network,” Clinical Engineering Manager W. Doiel said. HEALTHCARE SECURITY The recent Webinar Wednesday presentation “Perspectives in Healthcare Security” by CyberMDX Senior Director of Product Marketing Rich DeFabritus was eligible for 1 credit from the ACI. The webinar was sponsored by CyberMDX. In the 60-minute webinar, DeFabritus shared insights regarding key insights from a study of hospital executives in information technology and information security roles, as well biomed technicians and engineers. The presentation included information about the lack of automation for medical device inventory as well as the impact of device shutdowns on hospitals. The low prioritization of cybersecurity investment was also a topic covered in the webinar. DeFabritus also fielded questions from attendees. One attendee asked, “Do you have insight into C suite or IT leadership beliefs about who is responsible for remediating cyber risks on medical devices?” He admitted that “it’s really not an easy question to answer because everybody treats it differently, but it should be a collaboration.” He said OEMs should help and that it must be a joint effort.

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“At the end of the day, no one person is responsible,” he added. Another question was, “What do you recommend from a fact- or statistical-based perspective that can be used to secure funding for cybersecurity programs?” DeFabritus said hospitals and health care organizations are among the most targeted groups and that is one fact to help secure funding. He suggested benchmarking against similar organizations is another revenue to show the need for funds. RANSOMWARE DEFENSE The Webinar Wednesday presentation “Defending Against Ransomware in Healthcare – 5 More Steps You Can Take Today” was sponsored by Cynerio and eligible for 1 credit from the ACI. In this 60-minute webinar, Cynerio Security Evangelist Chad Holmes discussed how ransomware attacks on health care environments have continued to rise significantly for the third year in a row. The rise in these attacks has also resulted in a better understanding of why and how they happen. In short, the health care industry provides a target-rich environment with lagging security practices and highly valuable data. Unfortunately, those lagging practices are not evolving at a rate that will deter attackers. The Cynerio team discussed five areas where health care facilities can begin to improve security practices. The discussion including a range of topics from guiding principles in understanding attacker motives to adopting specific new technologies. The presentation served as a guidance to improve a facility’s risk posture and reduce the likelihood of becoming the victim of a successful attack. Holmes also answered questions after his presentation. He explained the HHS website’s “Wall of Shame” in response to a

question about the statistics used during the presentation. Holmes said that the Health and Human Services (HHS) has what’s nicknamed the Wall of Shame, where it lists every single breach. The website shows more than 700 breaches last year. “That website also shows the number of records exposed, which is where that 40 million number comes from,” Holmes said. “That $20 billion or $21 billion cost is from an analyst’s report, I believe.” Another question was, “Why is there such a rise in ransomware attacks over the last few years?” Holmes explained that bad actors often go after easier targets. “Hospitals are the low hanging fruit. If you look, I’m going to pick on Goldman Sachs because they’re easy to pick on. If you look at Goldman Sachs, they know where every dollar is spent. And they know how much they can invest in cybersecurity to protect every single dollar they make. So, they overinvest in security, because they know exactly the value there,” Holmes said. “Hospitals, on the other hand, overinvest in patient care, which is what we want them to do, that’s not a critique of them. But the reality is that hospital cybersecurity practices lag nearly every other industry. When you combine that with the fact that they have incredibly valuable data in the form of records, then you have this environment where they have low cybersecurity practices, valuable information, and they’re under enormous stress, from COVID right now, all hands on deck to do whatever they can, to help with the actual care of patients.” “So, the reality is that it’s a very easy target with lower defenses, and hackers are evil people that want to make money off that the easiest way they can, and that’s what they’re doing,” he added. “It’s just kind of a sad, simple reality.” Holmes answered more questions,

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and the complete presentation is available for on-demand viewing at WebinarWednesday.live. The webinar was popular with almost 100 registered attendees. A post-webinar survey collected positive feedback including answers to the question, “Why did you attend today’s webinar? And, was it worth your time?” “Safe HDO networks are valuable. Understanding how to directly respond to an attack is something we should all understand and be prepared for. Thank you for the presentation,” Biomed J. Cozadd said. “To learn more about ransomware attack prevention and cybersecurity. Yes, it was,” Clinical Engineering Manager P. Graham said. “I am interested in new technologies and new approach to issues,” QA Manager A. Warren said. For more information, including a list of upcoming presentations, visit WebinarWednesday.live.

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ROUNDTABLE

ROUNDTABLE AEDS/Defibrillators

echNation reached out to several leading companies and experts for this roundtable article on AEDs and defibrillators. Participants sharing their insights are Avante Health Solutions Market Manager Brent Kramer, ReNew Biomedical Field Sales and Service Representative David Okeson and SakoMed CEO Matin Kondori.

Q: WHAT TYPES OF CHECKS AND REGULAR MAINTENANCE DO DEFIBRILLATORS/AEDS REQUIRE? KRAMER: In a hospital setting, defibrillators need to be checked monthly for basic function. Then checks at 3, 6 and 12-month intervals each having an increasing number of intricacy of tests performed. AEDs require a monthly check of function, battery life and pad expiration date.

Q: WHAT ARE THE BASIC FUNCTIONS OR FEATURES EVERY DEFIBRILLATOR/AED SHOULD HAVE? KRAMER: It is recommended for AEDs to have visual and voice prompts with simple illustrations and instructions printed on the case. It needs to be very user friendly so that any non-professional can use it in a fast and efficient way. When evaluating defibrillators, it is important to understand where in the facility the device will be used. A crash cart unit may only need basic functionality in 3-lead ECG, AED and pacing. Whereas a defibrillator for EMS will need a fully loaded defibrillator to include, AED, ECG (3- or 5-lead), capnography, SpO2 and pacing.

OKESON: All AEDs perform automated self-tests, some daily and some weekly, and recommend a visual inspection once per month. Depending on the location of the AED, there may be other local requirements. On the other hand, defibrillators require a manual daily self-check, and some newer units even assist with automated tests.

OKESON: Two essential functions should be present with every AED. One, the AED should always be rescue-ready and in a place easily accessible. Each manufacturer offers features on their

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APRIL 2022

Brent Kramer Avante Health Solutions AEDs to assist in this function and a variety of other additional support. Second, an AED should always be easy to use and support the steps in the chain of survival taught in CPR class. KONDORI: The most important part on AEDs are delivering the right amount of energy. Also, being able to show the correct steps on AEDs is a good feature that can helps users (with minimum knowledge) to make sure they are in the right path to save lives. In order to make AEDs following the basic functions and features, AAMI and IEC standards are being used to help biomeds make the best decision on purchasing AEDs.

KONDORI: All AEDs need to have a good life of battery and pads with alarm or visual check mark that helps users to be aware that the AED is operatable. Defibrillators also need to be PM/calibration every year from checking on cosmetic to make sure on energy output is accurate. If defibrillators come with other monitoring parameters, we also need to make sure that they are within accuracy range. Other than annually biomed PM/calibration, facility nurses or staff also need to check AEDs/ defibrillators every day to make sure they are ready to save lives.

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ROUNDTABLE

on where we are going to use the defibrillator, our choices vary considering weight, size and the monitoring parameters. For example, a defibrillator on crash cart is very different than a defibrillator used on an ambulances.

Matin Kondori SakoMed Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR IN A DEFIBRILLATOR/AED? KRAMER: The new PMA regulations are impacting which defibrillators and AEDs are able to be purchased and sold. It is critical for buyers to understand which units and accessories are FDA approved. One common functionality of AEDs for buyers is whether the unit is semi-automatic or fully automatic. Semi-automatic AEDs give the responder control over when the shock is delivered. OKESON: It is very important to acquire a defibrillator/AED from a reputable source that will be able to service and support the product. You want to buy a defibrillator/AED that has accessories such as pads and batteries readily available on the market. A unit that has FDA PMA approval assures you will have the accessories and parts available as well as the support of the manufacturer. KONDORI: If we are considering a defibrillator by itself, we are looking at the accuracy of the delivered energy and the accuracy of separating shockable and non-shockable based on analyzing the ECG rhythm. Depending

Q: HOW CAN A HTM PROFESSIONAL EXTEND THE LIFE OF DEFIBRILLATORS/AEDS? KRAMER: Compared to other medical devices, defibrillators/AEDs are low maintenance and seldom have system errors. By simply performing the recommended maintenance interval checks such as electrical safety tests, preventative maintenance checks and up-to-date pads and accessories, your device is sure last. OKESON: Annual preventative maintenance (PM) is the first step your HTM professional can perform to assure your units are working properly and are up to date with current software and potential future problems are addressed. Your HTM professional can also make you aware of any recall issues with your equipment. KONDORI: By performing on time PM and calibration and choosing the right service company to maintain and do the right service based on the manufacturer by a trained biomed, using the OEM/FDA-approved accessories and making sure to mount the AEDs safely in cabinets or using soft/hard carry cases to avoid any physical damages is highly recommended. SakoMed offers a 24-hour hotline service and training based on the manufacturer to avoid any high-cost repairs and keep defibrillators always ready to save lives. Q: WHAT ELSE SHOULD TECHNATION READERS KNOW ABOUT DEFIBRILLATORS/ AEDS? KRAMER: Defibrillators should stay

David Okeson ReNew Biomedical Field plugged into an A/C outlet when not in use in order to keep the batteries charged to their fullest capacity. A daily system test should be performed and logged to avoid any unfortunate events when a defibrillator/AED is needed. Defibrillators should only be used by trained personnel, whereas AEDs can be used by any non-professional without training. OKESON: AEDs and defibrillators are like any other piece of electronic equipment and have an end of life. Since AEDs are seldom used and usually out of sight, they are often forgotten. Know when your end-of-life is and budget for replacement equipment. KONDORI: Besides on time service, PM and calibration I recommend upgrading defibrillators and make sure you are following FDA guidelines. All our focus is to make sure our defibrillators are ready to save lives.

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

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as anyone ever felt anxiety knowing that an accrediting organization would soon make a visit? Is the prospect that The Joint Commission (TJC) surveyor is visiting causing some trepidation or anxiety? Are you part of a new hospital seeking accreditation?

Achieving accreditation means compliance with standards set by a number of organizations; some only in the U.S. and others that have a global presence. For this reason, biomed departments must have a working familiarity with the many factors found within these standards. Those in the healthcare technology management (HTM) department tasked with achieving accreditation should also have an understanding of hospital operations and regulatory requirements. There are approximately 17 organizations that can accredit hospitals, many with “deeming” power for Medicare and Medicaid. The Joint Commission accredits more than 4,000 hospitals. According to the Joint Commission; “all medical equipment is required to be on the medical equipment inventory,” if the facility is accredited through The Joint Commission. “I would suggest HTM leaders address this topic with a multi-step process,” says Mike Busdicker, MBA, CHTM, FACHE , system director of Clinical Engineering/ Intermountain Environment of Care at Intermountain Healthcare in Midvale, Utah. He says to identify the regulatory agencies governing medical equipment requirements for your facilities; DNV, TJC, CMS, FDA, CDRH, State Health Department.

Understand what those requirements are and how they impact the HTM department and all other departments within the health care facility. What, if anything, is currently in place within the organization to address those requirements? “Work with compliance, risk, or other appropriate departments to review, refine and develop proper procedures, policies, guidelines,” Busdicker says He says that there is no need to reinvent the wheel. HTM departments should utilize resources available through organizations like AAMI. One published resource that can provide guidance is AAMI’s Planned Maintenance Compliance and Definitions Guide, created by AAMI’s Technology Management Council Standardization Subcommittee. BEST PRACTICES There are a number of baseline best practices that an HTM department can follow to satisfy CMS, TJC, DNV and other accrediting agencies. In a 2021 AAMI eXchange Rewired presentation, “The Basics: How to Ace the Accreditation Survey,” Danielle Bruno, site health team lead at GE Healthcare, and Josh Virnoche, HTM quality leader at GE Healthcare, laid out the considerations to logically and calmly face this inevitability. Their session provided an overview for participants to learn the “key components of a successful HTM program” and how to meet the requirements of the major accrediting agencies. Both presenters have a wealth of experience in HTM, including leadership.

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“It sounds remedial, but having a robust and easy-to-follow medical equipment management program (MEMP) and an established annual review process through the EOC committee [are important]. A bonus is having specific measurable goals established for your facility,” says Virnoche. He asks, if you’re seeing a large influx of physical damage, how can your HTM team help mitigate some of that? Or, if you’re seeing an influx of new equipment bypassing the HTM department, before making its way to the floor, how can you improve the process? “The MEMP should be the core of all your HTM activities, it should answer the question, how does my department and hospital meet the regulatory standard?” Virnoche says. He suggests double checking to make sure your processes, policies, procedures and day-to-day activities align with the regulatory standards. “It’s one thing to have a robust MEMP, but when surveyed, significant gaps are observed between what you say you do and what you practice, there will be further in-depth discussion with the surveyors,” Virnoche says. He also suggests having an internal mock auditing/survey process that mimics a CMS/ TJC/ DNV survey. Walk the floors, look at equipment ID tags, PM stickers, broken devices that haven’t been reported. Do a work order/service request audit, to ensure the team is following good documentation practices. Ensure test equipment is listed in the work order. “Quiz team members on process/ policy and where to find them. Make sure annual training is up to date. Knowledge sharing is important, and knowledge of the service program

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throughout the organization is generally a good sign that there is a well-functioning HTM department,” Virnoche says. Bruno adds that some additional baseline best practices would include ensuring PM compliance of 100 percent with documented status. She also suggests having proper documentation on hand in case of random audits and maintaining an accurate inventory through the use of passive tags along with scanner. “Tracking the percentage of devices not touched in two years and determining the status of the device. Less than three percent of inventory should be not touched in 24 months,” she says. Kirwan adds some best practice suggestions: • Have an escort with radio for each surveyor and radio in requests for documents • Navigate inspectors to desired locations, relay intended destinations • Have a central command for all documents and when documents are requested, they are brought in for review. Documents are presented to the surveyor in the area they work from. He also says to have an executive assigned as an expediter who has the authority to make decisions hospital wide, including overtime, contractor work approval, purchases, etc., adjusts staffing as needed for clearing findings, is responsible for helping to clear any findings, works with department heads to get them what they need and defers only when a decision would violate hospital policy or procedure such as capital purchasing. “If possible, have a resident expert on medical equipment regulatory requirements for continuous review,” Busdicker says. He also says to educate all HTM caregivers on regulatory

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compliance and accreditation for medical equipment. Utilize training and resources provided through the AAMI Exchange, MD Expo conferences, TJC Boot Camp, local/regional HTM societies and other sources. SETTING EXPECTATIONS CORRECTLY Part of the goal of attaining the right mindset ahead of a survey is to view the surveyor’s mission in the right light. You are not expected to walk on water. “Half of the battle, so to speak, is knowing the intent of surveyors and what to expect from them. First and foremost, many facilities approach surveys with a sense of trepidation. Sure, hospital accreditation is at stake, however the mission of the surveyors is not to deny accreditation. Their role, generally speaking, is about safety, quality, performance improvement and the exchange of best practices,” says Perry Kirwan, vice president of Technology Management/ENTECH at Banner Health in Phoenix, Arizona. He says that from the surveyors, you can expect a thorough review of documentation (including personnel files, policies and procedures, medical equipment inventories, billing and maintenance). You can expect them to perform walkthrough inspections of the facility and to observe multiple procedures in the hospital. The important thing to

remember is that they are there to help. “From the hospital perspective, it is important to know that perfection is elusive. The main thing you want to avoid is immediate jeopardy, understand that from 8 a.m. to 5 p.m. (typically) is the survey and from 5 p.m. to 8 a.m. is an opportunity to correct findings. As such, it’s good to plan for a bit of overtime and/or extra shifts,” Kirwan says. He says that from an HTM team’s perspective – have as many people rounding and reporting issues as you can. “And, in doing so, keep in mind not only your area of responsibility but help look out for other areas as well. It’s advisable to have a head on a swivel mentality – looking at all possible problems and engaging the necessary personnel/teams to help address them. Be prepared for document review,” Kirwan says. SURVEY PREPARATION Motivational speaker Zig Ziglar once said that “Success occurs when opportunity meets preparation.” The opportunity to meet or continue accreditation is best answered with preparation. “The best survey preparation is having a solid HTM /CE program. Documentation is key. You must have an accurate medical equipment inventory and record full service history on all devices in the

“Half of the battle, so to speak, is knowing the intent of surveyors and what to expect from them. First and foremost, many facilities approach surveys with a sense of trepidation. Sure, hospital accreditation is at stake, however the mission of the surveyors is not to deny accreditation. Their role, generally speaking, is about safety, quality, performance improvement and the exchange of best practices.” - Perry Kirwan

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program. The service history should include calibrated tools listed on service reports and accurate detailed description of service. Randomly auditing these records is a good way to ensure and instill confidence of this,” Kirwan says. He says that PM completion percentage, like them or hate them, is a big part of documentation review, so know the requirements and make sure your policies and procedures are very clearly about things like alternative equipment maintenance (AEM) and could-not locates. “There are a lot more requirements around personnel qualifications. Consider having documentation of background checks, up-to-date shot records and, of course, all training records that reinforce competencies for your service personnel,” Kirwan says. KNOW YOUR ROLE DURING A SURVEY Kirwan says that a survey is the time to take ownership. Make sure to verify PM completion and documentation and round more frequently. “Everyone is going to be really busy leading up to the survey, and during the survey, all the while taking care of patients. As such, people may be less available due to extra duties. There may be more needs than normal on the floors so preparing for that makes a big difference,” he says. He says to create a supportive environment. Even with the greatest amount of preparation, there will still be stress and anxiety during a survey. “Be sensitive to that and help support each other not only within your areas of responsibility but also outside of it as well. Grace under pressure is a hallmark of HTM professionals and it is really appreciated by executive leadership especially when other departments may not be operating at the same level,”

Kirwan says. He suggests that the HTM department should be the eyes and ears. “Look at everything from ceiling tiles to floor conditions and ensure that any issues are reported to the command center (if applicable) or those charged with leading the survey effort on behalf of the facility,” Kirwan adds. BEYOND THE MAJOR ACCREDITATION ORGANIZATIONS “Aside from the major AO’s, the most common stakeholders outside of your organization are going to be specialty accreditations like CAP and AABB. Additionally, sometimes local and state departments of health have specific requirements as well,” Virnoche says. He says that his best recommendation for CAP and AABB is to make sure you’re aligning with their maintenance requirements. Partner with the director of lab and/or blood bank, as they’ll be the subject matter experts for those specialty accreditations and review the current service procedures and intervals with them to ensure compliance. “For state and local departments of health, there can be different requirements based on the treatment areas (i.e., oxygen enriched environments, wet areas or other high-risk critical areas). This can pose an entirely different problem than a CAP or AABB accreditation, because generally lab and blood bank equipment is used in the same location or type of location across the health care delivery organization,” Virnoche says. He says that for the department of health, you could have very generic, low-risk equipment that is highly mobile and used in high-risk areas that required more frequent PMs. But one day, that device could be in a low-risk area that doesn’t meet the

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requirements for more frequent maintenance, and the next day it does. “I have two different points of view on this topic. One from my time being an in-house service provider, and one from my current role as a third-party service provider with hospitals in all 50 states,” Virnoche says. He says that as a third-party service provider, with a broad group of hospitals, the goal is to create a program that meets the ISO13485 regulatory requirements for servicing medical devices, establishing a QMS that meets the ISO9001 requirements, and then we ensure that the MEMP and program meets the CMS requirements surveyed by TJC, DNV, HFAP, CIHQ, etc. “In this case, because we have such a broad scope, we try to get to the most common denominator for all sites. That would be CMS-based regulations. We rely on specific sites, with additional specific accrediting requirements to tweak the program to meet the customer’s more stringent requirements. We can always be more stringent, but never less,” Virnoche adds. The predominant message is that preparation, empathy with the surveyor’s job and goals and maintaining a solid MEMP are key. These things will all reduce the stress and anxiety that are often an inherent part of these inspections. Kirwan says that there are also some considerations for the participants which may be overlooked. “Take care of the team. Make sure that everyone has the support they need. Check in on your team members and make sure they get enough rest and that they eat. Be kind to those from other departments; they are stressed,” he says. Kirwan says to remember there is life outside of the hospital. This is temporary.

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CAREER CENTER Should you disclose your side gig to your primary employer? Kathleen Furore

BY KATHLEEN FURORE

ith both remote work and “side hustles” becoming the norm, it has become easier than ever for employees to juggle multiple jobs behind the scenes. If someone is working a second job or starting a business on the side, should they let their primary employer know?

The career experts and business owners I reached out to all believe it is fine to have a side hustle. “As long as an employee is producing high-quality work and is attending all required meetings, there’s little downside to having them engage in a side hustle,” Caleb Rule, inbound marketing manager at The Pedowitz Group, says. “I sincerely believe that whatever my employee does in his free time is no longer under my control,” concurs Sherry Morgan, CEO and founder of Petsolino. “This means that if he decides to get a side hustle outside of the full-time job he has with me, it’s totally fine as long as it is not a conflict of interest with my company and he is not sacrificing his time for the job he has with me.” Opinions differed, however, about how open a “side hustler” should be with an employer. Rule advises keeping information about any “extra” job you might have to yourself. “What you do with your outside-of-work time is up to you,” he says, but he also notes two exceptions, including “potential conflicts of interest” or if it impacts “your

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ability to make a particular deadline.” Rule continues, “I’d argue it’s a poor company culture if employees feel they have to report what they’re doing outside of work to their manager.” Daniel Cook, who specializes in business development, HR, and team motivation at the law firm of Mullen and Mullen, takes the opposite view. He thinks people should be open about any side hustle. In fact, several employees have discussed their side hustles directly with him. “Usually when an employee tells me about their side hustle, I try to be as supportive as possible, since these are trying times and employees are trying their best to establish their careers while providing for their families,” reports Cook, who cites one possible side benefit of sharing your side hustle: “It’s possible that they learn about your other skills through this and improve your job description.” Cook also points out an unintended negative to keeping information from your primary employer. “Hiding your side hustle from your boss could later on result in an awkward conversation when they find out about it from somewhere else,” he says. “Imagine your co-worker bringing up your work in front of your boss at lunch and you have no way to cover it up. Hence, it’s always better to be honest with your primary employer and gain their trust.” No matter how you handle it, Rule stresses there are three things that employees working a side job should do:

• Manage your calendar. “For example, I have my lunch break blocked off on a daily basis, so if I have a side hustle call, I’ll take it at that time so as to not interrupt my workflow for my primary employer,” Rule explains. • Give 100% to the primary employer. For many people (if not most), the primary employer is the primary source of income (and often of benefits too). “The side hustle is extra, and so your efforts should reflect that!” Rule says. • Keep your side hustle and day job separate. “Otherwise, you risk blurring the lines of responsibility and using company resources for your own gain, which isn’t ethical,” Rule says. “Do the job you were hired to do.” And there’s one thing that both employers who are worried an employee might be doing outside work on the company’s dime and employees who are tempted to beg out of a meeting so they can turn their attention to their side hustle should remember. “For remote work, there are certain measures you can take to monitor employees such as the use of time and activity tracking software to prevent this type of situation,” Morgan says. – Kathleen Furore is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

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Tips to Consider when Purchasing a Refurbished Defibrillator/AED BY BRENT KRAMER

refurbished defibrillator/AED is a good investment for almost any medical facility. Finding a properly refurbished defibrillator/AED from a reputable medical equipment source requires research and special purchasing considerations. Here are some buying tips for a smoother purchasing process.

WHAT TO CONSIDER WHEN PURCHASING A REFURBISHED AED An AED is used to help those experiencing sudden cardiac arrest, so it is important to understand what facility type or setting the AED is for, and who may need to use the AED. This sophisticated, yet easy-to-use, medical device can analyze the heart’s rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish an effective rhythm. Another thing to consider when purchasing is whether you need semi-automatic or fully automatic. Both semi-automatic and fully automatic AEDs are equally effective at saving lives and all AEDs provide clear, concise audio instructions throughout the rescue process. BENEFITS OF A SEMI-AUTOMATIC AEDS Semi-automatic AEDs provide the

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located. Defibrillators can be used on children, teens and adults and should be easily accessible in high-risk areas.

rescuer with control over when the shock is administered. This can be desirable because it allows rescuers to ensure nobody is in contact with the patient’s body at the time of shock.

WILL THE DEFIBRILLATOR BE FOR A CRASH CART? The configuration of defibrillators used on a crash cart may vary, and your typical unit on a crash cart contains the following parameters 3-lead ECG, AED and pacing. Many hospitals will also keep a defibrillator and heart monitor on top of the crash cart since these devices are also needed in many cases.

BENEFITS OF A FULLY AUTOMATIC AEDS A fully automatic AED eliminates this opportunity for a rescuer to hesitate or freeze and not deliver a shock when needed. When using a fully automatic AED, the rescuer is not responsible for pushing the button and instead only has one action: ensuring no one is touching the patient when the shock is delivered.

WILL THE DEFIBRILLATOR BE USED FOR EMS? Sudden cardiac arrest strikes without regard to age, social or economic status, or the health of the person, and the use of defibrillators by EMS first responders is widely advocated. A fully loaded defibrillator will typically include, AED, ECG (3 or 5 lead), capnography, SpO2 and pacing.

WHAT TO CONSIDER WHEN PURCHASING A REFURBISHED DEFIBRILLATOR Defibrillators are used to prevent or correct an arrhythmia, or they can restore the heartbeat if it suddenly stops. Due to the importance of this device, you should consider where in the facility the defibrillator will be

IS IT SAFE TO BUY REFURBISHED AND IS AVANTE QUALIFIED TO REFURBISH A DEFIBRILLATOR/AED? Refurbished AEDs and defibrillators are safe. It is critical to ensure they are checked out by biomedical professionals. A reputable defibrillator/AED refurbisher, like Avante

Brent Kramer

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Health Solutions, should have a standard refurbishment process that is transparent and addresses all aspects of the defibrillator/AED. Here is an example of our typical refurbishment process for a defibrillator/AED: • Evaluation: When a defibrillator/AED arrives at the facility, technicians perform a full evaluation to assess its condition. • Biomedical refurbishment: Technicians replace, adjust and verify the effectiveness of the defibrillator/AED’s working parts. Cosmetic refurbishment: The defibrillator/AED is cleaned and polished. • Testing: The defibrillator/AED is thoroughly tested to make sure it meets original equipment manufacturer specifications. • Shipping: Each defibrillator/AED is shipped patient-ready with all required accessories. • Warranty: Twelve-month warranty on all refurbished AEDs or defibrillators.

HOW OFTEN SHOULD THE FACILITY CHECK AN AED OR DEFIBRILLATOR? This equipment is a critical life saving device and should be checked a minimum of monthly to ensure it is in good working condition. It is important to verify the batteries have charge and pads are not expired. Defibrillators should be checked annually. WHAT IS PMA? PMA, or pre-market approval, is the FDA’s regulatory review process designed to ensure the safety and effectiveness of medical devices. If the AED or defibrillator is not approved under the FDA’s new requirements effective February 2, 2022, all pads or accessories can no longer be purchased or sold for that AED or defibrillator. One of our equipment experts can assist with any questions on which devices are FDA-approved. For more information, call us at 800-462-8195.

– Brent Kramer is a market manager for Avante Health Solutions

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CYBERSECURITY

HL7 Messages: Handle with Care BY SEAN M. HOULE, CISSP

ne of the biggest factors in the adoption of electronic health records is a common standard of communication that allows dissimilar systems to be able to communicate with one another in a meaningful way. This is where the Health Level Seven or HL7 messaging standard is a true champion.

The messaging standard creates a much more efficient environment of care for patients as it greatly reduces the amount of paperwork for patients, health care providers, administrative staff and others to complete in the course of care. Once the initial information has been collected from the patient and entered into the electronic health record, that same information can be used when ordering medications, diagnostic lab tests or radiology images. It can also be used for transferring the results of those tests back to the health record for the health care provider to review and to become part of the patient’s permanent health record. This allows providers to spend more time caring for patients and less time with paperwork. It also helps prevent clerical errors by using information that has already been entered into the system. All this data can even be transferred to another health care facility to provide continuity of care. As we take a deeper look into HL7 from a security perspective, we’ll focus on the HL7 version 2 (V2) messaging standard. According to the HL7 organization, 95% of U.S. health care organizations use HL7 v2.x and it is used by more than 35 countries. HL7 V2 was first released in 1987 as an application protocol for electronic data

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Sean M. Houle exchange in health care environments. The seven in the name HL7 is derived from the OSI network model, being an application layer, or layer 7 protocol. Being an application layer protocol released in 1987 with no direct end user interaction, security was not part of the design, instead relying on lower layers of the OSI model to handle security of the data being transmitted. As such, HL7 messaging protocol had no inherent authentication, confidentiality or integrity on its own. One aspect of no confidentiality is that the information being transmitted is done so in plain text. To demonstrate, I setup a lab with one computer acting as the HL7 engine sending messages and another computer acting as the receiving client. I captured the network traffic on the client PC using Wireshark. As you can see from the packet capture (Figure 1), the data came across in plain text which included patient name, date of birth, address, phone number, patient ID number, health history and more. In our case, all of this data is fictitious. In day-to-day operations it is data that could be up for sale to the highest bidder.

For further investigation I set up a third computer in the lab, one that would play the role of bad actor (Figure 2). This computer was in the same network as the sender and receiver. I used a freely available security tool to conduct ARP poisoning, that is I sent messages throughout the local area network telling other hosts on the network that messages intended for the IP of the client machine should be sent to the MAC address of the hacker machine. Once the attacker machine was actively poisoning the network, Wireshark was set to capture packets as they came across the network interface of the attacker machine. The transmission was started between the HL7 server and the HL7 client and within a matter of seconds the sample patient data showed up in the captured packets just as we saw in our last test (Figure 3). The attacker retained a copy of all the data and also forwarded the data to the client so that the system would continue to operate as normal. Theft of patient information is bad, but the consequences of an attack like this could be far more devastating. As the middleman in the network traffic flow between the two computers, the attacker machine could have altered the message in transit resulting in incorrect data at the receiving end. This could mean things like a different medication or dosage than what was ordered, or perhaps the removal of allergy information. This is because there is no integrity control built into HL7 v2, or in other words no way to check to see if the message received is the same as the message that was sent.

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One thing that I didn’t mention earlier is that to receive the messages, I did not have a fancy HL7 integration software. I used the very simple program Netcat. Netcat is built into most Linux distributions and is available as freeware for Windows. Without a method for authentication, I simply setup a listener on the port that the HL7 server was sending messages out on and collected the data. In this case, I output it to the screen to see immediate results, but the data can be easily piped out to a file as in the example (Figure 4). Now how do we address this? We can’t cover all the details in this article but hopefully you can find some things to investigate and see if it would be a good fit for your network. Proper network segmentation is important in many ways and one of those is to help prevent ARP poisoning attacks. ARP messages do not travel beyond the local subnet so it can only affect machines within the same subnet. Many managed switches can support Dynamic ARP inspection to identify suspicious ARP packets. Next, encrypt data in transit whenever you can. This will render captured data useless to attackers as well as prevent the messages from being changed in transmission. One method that works well for in-house transmissions is SSH tunneling. If you are transferring HL7 data across the WAN outside of your organization, then a site-to-site VPN could be a good solution. Finally, good technology hygiene is important. When you decommission systems make sure you decommission everything related to them including HL7 links. Implementing these steps are good security practices beyond securing just HL7 and every step you take adds another layer to your defense in depth approach.

Figure 1 Clear Text Patient Data

Figure 2 Man In The Middle Topology

Figure 3 Intercepted Patient Data

Figure 4 Netcat Command Line Examples

– Sean Houle, CISSP, is an Information Systems Biomedical Equipment Support Specialist (IS-BESS) with the Department of Veterans Affairs in Louisville, Kentucky.

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20/20 IMAGING INSIGHTS Troubleshooting Mechanical 3D Ultrasound Probes? BY TED LUCIDI

espite advancements in matrix array technology, mechanical 3D probes still remain very popular for abdominal and Obstetrics and Gynecology (OB/GYN) applications. Given their design, there are modes of failure specific to mechanical 3D probes. Throughout our history, Innovatus has repaired over 10,000 mechanical 3D probes. We wanted to share with you a little about the technology, the modes of failure and some troubleshooting tips for when you’re in the field.

Mechanically acquiring a 3D image requires that the acoustic array be oscillated back and forth, while multiple single images (or slices) are acquired by the scanner. The multiple images are then integrated with one another and assembled to render the 3D image. A lot of technology is required to make this happen. The probe as well as the scanner require additional electro-mechanics. Within the probe, the array is mounted to a plastic assembly that allows it to pivot on metal hinge points (details important later). A motor and push/pull mechanism oscillate the array, while sensors determine the motor’s speed and position. The entire upper half of the probe’s electro-mechanics are encased within an oil-filled bladder to allow for

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APRIL 2022

lubrication and acoustic coupling. On top of the probe is a soft rubber dome, which acts as the top of the oil bladder, and is the area that contacts the patient. The scanner also requires additional complexity. There’s usually a dedicated motor control PCB and additional power requirements to manage the probe’s electro-mechanics. Mechanical 3D probes, just like all other ultrasound probes, are subject to normal wear due to continued exposure to harsh chemical disinfectants and repeated cable flexing. Even when using approved chemicals properly, seams and seals will deteriorate over time. Using approved chemicals improperly, or unapproved chemicals, has the potential to significantly accelerate wear and tear. While image dropout and mechanical damage are common to all probe types, they may actually be more prevalent with mechanical 3D probes. The added technology within a mechanical 3D probe not only increases its size but can almost double its weight when compared to its 2D counterpart (GE RIC5-9-D versus GE IC5-9-D). It also introduces additional points of failure. Like all mechanical components, those inside 3D probes are subject to wear. Combining this with any small amount of accidental trauma can introduce a variety of new problems. A

Ted Lucidi

common problem is deterioration of or damage to the internal seals on the oil bladder, which results in an internal leak. This usually begins to present itself as air bubbles casting shadows in the image (that move based on the probe’s position or orientation) but can progress, depending upon severity, to oil draining from the probe housing. The same problem can occur externally to the dome. We’ve seen everything from small punctures and slices to the entire dome itself missing. Although its possible for chemicals to damage the seal between the dome and probe housing, most failures are a result of trauma or improper/unqualified adhesives used to install or repair. The rebuilding of the fluid system is a complex process and requires the use of proprietary instruments to ensure the proper/qualified fluid is degassed; if not, micro-bubbles will soon aggregate and create image artifacts. When a mechanical 3D probe is plugged into a scanner and selected by the user, the probe undergoes an initialization process. The scanner attempts to initialize the probe’s electro-mechanics, determine the motor’s position, and exercise its range of motion. If any of these items aren’t within the acceptable range, the scanner displays an error message. A common

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EXPERT ADVICE error when using a Philips 3D9-3v is “Error 30.” On GE probes (RICs, RABs, etc.), the common error is “MotCntl: No Reference Position Signal.” Both error messages instruct users to disconnect/ reconnect the probe to reinitialize the electro-mechanics. There are instances when sensors and electronics fail, but the root cause of most of these errors are due to user induced problems. The most frequent cause is trauma to the top of the probe. As mentioned above and shown here, the array is mounted to a plastic assembly that oscillates on metal pivot points. An impact to the top of the probe can sheer-off the plastic hinge pins or jam the mechanics. The result can be decreased range of motion, no oscillation whatsoever or intermittent operation depending upon severity. In some instances, an error is displayed immediately, other times the probe vibrates or works intermittently. Other causes for these errors are gross fluid invasion short circuiting the probe’s electro-mechanics or intermittent wiring in the cable harness.

WHAT TO DO IF YOU HAVE A PROBLEM The first step in any troubleshooting tree should be a thorough visual inspection. Starting at the top of the probe, look for the appearance of scuffs, dents or impact marks to the dome or probe housing. These would be strong indicators of internal mechanical damage. The dome should appear uniform in shape. Any bulges or malformations are indications of internal damage, such as the array becoming unseated from its pivot points. On the probe housing sections, examine all joints where the various sections meet. There should be no oily sheen or residue, and by no means any fluid, oil or otherwise, leaking from the housing. In the field, a good way to assess mechanical performance is to 1) initialize the probe on the scanner, 2) place the scanner in continuous 3D acquisition mode, and 3) apply very gentle pressure to the top of the dome using the palm of your hand. With gentle pressure applied to the dome, no error message should present. If a mechanical failure exists, or if excessive pressure is applied to the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

dome, it may hinder the probe’s operation and induce an error. You should also wiggle the cable through its entire length inspecting for any intermittencies. Innovatus Imaging supports the most popular 3D imaging probe models, whether mechanical or matrix technology. Multiple models are fully repairable, meaning that you’re not presented with costly options for replacement … just cost-effective repair solutions. Our approach to repair with mechanical 3D probes is such that we fully rebuild the fluidics system anytime there is invasive work performed. It’s a key factor to our 6-month warranty period resulting in an extremely negligible return rate. For more information, email at TedL@innovatusimaging.com or visit www.innovatusimaging.com/ultrasound. -Ted Lucidi, CBET, is a clinical, technical and commercial specialist at Innovatus Imaging.

APRIL 2022

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THE FUTURE

Terms and Translations: A Lighter Look at an Ever-Changing Language BY ROGER A. BOWLES

he idea for this column came from my students in an in-person, good old-fashioned, face-to-face classroom, as the students were conversing with each other. The nice thing about face-to-face classes is that students often learn from each other. Also, I learn from them, sometimes without even realizing how much learning is actually occurring when the conversation is spontaneous and based upon something someone else said. Let me explain.

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Most of us can agree that we use terms today that were not around just a few years ago. In biomed, I think of terms like HTM, cybersecurity, LinkedIn, ransomware and webinar. But beyond that, I think of how everyday slang has evolved over the years. As I take a closer listen, I realize that I am now two generations behind the latest slang. It makes perfect sense because several of my students are children of previous students. Most of you are familiar with the different generations and what they are called. But here is a short review. Generally, people of my generation are called “Generation X,” and were born between 1965 and 1980. Individuals born before 1965 are sometimes called “Boomers.” Hence, the derogatory phrase, “OK, Boomer,” expressed by those younger generations who cannot rapidly think of a proper response when confronted with ideas older than their own, regardless of if those ideas are good ones. Those of us in the Generation X age might ask them instead to take a “chill pill.” Millennials are those individuals born between 1981 and 1996 (roughly between 26 and 40 years of age if my math is close). They have gone through their struggles with “adulting” but have mostly overcome that hurdle and are focusing on

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“keeping it 100.” I have nothing against any generation. I have generally been able to keep up with most of the terms and slang heard around campus over the past 25 years. But some of the latest terms have me a bit confused. The newest generation, often called Generation Z, are individuals born between 1997 and 2012 (ages 10-25), and many are now on college campuses. They have some interesting new ways of using familiar words. For example, one student said another was a “CEO” at troubleshooting. Turns out this is a common term (unfortunately) that means someone has mastered something. I tell them that if their goal is to be good at troubleshooting, they should set their goals a little higher. Oof. A weird term, that I haven’t seen before is “cheugy,” which means not at all trendy or perhaps someone who is trying too hard to be trendy, usually aimed at someone from an older generation. Just letting you know now, if you like Apple products, Harry Potter, skinny jeans, or Tory Burch (what the heck is that?), you may be cheugy. One that just floored me was “drip,” as in “That guy has drip.” Now, in another lifetime, over 35 years ago, I was a proud member of the U.S. Navy and that sentence would have meant that someone needed to visit the Hospital Corpsman or perhaps a Navy doctor at his earliest convenience. But apparently, now, it is the thing to have. And now, “snack” apparently means someone “looking exceptionally good” instead of a meal between meals. At my age, I have no doubt that no one will confuse what I mean when I say snack. One term I do get is “Oof” which is used to reflect “something bad.” See the example above. That one goes back before my time to the great Jackie Gleason. One of the things we are not allowed to

Rodger A. Bowles do is to “drag” someone as in make fun of them or roast them. Some might call this teasing. Of course, 30 something years ago, other meanings would come to mind, one involving drawing smoke from a cigarette or something else, another referring to a certain fashion statement. Just a couple more. To say someone “understood the assignment” means that person is successful at what they needed to do. This one I understand, especially in the education environment. “Say less” is a more polite term for “shut up” (I like that one and might adopt it when needed). Of course, there are many more. These are just some of the more common ones I have heard around campus. As time marches on, the next generation, called Generation Alpha by some, is on its way. These folks were born after 2012. There is a good chance this generation will teach me even more “cool” terms. And that’s no cap. – Roger A. Bowles, MS, EdD, CBET, is a biomedical equipment technology/medical imaging technology instructor at Texas State Technical College-Waco.

APRIL 2022

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SPONSORED CONTENT

Small and Mid-Sized HTM Departments Face Big Challenges

That’s Why Nuvolo Has Introduced Connected Workplace for Healthcare-SMB

ospitals – and healthcare technology management (HTM) departments within them – have faced more than their fair share of challenges in recent years. Between the pandemic, growing cyber threats, staffing shortages, budget constraints (and the list goes on and on), challenges abound. But for small to mid-sized hospitals – especially those that are not part of a health system – these one-two punches have hit even harder.

Most smaller hospitals, especially those in rural areas, are facing severe budget constraints due to supporting an older, poorer population, while at the same time facing declining Medicaid and Medicare reimbursements. This is exacerbated by the fact that many of these hospital facilities are aging themselves and have older equipment that needs more maintenance. These economic pressures have forced approximately

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APRIL 2022

180 rural hospitals to close their doors in the past 17 years. Regardless of the added challenges these smaller HTM departments must overcome, they still have the same clinical, operational and regulatory responsibilities as their larger counterparts. Smaller HTM organizations have become very resourceful at keeping old equipment functioning and making do with less, while still providing their hospitals with exceptional support. This sometimes means having to manage their clinical equipment using outdated CMMS applications, spreadsheets, and even paperwork orders, which creates additional work for staff members already stretched too thin. With this need in mind, Nuvolo developed and introduced Connected Workplace for Healthcare-SMB, an economical computerized maintenance management system (CMMS) designed specifically for small- to mid-sized hospitals and equipment

service providers. Unlike Nuvolo’s flagship CMMS solution, Connected Workplace for Healthcare, which is designed to meet the needs of larger, more mature¹ HTM organizations and thus takes longer to configure and implement, the new SMB solution comes fully configured on the ServiceNow platform to meet the modern needs of smaller HTM departments and service providers. Nuvolo recognizes that the responsibilities of all HTM and health care facilities departments – regardless of their size – have evolved over the years. These departments aren’t just responsible for maintenance anymore, and therefore their CMMS needs to do so much more than maintenance. At long last, smaller organizations can now afford a robust, modern CMMS that supports the work they do today. Some key capabilities of Nuvolo Connected Workplace for Healthcare-SMB are:

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EXPERT ADVICE • Enterprise asset management capabilities • Work order ticketing and management • User-friendly planned maintenance • Parts and warehouse procurement functionality • A mobile application for technicians • Vendor management capabilities “Our goal when we developed the SMB offering was to give smaller hospitals the tools and functionality they need in their CMMS to be a high-performing HTM department and all that entails,” says Kristy Tupper, Nuvolo General Manager for the SMB solution. “SMB is pre-configured, so it’s as close as you can get to ‘plug and play’ in a CMMS. This allows us to make the system affordable to even the smallest hospitals while still being able to provide them with a world-class solution.” Key benefits of Connected Workplace for Healthcare-SMB include:

• •

Fast implementation – get up and running in weeks, not months. Automatic software upgrades – customers automatically receive product enhancements and are always using the latest version of the solution. Easy set up – the solution is easy to implement, needing only minimal configurations to get started. Ability to scale – as your HTM organization grows and matures, you can easily scale up to meet your evolving needs.

Visit https://www.nuvolo.com/solution/connected-workplace-for-smalland-mid-sized-businesses/ to learn more. Mature HTM organizations are those described in AAMI’s HTM Levels Guide (third edition) as Level 3, 4 or 5. 1

Nuvolo’s new Connected Workplace for Healthcare-SMB is a modern-day CMMS developed specifically for small to mid-sized HTM departments and service providers.

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Electrosurgical Units: Misconceptions, Repairs, PMs, and Cost-Saving Tips with ReNew Biomedical Josh Weatherford, ReNew Biomedical’s electrosurgical expert, answers FAQs about maintenance, service and money-saving tips for ESUs. Q: WHAT STEPS CAN A FACILITY TAKE TO INCREASE THE LIFESPAN OF ITS ELECTROSURGICAL UNIT? WEATHERFORD: An ESUs lifespan can be prolonged by adhering to the directions for use outlined in the operation manual. For example, most ESUs specify a 10 second cut time, followed by a 30 second rest time. This interval allows the unit’s circuitry to cool after delivering the intense energy required to produce an output. Another easy way to achieve a longer lifespan for any electrical equipment is routine cleaning. Dust buildup alone can cause units to operate at a hotter temperature due to reduced airflow inside the unit. Routine maintenance will also prolong the life of an ESU. Regular maintenance will thoroughly test the unit against the manufacturer’s specifications and identify any issues or potential future issues. It’s also a great opportunity to fully clean the unit. Here at ReNew Biomedical, each unit receives a detailed cleaning during maintenance or repair at no additional charge. Q: WHAT ARE SOME COST-SAVING TIPS FOR ESUS? WEATHERFORD: The best way to save money regarding ESUs is to be gentle. Mishandling of the units causes many of the repairs we perform at ReNew. ESUs are particularly delicate. A hit to the nosecone can cause many internal issues that result in the unit no longer functioning. The unit is also easily damaged from falls. I recommend careful handling of ESUs in transport as well as storage. Additionally, there are aftermarket support options for ESUs should your facility need outside repairs or PM services. Q: HOW ARE NEWER ESUS IMPROVING OVER THE OLD VERSIONS? WEATHERFORD: Newer ESUs are receiving

TECHNATION

APRIL 2022

Josh Weatherford

more technology integration. They are “smarter” and faster than their predecessors. For example, the older Valleylab Force FX had a sampling rate of 200 samples per second using Instant Response technology. At the time, 200 samples/second was cutting edge. However, the newest Valleylab model, the FT10, boasts a sample rate of 434,000 decisions every second. Technology integration also helps the biomed community. These “smarter” units are better able to generate error codes and identify the issues they are experiencing. In some cases, the unit can even diagnose the error. This aids the biomed by expediting the repair process. The unit’s advanced self-testing also gives an additional repair verification once repaired. Q: WHAT ARE SOME STEPS FOR PREVENTIVE MAINTENANCE, AND WHY ARE PMS IMPORTANT FOR ESUS? WEATHERFORD: Preventative maintenance (PM) is vital for any medical device, and ESUs are no different. A typical PM inspection would follow the manufacturer’s testing process outlined in the service manual. The most important tests in a PM are output testing, return electrode monitor (REM) function testing and leakage testing. The biomed will activate the unit during output testing and observe the energy delivered to a calibrated ESU analyzer. The tech will then record this measurement and

compare it against the manufacturer’s acceptable energy range. REM function testing is another critical test. The REM function provides a complete pathway for energy flow from the ESU to the patient. A fault with the REM circuit could cause the ESU to have no monopolar function, potentially causing harm to the patient. Leakage testing measures the leakage produced by the ESU during use. This measures energy not being delivered through the handpiece and could be dangerous if the leakage is outside acceptable ranges. Q: ARE THERE ANY COMMONLY MISSED STEPS THAT OFTEN GET OVERLOOKED IN PMS? WEATHERFORD: The most overlooked part of the manufacturer’s service recommendation is the service interval. Most manufacturers recommend their products have output testing done every six months. Instead, most units are checked annually. Unit calibration should occur anytime the outputs are measured outside the service manual’s parameters. The unit will not pass the manufacturer’s PM criteria if the outputs are outside the acceptable range. Q: ARE THERE ANY COMMON BIOMEDICAL MISCONCEPTIONS ABOUT ESU DEVICES? WEATHERFORD: Electrosurgery is often misunderstood in the biomedical field. Many techs feel that ESUs are incredibly dangerous and difficult to understand. ESUs can be dangerous; however, every modern ESU has many safety measures designed to mitigate most risks. For example, the monopolar function will not activate if the REM circuit does not provide the correct feedback resistance. ESUs are complex machines, but they rely on basic principles of electricity for function. To understand how an ESU works, one has to understand the way electricity behaves.

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WITT’S END BY DAVID WITT

hen the COVID-19 pandemic began, we were sequestered to the point that some remedial efforts to return to normalcy with regards to interpersonal and interdepartmental communication should be considered.

For nearly two years we have been forced into (and now tend to favor) remote meetings, webinars and other non-participatory avenues by which to communicate. Texting is still on the rise as the preferred communication style. It’s amazing to see someone text with the skill of a typist using only their two thumbs! A few years down the road, though, we may see a surge in medical conditions such as Trigger Thumb. This is just one indicator of society’s full immersion into communication technology. The side effects of the head-long dive into communication technology, if they were listed, might look something like: • Chronic thumb-joint pain and dysfunction; • Reduced attention span when actually speaking to someone in person; • Inability to speak without emojis; • Difficulty understanding facial expressions, body language, detecting of emotions, etc.; • Co-dependency upon the use of acronyms instead of writing out (or speaking) a word or a phrase; • Texting someone else while listening attentively to you … right; and • Placing self and others in immediate danger while texting and driving (now considered the same as driving under the influence of drugs and alcohol). • These tongue-in-cheek symptoms just might be the next specialty for new physicians to train on! While on webinars, Zoom meetings and other venues by which we gather to share and receive information, there is evidence of

non-participation, including keyboard typing sounds, someone on another phone, a television program on, the sounds of paper shuffling and the “hot mike” experience when the person making a wisecrack about the COO was not aware that his phone was NOT on mute and the COO was in the meeting. Then, there are the filibuster types. These are individuals who find it difficult to stop speaking to their captive audience until someone suggests the subject be taken offline. With the use of technology, the mistaken thought was that of time compression – doing more in less time while indicating time management and enhanced performance. In theory, maybe. Nothing can be farther from the truth that interpersonal meetings and conversation include true dialogue and understanding are less effective than remote information sharing, (I did not say communication). Webinars and such hemorrhage information in quantities too large to comprehend and allowing a fraction of time for questions and answers. Oh, sorry … Q&A, in order to measure the success of the meeting attended. Let’s not forget the financial impact associated with innovative software changes that are advertised and acquired at a pace faster than that of changing clothes! In the quest of acquiring artificial intelligence (AI) prowess, it is we, rather, who are becoming increasingly artificially intelligent while growing severely codependent upon media and gadgets in exchange for insight, innovation and collaboration with others. Who needs education, the effort to secure that education and the self-worth that an education brings, when all one must do is browse for information? This information tsunami cannot and must not be confused with communication between people and the corresponding understanding that results. Back in the day, communication was supplemented with information. Not so now, as information is

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

David Witt supplemented with communication in such a manner that fully understanding is almost impossible. As I write this, I feel somewhat hypocritical. I have two computers and three monitors to perform my daily routine, surfing three email sites for useable information while listening to two iPhones for text messages and phone calls which I choose whether or not to attend to the caller. I forgot to mention yet another computer and an iPad while considering the merits of a “Dick Tracy” smart watch. My “analog” desk phone goes unused most of the time, but I do sport an analog watch to demonstrate to my grandchildren how to really ascertain the time of day. My point is that though technology is now, and until the next solar flare or other form of electromagnetic interference, welded to us; just ask Alexa or Siri. Miracles in communication, medicine and industry are now a constant with the use of technology. The wise acquisition and management of this miracle is yet to be determined. Got to go! My iPhone just reminded me that my smart TV is getting ready to begin a program it knows I like! – David Witt has more than 40 years of experience in the international field as a technician, instructor and advisor. He is currently the director of clinical engineering at a major Las Vegas hospital.

APRIL 2022

TECHNATION

SPECIAL REPORT

Top 10 Health Technology Hazards for 2022 Prevent dangerous device hazards and improve patient safety DOWNLOAD THE EXECUTIVE BRIEF

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BREAKROOM

DID YOU KNOW? Image of a Denisovan girl deduced from genes that govern face shape

Science Matters

Cave rock a source of early human DNA

Researchers have isolated fragments of DNA from sediment taken from the Siberian cave where the mysterious Denisovan people lived 300,000 years ago.

The Denisovans were ancestors of modern humans and lived at the same time as Neanderthals

1 Denisova Cave, Siberia

ASIA

Baishiya Karst Cave, China

The two known Denisovan sites

Traces of DNA were shed as feces, bone fragments in long-occupied cave

Researchers found undisturbed rocks of compressed sediment in cave’s floor

Denisova Cave

Tiny DNA samples were drilled in laboratory from the cave rocks

Millions to billions of copies of the DNA were created by polymerase chain reaction, the “PCR” method used to detect COVID virus

Some of the DNA amplified by this method was from Neanderthals, Denisovans and modern humans; some was from bears and other ancient mammals

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Source: Diyendo Massilani and Matthias Meyer of Max Planck Institute for Evolutionary Anthropology; Mike Morley of Flinders University (Australia); Maayan Harel (face sculpture) Graphic: Helen Lee McComas, Tribune News Service © 2022 TNS

APRIL 2022

TECHNATION

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THE VAULT D

o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation. com/vault-april-2022. Good luck! SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing.com and you could win a $25 Amazon gift card courtesy of TechNation!

MARCH PHOTO Pacemaker Tester

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FEBRUARY WINNER Kyle MacEachern, Biomedical Engineering Technologist at Nova Scotia Health Authority

APRIL 2022

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TO LEARN MORE ABOUT ADVANCING YOUR CAREER!

Biomedical Technician Manager

Healthcare Technology Manager

Love being a Biomed, but also want to do more? Does Profit Sharing intrigue you? How about managing your own territory and growing it like a business owner? EDGE is looking for just that kind of BioMed’s to oversee the Biomedical operations for our customers located in the territory specified. Eligible for our profit sharing and MOP programs after 90 days of hire!

Supervising the daily operations of the technical service team and ensuring strict compliance with product quality assurance, equipment, and procedural standards, health, and safety protocols, as well as engineering specifications. Demonstrate competency in strategic thinking and leadership.

Under relatively close supervision, repair, calibrate and maintain all types of basic biomedical technologies, devices, instruments and systems. Inspect, install and perform preventive maintenance service on general medical equipment.

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Healthcare Technology Manager

Biomedical Equipment Specialist Sterilizer

Biomedical Equipment Technician III

We are always looking for talented, passionate, hard-working people to join our team. Our employees are not afraid to speak their mind, to try new things, and to wear multiple hats. Our people are empowered to help our customers. We foster teamwork and cooperation, and always promote a “customer first” philosophy. We uphold this standard with our associates, clients, partners, and the communities in which we do business.

The main role of the position will be to ensure all medical equipment is maintained in a quality and timely manner. As a team member working within Sodexo Clinical Technology Management (CTM), you will partner with our Healthcare clients to manage their medical equipment technology needs.

If you are wondering what makes TRIMEDX different, it’s that all of our associates share in a common purpose of serving clients, patients, communities, and each other with equal measures of care and performance.

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National Clinical Support Specialist (CT)

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The National Clinical Support Specialist (NCSS) is required to perform the responsibilities of a clinical subject matter expert and act as the coordinator of a cross functional team to resolve customer issues. The NCSS will be required to coordinate service, sales and BU resources to implement and document resolution strategies. This position is a senior member of the applications field team and will be required to participate as a member of the applications leadership advisory team.

Opportunities for employee development include project and time management, temperament training, leadership academy topics, and vendor-provided technical training. Teamwork is key in this department and you will be empowered to utilize resources and collaborate to ensure consistent service delivery. Some travel may be required depending on the facilities you support. Future career growth includes opportunities in medical imaging, planning, security, integration and quality areas. In addition, tuition reimbursement and tuition discounts are available for continuing education costs.

We have a vast array of opportunities ranging from Nursing, Clinical, to Finance, IT, Administrative, Research and Support Services to name a few. Across all locations, you’ll find career opportunities that support diversity, equity and inclusion. At Mayo Clinic, we invest in you with opportunities for growth and development and our benefits and compensation package are highly competitive. We invite you to be a part of our team where you’ll discover a culture of teamwork, professionalism, mutual respect, and most importantly, a life-changing career!

VIEW FULL DETAILS www.htmjobs.com

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APRIL 2022

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Advancing the Biomedical/HTM Professional

LIGHT

DEPA OF TH RTMENT The Tu cson M E MO edical NTH Cente r Clinic al En T BY K.

RICHA

RD DO

UGLAS

he So no countr ran Deser t is a y unlike reg pa southe sses southe any other. ion of the It encom ast CBET The city ern Califo rn Arizon a as , mana TMC. deser of Tucson rnia and pa well as ger of t region , Arizon rts of clinica Me . l eng a sits ineeri within xico. tha “TMC als ng at o has this t pro specia medic vide prima a network The me list-sy ine of 21 ry car tro -Tu stems Garci numb , internal nearly clin e cson ; Guille a, er medic and family ics a IGHT are SPOTL BMET BMET II; engine of specia rmina the Un million peo a is po ine as lty pu Da eri well “Mina iversit lated ser ple. Th ng sup Lynn III; Jaye Joh rell Hend well Natio y with ” e city ports vices. Clinic as a , BM as nal Pa of Arizo is ho all of ET III; nson, BM rickson, al na an III; Jim TMC: the follow U.S. rk. It me these d Sag Scott ET II; bo ing is 60 hospi areas uaro to MacL John mi Roon Pangrac, geriat ce, am facilities larges rder with BM ach ey, BM ric psy Mexic les north affiliat as t city bu lat of the servic gym,” ory sur ch ser ET I; ET III; Re lan, BMET ed wi Hand in Arizona o and is es Joe Sm th vice an bec she gery the sec ling . imagi engineer center, those d an ith, im ca Clinic says. ond I; ng em people the medic and Ma agi ser ployee al eng al nee Direc (TM rk We ng Brish vices eng ineeri C), wh is the Tu ds of tor of ineer. ng rep ltz, sen says cson all cen IT tio ich is ty-ba of ser Infras ns Su orts to trally ior sed ho a stand Medical mana vice contra TMS each up of san Sneda tructure Ce -alon ged “Hosp spital lice cts dep an 16 me ker e, com nter nsed ital ble for artment by clinica were no mbers . The CE d Operapediat mu at 60 The t l eng mana . team ric em specialty 0 bed niineeri their the contra ger wa are includ team under is ma ortho ergenc s. ng; depart de cts for pedics es Ell s res y car as include: Brish’ is ment. Cahil e, ,” say equipm ponsiIn 20 l, imagi Brittin, BM s direct lea s Karla cardiolog ent in equipm 16, that y an Calde dershi ng ser ET II; Brish, chang ron, p MBA, d BMET vices lead; Walter ed an assign ent servic Tim 12 d all e agr Casse Rober ed to I; TECHN Di me eem ll, sen rk Ca the clin depart engine dical ATION ent ior im ll, BM to ment er; Bri ical eng s were APRIL aging ET III; to be an Da ine “This 2018 servic rr, bio move managed ering es leader medic . s as ma was we al equ ll-rece time ipment ny of or ived them of a ser expertise did no by clinica vice con to mana t have l ge the the tract,” delive Brish rables says.

gineeri ng De partm ent

PROFESSIONAL E MONTH OF MaTH rtoglio Chuck ssic Rock Ultrasound to Cla

WWW.1

TECHN

Y ANDMIMAGING ISSUES NETWORK SECURIT job to es come with the went to a meeting Projects and challeng tion (BAAMI), and network has worked on as it seemed. I was and Martoglio see if it was as good that and imaging issues. the support I received security projects of overwhelmed by ing taking care o says. “It can be challeng night,” Martogli when there are a manager at sites, especially multiple “I met David Booker, different at only the same time hospitals. Not critical issues at one of the BayCare s, he tely, that doesn’t of my question locations. Fortuna did he answer all out. I and I get good support shop to check it happen very often invited me to the or I field service staff caliber of people from the other was hooked. The s he says. areas of the hospital biomeds on site,” ing as work with in all can be challeng me thankful I made “DICOM issues continues to make who are multiple causes someone adds. then, that well because there the change,” he It’s no surprise n have access to or on automobiles I do not always from the auto technicia work that to Going trained is n good relationships HTM meant some skill set to transitio control of. Having profession into would have the applications, . Marton. clinical training ed professio ing, HTM with network key additional specializ those skills to the receive io members has been go to school and what Chuck Martogl and security team been glio was able to That is exactly special” he adds.“I’ve ce at the same time. is a field service to troubleshooting, hands-on experien did. Martoglio of network security cs engineering in the clinical engineer involved in a number “I took the electroni ist, ultrasound, I recently assisted ugh Community ent at BayCare and migration projects. program at Hillsboro s he ing services departm out of vascular location d with an A.S.,” which is based three heart and College and graduate Health System, . This involved to our network Florida. migrate ter, says. ions, Clearwa n for clinical applicat school, I got a chance repair technicia working with our “While I was in ensure “I was an auto r. I security teams to shop as a voluntee in need of a career networking, and to work in Dave’s secured or at 23 years. I was I configured and biomed supervis no idea of what everything was also met Bill Hart, healthchange, but had BAAMI mine the challenges of l Hospital, at a day, a friend of properly. With Lakeland Regiona active in tech wanted to do. One ed have been very a part-time PM ry therapist mention care security, we meeting, and landed who is a respirato equipment. My opportunities were I would be a good securing our medical out position there. These I locking that he thought while ce included have experien io remembers. responsibilities extremely valuable ter biomed,” Martogl ry patching, and of the profession, Martoglio says.“Af USB ports, WannaC was in school,” “I had never heard at d it, our security team,” hired as a biomed it. The more I researche gathering data for graduation, I was II but looked into what s. promoted to a biomed that it was exactly Martoglio continue BayCare. I was the more I realized , field the my current position I found and joined to for. then looking and was I nd,” he says. ing group, the Bay service, ultrasou local biomed network ntaof Medical Instrume .COM Area Association WWW.1TECHNATION

BY K. RICHARD

DOUGLAS

on cars or medhether you work there are a few ical equipment, ics, knowing constants – diagnost nding tools and understa how to work with nts work. The goal how different compone to make both; with is always the same as the manufacturer that machine work intended it to.

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